The Hawaii State Department of Health's
Tobacco Prevention and Education Program (TPEP) is the official state
government program addressing tobacco control in Hawaii. It is funded
by the Centers for Disease Control and Prevention (CDC) through the Comprehensive
National Tobacco Control Program. The TPEP program covers the following
areas:
The purpose of the Tobacco Prevention and Education
Program is to reduce tobacco consumption, and subsequently the
resultant burden of disease and disability caused by its use through a
comprehensive multi-strategy approach that reflects prevention and
education approaches. The complete goals and objectives can be
understood by reading the Program
Narrative; however the program's activities are based on four
overall goals:
Prevent tobacco use initiation among youth;
Promote quitting among adults and youth;
Eliminate exposure to environmental tobacco smoke
Identify and eliminate disparities among populations.
Community planning should focus on four goals: 1) prevention of the
initiation of tobacco use among young people, 2) cessation for current
users of tobacco, 3) protection from environmental tobacco smoke, and
4) elimination of disparities in tobacco use among populations. These
goals can be best achieved by programs that increase the number of
organizations and individuals involved in planning and conducting
community-level education and training programs; use State and local
counter-marketing campaigns to place pro-health messages that inform,
educate, and support local tobacco control initiatives and policies;
promote the adoption of public and private tobacco control policies;
measure outcomes using surveillance and evaluation techniques.
To achieve the individual behavior change that supports the nonuse of
tobacco, communities must change the way tobacco is promoted, sold, and
used while changing the knowledge, attitudes, and practices of young
people, tobacco users, and nonusers. Effective community programs
involve people in their homes, work sites, schools, places of worship
and entertainment, civic organizations, and other places.
Because most people who start smoking are younger than
18, programs that prevent the onset of smoking during the school year
are a crucial part of a comprehensive tobacco prevention program.
Several studies have shown that school-based tobacco prevention
programs that identify the social influences that promote tobacco use
among youth and that teach skills to resist such influences can
significantly reduce or delay adolescent smoking. Programs that vary in
format, scope, delivery methods, and community setting have produced
differences in smoking prevalence between intervention and
nonintervention groups ranging from 25% to 60% and persisting for 1 to
5 years after completion of the programs. Although long-term follow-ups
of programs have indicated that the effect may dissipate over time,
other studies have shown the effectiveness of school-based tobacco
prevention programs is strengthened by booster sessions and community
wide programs involving parents and community organizations and
including school policies, mass media and, restrictions on youth
access. Because many students begin using tobacco before high school
and impressions about tobacco use are formed even earlier, tobacco use
prevention education must be provided in elementary school and
continued through middle and high school grades.
It is pertinent to increase community education, which
includes all efforts to increase knowledge and to change attitudes
about the health effects of exposure to secondhand smoke. Community
education provides information to parents, other occupants, and
visitors to the home about the health risks of secondhand smoke for
nonsmoking adults and for children. For infants and children, most
secondhand smoke occurs in the home. Information could change the
knowledge and attitudes of smokers, prompting them to reduce or
eliminate smoking indoors, reduce consumption, or quit entirely.
Nonsmokers might increase their support and encouragement to smoking
household members to quit, or they might create and enforce home
smoking bans or restrictions. The combination of reduced indoor smoking
and increased cessation would result in a reduction in secondhand smoke
exposure, with a consequent reduction in morbidity and mortality.
Programs that successfully assist young and adult smokers in
quitting can produce a quicker and probably larger short-term public
health benefit than any other component of a comprehensive tobacco
control program. Smokers who quit smoking before age 50 cut in half
their risk of dying in the next 15 years. In addition, the cost savings
from reduced tobacco use resulting from the implementation of
moderately-priced, effective smoking cessation interventions would more
than pay for these interventions within 3-4 years. One smoker
successfully quitting reduces the anticipated medical cost associated
with acute myocardial infraction and smoke by an estimated $47 in the
first year and $853 during the next 7 years. Smoking cessation is more
cost-effective than other commonly provided clinical preventive
services, including mammography, colon cancer screening, PAP tests,
treatment of mild to moderate hypertension, and treatment of high
cholesterol.
The purpose of the Tobacco Prevention and Education Program is to
reduce tobacco consumption through a comprehensive multi-strategy
approach that reflects prevention and education strategies. This
approach focuses on defining the tobacco use problem, strategic
planning, coordination and implementation of tobacco use prevention and
control activities among partners, mobilizing communities, programmatic
actions addressing legislation policy, media advocacy and
counter-marketing, data gathering, surveillance and evaluation. This
approach focuses on:
eliminating exposure to secondhand smoke;
preventing tobacco use initiation and promote quitting among
youth;
promoting quitting among adults;
identifying and eliminating disparities among populations
The Hawaii Department of Health, Tobacco Prevention and Education
Program strives to use data to inform the program planning and
evaluation process. Hawaii participates in several national
population-based health surveillance systems which collect information
on tobacco use. To supplement these, TPEP has participated in and
commissioned additional surveys to collect more in-depth information
about knowledge, attitudes and media exposure. Periodically,
information from these various data sources are pooled to create and
update fact sheets, and data monographs which are made available to the
public for use and reproduction. In addition, this area covers all the
printed materials designed and distributed by the Tobacco program
including the Law's Brochure, Cessation materials, secondhand smoke
materials among many others.
