Around a quarter of adults in Wyandotte County, Kansas, smoke. That’s about twice the rate in Johnson County and well above the state average. Wyandotte County’s government recently created a coalition of partners to find ways to address the problem. For the latest in our series KC Checkup, we talked with Rebecca Garza, coordinator of Tobacco Free Wyandotte, who began by explaining the significance of Kansas City, Kansas’ recent decision to raise the legal age for the sale of cigarettes and other tobacco products to 21.
Kansas City, Kansas, along with Kansas City and Independence, Missouri, recently introduced a minimum buying age of 21 for tobacco. What’s the importance of that?
We know that 90 percent of smokers started smoking before they’re 21. And if we can get those youth to not smoke for another couple of years – when their brain is developed more and they’re not in that same peer pressure environment as high school – then they’re less likely to become smokers in the long run.
More so, though, the reason this is incredibly impactful is that 80 percent of our senior classes are 18, which means that you have a great way for 15-year-olds, 16-year-olds, 17-year-olds to get ahold of cigarettes, because they’re going to school with these friends that can buy for them. As one of our youth advocates at the launch of Tobacco 21 said, you think you’re being nice. You’re buying your friend a pack of cigarettes because they’re not able to yet. So when you move that age up to 21, you’re really cutting off that social supply chain into high schools.
You’ve just started this big campaign to try to reduce tobacco use in Wyandotte County. At this point, what are the big questions you have?
We know from other cities and other partners that tobacco retailers tend to be concentrated in areas with higher poverty, and we know that all of Wyandotte County has levels of poverty, but there are certain parts that are worse off than others. So we want to know where tobacco retailers are – if our patterns mimic other places. We want to know what the signage is like because we know that just as there are more tobacco retailers, often there’s more advertising for tobacco products and menthol products, which are generally gateways for youth and certain populations to start tobacco.
In these initial meetings, have there been surprises or new ideas that have come out of getting together?
There’s a lot of evidence-based policies and initiatives that we know work. It’s just that they aren’t being done here yet, or they’re not – something’s gone wrong in the system, whether it’s a clinic that needs a certain resource to really implement a referral system into a (telephone) quit line resource. Or a pharmacist doesn’t know how to get the Medicaid reimbursement for the patient’s NRTs (nicotine replacement therapies).
Everyone wants to increase utilization by Medicaid users of cessation resources because it’s free, and we know it’s effective. But even though 30 percent of Medicaid users smoke, only 3 percent in Kansas are using resources that are free to them. And there’s a lot of reasons why, a lot of barriers. So hopefully, we can address those barriers to give our people what they need to successfully quit.
Are there different strategies that you use to try to reduce tobacco use in different communities?
Yes, definitely. We know that the Latino community might not have an interest in using pharmacotherapy – in using things like Chantix or Wellbutrin or the medication that we know is effective. Maybe there isn’t as much of an interest in taking a pill. So we need to figure out a different model for delivering resources. Or if they feel that the quit line is mostly for English speakers, then how can we change that resource or create a different resource or show them this other resource that is effective for them.
What are your plans looking ahead? I mean, what would you like to see happen with the group in the next year or so?
One of our really big dreams that I’m hoping will happen by the end of the year is to create a youth prevention and advocacy coalition. I think that that could be a really powerful resource in Wyandotte County because you can do peer-to-peer education about tobacco. And when you’re talking to people you’ve grown up with and people that understand the barriers you’re facing in your life, I think the education comes across a lot better and it’s a lot more effective. But also a lot of the coalitions like that – the advocacy coalitions – they offer an opportunity for our youth to be public health advocates. Teens are perfectly capable of advocating for local policy change or legislation out in Topeka. And it would be very empowering, I think, for them to know that this 25 percent smoking rate – that doesn’t have to be the case for their generation.
Alex Smith is a reporter for KCUR, a partner in the Heartland Health Monitor team. You can reach him on Twitter @AlexSmithKCUR