Tobacco Use - Adult Smoking Prevalence

Why Is This Important?

Smoking is the leading preventable cause of death in the United States. Smoking is initiated and established primarily during adolescence, with more than 80% of adult smokers first smoking before age 18. One in six adults and one in eleven youth smoke in New Mexico. About half of all lifetime smokers will die early because of their tobacco use. In New Mexico, about 2,800 people die from tobacco use annually and another 84,000 are living with tobacco-related diseases. Annual smoking-related medical costs in New Mexico total $844 million. According to the CDC's SAMMEC (Smoking Attributable Mortality, Morbidity, and Economic Costs) website, smoking is responsible for a significant proportion of the deaths from numerous types of malignant neoplasms (e.g., lung, esophageal, and laryngeal cancers); from cardiovascular diseases (e.g., ischemic heart disease, cerebrovascular disease); and from several respiratory diseases (e.g., bronchitis, emphysema, chronic airway obstruction). Combined, these smoking-related deaths make smoking the leading behavioral cause of death in the United States.

Definition

A current smoker is defined as a person 18 years or older who has smoked more than 100 cigarettes in his or her lifetime and currently smokes every day or some days.

Data Sources

• Behavioral Risk Factor Surveillance System Survey Data, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, together with New Mexico Department of Health, Injury and Behavioral Epidemiology Bureau.
  (https://www.nmhealth.org/about/erd/ibeb/brfss/)
• U.S. data source: Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System (BRFSS) Prevalence and Trends Data.
  (https://www.cdc.gov/brfss/brfssprevalence)

How the Measure is Calculated

How Are We Doing?

Although overall cigarette smoking continues to decline, smoking rates continue to be higher among certain population groups including people with lower levels of education or income, the uninsured, people with a disability, African Americans, and people who identify as lesbian, gay, or bisexual. In addition, the landscape of tobacco use and nicotine addiction is changing in light of emerging products such as e-cigarettes, hookah, and a variety of flavored tobacco products. About 5% of NM adults and 34% of NM high school youth use e-cigarettes and many of these individuals are using them in combination with conventional cigarettes.

How Do We Compare With the U.S.?

Adult smoking prevalence in New Mexico continues to track closely to the US rate, about one in six adults. In New Mexico, adult smoking has declined significantly, from 21.5% in 2011 to 16% in 2019.

What Is Being Done?

The NM Tobacco Program has a five-year action plan for 2020-2025 to do the following work together with its contractors and other statewide partners. GOAL 1: Prevent Initiation of Tobacco Use among Youth and Young Adults Strategy 1a: Educate and inform stakeholders and decision-makers about evidence-based policies and programs to prevent initiation of tobacco use. Strategy 1b: Establish and strengthen tobacco-free policies in schools and on college or university campuses. GOAL 2: Eliminate Nonsmokers' Exposure to Secondhand Smoke Strategy 2a: Increase voluntary policies for smokefree multi-unit housing. Strategy 2b: Implement evidence-based mass-reach health communication interventions to reduce exposure to secondhand smoke. GOAL 3: Promote Quitting Tobacco Among Youth and Young Adults Strategy 3a: Support state quitline capacity Strategy 3b: Increase engagement of health care providers and systems to expand utilization of proven cessation methods Strategy 3c: Expand insurance coverage and availability of comprehensive cessation services Strategy 3d: Promote health systems changes to support tobacco cessation Strategy 3e: Implement evidence-based mass-reach health communication interventions to increase cessation and promote the quitline. GOAL 4: Identify and Eliminate Tobacco-Related Disparities (see Health Program Information section)

Evidence-based Practices

Addressing tobacco use is best done through a coordinated effort to establish tobacco-free policies and social norms, to promote and assist tobacco users to quit, and to prevent initiation of tobacco use. This comprehensive approach combines educational, clinical, regulatory, economic, and social strategies. Research has documented strong or sufficient evidence in the use of the following strategies: - Increasing the unit price of tobacco products - Restricting minors' access to tobacco products; restricting the time, place, and manner in which tobacco is marketed and sold - Strategic, culturally appropriate, and high impact health communication messages (mass media), including paid TV, radio, billboard, print, and web-based advertising at state and local levels - Ensuring that all patients seen in the health care system are screened for tobacco use, receive brief interventions to help them quit, and are offered more intensive counseling and low- or no-cost cessation medications; providing insurance coverage of tobacco use treatment; phone- and web-based cessation services are effective and can reach large numbers of tobacco users; - Passage of laws and policies in a comprehensive tobacco control effort to protect the public from secondhand exposure - Focusing tobacco prevention and cessation interventions on populations at greatest risk in an effort to reduce tobacco-related health disparities Sources: CDC. Best Practices for Comprehensive Tobacco Control Programs - 2014 (www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2014/comprehensive.pdf) The Guide to Community Preventive Services: Tobacco Use - 2010 (www.thecommunityguide.org/tobacco/index.html)

Other Objectives

Substance Abuse Epidemiology Report Indicator The Adult Smoking Prevalence indicator is specifically included in the New Mexico Department of Health (NMDOH) Strategic Plan. The indicator (percent of adults who smoke) appears in the NMDOH Strategic Plan under the objective to reduce tobacco use in the Result 1 Section: Improved health outcomes for the people of New Mexico. Tobacco use is considered a super-priority public health area by the Department of Health and is also included in the State Health Improvement Plan as a priority health indicator. New Mexico Community Health Status Indicator (CHSI)

Available Services

Current tobacco cessation services include a free telephone helpline (1-800-QUIT NOW), with a personalized quitting plan, a trained quitting coach, multiple calls per enrollee, and quit coaching translation available in 200 languages. Web-based cessation services are also available (www.QuitNowNM.com) stand-alone or in combination with the telephone helpline. The telephone helpline is also available in Spanish (1-855 DEJELO YA), and the Spanish web-based services are available at www.DejeloYaNM.com. Additional services include free nicotine patches or gum and text-messaging support.

More Resources

Visit www.nmtupac.com for full information about the NM Tobacco Use Prevention and Control Program.

Health Program Information

IDENTIFYING AND ELIMINATING TOBACCO-RELATED DISPARITIES: The NM Tobacco Program has identified six priority populations based on the disproportionate impact or burden of tobacco use. The groups include: American Indians (Navajo and Pueblo); African Americans; people with disabilities; Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) people; Asian Americans/Pacific Islanders; and people whose primary language is Spanish. In addition to these six populations, people living in poverty are an overarching population of focus in the Tobacco Program, and there are also significant efforts in reaching young adults (18-29 year olds). One of the most significant accomplishments in tobacco disparities and health equity work in NM is the development and growth of statewide Priority Population Networks. There are seven Networks who engage their respective populations through outreach and education efforts aimed at increasing awareness of tobacco disparities, improving access to culturally- and linguistically-appropriate tobacco prevention and cessation resources, and in developing innovative or promising practices. In addition, since 2012, the Tobacco Program and the Networks have engaged in a process of ongoing mutual advisement, which has been integral to ensuring a voice and input from community representatives and a venue for the sharing CDC Best Practices and tools and strategies developed by National Networks. The formal advisement process occurs three times per year, with additional work in between meetings. A specific example of a project addressing disparities is the development of a culturally appropriate Spanish-language media campaign to promote cessation services to NM tobacco users who speak Spanish as their primary language. The DEJELO YA campaign incorporates cultural concepts (e.g., family, respect, confidence, perseverance) that are important and valued by this community. The Spanish-speaking population Network conducted formative research that was used to advise the statewide media contractor in a unique partnership to jointly develop culturally- and linguistically-appropriate media messaging to promote cessation services to this underserved population in NM. Rather than simply translating an English campaign, the DEJELO YA campaign developed messages in Spanish by native speakers of the language to ensure that the message would resonate with the target audience. Another example of promoting health equity is the Have a Heart campaign, where the NM Department of Health used awareness of diabetes among Navajo and Pueblo communities to educate members on the less well-known dangers of secondhand smoke. The Department created a single message about the harmful environment secondhand smoke creates for everyone, especially people with diabetes. The Have a Heart campaign used artwork by local artists, placed ads in English and the local tribal language on Navajo radio stations, and aired messages in Navajo Indian Health Service clinic waiting rooms.