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City’s use of tobacco grant could help determine future health care spending

Friday, May 21, 2010 by Josh Rosenblatt

The city has begun spending millions of federal stimulus dollars to decrease and prevent tobacco use in Austin. And according to Vince Cobalis, assistant director of Human Services, the results of local efforts could affect how billions of dollars in federal funds are spent on future public health and prevention programs.


On April 22, the City Council accepted $7.47 million in American Recovery and Reinvestment Act funds as part of the Communities Putting Prevention to Work Tobacco Grant. Austin was one of 44 cities out of 263 applicants chosen to test programs to decrease the rate of tobacco use.


Before the Public Health and Human Services Committee on Tuesday, Dr. Philip Huang said that the grants represent “unprecedented levels of funding to communities to address tobacco” and that the effect of the two-year project could play a large role in determining how the federal government moves forward with health care funding in the future. Huang is medical director of the Austin-Travis County Health Department.


“Under the recently passed health care bill,” Huang said, “$2 billion in federal funds will be available for prevention and public health by 2015. They’ve not yet decided how these resources are going to be used, so (the Centers for Disease Control and Prevention) emphasized that how we perform, these 44 communities … may play very much into how significant funds will be used in the future, not only for tobacco but addressing some of our other prevention interests, like physical activity, nutrition, and obesity.”


Tobacco use is the number one preventable cause of death in Travis County, Huang said, killing more people than AIDS, crack, heroin, cocaine, alcohol, car accidents, fire, and murder combined. In order to reduce the damage of tobacco use, the long-term goals of the anti-tobacco initiative include:


        A 10 percent decrease in adult smoking prevalence, preventing tobacco-related death in one-third of these adults;


        A 40 percent decrease in the percentage of adult nonsmokers exposed regularly to secondhand smoke;


        A 25 percent decrease in youth smoking prevalence (up to age 18), preventing tobacco-related death in one-third of these youth; and


        A 30 percent decrease in the percentage of youth (ages 2-18) exposed regularly to secondhand smoke.


Huang says in order to help achieve the program’s goals, the city will be focusing much of its attention on changing social norms, as per the grant’s directives. “I remember back in 1995 when I testified at the City Council hearing when the city was first considering a smoke-free ordinance for restaurants. At the time everyone was saying the restaurants were going to go out of business. Certainly at that time they never thought bars would be smoke-free. But we passed the restaurant ordinance and it became accepted, and everyone then moved a couple years ago to smoke-free bars, and now that’s accepted,” he said.


“Those are examples of changing the social norms, and that’s what we’re continuing to push, so that things that seem far out there and impossible become acceptable.”


To do this the city will be working with various city and county groups, agencies, school districts, and governmental departments to promote awareness about the health risks involved with tobacco use, provide cessation resources for those looking to quit, and set up more smoke-free environments, such as campuses, bus stops, and train stations.


Huang said staff is already preparing to invest heavily in media and counter-advertising campaigns. They are also looking into the possibility of limiting free sampling and discounts and restricting point-of-purchase advertising and advertising near where youth congregate.


As of Tuesday’s meeting, four of nine staff members for the grant work had been hired and a media RFP had been released. Huang anticipates his department coming back to the subcommittee in June for RCA approval of several interlocal agreements with the UT School of Public Health, AISD, Travis County, Capital Metro, and others.

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