Latest Trends in Tobacco
What is the scope of tobacco use in Middlesex County?
Middlesex County youth use tobacco less often than their peers in Connecticut. (This stands in contrast to the higher percentages of alcohol and marijuana use.) Table A compares past-30-day use in Middlesex County with state and national data.
Table A. Past-30-day tobacco use, 2010-2012
12-17 yrs. 18-25 yrs. 26+ yrs.
Middlesex 9.99 — —
Connecticut 12.05 43.4 26.52
USA 10.34 40.17 26.72
Sources: Mx. Cty. Student Surveys, NSDUH
People ages 18-25 are clearly in the highest-risk category. Nearly half of young adults report recent smoking, a rate more than triple than the teen years and nearly double the mature adult years. We can deduce that an effort to quit smoking often takes place after age 25; one factor fueling this behavior might be pregnancy and childrearing.
In the statewide survey most similar to Middlesex County surveys, YRBS found that 15.9% of high school students had smoked in the past month. Middlesex County high schools average favorably at only 13.5%. A town breakdown can be seen in Graph B.
Graph B. Student past-30-day use of tobacco (%)
(Middle School = blue / High School = red)
Source: Mx.Cty. student surveys 2010-2012, YRBS
National and local health campaigns against tobacco have clearly made an impact on young people. In fact, local youth now perceive tobacco as considerably risker than alcohol or marijuana. The percentage of Middlesex County students who indicated that people who regularly use the following substances are at risk or great risk is as follows:
Alcohol Tobacco Marijuana
Middle School 64 82.7 80.0
High School 64.9 87.2 67.6
Note that high school students perceive tobacco as the riskiest substance (87.2%), even more so than middle school children. Whether that perception of risk is shared by their peers across the state, and carries into young adulthood, remains to be seen. If it does, tobacco use in the 18-25 year age range should drop sharply in Connecticut.
The Consequences of Tobacco Use
The average national compliance rate (those stores inspected and selling only to patrons eighteen years and older) increased from a baseline of 59% in 1997 to a record high of 91.5% in 2004 (SAMHSA). At the same time, the percentage of U.S. high school smokers who purchased cigarettes at a store or gas station in the past 30 days decreased from 39% in 1995 to 14% in 2011 (YRBS).
All Middlesex County public schools prohibit smoking on school grounds, and many use in-school or out-of-school suspensions to punish offenders (Table C).
Table C. Tobacco-related school suspensions, lowest to highest, 2009
Chester 0 Haddam 3
Deep River 0 Killingworth 3
Essex: 0 East Haddam 5
E. Hampton 0 Durham 6
Old Saybrook 1 Middlefield 6
Portland 2 Cromwell 9
Westbrook 2 Middletown 23
Clinton 3 Total 63
Source: Connecticut Data Collaborative
The health impact of tobacco is severe, from worsened asthma to emphysema and cancers. Clearly, environmental and genetic factors impact lung cancer rates, but smoking remains a major factor. The crude rate for lung cancer in Middlesex County is found in Table D.
Table D. Lung cancer deaths, crude rate
E. Haddam 9.90 Middletown 54.0
Durham 30.0 Cromwell 56.7
Deep River 36.0 Old Saybrook 61.0
Clinton 43.2 Chester 62.2
Middlefield 47.5 Haddam 65.0
Portland 49.4 E. Hampton 65.9
Essex 51.0 Killingworth 66.1
Westbrook 51.8 Average 50.0
Source: Connecticut Dept. of Public Health
Our Capacity to Address This Issue
There are solid resources in Middlesex County for smoking cessation, including Middlesex Hospital and the Community Health Center in Middletown. MCSAAC refers hundreds of people to the Quitline and to 3 private “quit counselors” in our region. MCSAAC holds a two-year contract with DPH for tobacco education at the Connecticut Juvenile Training School; we have had great success with this high-risk 13-17 year old population. CT Valley Hospital, also in Middletown, has recently gone tobacco free.
However, despite local and society-wide pressures against tobacco, we are now up against the most intransigent (i.e., most addicted) smokers. For this reason, CNAW members rated the ability of our population to address the tobacco problem at 3.4 on a scale of 5.