One in Five New York Men Use Tobacco

Men Disproportionately Impacted by Tobacco Use, Particularly Men with Low Incomes and/or Less than a High School Education

(New York, NY) – Tobacco use remains the leading cause of preventable death in the U.S., responsible for more than 480,000 deaths annually. Disproportionately impacted by tobacco use, both in New York State and nationally, are men, who account for more than 60 percent of all tobacco-related deaths in New York State.2 Nearly one in five males use tobacco, with prevalence rates highest among individuals with low incomes and/or less than a high school education or GED.1 Men also are significantly less likely to have contact with the health care system than their female counterparts, making it critical for health systems to screen this population for tobacco use and provide tobacco dependence counseling and treatment at every encounter.3  While 70 percent of all tobacco users want to quit, according to the Centers for Disease Control and Prevention (CDC), nearly half will make a quit attempt this year and fewer than 10 percent of tobacco users ultimately will succeed on their first quit attempt.4,5

To help address this issue, efforts are underway to ensure all New Yorkers are screened for tobacco use and have access to tobacco dependence treatment, as well as resources to help them quit. With funding from the New York State Department of Health, Bureau of Tobacco Control, 10 regional contractors are working with health care organizations across the State to implement health systems improvements to integrate evidence-based tobacco dependence screening and treatment into standard care delivery. As the Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free New York, CAI is supporting the efforts of the 10 regional contractors through the provision of training, technical assistance, and tool and resource development, as well as the promotion of policies to further facilitate the integration of evidence-based tobacco dependence treatment into care Statewide.

“By working on the systems level, specifically within systems that serve populations for which tobacco use prevalence rates have not decreased in recent years, we can assure that every patient is asked about tobacco use at every clinical encounter and offered evidence-based treatment. These efforts, in turn, will increase our chances of helping tobacco users, particularly men, take advantage of the resources available to help them quit,” said Elizabeth Jones, Director of the COE for HSI.

A December 2014 report released by the CDC confirms that receiving tobacco dependence treatment assistance from a physician more than doubles the odds that a tobacco user will quit successfully.

“In observance of Men's Health Month, June is an opportune time to focus on treating men, particularly those with low incomes, who deserve an opportunity to address this deadly addiction,” noted Elizabeth Jones. “We’ve got to make tobacco dependence treatment a priority and a standard part of the health care they receive, regardless of the reason for which they seek out care.”

Annually, more than 82 percent of adults in the U.S. have contact with a health care professional, resulting in one billion opportunities to screen for tobacco use and deliver life-saving tobacco dependence treatment.7

For more information about the work of the COE for HSI, visit www.tobaccofreeny.org.

About CAI: CAI is a global nonprofit organization dedicated to improving the health and well-being of underserved populations worldwide. For 36 years CAI has provided customized capacity building services to health and human service organizations in over 27 countries and in all 50 states. Offering over 1,500 training programs annually, CAI’s passionate staff works to fulfill its mission: to use the transformative power of education and research to foster a more aware, healthy, compassionate and equitable world. For more information about CAI, visit our website: www.caiglobal.org.

About the Center of Excellence for Health Systems Improvement: With funding from the New York State Department of Health Bureau of Tobacco Control, CAI serves as the Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free NY. The COE for HSI promotes large-scale systems and policy changes to support the universal provision of evidence-based tobacco dependence treatment services. The COE for HSI aims to support 10 contractors throughout New York State working regionally with health care systems and organizations that serve those populations for which smoking prevalence rates have not decreased in recent years - adults with low income, less than a high school diploma and/or poor mental health. Focused on providing capacity building assistance services around topics like how to engage and obtain buy-in from leadership to implement the kinds of systems-level changes that will result in identification and intervention with every tobacco user who seeks care, the COE for HSI also will offer materials and resources to support contractors in their regional work. For more information, click here to visit the project website.


[1] “Bureau of Tobacco Control StatShot, Vol. 8, No. 2/Feb 2015,” New York State Department of Health, Feb. 2015. Accessed 23 June 2015 at: https://www.health.ny.gov/prevention/tobacco_control/reports/statshots/volume8/n2_adult_smoking_prevalence_in_2013.pdf.
[2] U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Printed with corrections, January 2014. Accessed 23 June 2015 at: http://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf.
[3] Kaiser Family Foundation. Putting Men’s Health Care Disparities on the Map: Examining Racial and Ethnic Health Disparities at the State Level, September 2012. Accessed 23 June 2015 at: https://kaiserfamilyfoundation.files.wordpress.com/2013/01/8344.pdf.
[4] “Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, Vol. 60, No. 44: Quitting Smoking Among Adults—United States, 2001-2010,” Centers for Disease Control and Prevention. 11 Nov. 2011. Accessed 23 June 2015 at: http://www.cdc.gov/mmwr/pdf/wk/mm6044.pdf.
[5] "Immediate Rewards of Quitting," Guide to Quitting Smoking. American Cancer Society, 1 Jan. 2011.
[6] “National Ambulatory Medical Care Survey: 2010 Summary Tables,” Centers for Disease Control and Prevention, 2010. Accessed 23 June 2015 at: http://www.cdc.gov/nchs/data/ahcd/namcs_summary/2010_namcs_web_tables.pdf.
[7] Fiore et al. Treating Tobacco Use and Dependence: 2008 Update. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, 2008
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Tobacco Use and Serious Mental Illness: A Deadly Combination

Americans with serious mental illness are 70 percent more likely to be tobacco users 1

New York, NY – Tobacco accounts for 443,000 deaths in the United States annually, and 45 percent of those deaths are among individuals with serious mental illness 2. Those with serious mental illness not only have significantly higher tobacco use prevalence rates than the general population, but also consume more cigarettes per day and have lower quit rates on average 3. In observance of National Mental Health Month, May is an opportune time to recognize the disproportionate impact of tobacco use among individuals with serious mental illness - specifically the health disparities experienced by this population as a result of such disproportionate use - as well as the critical need for intervention strategies tailored to this high-risk population.

In New York State, several efforts are underway to address the issue of tobacco use among the individuals with serious mental illness. Of note, the New York State Department of Health's Bureau of Tobacco Control has funded 10 regional contractors to work with health care organizations across the State, including inpatient and outpatient mental health treatment facilities, to support the implementation of health systems improvements that will assure that every patient is screened for tobacco use and receives evidence-based tobacco dependence counseling and treatment, if desired, as part of the standard care delivery. As the Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free New York, CAI supports regional contractors in these efforts, developing tools and resources to assist regional contractors in their work within mental health treatment facilities. The COE for HSI also works on the Statewide-level to promote a policy environment that facilitates the integration of evidence-based tobacco dependence treatment into care delivery in these settings.

"With the support of evidenced-based tobacco dependence treatment and trained health care professionals, populations with serious mental illness are just as capable of quitting successfully as other tobacco users," said Elizabeth Jones, Director of the COE for HSI. "The COE for HSI and the 10 regional contractors were funded to build the capacity of health systems serving individuals with serious mental illness and the professional working within them to deliver life-saving tobacco dependence treatment to their patients."

Tobacco use is more prevalent in those with serious mental illness than in the general population, with 36 percent of the adult population using tobacco as opposed to 21 percent, respectively 4. Tobacco use rates are estimated to be 59 percent for people diagnosed with schizophrenia, 46 percent for those with bipolar disorder, and 38 percent for people with serious psychological diseases 5.

"There is an epidemic of tobacco-related disease among those suffering from serious mental illness," noted Elizabeth Jones. "Individuals with serious mental illness treated in the public health system die 25 years earlier than the general population, frequently from tobacco-related diseases, such as cancer, heart disease, and lung disease. And these individuals do not survive serious mental illness just to die from tobacco. As such, it is the responsibility of the health care systems that treat individuals with serious mental illness to address tobacco use among their patients and deliver evidence-based tobacco dependence treatment at every opportunity."

For more information about the work of the COE for HSI, visit www.tobaccofreeny.org.

About CAI: CAI is a global nonprofit organization dedicated to improving the health and well-being of underserved populations worldwide. For 35 years, CAI has provided customized capacity building services to health and human service organizations in over 23 countries and in all 50 states. Offering over 1,500 training programs annually, CAI's passionate staff works to fulfill its mission: to use the transformative power of education and research to foster a more aware, healthy, compassionate and equitable world. For more information about CAI, visit our website: www.caiglobal.org.

About the Center of Excellence for Health System Improvement: With funding from the New York State Department of Health Bureau of Tobacco Control, CAI serves as the Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free New York. The COE for HSI promotes large-scale systems and policy changes to support the universal provision of evidence-based tobacco dependence treatment services. The COE for HSI aims to support 10 Regional Contractors throughout New York State working regionally with health care systems and organizations that serve those populations for which tobacco use prevalence rates have not decreased in recent years - adults with low income, less than a high school diploma, and/or serious mental illness. Focused on providing capacity-building assistance services around topics like how to engage and obtain buy-in from leadership to implement the kinds of systems-level changes that will result in identification and intervention with every tobacco user who seeks care, the COE for HSI also will offer materials and resources to support contractors in their regional work. For more information about the Center of Excellence for Health Systems Improvement, visit www.tobaccofreeny.org.


1 "CDC Vital Signs: Current Cigarette Smoking Among Adults Aged 18=>18 Years with Mental Illness – United States, 2009-2011," Centers for Disease Control and Prevention, February, 2013, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a2.htm?s_cid=mm6205a2_w.

2 "Smoking Cessation," National Alliance on Mental Illness, 2015, http://www2.nami.org/Content/NavigationMenu/Hearts_and_Minds/Smoking_Cessation/Smoking_and_Mental_Illness.htm.

Glasheen C, Hedden Sl, Forman-Hoffman VL, Colpe LJ. Cigarette smoking behaviors among adults with serious mental illness in a nationally representative sample. Ann Epidemiol. 2014 Oct; 24(10):776-80.

"CDC Vital Signs: Adult Smoking Focusing on People with Mental Illness," Centers for Disease Control and Prevention, February, 2013, http://www.cdc.gov/vitalsigns/pdf/2013-02-vitalsigns.pdf.

5 McClave AK, McKnight-Eily LR, Davis SP, Dube SR. Smoking characteristics of adults with Selected Lifetime Mental Illnesses: Results from the 2007 National Health Interview Survey. American Journal of Public Health, 2010; 100:12, 2464-72.

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Continuing Education Scholarships Available for HIV Care Team Members

Funding to Attend National HIV Conferences to Gain Knowledge and Share Promising Practices with Peers

(New York, NY) – As part of an effort to decrease the estimated 50,000 new HIV infections that occur each year in the U.S.1, CAI’s CBA Center will be awarding four scholarships nationwide to health care team members on the front-lines of High-Impact HIV Prevention (HIP). The scholarships will provide dedicated providers the opportunity to attend national HIV conferences, serving as CBA Center Conference Ambassadors to learn about new evidence-based strategies for HIV treatment and prevention, and share best practices around client-centered care and linkage and retention in care.

“Peer to peer programs like this one promote information sharing among HIV providers across the country with the goal of decreasing new infection rates in the U.S. by 25%,” said Dr. Tony Jimenez, Director of the CAI CBA Center. “The aim of the Conference Ambassador Scholarship Program is to promote the sharing of first-hand knowledge, tactics and best practices in the field of HIV care."

The Scholarship Program is open to all members of the HIV care team, including medical directors, clinicians, nurses, case managers and front desk staff. Selected scholarship recipients will also participate in a CBA Center webinar and share their own experiences related to viral load suppression and be featured in the fall edition of the quarterly CBA Center News Bulletin.

“Every member of the HIV care team has an important role and this scholarship opportunity highlights the significant role each team member plays in patient retention and satisfaction in care,” said Dr. Jimenez.

This scholarship is funded through the Centers for Disease Control and Prevention (CDC) Capacity Building Assistance project. Each scholarship will provide an HIV provider with an opportunity to network with national HIV treatment and prevention leaders, serve as a peer to peer advisor, and gain knowledge to help stay up to date on HIV treatment and prevention.

For more information about the CBA project initiative, scholarship eligibility or to complete an application, visit CAI's CBA Center website at www.HIVCBAcenter.org. The application deadline is June 1, 2015.

About CAI: CAI is a global nonprofit organization dedicated to improving the health and well-being of underserved populations worldwide. For 36 years CAI has provided customized capacity building services to health and human service organizations in over 27 countries and in all 50 states. Offering over 1,500 training programs annually, CAI’s passionate staff works to fulfill its mission: to use the transformative power of education and research to foster a more aware, healthy, compassionate and equitable world. For more information about CAI, visit our website: www.caiglobal.org.

About the CBA Center: CAI has been selected by the Centers for Disease Control and Prevention (CDC) to serve as a Capacity Building Assistance provider to healthcare organizations nationwide. The CBA Center concentrates on strengthening the capacity of the HIV prevention workforce to implement High-Impact HIV Prevention interventions -- scalable, scientifically proven approaches tailored to specific populations -- with a new focus on treatment as a critical component of prevention. Through partnerships with expert healthcare faculty and a national consortium of organizations that have pioneered effective implementation of High Impact Prevention, CAI delivers tailored, evidence-based capacity building services to healthcare organizations and staff in clinical settings across the US. For more information, visit www.HIVCBAcenter.org.


 

[1] http://www.cdc.gov/nchhstp/newsroom/docs/2012/HIV-Infections-2007-2010.pdf

Access to Evidence-Based Treatment Is the Key to Reducing Tobacco Use Among Low-Income Adults

Less than half of all ACA health plans offer all seven FDA-approved tobacco dependence treatment medications at no cost1

(New York, NY) – Tobacco use continues to be the single largest preventable cause of disease and premature death, killing more than 28,000 New Yorkers every year.2 Tobacco users not only have increased risk for multiple cancers; they also are more likely to suffer from heart disease, stroke, Chronic Obstructive Pulmonary Disease (COPD), and diabetes.3 Of the nearly 42 million current U.S. tobacco users, 42.7 percent report having made at least one quit attempt in the last year.4 As part of the Affordable Care Act (ACA), all health plans purchased through marketplaces are required to cover screening for tobacco use and tobacco cessation medications without prior authorization or associated cost-sharing. Based on guidance issued by the Centers for Medicare and Medicaid Services (CMS), this benefit includes coverage for all seven Food and Drug Administration (FDA)-approved tobacco dependence treatment medications.

A new report from the American Lung Association shows that health plans are falling short in this effort, with only 17 percent of all health insurance plans offering all seven FDA-approved tobacco dependence medications on their formularies.1 In New York State, only 11 percent, or two, plans covered all seven FDA-approved tobacco dependence treatment medications.

The Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free New York is building the capacity of ten Regional Contractors to work with federally qualified health centers (FQHC), mental health treatment facilities, and other health care organizations across New York State to implement health systems improvements that will ensure that every patient is screened for tobacco use, and that every tobacco user is offered and receives timely tobacco dependence treatment, if desired. The settings targeted by Regional Contractors serve populations for which tobacco use prevalence rates have not declined in recent years, specifically individuals with low-incomes, less than a high school diploma, and/or serious mental illness.

"Critical to a health system being able to successfully support a patient's quit attempt is the ability of the health care providers within it to tailor treatment plans to the needs of each individual patient," said Elizabeth Jones, Director, COE for HSI. "The evidence tells us that this entails being able to provide treatment that will maximize the likelihood that a quit attempt is successful."

Recent research shows that providing tobacco dependence treatment to those enrolled in the marketplace plans is especially important because tobacco use rates are higher among this population, which is made up of low-income populations and those previously uninsured.3

The full report from the American Lung Association is available at State Health Insurance Marketplace Plans: New Opportunities to Help Smokers Quit.

For more information about the work of the COE for HSI, visit www.tobaccofreeny.org.

About CAI: CAI is a global nonprofit organization dedicated to improving the health and well-being of underserved populations worldwide. For 36 years CAI has provided customized capacity building services to health and human service organizations in over 27 countries and in all 50 states. Offering over 1,500 training programs annually, CAI's passionate staff works to fulfill its mission: to use the transformative power of education and research to foster a more aware, healthy, compassionate and equitable world. For more information about CAI, visit our website: www.caiglobal.org.

About the Center of Excellence for Health Systems Improvement: With funding from the New York State Department of Health Bureau of Tobacco Control, CAI serves as the Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free NY. The COE for HSI promotes large-scale systems and policy changes to support the universal provision of evidence-based tobacco dependence treatment services. The COE for HSI aims to support 10 contractors throughout New York State working regionally with health care systems and organizations that serve those populations for which smoking prevalence rates have not decreased in recent years - adults with low income, less than a high school diploma and/or poor mental health. Focused on providing capacity building assistance services around topics like how to engage and obtain buy-in from leadership to implement the kinds of systems-level changes that will result in identification and intervention with every tobacco user who seeks care, the COE for HSI also will offer materials and resources to support contractors in their regional work. For more information, click here to visit the project website.


 

[1] American Lung Association. State Health Insurance Marketplace Plans: New Opportunities to Help Smokers Quit, 2015. Retrieved from http://www.lung.org/assets/documents/publications/other-reports/state-health-insurance-opportunities.pdf
[2] Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs—2014. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Retrieved from http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm?s_cid=cs_3281
[3] Centers for Disease Control and Prevention. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: Government Printing Office, 2010.
[4] Centers for Disease Control and Prevention. Smoking and Tobacco Use: Fast Facts. Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/ 

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Center of Excellence for Health Systems Improvement Heads To Albany to Underscore Vulnerable New Yorkers’ Need for Tobacco Control

Adults with Mental Illness Smoke a Third of All Cigarettes [i]

New York, NY – Tobacco control programs are urgently needed to help New Yorkers with serious mental illness. That is the message representatives from The Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free New York will take to the New York State Capitol tomorrow as they educate state lawmakers about established comprehensive tobacco control programs, many funded by the State, that currently are in place to reduce the burden caused by tobacco and ultimately save lives and state tax dollars.

New York State legislators are invited to visit Meeting Room 1 of the Empire State Plaza Concourse from 9:00 a.m. to 1:00 p.m., where representatives of Advancing Tobacco-Free Communities (Community Engagement and Reality Check) and Health Systems for a Tobacco-Free New York will be joined by volunteer youth leaders to answer questions and offer resources about effective tobacco prevention programs being delivered across the state.

The COE for HSI, a program of CAI funded through the New York State Department of Health Bureau of Tobacco Control, will participate in the day's activities by meeting with local elected leaders to explain the importance of supporting large-scale health system improvements in settings serving New Yorkers suffering from mental illness, specifically standardized screening for tobacco use and provision of evidence-based tobacco dependence treatment to all interested patients.

According to the Centers for Disease Control and Prevention (CDC):

  • 31 percent of all cigarettes are smoked by adults with mental illness
  • 40 percent of men and 34 percent of women with mental illness smoke
  • 48 percent of people with mental illness who live below the poverty level smoke.[i]

"Adults with mental illness are less likely to quit, and are more likely to suffer from tobacco-related diseases or die early from tobacco use. In fact, individuals with serious mental illness and substance abuse die a startling twenty-five years earlier than those without mental illness," said Elizabeth Jones, Director of the Center of Excellence for Health Systems Improvement. "The NYS Tobacco Control Program has made significant progress in supporting this vulnerable group, but there is still so much work to do to help those dealing with mental illness access tobacco dependence treatment and resources to help them quit."

Research indicates that, despite common misperceptions, smokers with mental illness are no less motivated or capable of quitting smoking than the general population.[ii] In New York State, more than 28,200 lives are lost due to tobacco use annually.[iii]

The New York State Tobacco Control Program uses a policy-driven, population-based approach designed to prevent youth from smoking and motivate adult smokers to quit. The efforts are leading the way toward a tobacco-free society.

About CAI: CAI is a global nonprofit organization dedicated to improving the health and well-being of underserved populations worldwide. For 35 years, CAI has provided customized capacity building services to health and human service organizations in over 23 countries and in all 50 states. Offering over 1,500 training programs annually, CAI's passionate staff works to fulfill its mission: to use the transformative power of education and research to foster a more aware, healthy, compassionate and equitable world. For more information about CAI, visit our website: www.caiglobal.org.

About the Center of Excellence for Health System Improvement: With funding from the New York State Department of Health Bureau of Tobacco Control, CAI serves as the Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free NY. The COE for HSI promotes large-scale systems and policy changes to support the universal provision of evidence-based tobacco dependence treatment services. The COE for HSI aims to support 10 contractors throughout New York State working regionally with health care systems and organizations that serve those populations for which smoking prevalence rates have not decreased in recent years - adults with low income, less than a high school diploma, and/or poor mental health. Focused on providing capacity building assistance services around topics like how to engage and obtain buy-in from leadership to implement the kinds of systems-level changes that will result in identification of and intervention with every tobacco user who seeks care, the COE for HSI also will offer materials and resources to support contractors in their regional work.

 


 

[i] Smoking among Adults With Mental Illness, Centers for Disease Control and Prevention (CDC), http://www.cdc.gov/features/vitalsigns/smokingandmentalillness/

[ii] Weir K. Smoking and mental illness. American Psychological Association, 2013; 44(6):36.

[iii] Best Practices for Comprehensive Tobacco Control Programs, 2014, Section C: Recommended Funding Levels, by State New York, Centers for Disease Control and Prevention, http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm?s_cid=cs_3281

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