Tobacco-Free Mississippi

Tobacco-Free Mississippi

This project is a partnership between the CHCAMS and the MS State Department of Health Office of Tobacco Control (OTC). Program funding and support is provided by OTC.

The OTC mission is to promote and protect the health of all Mississippians by reducing tobacco-related disease and death. OTC program components include:

  1. State & Community Interventions,
  2. Tobacco Cessation Interventions,
  3. Health Communication Interventions, and
  4. Surveillance & Evaluation.

The Purpose of the Tobacco-Free project is to strengthen statewide capacity to conduct clinical tobacco cessation programs and activities. A fundamental philosophy is that people are more likely to follow through with advice to cease tobacco use when it comes from a healthcare provider.

Statistics of Need (from MSDH/OTC)

  • Tobacco use is the leading preventable cause of disease and death in the United States
  • In Mississippi, 4,700 adults die each year from smoking, and 192,000 children are exposed to secondhand smoke at home
  • Tobacco use is strongly associated with increased rates of morbidity and mortality (Heart disease, lung disease, cancer, etc.)
  • Mississippi has one of the highest state smoking rates 22.7% of state adults smoke, compared to the Healthy People 2020 objective of 12%

Project Design

The project design features provider training to improve clinical knowledge and skills to effectively deliver brief evidence-based tobacco screening and assessment. The clinical approach is based on The Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence. This curriculum is based on the 5A’s technique: 1) Ask, 2) Advise, 3) Assess, 4) Assist, & 5) Arrange. The program also embraces physician-directed use of prescribed cessation medication, additional patient education provided in clinical setting, and healthcare provider referral to a cessation program such as the Mississippi Tobacco Quitline and the ACT Centers for Tobacco Treatment, Education and Research.

Mississippi FQHCs Currently Participating in Tobacco-Free Mississippi

  1. Access Family Health Services
  2. East Central Mississippi Health Care
  3. Family Health Care Clinic
  4. North Mississippi Primary Health Care
  5. Mantachie Rural Health Care

Target Population

The total state FQHC adult patient population (ages 18+) numbers approximately 200,000. The estimated adult patient population for seven individual participating health centers is 66,667. Applying the state smoking rate of 22.7% to 66,667 results in a conservative target population of approximately 15,000. However, research conducted during Project Year 1 found a tobacco use rate among adult FQHC patients of 40.6%. Applying this rate to a general adult patient population of 66,667 results in a revised target population of adult FQHC tobacco users of approximately 26,867.

Key FQHC Activities

  1. Administer initial tobacco prevalence survey to adult patients
  2. Clinical staff training in the 5As
  3. Participation in Tobacco Treatment Specialist (TTS) training
  4. Adopt and implement smoke-free campus policy
  5. Adopt and implement tobacco assessment/ treatment measures and protocols
  6. Provide enhanced tobacco education/ treatment services to CHC patients
  7. Administer follow-up tobacco prevalence survey to adult patients

Anticipated Impact

  • Establish baseline prevalence of tobacco use/smoking within the adult FQHC patient population
  • Train healthcare providers to conduct tobacco-use screening and brief intervention
  • Institute clinical-level systems changes to improve delivery of evidence-based tobacco-use treatment
  • Healthcare providers increase referral of tobacco-using patients to the Mississippi Tobacco Quitline & ACT Centers
  • Increase patient availability of, and access to, comprehensive tobacco education resources

Tobacco Use Prevalence Survey

Study Design

  • Adult CHC patients were asked to complete self-administered survey
  • The survey captured demographic information, and asked questions regarding tobacco use, plans to quit, and readiness to quit
  • Over 2500 patients participated
  • The average age was 45 years, with a range of 18 – 89 years
  • 65% of survey respondents were female
  • 57% were black/African American & 38% were white/ Caucasian
  • 39% uninsured, 24% private insurance, 17% Medicaid, 10% Medicare

Key Survey Results

  • 38.1% smoke (40.6% use tobacco)
  • 50.2% of uninsured smoke
  • Over 50% reported readiness to quit within 6 months