• Objective 1: To decrease the proportion of people 18 to 64 years of age who smoke from 27.5% (2003) to 20% in 2010.
  
  
• Objective 2: To decrease the proportion of adults 65 years and older who smoke from 11.2% (2003) to 6% in 2010. (BRFSS)
  
  
• Objective 3: To decrease the proportion of middle school students in public schools who smoke from 14.3% (2003) to 10% in 2010. (YTS, YRBS 2003)
  
  
• Objective 4: To decrease the proportion of high school students in public schools who smoke from 33.7% (2003) to 12% in 2010. (YTS, YRBS)
  
  
• Objective 5: To increase the proportion of adult smokers counseled by a health professional to stop smoking within the previous 12 months by a health professional from 46.8% (2000) to at least 60% by 2010. (BRFSS)

Objective 1: To decrease the proportion of people 18 to 64 years of age who smoke from 27.5% (2003) to 20% in 2010. (BRFSS) (The definition of a 'smoker' is one who currently smokes and has smoked at least 100 cigarettes.)
Discussion: The objective to decrease the proportion of people 18 to 64 years of age who smoke from 26% to 20% in 2003 was not reached, and in fact the smoking rate increased slightly among adults.

Objective 2: To decrease the proportion of adults 65 years and older who smoke from 11.2% (2003) to 6% in 2010. (BRFSS)
Discussion: The objective to decrease the proportion of adults 65 years and older who smoke from 11% (1997) to 6% in 2003 was not reached, but instead remained flat. (BRFSS)

Objective 3: To decrease the proportion of middle school students in public schools who smoke from 14.3% (2003) to 10% in 2010. (YTS, YRBS 2003) (An 'adolescent smoker' is one who has smoked cigarettes within the past 30 days.)
Discussion: Using YRBS, the objective to decrease the proportion of middle school students in public schools who smoke to 10% in 2003 was nearly met (12.8%, YRBS 2003). However, a more accurate survey method now exists, the Youth Tobacco Survey (YTS). Using YTS, middle school smoking rates are 14.3%.

Objective 4: To decrease the proportion of high school students in public schools who smoke from 33.7% (2003) to 12% in 2010. (YTS, YRBS)
Discussion: Although the number of high school students in public schools who smoke has decreased to 24.8% in 2003 using YRBS data, or 33.7% using YTS data, the objective of 12% was not met in 2003.

Objective 5:To increase the proportion of adult smokers counseled by a health professional to stop smoking within the previous 12 months by a health professional from 46.8% (2000) to at least 60% by 2010. (BRFSS)
Discussion: This is a new objective that was not included in the 1999-2003 plan.

Specific Actions Supported by the HDSP Program:

1. Support the continued adoption of the Starting the Conversation Tools within health care settings.
2. Support tobacco-control evaluation and surveillance, particularly for community level indicators. An example is the N.C. Restaurant Heart Health Survey led by the HDSP Branch and supported by TPCB.
3. Support efforts to reduce exposure to environmental tobacco smoke.
4. Monitor tobacco use assessment and counseling as part of quality care and secondary prevention of heart attack and stroke. (MRNC, Acute Stroke Registry)

Actions to Get There:

• Publicize that the BASIC Initiative, from a baseline of 0 in 1998, has achieved 100% of state public and private health plans providing benefits for tobacco cessation by 2004.
• Support Quit Now NC!, to expand cessation and quitting efforts across the state through use of the Starting the Conversation Tools, quit lines, and cessation services.
• Support the TPCB and the EnTER program at UNC-Chapel Hill’s Department of Family Medicine in assisting worksites to go smoke-free.
• Join the TPCB in promoting smoke-free dining.

Responsible Parties and Partnering Organizations:
Division of Public Health, Tobacco Prevention and Control Branch; local ASSIST coalitions; Medical Review of North Carolina; The Institute of Medicine; N.C. Medical Society; N.C. for Tobacco-Free Youth Council; Department of Public Instruction; Tobacco Workgroup of the Advisory Committee on Cancer Coordination and Control; Association of Local Health Directors; local Boards of Health; Wellness Council of N.C.; N.C. Prevention Partners; Healthy Carolinians; Alliance for Health; UNC at Chapel Hill, Department of Health Promotion and Disease Prevention; Leadership Council for Healthy Schools; HDSP Branch and the six lead HDSP counties and two disparity counties.