Achieving Health Equity: Breaking the Commercial Tobacco Industry's Cycle of Addiction, Death, and Environmental Degradation, 2023–2024.

About the Plan

Every two years, TEROC develops a comprehensive plan that not only outlines TEROC’s strategic goals for the next two years, but also serves as a call to action for stakeholders, partners, and allies in tobacco control. The 2023-2024 TEROC Plan serves as a strategic plan for the next phase of moving California from commercial tobacco prevention and control to ending the commercial tobacco epidemic for all of California’s diverse populations. The Plan includes broad objectives aimed at addressing many different areas of commercial tobacco control such as reducing youth uptake of tobacco products to prevent young people from ever starting to use tobacco products and countering the tobacco industry which continues to produce and market novel tobacco products. Each of these strategies and recommendations are based on the most current, evidence-based research and best practices aimed at eradicating the tobacco industry’s manipulative, predatory, and deadly influence in California. 

The TEROC Plan as a Guide for Addressing Health Equity by Ending the Commercial Tobacco Epidemic in California:

The mission of TEROC and the agencies it oversees is to support the right of all Californians to be as healthy as possible by eliminating tobacco-related disparities. While California has made great progress over the past three decades in reducing rates of tobacco use, exposure to secondhand smoke, and tobacco-related death and disease, this progress has been more pronounced in certain communities than others.₁ This is in part due to decades of the tobacco industry's strategic targeting and exploitation of certain communities through manipulative messaging and deceitful marketing tactics._2–4 The tobacco industry has consistently put profit above all else to addict a new generation of users to their deadly products, and its discriminatory marketing and messaging strategies continue to disproportionately harm historically excluded populations._1,5

In order to combat the tobacco industry's influence, California and other nations are part of a paradigm shift in tobacco prevention work to move beyond "controlling" the commercial tobacco epidemic to ending it.₆ California is moving into a new phase that seeks to eliminate the industry's influence in California, making all communities free from commercial tobacco, and ending the commercial tobacco epidemic in this state once and for all.

How To Use This Strategic Plan

The Plan is organized into eight objectives, each of which contains different strategies which are tailored for local health departments, elected officials and advocates to reference when prioritizing strategies locally and setting tobacco-related agendas.

The TEROC Plan as a Guide for a Commercial Tobacco-Free California

The movement to end the commercial tobacco epidemic in California is driven by a vision to eradicate the tobacco industry's deadly influence in California, and for the only tobacco use to be sacred use among Tribes with that tradition. TEROC's vison for a commercial tobacco-free California is one in which:

• ·There is no commercial tobacco use in California, only sacred use among Tribes with that tradition.
• No community is disproportionately impacted by tobacco or by tobacco-related disease and death.
• All children, whether their families rent or own their homes, grow up breathing clean, fresh air.
• No one is exposed to secondhand smoke or related contaminants in their homes, places of employment, neighborhoods or communities.
• No young person ever becomes hooked on nicotine, and no adult has to overcome a lifelong addiction to it.
• Families never grieve the loss of a loved one due to tobacco-related disease.

It is important to differentiate between the use of traditional tobacco during tribal ceremonies by American Indian or Alaskan Native groups, and the use of commercial tobacco sold by the tobacco industry. Throughout this Plan, whenever TEROC uses the word "tobacco" it is meant to only include commercial tobacco and not traditional tobacco which is used for sacred purposes by American Indians.

Traditional vs. Commercial Tobacco "Traditional and commercial tobacco are different in the way that they are planted and grown, harvested, prepared, and used. Traditional tobacco is and has been used in sacred ways by American Indians for centuries. Its use differs by Tribe, with Alaska Natives generally not using traditional tobacco at all. Commercial tobacco is produced for recreational use by companies, contains chemical additives and is linked with death and disease."₇

Progress Reports

Tobacco-related priority populations are groups that use tobacco at higher rates, experience greater secondhand/thirdhand smoke exposure, are disproportionately targeted by the tobacco industry, and/or have higher rates of tobacco-related disease. Priority populations include, but are not limited to:

• Black/African Americans, Hispanic/Latinos/as, Asians, Native Hawaiians, Pacific Islanders, American Indians, and Alaska Natives.
• Lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) people.
• People of low socioeconomic status or with limited education (reflected in the progress report as "Low Income").
• People with substance use disorders or behavioral health conditions (reflected in the progress report as "Poor Mental Health").
• Rural residents.
• School-age youth.
  

Agencies may identify additional priority populations by applying the criteria above or using other disparity indicators, such as those on the Story of Inequity website

In the links below, TEROC has included progress reports and implementation strategies for priority populations most impacted by tobacco. The progress reports provide tobacco use data from 2016-2020 for both adults (age 18+) and youth (10th and 12th grades) for the following populations: general statewide data, Hispanic or Latino; African American or Black; American Indian or Alaska Native; Asian; Native Hawaiian or Pacific Islander; Lesbian, Gay, Bisexual, Transgender, Queer and Questioning (LGBTQ+); Low Income, Poor Mental Health, and Rural. The progress reports do not include all priority populations listed above and only represent those populations for which data is available. This Plan does not include a progress report for pregnant women due to limitations on data collection among this population, however, implementation strategies for this population are included in this Plan.

TEROC Master Plan 2021–2022

The full Achieving Health Equity: Toward a Commercial Tobacco-Free California Plan, 2021–2022 (PDF, 2.5MB)

Achieving Health Equity: Toward a Commercial Tobacco-Free California, 2021–2022 Executive Summary (PDF)

TEROC Master Plan 2018–2020

New Challenges, New Promises for All 2018–2020 (PDF, 12MB)

Technical Supplement to the 2018–2020 Master Plan (PDF, 1 MB)

New Challenges - New Promises for All (PDF)

TEROC Master Plan 2015–2017

Changing Landscape, Countering New Threats 2015–2017  (PDF, 3MB)

Changing Landscape Info-Graphics (PDF)

TEROC Master Plan 2012–2014

Toward a Tobacco-Free California 2012–2014: Saving Money, Saving Lives (PDF, 2.6MB)

Toward a Tobacco-Free California 2012–2014: Saving Money, Saving Lives (Executive Summary)(PDF, 1.8MB)

TEROC Master Plan 2009–2011

Toward a Tobacco-Free California 2009–2011 Endangered Investment (5.5MB)

Toward a Tobacco-Free California 2009–2011 Endangered Investment (Executive Summary)(PDF. 1.1MB)

References:

1. California Department of Public Health, California Tobacco Control Program. California Tobacco Facts and Figures 2021. Sacramento, CA: California Department of Public Health; 2021. Accessed October 3, 2022. https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/CDPH%20Document%20Library/ResearchandEvaluation/FactsandFigures/CaliforniaTobaccoFactsAndFigures2021-V3A.pdf

2. U.S. Department of Health and Human Services. Tobacco Use Among U.S. Racial/Ethnic Minority Groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health: 1998.

3. Lee JG, Henriksen L, Rose SW, Moreland-Russell S, Ribisl KM. A systematic review of neighborhood disparities in point-of-sale tobacco marketing. Am J Public Health. 2015;105(9):e8-e18. doi: 10.2105/AJPH.2015.302777

4. Mills SD, Henriksen L, Golden SD, et al. Disparities in retail marketing for menthol cigarettes in the United States, 2015. Health Place. 2018;53:62-70. doi: 10.1016/j.healthplace.2018.06.011

5. Centers for Disease Control and Prevention. Health Disparities Related to Commercial Tobacco and Advancing Health Equity. Accessed April 14, 2022. https://www.cdc.gov/tobacco/disparities/index.htm

6. Puljević C, Morphett K, Hefler M, et al. Closing the gaps in tobacco endgame evidence: a scoping review. Tob Control. 2022;31(2):365-375. doi: 10.1136/tobaccocontrol-2021-056579

7. Traditional vs. commercial tobacco. Traditional vs. Commercial | Keep It Sacred. (n.d.). Retrieved December 2, 2022, from https://keepitsacred.itcmi.org/tobacco%20and%20tradition/traditional%20v%20commercial/