We have released our Annual Report for Fiscal Year 2014, covering the period of July 1, 2013-June 30, 2014. The Annual Report highlights ClearWay Minnesota’s activities in tobacco cessation, public policy, research, diverse community outreach and other areas.
Today the Minnesota Department of Health released findings from the Minnesota Youth Tobacco Survey, the most comprehensive study on youth tobacco use in our state. The study found a significant decrease in youth smoking in Minnesota, which fell to 10.6 percent from 18.1 percent in 2011. This is the steepest decline in youth smoking ever recorded in the state.
The study findings also raised concerns around e-cigarette use, with 12.9 percent of students reporting they have used or tried an e-cigarette within the past 30 days.
“I have a sense of déjà vu about e-cigarettes,” said Minnesota Commissioner of Health Dr. Edward Ehlinger. “We need to take a hard look at what actions we can take at local and state levels to stop this trend.”
The Raise it for Health coalition, a group of leading Minnesota health organizations, released a statement highlighting the importance of cigarette taxes in reducing youth smoking.
“These results reinforce what we know: increasing the tax on tobacco products was a victory for the health of Minnesota’s kids,” said Janelle Waldock, a Raise it for Health co-chair and Director of the Center for Prevention at Blue Cross and Blue Shield of Minnesota.
More information on the Minnesota Youth Tobacco Survey can be found here.
Low-income Minnesotans are disproportionately impacted by tobacco’s harm. According to the national Campaign for Tobacco-Free Kids, there is a direct relationship between smoking rates, income and education levels. Individuals of lower socioeconomic status also have higher tobacco-related disease rates and less access to health care.
“Smoking rates among the general population have fallen,” said Amanda Jansen, Senior Cessation Manager at ClearWay Minnesota. “But we can’t forget about low-income Minnesotans, who still have high rates of addiction, death and disease caused by tobacco use.”
ClearWay Minnesota has been working to expand access to tobacco dependence treatment for Minnesotans covered by Medical Assistance and MinnesotaCare. While 94 percent of smokers are asked about smoking by health practitioners, fewer than half are referred to quitting help. Expanding access to cessation treatment for this low-income population has the potential to decrease tobacco use – saving lives and money for the state at the same time.
One way this is being accomplished is by focusing on Certified Tobacco Treatment Specialists (CTTSs). These are professionals trained to treat individuals seeking to stop using tobacco. CTTSs are increasingly being recruited by health systems to be part of health care teams and deliver care to tobacco-using patients.
Until recently, many CTTSs could not seek reimbursement for delivering cessation treatment to patients. However, our collaboration with the Minnesota Department of Human Services has now opened the door for health systems that employ CTTSs to receive reimbursement for providing cessation counseling for tobacco users covered by Medical Assistance and MinnesotaCare. These team members must be a CTTS, employed by a physician or by the same provider organization that employs the physician, and meet the supervision requirements of a physician extender as defined by Minnesota Health Care Programs. The new policy will be implemented on November 1.
“This change gives health systems another incentive to talk to their patients about how to quit,” said Jansen. “This means it’s much more likely that low-income Minnesotans will receive treatment and will try to quit.”
American Indians have an ancient relationship with tobacco, which is seen as a sacred medicine and is often central to tribal culture. But for generations, the commercial tobacco industry has corrupted traditional tobacco practices, and has marketed directly to American Indians by exploiting their images in advertisements.
As reported earlier this year by Minnesota Public Radio, today the smoking rate among American Indians in Minnesota is enormously high: 59 percent compared to 16 percent in the general population. Smoking-related diseases are the top killers in their communities, with cancer and heart disease at epidemic levels.
There are a number of reasons smoking among American Indians has not declined as fast as in the mainstream population. “Indian Nations are sovereign, and so state policies that reduce smoking, like cigarette taxes and the smoke-free law, don’t apply to them,” said CoCo Villaluz, who leads ClearWay Minnesota’s efforts in Indian Country. “Many American Indians are also cautious, considering the damage historically done to their culture by outsiders trying to ‘improve’ their ways,” she added.
ClearWay Minnesota is addressing these challenges by working directly with tribes. Through our Tribal Tobacco Education and Policy Initiative, we fund reservations working to advance smoke-free policies and raise awareness of the dangers of commercial tobacco use and secondhand smoke exposure. The project allows the tribes themselves to drive the work, and to determine readiness for specific changes within their communities.
A new advertising campaign this year is also reaching American Indian communities around the state. Billboards remind Native audiences that there is a difference between sacred tobacco practices and commercial tobacco use like cigarette smoking – a traditional teaching.
“A campaign trying to reach American Indians can’t talk down to them,” said Villaluz. “Keeping tobacco sacred is a concept that has deep meaning for Native peoples, and these ads respect their traditions while educating about the harms of smoking.”