Carroll County Coalition For Public Health

April, May, June – a time when the weather is warming up and everyone is excited for the summer! However, these months also bring an increase in risky behavior for teens. Outdoor parties and graduation activities start to occur on a more frequent basis, which can lead to underage drinking. Each year, one-third of the alcohol-related traffic fatalities involving teens occur during these three months – April, May, June.

There should definitely be regular conversations between teens and parents during ‘graduation season’. Teens put lots of thoughts into their spring activities and post-graduation parties, but there should also be planning with parents about the logistics of staying safe. It’s important for parents to place attention on safety and good decision-making in order to promote healthy, memorable experiences.

Whether or not your teen is graduating, the spring-time season can be a high-risk time for teens, where alcohol & drugs can often be seen as “part of the experience” at parties and graduation events. 2011 data from Belknap and Carroll Counties showed that 45% of high school students had drank in the past 30 days, 26% had used marijuana and 11% had abused a prescription drug (2011 NH Youth Risk Behavior Survey). These situations can be amplified during graduation season, so parents and teens have to be prepared.

Discussion topics between parents and teens should include: times & specific location of activities/ events, safe transportation, checking-in at certain times, avoiding alcohol and drugs, and avoiding the pressure to have sex. Parents should also ASK their teen what they are most concerned about before they head out to a party of graduation event. Building trust and communication between teens and parents can help to facilitate responsible behavior.

Help your teen identify risky behaviors by discussing them – it is important to remember that Parents DO Make the Difference. Teens who learn anti-drug & alcohol messages at home are 42% less likely to use drugs & alcohol.

SADD, or Students Against Destructive Decisions, has a “Contract for Life” that may be a useful tool to review with your teen. Go to www.sadd.org/contract.htm to download a copy.
Here are some more tips to help your teen have a FUN and SAFE Graduation Season:
-Ask your teen for details about parties and events they attend, including venues, times and contact numbers.
-Know exactly what activities are taking place and where – if the party is at a friend’s house, CALL the PARENTS to confirm and make sure that alcohol will not be present.
-Establish an agreed-upon curfew.
-Get to know your teen’s friends.
-Make sure your teen will have a charged cell phone that is turned ON at all times.
-Outline your policy on alcohol and drug use and the consequences for violating the rules.
-Remind your teen not to use alcohol or drugs, or ride in a vehicle with a driver who is under the influence.
-Tell your teen that if anything occurs at a party that makes them feel uncomfortable, they can call you and arrange to leave with no questions asked.
-If for some reason, they do consume alcohol or drugs, or get into any kind of trouble, let them know they can still call you and arrange to leave at any time.
And, remember, those who HOST, can lose the most: Most underage drinkers get their alcohol from adults. In 2004 the NH legislature passed a law (RSA 644:18) to hold “hosts” of parties responsible for the actions of underage participants. This law can be applied to any adult.
Under this Law
“Host” means a person who:
• is at least 17 years old;
• owns, rents, or has control of the site;
• knows about the party; and
• knows that persons under the age of 21 have a plan to drink alcohol or use drugs;
“Party” means:
• five or more people under the age of 21 (not related to the host) are present; and
• at least one person under the age of 21 has an alcoholic drink or an illegal drug.
What can happen to “hosts”? Under this law, a person who hosts a party where minors drink alcohol or use drugs may be charged with a misdemeanor, fined up to $2,000 and spend a year in jail.
To Stay Safe Under This Law
People whose properties may be the site of underage drinking or drug parties should:
• tell local law enforcement officials as soon as possible;
• take action to prevent the party; and/or
• try to stop the party, if it has already started.

You can be part of the solution: Call the NH Liquor Commission’s Bureau of Enforcement at 1-888-8-Over-21 (888-868-3721, then #2 after prompt) to anonymously report underage alcohol violations such as sales to minors or upcoming parties. Partnering with law enforcement is a key strategy to reduce underage drinking in our communities.

The New Hampshire Department of Health and Human Services (DHHS) will declare February 17-23 Through with Chew Week, following the lead of other states in the Nation concerned with the oral health of their residents, especially youth.

Through with Chew Week started in the state of Wyoming to draw attention to the health issues related to smokeless tobacco. Among the health effects caused by smokeless tobacco, cancer and poor oral health are the most common. After increasing for many years, the use of smokeless tobacco by New Hampshire youth has leveled off, according to the latest data from the NH Youth Risk Behavior Surveillance System (2011 YRBS). The percentage of female smokeless tobacco users (2.2%) is significantly lower than the male students (14.2%) (2011 YRBS).

The use of smokeless tobacco is at 3% for New Hampshire adults, and 45% of adult smokeless tobacco users also smoke cigarettes (2011 NH Behavioral Risk Factor Surveillance System, BRFSS). Nationally, declines in the use of smokeless tobacco by youth and young adults have stalled after years of steady progress. New Hampshire has the opportunity to do more to educate students about the harmful effects of smokeless tobacco and maintain the gains currently being made in the oral health of the young.

“The use of smokeless tobacco is not a safe substitute for smoking cigarettes,” said Dr. José Montero, Director of Public Health at DHHS. “Smokeless tobacco can cause cancer and lead to nicotine addiction and dependence. Scientific evidence clearly demonstrates the need for intense and sustained efforts to prevent our young people from using tobacco.”

Smokeless tobacco is tobacco that is not burned. Other recent products on the market are snus, orbs, sticks, and dissolvables. Smokeless tobacco is associated with oral cancer, esophageal cancer, and pancreatic cancer. Using smokeless tobacco may also cause heart disease, gum disease, and oral lesions other than cancer, such as leukoplakia (precancerous white patches in the mouth). The price of treating disease and disfigurement is costly and many of these diseases result in deformation or death. But they can be prevented.

“Effects from prolonged use of chewing tobacco are often visible on the gum tissue where the user holds the wad of tobacco,” said Montero. “Gum recession and pre-cancerous oral lesions may be the first sign of a problem identified during a visit to the dentist. However, quitting is achievable, especially when combined with counseling and nicotine replacement therapies. Of course the best thing for youth is to never start.”

To hold your own Through with Chew Week or the Great American Spit Out, visit www.ThroughWithChew.com. For information or free support in quitting, call the NH Tobacco Helpline at 1-800-QUIT-NOW (1-800-784-8669) or visit www.TryToStopNH.org and www.MyLastDip.org. Visit www.dhhs.nh.gov for more information on the NH Oral Health Program.

The New Hampshire Department of Health and Human Services, in recognition of February as Children’s Dental Health Month, reminds parents and providers that children should receive their first oral health check up before one year of age, and remember to brush twice a day for 2 minutes each time—think “2×2.”

Tooth decay is almost entirely preventable. Tooth decay is the most widespread chronic childhood disease and can cause a lifetime of problems if not prevented or treated early in a child’s life. Untreated cavities may lead to pain and infection, and when children suffer from oral health problems so does their ability to concentrate and learn. Early tooth loss from dental decay can cause impaired speech development, absence from school, difficulty with concentration, and reduced self-esteem.

The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend that children begin regular oral exams when their first teeth become visible or by one year of age. New Hampshire Medicaid and many other dental insurance programs cover the cost of these examinations.

“These are problems that can be easily prevented by taking care of children’s mouths and teeth from the time they are infants,” said Dr. José Montero, Director of Public Health at DHHS. “It‘s an investment that lasts a lifetime. The National Partnership for Healthy Mouths has created the new 2×2 initiative that makes it easier for parents and caregivers to remember this important part of preventing oral health problems during our busy days.”

Here are important steps to take to help preserve dental health in children:
* Brush and floss children’s teeth 2 times a day.
* Use a toothpaste with fluoride.
* Give fluoride prescribed by your health care provider if your water supply doesn’t have the right amount of fluoride to protect a child’s teeth.
* If using a pacifier, do not dip it in anything sweet such as honey or sugar.
* Clean an infant’s teeth and gums every day, especially after feeding and before bed.
* Have regular dental checkups, starting before age one.
* Do not give infants juice until 12 months of age, and always use a cup and not a bottle for juice.
* Never put a baby to bed with a bottle.
* Don’t let your child catch the bacteria that cause tooth decay by sharing food, utensils, or toys with others.
* Avoid sticky snacks, dried fruits, candy, and sweetened drinks. Offer healthy snacks, such as fresh fruits and vegetables.
* Follow your health care provider’s advice.

For more information on the “2 minutes, 2 times” national campaign, visit http://2min2x.org/. For resources on celebrating National Children’s Dental Health Month, go to the American Dental Association’s website at http://www.ada.org/6712.aspx. To learn about the New Hampshire Oral Health Program go to http://www.dhhs.nh.gov/dphs/bchs/rhpc/oral/index.htm or call 271-4535. Families with preschool children may be eligible for the WIC Nutrition Program and to receive nutrition education about healthy meals and snacks for infants and preschoolers. Contact WIC at 1-800-942-4321 or http://www.dhhs.nh.gov/dphs/nhp/wic/index.htm.

The State of New Hampshire received a third-place ranking among the 50 states and the District of Columbia today by the Trust for America’s Health in their report A Call to Action for Individuals and Their Communities. The report looked at various health indicators, such as obesity and smoking rates, and ranked all the states based on the data.

Last year New Hampshire was ranked second, and in 2010 the State was also ranked third. Some of New Hampshire’s strengths are a low sedentary lifestyle rate, a low incidence of infectious disease, and a low rate of children in poverty. New Hampshire has also seen a decline in the infant mortality rate from 8.4 deaths per 1,000 live births in 1990 to 4.4 in 2012 and a decrease in the number of smokers.

“We are lucky to be living in such a healthy state,” said Dr. José Montero, Public Health Director at DHHS, “but there is more work to be done. Our obesity rate continues to climb and we can do better on our cancer and diabetes rates.”

The report looks at a wide range of indicators including cardiovascular disease deaths, preventable hospitalizations, immunization coverage, and air pollution levels. Then the scores are calculated to determine an overall ranking. While the percentage of Granite Staters who smoke has been steadily decreasing, the number of those who are overweight or obese has been climbing dramatically since 1990.

“It is extremely important to maintain a healthy weight,” continued Dr. Montero, “and to be physically active for overall health. Diabetes, heart disease, some cancers, arthritis, sleep apnea, and other diseases are directly linked to poor diet, excess weight, and lack of exercise. With the New Year we should all make a resolution to eat a healthier diet and move more. Even small changes, such as eliminating sugary beverages and walking 15 minutes more a day, can have a big impact.”

To read the entire report, go to www.healthyamericans.org. For more information about any of the issues addressed, visit the NH Department of Health and Human Services website at www.dhhs.nh.gov. For tips on getting healthy, visit www.dhhs.nh.gov/dphs/nhp/obesity.htm.