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Tobacco Disparities Planning Project
CLOSING THE GAPS:
Identifying & Eliminating Tobacco Related Disparities in Oregon - Executive Summary (2002)
In 2002, TPEP gathered together leaders in tobacco control and public health within Oregon's diverse communities to outline a plan to reduce identified disparities. Having received support from the CDC Office on Smoking or Health, the Tobacco Disparities Planning Committee examined data, identified and defined disparities, and made recommendations about how to move all communities forward in the reduction of tobacco use.
Download the Executive Summary (pdf) for printing.
Sweeping changes in attitudes towards the use of tobacco have been woven into our social fabric over the last 20 years. Officials estimate that 1,800 lives and $450 million will be saved in Oregon as a result of these changes. The time has come to focus, refine, and expand Oregon's tobacco control efforts to allow disparate communities to share in this success. The workgroup stands ready to partner with other professionals, communities, and politicians, to champion the cause into the future.
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Key Findings
1. Lack of available best practices, locally or nationally, for working with disparate groups.
2. Disparately high prevalence of tobacco use among African Americans, Native Americans, 18-24 year olds, some Asian/Pacific Islander groups, persons of low socioeconomic status and the Gay, Lesbian, Bisexual, and Transgender community.
3. Disparately high prevalence of chew-tobacco use among Native Americans and rural males.
4. Tobacco companies are aggressively targeting Hispanics, African Americans, Native Americans, Asian/Pacific Islanders, the Gay, Lesbian, Bisexual, and Transgender community, and the 18-24 year olds to expand their markets.
5. Existing data collection methods do not provide accurate data about tobacco prevalence within the Gay, Lesbian, Bi-sexual, Transgender community, and among sub-groups of Asian/Pacific Islanders.
6. Lack of funding for tobacco control programs within the Gay, Lesbian, Bisexual, and Transgender community, despite indications of extremely high prevalence.
7. Limited resources for tobacco control programs among communities with disparities.
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Project Goals
1. Identify, develop, and promote the use of best practices for eliminating tobacco-related disparities in Oregon.
2. Develop and implement effective population specific tobacco control programs directed at African Americans, Native Americans, 18-24 year olds, some Asian/Pacific Islander groups, persons of low socioeconomic status, and Gay, Lesbian, Bi-sexual, and Transgender individuals who have disparately high prevalence of tobacco use, and Hispanics who, along with the above, are heavily targeted by the tobacco industry.
3. Develop and implement specific programs to reduce the use of chew-tobacco by Native Americans and rural males.
4. Assure that data collection efforts determine the prevalence of tobacco use within the Gay, Lesbian, Bisexual, and Transgender and sub-groups of the Asian/Pacific Islander populations.
5. Fund effective community-based tobacco control programs for the Gay, Lesbian, Bisexual, and Transgender community.
6. Increase the capacity of population groups with higher tobacco use prevalence and other tobacco related disparities to apply for and secure funding within both existing and new funding streams.
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Diversity & Disparity
As defined in tobacco control work, diversity is the commitment of a program to be inclusive of all populations (racial/ethnic, gender specific, etc.) Disparity is a specific and identifiable gap revealed by indicators such as tobacco use prevalence, exposure to second-hand smoke, relapse rates, access to prevention and cessation programs, and tobacco industry marketing.
This planning process revealed diverse communities that suffer from disparities but also revealed diverse communities that do not.
The Time to Act is Now
Sweeping changes in attitudes towards the use of tobacco have been woven into our social fabric over the last 20 years. Officials estimate that 1,800 lives and $450 million will be saved in Oregon as a result of these changes. The time has come to focus, refine, and expand Oregon's tobacco control efforts to allow disparate communities to share in this success. The workgroup stands ready to partner with other professionals, communities, and politicians, to champion the cause into the future.
Oregon's Tobacco Control Programs Are Working
Oregon's tobacco prevention and education program is nationally recognized for its success. Since the program's inception in 1997, per capita tobacco consumption has been reduced by 29%-twice the national average-and smoking prevalence in adults has been reduced by 12%. This reduction is a result of providing resources and support to local coalitions, school-based programs, public awareness and education efforts, the Oregon Tobacco Quit Line, tribal programs, and other multicultural projects. However, this is only the beginning.
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Oregon's Next Step: Close the Gaps
As impressive as the statistics are, closer inspection reveals that Oregon's diverse populations are not equally sharing the benefits of tobacco control programs. Declining tobacco use across the state is exposing disparities in some distinct communities; disparities that current programming does not adequately address. Close scrutiny of preliminary 2000-2001 data shows strikingly high prevalence among Native American (41%) and individuals of low socio-economic status (SES: 36%). Additionally, chewtobacco rates are prominent among Native American (10%) and rural males (10%).
Although information about the Gay, Lesbian, Bisexual, and Transgender community is difficult to assess due to a lack of Oregon-specific data, a recent review of published studies estimates smoking prevalence ranges from 25 - 50% for gay and bisexual men and from 11 - 50% for lesbian and bisexual women*. These groups are not alone.
Disparities also exist in the African American and several Asian/Pacific Islander communities as well as among young adults between the ages of 18 and 24. These tobacco disparities have not gone unnoticed by the tobacco industry, which is fully aware of the potential of these communities. Its marketing strategies and tactics aggressively target these disparate groups and the Hispanic community in their effort to maximize profits and expand markets.
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* Race/ethnicity estimates based on 2000 and 2001 combined data.
** No Oregon-specific data is available for the GLBT population. A recent review of published studies estimates the smoking prevalence ranges from 25-50% in gay and bisexual men and from 11-50% in lesbian and bisexual woman (mid-point of the range for gay and bisexual men presented above).
In all but one study, the rates were higher than those of the general adult population during the same period of time.
* Race/ethnicity estimates based on 2000 and 2001 combined data.
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Growing evidence of this disturbing trend led the Federal Centers For Disease Control and Prevention Office on Smoking or Health (CDC/OSH) to initiate the Pilot Training Program, an endeavor to provide select states a model, the training, and financial support necessary to create a strategic plan to identify and eliminate disparities.
Oregon was selected as one of the states to implement this pilot program, and the Tobacco Disparities Planning Project was formed in April 2002. The project served to bring together an inclusive and diverse workgroup to examine available data, identify and define disparities, and make recommendations about how to achieve parity and move all communities forward together.
Moving Forward Together
The workgroup's findings are detailed in the Strategic Plan for Closing the Gaps: Identifying & Eliminating Tobacco-related Disparities in Oregon. It outlines a plan to reduce identified disparities, collect data to identify additional disparities, and support communities targeted by the tobacco industry. This plan is a call to action and will serve as a blueprint for the Department of Human Services and tobacco prevention partners around the state as they work to eliminate tobacco-related disparities in Oregon.
Workgroup Members
- Faye Burch, FM Burch Consulting
- Cathryn Cushing, Cathryn Cushing Consulting
- Sik Yin Chan, Portland Impact and Asian-Pacific Consortium, on Substance Abuse
- Shannon Chrisman, Confederated Tribes of Siletz Indians of Oregon
- Nelia Collins, Asian Family Center
- Lorrie Piatt-Montry, Asian-Pacific Consortium on Substance Abuse
- Judith Van Osdol, DHS/Oregon Medical Assistance Program
- Kurt Schweigman, Native American Rehabilitation Association
- Jackie Scott, Urban League of Portland
- Liling Sherry, Northwest Portland Area Indian Health Board
- Philip Knowlton, Cascade Aids Project
- Raheve Gray, Multnomah County Health Department
- Janet Jones, Umatilla County Coalition Against Tobacco
- Sayaka Kanade, Northwest Portland Area Indian Health Board
- German Nunez, OHSU Diversity and Multicultural Affairs
- Raleigh Lewis, Governor's Office Affirmative Action Office
- Kerri Lopez, Native American Rehabilitation Association
- Gloria Muzquiz, Oregon Human Development Corporation
Department of Human Resources Representatives
- Mary Boehme, Tobacco Prevention & Education Program
- Luci Longoria, Tobacco Prevention & Education Program
- Gerry Odisio, Tobacco Prevention & Education Program
- Kristen Rohde, Tobacco Prevention & Education Program
- Mike Stark, Program Design & Evaluation Services
Facilitators
- Carol Gelfer
- Sheri Campbell
The executive summary and strategic plan for Closing the Gaps: Identifying & Eliminating Tobacco-related Disparities in Oregon have been prepared by members of the Tobacco Disparities Planning Project 2002. The contents reflect the combined wisdom of leaders in tobacco control and public health within Oregon's diverse communities. For additional copies of the summary or strategic plan, please contact the Department of Human Services Tobacco Prevention & Education Program (971.673.0984).
*Ryan H, Wortley PM, Easton A, Pederson L, Greenwood G.
Smoking among lesbians, gays, and bisexuals: A review of the literature. Am J Prev Med 2001; 21(2).
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