1. Random Thoughts from a Has Been 1

2. Retrospective August 17, 1987 – 25 years ago Mike Castle was Governor Tom Carper was Congressman Delaware was #2 in CANCER MORTALITY 2

3. Retrospective August 17, 1987 – 25 years ago Delaware was number 2 in cancer mortality Adult smoking rate was about 25% - there were cigarette vending machines everywhere, including Legislative Hall. You could even give away free cigarettes! 3

4. There was NO Screening for Life Program or Federal Breast Cancer Treatment program Mammography Van Smoke Free Air Legislation Gold Rating from NAACCR for Delaware’s Cancer Registry 4

5. The Cigarette tax was $.14 per pack - now it is $1.60 and slightly above the national average 5

6. There was NO Smoke Free properties like schools Delaware Quitline Delaware Cancer Treatment Program Media awareness campaigns about smoking, although we have less funding than we used to have… 6

7. What we have now: Organizations, coalitions and groups such as: Delaware Cancer Consortium Kick Butts Generation American Cancer Society - Cancer Action Network Governor’s Council on Health Promotion and Disease Prevention Center for Health Promotion IMPACT Delaware Pain Initiative 7

8. We had to ADVOCATE! We had to provide support services We had to create policy We had to create financial investments for our future We had to develop treatment facilities with world class talent 8

9. Comparison American Lung Association issues Delaware’s report card: A – Smoke free air B – Tobacco Prevention C – Cessation coverage C – Cigarette tax Tobacco KILLS 1,200 people a year in Delaware CDC recommends we spend $13.9 million on tobacco prevention funding we are at $9 million 9

10. Pain & Palliative Care Delaware lacks hospital capacity to care for all patients Controlled substance prescriptions for pain are only valid for seven days, this is a barrier for our patients Prescriptions can only be written for a thirty day supply, adding one more barrier to our patients 10

11. We Can Do Better State lawmakers play a critical role in guaranteeing access to care through - State-funded screening programs Medicaid coverage for low-income populations Health benefit exchanges 11

12. Prospective State of State Address by Governor Markell: Total ban on smoking on state agency campuses. Shift Medicaid money to prevention services to decrease overall costs. Spend on bike and hiking tails to invest in state health infrastructure – decrease in obesity and lack of physical activity 12

13. Emerging Issues Need tax equity on tobacco products known as OTPs. Lower priced Desirable to young people Increase in youth nationwide 15% between 2002 – 2009 13

14. Emerging Issues No child under 18 should never be allowed to use a tanning bed unless it is with the express order of a physician. Eliminating food deserts Expanding screening for chronic disease risk factors London Associated Press Published Study: Tanning beds can be as deadly as arsenic 14

15. Focus on Prevention Change in Care Model improve health in Delaware and the nation 15

16. Need for Coordination & Cooperation What could happen if we all got involved in one room and shared the funding? Does anyone know all the available money in Delaware for prevention? We need coordination, cooperation, transparency and commitment from all - WE EVERYONE! 16

17. Call to Action Achieve and maintain a healthy weight throughout life – be as lean as possible. For those that are overweight or obese, losing even a small amount of weight makes a difference and is a place to start. Adopt a physically active lifestyle, by limiting sedentary behavior and engaging in moderate to intense activity throughout the week. Eating a diet including lots of fruits and vegetables, whole grains and limited processed and red meats. Limit alcohol consumption, women one drink a day; men two a day – no you can’t save them all for the weekend. 17