Executive Summary:

The purpose of the Kentucky Tobacco Use Prevention and Cessation Report Card is to describe tobacco use and policy patterns in the Commonwealth and selected local health department service areas from 1997 to 2001. Tobacco use is the single most preventable cause of death in Kentucky and the U.S. Kentucky leads the nation in adult cigarette smoking prevalence and spends over $1 billion dollars each year treating sick smokers.

Although the Commonwealth of Kentucky is not making progress in reducing the percent of adults and pregnant women who smoke, the state is moving forward in reducing youth tobacco use, reducing youth access to tobacco products, adopting local voluntary smoke-free policies, and providing cessation programs. Public support for raising the tobacco tax and local option to pass laws related to tobacco prevention has remained the same over time, and very few manufacturing facilities ban smoking or offer resources to promote tobacco cessation for their employees. While almost all middle and high, public and private schools in the state ban smoking on school grounds for students, less than half have tobaccofree campuses banning tobacco use for employees.

The Kentucky Department for Public Health (KDPH) Tobacco Prevention and Cessation Program supports local health departments in implementing comprehensive community-based programs that address the four Centers for Disease Control and Prevention (CDC) goals to reduce tobacco use and the associated health risks. The CDC goals are to (a) prevent initiation of tobacco use by youth and young adults; (b) promote cessation; (c) reduce exposure to secondhand smoke; and (d) identify and eliminate disparities among population groups that are disproportionately affected by tobacco use.

The Kentucky Tobacco Prevention and Cessation Program has developed an Annual Plan that is based on the Healthy Kentuckians 2010 goals to reduce tobacco use. This Report Card illustrates the extent of progress toward meeting these goals at both the state and local level in selected health department service areas.

For fiscal years 2000-2002, the Kentucky General Assembly allocated $5.5 million of the Master Settlement Agreement (MSA) monies to the Kentucky Department for Public Health for tobacco control (an average of $.60 per capita). The CDC recommends that Kentucky spend at least $6.42 per capita for comprehensive, evidence-based tobacco control. Prior to state MSA funding, ten local health departments received $60,000 per year from KDPH through a cooperative agreement with the CDC for comprehensive tobacco control. Seven of the 10 CDC funded health departments have been funded by the CDC since FY 1997-1998. The remaining three CDC funded health departments have been funded for tobacco control since FY 1998-1999.

As a group, the 10 CDC funded health departments are significantly different than the non-CDC funded health departments in three areas: (1) the percent of smoking during pregnancy has remained significantly lower over time; (2) participation rates in tobacco cessation programs have steadily increased over time; and (3) the percent of smoke-free eating establishments has been significantly higher over time, compared to non-CDC funded health departments.