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Surveillance informing policy and practice

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Abstract

Mississippi State University has provided surveillance and evaluation services to Mississippi statewide tobacco control programs since 1999. In addition to informing programmatic decisions and monitoring progress towards outcome objectives, our survey and administrative data have shaped local and state policy decisions and health care practices. This poster illustrates how we have used data from adult surveys to demonstrate strong public support for clean air legislation, increasing state taxes on tobacco, and raising the age of sale for tobacco to 21. To complement public opinion data, we have also used heart attack admissions data and sales tax data to highlight health benefits and debunk loss of revenue myths about smoke-free legislation. We have also utilized tax revenue and per capita sales records to highlight the benefits of increases in the tax on tobacco. In collaboration with stakeholders, we summarized the implications of our analyses and then our graphic designer develops attractive fact sheets and infographics for dissemination to advocates and policy makers. Dissemination strategy involves social media and collaborative distribution to local coalition directors, statewide legislative liaisons from the voluntary health organizations, and other partners within the Mississippi Tobacco Control Network. We also publish research articles in the editor-reviewed Journal of the Mississippi Medical Association in order to educate health care providers on issues related to youth tobacco use, emerging tobacco products, and economic issues associated with smoke-free local ordinances. Finally, we actively inform local and statewide policy decisions through invited testimony to legislative meetings and local hearings.
informing
surveillance
policy + practice
i n m i s s i s s i p p i
Mississippi State University has provided surveillance
and evaluation services to Mississippi statewide tobacco
control programs since 1999. In addition to informing
programmatic decisions and monitoring progress towards
outcome objectives, our survey and administrative data
have shaped local and state policy decisions and health
care practices. This poster illustrates how we have used
data from adult surveys to demonstrate strong public
support for clean air legislation, increasing state taxes on
tobacco, and raising the age of sale for tobacco to 21. To
complement public opinion data, we have also used heart
attack admissions data and sales tax data to highlight
health benets and debunk loss of revenue myths about
smoke-free legislation. We have also utilized tax revenue
and per capita sales records to highlight the benefits of
increases in the tax on tobacco.
In collaboration with stakeholders, we summarized
the implications of our analyses and then our graphic
designer develops attractive fact sheets and infographics
for dissemination to advocates and policy makers.
Dissemination strategy involves social media and
collaborative distribution to local coalition directors,
statewide legislative liaisons from the voluntary health
organizations, and other partners within the Mississippi
Tobacco Control Network. We also publish research
articles in the editor-reviewed Journal of the Mississippi
Medical Association in order to educate health care
providers on issues related to youth tobacco use, emerging
tobacco products, and economic issues associated with
smoke-free local ordinances. Finally, we actively inform
local and statewide policy decisions through invited
testimony to legislative meetings and local hearings.
{i n t r o d u c t i o n }
August 6, 1996 | West
October 2007 | Greenville
November 15, 2007 | McComb
January 10, 2008 | Summit
May 1, 2008 | Gulfport
July 31, 2008 | Walls
January 6, 2010 | Columbus
Partial Smoke-free
C O M M U N I T I E S
in Mississippi
There
Metcalfe
maYersville
S T A R K V I L L E
Tupelo
Oxford mantachie
hattiesburg
ridgeland
kosciusko
Amory
Aberdeen
h e r n a n d o
Corinth
Petal
Flora
Ecru
Pontotoc
COLLI NS
Clinton
Laurel
greenwood
Grenada
Hollandale
Meridian
Batesville
bassfield
Prentiss
Crystal Springs
l u m b e r t o n
Madison
Sumrall
Jackson
Belzoni
W E S S O N
Pearl
JO N ESTO WN
F L O W O O D
Mathiston
marks
C A L H O U N C I T Y
brookhaven
CENTREVILLE
R O L L I N G F O R K
new albany
Byram
monticello
Canton
anguilla
Georgetown
Durant
verona
booneville
A R C O L A
S H U Q U A L A K
New Augusta
Moss Point
D U N C A N
sumner
Alligator
forest
Ethel
I N D I A N O L A
Cary
moorhead
lucedale
Wiggins
B A L D W Y N
PLANTERSVILLE
pascagoula
okolona
Woodville
W A L N U T
magee
Morton
bruce
Itta Bena
F R I A R S
P O I N T
FARMINGTON
louisville
M E N D E N H A L L
Southaven
sledge
P I C A Y U N E
Crawford
June 3, 2010 | Goodman
October 5, 2010 | Rienzi
June 2011 | Olive Branch
June 6, 2012 | Vaiden
July 3, 2014 | Gautier
OF WHICH HAVE ORDINANCES
THAT INCLUDE RESTRICTIONS ON
E L E C T R O N I C C I G A R E T T E S
*90
DUCK HILL
Weir
CLARKSDALE
I S O L A
Senatobia
Beulah
poplarville
Iuka
Walnut Grove
Nettleton
Tutwiler
PITTSBORO
COURTLAND
Brandon
Fayette
Sidon
100% Smoke-free
C O M M U N I T I E S
in Mississippi
u p da t e d
|
m a r c h
2017
132
are
Smoke-Free
c o m m u n i t i e s
i n m i s s i s s i p p i
BRO O KSVI LLE
state line
Noxapater
FLO R ENCE
2017 mississippi tobacco data
pickens
Saltillo
Macon
HOLLY SP RI NGS
Charleston
LEXINGTON
Drew
Lyon
E L L I S V I L L E
Louise
Diamondhead
Coahoma
COLDWATER
eden
CRUGER
LEAKESVILLE
Shubuta
Artesia
shaw
Tchula
HO U STON
Lula
RENOVA
Utica
MAGNOLIA
Woodland
Sebastopol
edwards
Robert McMillen | Emily McClelland | Nell Valentine
Mississippi Social Climate Survey of Tobacco Control
Survey of Mississippi Restaurants
Hospital Discharge Data
Mississippi Department of Revenue
Medicaid
{d a t a s o u r c e s }
s u p p o r t i n g
s m o k e -f r e e i n i t i a t i v e s
designed by: miranda robertson
mstobaccodata.org
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%
Overall
18-20 Year Olds
Current Smoker
Former Smoker
Never Smoker
Independent
Democrat
Republican
74.9%
48.5%
63.2%
70.1%
80.3%
67.8%
82.7%
72.9%
theage
ofsale
for tobacco
inmississippi
21
to
75%
of Mississippi
Adults
support this policy
Public Support among MS Adults
{for Raising Age of Purchase to 21}
Cities and states across the United States
have raised or are considering raising the
age of purchase for tobacco to 21.
This policy
decreases teen
smoking by
making it harder
to get tobacco
products for
minors.
Raising the age
of purchase is
effective because
it puts legal
purchasers
outside high
school students’
social networks.
This study demonstrates broad public support for raising the sales age of tobacco to 21 among Mississippi adults.
2 017 m i s s i s s i p p i tob a c c o d a t a
DATE OF ORDINANCE
*
AVERAGE % CHANGE
(DURING THE SAME
PERIOD) IN THE
AGGREGATED NO -
ORDINANCE COMPARI -
SON COMMUNITIES
% CHANGE IN SMOKE-
FREE COMMUNITIES
LOCATION DIFFERENCE
ABERDEEN
BALDWYN
BATESVILLE
BRANDON
CANTON
CLINTON
CORINTH
FLORENCE
FLOWOOD
GREENWOOD
GRENADA
HATTIESBURG
HOLLY SPRINGS
INDIANOLA
JACKSON
KOSCIUSKO
LAUREL
MAGEE
MOSS POINT
NEW ALBANY
OXFORD
PASCAGOULA
PEARL
PICAYUNE
PONTOTOC
RIDGELAND
STARKVILLE
TUPELO
TOTAL
3/22/2007
7/5/2013
3/4/2010
6/3/2015
1/19/2012
8/14/2008
11/6/2007
8/19/2012
5/4/2011
8/16/2007
4/8/2009
1/1/2007
10/1/2015
11/7/2012
7/1/2010
11/1/2007
12/4/2008
11/19/2013
6/14/2012
12/1/2011
11/16/2006
7/18/2013
9/1/2010
7/17/2014
5/1/2008
7/19/2007
5/20/2006
10/5/2006
6.66%
-3.68%
9.27%
8.19%
15.91%
32.04%
-2.93%
3.18%
5.95%
4.16%
3.29%
-3.31%
5.00%
-6.35%
-2.96%
-16.86%
5.60%
12.66%
2.49%
3.95%
-0.44%
-16.38%
4.81%
6.51%
32.64%
8.30%
5.14%
5.58%
4.94%
-2.45%
0.67%
3.77%
-3.75%
3.45%
-4.81%
1.54%
1.14%
-2.34%
5.42%
-5.95%
-0.71%
-5.42%
0.95%
4.42%
1.54%
-4.84%
-3.58%
2.16%
-0.11%
-5.80%
5.34%
2.14%
-3.64%
-4.44%
2.89%
-4.72%
-5.91%
-0.89%
9.12%
-4.35%
5.50%
11.95%
12.46%
36.84%
-4.47%
2.04%
8.29%
-1.25%
9.24%
-2.60%
10.42%
-7.30%
-7.38%
-18.40%
10.44%
16.25%
0.33%
4.06%
5.37%
-21.72%
2.68%
10.15%
37.08%
5.40%
9.86%
11.49%
5.83%
*
STUDY PERIOD:
12
MONTHS BEFORE THE ORDINANCE AND
12
MONTHS AFTER THE ORDINANCE
Economic Effects of Smoke-Free
Ordinances in Mississippi Communities:
a n e X a m i n a t i o n o f t o u r i s m
&
e c o n o m i c d e v e l o p m e n t t a X r e v e n u e s
This table presents the infl ation-adjusted pre- and post-ban data for the Mississippi communities that have comprehensive
smoke-free ordinances, collect a TED tax, and have at least 12 months of post-ban data . The percentage change in revenue
for these towns ranges from -17% to 33%. As other researchers have noted, this wide range refl ects the volatile nature of the
restaurant and hospitality industries, due to seasonality and turnover in businesses. Also, the largest percentage changes occurred
in the smaller communities.
For the communities with smoke-free ordinances as a whole, infl ation-adjusted TED tax
revenue was 4.94% greater in the 12 months following the enactment of a smoke-free
ordinance. Conversely, there was no meaningful change in TED tax revenue in the aggregated control communities (-0.06%).
1
N O V E M B E R
2 0 1 6
2016 mississippi tobacco data
Tobacco Data
M I S S I S S I P P I
2 0
1 2
The Starkville & Hattiesburg Heart Attack Studies
R E D U C T I O N S I N H E A R T A T T A C K A D M I S S I O N S F O L L O W I N G
T H E I M P L E M E N T A T I O N O F L O C A L S M O K E -F R E E O R D I N A N C E S
JANUARY 2012
Starkville implemented a comprehensive smoke-free ordinance that prohibited
smoking inside of all indoor public places on May 20, 2006. Seven months later,
Hattiesburg implemented a similar comprehensive ordinance on January 1, 2007.
Findings from controlled observational studies demonstrate that hospital admissions
for heart attacks in both Starkville and Hattiesburg decreased substantially following
the implementation of the smoke-free ordinances. Moreover, the observed decrease in
these communities was much higher than that observed in control communities that did
not have a smoke-free ordinance.
ROB E RT M C MI L LE N , P H D
|
AN N A H I LL , M P P, M P H
|
NE L L VAL E NT I NE, MS
|
ROB E RT C O LL I NS , MD
S T A R K V I L L E
| 2 7 . 7 %
R E D U C T I O N I N H E A R T A T T A C K
A D M I S S I O N S , C O S T S A V I N G S O F
$ 2 8 8 , 2 7 0 .
H A T T I E S B U R G
| 1 3 . 4 %
R E D U C T I O N I N H E A R T A T T A C K
A D M I S S I O N S , C O S T S A V I N G S O F
$ 2 , 3 6 7 , 9 0 9 .
2016 Mississippi Social Climate
S U P P O R T F O R S M O K E F R E E A I R
|
M A R C H
2 0 1 7
Results from the most recent Social Climate Survey
demonstrate strong support for smoke-free air in Mississippi.
Survey of Tobacco Control
Would you favor or oppose a law in Mississippi prohibiting smoking in
most public places, including workplaces, offices, restaurants, and bars?
Favor a Smoke-Free Law
Oppose a Smoke-Free Law
Neither
75.2%
21.0%
3.8%
2017 mississippi tobacco data
MS
SCS
-
TC
2016
]
]
More than three-quarters of Mississippi adults (75.2%) favor a
state law prohibiting smoking in most indoor places, including
workplaces, public buildings, offi ces, restaurants, & bars.
Only 21.0% of Mississippi adults oppose a state law.
52.1% of smokers support a state law compared to
only 42.9% who are opposed.
Republicans (79.5%) and Democrats (75.5%) are
equally supportive of a state law.
Tobacco Data
m i s s i s s i p p i
MedicaidCosts SecondhandSmoke
&
0
14
2
attributable
population risk total costs
population - birth to age 17
low birth weight codes -
icd codes that begin with 765
acute lower respiratory illness
(birth to age 5 only) - icd codes
that begin with 480-488, 466
otitis media and middle ear effusion -
icd codes that begin with 382
asthma - icd codes that begin with 493
population - ages 18+
heart attacks and other heart diseases -
icd codes that begin with 410
lung cancer - icd codes
that begin with 162
18.0%
25.0%
14.0%
35.0%
6.9%
4.9%
$85,240,444
$28,551,853
$16,501,901
$28,344,206
$12,149,244
$12,204,636
$15,343,280
$7,137,963
$2,310,266
$9,920,472
$838,298
$598,027
$182,992,283 $36,148,306
costs attributable
to exposure to
secondhand smoke
{• AccordingtotheU.S.SurgeonGeneral,ournation’sleadingauthorityonhealth,thescientific
evidenceindicatesthatthereisnorisk-freelevelofexposuretosecondhandsmokeandeliminating
smokinginindoorspacesfullyprotectsnonsmokersfromexposuretosecondhandsmoke1.
• MostMississippiadultssupportastatewidelawinMississippiprohibitingsmokinginmostpublic
places,includingworkplaces,ofces,restaurants,andbars( 7 7. 3 % ) , whileonly14.7%oppose
suchalaw2.
• Moreover,arecentsurveyofMississippirestaurantownersandmanagersfoundthat69.9%of
restaurateurssupportthislaw,whilelessthan20percent(18.7 )oppose3.
dates of service: 07/01/2012 - 06/30/2013 specified diagnosis present in either the principle
diagnosis field or other diagnosis codes 1-4 positions
Tobacco Data
M I S S I S S I P P I
Support for Smoke-Free Air in Mississippi
A M O N G R E S T A U R A N T O W N E R S
&
M A N A G E R S
69.9%
18.7%
r e s t a u r a n t s i n m s
72.4%
17.1%
m s r e s t a u r a n t
&
h o s p i t a l i t Y
a s s o c i a t i o n m e m b e r s
69.9% of restaurants would favor a law in Mississippi that would prohibit smoking in restaurants.
Only 18.7% of restaurants would oppose a law in Mississippi that would prohibit smoking in restaurants.
72.4% of Mississippi Restaurant and Hospitality Association members would favor a law in Mississippi that would
prohibit smoking in restaurants.
Only 17.1% of Mississippi Restaurant and Hospitality Association members would oppose a law in Mississippi
that would prohibit smoking in restaurants.
64.4% of restaurants that do serve alcohol would favor a law in Mississippi that would prohibit smoking in restaurants.
Only 23.3% of restaurants that do serve alcohol would oppose a law in Mississippi that would prohibit smoking
in restaurants.
n=945 n=340
64.4%
23.3%
r e s t a u r a n t s i n m s
t h a t s e r v e a l c o h o l
n=472
0
13
2
The Mississippi(Tax)Experience
Packs Sold | 2008-2015
Revenues Collected | 2008-2015
These data from tax records clearly demonstrate that following the 2009 increase in the state cigarette tax, the number
of packs of cigarettes sold in Mississippi decreased by more than 30%, while tax revenue from cigarette sales almost tripled.
The average state cigarette tax is currently $1.63 and Mississippi’s tax ranks 39th.
The Mississippi Legislature increased the state cigarette tax from 18 cents to 68 cents on May 15, 2009.
July 2016
2016 mississippi tobacco data
2008 2009 2010
0
50
100
150
200
250
300
273,100,000 263,100,000
207,400,000 201,600,000
2011
198,200,000
2012
190,800,000
2013
183,100,000
2014
t a X i n c r e a s e - m a Y
15 , 2 00 9
187,300,000
2015
0
$50
$100
$150
$200
$49,153,000
$67,920,000
$141,054,000 $137,064,000
$134,744,000
$129,739,000
$124,474,000
15 , 2 00 9
$250
$127,365,000
{s u c c e s s e s }
s u p p o r t i n g
s m o k e -f r e e i n i t i a t i v e s
support for raising the age
of sale of tobacco to 21
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