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Surveys show decline in Iowa youth tobacco use

Creation of the Iowa Division of Tobacco Use Prevention and Control as a separate entity has played pivotal role

By Eduardo Zamarripa | Drake University

Des Moines, Iowa (Nov. 21, 2011)- Recent surveys by the Iowa Youth Survey and by the Iowa Division of Tobacco Use Prevention and Control have revealed a decline in tobacco usage among Iowa high schools and middle schools in the last decade.

Iowa Youth Survey

The Iowa Youth Survey is a voluntary survey given to sixth graders, eighth graders and 11th graders every three years. In 1999, the survey revealed that three percent of sixth graders, 13 percent of eighth graders and 32 percent of 11th graders reported they had smoked a cigarette in the last 30 days.

The most recent survey conducted in 2008, revealed a decrease in all three grade levels. One percent of sixth graders, five percent of eighth graders and 19 percent of 11th graders reported they had smoked a cigarette in the last 30 days.

“They’ve been very reliable. Schools always feel that their data would be different, but they’re pretty right on,” said Iowa Department of Education consultant Sara Peterson.

Iowa Division of Tobacco Use Prevention and Control survey

The survey conducted by the Iowa Division of Tobacco Use Prevention and Control yielded similar results to the survey administered by the Iowa Youth Survey.

Since 2000, the percentage of Iowa middle school and high school students who currently use tobacco has dropped dramatically. Comparing the surveys taken in 2000 and 2008, tobacco use among middle school students dropped from 17 percent to three percent. Tobacco use among high school students dropped from 39 percent to 27 percent.

“It’s a random sample of middle schools and then another random sample of high schools,” said Iowa Division of Tobacco Use Prevention and Control epidemiologist Joann Muldoon. “We divide them by urban and rural. We send a list of all public schools to CDC (Centers for Disease Control and Prevention) and they put it in and then they send us back the schools to participate in the survey.”

These surveys are funded by the CDC, as well as the Iowa Office on Smoking and Health. Schools are not forced to participate and the random sampling also selects different class periods throughout the day to administer the survey. Still, the Iowa Division of Tobacco Use Prevention and Control feel the results are accurate.

“I think they are pretty accurate. We can’t force schools to participate. The middle-class or wealthier schools are less likely to participate,” Muldoon said. “We don’t sample in alternative schools and they generally have higher smoking rates. But it’s reliable from year-to-year.”

Alternative schools are schools designed to accommodate the needs of students who are in danger of failing academically and have dropped out from other schools. Every school district in Iowa provides alternative schools.

Tobacco Master Settlement Agreement

The progress made against Iowa tobacco youth prevention in the last decade coincides with the creation of the Iowa Division of Tobacco Use Prevention and Control within the Iowa Department of Public Health in 2000. Before that, tobacco prevention had been clumped together with the Iowa Bureau of Substance of Abuse.

However, the creation of the division was related to the Tobacco Master Settlement Agreement.  In 1998, Iowa was one of 46 states that filed a lawsuit against the nation’s four largest tobacco companies, asking for the recovery of tobacco-related health care costs through Medicaid. The settlement ruled that the 46 states were to receive $206 billion over 25 years divided in different sums for each state.

“In that context, the legislature said ‘tobacco is important enough that we have a different division for it,’” said Iowa Division of Tobacco Use Prevention and Control community health consultant Garin Buttermore.  “With those high rates and extra money and attention paid, a few different programs helped the smoking rates go down.”

Just Eliminate Lies

Since then, the settlement has allowed the Iowa Division of Tobacco Use Prevention and Control to act as a separate entity and use the money from the settlement to implement programs against tobacco use. Along with smaller programs that they have come out with through the years, there are two that stand out. Quitline Iowa is a telephone service program designed to help “older” tobacco consumers. Just Eliminate Lies is a program designed to target young Iowans.

“JEL was definitely geared towards high school. The importance of meeting or engaging with that population is because that’s where the tobacco people are engaging. That’s where most adult tobacco users start,” Buttermore said.  “If you can get to high school students, that’s the right time to get to them.”

However, the progress made in the last decade against tobacco use in Iowa may be halted by budget cuts across the state.

Budget cuts

While the Iowa Division of Tobacco Use Prevention and Control enjoyed almost a million dollars last year to create counter marketing programs against tobacco companies, the budget was reduced this year to a much lower number: zero.

“I think we will (see a rise in tobacco use), because we used to have a huge counter marketing program aimed at kids thinking of starting to use tobacco,” Muldoon said. “Right now, there’s no immediate money. Tobacco spends millions and millions in marketing kids each year.”

For now, Iowa will have to rely on its tobacco prevention programs and hope that the marketing campaigns launched by tobacco companies do not undermine the progress that has been made in the last decade.

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