Addressing Secondhand and Thirdhand Smoke: Tips for Public Health Professionals

November 29, 2012

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presentation.

• Questions will be answered at the end of the webinar – they can be left at any time throughout the training by writing them into the “question” text box in the webinar toolbox.

• The presentation will be archived and made available on www.slideshare.net/breatheeasy (please allow at least 48 hours for presentations to be uploaded).

About the Breathe Easy Coalition:

Funded by the Partnership For A Tobacco-Free Maine, Maine CDC/DHHS.

Breathe Easy Coalition of Maine

Smoke-Free Housing

Coalition of Maine

Maine Tobacco-Free Hospital

Network

Maine Tobacco-Free College

Network

About the Breathe Easy Coalition: • Mission: Reduce exposure to secondhand smoke

through the promotion of strong voluntary policies that lead to reduced tobacco use and increased tobacco-free living throughout Maine.

• Vision: A state where all can live free from involuntary exposure to secondhand smoke.

• How: Providing technical assistance, resources and initiatives to promote policy and environmental change.

Webinar Agenda

1. Background: Environmental Tobacco Smoke

2. Tips for SF/TF Policy Change

3. Environment Specific Policies

4. Incorporating ETS into Wellness Initiatives

5. Resources

6. Questions

Breathe Easy, You’re In Maine! • Maine laws protect people from SHS in: ▫ Workplaces, indoors and within 20-ft of

entryways, etc ▫ Indoor public places ▫ Restaurants/Bars, including outdoor dining areas ▫ State Parks, Beaches and Historical Sites ▫ Vehicles when children under 16 are present

Breathe Easy, You’re In Maine! • Policy changes to reducing SHS exposure: ▫ 100% Public Housing Authorities ▫ 48% of Private Multi-Unit Housing Buildings ▫ 26 of 39 Maine Hospitals ▫ 6 of 34 Maine Colleges and Universities ▫ Numerous worksites and municipalities have

adopted smoke-free/tobacco-free policies or ordinances.

Dangers of Tobacco Use • Tobacco use continues to be the leading cause of

preventable disease and death in the United States.

• Smoking causes 443,000 premature deaths in the U.S. each year.

• Smokeless tobacco can cause cancer, oral health problems and nicotine addiction.

• Quitting smoking at any age and at any time is beneficial – tobacco-free policies encourage users to quit.

No Risk-Free Level of Exposure • Secondhand smoke is defined as the tobacco

smoke exhaled by smokers or given off by the burning end of tobacco, which is inhaled involuntarily or passively by someone who is not smoking.

• The US Surgeon General has repeatedly stated

that there is no safe level of exposure to secondhand smoke. Even brief exposure causes damage that can lead to serious disease and death.

No Risk-Free Level of Exposure • Secondhand smoke contains thousands of

chemicals – at least 69 of which are known to cause cancer in humans.

• Exposure to secondhand smoke increases a nonsmoker’s risk of developing heart disease by 25-30% and for developing lung cancer by 20-30%.

No Risk-Free Level of Exposure • Children exposed to secondhand smoke are at a

higher risk of health issues, including: ▫ Sudden Infant Death Syndrome ▫ Acute Respiratory Infections ▫ Ear Problems ▫ Learning Disabilities/Behavioral Issues

• Children exposed to secondhand smoke in the home are 44% more likely to suffer from asthma.

No Risk-Free Level of Exposure • Separating smokers from nonsmokers inside a

building by using air filters and ventilations systems does not eliminate the harmful effects.

• Secondhand smoke poses a significant health risk in outdoor settings – research finds that smoking within 20 feet of nonsmokers can cause harmful levels of exposure that can be as high outside as they are inside.

Lingering Tobacco Smoke • Thirdhand smoke is the tobacco smoke

contamination, or smoke residue, that remains after a cigarette, cigar or other tobacco product has been extinguished.

• The toxins linger on carpets, sofas, clothes, hair, skin and other surfaces long after smoking has ceased.

Lingering Tobacco Smoke • Dangers of exposure to thirdhand smoke include

higher risk of heart disease, stroke and smoking related diseases.

• Infants and children are uniquely susceptible to thirdhand smoke because they are often held close to hair, clothes and skin. They can ingest tobacco residue by putting their hands in their mouths after touching contaminated surfaces.

Lingering Tobacco Smoke • Thirdhand smoke exposure increases infants

potential for suffering from Sudden Infant Death Syndrome (SIDS).

• Exposure increases the risk of asthma for infants and children and can worsen symptoms for those already suffering from asthma.

Lingering Tobacco Smoke • Thirdhand smoke builds up over time and resists

normal cleaning. It can’t be eliminated by airing out rooms, opening windows or using fans or air conditioners, or confining smoking to only certain indoor areas.

• Thirdhand smoke doesn’t just stay on initial surfaces – it can rub off on skin and dust can carry it into lungs.

Your Important Role: • Many organizational decision makers want to go

smoke-free/tobacco-free but need help in policy planning and implementation. Fears about enforcement can be high – your support will increase confidence of success!

• Explain the case the harmful effects of tobacco smoke, the case for policy change and provide assistance for successful implementation.

Smoke-Free or Tobacco-Free? • Specific policy language is important – need to

determine what is appropriate for each environment.

• Things to consider: ▫ Should you address smoke or all tobacco

products? ▫ Indoor only policy, designated smoking areas or

campus-wide policy? ▫ Is thirdhand smoke appropriate to address?

Smoke-Free or Tobacco-Free? • Good general rules: ▫ Health care/child care settings – look to

addressing thirdhand smoke in policy. ▫ 100% tobacco-free policies encourage quit

attempts, change the social norm and are often easier to enforce then designated outdoor use areas – encourage worksites, colleges/universities and hospitals to adopt these policies.

▫ SHS/costs are basis for multi-unit housing – encourage smoke-free policies.

SF/TF Policy Key Talking Points • It’s about the smoke, not the smoker. • Secondhand smoke travels and is harmful to

others – in both indoor and outdoor settings. • Prohibiting smoking saves will save you money • Communicating the policy is the key to

successful implementation. • Tobacco use remains the leading cause of

preventable disease and death – smoking policies change the social norm around use.

Changing Policies: Health Care • Adopting a tobacco-free campus policy is an example of

a healthcare organization’s commitment to creating a healthier community – benefits patients, employees, visitors and role models positive health policies for the entire community.

• Currently, more than 3,400 hospitals nationally and 26 hospitals in Maine have adopted 100% tobacco-free hospital campus policies.

Changing Policies: Health Care • Policy Adoption Strategies/Steps:

1. Establish a policy committee/workgroup. 2. Draft a tobacco-free policy. 3. Gain approval and support from hospital stakeholders. 4. Communicate policy before it goes into effect. 5. Prepare and distribute educational materials for

employees, patients, visitors on the policy and quit resources.

6. Implement and enforce policy.

Changing Policies: Health Care • Tips & Tools: ▫ Utilize the MTFHN Gold Star Standards of Excellence during

policy planning – ten best practice standards for tobacco-free hospitals.

Changing Policies: Colleges/Universities

• As leaders in higher learning, colleges and universities have a commitment to providing a safe and healthy environment. Tobacco-free campus policies are examples of this commitment as they benefit students, faculty, staff, visitors and help change the community norm around tobacco use.

• More than 608 colleges and universities nationally and 6 in Maine have adopted 100% tobacco-free campus policies.

Changing Policies: Colleges/Universities

• Policy Adoption Strategies/Steps: 1. Establish a policy committee/workgroup. 2. Determine policy parameters – draft plan (timeframe,

policy language, enforcement strategies, etc). 3. Build support of key stakeholders (administration, student

leaders, faculty and staff leaders). 4. Communicate policy to campus community prior to when it

takes effect and post signage. 5. Prepare and distribute educational materials on policy,

tobacco use, quitting and secondhand smoke to faculty, staff and students.

6. Implement and enforce tobacco-free campus policy.

Changing Policies: Colleges/Universities

• Tips & Tools: ▫ Use the MTFCN Gold Star Standards of Excellence as a guide for

policy implementation and during reviews – ten best practice standards around creating tobacco-free environments and supporting tobacco-free lifestyles.

Changing Policies: Multi-Unit Housing

• Smoke-free multi-unit housing policies provide a win-win opportunity for landlords and residents. Providing a safer, healthier living environment while reducing unit turnover costs and potential property damage.

• Who has adopted a voluntary policies: • 100% Public Housing Authorities • 2 of 5 Tribal Housing Authorities • 48% of Private Landlords/Property Managers

• Also: • Secondhand smoke landlord disclosure law • Requirement for Maine’s QAP (Low-Income Housing Tax Credit)

Program • SF designation given on MaineHousing’s MUH Registry

Changing Policies: Multi-Unit Housing Myths vs. Realities

Smoke-Free Housing Is Not

• About targeting people who smoke or making people quit • About evicting people who smoke

Smoke-Free Housing Is • Saving property owners/managers money

• About the smoke, not the smoker • Providing healthy indoor air for all residents of multi-unit

housing • Protecting the integrity of multi-unit buildings

Changing Policies: Multi-Unit Housing

• Policy Implementation Strategies/Steps: 1. Make a plan. Start by creating a plan to make the entire residence smoke-

free. Gather support/survey tenants. Do not grandfather tenants. 2. Hold a Meeting. Explain benefits that a smoke-free building will bring

them (safety and health). Gather with tenants to discuss the change. There may be resistance, but remember, non-smoking tenants have rights under their leases, too.

3. Inform Tenants. Review the legal information concerning your rights and your tenants' rights- be clear with them about the timeline & policy. Properly prepare everyone – keep it positive.

4. Amend New Leases. Change the language of your lease to include your new smoke-free policy. When new tenants sign on, your policy will be crystal clear.

5. Promote Your Status. Begin advertising your smoke-free status to gain new tenants who appreciate a clean air environment.

Changing Policies: Multi-Unit Housing

• Tips and Tools: ▫ Utilize Coalition Resources: Template Policy and Disclosure Law Language

Free signage, window clings, and other materials

Fact Sheets

Implementation and Enforcement Tips

Changing Policies: Multi-Unit Housing

• Tips and Tools: ▫ Encourage families in your community to take the smoke-free homes pledge:

Incorporate SF/TF Policies into other Wellness Initiatives • Don’t think about addressing secondhand and

thirdhand smoke in a vacuum – incorporate these talking points into other wellness and policy initiatives!

• Things to consider: ▫ How does secondhand smoke/thirdhand smoke

exposure effect current target stakeholders and organizations?

▫ Will including SHS/THS/policy information enhance other projects and provide new opportunities?

Incorporate SF/TF Policies into other Wellness Initiatives • Examples of comprehensive approaches: ▫ Healthy Homes If you are connecting with landlords/tenants about

another healthy homes topic (lead, mold, asthma, etc) – include smoke-free housing in presentations or outreach materials.

▫ Target Audience Utilize existing relationships with those already

invested in wellness and get them to consider including tobacco in their policy language or wellness campaigns.

Additional Resources • Fact Sheets: General and Environment Specific

Additional Resources & Support • Template policy language • Comprehensive websites and materials • BEC can provide data and information on

existing policies. • Technical assistance around policy development,

implementation and enforcement for organizations, Healthy Maine Partnerships and other public health professionals.

Questions/Connect with BEC • www.SmokeFreeforME.org • www.MaineTobaccoFreeCollegeNetwork.org • www.MaineTobaccoFreeHospitalNetwork.org

• E-Mail: sam@portlandmaine.gov • Phone: 874-8774

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