Tobacco Free Weld County

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• Tobacco Disparities
• Short History of Tobacco

• 1000 -  Tobacco appears in Mayan Stone Carvings
• 1492 – natives observed smoking tobacco from pipe
• 1550 – Hernando Cortez – Spain -  exporting tobacco to Europe
• 1560 – Nicotine used to treat medical conditions
• 1560’s - Early references to nicotine as an Addictive Drug
• 1604 – James I writes “Counterblaste of Tobacco?
• 1630 – Smoking Prohibited on board sailing Vessels by Christian IV
• Shortly after, repealed due to the addiction of the Sailors
• 1880 before the invention of the cigarette manufacturing machine, smokers averaged only 40 cigarettes per year.
• 1977, the peak of American cigarette consumption almost 13,000 per year. 
• Big Tobacco companies now spend 4 million/week in Colorado alone much of it to “normalize? it in the mainstream culture

Weld County is about 27% Hispanic and Greeley is about 30% Hispanic (Census 2000 data).

DEFINITION OF DISPARITIES:

• Differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States –National Institutes of Health
• Lower level of access to prevention or cessation service programs, tobacco industry targeting and marketing, exposure to SHS, higher rates of use or comb

SWIFT FOCUS GROUP - SPANISH SPEAKING SMOKERS (translated)

• “I believe that yes we are being targeted. In the Latino community, parents don’t talk about smoking. In Latino shops here they sell to children. In Mexico it is very common.?
• “We do not read news papers very often, La Tribuna maybe. (Advertise) also in the Tribune or in the radio maybe. Or announce events and messages on the banner on 8th Ave"
• Tele Azteca,Telemundo, Tele Futuro, Galavision, Univision, telenovelas get message out 
• “You cannot smoke anywhere anyway so we just smoke at home.  We are happy about the smoke free laws because it is protecting our families and other people that don’t smoke."

DATA INDICATES HISPANIC POPULATION:

• Rarely uses Quitline and/or pharmaceutical quitting aids
• Hispanic women-less likely to smoke, but smoking increases with acculturation
• In Colorado 21.5% of Hispanics compared to 19% of whites smoke
• Hispanic men 2x more likely to be exposed to secondhand smoke than white men
• Secondhand smoke also causes significant damage to Latino community health. Latinos are the largest segment of workers in the hospitality industry, which is the
• industry that has the greatest exposure to secondhand smoke.

(Racial and Ethnic Health Disparities in Colorado 2005).;

HIGHSCHOOL GRADUATION MATTERS IN TOBACCO

• Completion of high school, 18.4% smoked
• No diploma, 42.8% smoked
• In Weld County, the Greeley-Evans SD 6 is in the bottom 10% of the state in student achievement 
• Nine out of 12 school districts report a higher graduation rate for white students compared to Hispanic students.

(United Way Data Set and Unequal Tobacco Burdens)

LOW SOCIOECONOMIC STATUS

• Often a characteristic shared by members of these groups
• For those at median income or above in Colorado, 16.7% smoked
• Below the median 27.1% smoked
• At poverty level, 35.7% smoked
• In Weld County, eight percent of families, 12.5% of individuals, 8.5% of older adults and 14.6% of children below poverty 
• People with health insurance 16.2% smoke
• Compare with 41.2% who do not have health insurance and who smoke
• In Weld County 18.9% are not insured compared with the state average of about 15.9%
  (Weld County Communities at a Crossroads and Unequal Tobacco Burdens).

Advocacy groups have also found that tobacco advertising is more common in Latino neighborhoods and at events attended predominantly by Latinos than compared to “non-minority? venues.6 Similarly, both alcohol and tobacco advertising are overly directed at Latino youth, as compared to their non-Hispanic White counterparts. These examples indicate that advertising that targets Latinos is not only a public health issue, but as this article will discuss, due to various forms of discrimination against Latinos, it is also a civil rights issue.

In particular, these types of ads have resulted in serious health consequences that have not been adequately addressed by the legal system to date. It is also legally questionable that the marketing of these products has targeted Latino youth. In addition, aggressive advertising campaigns disparately impact the Latino
community, because it is the race/ethnic group that suffers from the worst health disparities in the United States today. The failure of government entities to regulate marketing and protect Latino consumer rights represents another civil rights issue at stake.

The prevalence of tobacco use is significant because the leading causes of death for Latinos include heart disease, cancer, and pulmonary/respiratory problems.31 Secondhand smoke also causes significant damage to Latino community health. Latinos are the largest segment of workers in the hospitality industry, which is the industry that has the greatest exposure to secondhand smoke.32

Compared to other ethnic groups, Latinos generally have lower smoking rates, more smoke-free homes, and express support for smoke-free laws, but their over-exposure to secondhand smoke in the workplace has caused higher rates of heart disease and lung cancer.

Cigarette smoking is the single most preventable cause of disease and premature death in the U.S. Smoking is related to a variety of  health problems, including cancers, cardiovascular diseases, and respiratory diseases. This is significant, since the leading causes of death for Latinos include heart disease, cancer, and
pulmonary/respiratory problems.264

The Latino community suffers significant health disparities. Tobacco companies should know the severity of health disparities, and that access to health information and health care is markedly lower in the Latino community. Therefore, it is logical and tobacco companies must know that the smoking impacts the Latino community more severely than other communities.

A third negligence argument could be based on implied knowledge of increasing smoking rates upon “acculturation.? Tobacco companies must know that new Latino immigrants smoke less than those who have spent more time in the United States. It is also relevant that new Latino immigrants are younger than the U.S. Latino population, and that these young immigrants are the fastest-growing segment of the booming Latino population.

Doctors play a huge role in whether a person quits tobacco, understands the consequences and receives proper treatment for health problems that result from tobacco us. by Executive Order 13166, issued in 2000 to ensure compliance with Title VI of the Civil Rights Act.109 The Commonwealth Fund reported in 2003 that nearly half of Spanish-speaking Latinos had difficulty communicating with their physicians.110 As the Civil Rights Commission reported in 1999, “lack of interpretive services ultimately results in inequities in treatment and service utilization rates.?111 The Commission also found that reforming structural inequities must include language access and cultural competency, the lack of which are major factors producing health disparities for Latinos, especially in the mental health field.112 Furthermore, according to the U.S. Departments of Health and Human Services (HHS), lack of interpretive services for LEP persons is not only widespread, as U.S. courts have found, it is quite often the pretext for national origin discrimination.113

• RESOURCES CONSULTED
  Colorado Tobacco Attitudes and Behavior Survey (TABS) (2001).
• Hunsaker, J. et al. (2005) Racial and Ethnic Health Disparities in Colorado 2005. Colorado
• Department of Public Health and Environment Office of Health Disparities.
• Levinson, Arnold H. (2002). Unequal Tobacco Burdens: A Report on Colorado Disparities in use and exposures.
• Smoking Facts and Quitting Tips for Hispanics. (March 1992). National Cancer Institute.
• U.S.  Department of Health and Human Services
• Tobacco Control Partners. http://www.tobaccocontrolpartners.org/
• June/July 2006. Quitline and data sets. STEPP.
• Wacker, R. (2005) Weld County Communities at a Crossroad. An Assessment of the Needs & Strengths of Weld County. United Way of Weld County and University of Northern Colorado.
• Weld County Colorado. www.co.weld.co.us. Accessed June/July 2006. Includes Census Data.
• Youth Risk Behavior Survey Report. (2005). Nutrition, Physical Activity and Tobacco Use. Prepared by the Weld County Department of Public Health and Environment