© Windsor-Essex County Health Unit, February, 2016
CHRONIC DISEASE AND INJURY PREVENTION DEPARTMENT - E-CIGARETTE ACT & TOBACCO
PROGRAMMING 2015
KRISTY MCBETH, Director, Knowledge Management ERIC NADALIN, Health Promotion Specialist, Chronic Disease and Injury
Prevention
© Windsor-Essex County Health Unit, February, 2016
TOBACCO PROGRAM – STAFFING OVERVIEW
• 1 Health Promotion Specialist
• 1 Public Health Nurse (Cessation focus)
• 1 Youth Engagement Specialist
• 6 Tobacco Enforcement Officers
• Designated under both SFOA and the ECA (provincial)
• Designated to enforce following municipal smoke free outdoor space by-laws
• Town of Lakeshore
• Town of Tecumseh
• Town of Essex
• Town of Kingsville
• Town of Leamington
• Town of LaSalle
© Windsor-Essex County Health Unit, February, 2016
ELECTRONIC CIGARETTES ACT, 2016
Effective Jan 1, 2016
• Prohibiting the sale and supply of e-cigarettes to anyone less than 19 years of age;
• Prohibiting the sale and supply of e-cigarettes to any person who appears to be less than 25 years old without asking for identification;
• Prohibiting the use of false identification to purchase an e-cigarette; • Prohibiting the sale of e-cigarettes in retail settings if prescribed signs
are not posted; • Prohibiting the sale of e-cigarettes in vending machines; and • Prohibit an employer from retaliating against an employee because
the employee has acted in accordance with the Act. *The government delayed proclamation of the use provisions under the ECA to a future date.
© Windsor-Essex County Health Unit, February, 2016
TOBACCO PROTECTION 2015 - ENFORCEMENT
Workplaces & Public Places
Restaurants & Bars
Tobacco Vendors – Youth Access
Tobacco Vendors – Display, Promotion & Handling
TOTALS
Total # inspections
696 667 671 434 2468
Total # Charges
52 22 47 2 123
Total # Warnings
48 84 0 21 153
© Windsor-Essex County Health Unit, February, 2016
PROTECTION – ENFORCEMENT STATS Sell/Supply to a
person who is less
than 19 years of
age/OR appears to be
under 25 years
Section 3(1)
Smoke/Hold
Lighted Tobacco
in Workplace or
Prohibited Space
9(1), 9(2)
Failure of Employer
to comply
9(3)(a,b,c,d,e,f)
Failure of Proprietor
to Comply
9(6)(a,b,c,d,e,f)
Display/Promo
te Tobacco
Products
3.1(a)(b), 3.1
(2)(3)
Failure to Post No
Smoking Signs 10
Sell/Offer/Display
improper packaged
tobacco 5(1)(a)(b), 5(2)
Obstruction Totals
2006 34 8 6 14 33 4 5 0 104
2007 41 22 9 6 14 0 9 0 101
2008 32 18 1 4 3 1 2 0 61
2009 28 14 4 0 3 0 0 0 49
2010 55 11 9 1 1 1 2 2 82
2011 69 6 2 1 1 0 0 1 80
2012 33 2 4 1 4 0 0 0 44
2013 26 1 7 0 0 0 0 0 34
2014 23 11 3 2 0 0 0 0 39
2015 47 54 16 1 2 3 0 0 123
TOTALS 388 147 61 30 61 9 18 3 717
• 34% increase in sales/supply to minor
• 66% increase in smoking in prohibited spaces
• 68% increase in failure of employer to comply
Overall increase of 52% in total charges from 2014 to 2015
© Windsor-Essex County Health Unit, February, 2016
93.75 95.29
97.63
96.65
90.31
86
88
90
92
94
96
98
100
2011 2012 2013 2014 2015
Youth Access Compliance Rate 2011-2015
Actual Compliance Rate Target Compliance Rate or higher
© Windsor-Essex County Health Unit, February, 2016
2015 DECREASED COMPLIANCE –EXPLANATIONS
• Increased number of smoke free spaces under the SFOA amendments (playgrounds, sports fields, patios)
• Although education was the priority, non-compliance resulted in charges where appropriate
• Increased number of seasonal inspections from May-October
• Increased surveillance during evenings and weekends
• 100% complaint follow-up policy – 240 complaints/follow-up inspections at workplaces/public
places (indoors & outdoors)
© Windsor-Essex County Health Unit, February, 2016
2015 DECREASED COMPLIANCE –EXPLANATIONS
• Increased sales to minor rate difficult to account for but creates need for proactive strategies to increase compliance in 2016
• The provincially calculated compliance rate uses the rate of compliance at the time of the last inspection
• All owners/operators are notified of a sale to minor through the sale notification letter (whether or not they are present at the time of the illegal sale)
• Tobacco vendors are visited by for enforcement activities a minimum of 3 times per year
• Promotion of Not to Kids Binder and regional website SFOAtraining.com
• Annually provide “year” stickers that show the year of when someone would need to have been born in order to be 19
• Continue to run our education based “Under 25” campaign in the Spring and offer on-site education sessions for staff
© Windsor-Essex County Health Unit, February, 2016
2016 ENFORCEMENT PLAN
Other Enforcement Priorities
• Ongoing prohibited spaces enforcement
Workplaces & public places indoors
Patios, fairs and festivals
Outdoor recreation spaces (by-law and SFOA)
• New areas of enforcement for 2016:
Smoke free hospital grounds
Flavoured tobacco ban (excluding menthol until Jan 1, 2017)
© Windsor-Essex County Health Unit, February, 2016
There’s more to it than just enforcement and regulation…
• Enforcement and protection activities and policies are effective strategies to move people along the stages of change
• Need to also provide support once people are ready to quit
© Windsor-Essex County Health Unit, February, 2016
CESSATION OUTCOMES
• Protection and enforcement goals tie closely to health outcomes • Impact quit attempts.
© Windsor-Essex County Health Unit, February, 2016
WECHU SMOKING CESSATION PROGRAM
• Commenced in February 2015
• Funding for Nicotine Replacement Therapy (NRT) received through one time Ministry request process
• TEACH trained staff in CDIP and Healthy Families treating clients
• In depth initial assessment to determine eligibility and referral ready status
• To date 67 clients since February 2015
© Windsor-Essex County Health Unit, February, 2016
WECHU SMOKING CESSATION PROGRAM
• Follow-up at 2, 4, 6, 8 , 12 and 16 week intervals. 6 month long term follow-up
• Approximately 53% drop out after first appt.
• Attrition attributed to: • Return to smoking (i.e., not ready/willing to change behaviour)
• Quit and no longer interested in NRT/Counselling
• Death
• Contact lost to follow-up
• To date, 29 clients eligible for 6 month follow-up • 13 clients consented to complete 6 month follow-up
• 5 quit; 2 smoked >50cpd
• Follow-up ongoing for remaining clients (enrolled late in 2015)
© Windsor-Essex County Health Unit, February, 2016
CESSATION 2015 – CONT'D
Campaign/Initiative Enrollment (W/E)
NRT Services
WouldURather 728 168 registrants ordered NRT
• Link to LTPB which offers education materials
Driven2Quit 285 Linked through referral to SHL
• Referral to SHL
Smokers’ Helpline 245* Referred externally to NRT sources
• Individualized quit counselling by trained cessation coach
STOP on the Road 200 5-weeks of NRT provided to all participants
• Educational workshop from WECHU PHN
*Unique referrals through WECHU services
• 658 Quit Attempts from WECHU promoted initiatives in 2015
• SOTR – 200; Clinic – 67; WUR – 106; D2Q - 285
© Windsor-Essex County Health Unit, February, 2016
2016 CESSATION PLAN
• Host monthly community (Smoking Treatment for Ontario Patients) STOP sessions
• Engagement of local health care providers to support integration of minimal contact intervention policies
• Support local health care providers interested in smoking cessation services by hosting a Community of Practice
• Maintain community services locator to ensure up to date inventory of smoking cessation services available in Windsor-Essex
© Windsor-Essex County Health Unit, February, 2016
PROVINCIAL CESSATION CAMPAIGNS
• Promotion of MOHLTC media compaign
• Promotion/implementation of provincial
cessation campaigns
© Windsor-Essex County Health Unit, February, 2016
QUESTIONS