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State of Alaska

Health Indicator Report of Tobacco Use - Adults (18+) - Not Smoking Cigarettes (HA2020 Leading Health Indicator: 3)

Tobacco use is the leading cause of preventable disease and death in the United States.^1^ There have been over 12 million tobacco-related deaths in the United States since the landmark 1964 Surgeon General's report, which broadcast that smoking was a cause of cancer.^2^ And smoking kills more than just those who choose to smoke. Exposure to secondhand smoke kills approximately 50,000 Americans every year.^3^ The use of tobacco products (both cigarettes and smokeless tobacco products, such as chewing tobacco) is responsible for 30% of all cancer deaths, 21% of all coronary heart disease deaths, and 18% of all stroke deaths.^2^ For every one person who dies from tobacco use, another 20 suffer reduced quality of life from tobacco-related illness.^4^ In addition, tobacco use costs the US economy more than $96 billion each year in direct medical expenses and another $97 billion per year in lost productivity;^3^ Alaska's share of these costs are approximately $546 million annually.^5^[[br]] [[br]] ---- {{class .SmallerFont 1. U.S. Centers for Disease Control and Prevention (CDC). Best Practices for Comprehensive Tobacco Control Programs-2014. [http://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2014/comprehensive.pdf]. Published 2014. Accessed October 4, 2016. 2. U.S. Department of Health and Human Services. The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General, 2014. [http://www.surgeongeneral.gov/library/reports/50-years-of-progress/]. Published 2014. Accessed October 4, 2016. 3. U.S. Centers for Disease Control and Prevention (CDC). Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses-United States 2000-2004. Morbidity and Mortality Weekly Report (MMWR) 2008;57(45):1226-1228. 4. U.S. Centers for Disease Control and Prevention (CDC). Cigarette smoking-attributable morbidity-United States, 2000. Morbidity and Mortality Weekly Report (MMWR) 2003; 52(35):842-844. 5. U.S. Centers for Disease Control and Prevention (CDC). Smoking-Attributable Mortality, Morbidity, and Economic Costs. [https://chronicdata.cdc.gov/Health-Consequences-and-Costs/Smoking-Attributable-Mortality-Morbidity-and-Econo/ezab-8sq5?]. Updated 2009. Accessed October 4, 2016. }}

Notes

U.S. values are based upon the median value of the states, District of Columbia, and territories.

Data Sources

  • Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion
  • U.S. Data: National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS)

Data Interpretation Issues

The Behavioral Risk Factor Surveillance System (BRFSS) is a primary source for estimating not cigarette smoking for Alaska. The median of states, District of Columbia, and territories provides a comparison for the United States (U.S.). The BRFSS is a telephone survey of adults 18 and over. Information on background and methodology of the BRFSS managed by the Centers for Disease Control and Prevention (CDC) can be found at: [http://www.cdc.gov/brfss/]. The website for the Alaska BRFSS is: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx]. The questions on not cigarette smoking have been asked on the standard BRFSS (1991 onward) as well as the supplemental BRFSS survey since its inception in 2004.

Definition

Percentage of adults 18 years of age and older who responded "No" on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] to the question: "Have you smoked at least 100 cigarettes in your entire life?" or, if the response was "Yes", they responded "not at all" to the question: "Do you now smoke cigarettes every day, some days, or not at all?"

Numerator

Weighted number of adults (18+) who responded "No" on the BRFSS to the question: "Have you smoked at least 100 cigarettes in your entire life?" or, if the response was "Yes", they responded "not at all" to the question: "Do you now smoke cigarettes every day, some days, or not at all?"

Denominator

Weighted number of adults (18+) with complete and valid responses on the BRFSS to the question: "Have you smoked at least 100 cigarettes in your entire life?" and, if "Yes", also to a second question on smoking frequency.

Healthy People Objective: Reduce tobacco use by adults: Cigarette smoking

U.S. Target: 12.0 percent

Other Objectives

Healthy Alaskans 2020 Indicator 3: Increase the percentage of adults (age 18 years and older) who currently do not smoke cigarettes to 83% by 2020.

How Are We Doing?

Over 80% of Alaskan adults (18+) did not smoke cigarettes in 2016. Alaska Native adults (18+) had a smoking rate of 37.9%, resulting in a significantly lower rate of not smoking cigarettes (62.1%) than other races in 2014-2016. The highest rates of not smoking cigarettes were found among those 65 years of age and older, Asians, those with higher incomes, those not in the workforce, college graduates, those who were married, and urban residents. The prevalence rates for not smoking cigarettes from the BRFSS are initially presented for all Alaskans, Alaska Native people, and the median from states, District of Columbia, and territories for all available years. Subsequent analyses by demographic subpopulations (i.e., sex, age, race/ethnicity, ethnicity, marital status, education, employment status, income, poverty status, and weight status) are limited to 2010 and later to allow for ease of assessing recent trends. Crosstabulations of not smoking cigarettes by body mass index (BMI), sexual orientation, and disability were conducted for the 3-year average of 2014-2016. Each comparison showed significant differences in prevalence. Prevalence of not smoking cigarettes by regions of Alaska are presented for the most recent time period allowing reporting for all Alaskans and Alaska Native people: 1) single-year for the 7 Alaska Public Health Regions, 2) three-year averages by the 5 Metropolitan or Micropolitan Statistical Areas and rural remainder, 3) single-year for the 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) three-year averages for 29 boroughs and census areas, and 5) five-year averages for the 12 tribal health organization regions. These time intervals match those for the InstantAtlas health profiles for each of the geographic regionalizes of Alaska for those desiring longer time series.

How Do We Compare With the U.S.?

The Alaska adult smoking rate has somewhat paralleled, but been consistently above the rate for the national median of states, District of Columbia, and territories. In 2015, the median for the United States was 82.5% compared to the 80.8% among all Alaska adults.

What Is Being Done?

In collaboration with partners statewide, the Alaska Tobacco Prevention and Control (TPC) program provides leadership, coordinates resources, and promotes efforts that support Alaskans in living healthy and tobacco-free lives. Specifically, the Alaska TPC provides funding and technical assistance for regional tobacco prevention and control programs; provides media and other counter-marketing communications statewide; operates a tobacco quit-line that provides cessation counseling and nicotine replacement therapy (NRT) free of charge; ensures the ongoing surveillance of tobacco use trends in Alaska and the evaluation of program efforts; and supports tobacco-free partnership projects in Alaska. Additional information on current tobacco prevention efforts in Alaska is available at: [http://www.hss.state.ak.us/dph/chronic/tobacco/default.htm] or [http://www.tobaccofree.alaska.gov]. A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_3_Tobacco_Adult.pdf].

Evidence-based Practices

As part of the Healthy Alaskans 2020 health improvement process, groups of Alaska subject matter experts met over a period of months in a rigorous review process to identify and prioritize strategies to address the 25 health priorities. Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs.* '''Strategy 1:''' [[br]]Introduce and implement statewide or community comprehensive smoke-free workplace laws. '''Evidence Base:''' [[br]]Several of the Surgeon General's reports, CDC Best Practices, and The Community Guide all list smoke-free workplaces as an evidence-based strategy to change social norms, support smokers in their quit attempts, and prevent young people from starting to smoke. '''Strategy 2:''' [[br]]Adopt and implement comprehensive tobacco-free and smoke-free post-secondary and healthcare campus and multi-unit housing policies. Address emerging issues guided by the evidence base. '''Evidence Base:''' [[br]]Several Surgeon General's reports, CDC Best Practices, The Community Guide, and U.S. Public Health Service Clinical Practice Guideline all list tobacco-free or smoke-free campus policies as an effective, evidence-based method to reduce tobacco use. Young adults are particularly vulnerable to transitioning from trying smoking to lifelong smoking depending on their environments. Post-secondary campus policies help establish a community context where young adults can be tobacco-free and prepare for the workforce with a smoke-free/tobacco-free policy. Worksites and healthcare campuses that establish a culture of health support their employees who are trying to quit through smoke-free or tobacco-free policies. In addition. healthcare campuses that are tobacco-free promote health and wellbeing before, during, and after illness. Healthcare campuses should include clinical practice guidelines and provide Nicotine Replacement Therapies to in-patients. Smoke-free multi-unit housing policies protect adults and youth from exposure to secondhand smoke in their homes, support adults to quit tobacco, and prevent youth from starting. '''Strategy 3:''' [[br]]Train healthcare providers to ask at every visit, advise patients to quit, and refer to cessation services. Document in the electronic health record systems. Providers include physicians, nurses, dentists, behavioral health providers, pharmacists, Community Health Aides/Practitioners, nurse practitioners, case managers, intake specialists, and others. '''Evidence Base:''' [[br]]The U.S. Public Health Service Clinical Practice Guideline for Treating Tobacco Use and Dependence is a step by step tool to promote comprehensive, evidence-based strategies to reduce tobacco use among adults. Several Surgeon General's reports, the Community Guide, and CDC Best Practices also note these evidence-based strategies to support individuals who use tobacco in their quit attempts. * Sources for strategies can be found at [http://hss.state.ak.us/ha2020/assets/EBS/HA2020_EBS3_Tobacco-Adults.pdf] A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_3_Tobacco_Adult.pdf].

Available Services

The Alaska Tobacco Quit Line and Alaska's online quitting program offer assistance in quitting tobacco use to Alaska adults and teens. For services and information call the Alaska Tobacco Quit Line at 1-800-QUIT-NOW or visit Alaska's online tobacco cessation support program at [http://www.alaskaquitline.com].

Health Program Information

For information on quitting tobacco use, call the Alaska Tobacco Quit Line at 1-800-QUIT-NOW or visit Alaska's [http://www.alaskaquitline.com/online tobacco cessation support program].
Page Content Updated On 08/10/2017, Published on 09/21/2017
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 26 May 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Thu, 21 Sep 2017 10:40:42 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 26 May 2018 6:01:41 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Thu, 21 Sep 2017 10:40:42 AKDT