Modifications to Objectives and Subobjectives

The following discussion highlights the modifications, including changes, additions, and deletions, to this focus area's objectives and subobjectives as a result of the midcourse review.

At the time of the midcourse review, four developmental objectives became measurable on the basis of newly available data sources that are nationally representative. These objectives were initiation of tobacco use (27-3), tobacco advertising and promotion targeting adolescents and young adults (27-16), tobacco control programs (27-18), and sales-weighted average level of toxic chemicals in tobacco products sold in the United States (27-20). Within these 4 objectives, 10 subobjectives were added to stratify and track the information. For smoke-free indoor air laws (27-13), a subobjective measuring smoke-free laws in bars (27-13i) was added to reflect growing State activity in this area. The language in this objective that allowed for "limited to separately ventilated areas" was deleted because ventilation was shown to be inadequate to protect nonsmokers' health. Worksite smoking policies (27-12) was similarly revised. For adolescent tobacco use (27-2), a subobjective that tracks use of bidis in the past month (27-2e) was added to track the growing popularity and use of bidis among teens and young adults.

One tobacco tax subobjective was reworded from "increase the average Federal and State tax on tobacco products" to "increase the average Federal and State tax on cigarettes and expand the number of States with higher smokeless tobacco taxes over the decade" (27-21b). This change was made to ensure that all applicable taxes were measured.

As stated in Healthy People 2010: "Most developmental objectives have a potential data source with a reasonable expectation of data points by the year 2004 to facilitate setting 2010 targets in the mid-decade review. Developmental objectives with no baseline at the midcourse will be dropped." At the midcourse review, two subobjectives were dropped from this focus area because nationally representative data sources could not be identified: reduce use of other tobacco products (that is, use of something other than cigarettes, spit tobacco, or cigars) by adults (27-1d) and increase all insurance coverage of evidence-based treatment for nicotine dependency (27-8c). However, the U.S. Department of Health and Human Services and the agencies that serve as the leads for the Healthy People 2010 initiative will consider ways to ensure that these public health issues retain prominence despite their current lack of data.

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