@article{Chung_Coleman_OLUWAYOMI_Lloyd_Bicego_2017, title={The Role of Tobacco Surveillance to obtain Policy, Systems, and Environmental Changes}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7664}, DOI={10.5210/ojphi.v9i1.7664}, abstractNote={<div style="left: 76.9091px; top: 291.193px; font-size: 12.1061px; font-family: sans-serif; transform: scaleX(1.08245);" data-canvas-width="54.50148484848485">Objective</div><div style="left: 89.7273px; top: 303.97px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.96525);" data-canvas-width="324.7099681818182">To analyze tobacco use in Georgia to influence policy, systems</div><div style="left: 76.9091px; top: 318.212px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.950608);" data-canvas-width="337.14894545454547">and environmental changes as tools to reduce its burden on health</div><div style="left: 76.9091px; top: 332.455px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.00149);" data-canvas-width="46.4025303030303">outcomes</div><div style="left: 76.9091px; top: 359.557px; font-size: 12.1061px; font-family: sans-serif; transform: scaleX(1.11939);" data-canvas-width="70.61465151515151">Introduction</div><div style="left: 89.7273px; top: 372.333px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.00783);" data-canvas-width="323.5962106060606">Tobacco use is the leading cause of preventable illness and deaths</div><div style="left: 76.9091px; top: 386.576px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.980561);" data-canvas-width="338.21185757575745">in Georgia. About 10.1% of deaths among adults in Georgia are</div><div style="left: 76.9091px; top: 400.818px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.990662);" data-canvas-width="335.88386212121213">linked to smoking related illnesses. Most first use of cigarettes occurs</div><div style="left: 76.9091px; top: 415.061px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.02326);" data-canvas-width="336.75428787878786">by age 18 (87%), with nearly all-first use by 26 years of age (98%).</div><div style="left: 76.9091px; top: 429.303px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.974558);" data-canvas-width="337.3595909090912">Although cigarette smoking has declined significantly since 1964,</div><div style="left: 76.9091px; top: 443.545px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.985011);" data-canvas-width="333.60671212121235">very large disparities in tobacco use remain across different sub-</div><div style="left: 76.9091px; top: 457.788px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.991772);" data-canvas-width="335.8802303030302">groups of the population. Multiple environmental, psychological, and</div><div style="left: 76.9091px; top: 472.03px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.01892);" data-canvas-width="336.88866515151506">social factors have been associated with tobacco use, including race</div><div style="left: 76.9091px; top: 486.273px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.979194);" data-canvas-width="337.6586106060604">and ethnicity, age, SES, educational accomplishment, gender, and</div><div style="left: 76.9091px; top: 500.515px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.01119);" data-canvas-width="336.6743878787879">sexual orientation. These factors within the social environment have</div><div style="left: 76.9091px; top: 514.758px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.980374);" data-canvas-width="335.7615909090907">a huge influence on motivation to begin and to continue using tobacco</div><div style="left: 76.9091px; top: 529px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.998337);" data-canvas-width="336.19014545454536">products for not just the individual but also certain community group</div><div style="left: 76.9091px; top: 543.242px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.97674);" data-canvas-width="337.463703030303">within the population. Established in 2000, Georgia Tobacco Use</div><div style="left: 76.9091px; top: 557.485px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.977424);" data-canvas-width="338.09079696969695">Prevention Program (GTUPP) is a program designed to meet the</div><div style="left: 76.9091px; top: 571.727px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.0246);" data-canvas-width="337.0932575757576">overall goal of reducing the health and economic burden associated</div><div style="left: 76.9091px; top: 585.97px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.987942);" data-canvas-width="335.88386212121213">with tobacco use for all members of the community. By working with</div><div style="left: 76.9091px; top: 600.212px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.980828);" data-canvas-width="337.4867045454544">various partners, GTUPP plans, implements and evaluates policy,</div><div style="left: 76.9091px; top: 614.455px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.992149);" data-canvas-width="333.46143939393966">systems, and environmental changes designed to reduce tobacco-</div><div style="left: 76.9091px; top: 628.697px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.981578);" data-canvas-width="337.842622727273">related illnesses and deaths. Best practice strategies focus on the</div><div style="left: 76.9091px; top: 642.939px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.0037);" data-canvas-width="338.3643939393941">following goals: preventing the initiation of tobacco use among</div><div style="left: 76.9091px; top: 657.182px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.964537);" data-canvas-width="337.5557090909091">young people; promoting quitting among young people and adults</div><div style="left: 76.9091px; top: 671.424px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.00882);" data-canvas-width="338.28933636363655">(e.g. Georgia Tobacco Quit Line (GTQL); eliminating exposure</div><div style="left: 76.9091px; top: 685.667px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.960412);" data-canvas-width="337.29663939393924">to secondhand tobacco smoke; and identifying and eliminating the</div><div style="left: 76.9091px; top: 699.909px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.0016);" data-canvas-width="326.48834848484836">disparities related to tobacco use among various population groups.</div><div style="left: 76.9091px; top: 727.011px; font-size: 12.1061px; font-family: sans-serif; transform: scaleX(1.07452);" data-canvas-width="49.768015151515144">Methods</div><div style="left: 89.7273px; top: 739.788px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.07939);" data-canvas-width="327.64931969696977">The following data collection tools were used to educate</div><div style="left: 76.9091px; top: 754.03px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.0031);" data-canvas-width="338.47940151515144">community members, local coalition groups and policy decision</div><div style="left: 76.9091px; top: 768.273px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.973287);" data-canvas-width="337.7954090909091">makers on the burden of tobacco use in Georgia: Youth Tobacco</div><div style="left: 76.9091px; top: 782.515px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.976548);" data-canvas-width="335.8511757575757">Survey (YTS), Youth Risk Behavioral Survey (YRBS) and Behavioral</div><div style="left: 76.9091px; top: 796.758px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.995065);" data-canvas-width="336.06666363636367">Risk Factor Surveillance System (BRFSS). These tools allows public</div><div style="left: 76.9091px; top: 811px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.96864);" data-canvas-width="337.3450636363638">health professionals to create messaging needed to reach different</div><div style="left: 76.9091px; top: 825.242px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.978287);" data-canvas-width="338.047215151515">stakeholders. The following are examples of key data points that</div><div style="left: 76.9091px; top: 839.485px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.03677);" data-canvas-width="337.1392606060606">were used to influence policy, systems, and environmental change:</div><div style="left: 76.9091px; top: 853.727px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.991668);" data-canvas-width="336.0267136363636">27,000 of middle school students and 79,000 of high school currently</div><div style="left: 76.9091px; top: 867.97px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.995324);" data-canvas-width="336.0545575757575">use tobacco (cigarettes, smokeless tobacco or cigars). Approximately</div><div style="left: 76.9091px; top: 882.212px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.00468);" data-canvas-width="336.43347727272726">32,400 of middle school students and 72,900 of high school students</div><div style="left: 76.9091px; top: 896.455px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.01876);" data-canvas-width="338.87284848484836">say they have tried smoking electronic cigarettes (e-cigarettes).</div><div style="left: 76.9091px; top: 910.697px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.00501);" data-canvas-width="338.486665151515">Smoking prevalence among adult males 740,000 is significantly</div><div style="left: 76.9091px; top: 924.939px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.03935);" data-canvas-width="339.29656060606044">higher than among females 510,000, and the overall smoking</div><div style="left: 76.9091px; top: 939.182px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.00149);" data-canvas-width="303.2689242424242">prevalence is highest among adults’ ages 25-34 years 292,000.</div><div style="left: 76.9091px; top: 966.284px; font-size: 12.1061px; font-family: sans-serif; transform: scaleX(1.08549);" data-canvas-width="43.72709090909091">Results</div><div style="left: 89.7273px; top: 979.061px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.970577);" data-canvas-width="324.83587121212116">Currently, the following policies have been adopted as a result</div><div style="left: 76.9091px; top: 993.303px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.04041);" data-canvas-width="333.5038106060604">of using surveillance to educate policy decision makers and multi-</div><div style="left: 76.9091px; top: 1007.55px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.991389);" data-canvas-width="338.2784409090908">sector groups in the community at large: 116 school district are</div><div style="left: 76.9091px; top: 1021.79px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.996475);" data-canvas-width="336.1441424242425">100% tobacco free, 28 parks and recreation are 100% tobacco/smoke</div><div style="left: 76.9091px; top: 1036.03px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.973989);" data-canvas-width="337.909206060606">free, 46 colleges/universities are tobacco free, 6 cities in Georgia</div><div style="left: 435.818px; top: 289.727px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.984333);" data-canvas-width="338.00363333333325">have a comprehensive smoke free air law, 65 multi-unit housing</div><div style="left: 435.818px; top: 303.97px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.03273);" data-canvas-width="336.87776969696966">(private/public) are smoke free, and 132 hospitals are tobacco free.</div><div style="left: 435.818px; top: 318.212px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.978972);" data-canvas-width="337.8922575757577">Between June 2015 and July 2016, over 15,000 Georgia tobacco</div><div style="left: 435.818px; top: 332.455px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.00289);" data-canvas-width="336.369315151515">users used the GTQL services to make a quit attempt, and healthcare</div><div style="left: 435.818px; top: 346.697px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.02587);" data-canvas-width="337.11746969696935">providers through a systems change referral approach referred 13%</div><div style="left: 435.818px; top: 360.939px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.00122);" data-canvas-width="124.4018787878788">of the users to the GTQL.</div><div style="left: 435.818px; top: 388.042px; font-size: 12.1061px; font-family: sans-serif; transform: scaleX(1.10408);" data-canvas-width="72.6484696969697">Conclusions</div><div style="left: 448.636px; top: 400.818px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.08251);" data-canvas-width="327.85633333333305">Working with schools (K-12), parks, colleges/universities,</div><div style="left: 435.818px; top: 415.061px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.05427);" data-canvas-width="339.7904878787878">hospitals, worksites, and municipalities to adopt tobacco free</div><div style="left: 435.818px; top: 429.303px; font-size: 12.1061px; font-family: serif; transform: scaleX(1.00585);" data-canvas-width="338.4007121212124">policies and promote cessation services provides an opportunity</div><div style="left: 435.818px; top: 443.545px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.951889);" data-canvas-width="337.2542681818183">for all members of the community to be tobacco free. As tobacco</div><div style="left: 435.818px; top: 457.788px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.970592);" data-canvas-width="337.68524393939384">use is associated with chronic diseases it is imperative to engage</div><div style="left: 435.818px; top: 472.03px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.982137);" data-canvas-width="338.035109090909">all members of the community in tobacco free living. Removing</div><div style="left: 435.818px; top: 486.273px; font-size: 12.1061px; font-family: serif; transform: scaleX(0.983077);" data-canvas-width="337.9164696969696">avoidable structural and social barriers and equally implementing</div>tobacco use prevention programs and policies is essential.}, number={1}, journal={Online Journal of Public Health Informatics}, author={Chung, Alina and Coleman, Anne-Marie and OLUWAYOMI, FABAYO and Lloyd, Kayla and Bicego, Emma}, year={2017}, month={May} }