CDC's Tobacco Use

Prevention Program:

Working Toward a Healthier Future



For more information, please contact the Centers for Disease Control and Prevention, National Center for-Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, ail Stop K-50, 4770 Buford Highway, Atlanta, GA 30341-3724,(770) 488-5705

Internet: http:Hwwiv.cdc.govlnccdpliploshltobacco.htm

1-800-CDC- 1311

"One of the most important things we can do to strengthen our families, cherish our
children, and give every single one of our young people the childhood that he or she
deserves is to protect our children from what is rapidly becoming the single greatest threat
to their health - cigarette smoking and tobacco addiction."

President Clinton, State of the Union Address, 1996


Public Health Service

Tobacco Use in the United States

Since the release of the first Surgeon General's Report in 1964, the scientific knowledge about the health consequences of tobacco use has greatly increased. It is now well documented that smoking cigarettes causes heart disease, lung and esophageal cancer, and chronic lung disease. Cigarette smoking contributes to cancer of the bladder, pancreas, and kidney. Consequences of using smokeless tobacco include cancer of the gum. mouth, pharynx, larynx, and esophagus.

Studies have also demonstrated that women who use tobacco during pregnancy are more likely to have adverse birth outcomes, including low birth weight babies. Low birth weight is a leading cause of death among infants.

Studies also indicate that nonsmokers are adversely affected by environmental tobacco smoke. Researchers have identified more than 4,000 chemical compounds in tobacco smoke; of these, at least 43 cause ancer in humans and animals. Each year, because of exposure to environmental tobacco smoke, an estimated 3,000 nonsmoking Americans die of lung cancer, and 300,000 children suffer from lower respiratory tract infections.

In 1993, smoking-related illnesses
cost the nation $50 billion in
direct health care costs.

Particularly alarming is the fact that more than 3 million young people under age 18 smoke half a billion cigarettes each year and that more than one-half of them consider themselves dependent upon cigarettes. The decision to use tobacco is nearly always made in the teen years, and about one-half of young people usually continue to use tobacco products as adults.

... and that reinforces the evidence of health risks from exposure to environmental tobacco smoke. Public health efforts to reduce tobacco use in the United States have evolved as federal, state, and local government agencies and numerous health organizations have joined together to design and develop prevention activities.

The majority of tobacco control activities focus on six key components:

Key Elements of CDC's Tobacco Control Program

Efforts to reduce tobacco use in the United States have undergone a shift from a primary focus on smoking cessation interventions for individual smokers to broader population-based interventions that prevent tobacco use, that encourage and motivate people to quit smoking

Economic incentives

Product regulation

The Centers for Disease Control and Prevention (CDC) stimulates, supports, and coordinates tobacco control activities that reflect these key components. Central to its role is providing technical assistance to other federal agencies, state health departments, national organizations, and public health profession, als. The mission of CDC's tobacco control program is to lead and coordinate strategic activities that prevent tobacco use and to reduce exposure to environmental tobacco smoke.

These activities are designed to reach multiple populations, particularly high-risk groups, such as youth, minorities, blue-collar workers, individuals with low socioeconomic status, and women.

Tobacco use causes approximately
one of every five deaths in the
United States and is the single most
preventable cause of death and
disease in our nation.

Tobacco Control Framework

Expanding the Science Base. CDC strengthens and expands the scientific foundation of tobacco control by examining trends, patterns, health effects, and the economic costs associated with tobacco use. For example:

* The Surgeon General's reports document comprehensive, scientific information on cigarette smoking and smokeless tobacco use. Recent reports have addressed tobacco use among adolescents and among special populations.

* CDC's Morbidity and Mortality Weekly Reports (MMWR) serve as a major outlet for surveillance of and research on tobacco use on such topics as state laws on tobacco use and trends in smoking initiation among youth.

* CDC's Smoking-Attributable Mortality, Morbidity, and Economic Cost (SAMMEC) software, a computer program designed to estimate deaths, disease impact, and costs related to smoking, provides essential information for state-based tobacco control programs as well as Surgeon

Generat's reports, MMWR articles, and responses to public inquiries.

Building Capacity to Conduct Programs. CDC strengthens national tobacco control efforts through its strategic partnerships with all states, U.S. teff itoties, and national organizations. For example:

Through its IMPACT (Initiatives to Mobilize for the Prevention and Control of Tobacco Use) program, CDC supports 32 states and the District of Columbia to implement state tobacco control programs. CDC provides extensive technical assistance and training through site visits, conferences, workshops, and teleconferences on planning, developing, implementing, and evaluating tobacco control programs.

Through IMPACT, CDC also supports and actively collaborates with a variety of national organizations to ensure participation of diverse community groups, coalitions, and community leaders.

Communicating Information to the Public. CDC serves as a primary resource for tobacco and health information. In this role, it develops and distributes important information about tobacco and health to the public and special constituents nationwide. For example:

CDC responds to a diverse audience, with as many as 60,000 inquiries each year, using many different channels, including brochures, fact sheets, articles, and video products, and provides a toll-free information dissemination service. In addition, CDC provides the public with ready access to tobacco use prevention information through a World Wide Web site on the Internet.

CDC makes high-quality tobacco control and prevention advertising materials from across the country available to all states, localities, and organizations through its Media Campaign Resource Center. Along with providing counteradvertising materials, the Resource Center provides information on how to work with various media outlets, why advertising is an important aspect of tobacco control, and what logistics are involved with media placement. Tobacco control and prevention advertising materials such as those pvided through the Media Campaign Resource Center counter the $6 billion a year spent to advertise and promote tobacco use.

CDC develops media campaigns and associated collateral materials, such as the "Smokefree Kids and Soccer," "Stop the Sale, Prevent the Addiction," and "Performance Edge" campaigns, to communicate tobacco and health information to the public and special constituents.

Facilitating Action with Partners. CDC collaborates with professional, voluntary, academic, medical, and international organizations; with other federal agencies; and with state health departments to build a strong tobacco use prevention network. For example:

Federal Activities-CDC supports the Interagency Committee on Smoking and Health-a national, congressionally mandated committee that advises the Department of Health and Human Services (DHHS) on the coordination, communication, and exchange of information among Federal agencies about the health risks of tobacco use.

External Partnerships-CDC continues to work toward expanding and enhancing external partnerships by developing relations with organizaions to support comprehensive strategic communications and social marketing activities.

University Collaborations-CDC supports university-based research activities through its Prevention Centers Program. Among other activities, this program focuses on identifying differences in smoking behavior and smoking patterns among subgroups of youth, evaluating the effects of tobacco advertising and promotion, and analyzing the indirect costs associated with tobacco. In addition, CDC cosponsors an annual Tobacco Use Prevention Summer Institute to provide participants with an understanding of specific tobacco use prevention issues.

Academic Associations-CDC collaborates with the Minority Health Professions Foundation, the Association of Schools of Public Health, the Association of Teachers of Preventive Medicine, ad the Historically Black Colleges and Universities to assist in planning and developing tobacco initiatives, provide research data on various topics, and expand their capacity to participate in health promotion and disease prevention programs.

International Activities-Through an agreement with the World Health Organization designating CDC as a Collaborating Center for Smoking and Health, CDC prepares and implements intemational and regional studies and activities, provides health education regarding smoking cessation programs and for programs to prevent tobaccorelated illnesses, and conducts epidemiologic research. In addition, CDC works with other international organizations and individual countries to build capacity for tobacco control initiatives and to establish partnerships on tobacco control issues.

Key Partners
* Advocacy Institute National Association of African Americans
* American Academy of Otolaryngology for Positive Imagery*
* American Academy of Pediatrics National Association of County and
* American Cancer Society City Health Officials
* American Dental Association National Center for Tobacco-Free Kids
* American Heart Association National Coalition of Hispanic Health and
* American Lung Association Human Services Organizations*
American Medical Association National Medical Association*
American Medical Women's Association* National Organization of Women*
Americans for Non-Smokers' Rights Northwest Portland Area Indian Health Board*
American Public Health Association Pan American Health Organization
Asia Health Services* Parent Teacher Association
Association of Schools of Public Health Prevention Centers
Association of State and Territorial Robert Wood Johnson Foundation
Health Officials Student Coalition Against Tobacco*
Association of Teachers of Preventive Medicine Stop Teenage Addiction to Tobacco
Congress of National Black Churches: The HMO Group
Coalition on Smoking OR Health Women and Girls Against Tobacco
Historically Black Colleges and Universities World Health Organization
Inter-religious Coalition on Smoking OR Health *Funded by CDC through the IMPACT program to build
Minority Health Professions Foundation infrastructure and capacity regarding tobacco control and prevention.