Protecting Children and Families from Tobacco: Leadership Advocacy Training Jonathan D. Klein, MD, MPH AAP Associate Executive Director and Director, Julius B. Richmond Center - PowerPoint PPT Presentation

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Protecting Children and Families from Tobacco: Leadership Advocacy Training Jonathan D. Klein, MD, MPH AAP Associate Executive Director and Director, Julius B. Richmond Center

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Title: Protecting Children and Families from Tobacco: Leadership Advocacy Training Jonathan D. Klein, MD, MPH AAP Associate Executive Director and Director, Julius B. Richmond Center


1
Protecting Children and Families from
TobaccoLeadership Advocacy TrainingJonathan
D. Klein, MD, MPHAAP Associate Executive
Director and Director, Julius B. Richmond Center

2
Sponsoring Partners
  • American Academy of Pediatrics
  • American Medical Association
  • American Academy of Family Physicians
  • American Congress of Obstetrics and Gynecology
  • American College of Physicians

3
Funders
  • Grant support to the American Academy of
    Pediatrics from
  • DHHS National Technical Assistance to the
    Communities Putting Prevention to Work Program
  • Flight Attendant Medical Research Institute
    (FAMRI)
  • Legacy
  • Unrestricted donation from
  • Pfizer, Inc.

4
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5
dedicated to eliminating childrens exposure to
secondhand smoke and tobacco.
6
Global State of Tobacco Control
  • 2011 WHO Report on the Global Tobacco Epidemic
  • Tobacco use continues to be the leading
    preventable cause of premature death and disease
    worldwide
  • 6 million people die each year due to tobacco
    related illnesses, most of these in low- and
    middle-income countries
  • This disparity is expected to widen, with deaths
    expected to increase to gt 8 million a year by
    2030
  • 700 million children almost half of the worlds
    children - are exposed to secondhand smoke

7
US Tobacco Control
  • Tobacco is the leading cause of preventable death
    and disease in the United States, too
  • Approximately 443,000 die each year
  • 19.3 of adults gt18 years smoked in 2010 (45
    million)

8
Secondhand Smoke Exposure
  • An estimated 88 million nonsmokers were exposed
    in the United States in 2007-2008
  • Children are at particular risk for exposure
  • Only 5.4 of adult nonsmokers live with a smoker
  • Among children
  • 41.1 exposed to SHS at home
  • 54.9 exposed to SHS in public places
  • Global Youth Tobacco Surveillance, 20002007
    cdc.gov/preview/mmwrhtml/ss5701a1.htm

9
Secondhand Tobacco Smoke
  • Children exposed to SHTS have greater risk/rates
    of
  • Decreased lung function
  • Asthma
  • Sudden Infant Death Syndrome
  • Upper and lower respiratory track infections
    pneumonia and bronchitis
  • Ear infections
  • Neuro-cognitive delay and behavior problems
  • Increased adult risk of
  • Lung cancer and leukemias
  • Heart disease, lipid disorders,and metabolic
    syndrome
  • Smoking themselves

10
Are we asking the right questions?
Screening
11
WHO MPOWER Package
  • Monitor tobacco use and prevention policies
  • Protect people from tobacco smoke
  • Offer help to quit tobacco use
  • Warn about the dangers of tobacco
  • Enforce bans on tobacco advertising, promotion
    and sponsorship
  • Raise taxes on tobacco.

12
HHS Strategic Plan Ending the Tobacco Epidemic
  • Accelerate progress for four Healthy People 2020
    goals
  • Reduce tobacco use by adults and adolescents
  • Reduce initiation of tobacco use among
    children,adolescents, and young adults
  • Increase successful cessation by smokers
  • Reduce nonsmokers exposure to secondhand smoke
  • Support FDA regulation of manufacture, marketing,
    and distribution of tobacco products






13
Conference Goals
  • To improve the spread and effectiveness of
    clinical services for tobacco cessation
  • To engage health care organizations in state,
    county and local community policy advocacy for
    better access to tobacco control services.

14
Tobacco Control Champions
  • Identify at least two qualities physicians bring
    to advocacy.
  • Describe trends in tobacco use and secondhand
    smoke prevention.
  • Identify risk factors for initiation and barriers
    to cessation.
  • Advocate for coverage of tobacco cessation and
    pharmacotherapy.
  • Educate private and public leaders about tobacco
    control policiess, cessation and pharmacotherapy.
  • Articulate at least two policy changes to improve
    tobacco control.
  • Identify opportunities for tobacco advocacy in
    states and communities.
  • Develop a commitment to change, advocacy goals
    and strategies.

15
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16
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17
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18
Tobacco Advocacy and Policy Issues
19
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20
Adolescent and Adult Smokers
  • Know they are addicted and want to quit
  • Many have tried to quit without success
  • Younger smokers less likely to think there are
    resources to help
  • Many clinicians feel unprepared to help
  • With advice, most parents say they would be able
    to set strict smoking policies

21
Evidence-based best practices
  • Increase price/taxation of tobacco
  • Smoking bans and restrictions
  • Counseling reframe expectations of success
  • 5As - Ask, Advise, Assess, Assist and Arrange
  • Strict No Smoking Rules - Smoke-free homes and
    cars
  • Availability of treatment
  • Reduced cost for pharmacotherapy treatment
  • Provider reminder systems
  • Telephone/web counseling and support
  • Mass media counter-marketing campaigns

22
Community and public health
  • Make tobacco control for children and youth a
    priority
  • Include secondhand smoke
  • Headstart, schools, housing, etc.
  • Age of sale restrictions and enforcement
  • Advertising limitations
  • Smokefree Movies
  • Public smoke exposure reduction
  • Do not allow preemptive efforts by tobacco
    industry
  • Reduce social acceptability of smoking

23
Exposure to Tobacco Use in Movies and Smoking
Among 5th-8th grader

8th Grade 7th Grade 6th Grade 5th Grade
Adapted from Sargent, DiFranza, 2003
24
Smoke Free Movies
  • Rate new smoking movies "R"
  • Certify no pay-offs
  • Require strong anti-smoking ads
  • Stop identifying tobacco brands
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