WHO is Smoking and Using Tobacco in Muskegon and Michigan ? Farid Shamo: State Tobacco Control Program shamof@Michigan.gov Who is Smoking/Using Tobacco in Michigan and Muskegon? Smoking Behavior Among ADULTS. Prenatal Smoking in Michigan and Muskegon. Smoking/Tobacco Use Among High School Students.
Tobacco Use in Michigan 20.4% of Michigan adults currently smoke cigarettes (BRFSS-2016) 21.5% of Muskegon adults currently smoke cigarettes BRFS 2014-2016) 10% of Michigan high school students currently smoke cigarettes (YRBS-2015) 7.5% of Muskegon high school students currently smoke cigarettes (YRBS-2015) 23% of Michigan high school students currently use E- Cigarette (YRBS-2015) 17.5% of Muskegon high school students currently use E- Cigarette (YRBS-2015)
Adult smoking prevalence in Muskegon compared to Michigan and USA (BRFSS 2011-2016) 30% Michigan 26% USA 25% 23.8% 23.3% Muskegon 22% 21.4% 21.2% 21.5% 20.7% 20.4% 19.2% 20% 17.5% 17% 15% 10% 5% 0% 2011 2013 2015 2016
Causes of Preventable Death Muskegon County-Michigan Cigarettes 246 Secondhan… 34 Drug… 18 Suicide 16 Auto… 17 Alcohol 17 Tobacco kills more people in Michigan * Homicide 8 than AIDS, alcohol, auto accidents, cocaine, heroin, murders and suicides - AIDS 2 combined . 0 50 100 150 200 250 300 Deaths/ Year * Source: CDC-SAMMEC- 2009 and MDHHS Vital Statistic 2015
Adult Smoking Rates by Educational Levels over the period from 2011-2016 in Michigan (MiBRFSS) and Muskegon 50 46.3 45 42.9 [VALUE]% 39.7 40.3 43.2 40 < HS 39.3 35 30 [VALUE]% 27.4 26.7 26.4 25.8 25.8 25.5 25 HS 20 15 10 College 8.8 8.1 8.8 7.3 7.5 5 [VALUE]% 7.2 0 2011 2012 2013 2014 2015 2016 2016
Adult Smoking Rate by Household Income Level Over the Period From 2011-2016 (MiBRFSS) in Michigan and Muskegon 45 39.9 40 37.5 [VALUE]% 36.4 35.7 35.3 35.5 35 <$20K 30 25 22% 21.6 21.8 21.5 21.3 21 20.6 <$35-49K 20 15 13.2 10 12.2 [VALUE]% >$75K 11 10.9 10.9 10.8 5 0 2011 2012 2013 2014 2015 2016 2016
Adult Smoking Rates By Gender in Michigan and Muskegon – 2016 BRFSS 25 23.6% Male [VALUE]% Female 19.7% 20 18.7 15 10 5 0 Michigan Muskegon
Adult Current Smoking Rates by Populations Disproportionately Impacted by Tobacco Use in Michigan, 2016 Behavioral Risk Factor Survey. State Average = 20.4% HIV-positive person* 41% Low SES 46.2% Native American 40.3% With poor Mental 39.8% Health LGBT 41.4% Uninsured 32.3% Arab American ** 25.6% With disability 28% African American 24.9% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% * HIV Client Survey 2017 ** Arab & Chaldean American Survey 2017
Adult Current Smoking Rate by Age Groups in Muskegon (Red columns) Compared to Michigan - BRFSS 2016 35 [VALUE]% [VALUE]% 30 26.9% 25.3 [VALUE]% 24.9 25 21.8% Muskegon average =21.5% 20 [VALUE]% 15.6% [VALUE]% 15 [VALUE]% 11.4 10 6 [VALUE]% 5 0 18-24 years 25-34 35-44 45-54 55-64 65-74 75+
Smoking Status Among Adults Ever Told They Have Cancer (other than skin cancer)* MiBRFSS 2016 100% 90% 80% 70% 58.2% 60% 50% 41.8% 40% 30% 20% 10% 0% Current and former smokers Never smoked * There is a statistically significant difference between the 2 groups of Cancers .
Smoking Status Among Adults Ever Told They Have Stroke* MiBRFSS 2016 100% 90% 80% 70% 62.7% 60% 50% 37.3% 40% 30% 20% 10% 0% Current and former smokers Never smoked * There is a statistically significant difference between the 2 groups
Smoking Status Among Adults Ever Told They have Heart Attack* MiBRFSS 2016 100% 90% 80% 68% 70% 60% 50% 40% 32.4% 30% 20% 10% 0% Current and former smokers Never smoked * There is a statistically significant difference between the 2 groups
Smoking Status Among Adults Ever Told They Have Diabetes MiBRFSS 2016 100% 90% 80% 70% 60% 55% 50% 45% 40% 30% 20% 10% 0% Current and former smokers Never smoked
Current Smoking Rate Among Adults Reporting Poor Mental Health* Compared to the State Average, Michigan BRFSS 2011-2016 100% Adults With Poor Mental Health 90% State Average 80% 70% 60% 50% 42.9% 40.6% 39.2% 39.8% 38.2% 38.0% 40% 30% 23.3% 23.3% 21.4% 21.2% 20.7% 20.4% 20% 10% 0% 2011 2012 2013 2014 2015 2016 * With Poor Mental Health 14 or More Days of the Past 30 Days.
Current Smoking Rate Among Adults Who are Heavy Alcohol Drinkers* Compared with the State Average, MiBRFSS 2011-2016 100% Adults Who are Heavy Alcohol Drinker 90% State Average 80% 70% 60% 50% 42.2% 39.3% 41.2% 39.0% 36.9% 40% 35.3% 30% 23.3% 23.3% 21.4% 21.2% 20.7% 20.4% 20% 10% 0% 2011 2012 2013 2014 2015 2016 * Heavy Alcohol Drinker = consuming an average of > 2 alcoholic drinks per day for men and > 1 per day for women
Rate of Live Births to Mothers Who Smoked During Pregnancy in Muskegon Compared to Michigan for the years 2007-2016 (MDHHS-Vital Statistics) Muskegon Michigan 32 [Y VALUE]% 29 [Y VALUE]% [Y VALUE]% 26.5 27 [Y VALUE]% [Y VALUE]% [Y VALUE]% [Y VALUE]% % 24.5% 22 19.8 [Y VALUE]% 19.3 [Y VALUE]% [Y VALUE]% [Y VALUE]% 17 17.7 [Y VALUE]% [Y VALUE]% 16% 12 2006 2008 2010 2012 2014 2016 2018
Prevalence of Current Smoking During Pregnancy Among Pregnant Women in Muskegon, Vital Statistics 2011-2016 35 34 33 32 31 30 [VALUE]% [VALUE]% [VALUE]% 29 [VALUE]% 28 [VALUE]% 27 26 [VALUE]% 25 24 23 22 21 20 19 18 17 16 15 14 13 12 2011 2012 2013 2014 2015 2016
Smoking Rates of the Pregnant Women by Age Groups in Michigan. Vital Statistics 2015 30 24.9 25 20 [VALUE]% 15.3 15 11.1 10 5 0 All ages 18-24 Yr 25-34 Yr 35-45Yr
Smoking Rates of the Pregnant Women by Educational Levels in Michigan. Vital Statistics 2015 35 32.4 30 26.8 25 20 17.3 17.3 15 10 5 2.7 0 All Levels Less than High School High School Some College College
Smoking Rates of the Pregnant Women By Their Race in Michigan. Vital Statistics 2015 45 42.3 40 35 30 25 20 18.6 17.3 16.6 15 11.5 10 [VALUE]% 5 2.6 1.9 0 All Races White Black Native Hispanic Asian Arab Other American
Smoking Rates of the Pregnant Women by their Type of Health Insurance Plans in Michigan. Vital Statistics 2015 35 Medicaid 30 28.8 Private insurance 28.4 27.9 25 23.6 20 18.3 15 10 8.9 7.3 6.1 5 0 All ages 18-24 Yr 25-34 Yr 35-45Yr
Infant Mortality Rate in Michigan by Smoking Status of the Mother for the Period from 2010-2015 (per 1000 live births-Vital Statistics) 12 Smoking Mom 10.4 Non-smoker 10 9.5 9.1 8.7 8.7 8.5 8 % 6.4 6.1 6.1 6 5.9 5.8 6 4 2 0 2010 2011 2012 2013 2014 2015
Quitlines are effective and recommended in Pregnancy : Because Pregnant Women does not need to leave her home. Because of social stigma attached to “Smoking during Pregnancy” the Quitline may be the most attractive method. May work very well when there are transportation barriers or mobility issues for some pregnant women. ……………………………. BUT
Number of Successful Intake Calls for Fax Referred Smokers Compared to Unreachable Phones- “ Quitline database 2013- 2016” 2500 2350 Intake calls Unreachable Phones 2000 1602 1500 1287 1114 1000 500 354 194 168 148 0 2013 2014 2015 2016
What can we do to increase reachability and enrollment Educate and train providers: To convince the pregnant to quit, and this will cover the 3 As (Advise, Assess and Assist) To fill out patient’s information completely in the FAX referral form specifically her preferred time to be reached by quitline.. To be sure that patient/client likes and understands the fax referral to quitline . Tell patient/client to expect a call from “1800 -784- 8669” the quitline number next day or so. Ask patient/client to save the quitline number 1(800)-784-8669 in her cell phone as the “Quitline” (When applicable) F ollow up calls to ask about patient/client’s quitting status.
Quitline Prenatal Protocol There are specially trained counselors who have been dedicated to working with prenatal callers Prenatal enrollees will receive 9 counseling calls: - 5 calls prior to delivery and - 4 calls post-partum Prenatal enrollees receive incentives for participation
Quitline Prenatal Incentives Studies have shown that incentives are effective in the prenatal population. Prenatal Calls – For each counseling call an enrollee completes with her coach, she will receive a $5 Visa gift card. (5 in total=$25) Postpartum Calls – For each counseling call completed after delivery, the enrollee will receive a $10 gift Visa gift card . (4 in total=$40) Total incentives = $65 (when complete all 9 calls)
Percentage of Current Cigarette Smoker Among School Students by grade and year of the survey in Muskegon Co. MiPHY 2014 and 2016 14% 7th Grader 13% 9th Grader 12% 11th Grader 10% 8.4% 8% 7% 6.8% 6% 4% 4% 2.1% 2% 0% 2014 2016
Percentage of Current Cigarette Smokers compared to E-cigarette Users By grade of the students in Muskegon, MiPHY 2016 25% Current cigarette smokers E-cigarette user 20% 20% 15.5% 15% 8.4% 10% 6.8% 5.6% 5% [VALUE] 0% 7th grader 9th grader 11th grader
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