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Second Annual Independent Evaluation of New York's Tobacco

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Second Annual Independent Evaluation of New York's Tobacco August 2005 Second Annual Independent Evaluation of New York’s Tobacco Control Program Final Report Prepared for New York State Department of Health Corning Tower, Room 710 Albany, NY 12237-0676 Prepared by RTI International 3040 Cornwallis Road Research Triangle Park, NC 27709-2194 RTI Project Number 08800.003.002 RTI Project Number 08800.003.002 Second Annual Independent Evaluation of New York’s Tobacco Control Program Final Report August 2005 Prepared for New York State Department of Health Corning Tower, Room 710 Albany, NY 12237-0676 Prepared by Matthew C. Farrelly Kevin C. Davis James M. Nonnemaker Maria Girlando Erik Crankshaw Joanne Pais Betty Markatos Belle Federman RTI International* 3040 Cornwallis Road Research Triangle Park, NC 27709-2194 The authors would like to thank Susan Murchie for editorial assistance and Kim Madsen and Mark Engelen for analytic support. Inquiries about this report should be directed to: Matthew C. Farrelly E-mail: [email protected] Telephone: 919-541-6852 *RTI International is a trade name of Research Triangle Institute. Contents Section Page Executive Summary ES-1 1. Introduction 1-1 2. Overview 2-1 2.1 Changes to the Strategic Plan .................................................................. 2-1 2.2 Addressing Recommendations from the 2004 Independent Evaluation Report .................................................................................................. 2-5 2.2.1 Overall Program Implementation .................................................... 2-5 2.2.2 Program Component Implementation .............................................. 2-7 2.2.3 Addressing Programmatic Goal-Oriented Evaluation Findings .............2-22 2.3 Summary of Progress in Addressing 2004 IER Recommendations .................2-33 3. Evaluation Studies and Methods 3-1 3.1 Evaluation Studies.................................................................................. 3-1 3.1.1 Adult Tobacco Surveys .................................................................. 3-2 3.1.2 Youth Tobacco Surveys ................................................................. 3-2 3.1.3 Monthly Tax-Paid Cigarette Sales.................................................... 3-3 3.1.4 Web-Based Community Activity Tracking System .............................. 3-3 3.1.5 News Media Tracking .................................................................... 3-4 3.1.6 Retail Advertising Tracking Study.................................................... 3-5 3.1.7 Health Care Provider, Provider Organization, and Substance Abuse Treatment Facility Surveys ............................................................ 3-6 3.1.8 Quitline Call Volume Data .............................................................. 3-6 3.1.9 Quitline Follow-up Surveys ............................................................ 3-7 3.2 Evaluation Methods ................................................................................ 3-7 3.2.1 Reasonable Expectations for the Size and Timing of Outcome Changes ..................................................................................... 3-8 3.2.2 Evaluation Methods .....................................................................3-11 4. Evaluation Findings 4-1 4.1 Cross-Cutting Evaluation Findings............................................................. 4-1 4.1.1 Are Trends in the Prevalence of Smoking Among Adults and Youth in New York Declining Faster than in the United States?..................... 4-2 4.1.2 Is Monthly Cigarette Consumption Among Adult Smokers Declining Over Time?.................................................................................. 4-4 iii 4.1.3 Are Trends in the Prevalence of Other Tobacco Product Use Declining Among Adults and Youth? ................................................ 4-6 4.1.4 Are Trends in Tax-Paid Cigarette Sales Declining Faster in New York than in the United States as a Whole? .....................................4-10 4.1.5 Is Tax Evasion Eroding the Effects of Cigarette Excise Tax Increases in New York? ................................................................4-13 4.1.6 Summary, Conclusions, and Recommendations................................4-17 4.2 Goal 1: Eliminate Exposure to Secondhand Smoke.....................................4-19 4.2.1 Overview ...................................................................................4-19 4.2.2 Summary of Activities in Support of Goal 1 .....................................4-20 4.2.3 How Have SHS-Related Topics Been Covered in the Print News Media?.......................................................................................4-27 4.2.4 Has Overall Exposure to SHS Among Adults and Youth Declined Over Time?.................................................................................4-29 4.2.5 Has Exposure to SHS in the Workplace Declined Over Time?..............4-37 4.2.6 Are Bars and Restaurants Complying with CIAA?..............................4-37 4.2.7 How Have Sales Tax Receipts Changed for Bars and Restaurants Compared to the Retail Sector as a Whole? .....................................4-43 4.2.8 What Is the Level of Support of Smoke-Free Policies (i.e., CIAA and Restrictions on Smoking in Outdoor Public Places and Building Entranceways)? ..........................................................................4-43 4.2.9 How Have Knowledge of and Attitudes Toward SHS Changed Over Time? ........................................................................................4-46 4.2.10 Are Voluntary Restrictions on Smoking in Homes and Cars Increasing, Particularly in Households with Smokers? .......................4-55 4.2.11 Summary, Conclusions, and Recommendations................................4-55 4.3 Goal 2: Decrease the Social Acceptability of Tobacco Use............................4-61 4.3.1 Overview ...................................................................................4-61 4.3.2 Summary of Activities in Support of Goal 2 .....................................4-63 4.3.3 How Have the News Media Covered Tobacco Issues in New York?.......4-68 4.3.4 Have Tobacco Sponsorships Decreased Over Time? ..........................4-71 4.3.5 What Is the Level of Point-of-Purchase Tobacco Advertising and Promotions Prior to the Advertising, Sponsorship, and Promotion Initiative?...................................................................................4-74 4.3.6 Has Awareness/Receipt of Pro-Tobacco Advertising and Promotions Declined Over Time?....................................................................4-77 4.3.7 Have Awareness of and Receptivity to Tobacco Control Messages Increased Over Time? ..................................................................4-82 4.3.8 Has Knowledge about the Health Risks of Smoking and Antitobacco Attitudes and Beliefs Increased Over Time?.....................................4-93 4.3.9 Summary, Conclusions, and Recommendations..............................4-104 4.4 Goal 3: Promote Cessation from Tobacco Use..........................................4-107 4.4.1 Overview .................................................................................4-107 iv 4.4.2 Summary of Activities in Support of Goal 3 ...................................4-109 4.4.3 Prior to Implementation of the Cessation Centers, To What Extent Do Health Care Provider Organizations Have a System in Place to Screen All Patients for Tobacco Use and Provide Brief Advice to Quit at Every Patient Visit? ................................................................4-114 4.4.4 What Percentage of Smokers Report that Their Health Care Providers Offer Support for Cessation? .........................................4-118 4.4.5 Has the Percentage of Smokers Who Have Heard of and Called the New York State Smokers’ Quitline Increased Over Time?.................4-121 4.4.6 Is Nicotine Replacement Therapy Use Increasing Over Time?...........4-124 4.4.7 Are Cessation Outcomes (e.g., Percentage of Smokers Who Have Quit for at Least 6 Months, Number of Quit Attempts, Duration of Longest Quit Attempt) Improving Over Time?................................4-125 4.4.8 Summary, Conclusions, and Recommendations..............................4-128 4.5 Goal 4: Prevent the Initiation of Tobacco Use Among Youth and Young Adults................................................................................................4-132 4.5.1 Overview .................................................................................4-132 4.5.2 Summary of Activities in Support of Goal 4?..................................4-133 4.5.3 How Do Changes in Adult Smoking Influence Youth Smoking? .........4-135 4.5.4 How Have Recent Changes in Cigarette Taxes Affected Youth Smoking Rates in New York, and Have Low Price Alternatives Weakened the Effects of Taxes on Youth? .....................................4-137 4.5.5 Are Illegal Sales to Minors Decreasing, and Are Restrictions on Access to Tobacco Influencing Youth Smoking Rates? .....................4-141 4.5.6 Summary, Conclusions, and Recommendations..............................4-142 5. Summary, Conclusions, and Recommendations 5-1 5.1 Responses to 2004 IER and Additional Recommendations ............................ 5-1 5.2 Summary of Findings.............................................................................. 5-4 5.2.1 Cross-Cutting Findings .................................................................. 5-4 5.2.2 Goal 1 Findings: Eliminate Exposure to Secondhand Smoke................ 5-5 5.2.3 Goal
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