Healthy People 2020 Tobacco Use Prevention Program Budget

Introduction to Healthy People 2020

Healthy People provides nationwide health objectives on a ten-year cycle, grounded in science, with the goal of improving the health of all Americans. For the past 30 years, Healthy People has established standards and monitored progress over time in order to measure the influence of prevention activities, empower individuals to make informed health decisions, and encourage partnerships across communities and diverse sectors. Healthy People 2020 aims to improve the health of the nation, with the overarching vision of achieving a society in which all individuals live long and healthy lives (Healthy People, 2017).

The following outlines a small proposed program budget that delineates expenses, explains how the program will be funded, addresses the suitability of that funding source, and justifies why the program is essential based on an objective drawn from Healthy People 2020.

The Effects of Tobacco Use on Youth

More than 1,200 individuals die daily from the harmful effects of smoking. Despite progress in reducing youth tobacco consumption, an alarmingly large number of young people continue to use tobacco products. At present, more than three million high school students and 600,000 middle school students are cigarette smokers. Over the past decade, the rate of smoking cessation has declined, and smokeless tobacco consumption rates, after previously declining, have actually begun rising in certain population groups. For every death caused by smoking, at least two young people begin smoking regularly. Nine out of ten replacement smokers start smoking by the age of eighteen (Surgeon General, 2017).

Adolescents and young adults are eager to fit in with their peers. They are susceptible to environmental and social influences, and smoking is often depicted as a social norm. The presence of images and messages that increase tobacco's appeal worsens the problem. Young people see their friends using tobacco products and also encounter favorable depictions of smoking in video games, movies, websites, and their own communities. Youngsters with greater exposure to such images show a significantly higher likelihood of beginning to smoke (Surgeon General, 2017).

Young people who see smoking depicted in movies are more likely to take up the habit themselves. The likelihood of developing this habit among the most highly exposed group is twice that of the least exposed group. While smoking imagery in movies has declined over the past decade, approximately 33 percent of the highest-grossing children's movies (rated G, PG, or PG-13) in 2010 still depicted smoking. Furthermore, young people tend to identify with peers considered social leaders and may attempt to emulate them. As a result, youth exposed to sibling or peer smoking are more likely to develop the habit themselves (Surgeon General, 2017).

Young people are particularly drawn to cigars, especially cigarette-sized varieties. Twenty percent of high school boys report smoking them. Cigar use also appears to be growing in other demographic groups. Young people frequently use more than one tobacco product — including cigars, smokeless tobacco, and cigarettes. If progress in reducing tobacco use were to match the rate achieved between 1997 and 2003, three million fewer young people would become addicted to smoking (Surgeon General, 2017).

Youth tobacco use produces both short- and long-term adverse health consequences. Approximately one-third of young people who do not quit smoking die prematurely from smoking-related illnesses. Among the most serious health outcomes is nicotine dependence, which prolongs tobacco use and causes serious health problems. As the age of smoking initiation decreases, the likelihood of developing dependence increases. Young people are more sensitive to nicotine than older adults and may develop dependence early. Nicotine dependence causes 75 percent of adolescent smokers to continue smoking into adulthood, even when they intend to quit in the near future (Surgeon General, 2017).

Smoking slows lung development and reduces lung function. Adolescent smokers may begin experiencing breathlessness at a young age and may grow into adulthood with the permanent damage of underdeveloped lungs. This increases susceptibility to chronic obstructive pulmonary disease (COPD). A majority of adolescent and young adult smokers also show signs of premature cardiovascular damage, and the most vulnerable individuals die prematurely (Surgeon General, 2017).

Prevention efforts need to concentrate on the 18–25 age group. Very few individuals begin smoking after the age of 25. Almost 90 percent of smokers start before or shortly after reaching legal adulthood, and 99 percent begin before the age of 26. The transition from occasional to regular smoking occurs, in nearly all cases, by age 26 (Surgeon General, 2017).

It is essential to begin smoking prevention interventions early. Effective, multicomponent programs will ensure that people are never tempted to smoke for the first time and will more than pay for themselves through the lives and healthcare costs saved.

Approaches that constitute effective, comprehensive tobacco control include increases in tobacco product prices, mass media campaigns, smoke-free policies and regulations, sustained community-wide efforts, and evidence-based school programs. Comprehensive tobacco control initiatives work best when they are financed at levels recommended by the Centers for Disease Control and Prevention (CDC) (Surgeon General, 2017).

One of the central objectives of Healthy People is to improve the nation's status with respect to tobacco use. The goal is to reduce the illness, disability, and death associated with tobacco use and exposure to secondhand smoke. Healthy People 2020 specifically provides a framework for action aimed at reducing tobacco use to the point where it is no longer a public health crisis for the United States. The Healthy People 2020 tobacco use objectives are organized into three key areas: tobacco use prevalence, social and environmental changes, and health system changes (Healthy People, 2017).

The Necessity of a Health Program Targeting Tobacco Use

The following table presents the proposed budget for the Healthy People 2022 Tobacco Use Prevention and Control Program for the 2018 fiscal year:

Proposed Tobacco Use Prevention and Control Program — 2018 Budget