Tobacco Use

Background

The public health impact of tobacco use is enormous. The Surgeon General has concluded that smoking is the single most preventable cause of death and premature disability in our society. The rate of smoking is high in our state, and an average of 12 West Virginians die each day because they smoked cigarettes. One in five deaths, or about 4,200 deaths per year, are caused by smoking.

Smokers are not the only ones placed at risk from exposure to tobacco smoke. Nationally, approximately 3,000 deaths a year are attributed to secondhand smoke, as well as 150,000 to 300,000 respiratory tract infections in children younger than 18 months of age. To protect individuals from the health hazards of secondhand smoke, restrictions on smoking in public places and at worksites are increasing.

The West Virginia Bureau for Public Health's Tobacco Control Program, which is funded by the National Cancer Institute's American Stop Smoking Intervention Study for Cancer Prevention (ASSIST) Project, is working with community tobacco control coalitions and the statewide Coalition for a Tobacco-Free West Virginia to address tobacco use issues in the state and achieve Objectives 3.1 through 3.4.

The Objectives

OBJECTIVE 3.1 Reduce cigarette smoking to a prevalence of no more than 15% among West Virginians age 18 and older.

UPDATE The 1995 prevalence of cigarette smoking of 25.7% was lower than the 1994 rate of 26.9%, continuing the overall downward trend in adult smoking since Behavioral Risk Factor Surveillance System (BRFSS) monitoring began in 1984 (see Figure 1). Since 1990, however, only 7.8% of Objective 3.1 (an overall decline to 15%) has been achieved. If the present rate of decline continues, the year 2000 rate of smoking among West Virginia's adults is projected to be 24.7%.

OBJECTIVE 3.2 Expand public smoking restriction laws to include enclosed public places, worksites, health care facilities, day care centers, and schools.

UPDATE As of February 1, 1997, boards of health in 30 counties had enacted clean indoor air regulations to protect individuals from the health hazards associated with the involuntary exposure to secondhand smoke. These regulations protect nearly 60% of the state's population and restrict smoking in workplaces, restaurants, and enclosed public places. Several more counties are in the process of developing and implementing clean indoor air regulations, expanding the number of such regulations as mandated in Objective 3.2.

OBJECTIVE 3.3 Reduce the use of smokeless tobacco to a prevalence of no more than 10% among males aged 18 and older.

UPDATE The 1995 overall smokeless tobacco use rate was 8.4%. Among male BRFSS respondents only, 17.7% reported the current use of smokeless tobacco products (chewing tobacco and/or snuff), compared to 0.2% of females. Since 1986, there has been only a slight downward trend in the rate of smokeless tobacco use among WV men (see Figure 2), and the year 2000 rate is projected to be 17.0%, much higher than the target rate of 10%. A statewide campaign that was begun in 1996 (called Through with Chew) will attempt to further lower the prevalence of smokeless tobacco use in West Virginia by the year 2000.

OBJECTIVE 3.4 Reduce the initiation of tobacco products use by children and youth so that no more than 15% have become regular users by age 20.

UPDATE Experimentation with smoking is occurring at younger ages, and initiation now occurs almost entirely during adolescence. Most of the approximately 8,000 West Virginians who begin smoking each year are under the age of 18. According to the 1995 Youth Risk Behavior Survey, 76% of students in grades 9-12 had tried cigarettes, and 43% of the same students said they had smoked cigarettes in the past 30 days. Among male teens, 35% reported that they had used a smokeless tobacco product within the past 30 days.

Meeting the Objectives

The Coalition for a Tobacco-Free West Virginia is a statewide organization comprised of more than 100 organizations and individuals dedicated to improving the health of West Virginians. The Coalition is working with the WV Bureau for Public Health (WVBPH) and community tobacco control coalitions toward reducing tobacco use in the state and meeting the year 2000 objectives. The WVBPH and the coalitions are using the health promotion channels listed in the box on the previous page to reach the communities with their plans to achieve a tobacco-free state. The Program Manager of the WVBPH Tobacco Control Program is the contact person for issues concerning the year 2000 tobacco use objectives.

The membership of the Coalition for a Tobacco-Free West Virginia represents a cross-section of West Virginia, including health care organizations, public and private businesses, schools, civic organizations, and other interested individuals. The mission of the Coalition is to eliminate the use of tobacco products by minors, protect individuals from exposure to secondhand smoke, and protect West Virginians from the consequences of tobacco use.

The Coalition has been in existence since January 1995. Previously, the Coalition had operated as an advisory council to the Bureau for Public Health under the name of the West Virginia Tobacco Control Coalition (WVTCC). The WVTCC was disbanded by the Bureau Commissioner in December 1994. The Coalition now operates as an independent entity with strong leadership.

The Coalition has adopted the four ASSIST priorities on which to focus its activities. These priorities are (1) eliminating environmental tobacco smoke exposure and associated hazards; (2) reducing tobacco product advertising and promotion; (3) reducing access to and availability of tobacco products, particularly to those under the legal age to purchase, and (4) reducing the consumption of cigarettes and other tobacco products through price increases using increased taxes and other costs imposed on these products.

In addition to its statewide committees and task forces, the Coalition supports the efforts of 19 local tobacco control coalitions, covering 26 counties, by providing funding, technical assistance, and training opportunities through the West Virginia ASSIST Project and the West Virginia Youth Tobacco Prevention Campaign.

The Coalition, as well as the West Virginia ASSIST Project, encourages policy advocacy efforts. Impacting society through policy change reaches whole populations -- whether it be at a worksite, on a county level, or at the state level. The state is benefitting from many successes through policy changes at the local level. Although the Coalition annually supports a state-level policy agenda, legislative changes have not been successful to date. This may soon change since much headway has been made at the local level, heightening awareness and education at the grassroots level.

Tobacco Use - Meeting the Objectives

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