THE PUBLIC'S HEALTH: County program continues to snuff out tobacco use
By Karen Sullivan
More than one-fifth of adults in Butte-Silver Bow — 20.9 percent exactly — smoke cigarettes, with the vast majority of those adults (18.6 percent) smoking every day. Sadly, cigarette smoking in our county is more prevalent among lower-income residents, as well as men and adults under the age of 65. Among women of child-bearing age (18 to 44), 18 percent currently smoke. This is concerning, since tobacco use increases the risk of infertility, as well as the risks for miscarriage, stillbirth and low birth-weight for women who smoke during pregnancy.
More concerning data: Among Butte-Silver Bow households with children, almost 18 percent have someone who smokes cigarettes in the home. And almost 8 percent of adults in the county use some type of smokeless tobacco every day or on some days. This is twice — twice! — the national percentage.
In a “key informant” survey for the 2014 Butte-Silver Bow Community Health Needs Assessment, a social services representative said: “Even though they cannot afford to buy food, almost 50 percent or more of our clients use tobacco.” Another social services representative said: “Despite the significant dangers, many continue to use (tobacco). Some elderly people use it while on oxygen.” A physician said: “Underage tobacco use is atrocious.” Another physician said, simply: “Most patients smoke.”
The thing about tobacco use? It’s preventable! In fact, tobacco use is the single most preventable cause of death and disease in the United States. But annually, about 443,000 Americans die from tobacco-related illnesses — cancer, heart disease, lung diseases — such as emphysema, bronchitis and chronic airway obstruction — and, again, premature birth, low birth-weight, stillbirth and infant death. For every person who dies from tobacco use, 20 more people suffer with at least one serious tobacco-related illness. There is a national price being paid: tobacco use costs the country $193 billion every year in direct medical expenses and lost productivity.
This we also know — there is no risk-free level of exposure to second-hand smoke, which causes heart disease and lung cancer in adults and a number of health problems in infants and children, including severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome. Smokeless tobacco causes a number of serious oral health problems, including cancer of the mouth and gums, periodontitis, and tooth loss.
In Montana, diseases caused by tobacco use claim an average of four lives every day. These diseases are the leading cause of death in the state.
The Butte-Silver Bow Health Department’s Tobacco Use Prevention Program works hard to address the public health crisis caused by the use of all forms of commercial tobacco products. Simply put, we are attempting to prevent and eliminate tobacco use, particularly among young people in Butte-Silver Bow. Our program goals: prevent tobacco use initiation among youth and young adults; promote quitting among adults and youth; eliminate exposure to second-hand smoke; and identify and eliminate tobacco-related disparities among vulnerable populations.
How is our program funded? In 1997, Montana, along with other states, filed suit against the tobacco industry, and Montana was part of the national settlement reached by several attorneys general a year later. In 2000, Montana voters approved a constitutional amendment that dedicated at least 40 percent of the tobacco settlement to a permanent, income-producing trust fund. Of the interest earned by the trust fund, 90 percent must be used for health care benefits, services, education programs and tobacco disease prevention. Today, 32 percent of that amount is distributed for tobacco prevention/cessation programs and other human service programs.
My department’s program is part of the Montana Tobacco Use Prevention Program, which recently issued a report titled Tobacco Prevention: Leading the Way to a Healthier Montana. The report cites progress on the war against tobacco from July 2014 through June 2016. It is located at http://dphhs.mt.gov/Portals/85/publichealth/documents/Tobacco/FactSheet/2014-16MTUPPProgressReport.pdf.
The report relays how the tobacco industry continues to create and market products to youth and provides some updates on e-cigarettes. Montana youth, says the report, are particularly susceptible to point-of-sale marketing, with tobacco products located at the eye level of children, and near candy. (Butte-Silver Bow is home to 32 tobacco retailers.)