“Even if you're on the right track, you'll get run over if you just sit there.”
 
–Will Rogers

TRU Summer Tour Wraps up Successful 

First-ever Road Trip

The TRU (Tobacco. Reality. Unfiltered)  campaign took its life-affirming teen tobacco prevention message into the streets of North Carolina this summer. The TRU Road Trip, a first for the campaign sponsored by the N.C. Health and Wellness Trust Fund (HWTF), rolled into seven cities across the state, recruiting new teens to the cause and turning up the heat on tobacco prevention efforts. 

The Road Trip offered young people an opportunity to view thought-provoking exhibits on the dangers of tobacco use, as well as a chance to talk with members of SAVE (Survivors and Victims of Tobacco Empowerment) about their harrowing experiences with tobacco-related illnesses.  HWTF grantees were on hand to share information on tobacco and how to get involved in the TRU movement.   Teens could also offer their personal thoughts on and experiences with the dangers of tobacco as part of testimonials captured by a camera crew for possible use in new TRU TV spots.

The TRU Road Trip kicked off with a stop in the state’s capital, before visiting Durham’s American Tobacco Historic District, Cross Creek Mall in Fayetteville, the N.C. State Games in Winston Salem, and tobacco-free minor-league baseball games in Kinston, Wilmington, and Hickory.

Research shows that teens’ talking to teens is the most effective way to spread the tobacco prevention message. Based on this finding, the TRU Road Trip set out to bring teens together to provide information and to help build a buzz to keep teens tobacco-free.  The TRU Road Trip has seen increasingly positive results from the innovative grassroots campaign.

Lt. Gov. Beverly Perdue, HWTF chairperson, noted that when TRU aired its first-ever TV spots in  April, visits to the campaign’s Web site, www.realityunfiltered.com, shot up 140 percent from the site’s previous high mark and that traffic has remained higher in 2004 than in 2003.  “Teens are definitely interested,” Lt. Gov. Perdue said.  “Now is the time to act.” 

The TRU Road Trip team agreed.  While the TRU Road Trip wrapped up in Hickory at the end of August, it will have a lasting impact on teen tobacco prevention in North Carolina.  TV spots culled from the Road Trip will started airing in September.  The numerous HWTF grantees that participated in the events will benefit from local media coverage.  And young people may feel more empowered to say no to tobacco.

Thank you to everyone who supported the TRU Road Trip.  We look forward to visiting more cities and towns next time!   

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The Public Health Benefits   of a 75-cent Increase in   N.C.'s Cigarette Tax

The Scientific Evidence
The Task Force on Community Preventive Services' review of the scientific evidence demonstrates that increasing the price of tobacco products is effective both in 1) reducing tobacco use prevalence and consumption among both adolescents and young adults and, 2) increasing tobacco use cessation. ¹ This Task Force is an independent group of scientists who systematically reviewed the available tobacco price data and its relationship to initiation, consumption and cessation of tobacco use.  Numerous studies indicate that a 10 percent increase in product price results in an overall 3-5 percent decrease in cigarette consumption and a 7 percent decrease in youth smoking.²
A recent study by the University of Illinois at Chicago (April 2001) found that a 10% increase in the price of cigarettes would decrease the probability of an adolescent starting smoking between 3 and 10 percent, depending on the type of initiation, including initiation of any smoking (including experimentation), initiation of daily smoking, and initiation of smoking at lease one half-pack per day.  Price was found to have the largest impact on stemming the initiation of daily smoking among youths.³ A study published in the American Journal of Public Health shows that a 10% increase in price would reduce smoking rates among pregnant women by 7 percent.

The Health Toll of Tobacco in N.C.
Tobacco use continues to be the leading preventable cause of mortality in North Carolina, resulting in more than 14,000 deaths annually.⁴ Although 52 percent of adults have never smoked a cigarette, current smoking prevalence continues to hover around a quarter (24.8 percent) of the population or an estimated 2.1 million North Carolinians.⁵ Currently 33.7 percent of high school and 14.3 percent of middle school students use tobacco products; 27.3 percent of high school and 9.3% of middle school students smoke cigarettes (N.C. Youth Tobacco Survey 2003). The current prevalence rate is expected to lead to the deaths of 210,000 current youth if the trend prevails.⁶ 

The Economic Toll of Tobacco Use
Tobacco use in North Carolina costs the state $1.9 billion in direct medical expenditures alone, or more than $255 per person. In 1998, about 13 percent ($600,000,000 or $513.30 per recipient) of all Medicaid expenditures were spent on smoking-related illnesses.  Lost productivity costs are estimated to be greater than $2.8 billion, or $370 per person. When combined, direct medical and productivity losses cost NC $4.8 billion annually.⁷

The Current Average Cigarette Tax
The current average cigarette tax among all states is 79.2 cents per pack.  North Carolina’s cigarette tax is 5 cents per pack.  North Carolina is ranked 50th among the 50 states plus the District of Columbia; only Kentucky’s tax is lower.  North Carolina’s smoking-caused deaths total $5.90 per pack sold. ⁸  The current tax on smokeless tobacco products is 2 percent of the wholesale price in North Carolina, which is among the lowest nationally. 

The Benefits of a 75-cent Tobacco Tax Increase
A 75-cent per cigarette pack increase in North Carolina would result in:

• Fewer state packs sold per year: -316.6⁸

• Percent decrease in youth smoking: 15.7%⁸

• Fewer future youth smokers: 103,000⁸

• Related lifetime health savings: $1,235 million⁸

• Adult smoker decline: -4.2%⁸

• Fewer adult smokers: 67,000⁸

• Youth Future Smoking Deaths Avoided: 32,900⁸

• Adult Future Smoking Deaths Avoided: 14,700⁸

• 5-year healthcare savings from fewer smoking-affected pregnancies & births: $15.9 million⁸

• 5-year healthcare savings from fewer smoking-caused heart attacks & strokes: $26.7 million⁸

• Long-term healthcare savings in state from declines in adult & youth smoking: $1,788,800,000⁸

• $346.5 million/year in additional revenue.⁸

References:
1 Hopkins, DP & Fielding, JE, 2001. Recommendations Regarding Interventions to Reduce Tobacco Use and Exposure to Environmental Tobacco Smoke. Task Force on Community Preventive Services, Supplement to the American Journal of Preventive Medicine, 20 (2S).
2 Tauras, J, et al., 2001. “Effects of Price and Access Laws on Teenage Smoking Initiation: A National Longitudinal Analysis,” Bridging the Gap Research, ImpacTeen, and other price studies at www.uic.edu/orgs/impacteen.  Chaloupka, F, 1999.  “Macro-Social Influences: The Effects of Prices and Tobacco Control Policies on the Demand for Tobacco Products," Nicotine and Tobacco Research and other price studies at http://tigger.uic.edu/~fjc;  Chaloupka, F & Pacula, R, 1998.  An Examination of Gender and Race Differences in Youth Smoking Responsiveness to Price and Tobacco Control Policies, National Bureau of Economic Research, Working Paper 6541,
Page 3
March 28, 2003

http://tigger.uic.edu/~fjc. Emery, S, et al., 2001. "Does Cigarette Price Influence Adolescent Experimentation?," Journal of Health EconomicsCigarette Taxes and Teen Smoking: New Evidence from Panels of Repeated Cross-Sections, working paper, www.bsos.umd.edu/econ/evans/wrkpap.htm. Harris, J & Chan, S, 1998.  “The Continuum-of-Addiction: Cigarette Smoking in Relation to Price Among Americans Aged 15-29,” Health Economics Letters 2(2): 3-12, www.mit.edu/people/jeffrey. 20:261-270. Evans, W & Huang, L, 1998.
3 Tauras, J, et al., 2001. “Effects of Price and Access Laws on Teenage Smoking Initiation: A National Longitudinal Analysis,” Bridging the Gap Research, ImpacTeen, and other price studies at www.uic.edu/orgs/impacteen.
4  North Carolina State Center for Health Statistics, 2002.  Unpublished data, available upon request.
5 North Carolina State Center for Health Statistics, 2004. NC Behavioral Risk Factor Surveillance System Data (2003).  Current Smoker, www.schs.state.nc.us/SCHS/healthstats/brfss/2003/nc/_rfsmok2.html.
6 Centers for Disease Control and Prevention, 2002. Tobacco Control State Highlights 2002: Impact and Opportunity. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
7 Centers for Disease Control and Prevention, 2002. Tobacco Control State Highlights 2002: Impact and Opportunity. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
8 Campaign for Tobacco Free Kids, 2003.  Benefits from a Cigarette Increase in North Carolina -- 75 cents.  August 13, 2004. Unpublished.  On file.

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Tobacco use is the #1 leading cause of preventable deaths in N.C. 80% of tobacco users start as teenagers $4.75 billion is the estimated cost of smoking to the state annually North Carolina's cigarette excise tax of 5 cents is the second-lowest in the U.S. 1 in 5 deaths in North Carolina each year are due to tobacco-related diseases 33% of high school students in North Carolina currently smoke cigarettes $11 billion was spent by the tobacco industry in 2003 on promotions

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Tobacco-free Schools: 43 and Counting

More and more North Carolina school districts are adopting a 100% tobacco-free school policy banning all tobacco use everywhere on campus, by everyone, at all times. Currently 43 North Carolina school districts have this policy in place.  Twenty-five school districts have adopted the policy in the past two years alone - a 200 percent increase.   School and community teams in seven more school districts will ask their local boards of education to adopt the policy in the next two months. It is indeed a grassroots phenomenon, driven by concerned parents, school staff, public health leaders and youth, which continues to build momentum across North Carolina communities.   Worksites, shopping malls, recreational venues and restaurants in the state are adopting tobacco-free policies; it’s time that all NC schools are 100% tobacco free, as well.

Eliminating access to tobacco products and opportunities for peers and adults on campus to "role model" smoking or chewing tobacco means that fewer students will start.  In fact, research shows that school districts with this policy in place have a 20-40 percent decrease in youth tobacco use. Keeping kids from starting and diminishing exposure to secondhand smoke leads to healthier students.  Healthier students learn better.   It just makes sense.  
 
Today, nearly 600,000 of NC’s 1.3 million students have the advantage of attending school in a 100% tobacco-free school district.   But that’s not good enough.  Our goal is for every North Carolina student to spend each day at a school that offers a safe and healthy learning environment. 

For more information on ways that you can work with your school district to adopt a 100% tobacco-free school policy, visit the Tobacco-Free School Program’s new website at http://nctobaccofreeschools.dph.ncdhhs.gov or call Suzanne DePalma, the Tobacco Free Schools Director, at (919) 715-4409.

Are Light or Low Tar Cigarettes Safer?

 

(As a regular feature in The Voice Box, we address Urban Legends about tobacco that we hear circulating in N.C. and give the real information to correct them. If you have any questions you’d like this column to address, email Julie Helsabeck)
          

Myth:	Switching to lights or low-tar cigarettes is safer than smoking regular  cigarettes.
Reality:	After the Federal Trade Commission (FTC) started to test cigarettes for tar and nicotine content in the late 1960s, cigarette companies began to develop more low-tar, low nicotine cigarette brands.  Entire brand lines were created based on the notion that low tar or low nicotine meant less risk.  Many smokers switched to these brands thinking that they were “healthier,” since tobacco companies’ ads seemingly conveyed a health benefit.  It worked.  More than 80 percent of all cigarettes sold in America today are low-tar brands.  But are they healthier or safer?
	Since these brands were developed, numerous studies have demonstrated that low-tar or light cigarettes have no health benefit.  The National Cancer Institute completed the most comprehensive source outlining the topic in 2001.  This monograph documented that there is no health benefit switching from “full-favor” to “light” or “low-tar” tobacco products.  The truth is that light cigarettes do not reduce the health risks of smoking.  People who switch to light cigarettes are likely to inhale the same amount of hazardous chemicals, and they remain at high risk for developing smoking-related cancers and diseases.  Furthermore, there is no evidence that switching to low/lights helps smokers quit.  The best way for smokers to reduce their risk is to stop smoking. Sources: The Low Tar Myth, 60 Minutes, Originally aired Feb. 20, 2001.  Transcript on file. National Cancer Institute.  Risks Associated with Smoking Cigarettes with Low Machine-Measured Yields of Tar and Nicotine. Smoking and Tobacco Monograph 13. Bethesda, MD: NCI, 2001

   

 

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(Editor’s Note: If you have a web site you would like to recommend, send it to Julie Helsabeck,and we will consider it for a future issue.)

This issue’s website is http://www.questionwhy.org/

Questionwhy.org is the latest addition to the youth advocacy resources provided by the Question Why Youth Empowerment Centers of North Carolina.  There are currently four Question Why Centers:  one in the eastern region, two in the central region and one in the western region.  Question Why is a statewide education, advocacy and training movement that began in January 2001 with funding from the Robert Wood Johnson Foundation and the vision of committed adults from the N.C. Tobacco Prevention and Control Branch and local agencies.  Currently the Question Why Centers are funded through the Health and Wellness Trust Fund to continue to empower youth, organizations and communities to develop skills to become problem solvers, decision-makers, and active participants in creating change in the area of tobacco use prevention. 
The recently launched website is an excellent resource for North Carolina teens and adults who work with teens to get up to date information, tips, tools and practical advice about tobacco use prevention.  Visitors can also see first hand some of the work accomplished by North Carolina teens through articles, graphics, TV and radio clips.

What will you find? 

• The latest training calendars and contact information for each site, as well as a map showing which Question Why Center covers each county.

• A message board for teens to communicate with Question Why youth and adult staff, as well as each other, about tobacco prevention issues and events.
  

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If you have feedback or comments please let us know, OR you can contribute your own story about tobacco prevention and control in N.C. Please send to Julie Helsabeck.