The states this year (Fiscal Year 2012) will collect $25.6 billion in revenue from the 1998 state tobacco settlement and tobacco taxes, but will spend only 1.8 percent of it – $456.7 million – on programs to prevent kids from smoking and help smokers quit. This means the states are spending less than two cents of every dollar in tobacco revenue to fight tobacco use.

Both the total amounts states are spending on tobacco prevention programs and the percentage of tobacco revenue spent on these programs are the lowest since 1999, when the states first received significant tobacco settlement funds.

With nearly 20 percent of Americans still smoking, the report warns that continued progress against tobacco use – the nation’s number one cause of preventable death – is at risk unless states increase funding for tobacco prevention and cessation programs. The report also calls on states to increase tobacco taxes and, for states that have yet to do so, to enact strong smoke-free laws that apply to all workplaces, restaurants and bars.

The report further calls on the federal government to launch a national tobacco prevention and cessation campaign, including a mass-media campaign and support for telephone quitlines, as the Obama Administration proposed in its Tobacco Control Strategic Action Plan. It also calls for preservation of the Prevention and Public Health Fund, created by the health care reform law to support such disease prevention initiatives.

The report, titled “A Broken Promise to Our Children: The 1998 State Tobacco Settlement 13 Years Later,” was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association, Robert Wood Johnson Foundation and Americans for Nonsmokers’ Rights. Issued annually, the report assesses whether states have kept their promise to use tobacco settlement funds – expected to total $246 billion over the first 25 years – to fight tobacco use.

“More than ever, this report shows that the states have squandered the opportunity presented by the tobacco settlement to significantly reduce tobacco use and its devastating toll on our nation,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. “It’s no coincidence that progress against tobacco has slowed at the same time that states have slashed tobacco prevention funds. We cannot win the fight against tobacco unless elected officials at all levels step up efforts to implement proven solutions.”

Other findings of this year's report include:

• Most states are falling far short of recommended funding levels for tobacco prevention programs set by the U.S. Centers for Disease Control and Prevention (CDC). The $456.7 million the states have budgeted is just 12 percent of the $3.7 billion the CDC recommends for all the states combined. It would take less than 15 percent of total state tobacco revenues to fully fund tobacco prevention programs in every state.
• States have cut funding for tobacco prevention and cessation programs by $61.2 million (12 percent) in the past year and by $260.5 million (36 percent) in the past four years.
• Counting both state funds and federal grants, only Alaska and North Dakota currently fund tobacco prevention programs at CDC-recommended levels. Only four other states provide even half the recommended funding, while 33 states and Washington, DC, provide less than a quarter. Four states – Connecticut, Nevada, New Hampshire and Ohio – and DC have budgeted zero state funds for tobacco prevention this year.
• Tobacco companies spend $23 to market tobacco products for every $1 the states spend to fight tobacco use. According to the latest data from the Federal Trade Commission, tobacco companies spend $10.5 billion a year on marketing.
• Federal grants have helped to cushion the impact of state funding cuts, but some of that funding is temporary and will run out this year. In fiscal year 2012, the federal government is providing $91.2 million in state and community grants to reduce tobacco use. States have also received $196.4 million in stimulus funds for tobacco prevention, some of which will be spent this year.

The report comes as recent surveys have found that smoking declines in the United States have slowed. The CDC recently reported that the adult smoking rate in 2010 was 19.3 percent – only a small decline since 2004 when 20.9 percent smoked. While smoking among high school students has declined by 46 percent from a high of 36.4 percent in 1997, 19.5 percent still smoke.

“It is truly penny-wise and pound-foolish for the states to cut funding for tobacco prevention and cessation programs,” said Nancy Brown, CEO of the American Heart Association. “These programs not only reduce smoking, but also lower tobacco-related health care costs that total nearly $100 billion annually. Tobacco prevention programs are smart investments that save lives and money.”

“Tobacco prevention and cessation programs are a great example that when we invest in prevention and public health, we save lives, improve health and reduce health care costs. For example, we know that smoke-free workplaces and funding programs to help smokers quit are a win for business, worker productivity and a healthier community,” said Risa Lavizzo-Mourey, M.D., M.B.A., President and CEO of the Robert Wood Johnson Foundation.

“We know that the most effective way to curb the tobacco epidemic in this country is through regularly and significantly increasing tobacco taxes, enacting comprehensive smoke-free laws and fully funding tobacco prevention and cessation programs,” said John R. Seffrin, PhD, chief executive officer, American Cancer Society Cancer Action Network, the advocacy affiliate of the American Cancer Society. “States are putting lives at risk and leaving potential state revenue on the table when they fall short of implementing strong tobacco control policies.”

“The continued devastating cuts in tobacco prevention spending in 2011 are unfortunately part of a broader pattern of states backsliding on putting in place policies and making investments to fight tobacco use,” said American Lung Association President and CEO Charles D. Connor. “States are missing a key opportunity to save lives and money.”

"Comprehensive tobacco control programs not only reduce smoking, but they also prevent a new generation of young smokers and lead to policies that protect workers from exposure to secondhand smoke in public places and workplaces," said Cynthia Hallett, MPH, Executive Director of Americans for Nonsmokers' Rights. "It is a tragedy that less that 2 percent of tobacco revenue goes to evidence-based tobacco prevention programs. States should be advocating for public health and not toeing the line for the tobacco industry."

Tobacco use kills more than 400,000 people in the United States each year and costs the nation $96 billion in health care bills. Every day, another 1,000 kids become regular smokers – one-third of them will die prematurely as a result.

More information, including the full report and state-specific information, can be obtained at www.tobaccofreekids.org/reports/settlements.

In addition, the resolution urges the Florida Legislature to support local home-rule power over County owned property, especially public parks and other places where children play.

Read Full Text of Resolution (PDF 42kb)

The resolution further urges the Florida Legislature to support local home rule power over City owned property, especially public parks and other places where children play.

Read the full text of the Resolution (PDF 54kb)

The announcement came during Hitt’s State of the University address, which was held in front of students, alumni and community members in the Pegasus Ballroom of the UCF Student Union.

Hitt declared that UCF will host public discussions and forums as the second-largest university formulates its new smoking policy, which would align UCF with anti-smoking moves being made by Orange County government and Florida Hospital.

Hitt also addressed how underage drinking became a topic on campus following UCF freshman Ann Hefferin’s death.

“As president of this university, let me be very clear: UCF has no tolerance for underage and excessive drinking, drinking while driving, or illegal drug possession and use on our campuses,” Hitt said.

Ida Cook, Chair of the Faculty Senate, also spoke, along with UCF SGA President Matt McCann.

McCann expressed how students are hurting following major blows the Bright Futures Scholarship program has sustained at the state level, combined with the tuition hikes students are being slammed with year after year.

“Times are tough. These issues are being felt by all students within the State University System, some more than others,” McCann said.

McCann also announced a plan to bring a video rental service, similar to “Red Box,” to campus.

The measure also urges the Florida Legislature to support local home-rule power over municipally-owned property, especially public parks and other public places where children play.

The City of Belle Isle is the second city in Orange County to adopt such a resolution. On September 12, the City of Orlando passed a similar resolution.

See the full text of the resolution.

• Studies Reporting Outdoor Tobacco Smoke (OTS) Levels and Exposures (PDF 45kb)
• Measurements of Outdoor Air Pollution From Secondhand Smoke on the UMBC Campus (PDF 850kb)
• Real-Time Measurement of Outdoor Tobacco Smoke Particles (PDF 376kb)

Smokers, beware. The already-hostile atmosphere for smokers in public schools has gotten even more repressive. The Orange County School Board on Tuesday night expanded a policy that prevents tobacco use in school buildings so that it prohibits tobacco use anywhere on school grounds or on Board property, including recreational areas and stadiums. Visitors are expected to comply, as well. Lake County schools already have a similar no-tobacco policy.

Enforcement, which includes referral to a smoking cessation program, is set to begin January 1, 2012. The new policy will enable principals to end teacher smoke breaks, board members were told.

The Board’s only hesitiation was the cost of mounting signage at all of its properties, as well as the printing costs for cards to hand out to violators. But the Orange County Health Department stepped in and paid the entire cost.

In return, the board was presented with bags and T-shirts from the “All In” project, an anti-tobacco organization funded by the U.S. Department of Health and Human Services. Board member Kat Gordon asked, half-seriously, if the T-shirts were cheap, so as to be allowable gifts to school board members, who can’t take valuable items.

The City Council passed a resolution Monday that urges smokers not to light up in public parks and other outdoor spots where secondhand smoke could harm children.

The measure stops short of banning outdoor smoking because that's something the city doesn't have the authority to do. But it does ask the Florida Legislature to grant cities that power so Orlando officials can pursue an outright ban in the future.

"We want the public to realize our children need healthy areas to play in, and we can help with that," said Commissioner Sam Ings, who introduced the resolution.

Ings pushed for the measure with help from the Orange County Health Department and the All In project, an anti-tobacco organization funded by the U.S. Department of Health and Human Services. It was backed by Mayor Buddy Dyer, as well.

Even though the resolution doesn't allow the city to actually prohibit smoking on the sidewalk or at the park, smoking advocates see it as a larger attack on their rights.

"The anti-tobacco people have an overall agenda, which is to establish a prohibition of tobacco products. They are using this resolution of the city of Orlando in their scheme to ban all tobacco products," said Jeff Borysiewicz, owner of Orlando's Corona Cigar Company.

Dyer, whose father died of emphysema, said the Legislature should let locals decide whether smoking should be prohibited.

"I'm hopeful they'll give each local government the authority to decide where smoking is appropriate," he said.

The city's resolution originally went beyond parks to include sidewalks and public plazas, but those areas were deleted at the last minute.

Ings said some commissioners were concerned about going too far, even with a nonbinding resolution that simply asks people not to smoke.

"We know children play in parks," Ings said. "We're honing in on those places where children play."

Other cities, including Winter Park, are reportedly considering similar resolutions.

A poll commissioned in May by All In found that 60 percent of registered voters in Orange County support banning all tobacco use in public parks.

mschlueb@tribune.com or 407-420-5417

The all in project, as part of our public health education campaign is launching a FREE mobile information service that provides cessation and counter tobacco messages to help educate the public about the harmful effects of tobacco on our community.

People who text CLEAR AIR to 37932 will receive messages 2 times per week on the health effects of second-hand smoke. The messages may include startling statisitics, ways to protect yourself and your children, public opinon questions, and information about smoke-free events in Orange County, FL.

People who text SMOKE FREE to 37932 will receive messages 3 times per week on smoking cessation. The messages will include motivational quit tips, tobacco facts, benefits of quitting, and where to go for counseling and Nicotine Replacement Therapy (NRT).

If you want to stop receiving messages at any time text STOP to 37932 or help, text HELP to 37932.

FREE to sign up. Standard text messaging rates may apply.

FAQ

Do I have to pay for incoming text messages? No. This is a FREE service made possible with funding from the Department of Health and Human Services and all in. However, you should check with your carrier - standard text messaging rates may apply.

How many text messages will I receive a week? After signing up- you will receive 2-3 messages per week, depending on the program you are enrolled in. If you are enrolled in both  you should expect to receive messages up to 5 times per week.

When will text messages be sent? Messages will be sent at 1:00pm daily. The SMOKE FREE campaign will send out messages on Monday, Wednesday, and Friday. The CLEAR AIR campaign will send out messages on Tuesday and Thursday.

What topics do these text messages cover? Text messages may include startling statistics, ways to protect you and your children from the dangers of second-hand smoke, public opinion questions, information about smoke-free events, motivational quit tips, tobacco facts, benefits of quitting, and where to go for counseling and Nicotine Replacement Therapy (NRT).

What is the source of the text messages? Messages were developed by the all in project. The all in project was created as a result of funding from a Federal grant to support public health efforts to reduc tobacco us and exposure from second-hand smoke. This grant award is part of the Department of Health and Human Services Communities Putting Prevention to Work initative.  

For how long will I receive text messages? The messages will be sent over a period of 5 months.

How do I stop getting text messages? Text STOP to 37932.

Valencia is following the lead of several other Florida colleges and universities that have become smoke-free, meaning they don't allow students, faculty or visitors to smoke anywhere on school grounds — not even in cars in the parking lots.

Last summer, University of Florida in Gainesville banned smoking as well as the use of all tobacco products. Miami Dade College announced in April that it's now tobacco-free.

Meanwhile, several colleges across Central Florida — including Stetson University in DeLand and Seminole State College in Seminole County — will be discussing taking similar steps this coming school year.

"I hate to interfere in people's private lives and habits, but secondhand smoke affects everyone," said Valencia College President Sandy Shugart.

Colleges are also concerned about the cost and time it takes to clean up after tobacco users.

Valencia began debating the change about a year ago. Officials will spend the next year preparing its about 67,000 students and 3,500 employees for the August 2012 launch of the ban, including installing signs and promoting smoking-cessation programs.

Evan Salfelder, who is studying at Valencia to become an emergency-medical technician, thinks it's unfair for administrators to force everyone to give up smoking because of inconsiderate smokers who litter and blow smoke near others.

On a recent morning, Salfelder sat beneath a tree on the Kissimmee campus, away from buildings and the sidewalk, smoking Marlboros.

"What am I doing wrong that I'm being punished for?" he asked.

Florida law prohibits smoking in public buildings such as college classrooms and interior hallways. A growing number of colleges and universities are extending the ban to at least some other sections of campus.

As of July 1, there were at least 530 smoke-free colleges in the United States, according to the American Nonsmokers' Rights Foundation. This time last year, there were 420.

About four years ago, Stetson University began prohibiting smoking and other tobacco uses within 50 feet of building entrances, intake vents, sporting venues, university-owned vehicles or areas designated with no-smoking signs.

But the rule has been hard to enforce — a lot of people have trouble judging what constitutes 50 feet — so college leaders have been debating banning tobacco altogether, said Lynn Stadelman, Stetson's director of wellness and recreation.

This past spring, members of Stetson's Student Government Association were split when they voted on a campus-wide ban. The group will likely take up the issue again this fall, Stadelman said.

"It seems like it gains more support every year," she said.

Rollins College in Winter Park is reviewing its smoking policy as well.

At University of Central Florida, officials said they will be exploring ways to make the campus a healthier environment. Smoking is among the topics they will take up with students and employees.

A smoking ban was discussed by student leaders at Seminole State College this year. Christopher Ross, student-government president for the Sanford-Lake Mary campus, said students will be polled to try to gauge their support for a ban.

"It is sometimes uncomfortable to walk by certain areas on campus and have to cover up because the smell bothers me," he said. "But at the same time, I am aware that some students really have a strong urge to smoke on campus."

Alex Bravo, a criminal-justice student at Valencia, is glad his college has already made a decision.

He is tired of walking through cigarette smoke in the school parking lot and looking at cigarette butts on the sidewalks.

"If people want to smoke, I feel like they need to go elsewhere," Bravo said.

dbalona@tribune.com or 407-420-5470

Despite this progress, due to their wide reach, youth-rated movies still accounted for more than 40 percent of the smoking impressions delivered to U.S. theatre audiences in 2010, down from nearly 55 percent in 2005.

In 2010, the U.S. Department of Health and Human Services’ strategic plan to reduce tobacco use included reducing youth exposure to on-screen smoking. Nearly 80 percent of all adult smokers begin before the age of 18 and research concludes that on-screen smoking is a major factor in youth smoking uptake. The World Health Organization and numerous public health and health professional organizations have recommended several policies that would be effective in reducing harm from on-screen tobacco exposure, including assigning an R-rating for new movies that portray tobacco imagery so that studios would leave smoking and other tobacco use out of films designed to be marketed to youth.

“Each day in the United States, about 3,400 young people between the ages of 12 and 17 smoke their first cigarette, and an estimated 850 youth become daily cigarette smokers,” said Ursula Bauer, Ph.D., M.P.H., director of CDC's National Center for Chronic Disease Prevention and Health Promotion. “Completely eliminating smoking from new youth-rated movies could help prevent America’s young people from starting down the road of tobacco addiction, disease, and premature death.”

Today’s report emphasizes that point, concluding that, “Although three major motion picture companies have excluded nearly all tobacco incidents from their top-grossing youth-rated movies, inconsistent performance among motion picture companies threatens continuing progress. Consistent with the effects of anti-tobacco use policies adopted by the three motion picture companies, expanding the R-rating to include movies with smoking could further reduce exposures of young persons to onscreen tobacco incidents, making smoking initiation less likely.”

“Comcast/Universal, Disney, and Time Warner/Warner Bros. are to be commended for responding to this problem responsibly and nearly eliminating tobacco from their G, PG and PG-13 movies,” said Stanton Glantz, Ph.D., Professor of Medicine at University of California, San Francisco and Director of the Smoke Free Movies Project, another author of the study. “Without a uniform R-rating for smoking, it will be difficult to make further progress to finally end smoking depictions in films rated for youth that entice them to begin deadly life-long addictions.”

“This report reminds us that while we have made progress to reduce tobacco incidents in youth-rated films, youth are still exposed to billions of tobacco impressions every year. In 2007, the MPAA indicated it would consider smoking when rating films, and now would be the perfect time to act. Youth-rated films (mostly PG-13) still accounted for an astonishing 54 percent of top-grossing movies with onscreen smoking from 2005 - 2010, so an industry-wide R-rating policy addressing this issue has enormous potential to save lives.” said Cheryl G. Healton, DrPH, President and CEO of Legacy, the public health foundation that co-funded the research.

The report in today’s MMWR highlights the fact that in 2010, 15 states spent $288 million subsidizing top-grossing films with smoking in them. That is more than they budgeted for their tobacco control programs in 2011 ($280 million). The report suggests that these subsidy programs be harmonized with state health policies by making future film projects with tobacco content ineligible for tax payer support.

Thumbs Up! Thumbs Down!, a project of Breathe California of Sacramento-Emigrant Trails, collected the data for the report.

The National Cancer Institute, the Institute of Medicine and other authorities, state that there is a causal relationship between smoking in the movies and youth uptake of smoking. Smoking in films has also been a major public health priority for organizations like the American Academy of Pediatrics, the American Medical Association, the World Health Organization, American Heart Association, American Lung Association, American Public Health Association, Legacy and more. The groups are urging film studios to endorse four policy solutions developed by the national Smoke-Free Movies campaign:

1. Rating “R” any new movie with smoking, with the exception of movies that depict the health consequences of smoking or actual historic figures who actually smoked
2. Inserting strong, evidence-based anti-smoking public service announcements (PSAs) before movies with smoking, in all distribution and exhibition channels;
3. Requiring producers to certify that no consideration of any kind was received for tobacco depictions in a film; and
4. Ending the depiction of tobacco brands on screen.

“Smoking in Top-Grossing Movies – United States, 2010” reports that:

• Tobacco incidences in top-grossing youth-rated films declined by 66 percent since 2005.
• Three major movie studios have almost eliminated tobacco from their youth-rated movies, reducing the number of tobacco incidents per film (G/PG/PG13) by 96 percent.
• In contrast, studios without policies as well as independent companies reduced tobacco depictions in youth-rated movies by an average of only 42 percent over the same period.

The data find that three major movie studios (Comcast/Universal, Disney and Time Warner/Warner Bros.) have almost eliminated tobacco from their youth-rated movies, reducing the number of tobacco incidents per film (G/PG/PG13) by 96 percent. In contrast, studios without policies as well as independent companies (News Corporation/Twentieth Century Fox, Sony/Columbia/Screen Gems and Viacom/Paramount) reduced tobacco depictions in youth-rated movies by an average of only 42 percent over the same period.

MMWR: Smoking in Top-Grossing Movies - US, 2010 (PDF 2MB)

With the help of a federal grant for tobacco prevention and control in our community, the Orange County Health Department and community partners are working to develop a framework to implement comprehensive smoke-free air policies. This grant award is part of the U.S. Department of Health and Human Services’ (HHS) Communities Putting Prevention to Work initiative.  OCHD will be implementing smoke-free policies at each health department campus. This initiative called all in will:

• Inform and educate the community on the importance of tobacco-free environments

• Encourage medical providers to adopt the Ask. Advise. Refer. (AAR) intervention initiative to promote cessation services to their patients

• Reduce exposure to second-hand smoke by raising awareness of the health threats that second-hand smoke poses to others and increasing motivation to quit

• Monitor air quality of indoor and outdoor facilities that allow smoking

• Support the adoption of tobacco-free policies, and promote the use of the Florida Quitline cessation services

The Orange County Health Department also works to promote a tobacco-free atmosphere through the Orange County Tobacco Free Partnership and Students Working Against Tobacco (SWAT). The Tobacco Free Partnership’s goal is to:

• Prevent initiation of tobacco use among youth and young adults

• Increase restriction on minors' access to tobacco and reduce tobacco industry influence

• Eliminate second-hand smoke exposure

• Promote cessation and increase the use of cessation services

SWAT is Florida's statewide youth organization working to mobilize, educate and equip Florida youth to revolt against and de-glamorize Big Tobacco.  It is a united movement of empowered youth working towards a tobacco free future. OCHD currently has six (6) SWAT Chapters.  Five are operating out of community centers and one private school.  They are as follows: Boys and Girls Club, Jackson Community Center, Orlo-Vista Park, Pine Castle Christian Academy, Callahan Community Center, and Wadeview Community Center.

Partnering agencies working with the health department include the American Lung Association: http://www.lungusa.org/associations/states/florida/ and the
Center for Multicultural Wellness and Prevention: http://www.cmwp.org/

Helping smokers quit is an important opportunity to not only save lives, but also save Florida money. The American Lung Association estimates that providing smoking cessation treatments can save the state $44.1 million dollars a year. OCHD provides, through federal and state tobacco programs, proven evidence-based strategies to help …. thereby reducing chronic diseases.  For every dollar invested, we save $5.60 in health care cost.

Floridians can quit today for a healthy 2011
 
ORLANDO— Every year, millions of Floridians attempt to quit smoking.  As 2010 comes to a close and Florida smokers consider making their 2011 New Year’s resolutions, the Orange County Health Department Tobacco Programs, the Florida Department of Health, and Tobacco Free Florida can provide assistance to help smokers  quit for good with free support through phone, web and in-person quit smoking resources.

On the heels of the groundbreaking U.S. Surgeon General’s report released December 9, it is more important than ever before to quit smoking immediately.  The report emphasizes the importance of quitting early in life, in order to protect immunity and minimize the damage caused by each cigarette to you and people around you exposed to secondhand smoke. The report states that no level of exposure to tobacco smoke is safe. 

Although permanently quitting tobacco is very difficult, it is not impossible.  Sixty-one percent of adult Floridians who have ever smoked have quit and there are more former smokers in Florida than current smokers.  In 2009, about 58 percent of Floridian smokers tried to quit.  There are some important steps you can take to be successful in quitting. They are:

Step One: Set a Date

The first step one needs to take is to set a quit date.  Once the quit date is set, cigarettes, ashtrays and lighters should be removed from the home, office and vehicle. 

 Step Two: Get Help

Know why you are addicted and evaluate the health risks of smoking, spend sometime writing them down.  Look at the dangers of smoking and the damage it is causing.  What do you want to achieve and why?

Tobacco Free Florida offers a number of free resources to help smokers quit.

·Phone: Call the Florida Quitline at 1-877-U-CAN-NOW to speak with a Quit Coach who will help assess the user’s addiction and create a personalized quit plan.

·Online: Enroll in online counseling with the Florida Quitline, where each user can create a personalized, web-based quit plan. Visit https://www.quitnow.net/florida to enroll.

·For information about attending Quit Smoking Now classes, please call: (877) 252-6094.

Step Three: Keep Trying 

“No matter how many times you try to quit, don’t give up,” said Dr. Kevin M. Sherin, Director of the Orange County Health Department. “It is easy for people to relapse, but it’s important that people keep trying.” 

Most successful quitters make several attempts before finally quitting permanently.  In fact, the average number of attempts varies anywhere from five to more than 10 times before a person is successful.   

ABOUT TOBACCO FREE FLORIDA

Tobacco Free Florida (TFF) is a statewide cessation and prevention campaign funded by Florida’s tobacco settlement fund.  The program is managed by the Florida Department of Health, specifically the Bureau of Tobacco Prevention Program.  TFF’s mission is to combat the pervasive problem of tobacco use in the Sunshine State, where each year, more than 28,000 Floridians die from smoking and tobacco-related diseases cost the state an estimated $19.6 billion in healthcare costs and lost productivity.   Since its inception in February 2008, TFF has reached millions of Floridians through advertising, grassroots initiatives, social media, and public relations efforts as a means of providing information and offer resources to help tobacco users quit.  Smokers and smokeless tobacco users interested in quitting are encouraged to call the Florida Quitline at 1-877-U-CAN-NOW to speak with a quit coach.  To learn about TFF and the state’s free quit smoking resources, visit www.tobaccofreeflorida.com or follow the campaign on Facebook at http://www.facebook.com/TobaccoFreeFlorida or Twitter at twitter.com/tobaccofreefla

Children living in apartments are exposed to secondhand smoke even when no one smokes inside their own unit. This study, released online today by the journal Pediatrics, strongly suggests that housing type contributes to children’s exposure to tobacco smoke, despite the best intentions of parents.

This new study from the University of Rochester Medical Center, MassGeneral Hospital for Children and the American Academy of Pediatrics’ Julius B. Richmond Center for Excellence is the first to show significant evidence of increased tobacco smoke exposure in the blood of children who live in multi-unit housing. It will appear in the January 2011 issue of Pediatrics.

The U.S. surgeon general has said that there is no safe level of exposure to tobacco smoke. Children exposed to secondhand tobacco smoke are at greater risk for a variety of illnesses, such as respiratory infections, asthma and sudden infant death syndrome. In this study, researchers measured blood levels of cotinine, a chemical commonly used to test for tobacco exposure. Overall, using the most sensitive cutoff for tobacco smoke exposure, more than 84 percent of children in multi-unit housing had been exposed to tobacco smoke, compared to almost 80 percent of children living in attached houses and 70 percent of children in detached houses. At every cutoff level of cotinine, children living in apartments had higher rates of exposure.

“Parents try so hard to protect their children from dangers, such as tobacco smoke. It’s surprising to see these results and realize that too many parents have no control over whether their children are exposed to secondhand smoke in their own homes,” said Karen Wilson, MD, MPH, an assistant professor of Pediatrics at the University of Rochester Medical Center’s Golisano Children’s Hospital and lead author of the paper.

Controlling for other factors such as poverty and age, children living in apartments had an increase in cotinine of 45 percent over those living in detached houses. While some of the tobacco exposure may have come from family members who only smoke outside, but carry in tobacco residue on their clothes, study authors suggest this is unlikely to explain all of the difference since there are many more exposed children than adult smokers. Instead they conclude tobacco smoke may have seeped through walls or shared ventilation systems. Earlier studies have shown that tobacco smoke contaminates nonsmoking units of multi-unit dwellings.

The study, which was funded by the Julius B. Richmond Center of Excellence of the American Academy of Pediatrics, through a grant from the Flight Attendant Medical Research Institute, analyzed data from more than 5,000 children ages 6 to 18 in a national database (National Health and Nutrition Examination Survey 2001-2006) to see if there was any relationship between their smoke exposure and their housing type. Cotinine levels were highest for children who were under 12, black and living below the federal poverty level. Previous studies have shown that children with cotinine levels indicating even very low amounts of tobacco smoke exposure have delayed cognitive abilities and decreased antioxidant levels.

“This study is an important piece of evidence supporting universal smoke-free multi-unit housing,” said Jonathan Winickoff, MD, MPH, of the MassGeneral Hospital for Children and the senior author of the study. “More and more landlords, in all 50 states, know that they can set the smoke-free policy for their buildings, and with 80 percent of the population not smoking, market demands strongly favor smoke-free status. When landlords set a completely smoke-free policy they will enjoy lower fire risk and insurance costs, lower clean up costs between tenants, and they will be fostering a healthier home for everyone in the building.”

“In general, people who smoke are very respectful of not exposing children and nonsmokers to tobacco smoke in indoor environments. This research will help promote the notion that it is never acceptable to smoke indoors, even in your own unit, because the smoke get into the bodies of children in other units,” said Winickoff, who is also an associate professor of Pediatrics at Harvard Medical School.

The authors also stress the importance of making sure that tobacco cessation resources are provided for smokers whose buildings become smoke-free. “Hopefully this research and the movement towards smoke-free housing will open up programs and opportunities for more folks to quit smoking. Promoting the use of the free quitlines in every state is a great way to facilitate these efforts,” Wilson said.

Tobacco-Smoke Exposure in Children Who Live in Multiunit Housing

About the Author

Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $600 million. The hospital is home to major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, photomedicine, regenerative medicine, systems biology, transplantation biology.

Amartya K. 'Marty' Ray
Project Specialist | Office of Public Affairs
Massachusetts General Hospital | MassGeneral Hospital for Children
50 Staniford Street, Suite 830, Boston, MA 02114
617-726-0274 | aray6@partners.org

ORLANDO – The Orange County Health Department (OCHD) has kicked off a campaign called This project aims to improve the quality of life in our community by addressing tobacco-related issues. This two year campaign will include collaboration with community leaders who will work to ensure that, collectively, we take a step forward to reduce smoking rates and exposure to second-hand smoke, thereby saving lives.

Many millions of Americans, both children and adults, are still exposed to second-hand smoke in their homes and workplaces despite substantial progress in tobacco that includes the 2003 Clean Indoor Air Act. “The all in project will encourage smokers to seek cessation services and will protect non-smokers by creating additional smoke-free environments,” said Dr. Kevin M. Sherin, Director of the Orange County Health Department.

Specifically, the initiative, which was funded by a 6.6 million dollar grant, will work to make Orlando and Orange County parks, colleges, and universities smoke-free environments and reduce the exposure of second-hand smoke in public areas. The project will also focus on reducing youth access to tobacco, and encouraging physicians to refer patients to smoking cessation programs.

From a public health perspective the health department has an obligation to address situations that endanger the health of the public. We know that second-hand smoke is detrimental to the health of children and adults. Approximately 130 people die in Orange County each year from needless exposure to second-hand smoke. If a person stops smoking, within a year their risk of having a heart attack will be reduced by 50%.

The grant funding for this project is provided by the Department of Health and Human Services.

For more information about the ALL IN Project please visit www.allintohealth.org

Background

On March 19, 2010 the Orange County Health Department (OCHD) was awarded a grant of 6.6 million dollars for tobacco prevention and control in our community. This grant award is part of the U.S. Department of Health and Human Services’ (HHS) Communities Putting Prevention to Work initiative to support public health efforts to reduce obesity, increase physical activity, improve nutrition, and decrease smoking—four critical actions for combating chronic diseases and promoting health.

The $372.8 million, funded by the American Recovery and Reinvestment Act of 2009, was awarded to 44 communities, including cities, towns, and tribes. These communities are receiving awards to implement policy, systems and environmental change strategies over the next two years as one of several initiatives of HHS Communities Putting Prevention to Work.

"The burden of chronic diseases like cancer, heart disease, strokes, and lung disease threatens to overwhelm our health care systems. An estimated 81 Floridians die every day due to tobacco related diseases, said Dr. Kevin M. Sherin. “The answers in part lie in tobacco prevention programs such as those funded by this grant. Working together as a community we can save more lives."

The competitive funding awards to cities, towns, and tribes across the country will allow communities to support healthy choices among their residents through a variety of methods including increasing the availability of healthy foods and beverages, improving access to safe places for physical activity, discouraging tobacco use, and encouraging smoke-free environments.

Specifically, this initiative in Orange County will work to help make Orlando and Orange County parks smoke-free environments, reduce youth access to tobacco, and encourage physicians to refer patients to smoking cessation programs.

“As the Director of the Orange County Health Department I am keenly aware of the significant impact smoking and exposure to second hand smoke can have on the health of individuals. A 2010 report published by the Institute of Medicine supports the strong connection between second hand smoke and cardiovascular disease. We know that approximately 130 people die in Orange County each year from needless exposure to secondhand smoke. The Orange County Health Department in collaboration with community leaders will work over the next two years to ensure that, collectively, we take a step forward to improve the quality of life for our community and continue to save lives.”

--Kevin M Sherin, MD, MPH, Director, Orange County Health Department

Community Overview

• As the 5th largest county in the state of Florida, Orange County has a population of 1,115,204.
• Over the past 30 years, the population of Orange County has grown 160.0%. Just from 1990 to 2000, Orange County experienced a population increase of 33.3%.
• With a diverse population, 50% of the residents are White, 21% Black, 25% Hispanic, and 4% Asian/Pacific Islander. The Black and Hispanic population percentages (21% and 25%) are higher than the statewide percentages of 16% and 21% respectively. Approximately 32% of Orange County residents speak a language other than English at home.
• The majority of Black, Hispanic, and medically-underserved populations in Orange County reside in the following zip codes: 32805, 32807, 32808, 32811, and 32839 where the 2006 per capita income for residents ranges from $13, 871 to $18,674. Also levels of uninsured are much higher in these areas some as high as 25.9%.
• Approximately, 12% of the population lives below poverty; and 16.7% of the population living below poverty are less than 18 years of age.

Community Health Problems

• Data from 2002 show that 21% of Orange County adults smoke, and data from 2007 indicates that 17% of Orange County high school students smoked.
• 18-44 year olds are the age group with the largest number of smokers in Orange County and represent 22.1 % of smokers compared to the state's percentage for the same age group of 15.1 %.
• In addition, 60.1% of high school students surveyed in Orange County report exposure to second hand smoke. Data from 2007 revealed that 77.2% of middle school students reported living in homes where smoking was allowed thereby increasing their exposure to second hand smoke; and 2008 data shows that secondhand smoke exposure for adults in the county were at 16.4%, higher than the state at 14.9%.
• In 2007 the top two leading causes of death were cancer and heart disease respectively.
• Age adjusted death rates (AADR) for Cardiovascular Disease (2006-2008) is significantly higher among minority populations than the overall population. Cardiovascular disease AADR among Blacks in Orange County (247.3/100,000 population) is significantly higher than both County and State rates (229.5/100,000 and 209.9/100,000, respectively).

Community Assets

There is a strong history of forging partnerships and developing coalitions to improve the health of Orange County residents. The County is comprised of very active and influential partners experienced in policy development and implementation. Additionally, partners represent a diverse network of public, private, foundation, government, not-for-profit, and planning organizations that consistently network through multiple affiliations on councils, partnerships and other influential groups to support policy change.

• Partnerships and coalitions across the state successfully worked to get two Constitutional Amendments signed into law including Smoke-free Workplaces in 2002 and 15% of the annual tobacco settlement funding going to tobacco prevention in 2006.
• The local program will also build on substantial strides in tobacco policy changes made at the state level including smoke free air in restaurants, authorization of tobacco settlement funds to support tobacco prevention in youth, and the increase in tobacco products sales tax, all of which apply throughout Florida.

Community Story

Currently, 130 community residents die in Orange County each year from needless exposure to second-hand smoke. Second-hand smoke causes complications for those that don’t smoke but are exposed to it: especially those that must work around the smoke daily. According to recent research findings, 5 minutes of exposure to second-hand smoke, (SHS), is equal to smoking one cigarette. After 120 minutes of SHS exposure, there is a much higher risk of irregular heartbeat which could lead to a heart attack. Individuals who find themselves in the unfortunate situation to have to pursue their subsistence by working in an environment that do not enforce the Indoor Air Act of 2003, are at risk of developing conditions that are, by modern day standards, preventable. There are currently 22 states around the nation that have adopted comprehensive smoke-free laws to safeguard the quality of life of their citizens, however, Florida is not one of them. The Orange County Health Department, in collaboration with community partners, is working to ensure that all county residents, regardless of socio-economic status and/or industry, have access to a safe environment that values and supports their pursuit to a good quality of life.

Board

The all in board is comprised of high-level community leaders representing various industries and organizations in Orange County who are working towards a common goal of improving the health of our residents by reducing tobacco use. The board will accomplish this by:

• Developing policies and making recommendations to the highest levels of policy and decision makers
• Educating and empowering community resources to more effectively meet the needs of the people in Florida
• Providing leadership, expertise and accountability to ensure change in policies, systems, and enviroments as it relates to health

The all in board is committed to policy, system, and environmental changes related to Florida's health.

Coalition

The all in coalition is comprised of individuals and businesses who want to partner with us to improve the health of Orange County residents and visitors by reducing tobacco use in our community. The coalition will accomplish this by:

• Providing a forum for all agencies, programs, committees, consumers, concerned citizens, and individuals to meet collectively in the best interest of Florida's health.
• Encouraging grass roots efforts and creating momentum that the community can build on

Anyone is welcome to join the coalition. Persons interested in joining should complete the membership form and commit to attend quarterly meetings. Coalition members are invited to serve on various board subcommittees. For more information, please call 407-558-0460.

Coalition Membership Form (PDF 31kb)

For more information you can contact our office at: 407-558-0462 or visit http://allintohealth.org

ORLANDO - Today, the Orange County Health Department (OCHD) was awarded a grant of 6.6 million dollars for tobacco prevention and control in our community. OCHD will work with the Orange County Tobacco Free Partnership to implement policy changes and will partner with key community agencies such as the American Lung Association, Orange County Public Schools, and community based organizations like the Center for Multicultural Wellness and Prevention and county and city governments to improve the health of Central Florida residents and to help prevent deaths associated with smoking and second hand smoke.

This grant award is part of the U.S. Department of Health and Human Services’ (HHS) Communities Putting Prevention to Work initiative to support public health efforts to reduce obesity, increase physical activity, improve nutrition, and decrease smoking—four critical actions for combating chronic diseases and promoting health.

The $372.8 million, funded by the American Recovery and Reinvestment Act of 2009, was awarded to 44 communities, including cities, towns, and tribes. These communities are receiving awards to implement policy, systems and environmental change strategies over the next two years as one of several initiatives of HHS Communities Putting Prevention to Work.

"The burden of chronic diseases like cancer, heart disease, strokes, and lung disease threatens to overwhelm our health care systems. An estimated 81 Floridians die every day due to tobacco related diseases, said Dr. Kevin M. Sherin. “The answers in part lie in tobacco prevention programs such as those funded by this grant. Working together as a community we can save more lives."

The competitive funding awards to cities, towns, and tribes across the country will allow communities to support healthy choices among their residents through a variety of methods including increasing the availability of healthy foods and beverages, improving access to safe places for physical activity, discouraging tobacco use, and encouraging smoke-free environments.

Specifically, this initiative in Orange County will work to help make Orlando and Orange County parks smoke-free environments, reduce youth access to tobacco, and encourage physicians to refer patients to smoking cessation programs.

To learn more about Communities Putting Prevention to Work, visit http://www.hhs.gov/recovery and www.cdc.gov

The Orange County Health Department Will Hold a Press Conference in Conjunction with First Lady Michelle Obama and U.S. Department of Health and Human Services Secretary Kathleen Sebelius’

National Announcement of Prevention and Wellness Grant Awards to Communities Around the Country

ORLANDO - On Friday, March 19, 2010, The Orange County Health Department (OCHD) will be holding a press conference in conjunction with the First Lady in support of national, state and local efforts to prevent obesity and tobacco use while improving nutrition and increasing physical activity among the people of Orange County. The Orange County Health Department is one of only three communities that will be connected to the national announcement in Washington D.C. via satellite. The Surgeon General of the United States Regina Benjamin will also be visiting OCHD headquarters to assist in making the announcement.

WHO:

• Dr. Regina M. Benjamin, Surgeon General of the United States
• Dr. Ana M. Viamonte Ros, State Surgeon General
• Dr. Kevin M. Sherin, Director of the Orange County Health Department

WHEN: Friday, March 19, 2010 12:45 p.m.

WHERE: Orange County Health Department Headquarters 6101 Lake Ellenor Drive, Orlando, FL. 32809

The national event in Washington, DC will be available live via satellite for broadcast media on Friday, March 19 at 1pm (EDT): G-19 16K Digital Only Slot A Orbital Location: 97’ West Ku-Band D/L 11988.5 Mhz Horizontal FEC: 3/4 Symbol Rate: 6.111319 @ 204 packet = 8.448 Data Rate 4 X 3 Aspect Ratio. If broadcast media experience any technical issues during the event, please contact the U.S. Department of Health and Human Services at 202.690.6076 for assistance. Also, the event will be webcast on www.hhs.gov/recovery

Disclaimer: This media advisory was produced using a template prepared by the U.S. Department of Health and Human Services.