This document outlines strategies for reducing tobacco use and exposure to tobacco smoke. Tobacco is still the leading cause of preventable death in the US and Colorado, costing billions in healthcare costs and lost productivity each year. While smoking rates have declined overall, certain groups have higher rates of tobacco use, including people with lower socioeconomic status and Medicaid recipients. The document recommends increasing tobacco prices, prohibiting smoking in indoor areas, limiting youth access, and providing cessation services as evidenced-based strategies to further reduce tobacco use and its health impacts. Moving forward, efforts are still needed to help more smokers quit and prevent initiation among vulnerable groups.
What is wrong (and right) about the Tobacco Products Directive approach to E-...Clive Bates
These are the visual aids for my talk on the truly dreadful European Union Tobacco Products Directive as it applies to e-cigarettes, and why Totally Wicked has a legal case against it.
Challenges in Implementing Tobacco Dependence Treatment in Jordan and the Eas...Global Bridges
Presentation by Feras Hawari, M.D., a pulmonologist and the Global Bridges regional director for the Eastern Mediterranean region, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Materials developed and provided by the Health Policy Partners of Maine are for internal, informational use only. Materials are not to be used or replicated without the express permission of the coalition. For more information, please contact aolfene@lungne.org.
Presentation delivered by Dr Eibhlin Connolly, Deputy Chief Medical Officer at the Department of Health and Children at the Irish Pharmaceutical Healthcare Association Annual Meeting 2009.
What is wrong (and right) about the Tobacco Products Directive approach to E-...Clive Bates
These are the visual aids for my talk on the truly dreadful European Union Tobacco Products Directive as it applies to e-cigarettes, and why Totally Wicked has a legal case against it.
Challenges in Implementing Tobacco Dependence Treatment in Jordan and the Eas...Global Bridges
Presentation by Feras Hawari, M.D., a pulmonologist and the Global Bridges regional director for the Eastern Mediterranean region, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Materials developed and provided by the Health Policy Partners of Maine are for internal, informational use only. Materials are not to be used or replicated without the express permission of the coalition. For more information, please contact aolfene@lungne.org.
Presentation delivered by Dr Eibhlin Connolly, Deputy Chief Medical Officer at the Department of Health and Children at the Irish Pharmaceutical Healthcare Association Annual Meeting 2009.
10 provocations on why FDA's regulation of tobacco and nicotine is failing the American public. My presentation to the US E-cigarette Summit 2022 in Washington DC, with bonus content of additional background slides added in.
Barriers and unintended consequences How poor regulation of low-risk alternat...Clive Bates
A shirt presentation to Georgian health experts on the dangers of excessive regulation of safer alternatives to smoking causing perverse unintended consequences.
Ray Baxter from Kaiser Permanente's Community Benefit presented at the Bay Area Open Space Council's 2011 conference. More about the conference here: http://openspacecouncil.org/upload/page.php?pageid=53
Skip directly to searchSkip directly to A to Z listSkip directly to .docxjennifer822
Skip directly to searchSkip directly to A to Z listSkip directly to navigationSkip directly to page optionsSkip directly to site contentStart of Search Controls
Search Form Controls
Cancel
Submit
Search the CDC
CDC A-Z Index MENUCDC A-ZSEARCHABCDEFGHIJKLMNOPQRSTUVWXYZ#Start of Search Controls
Search Form Controls
Cancel
Submit
Search the CDC
Smoking & Tobacco Use
Note: Javascript is disabled or is not supported by your browser. For this reason, some items on this page will be unavailable. For more information about this message, please visit this page: About CDC.gov.
HomeOffice on Smoking and Health (OSH)How OSH Serves StatesNational Tobacco Control Program FundingState Fact SheetsFunding Opportunity AnnouncementsPublic Health Approaches for Ensuring Quitline CapacityFrequently Asked Questions and AnswersInteragency Committee on Smoking and HealthOverviewMembership RosterMeeting Summaries05/31/2017 [PDF—935 KB]08/23/2016 [PDF—806 KB]12/16/2014 [PDF—542 KB]05/13/2014 [PDF—443 KB]01/29/2013 [PDF—124 KB]Meeting ThemesNewsroomStay ConnectedOrganizationQuit SmokingHow to QuitBenefits of QuittingQuit Smoking ResourcesCessation Materials for State Tobacco Control ProgramsNational Quitline Data WarehouseBasic InformationHealth EffectsCancerHeart Disease and StrokeChronic Obstructive Pulmonary Disease (COPD)Smoking During PregnancySecondhand SmokeSmokeless ProductsElectronic CigarettesAbout Electronic Cigarettes (E-Cigarettes)Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young AdultsYouth Tobacco PreventionTobacco ProductsTobacco Ingredient ReportingHealthy PeopleTobacco Use Goals and Key AreasLeading Health Indicators and ObjectivesMidcourse ReviewTobacco Use ToolkitOnline ResourcesStay ConnectedContact InformationRelated ResourcesClinician ResourcesGovernment AgenciesOther U.S. OrganizationsInternational OrganizationsTobacco-Related DisparitiesAfrican Americans and Tobacco UseAmerican Indians/Alaska Natives and Tobacco UseAsian Americans, Pacific Islanders, Native Hawaiians and Tobacco UseHispanics/Latinos and Tobacco UseLesbian, Gay, Bisexual, and Transgender Persons and Tobacco UseCigarette Smoking and Tobacco Use Among People of Low Socioeconomic StatusTobacco Use by Geographic RegionTobacco Use Among Adults with Mental and Substance Use DisordersPromising Policies And Practices To Address Tobacco Use By Persons With Mental And Substance Use DisordersNew York Implements Tobacco-Free Campus PoliciesOklahoma Awards Grant Funds to Screen for Tobacco UseHawaii Trains Treatment Providers to Counsel Clients to QuitTexas Provides Free NRT to Treatment ProvidersNew York’s and Oklahoma’s Medicaid Programs Pay for MedicationStates Take More Steps to Quit Smoking for Behavioral Health ConditionsData and StatisticsFast Facts and Fact SheetsSurveysNational Youth Tobacco Survey (NYTS)National Adult Tobacco Survey (NATS)Youth Tobacco Survey (YTS)Alaska Native Adult T.
Circles of San Antonio Community Coalition Staff conducted a presentation for the Prevention Resource Center, Region 8 on why Alcohol is the # 1 drug of concern in San Antonio and Texas.
Albania National Association of Public health - Harm Reduction ConferenceClive Bates
Seven insights into tobacco harm reduction (20 min version) 20th December 2021.
1.The problem is smoking
2. Smoke-free alternatives
3. Quitting smoking with smoke-free alternatives
4. Health concerns
5. Youth vaping
6. Policy and unintended consequences
7. Innovation (and its enemies)
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Colonic and anorectal physiology with surgical implications
Best practicestobaccocontrol.trc. 10.21.11.final
1. Best Practices in Tobacco Control
Proven strategies to reduce tobacco use,
prevent initiation and eliminate exposure
to tobacco smoke
Cover this blue placeholder
with your program logo
2. Tobacco is still the leading cause of
preventable death in the US and in Colorado
• In Colorado, nearly
4,390 deaths each
year due to tobacco
use.*
• Smoking causes
more deaths than
HIV, illegal drug
use, alcohol use,
motor vehicle
injuries, suicides,
and murders
COMBINED.†
* MMWR (2009), 58 (02); 29-33.
†MMWR (2008), 57 (45): 1226 – 1228; CDC (2009), Health, United States, 2008; Mokdad AH,
Marks JS, Stroup DF, Gerberding JL. Actual Causes of Death in the United States. JAMA: Journal
of the American Medical Association 2004;291(10):1238–1245 .
3. Tobacco use is costly for everyone
Cost to United States economy each year in
healthcare costs and lost productivity:
$193 billion
Cost to Colorado each year in healthcare costs and
lost productivity:
$2.4 billion*
Annual U.S. Medicaid costs due to smoking:
$30.9 billion
Annual Colorado Medicaid costs due to smoking:
$319 million
4.
5. US Adult Smoking Prevalence-2010
Cover this blue placeholder
Source:2010 BRFSS
with your program logo
http://www.cdc.gov/vitalsigns/AdultSmoking/index.html
6. Adult Cigarette Use-Gender - 2010
21.5
17.4 18
17.3
16
14
CO Overall All States (median) CO Male US Male CO Female US Female
Source: Behavioral Risk Factor Surveillance System (BRFSS)
Cover this blue placeholder
with your program logo
7. Adult current smoking by demographic group
Cover this blue placeholder Note: * Estimates for education are based on adults aged 20 years and older. Estimates for racial/ethnic groups
with your program logo are based on combined 2009 and 2010 data. Source: CDC Behavioral Risk Factor Surveillance System
9. Tobacco Use in Medicaid Population
~500,000 individuals receive Medicaid each year in CO
40%
35%
30%
25%
20% 38%
15%
10% 18%
5%
0%
Medicaid Colorado Adults
Tobacco Use TABS 2008
10. Smoking Among Pregnant Women
35.0 33.0
30.0
25.8
25.0
19.2
20.0
15.0 13.3
10.0 8.5
5.3
5.0
0.0
Medicaid Non-Medicaid
Before pregnancy During pregnancy After delivery
Colorado PRAMS, 2004-2008
11. Middle School & High School Students Ever Smoking-Colorado
100.0%
80.0%
60.0%
2001
2006
40.0%
2008
54.2%
20.0% 43.2%
36.8%
25.7%
16.7% 14.4%
0.0%
Middle School High School
Source: Colorado Healthy Kids Colorado Survey on Tobacco and Health, 2001, 2006, and 2008
12. SOLVING THE TOBACCO PUZZLE:
REDUCE OR ELIMINATE CO- CREATE REMINDERS
PAYMENTS FOR CESSATION SYSTEMS FOR MEDICAL
THERAPY PROFESSIONALS
PROVIDE PROHIBIT SMOKING INCREASE THE
CESSATION IN INDOOR PUBLIC PRICE OF TOBACCO
SUPPORT TO HELP AND PRIVATE
PEOPLE QUIT WORKPLACES
TARGET SPECIFIC AND HIGH- REDUCE THE AVAILABILITY OF
RISK POPULATIONS THROUGH TOBACCO PRODUCTS TO YOUTH
MASS MEDIA CAMPAIGNS
13. CDC reports “statewide tobacco control
programs that are evidence-
based, comprehensive, sustained and
accountable are shown to reduce
smoking rates, tobacco related deaths
and diseases caused by smoking.”
Cover this blue placeholder
with your program logo
14.
15. Evidence Base for Interventions
CDC (Community IOM (Tobacco NIH (State of the
Guide) Blueprint) Science)
Increase the price of tobacco
Prohibit smoking in indoor public
and private workplaces
Reduce the availability of tobacco
products to youth
Provide cessation services
Target specific and high-risk
populations through mass media
campaigns
18. Moving Forward: Work to be done
• Decrease the cessation disparity affecting low
SES smokers
• Decrease smoking prevalence and initiation
among young adults who are not in college
• Place constraints on the tobacco industry
based on new FDA law
• Reduce initiation among low SES youth
• Recognize and treat tobacco addiction as a
chronic disease
• Increase the price of tobacco products
19. “It is unreasonable to expect that people
will change their behavior easily when
so many forces in the social, cultural,
and physical environment conspire
against such change.”
- Institute of Medicine
Editor's Notes
Cultural shift away from smoking acceptance, rates are down – can be lulled into a sense that the battle is won. Except – still a major killer and declines have stalled. Surgeon General Report There is no safe level of exposure to tobacco smoke – even an occasional cigarette or exposure to SHS can be harmful.SHS kills 50,000 US Deaths and 660 Colorado Deaths annually.It is a cause and/or contributor to lung cancer, numerous other cancers, stroke, COPD, and heart disease. It contributes to low infant birth weight.In the US, smoking causes more deaths than HIV, illegal drug use, alcohol use, motor vehicle injuries, suicides and murders combined.
*(2nd Row)$579 per Colorado Household Smoking harms others and costs everyone money. Tobacco addiction results in chronic disease that is expensive to treat and contributes to the ever-increasing medical costs that healthcare reform can’t fully solve. And exposure to second-hand smoke kills others. In fact, it has been shown to contribute to infant SIDS deaths.$193 billion – MMWR (2008) 57(45);1226-1228.$2306 million – CDC (2007) Best Practices…Medicare and Medicaid fed stat: Campaign for Tobacco Free KidsState Medicaid _ 2007 CDC Best Practices2nd-hand smoke stat: 2006 Surgeon General’s report on 2nd hand smoke – pg. 5-6.
Items for the Notes section:Past 20 year prevalence trend – peaked over 24% in 1994 currently at 16% an all time low in Colorado.1.5 billion fewer cigarettes smoked per year in the past decadeProgress has been made, but more to be done.Nationally and in Colo data show that there is a stall in the decrease for both youth and adults
2010 BRFSS data, Colorado adult smoking prevalence is 16%, Colorado is in the middle. (ranked 19th in the nation).
Adult prevalence has declinedCan see disparities among certain groups ethnicity, age and education (why?)Smoking rate is inversely proportional to educational atainment
Looking more closely at 18-24, highlighting the education disparity.
Women with Medicaid coverage for prenatal care and deliver were more than twice as likely to be smokers before pregnancy than women without Medicaid coverage (who were typically covered by private health insurance). One-third of women with Medicaid coverage reported smoking before pregnancy, compared to 13.3 percent of women not on Medicaid. Smoking prevalence rates during pregnancy were almost four times as high for women with Medicaid coverage as compared to women without Medicaid coverage.
As you can see from this figure, the rate of ever smoking among both middle and high school students has decreased since 2001. The prevalence of high school ever smokers is twice that of middle school students. While we don’t have income data on youth smoking (don’t ask for it), we know based on other research that kids who smoke are more likely to be low-income, based in part on what we infer from other data about low-income smokers.We know that kids who have friends or family who smoke, who don’t have a trusted adult tell them not to use tobacco, and that are exposed to higher levels of advertising, which is more prominent in low-income neighborhoods, are more likely to try tobacco.
Strategies are evidence-based, we also know that a comprehensive approach utilizing all strategies works best to reduce tobacco use prevalence.3 cessation strategies focus on current tobacco users. Smoke-free laws protect non-smokers, especially employees, contribute to social norming to make tobacco use less popular, and encourages cessation. Increasing price encourages current users to quit – especially youth, low-income and pregnant smokers, discourages susceptible youth from starting, and funds other intervention strategies, increasing their effectiveness.Mass-media campaigns support other interventions and contribute to social norming making tobacco use less popular.Reducing availability of tobacco products to minors typically means stricter enforcement to reduce illegal tobacco sales, and restrictions on tobacco advertising. Evidence shows that stronger laws also need strong enforcement to be effective.
According to CDC to implement a comprehensive Tobacco Control Program Colorado needs $54.4 million.The tobacco industry spends nearly $140 million to market tobacco products in Colorado.
This chart from Dr. Friedan at the CDC shows the rationale behind focusing on policy and environmental change initiatives. We know that the most significant impacts on health are socioeconomic factors – the Social Determinants of Health. The next level of the pyramid encompasses the kinds of change we have been focused on. Data shows that changing the context to make the healthy choice the easy choice has a larger impact on population-level health outcomes than more targeted, individual interventions. In an era of limited funding, it is a more cost-effective strategy for improving population outcomes.
The evidence base for these interventions is solid. Three leading sources for evidence-based tobacco interventions – CDC’s community guide, the Tobacco Blueprint from the Institute of Medicine, and the National Institutes of Health State of the Science report all recommend the strategies we have highlighted (the three cessation-related interventions are combined into one in this chart).
This slide shows program interventions and economic variables that coincide with changes in smoking prevalence and cigarette consumption in Colorado.The largest change in consumption was at the time of the state excise tax, voted in to law in Nov 2004 and effective January 1, 2005.The tobacco control program budget was at it’s peak in 2005. Colorado did meet the CDC recommended funding that year.The Colorado Clean Indoor Air Act was implemented July 1, 2006, casinos became smoke-free January 1, 2008.Items of historical significance were:1986 state tobacco tax - $0.201991 ASSIST grant awarded – 1992 eight community coalition grants, 1996 13 community coalition grants1994 Tobacco Free Schools law passed1994 Ballot initiative to raise tax from $0.20 to $0.70 fails due to heavy advertising by the industry2003 reduction to MSA program (show up tick)Reduced price and significant program funding to show decrease
New Mexico, Arizona, Utah of the corner states we are low