Achieving our goal will take time. Knowledge, attitudes, and behaviors surrounding tobacco use have evolved over time and have been shaped by many years of advertising by tobacco companies. Due to increased awareness of the potentially deadly effects of tobacco on health, the current incidence of tobacco use is lower than in the 1950s. However, more than one in five adults in New Jersey still smoke, and smoking rates among older youth have been on the rise in this decade. Those who continue to smoke in the 1990s are a tougher audience than those who have already quit. It is expected to take twenty years to see the long-term impact of a comprehensive tobacco plan.
As with so many human behaviors, no one single factor determines tobacco use or smoking patterns. These patterns are the result of complex interactions of multiple factors, including, but not limited to:
Reducing tobacco use is a significant challenge that requires a comprehensive, targeted public health campaign. Public health efforts to date in New Jersey have been hampered by limited resources. However, the resources available through the tobacco settlement present a unique opportunity to impact significantly on the health of New Jerseyans. The Master Settlement Agreement (MSA) does not mandate how the states must spend the settlement funds. Under the leadership of Governor Whitman, New Jersey is the first state to report that it will specifically target some of the funds for tobacco prevention and treatment, as opposed to solely supporting general health care or non-health related programs.
The Comprehensive Tobacco Plan will include four strategic interventions, a Youth Tobacco Awareness/Marketing and Communications Campaign, Community Partnerships, Programs Focused on Youth, and Treatment of Nicotine Addiction (Cessation), as well as an overall evaluation. These interventions will be described in upcoming sections of this plan. As part of the comprehensive plan, public and private sector organizations will continue to partner to bring about changes in the area of tobacco control. The New Jersey Breathes coalition, the American Cancer Society, New Jersey Division, the American Lung Association of New Jersey, the American Heart Association, New Jersey Affiliate, New Jersey GASP, the Medical Society of New Jersey, and many other organizations have individually and collaboratively played a prominent role in educating policy makers and the public on the deleterious effects of tobacco smoke and the need to restrict the use of tobacco. Support for tobacco control by public sector agencies has also been impressive. The New Jersey School of Public Health, the University of Medicine and Dentistry of New Jersey and Rutgers University have provided professional and technical assistance to many organizations in the area of tobacco control. The Department of Law and Public Safety has been an active partner with DHSS in developing the tobacco age-of-sale initiative in New Jersey, as well as bringing suit against the tobacco companies. The Department of Education has worked cooperatively with DHSS to assure quality core curriculum standards.
Although there has been excellent cooperation between State agencies, expanded resources will permit the expansions of these partnerships. In addition to enforcing smoke-free workplace environments, all State agencies will be encouraged to support their employees to quit using tobacco products. State agencies will be enlisted to promote the tobacco-free message to the public. While DHSS expects to expand the list of partnerships, the following initial partnership opportunities have been identified:
Department of Banking and Insurance: In cooperation with the Department of Banking and Insurance, a work group will be formed to explore methods to encourage New Jersey insurers to promote tobacco-free life styles with their plan enrollees.
Department of Community Affairs: The Department of Community Affairs has been identified as a vital partner in creating smoke- free places for New Jersey residents to live and play.
Department of Corrections: The Department of Corrections already supports the "Magicians" nicotine treatment program within its institutions. Magicians is a train-the-trainer program for quitting conducted by inmates for inmates. We expect to pursue the expansion of the program with the Department of Corrections.
Department of Education: The Department of Education will be instrumental in the successful implementation of all school-based tobacco prevention programming in New Jersey. Opportunities to expand to making nicotine treatment programs readily available for teachers, staff and students as well as parental education on environmental tobacco smoke (ETS) hazards will be explored.
Department of Health and Senior Services: Support for nicotine treatment during pregnancy is a high-priority, since smoking is associated with low- birth weight and Sudden Infant Death Syndrome (SIDS). While pilot programs have been initiated, a statewide, sustained approach will be possible with the additional resources of the Master Settlement Agreement. Opportunities to expand anti-tobacco initiatives with the Adolescent Health Program, WIC, the Division of Senior Affairs and the Office of Minority Health will also be pursued.
Department of Human Services: The Department of Human Services provides direct services to thousands of New Jerseyans. Questions on tobacco use could be incorporated into the standard intake procedure and referrals made for treatment, if necessary. Residential facilities should be encouraged and supported to offer nicotine treatment to both patients and staff who are addicted to smoking.
Department of Labor: In cooperation with the Department of Labor, systematic education regarding the prevention of nicotine addiction and treatment of nicotine addiction with employee groups and unions can be initiated and sustained. Thousands of New Jersey families can be positively influenced to be tobacco- free.
Commerce and Economic Growth Commission: In cooperation with the Commerce and Economic Growth Commission, (formerly the Department of Commerce) a systematic education program with employers on the benefits of tobacco-free workplaces and tobacco-free employees will be initiated and sustained.
Municipal and County Offices: Municipal and County governments will be approached to adopt tobacco-free policies. We envision a partnership with the Local Health Officers who will be instrumental in providing education, referrals and enforcement regarding tobacco and tobacco control.