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(A Program of the Division of Addiction Services)
Prevention Services Unit

Strategic Plan For A Comprehensive
Tobacco Control Program

Problem Statement

 

Tobacco is addictive; nearly 70% of smokers want to quit, but less than 3% of those who want to quit are successful each year.6

Therefore, a key strategy for limiting tobacco use is to focus on preventing the initial addiction. Since the data indicate that youth comprise a disproportionate share of all new smokers, persons under the age of 18 are the key target population for prevention strategies.

According to a 1997 survey by the Centers for Disease Control and Prevention (CDC), more than one in five adults in New Jersey smoke cigarettes (21.5%).7 Even more disturbing is the significant number of youth who smoke, many of whom will become addicted to tobacco products. The significance of smoking by youth is great enough that former Surgeon General Kessler classified smoking as a "pediatric disease." This classification was undoubtedly based on the knowledge that more than four out of five (82%) adults who ever smoked had their first cigarette by age 18 and three out of five (60%) of current smokers started before age 14.8 In 1996, the New Jersey Department of Law and Public Safety (DLPS) surveyed high school students and found that 18.5% of all high school seniors use tobacco on a daily basis; almost 40% use it on a monthly basis.9 Use of tobacco among youth is not limited to high school students. In 1995 the New Jersey Department of Health and Senior Services (DHSS) surveyed middle school students and found that one in four eighth graders (24%) were using tobacco on a monthly basis.10 Nationally, the percentage of twelfth graders who report that they smoke is increasing, although the percentages for eighth and tenth graders are decreasing.11

Studies are beginning to show that the percentage of college students who smoke is increasing. The percentage of U.S. College students who reported smoking cigarettes in the past year increased from 31.6% in 1993 to 39.5% in 1997.12 Now that the tobacco companies are expected to refrain from marketing to adolescents, they may target their advertising to college age youth.

Nationally, the prevalence of smoking among minority populations has decreased over the past 20 years. However, during the 1990s, the rate of increase for African American and Hispanic adolescents has been much greater than for white adolescents.13 While African American adolescents smoke less than their white and Hispanic counterparts, the rate of increase of tobacco use between 1991 and 1997 for African American adolescents nationally was 80% as compared to the increase for white adolescents (28%) or Hispanic adolescents (34%).14 As the rate of smoking has declined for the overall population, tobacco companies have targeted their products more aggressively to African Americans and Hispanics as a way to increase their market share.15,16 Studies show minority populations in the United States have higher rates of tobacco-related illness than whites.17 The increased tobacco advertising targeting minority populations combined with higher rates of illness for these same populations needs to be addressed as part of the overall comprehensive tobacco plan for New Jersey.

Tobacco use adversely affects the health of New Jersey's residents. One out of three smokers will die prematurely, with an average of 12 to 15 years of potential life lost as compared to normal life expectancy.18 In addition to shortening an individual's life, smoking can also reduce the quality of life. Smokers are more than twice as likely as non-smokers to develop dementia and Alzheimer's diseases.19 Encouraging adults to seek treatment for smoking can help them to continue functioning at the highest level possible. Quitting smoking has proven health benefits, even at later ages when it can significantly cut the risk of heart disease, stroke and lung disease.

Although preventing the initiation of tobacco use is preferred to needing to provide treatment to users who want to quit, interventions must also be available for those who currently smoke and need support for their efforts to quit. Research indicates that significant reductions in morbidity and mortality can be achieved when individuals who use tobacco stop using it. However, since the treatment of tobacco addiction is characterized by relapse, and no one intervention works for all users, a range of interventions should be available.

The deleterious effects of smoking are not limited to the individual who smokes. People are indoors nearly 90% of the time. For both smokers and non-smokers, exposure to environmental tobacco smoke (ETS) is a health hazard. Exposure to ETS increases nonsmokers' risk for lung cancer and heart disease. Among children, ETS is also associated with diabetes as well as serious respiratory problems including asthma, pneumonia and bronchitis.20,21,22,23 Additionally, substantial evidence now links ETS with sudden infant death syndrome (SIDS) and low birth weight among newborns.24,25 In New Jersey, low birth weight and SIDS are two of the three leading causes of death of infants.26


This document may only be reproduced in its entirety. No portion of this document may be reproduced without the permission of the New Jersey Department of Health and Senior Services.

1999 New Jersey Department of Health and Senior Services.

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