{"id":1870,"date":"2017-05-09T12:14:51","date_gmt":"2017-05-09T19:14:51","guid":{"rendered":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/?p=1870"},"modified":"2021-05-04T10:47:52","modified_gmt":"2021-05-04T16:47:52","slug":"2015-wyoming-adult-tobacco-survey","status":"publish","type":"post","link":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/2017\/05\/09\/2015-wyoming-adult-tobacco-survey\/","title":{"rendered":"2015 Wyoming Adult Tobacco Survey"},"content":{"rendered":"<h1>Executive Summary<\/h1>\n<p>The Wyoming Tobacco Prevention and Control Program (TPCP) works to reduce tobacco use in Wyoming by using a comprehensive, multi-strategy approach. The TPCP aligns its strategies around four goal areas that it shares with the Centers for Disease Control and Prevention (CDC):<\/p>\n<ol>\n<li>Preventing initiation of tobacco use (CDC, 2014b)<\/li>\n<li>Eliminating nonsmokers&#8217; exposure to secondhand smoke (Starr et al., 2005)<\/li>\n<li>Promoting quitting among adults and young people (CDC, 2015)<\/li>\n<li>Identifying and eliminating tobacco-related disparities (Starr et al., 2005)<\/li>\n<\/ol>\n<p>As part of monitoring progress on these goals, the TPCP contracted with the Wyoming Survey &amp; Analysis Center (WYSAC) at the University of Wyoming to conduct the 2015 Wyoming Adult Tobacco Survey (ATS) with guidance and assistance from the CDC.<\/p>\n<h2>Key Findings<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming1.png\" alt=\"\" width=\"311\" height=\"329\" \/>The adult smoking rate has shown a modest but steady decrease since 2006 (Figure ES-1).<\/p>\n<h3>Preventing Initiation<\/h3>\n<p>About two thirds of those who have ever smoked a whole cigarette smoked their first whole cigarette when they were younger than 18. Almost one third smoked a whole cigarette for the first time between the ages of 18 and 24 (Figure ES-2).<\/p>\n<h3>Eliminating Exposure to Secondhand Smoke<\/h3>\n<p>Few Wyoming adults were exposed to secondhand smoke while in indoor public places (13%); more were exposed in outdoor public places (38%). Overall, 43% of adults were exposed to secondhand smoke while in an indoor or outdoor public place.<\/p>\n<p>The majority of Wyoming adults supported smokefree indoor air laws for workplaces, restaurants, and casinos and clubs. About half supported a smokefree indoor air law for bars (Figure ES-3).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming2.png\" alt=\"\" width=\"321\" height=\"330\" \/> <img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming3.png\" alt=\"\" width=\"309\" height=\"336\" \/><\/p>\n<h3><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming4.png\" alt=\"\" width=\"271\" height=\"295\" \/>Promoting Quitting<\/h3>\n<p>In 2015, 63% of tobacco users who were advised to quit were also offered assistance to quit from their healthcare providers. Of this group, 73% received information about the Wyoming Quit Tobacco Program (WQTP) from their healthcare providers (Figure ES-4).<\/p>\n<h3>Eliminating Disparities<\/h3>\n<p>The 2015 overall adult smoking rate in Wyoming was 16%. The 2015 ATS data show that certain groups are disparately affected by the health burdens of tobacco use:<\/p>\n<ul>\n<li>Native Americans (30% smoking rate)<\/li>\n<li>Those with less than a high school education (40% smoking rate)<\/li>\n<li>People who identify as LGBT (29% smoking rate)<\/li>\n<li>Young to middle-aged adults (20% smoking rate among 18\u201334-year-olds and 23% among 45\u201354-year-olds)<\/li>\n<\/ul>\n<h3><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming5.png\" alt=\"\" width=\"342\" height=\"533\" \/>Health Consequences<\/h3>\n<p>Based on self-report data, many chronic diseases are significantly more common among Wyoming adults who have smoked at least 100 cigarettes compared to those who have not (Figure ES-5).<\/p>\n<h3>Conclusions<\/h3>\n<p>The Wyoming smoking rate among adults has declined steadily since 2006. Persistent state and federal tobacco prevention efforts that help prevent smoking initiation and help people quit are likely to maintain that downward trend. This will, over time, reduce the economic and healthcare costs of smoking in Wyoming.<\/p>\n<p><style>@media only screen and (max-width: 1200px){.fullWidth {width: 100% !important; height: auto;}}@media only screen and (max-width: 700px){.alignright, .alignleft, .alignnone, .card-body img {display: inline;float: none;margin: 20px 0;width: 100%;height: auto;}}<\/style>\n<p><!--nextpage--><\/p>\n<style>@media only screen and (max-width: 1200px){.fullWidth {width: 100% !important; height: auto;}}@media only screen and (max-width: 700px){.alignright, .alignleft, .alignnone {display: inline;float: none;margin: 20px 0;width: 100%;height: auto;}}<\/style>\n<\/p>\n<h1>Background<\/h1>\n<p>Evidence of the ill effects of smoking has been growing since the 1950&#8217;s. In 1964, the U.S. Surgeon General issued the landmark report Smoking and Health: Report of the Advisory Committee to the Surgeon General, which stated unequivocally that a link between smoking and certain cancers exists. Cigarette smoking and breathing secondhand smoke has now been causally linked to an increased risk for multiple cancers and chronic diseases and is the leading preventable cause of death in the United States (U.S. Department of Health and Human Services [USDHHS], 2010, 2014). In Wyoming, this leads to approximately 800 deaths each year and nearly $258 million in annual healthcare costs that can be directly attributed to smoking (Centers for Disease Control and Prevention [CDC], 2014a).<\/p>\n<p>The Wyoming Tobacco Prevention and Control Program (TPCP) works to reduce tobacco use in Wyoming by using a comprehensive, multi-strategy approach. The TPCP aligns its strategies around four goals that it shares with the CDC:<\/p>\n<ol>\n<li>Preventing initiation of tobacco use (CDC, 2014b)<\/li>\n<li>Eliminating nonsmokers&#8217; exposure to secondhand smoke (Starr et al., 2005)<\/li>\n<li>Promoting quitting among adults and young people (CDC, 2015)<\/li>\n<li>Identifying and eliminating tobacco-related disparities (Starr et al., 2005)<\/li>\n<\/ol>\n<p>As part of monitoring progress on these goals, the TPCP tracks the prevalence and consumption of tobacco products including cigarette smoking, use of electronic nicotine delivery systems (ENDS; also known as e-cigarettes), and use of other forms of tobacco.<\/p>\n<p>The Wyoming Adult Tobacco Survey (ATS) is a standardized telephone survey administered by the Wyoming Survey &amp; Analysis Center (WYSAC) at the University of Wyoming under contract to the Wyoming Department of Health, Public Health Division (PHD). Its purpose is to collect state and county level data pertaining to the prevalence of tobacco use, the four TPCP\/CDC goals, and the broader goal of reducing tobacco-related disease and death. WYSAC merged data from the 2015 ATS with data from previous iterations of the survey to analyze trends.<\/p>\n<h1>Methods<\/h1>\n<h2>Questionnaire Development and Survey Administration<\/h2>\n<p>WYSAC developed the 2015 Wyoming ATS items based on CDC&#8217;s core and supplemental ATS items. The TPCP and WYSAC selected some optional questions and created Wyoming-specific questions based on the indicators most directly related to Wyoming&#8217;s TPCP efforts.<\/p>\n<p>The random digit dialing (RDD) for landlines and cell phones began on June 16, 2015, and ended on October 14, 2015. The final dataset contained a total of 4,948 completes, including 2,461 landline completes with a response rate of 31% and 2,487 cell phone completes with a response rate of 43%. The overall response rate was 37%.<\/p>\n<h2>Weighting and Analysis<\/h2>\n<p>After the completion of the data collection, the CDC weighted the 2015 ATS data to make the results more representative of the Wyoming adult population based on selection probability; non-response adjustment to landline records; and post-stratification demographic characteristics: county, age, gender, race\/ethnicity, educational attainment, and phone type (cell phone only and all other types including landline only and dual phone use).<\/p>\n<p>WYSAC analyzed the data using the complex sample survey methods feature of Stata version 12.1. Throughout this report, including the appendices, estimates and associated confidence intervals are calculated using weighted data. Reported sample sizes and group sizes are not weighted. WYSAC used logistic regression to test for trends for time periods longer than two years and to identify statistically significant associations between outcomes and other variables.<\/p>\n<p>Throughout this report, WYSAC compares 2015 ATS data to the 2010 National Adult Tobacco Survey, previous iterations of the ATS (2002, 2004, 2006\u20132009, and 2012), and the 2013-14 County Tobacco Survey (CTS; reported as 2013 data). The protocols for these surveys were generally similar, allowing for analyses of trends for comparable questions on the surveys. Throughout the report, WYSAC identifies statistically significant differences, p &lt; .05.<\/p>\n<p><!--nextpage--><\/p>\n<style>@media only screen and (max-width: 1200px){.fullWidth {width: 100% !important; height: auto;}}@media only screen and (max-width: 700px){.alignright, .alignleft, .alignnone {display: inline;float: none;margin: 20px 0;width: 100%;height: auto;}}<\/style>\n<\/p>\n<h1><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming6.png\" alt=\"\" width=\"272\" height=\"337\" \/>Prevalence and Consumption<\/h1>\n<p>The Wyoming TPCP and the CDC track the prevalence and consumption of the use of tobacco products as key indicators across their four shared goals.<\/p>\n<h2>Cigarettes<\/h2>\n<p>About one third of Wyoming adults have tried smoking without going on to become regular smokers. These experimental smokers are adults who have smoked less than 100 cigarettes in their lifetime. There are about as many adults who have never smoked, not even a puff, as former smokers (Figure 1).<\/p>\n<p>The adult smoking rate (adults who have smoked 100 cigarettes and currently smoke every day or some days) has shown a modest but significant decrease since 2006 (Figure 2).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone fullWidth\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming7.png\" alt=\"\" width=\"554\" height=\"341\" \/><\/p>\n<h2><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming8.png\" alt=\"\" width=\"265\" height=\"286\" \/>Electronic Nicotine Delivery Systems (ENDS)<\/h2>\n<p>About three fourths of Wyoming adults have never tried ENDS; 7% use them some days or every day (Figure 3).<\/p>\n<p>The 2015 ATS asked respondents who had ever tried ENDS why they used them (Figure 4). <br \/>The most popular reason was curiosity; users wanted to try something new. After that, the top results show an inclination by ENDS users toward cutting down or quitting cigarette smoking and an acknowledgment of the dangers of cigarettes.<\/p>\n<h2><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming9.png\" alt=\"\" width=\"264\" height=\"475\" \/><\/h2>\n<h2>Other Tobacco Products<\/h2>\n<p>Compared to smoking cigarettes, relatively few Wyoming adults reported using non-cigarette, non-ENDS tobacco products in the previous month (Figure 5).<\/p>\n<p>Among adults who had smoked at least 100 cigarettes and had also used chewing tobacco, snuff, dip, or snus in their lifetime, 42% of them have used some form of smokeless tobacco as a substitute for smoking when they were in a place where smoking was not allowed.<\/p>\n<h2>Conclusions<\/h2>\n<p>Cigarettes are still the most popular form of tobacco in Wyoming, but ENDS use is now about as prominent as smokeless tobacco use. Two of the top three reasons for using ENDS are cutting back or quitting cigarettes.<\/p>\n<h2><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming10.png\" alt=\"\" width=\"261\" height=\"349\" \/><\/h2>\n<p><!--nextpage--><\/p>\n<style>@media only screen and (max-width: 1200px){.fullWidth {width: 100% !important; height: auto;}}@media only screen and (max-width: 700px){.alignright, .alignleft, .alignnone {display: inline;float: none;margin: 20px 0;width: 100%;height: auto;}}<\/style>\n<\/p>\n<h1><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming11.png\" alt=\"\" width=\"171\" height=\"276\" \/>Goal Area 1: Preventing Initiation of Tobacco Use<\/h1>\n<p>The Wyoming Tobacco Prevention and Control Program and the CDC share the goal of reducing the health burdens of tobacco use by preventing its initiation.<\/p>\n<h2>Age of Smoking a Whole Cigarette for the First Time<\/h2>\n<p>The majority of those who have ever smoked a whole cigarette smoked their first whole cigarette when they were younger than 18. However, there was still a large group who smoked a whole cigarette for the first time between the ages of 18 and 24 (Figure 6).<\/p>\n<p>&nbsp;<\/p>\n<h2><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming12.png\" alt=\"\" width=\"344\" height=\"338\" \/>Age of Initiating Daily Smoking<\/h2>\n<p>Among daily smokers or smokers who at one time had been daily smokers (at least one cigarette per day for 30 days in a row), 90% said they started smoking daily when younger than 25. The percentage of those who started smoking daily when under the age of 18 has significantly declined since 2010. Meanwhile, the percentage of those who started smoking daily at 25 or older significantly increased over the same time period. The percentage of young adults (18\u201324) who started smoking daily did not change significantly between 2010 and 2015 (Figure 7).<\/p>\n<h2><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming13.png\" alt=\"\" width=\"352\" height=\"393\" \/>Conclusions<\/h2>\n<p>The smoking habits of the vast majority of Wyoming adults begin when they are under the age of 25. After age 25, very few adults begin to smoke or begin to smoke daily, though the age at which smokers initiate daily smoking appears to be increasing.<\/p>\n<p>&nbsp;<\/p>\n<h1>Goal Area 2: Eliminating Nonsmokers&#8217; Exposure to Secondhand Smoke<\/h1>\n<h1><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming14.png\" alt=\"\" width=\"159\" height=\"358\" \/><\/h1>\n<p>The Wyoming Tobacco Prevention and Control Program and the CDC share the goal of reducing the health burdens of tobacco use by eliminating nonsmokers&#8217; exposure to secondhand smoke.<\/p>\n<h2>Support for Indoor Smokefree Policies and Laws<\/h2>\n<p>The 2015 ATS asked questions about both smokefree indoor air policies and smokefree indoor air laws. The policy questions asked respondents if they think smoking should be allowed indoors at workplaces, restaurants, bars, and casinos and clubs. (Casinos and clubs were asked as a single survey item, so WYSAC treated them as a single venue type.) The survey questions about smokefree laws asked respondents if they support or oppose statewide smokefree indoor air laws in Wyoming for all workplaces, restaurants, bars, and casinos and clubs. Results from the policy questions revealed that the percentage of Wyomingites who agreed that smoking indoors should never be allowed in workplaces or restaurants significantly increased from 2002 to 2015. For bars and casinos and clubs, more Wyoming adults believed that smoking should never be allowed indoors in 2015 than in 2013, but support for smokefree policies in these three venues was still lower than other venues (Figure 8).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone fullWidth\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming15.png\" alt=\"\" width=\"586\" height=\"406\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming16.png\" alt=\"\" width=\"348\" height=\"337\" \/><\/p>\n<p>The majority of Wyoming adults supported statewide smokefree indoor air laws covering all workplaces, restaurants, or casinos and clubs. About half (49%) supported a statewide smokefree indoor air law covering all bars (Figure 9).<\/p>\n<p>WYSAC performed logistic regression analyses to identify associations between support for a state smokefree indoor air law for each venue and seven demographic variables: age, gender, annual household income, education, race, ethnicity, and sexual orientation. WYSAC modeled each of the four venues in Figure 9 separately, using these seven demographic variables as predictors. When controlling for the other demographic variables, gender, income, and education were significantly associated with support for legally protected smokefree indoor air for workplaces, restaurants, bars, and casinos and clubs. Men were less likely to support smokefree indoor air laws than women. Adults with income less than $30,000 and adults with a high school diploma, GED, or less education were relatively unlikely to support smokefree indoor air laws (Table 1). See Appendix C for detailed results.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone fullWidth\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming17.png\" alt=\"\" width=\"578\" height=\"277\" \/><\/p>\n<h2>Support for Outdoor Smokefree Policies and Laws<\/h2>\n<p>In 2015, most Wyomingites (82%) agreed that smoking should be restricted at outdoor parks: 44% of adults agreed that smoking should be allowed only at some times or in some places; 38% agreed that smoking should never be allowed. These proportions have not significantly changed since 2010.<\/p>\n<p>Support for laws making outdoor workplaces smokefree was substantially lower than support for laws making indoor workplaces smokefree: 65% of Wyoming adults opposed a state smokefree air law for all outdoor workplaces while only 28% would support such a law; 8% said they were unsure.<\/p>\n<h2>Exposure to Secondhand Smoke<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone fullWidth\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming18.png\" alt=\"\" width=\"551\" height=\"380\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming19.png\" alt=\"\" width=\"366\" height=\"377\" \/>The percentage of Wyoming adults who reported they do not allow smoking inside their homes has increased significantly over time (Figure 10).<\/p>\n<p>Most Wyoming adults (91%) who worked indoors reported that smoking was never allowed in indoor areas (including inside a vehicle) at their place of work. Conversely, relatively few (including those who worked outside) reported that smoking was not allowed in outdoor areas (Figure 11).<\/p>\n<p>Most adults were not regularly exposed to secondhand smoke at their place of work; 78% reported that they had not breathed someone else&#8217;s smoke at their workplace in the previous seven days. However, 91% stated that their indoor workplace had smokefree policies, indicating that some Wyoming adults reported exposure to secondhand smoke despite those policies.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming20.png\" alt=\"\" width=\"354\" height=\"375\" \/>Relatively few Wyoming adults reported being exposed to secondhand smoke while at indoor or outdoor public places in the past seven days (Figure 12).<\/p>\n<h2>Conclusions<\/h2>\n<p>Opinions vary as to where and how smoking should be restricted. Wyoming adults have a high degree of agreement that indoor areas of restaurants and workplaces across the state should have smokefree indoor air. There is less agreement on smokefree air policies and laws for casinos, clubs, bars, and outdoor work areas. Most adults report working in places that have smokefree indoor air policies, but outdoor smokefree air policies at workplaces are rare. Most exposure to secondhand smoke occurs in outdoor areas, including at work and public places.<\/p>\n<p><!--nextpage--><\/p>\n<style>@media only screen and (max-width: 1200px){.fullWidth {width: 100% !important; height: auto;}}@media only screen and (max-width: 700px){.alignright, .alignleft, .alignnone {display: inline;float: none;margin: 20px 0;width: 100%;height: auto;}}<\/style>\n<\/p>\n<h1><img decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming21.png\" alt=\"\" \/>Goal Area 3: Promoting Cessation<\/h1>\n<p>The TPCP and the CDC share the goal of reducing the health burdens of tobacco use by promoting quitting among adults and young people.<\/p>\n<h2>Smokers&#8217; Cessation Efforts<\/h2>\n<p>The majority (68%) of current smokers stated that they wanted to quit, 26% said they did not, and 6% responded that they did not know or were not sure. At some point in their lives, most current smokers (86%) had stopped smoking for at least one day because they were trying to quit for good. Nearly half of current smokers (45%) had tried to quit smoking at least once in the past year (Figure 13). This has not changed significantly since 2010. Relatively few smokers who had tried to quit in the past year had used proven cessation aids. When they did use them, nicotine replacement therapy (NRT) was the most often used in both 2012 and 2015 (Figure 14).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming22.png\" alt=\"\" width=\"272\" height=\"337\" \/> <img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming23.png\" alt=\"\" width=\"274\" height=\"340\" \/><\/p>\n<h2>Involvement of Healthcare Providers in Tobacco Cessation<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming24.png\" alt=\"\" width=\"276\" height=\"386\" \/>The ATS asked tobacco users if they had seen a healthcare professional in the past year and if so, if they received advice to quit from a healthcare professional. Half (50%) of these current tobacco users were advised by a health professional to quit using tobacco. This result has remained stable since 2010. These respondents then answered more detailed questions about whether and how healthcare providers provided assistance. In 2015, 63% of tobacco users who were advised to quit were also offered assistance to quit from their healthcare providers. These tobacco users most often received information about the Wyoming Quit Tobacco Program (WQTP) from their healthcare providers (Figure 15).<\/p>\n<p>In a separate line of questioning, the majority (71%) of current tobacco users who had not been advised to quit and non-tobacco-using Wyoming adults reported that a healthcare professional had asked them whether they smoked cigarettes or used other forms of tobacco. This is a significant increase over time, going from 64% in 2010 to 66% in 2012 to 71% in 2015.<\/p>\n<h2>Tobacco Cessation and the Price of Tobacco<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming25.png\" alt=\"\" width=\"269\" height=\"334\" \/>Increasing the price of tobacco products is one method of encouraging cessation (CDC, 2015). Since 2003, the state of Wyoming has taxed cigarettes with an excise tax of $0.60 per pack. When asked how much of an increase above $0.60 they would approve, almost half (47%) of adults would approve an increase of some amount (Figure 16). The most popular amount was an increase of $1.50 or more, with 21% of adults supporting that change. For smokeless tobacco, 49% of adults indicated that they were &#8220;for&#8221; an increase in the tax while 40% said they were &#8220;against,&#8221; and 10% said that they did not know or were not sure.<\/p>\n<p>Most smokers (55%) were paying more than $5 per pack of cigarettes in 2015, a greater proportion than 2010 when it was just 25% (Figure 17).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone fullWidth\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming26.png\" alt=\"\" width=\"553\" height=\"340\" \/><\/p>\n<p>In 2015, 79% of all Wyoming adults who had smoked and had bought cigarettes for themselves in the past 30 days, did not take advantage of coupons, rebates, buy 1 get 1 free, 2 for 1, or any other special promotion.<\/p>\n<h2>Conclusions<\/h2>\n<p>The majority of smokers have tried to quit and want to quit for good. They are also paying more for cigarettes than they have in the past. However, the use of proven cessation aids is relatively low. Many tobacco users are not receiving screening and assistance from healthcare providers to help them quit. Only half of current tobacco users who saw a healthcare professional in the previous year were advised to quit, but over half of those were offered assistance. Greater collaboration with health professionals could result in more tobacco users becoming aware of, and receptive to, cessation services.<\/p>\n<p>Awareness of tobacco quitlines is another area of potential improvement. Less than half of nonsmokers were aware that a quitline (local or national) existed. The WQTP reports that friends and family of tobacco users (which would include non-tobacco users) are key referral sources (WYSAC, 2017). If more nonsmokers knew about the existence of this proven cessation aid, then they could inform and encourage tobacco users who may not know about it.<\/p>\n<h1>Goal Area 4: Identifying and Eliminating Tobacco-Related Disparities<\/h1>\n<p>The fourth goal of the TPCP and the CDC is to reduce tobacco use and associated health burdens among populations that are disparately affected (Starr et al., 2005). In 2015, 30% of Native Americans in Wyoming smoked cigarettes, almost double the statewide smoking rate of 16% (Figure 18). Women and men in Wyoming smoked at about the same rate (15% vs 17% respectively); 18% of women of childbearing age (18\u201344 years old) were current smokers. Young adults (aged 18\u201324) were one of three age groups with a relatively high smoking rate (Figure 19).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming27.png\" alt=\"\" width=\"267\" height=\"340\" \/> <strong><img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming28.png\" alt=\"\" width=\"271\" height=\"345\" \/><\/strong><\/p>\n<p>Those with less education were more likely to smoke (Figure 20). Adults who identified as lesbian, gay, bisexual, transgender, or &#8220;other&#8221; were more likely to smoke than those who identified as heterosexual (Figure 21).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming29.png\" alt=\"\" width=\"272\" height=\"305\" \/> <img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming30.png\" alt=\"\" width=\"277\" height=\"310\" \/><\/p>\n<h2>Conclusions<\/h2>\n<p>Compared to the state rate, Native Americans, young adults, adults with less education, and those who identify as LGBT have relatively high smoking rates. Although the smoking rate among women of child-bearing age is not exceptionally high, the health burdens of smoking while pregnant are substantial. Promoting quitting and reducing initiation among these groups will, over time, reduce the disparities in tobacco use and its health consequences.<\/p>\n<p><!--nextpage--><\/p>\n<style>@media only screen and (max-width: 1200px){.fullWidth {width: 100% !important; height: auto;}}@media only screen and (max-width: 700px){.alignright, .alignleft, .alignnone {display: inline;float: none;margin: 20px 0;width: 100%;height: auto;}}<\/style>\n<\/p>\n<h1><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2017\/05\/051017_1805_2015Wyoming31.png\" alt=\"\" width=\"324\" height=\"600\" \/>Health Consequences of Smoking<\/h1>\n<p>The TPCP collects data about the prevalence of several chronic diseases to understand the burden and consequences of tobacco use.<\/p>\n<p>The U.S. Surgeon General has concluded that smoking is harmful to nearly every organ in the body, causes disease, and worsens existing illnesses (USDHHS, 2014). WYSAC created a logistic regression model based on data from the 2015 Wyoming ATS. The model found that hypertension, high cholesterol, heart disease, chronic lung disease, and diabetes were significantly more common among people who had smoked at least 100 cigarettes (current and former smokers) compared to those who had not (Figure 22; see Appendix C for detailed results).<\/p>\n<p>In more general terms, current smokers reported worse overall health than nonsmokers. A quarter (25%) of all Wyoming smokers reported being in fair or poor health, more than double the percentage (11%) of nonsmokers.<\/p>\n<h2>Conclusions<\/h2>\n<p>Wyoming smokers are more prone to chronic illness and tend to feel less healthy overall. Reducing the prevalence of smoking will, over time, reduce the burden of chronic disease in Wyoming and help Wyomingites feel healthier.<\/p>\n<p><!--nextpage--><\/p>\n<style>@media only screen and (max-width: 1200px){.fullWidth {width: 100% !important; height: auto;}}@media only screen and (max-width: 700px){.alignright, .alignleft, .alignnone {display: inline;float: none;margin: 20px 0;width: 100%;height: auto;}}<\/style>\n<\/p>\n<h1>Summary and Discussion<\/h1>\n<p>The 2015 Wyoming adult smoking rate of 16% is the lowest smoking rate recorded by the Wyoming ATS since its inception in 2002. From a high of 21% in 2006, the smoking rate in Wyoming has declined significantly. Cigarettes are still the most popular form of tobacco use in Wyoming, but ENDS use is now about as prominent as smokeless tobacco use. Two of the three most common reasons for using ENDS are cutting back or quitting cigarettes. The broader public health community has yet to determine how to balance the risk of ENDS with the potential for them to be less harmful than cigarettes.<\/p>\n<p>The smoking habits of the vast majority of Wyoming adults begin when they are younger than 25, and especially before the age of 18. After age 25, very few adults begin to smoke or begin to smoke daily. A continued focus on preventing the initiation of smoking by youth and young adults could, over time, reduce the prevalence of smoking and associated health problems.<\/p>\n<p>Opinions vary as to where and how smoking should be restricted. Wyoming adults have a high degree of agreement that indoor areas of restaurants and workplaces across the state should have smokefree indoor air. There is less agreement on smokefree air in casinos, clubs, bars, and outdoor work areas. Most adults report working in places that have smokefree policies but outdoor areas rarely do. Most exposure to secondhand smoke occurs in outdoor areas, including at work and public places.<\/p>\n<p>The majority of smokers have tried to quit and want to quit for good. They are also paying more for cigarettes than they have in the past. However, the use of proven cessation aids is relatively low, and many tobacco users are not receiving screening and assistance from healthcare providers to help them quit. Only half of current tobacco users who saw a healthcare professional in the previous year were advised to quit, but over half of those were offered assistance. Greater collaboration with health professionals could result in more tobacco users becoming aware of, and receptive to, proven cessation aids and services.<\/p>\n<p>Awareness of tobacco quitlines is an area of potential improvement. Less than half of nonsmokers were aware that a quitline (local or national) existed. The WQTP reports that friends and family of tobacco users (which would include nonsmokers) are key referral sources (WYSAC 2017). If more nonsmokers knew about the existence of this proven cessation aid, then they could inform and encourage tobacco users who may not know about it.<\/p>\n<p>Native Americans, young adults, those with little formal education, and those who identify as LGBT have relatively high smoking rates. Although the smoking rate among women of child-bearing age is not exceptionally high, the health burdens of smoking while pregnant are substantial. Promoting quitting and reducing initiation among these groups will, over time, reduce the disparities in tobacco use and its health consequences.<\/p>\n<p>The health consequences of smoking in Wyoming are similar to reports in the medical literature (USDHHS, 2014). Compared to nonsmokers, Wyoming smokers tend to be less healthy overall and are more prone to chronic illness. Reducing the prevalence of smoking will, over time, reduce the health and economic burden of smoking-attributable chronic disease in Wyoming.<\/p>\n<p><!--nextpage--><\/p>\n<style>@media only screen and (max-width: 1200px){.fullWidth {width: 100% !important; height: auto;}}@media only screen and (max-width: 700px){.alignright, .alignleft, .alignnone {display: inline;float: none;margin: 20px 0;width: 100%;height: auto;}}<\/style>\n<\/p>\n<h1>References<\/h1>\n<p style=\"margin-left: 36pt;\"><span style=\"background-color: white;\">Centers for Disease Control and Prevention. (2014a). <em>Best practices for comprehensive tobacco control programs\u20132014<\/em>. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. <\/span><\/p>\n<p style=\"margin-left: 36pt;\"><span style=\"background-color: white;\">Centers for Disease Control and Prevention. (2014b). <em>Preventing Initiation of Tobacco Use: Outcome Indicators for Comprehensive Tobacco Control Programs\u20132014<\/em>. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. <\/span><\/p>\n<p style=\"margin-left: 36pt;\"><span style=\"background-color: white;\">Centers for Disease Control and Prevention. (2015). <em>Promoting quitting among adults and young people: outcome indicators for comprehensive tobacco control programs\u20142015. <\/em>Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. <\/span><\/p>\n<p style=\"margin-left: 36pt;\">Starr, G., Rogers, T., Schooley, M., Porter, S., Wiesen, E., &amp; Jamison, N. <span style=\"background-color: white;\">(2005). <em>Key outcome indicators for evaluating comprehensive tobacco control programs. <\/em>Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. <\/span><\/p>\n<p style=\"margin-left: 36pt;\">U.S. Department of Health, Education, and Welfare. (1964). <em>Smoking and Health:<\/em> <em>Report of the advisory committee to the Surgeon General of the Public Health Service. <\/em>Washington, DC: Department of Health, Education, and Welfare Public Health Service Publication No. 1103.<\/p>\n<p style=\"margin-left: 36pt;\"><span style=\"background-color: white;\">U.S. Department of Health and Human Services. (2010). <\/span><em>How tobacco smoke causes disease: The biology and behavioral basis for smoking-attributable disease: A report of the Surgeon General.<\/em><span style=\"background-color: white;\"> Atlanta, GA: <\/span>Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Retrieved from <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK53017\/\">http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK53017\/<\/a>.<\/p>\n<p style=\"margin-left: 36pt;\">U.S. Department of Health and Human Services. (2014). <em>The health consequences of smoking \u2013 50 years of progress: A report of the Surgeon General<\/em>. Retrieved December 8, 2016, from <a href=\"http:\/\/www.cdc.gov\/tobacco\/data_statistics\/sgr\/50th-anniversary\/index.htm\"><span style=\"color: #d38323; background-color: white;\">http:\/\/www.cdc.gov\/tobacco\/data_statistics\/sgr\/50th-anniversary\/index.htm<\/span><\/a><span style=\"color: #d38323; background-color: white; text-decoration: underline;\">. <\/span><\/p>\n<p style=\"margin-left: 36pt;\"><span style=\"background-color: white;\">WYSAC. (2016). <em>Electronic Nicotine Delivery Systems, <\/em>by L. Despain, E. Weaver, J. Simpson &amp; S. O&#8217;Donnell. (WYSAC Issue Brief). Laramie, WY: Wyoming Survey &amp; Analysis Center, University of Wyoming. <\/span><\/p>\n<p style=\"margin-left: 36pt;\"><span style=\"background-color: white;\">WYSAC. (2017). <em>Impact of tobacco in Wyoming. 2016 Annual Summary, <\/em>by L. Despain, S. O&#8217;Donnell &amp; J. Simpson. Laramie, WY: Wyoming Survey &amp; Analysis Center, University of Wyoming.<\/span><\/p>\n<h1>Appendix<\/h1>\n<p>To see the appendix, please download the full report.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Wyoming Tobacco Prevention and Control Program (TPCP) works to reduce tobacco use in Wyoming by using a comprehensive, multi-strategy approach. The TPCP aligns its strategies around four goal areas that it shares with the Centers for Disease Control and Prevention (CDC):<\/p>\n","protected":false},"author":4,"featured_media":1885,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[7,88,61,10,62,75,43,91,9,74,8,45],"coauthors":[21,22,20,125],"class_list":["post-1870","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-reports","tag-use-adults","tag-adults","tag-attitudes","tag-cessation","tag-cigarettes","tag-disparities","tag-electronic-cigarettes","tag-health","tag-health-econ","tag-secondhand-smoke","tag-laws","tag-wyoming"],"_links":{"self":[{"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/posts\/1870","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/comments?post=1870"}],"version-history":[{"count":25,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/posts\/1870\/revisions"}],"predecessor-version":[{"id":3314,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/posts\/1870\/revisions\/3314"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/media\/1885"}],"wp:attachment":[{"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/media?parent=1870"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/categories?post=1870"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/tags?post=1870"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/coauthors?post=1870"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}