1. A Needs Assessment of
Mineral County, Nevada
Regarding Adult Smoking
Danielle Poole
Health Educator
Department of Public Health for
Nevada
April 23rd 2014
3. Background Information
• Why is tobacco use an issue?
1. Negative health effects caused by smoking
2. Deaths caused each year by smoking
3. Financial impacts of smoking on our country’s
economy
4. 1. Major negative health effects caused by smoking
• Cancer
• Heart disease and stroke
• Respiratory diseases
• Pregnancy problems
2. The number of deaths caused each year by smoking
• Worldwide, tobacco use causes nearly 6 million deaths
per year (WHO, 2011)
• Cigarette smoking is responsible for more than 480,000
deaths per year in the United States (USDHHS, 2014)
3. The financial impacts of smoking on our country’s
economy
• More than $300 billion a year for US
• $170 billion in healthcare (Xu X, 2015)
• $156 lost in productivity (USDHHS, 2014)
5. • The state of Nevada had received grant money
to target Mineral county because of its high
prevalence of adult cigarette smokers
• A needs assessment of Mineral county has
been conducted to address (1) demographics,
(2) existing interventions, (3) other possible
interventions, and (4) potential partners in the
county to help with the effort to decrease
smoking rates
7. Where is the information coming from?
• Prevalence data is taken from the Behavioral Risk
Factor Surveillance System (BRFSS)
• BRFSS is a random national telephone survey
• The data represents the total population over 18
years of age residing in homes that have a land line
telephone
(County Health Rankings, 2015)
8. Demographics
Mineral County Nevada
Population 4,614 2,790,136
% Below 18 years of age 18.7% 23.7%
% 65 and older 23.9% 13.7%
% Non-Hispanic African
American
3.8% 8.1%
% American Indian and
Alaskan Native
16.5% 1.6%
% Asian 2.4% 8.1%
% Native Hawaiian/Other
Pacific Islander
0.2% 0.7%
% Hispanic 10.6% 27.5%
% Non-Hispanic white 65.9% 52.2%
% Not proficient in English 0.3% 6.2%
% Females 50.8% 49.6%
% Rural 31.9% 5.8%
http://www.countyhealthrankings.org/app/nevada/2015/rankings/mineral/county/outcomes/overall/additional
9. Objective
• Where does Mineral County stand?
– 27% adult smokers
• Goal of Healthy People 2020?
– Reduce to 12% adult cigarette smokers
(Healthy People 2020, 2014)
***A goal of more than half of adult smokers to cease
their unhealthy behavior!
10. Evidence-based Interventions
• Increasing the price of tobacco products
– Proved to be effective because of reduced consumption
and use, increased users that quit, reduced initiation of
young people, and reduced illnesses & deaths (The
Community guide, 2014)
• Mass-reach health communication interventions
– Targeting audiences through all media forms in order to
“change knowledge, beliefs, attitudes, and behaviors
affecting tobacco use” (The Community guide, 2014)
• Mobile phone-based cessation interventions
– For those interested in quitting, information and support
are sent via text to those signed up and the information
changes over the course of the intervention (The
Community guide, 2014)
11. • Quit-line interventions
– Follow-up counseling calls for those interested in quitting,
support is given by cessation specialists who follow standards
over needed period of time (The Community guide, 2014)
• Smoke-free policies
– Public and private rules and regulations that prohibit smoking
in both indoor and outdoor places (The Community guide,
2014)
• Provider-oriented interventions
– Doctors continually ask patients about smoking habits,
educate patients about the risks, recommend cessation, and
sometimes that is enough to convince patient to stop
• Community mobilization to restrict minors’ access to tobacco
products
– Creating and enforcing stronger laws in order to reduce use
and accessibility of tobacco for youth (The Community guide,
2014)
13. Existing Interventions
• Increasing price?
– Nevada has not increased the tax on tobacco since 2005!
– Nevada is ranked 35th with a tax of $0.80 (Ann Boonn, 2015)
• Smoke-free policies?
– Nevada prohibits smoking in most places except for bars and
casinos
– Smoking is allowed in bars and casinos depending on age
restrictions and areas where children are allowed
(State of Tobacco Control, 2015)
14. • Quit-line?
– CDCs recommended spending: $3.65/smoker
– Nevada spending: $0.69/smoke (State of Tobacco Control,
2015)
– HN receptionist did not know how to explain to me where to
access this
• Mass-reach health communication interventions?
– Health Nurse receptionist of Nevada only listed pamphlets as
means of reaching the community
• Mobile phone-based cessation interventions?
– Health Nurse receptionist said this was all government run and
did not have much to say about this intervention
15. • provider-oriented interventions
– When people go in to see Wanda Nixon, her
receptionist told her that she asks if patients
smoke, advises them to stop, and gives referrals to
help quit
• community mobilization to restrict minors’
access to tobacco products
– Managed by the government, not much
community effort put in, little information known
16. Proposed Interventions
There is great need for improvement…
• All areas need improvement
• There should be more unison and/or communication
between county and state
• Those answering phones should have info available or
info on where to go in regards to smoking help
• Why isn’t there a health department for Mineral
County?
• More “Health nurses” if HD isn’t an option
• Increase tax!
• Improve media beyond handouts and pamphlets
17. Potential Partners
• American Heart Association Nevada Affiliate Inc.
6370 West Flamingo Road Suite 1
Las Vegas NV 89103-2274
702 367-6490
• American Lung Association NV S Branch
PO Box 44137
Las Vegas NV 89116-2137
702 454-2500
• Nevada Tobacco Prevention Coalition
18. American Heart Association
• Mission:
– improve lives by eliminating cardiovascular disease and
stroke (AHA, 2015)
• Actions:
– Smoke-free public places & clean indoor air in public places
(AHA, 2015)
• Who to contact:
– Christopher Roller
• Director of Advocacy and State Health Alliances at
American Heart Association
• Why AHA?
– Knows the negative health effects of smoking and wishes to
eliminate smoking all together
19. American Lung Association
• Mission:
– Eliminate lung disease in order to improve lung
health eventually saving lives
• Actions:
– Educate public, research, evidence-based
decisions, overcome health disparities (ALA, 2015)
• Why ALA?
– They desire to overcome health disparities which
may help when dealing with the large population
of American Indian and Alaskan Native population
20. Nevada Tobacco Prevention Coalition
• Mission:
– reduce tobacco use and nicotine addiction in order to
improve health of those in Nevada (NTPC, 2015)
• Actions:
– Increase tobacco control spending & Improve and
expand the Nevada Clean Indoor Air Act
• Who to contact:
– They have a Facebook page that could be grown more
(only 37 likes)
– Contact on Fb or email (no names listed)
• Why NTPC?
– Started in Nevada, already has handful of partners,
could contain grassroot members
21. References
• American Heart Association. Retrieved April 20, 2015, from www.heart.org
• American Lung Association. Retrieved April 21, 2015, from www.lung.org
• Boonn, Ann. (2015, February 5). State Cigarette Excise Tax Rates & Rankings. Retrieved April 23, 2015, from
http://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf
• County Health Rankings. Nevada Adult Smoking. (2015). Retrieved April 21, 2015, from
http://www.countyhealthrankings.org/app/nevada/2015/measure/factors/9/map
• Healthy People 2020. Tobacco Use. (2014). Retrieved April 22, 2015, from
http://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use/objectives
• Mineral County Nevada. Mineral County Health Nurse. Retrieved April 22, 2015, from
http://www.mineralcountynv.org/index.php?option=com_content&view=article&id=95:mineral-county-health-
nurse&catid=49:mineral-county-departments&Itemid=84
• NV DHHS. Retrieved April 22, 2015, from http://dhhs.nv.gov/
• Nevada Tobacco Prevention Coalition. Missions and Priorities. (2015). Retrieved April 21, 2015, from
http://www.tobaccofreenv.org/about/mission-priorities/
• State of Tobacco Control. State at a Glance - American Lung Association Nevada. (2015). Retrieved April 20, 2015,
from http://www.stateoftobaccocontrol.org/state-grades/nevada/
• The Community Guide. Reducing Tobacco Use and Secondhand Smoke Exposure. (2014). Retrieved April 23, 2015,
from http://www.thecommunityguide.org/tobacco/index.html
• U.S. Department of Health and Human Services. 50 Years of Progress: A Report of the Surgeon General, 2014.
(2014). Retrieved April 20, 2015, from http://www.surgeongeneral.gov/library/reports/50-years-of-progress/50-
years-of-progress-by-section.html
• World Health Organization. WHO report on the global tobacco epidemic, 2011. (2011). Retrieved April 21, 2015,
from http://www.who.int/tobacco/global_report/2011/en/
• Xu, Xin, Ellen E. Bishop, Sara M. Kennedy, Sean A. Simpson, and Terry F. Pechacek. "Annual Healthcare Spending
Attributable to Cigarette Smoking.” American Journal of Preventive Medicine 48.3 (2015).