MMWR News Synopsis for October 6, 2016

State-Specific Prevalence of Current Cigarette Smoking and Smokeless Tobacco Use Among Adults — United States, 2014

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Evidence-based interventions such as increasing tobacco prices, implementing comprehensive smoke-free policies, conducting mass media anti-tobacco use campaigns, and promoting accessible smoking-cessation assistance are important to reduce tobacco use and tobacco-related disease and death among U.S. adults, particularly among sub-populations with the highest use. CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System to assess state-specific prevalence estimates of current use of cigarettes and/or smokeless tobacco among U.S. adults. Current cigarette smoking ranged from 9.7% (Utah) to 26.7% (West Virginia); current smokeless tobacco use ranged from 1.4% (Hawaii) to 8.8% (Wyoming); and current use of any cigarette and/or smokeless tobacco product ranged from 11.3% (Utah) to 32.2% (West Virginia). Disparities in tobacco use by sex and race/ethnicity were observed; any cigarette and/or smokeless tobacco use was higher among males than females in all 50 states. By race/ethnicity, non-Hispanic whites had the highest prevalence of any cigarette and/or smokeless tobacco use in eight states, followed by non-Hispanic other races in six states, non-Hispanic blacks in five states, and Hispanics in two states; use in the remaining states did not differ significantly by race/ethnicity.

Prevalence of Severe Joint Pain Among Adults with Doctor-Diagnosed Arthritis — United States, 2002–2014

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Almost 15 million U.S. adults with arthritis have severe joint pain that can limit their ability to perform basic functions and seriously compromise their quality of life. To address severe joint pain, healthcare professionals can promote proven physical activity and self-management education programs as effective ways to reduce or manage arthritis pain without the use of drugs such as prescription opioids. More than 1 in 4 U.S. adults has severe joint pain (SJP). The nearly 15 million U.S. adults with arthritis and SJP is a significant increase of more than 4 million since 2002. Health care professionals can treat severe joint pain without opioids by following the CDC Guideline for Prescribing Opioids for Chronic Pain as there is insufficient evidence for – and serious risks associated with – long-term use of opioid therapy to treat chronic pain. The report suggests that health care professionals begin to implement the 2016 National Pain Strategy objectives of taking steps to reduce barriers to pain care and increasing patient knowledge of treatment options and risks. Self-management education and appropriate physical activity interventions are effective, non-drug ways to reduce pain and improve health outcomes.

Vaccination Coverage Among Children in Kindergarten — United States, 2015–16 School Year

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Kindergartners at the national and state levels have high vaccination coverage rates, but there may be local clusters of under-vaccinated or unvaccinated students. Clusters of low vaccination coverage can place schools or communities at higher risk for an outbreak. Parents can protect their children from vaccine-preventable diseases by ensuring their children are vaccinated according to the recommended immunization schedule. Nationally, for the 201516 school year, most kindergartners are up-to-date on recommended vaccinations, and median exemption levels continue to remain low. CDC collected data to report for the first time the prevalence of children who were neither documented as fully vaccinated nor exempt. These students were enrolled in kindergarten under a grace period or provisional enrollment. A median of 2.0% of kindergartners were within a grace period or were provisionally enrolled at the time of the assessment. Immunization programs, in cooperation with schools, can improve vaccination coverage by ensuring all kindergartners are vaccinated during the grace period or provisional enrollment. Consistent, high coverage rates at the national level significantly reduce illness and death from vaccine-preventable diseases.

Vaccination Coverage Among Children Aged 19 — 35 Months — United States, 2015

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High coverage rates for childhood vaccinations explain why most vaccine-preventable diseases are at record low levels. However, it is crucial to maintain these rates to keep outbreaks from happening. According to the 2015 National Immunization Survey, the majority of parents are vaccinating their young children against potentially serious diseases. Nationally, there were no significant changes in vaccination coverage among children ages 1935 months for routinely recommended childhood vaccinations in 2015. However, opportunities for improvement remain. Lower coverage continues for vaccinations recommended during the second year of life. National vaccination coverage was also lower among children living in poverty and those living in rural areas, and there were widespread variations in coverage by state.

Real-Time Monitoring of Vaccination Campaign Performance Using Mobile Telephones — Nepal, 2016

CDC Media Relations
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Rapid convenience monitoring by mobile phones led to faster data transmission, analysis, and decision-making and to increased accountability at all levels of the health system in Nepal. In 2012, the Global Vaccine Action Plan established a goal to achieve measles and rubella elimination in five of the six World Health Organization Regions by 2020. Measles elimination strategies include achieving and maintaining ≥95% coverage with two doses of measles-containing vaccine and implementing mass vaccination campaigns in settings where routine two-dose coverage is low or where high-risk subpopulations exist. To ensure campaign quality and achieve ≥95% coverage, rapid convenience monitoring is used during or immediately after campaigns. Achieving measles and rubella elimination worldwide will be an important milestone in public health and every effort in this direction, including vaccination campaigns, should be of high quality and improved with innovations. One way to improve the quality of vaccination campaigns is to increase the use of mobile phones for monitoring campaign implementation with faster data transmission, analysis, decision-making, and increased accountability among levels of the health system.

Quick Stats

• Percentage of Children Aged 15 Years with Elevated Blood Lead Levels, by Race/Ethnicity — National Health and Nutrition Examination Survey, United States, 1988-1994, 1999-2006, and 2007-2014

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES