Presentation Objectives• Describe an organizational collaboration to

produce a joint research report.

• Characterize the desire to quit smoking among:– adult Minnesotans.– members of two publicly subsidized insurance

programs.– high school students.

• Identify unique barriers for low-income groups.

• Suggest use of results to advocate for offering cessation resources.

Collaborators • Minnesota Partnership for Action Against Tobacco

(MPAAT)– Barbara Schillo, Ph.D.

• Minnesota Dept. of Health: Center for Health Statistics– Brian Zupan, Ph.D.– Pete Rode, Ph.D.– Ann Kinney, Ph.D.

• Blue Cross Blue Shield of Minnesota– Steven Foldes, Ph.D.– Nina L. Alesci, M.P.H.

Who Was Surveyed?• Minnesota Adults (MPAAT)

– 6,000 adult state residents

• Blue Cross Blue Shield of Minnesota publicly subsidized adult members– Minnesota Care: 1,000 adult members – Prepaid Medical Assistance Program: 1,000 adult

members (under age 65)

• Minnesota Youth: Minnesota Dept. of Health Youth Tobacco Survey– 12,000 6th-12th grade students

Adult Survey Methods• One survey instrument developed by team

– Blue Cross Blue Shield of Minnesota– Minnesota Partnership for Action Against Tobacco– MN Dept. of Health & Dept. of Human Services– U of Minnesota: Medicine and Epidemiology

• Randomly selected adult sample (age 18 +)– Minnesotans: Random Digit Dial method– Blue Cross: List sample of members– Not representative of minority populations

• Telephone interviews conducted in 1999

What’s the Story?• Smoking Causes Death and Disease• Many Adult Minnesotans Smoke• Many Adult Smokers Try to Quit• Quitting is Difficult Because Smoking is Addictive• Many Smokers Quit Successfully, for Many Reasons• There are Many Barriers to Quitting Smoking• People Trying to Quit Smoking are Increasingly

Seeking Assistance• (Teen Story: 5 points)• Quitting Assistance Now Widely Available to

Minnesotans

Many Adult Minnesotans Smoke

Statewide adult smoking rates

Many Adult Minnesotans Smoke

Blue Plus MinnesotaCare adult smoking rates

Many Adult Minnesotans Smoke

Blue Plus PMAP adult smoking rates

Many Adult Smokers Try to Quit

Reduced smoking and quit attempts among current adult smokers

Quitting is DifficultBecause Smoking is Addictive

• Of current smokers who tried to quit in the 12 months before the survey:– 76% made multiple quit attempts– 25% tried to quit six or more times– All these attempts failed

• How addicted are these smokers?– 46% smoke their first cigarette within 30

minutes of waking– 17% within 5 minutes – Mean cigarettes per day = 15

Quitting is DifficultBecause Smoking is Addictive The more adults smoke, the less confidence they have in their ability to quit permanently.

There are Many Barriers to Quitting

Current adult smokers identify many barriers to quitting.

Percent reporting “yes”

There are Many Barriers to Quitting Smoking

• Variations in Barriers:– Risk of gaining weight

Women = 48% Men = 17%– Loss of way to handle stress

Women = 65% Men = 46%– Cost of medicines/products to help quit

State = 30%, MNCare = 50%, PMAP = 51%

• Social Environment:– Spouse or close friend is a current smoker

Never smoker = 30% Current smoker = 60%

People Trying to Quit are Increasingly Seeking Assistance

Former adult smokers’ use of quit aids by time since quit.

Former smokers who used a quit aid

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People Trying to Quit are Increasingly Seeking Assistance

• 36% of current smokers with at least one quit attempt in the prior 12 months used assistance in their most recent attempt.

• Interest in using assistance in future attempts “if cost were not an issue”:– 60% of all Minnesota smokers– 72% of Blue Plus MinnesotaCare smokers – 71% of Blue Plus PMAP smokers

Types of aid preferred by current adult smokers’ who would use assistance “if cost were not an issue.”

Percent reporting “yes”

Typ

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aid

• Minnesota Youth Tobacco Survey 2002

• High school students (9th to 12th grades) only, n=7,625

• About 1/3rd current smokers, i.e. smoked cigarettes on 1 or more of past 30 days– 17% frequent smokers– 15% moderate smokers

Many Teens in Minnesota Smoke

• Over 60% have tried unsuccessfully to quit at least once in the past year

• Of those who have tried to quit, almost 3/4ths attempted twice or more

• Likely underexposed to quit support. Only 10% report participating in quit program.

Most Teen Smokers Want to and Have Tried to Quit

Quitting is Especially Difficult for Teen who are Frequent Smokers

Frequent high school smokers encounter greater difficulty than moderate smokers when trying to quit.

Frequent smoker

Moderate smoker

• Family: – 61% of frequent teen smokers report living with

another smoker compared to 27% of teens who have never smoked.

• Friends: – 90% of frequent teen smokers have 2 or more

close friends who smoke, compared to 13% of “never-smokers.”

Family and Friends who Smoke Make it Harder for

Teens to Quit

Teens with Failed Quit Attempts are Least Confident

Frequent high school smokers, especially those with prior quit attempts, less often expressed confidence

than moderate smokers in their ability to quit smoking.

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Frequent smoker Moderate smoker

Recommendations

• What we already know: – Provide effective medications and counseling.– Develop more resources for teens.

• To build support:– Develop clear, simple, data-driven statements

and graphics.– Disseminate information widely.– Collaborate to provide a unified message.