Goal 3: Tobacco
To reduce tobacco-related death due to tobacco use and exposure to secondhand smoke by youth and adults in Gratiot County.
Tobacco Objectives
3.1 Community Norms: To correct the misperceived community norms involving tobacco use and exposure
3.2 Laws and Policies: To support and/or enhance laws and policies that reduce tobacco use and exposure
3.3 Promotion: To reduce the product promotion of tobacco
3.4 Social Availability: To reduce youth social access to tobacco, and to impact adult social access to tobacco
3.5 Retail Availability: To reduce youth access to tobacco, and impact adult retail access to tobacco.
3.1 Community Norms: To correct the misperceived community norms involving tobacco use and exposure
3.2 Laws and Policies: To support and/or enhance laws and policies that reduce tobacco use and exposure
3.3 Promotion: To reduce the product promotion of tobacco
3.4 Social Availability: To reduce youth social access to tobacco, and to impact adult social access to tobacco
3.5 Retail Availability: To reduce youth access to tobacco, and impact adult retail access to tobacco.
Tobacco Use Rates
The 2008 Prevention Needs Assessment results indicate that more youth in Gratiot County report using cigarettes than youth in the other eight counties in the Mid-South region. 12.8% of the 6th grade youth surveyed reported that they had tried cigarettes “one or more times” in their lifetime. 49.7% of 12th graders indicated that they had tried cigarettes in their lifetime. 4.1% of 6th graders, 8% of 8th graders, 17.3% of 10th graders, and 25.2% of 12th graders in the county indicated that they had smoked cigarettes “within 30 days” of the survey. Chewing tobacco consumption data for Gratiot County youth indicates that 2.5% of 6th graders, 1.8% of 8th graders, 8.2% of 10th graders, and 9.4% of 12th graders used chewing tobacco in the 30 days prior to the survey. This is also above the Mid-South region rates at all grade levels. By 12th grade 24% of Gratiot County youth indicate that they have at least tried chewing tobacco.
Adult consumption patterns involving tobacco in Gratiot County have been estimated at 19.7% in 2007. This is comparable to the estimated adult rate in the Mid-South region from 2006-2008, which was 19.3% and the State 2008 smoking rate of 20.2%. Information from MDCH in 2006 indicates that 22.6% of Gratiot County women, who were pregnant, smoked while pregnant. This number is considerably higher than the rate estimated at the State level, which is 13.8%. Smoking during pregnancy accounts for 20 to 30% of low birth weight babies, up to 14 percent of preterm deliveries, and about 10% of all infant deaths. These consequences may be reduced through effective smoking prevention and cessation efforts.
Adult consumption patterns involving tobacco in Gratiot County have been estimated at 19.7% in 2007. This is comparable to the estimated adult rate in the Mid-South region from 2006-2008, which was 19.3% and the State 2008 smoking rate of 20.2%. Information from MDCH in 2006 indicates that 22.6% of Gratiot County women, who were pregnant, smoked while pregnant. This number is considerably higher than the rate estimated at the State level, which is 13.8%. Smoking during pregnancy accounts for 20 to 30% of low birth weight babies, up to 14 percent of preterm deliveries, and about 10% of all infant deaths. These consequences may be reduced through effective smoking prevention and cessation efforts.
Risk and Protective Factors
Gratiot County data indicates that while 87.9% of 6th graders, 89.9% of 8th graders, 91.1% of 10th graders, and 92.1% of 12th graders believe that “smoking a half of a pack of cigarettes per day is harmful,” their perception in whether their peers believe it is “wrong or very wrong to smoke cigarettes” is different. 96.8% of students in 6th grade, report a perception of peer disapproval related to smoking. When 12th graders were asked this question, only 60.8% of them reported that their peers would disapprove. While numbers increase in the perceived risk of smoking heavily, Gratiot County’s use rate and peer disapproval of smoking changes considerably. The most significant jump is made between 8th and 10th grade, as 30 day use increases from 8% to 17.3%, while peer disapproval drops from 90.3% down to 76.8%. Finally, youth’s perception about parental disapproval of smoking also decreases. 97.4% of 6th graders reported that they believed their parents disapproved of smoking, while 84.9% of 12th graders believed that their parents’ disapproved. Strategies must focus on challenging behaviors around the risk of tobacco use.
Community Access to Tobacco
The Michigan smoke-free legislation passed in December of 2009. Prior to its passage, there were two attempts by the Mid-Michigan District Health Department (MMDHD) to pass a far less stringent tri county smoke-free air ordinance in Gratiot, Clinton and Montcalm counties, which excluded restaurants and bars. Despite its’ overwhelming support and approval in Clinton and Montcalm counties, the Gratiot County Board of Commissioners did not pass the proposed ordinance. There were several area residents who were very vocal about their opposition to the ordinance.
Perhaps one of the greatest challenges for Gratiot County to confront is the social norms related to tobacco and cigarette use. Most individuals are well aware of these risks associated with tobacco use, but many are not invested in addressing the problem. The reluctance by the Gratiot County Board of Commissioners to pass the tri county ordinance is symbolic of the ambivalence in the county surrounding tobacco use. When comparing the rates of cigarette and chewing tobacco use in Gratiot County to Clinton county (which also took the PNA), a noticeable trend emerges. 30 day and lifetime use rates for both cigarettes and chewing tobacco are significantly higher in Gratiot at every grade level, with the exception of one, from 6th through 12th grade. This comparison to Clinton is not intended to criticize the Board for not taking action, but rather is intended to illustrate the need to challenge community norms in order to develop a healthier future for people of Gratiot County.
A key factor impacting tobacco use rates for underage youth is social access to tobacco. Although 1104 out of 1416 (78.0%) Gratiot County 6th, 8th, 10th, and 12th graders overall chose not to smoke, by grade 12 the rate of smoke free students is down to 64.1% (234 of 365). Youth obtain cigarettes from a variety of sources. 38.8% of youth in Gratiot County who smoked indicated that they obtained the cigarettes from someone over 18. Interestingly, another 13.8% of youth got cigarettes from someone under 18, while the remaining 52.4% obtained cigarettes from other sources. Contrary to alcohol, only 3% of youth report getting cigarettes at home with a parent’s permission. However, retail availability of cigarettes and chewing tobacco to youth may account for some of this difference.
Perhaps one of the greatest challenges for Gratiot County to confront is the social norms related to tobacco and cigarette use. Most individuals are well aware of these risks associated with tobacco use, but many are not invested in addressing the problem. The reluctance by the Gratiot County Board of Commissioners to pass the tri county ordinance is symbolic of the ambivalence in the county surrounding tobacco use. When comparing the rates of cigarette and chewing tobacco use in Gratiot County to Clinton county (which also took the PNA), a noticeable trend emerges. 30 day and lifetime use rates for both cigarettes and chewing tobacco are significantly higher in Gratiot at every grade level, with the exception of one, from 6th through 12th grade. This comparison to Clinton is not intended to criticize the Board for not taking action, but rather is intended to illustrate the need to challenge community norms in order to develop a healthier future for people of Gratiot County.
A key factor impacting tobacco use rates for underage youth is social access to tobacco. Although 1104 out of 1416 (78.0%) Gratiot County 6th, 8th, 10th, and 12th graders overall chose not to smoke, by grade 12 the rate of smoke free students is down to 64.1% (234 of 365). Youth obtain cigarettes from a variety of sources. 38.8% of youth in Gratiot County who smoked indicated that they obtained the cigarettes from someone over 18. Interestingly, another 13.8% of youth got cigarettes from someone under 18, while the remaining 52.4% obtained cigarettes from other sources. Contrary to alcohol, only 3% of youth report getting cigarettes at home with a parent’s permission. However, retail availability of cigarettes and chewing tobacco to youth may account for some of this difference.
Retail Availability of Tobacco to Youth
Retail Availability of tobacco to youth has been studied through the Prevention Needs Assessment survey, as well as compliance checks to vendors throughout the county. In a question which asked students “how do you usually get your cigarettes,” 22 out of 131 (16.7%) 12th grade smokers indicated that they had bought them without a fake ID. In 2007, a baseline was conducted on 100% of tobacco vendors in the county. Out of 52 vendors which were checked for compliance, 12 sold to minors (23%). In 2009, compliance checks produced a much improved compliance percentage, as only 1 in 19 vendors sold (5.2%). Tobacco compliance checks to be completed in 2010 will help the coalition determine the appropriate level for compliance checks.
GCSAC has created a logic model to more specifically identify evidence based strategies that will impact these tobacco objectives. Evidence-based strategies may include social marketing campaigns, continued law enforcement compliance checks and vendor education, advocacy, and evidence-based programming. GCSAC will also strive to enhance formal linkages with pre-existing prevention service delivery with school districts, businesses, faith-based community groups, county and city government, public health departments, and other health and human service organizations. Additional strategies include conducting SYNAR and Designated Youth Tobacco Use Representative (DYTUR) activities as required by the Michigan Department of Community Health (MDCH) contract with Mid-South.
GCSAC has created a logic model to more specifically identify evidence based strategies that will impact these tobacco objectives. Evidence-based strategies may include social marketing campaigns, continued law enforcement compliance checks and vendor education, advocacy, and evidence-based programming. GCSAC will also strive to enhance formal linkages with pre-existing prevention service delivery with school districts, businesses, faith-based community groups, county and city government, public health departments, and other health and human service organizations. Additional strategies include conducting SYNAR and Designated Youth Tobacco Use Representative (DYTUR) activities as required by the Michigan Department of Community Health (MDCH) contract with Mid-South.
