COMPENDIUM
TOBACCO CONTROL
POLICY EXAMPLES
Compiled by the
ASTHO Tobacco Control
Resource Council (TCRC)
October 2002
During the past year, the
Tobacco Control Resource Council (TCRC) has concentrated its collective energy
on developing a set of tools to assist states in preparing to implement annual
action plans with a stronger policy focus. To that end, we have created the
following Compendium of Tobacco Control Policy Examples as a resource for Network
members. We anticipate that this compendium will grow larger over time as new
examples are added. It will contain
both state and local policy initiatives that produce results toward one or more
of the CDC program goals:
1)
Prevent
the initiation of tobacco use among young people
2)
Promote
quitting among young people and adults
3)
Eliminate
nonsmokers’ exposure to secondhand smoke
4)
Identify
and eliminate the disparities related to tobacco use and its effects among
different population groups
The
TCRC hopes this serves as a useful resource to your program, and provides
concrete ideas for state and local activities.
The policy efforts described herein are examples of the potential wealth
of knowledge and expertise members of the Network have to offer. We invite program managers and others
implementing successful policy initiatives to submit entries so the good news
may be shared quickly and effectively with everyone. Our wish is to see this
resource continue to grow, and in so doing to improve the collective strength
of all tobacco control programs. It is
posted on the ASTHO website at http://www.astho.org/?template=state_tobacco.html
and on the CDC Forum. If your state
would like to contribute a policy example, please contact Kristen Tertzakian at
ktertzakian@astho.org
or 202-371-9090.
PREVENT
INITIATION
State Policy Initiative: Project SMART (Sponsorship
Mission: Avoid Reliance on Tobacco) Money, California
Supports CDC Program Goal:
Prevent
the initiation of tobacco use among young people; Promote quitting among young
people and adults
Impacts
these Healthy People 2010 Objectives: 27-1: Reduce tobacco use by adults. 27-3:
Reduce the initiation of tobacco use among children and adolescents. 27-16:
Eliminate tobacco advertising and promotions that influence adolescents
and young adults. 27-17: Adolescent disapproval of smoking
Evidence Base for the initiative:
According to the US Surgeon General’s report, tobacco advertising
and promotion activities stimulate adult consumption and increase the risk of
youth initiation. In a review of numerous studies, the National Cancer
Institute’s Monograph #14 found a causal relationship between tobacco
marketing and smoking initiation. The
Federal Trade Commission reports that the tobacco industry spends nearly $9.6
billion a year, which is $26.2 million a day, to market its products.
Description of Initiative or
Project:
Project SMART (Sponsorship Mission: Avoid Reliance on Tobacco) Money (PS$) is
an example of a successful partnership between the State Health Department, the
Attorney General's Office, University researchers, and community level programs
with the goal of empowering California’s diverse events and organizations to
reject tobacco industry support. The
project is centered around two purposes: 1) enforcing prohibitions established
by the Master Settlement Agreement (MSA) with regard to tobacco industry
sponsorship; and 2) the adoption of voluntary policies by the boards of local
events, venues, and organizations prohibiting the acceptance of tobacco
industry sponsorship. Results have
included the adoption of over 204 organizational policies throughout the state
and several legal judgments against and settlements with tobacco
companies.
Background
PS$
was developed in 1998 as a statewide campaign committed to eliminating tobacco
company sponsorship of California's diverse events and organizations. PS$ began as a grassroots effort in the
early 1990’s with local health departments and community-based
organizations. In 1998, a statewide
campaign was developed with the assistance of these local experts, who continue
to strategically guide the efforts of the campaign by participating in a
workgroup.
Goals
The
current focus of PS$ is divided into two segments: (1) the development and adoption of organizational policies by
local organizations and events prohibiting the acceptance of tobacco industry
dollars; and (2) enforcement of the 1998 Master Settlement Agreement (MSA)
between the State Attorneys General and the tobacco industry.
Core
components
Policy
development and implementation is conducted at the local level by advocates
from within the community, with the PS$ workgroup providing technical
assistance when needed. Specific
strategies are outlined to target rodeos, racing events, bar nights, fairs,
community events and festivals, and corporate giving. Specialized tools have been developed by the PS$ workgroup to
assist with this effort, including: a
Corporate Giving Toolkit, a Rodeo Toolkit (for tobacco control advocates) and
Tack and Tools kit (a companion piece targeting rodeo event organizers), a
Racing Toolkit (in process), a Protect Your Profitability brochure (targeting
event organizers), model policies, and an index of organizations with current
policies on file. As of June 2002,
community organizations and events in California have adopted over 204 specific
anti-tobacco sponsorship and smoke-free venue policies for fairs, racing
events, rodeos, community festivals, faith based organizations, museums,
baseball teams, and Chambers of Commerce.
In
addition, PS$ has developed a partnership with the State Attorney General's
Office and University researchers to monitor whether tobacco companies are
complying with the sponsorship terms of the MSA and additional state laws that
may apply (California has a state law prohibiting sampling on public and
private grounds). A special "kit," entitled "Tobacco Industry
Watch, Post-Settlement," has been developed to assist local programs in
collecting evidence of tobacco sponsorship at community events in order to
assist the Attorney General's Office in this effort. In addition to the kit, additional event observation tools
include: an Event Observation Form, a Tobacco Industry Watch
Training Video (produced by the Attorney General’s office), a Pre/Post Event
Checklist, and a Photo Tip Sheet. Data
collected at the local level is reviewed by the Attorney General’s Office and
violations to the MSA are prosecuted. This
systematic approach to data collection and analysis enables the Project to
"spot check" for MSA violations by the tobacco industry as well as
provide teaching events and encouragement of active participation in the event
observation process by local programs and coalition members.
Cost of project: Unavailable
Evaluation:
As of June
2002, community organizations and events in California have adopted over 204
specific anti-tobacco sponsorship and smoke-free venue policies for fairs,
racing events, rodeos, community festivals, faith based organizations, museums,
baseball teams, and Chambers of Commerce.
Recent
success stories of the partnership of PS$ with the Attorney General’s Office
include:
*A
$375,000 settlement from Swedish Match for PS$ documented violations of CA
state sampling law. July 13, 2001
*A
$14.3 million fine levied against RJ Reynolds for PS$ documented violations of
CA state sampling law. April 29, 2002
*A
$20 million judgment against RJ Reynolds for advertising in magazines with a
significant percentage of youth readership (an MSA provision). June 6, 2002
Contact Information: Tonia Hagaman, MPH, Program Consultant, Tobacco Control Section, 916-445-2654 or thagaman@dhs.ca.gov.
PROMOTE
CESSATION
State
Policy Initiative: HealthCare Partnership,
Arizona
Supports
CDC Program Goal: Promote quitting among young
people and adults
Impacts
these Healthy People 2010 Objectives: 27-1: Reduce tobacco use by adults. 27-2:
Reduce tobacco use by adolescents.
27-5: Increase smoking
cessation attempts by adult smokers.
27-6: Increase smoking
cessation during pregnancy.
Evidence
Base for the initiative: The U. S. Public Health Service’s Treating Tobacco Use and
Dependence Clinical Practice Guideline finds that brief counseling is
effective to help smokers quit and recommends 5 pharmacotherapies that reliably
increase abstinence rates. The
Guideline recommends coordinated interventions within the health care system
and that it become institutionalized.
The Community Guide to Preventive Services strongly recommends providing
counseling and support to patients by telephone, when included as one component
of a multicomponent strategy to help smokers quit, to increasing cessation
rates.
Description
of Initiative or Project: The HealthCare Partnership, funded by the Arizona Department of Health
Services, Tobacco Education and Prevention Program (AzTEPP), has as its mission
to integrate comprehensive, innovative, evidence-based tobacco control programs
into Arizona healthcare systems and to foster and encourage cessation efforts among
individuals, their families and within communities.
The
HealthCare Partnership Working Group is comprised of members from Managed Care
Organizations, the Arizona Health Care Cost Containment Systems (the state’s
Medicaid program), Indian Health Service, the Veterans Affairs Health Care
System, professional and non-profit organizations, foundations, and AzTEPP
funded projects. This group was formed in 1998
when representatives from AzTEPP and the healthcare organizations met to
discuss tobacco control healthcare initiatives and formulate a mission
statement and objectives.
The
activities of the Working Group include:
1. arranging educational programs for
healthcare professionals in tobacco dependence treatment through a statewide
Speakers’ Bureau,
2. encouraging healthcare systems to provide
tobacco dependence treatments and to adopt a standard approach to tobacco
cessation, which includes ongoing screening, provider interventions and
medication benefits,
addressing
disease management activities and initiatives related to tobacco use treatment
within healthcare systems,
3. encouraging
representatives from community-based local projects, the Arizona Smokers’
Helpline and managed care organizations to form partnerships around tobacco
prevention and cessation, and
surveying
healthcare systems with regard to tobacco control policies, guidelines, and
services.
Through
these activities, relationships with Managed Care Organizations have been
strengthened and a number of successful outcomes have been achieved. A few of the group’s accomplishments are
highlighted below.
Healthcare
professional education: In the past two years, over
1200 individuals have participated in the “Tobacco Cessation Training for
Healthcare Professionals” program. This
program is approved for one and half hours of continuing education credit for a
variety of healthcare professionals including physicians, mid-level providers,
nurses, pharmacists, dentists, hygienists, dietitians, behavioral health
professionals, and respiratory therapists.
The curriculum teaches brief interventions, medication usage, resources
for intensive services, and system strategies for tobacco dependence
treatment. These programs have been
offered in a variety of setting including hospitals, private offices, and
managed care clinics. There has been
increasing interest in these educational opportunities by healthcare systems
and a number of Speakers’ Bureau members are practitioners within Managed Care
and other healthcare organizations. One
Managed Care Organization, for example, will be hosting a speakers’ training in
October 2002 to enable more staff physicians, nurses, pharmacists, and health
educators to provide these ongoing educational programs for their employees. This type of participation and ownership by
a Managed Care Organization reflects systems change, in that leadership has
approved this activity and reserved staff time to perpetuate healthcare
professional education within the healthcare system.
The
AzTEPP Education and Training Unit offers certification in both brief and
intensive tobacco interventions. Over
thirty five hundred people have participated in the Brief Tobacco Intervention
Skills training and another 250 individuals are certified to deliver intensive
services. An example of self-
sustaining healthcare professional educational activity within a healthcare
system is taking place at a large community hospital in Northern Arizona. At this hospital all staff are encouraged to
participate in the Basic Tobacco Intervention Skills certification training,
and Basic Skills certification is linked to career ladder advancement for
nurses. This educational effort is
self-sustaining in that Basic Skills instructors are hospital staff members and
employees participate in training on site.
Tobacco
dependence treatment within healthcare systems: Within one Managed Care Organization, 25 nurses have taken
advantage of the AzTEPP training for Tobacco Treatment Specialists and are
certified to deliver intensive services to health plan members. The cessation program operates as part of
the health promotion department.
Tracking of program utilization, monitoring of cessation rates, and
ongoing quality improvement efforts are underway. All of these activities are self-sustaining and funded by the
Managed Care Organization, and the intensive services are delivered on site to
plan members.
Linking
healthcare systems with community-based local projects and the Arizona Smokers’
Helpline/forming partnerships: One
Managed Care Organization offers reimbursement for twelve weeks of medication
for tobacco cessation when used in combination with behavioral counseling. Although this organization has offered
on-site intensive services, the health promotion department director found that
the on-site programs were not well attended.
A partnership was formed with the Arizona Smokers’ Helpline to provide
plan members with telephone counseling or referral to face-to-face programs
provided by community-based local projects.
Documentation of these behavioral services is then communicated back to
the health plan, so that members receive reimbursement for medications.
The
Arizona Smokers’ Helpline provides Managed Care Organizations with utilization
information by health plan membership.
A number of health plans find this information useful, and also provide
the Arizona Smokers’ Helpline with specific pamphlets to distribute to their
clients when they call.
Cost
of project: Unavailable at this time
Evaluation: See Description above for outcomes.
Contact Information: Mary Gilles, MD, Director, HealthCare Partnership, Continuing Education and Training Unit, Arizona Department of Health Services, Tobacco Education and Prevention Program, at gillesm@u.arizona.edu or 520-318-7253.
ELIMINATE
EXPOSURE TO
SECONDHAND SMOKE
|
State
Policy Initiative: Tobacco Free Schools Policy
Campaign, North Carolina |
|
Supports
CDC Program Goal: Eliminate Exposure to
Secondhand Smoke; Prevent Initiation and Promote Quitting of Tobacco Use
Among Youth |
|
Impacts
these Healthy People 2010 objectives:
27.3: Reduce the initiation of
tobacco use among children and adolescents.
27.10: Reduce proportion of
nonsmokers exposed to environmental tobacco smoke. 27.11: Increase smoke
free and tobacco free environments in schools, including all school
facilities, property, vehicles and school events. |
|
Evidence
base for the initiative: The CDC’s Best Practices for Comprehensive Tobacco Control Programs
and CDC's Guidelines for School Health Programs to Prevent Tobacco Use and
Addiction serve as guides for the Tobacco Free Schools Campaign. This multiple strategy approach –
involving policy, programmatic efforts and public education at the state and
community level has shown to be effective in reducing and preventing tobacco
use among children and adolescents. |
|
Description of initiative or project: In order to prevent youth tobacco use initiation, change
social norms, and reduce nonsmokers exposure to environmental tobacco smoke,
the NC Tobacco Prevention and Control Branch strategically focuses on policy
level change at the state and local level, while supporting community efforts
at the local level. A key initiative is the Tobacco Free Schools Campaign. The long-term objective of this campaign
is to increase from 12% to 100% the proportion of school districts in NC that
are 100% tobacco free for students, staff and visitors on campus and during
school-related events at all times. In
August 1999 the NC Department of Health and Human Services began working in
collaboration with multiple partners to plan a statewide Governor’s Summit on
Preventing Teen Tobacco Use. The
Summit, held in January of 2000, was an incredible success with over 800
participants, including over 400 youth representing 87 counties. It drew top state-level officials along
with multiple local level community/school decision-makers. During the Summit, youth developed and
promoted a statewide petition drive advocating for 100% tobacco free schools
for students, staff and visitors at all times. At that time, only 5 of the
117 or 2% of school districts in NC were 100% tobacco free. Since then, this number has increased to
16 (14%), with at least 37 or 32% of school districts currently working together
with their school/community leaders to advance a 100% tobacco free school
policy for students, staff and visitors at all times. This
achievement has been accomplished through a multi-component strategy and
ongoing interventions that include the following: ·
Policy advocacy – Youth-led and
adult-supported policy advocacy efforts helped convince then-Governor Jim
Hunt to write a letter to every school district that encourages each district
to become 100% tobacco free. A year
later, a similar letter followed this to all school districts from Governor
Mike Easley and State School Superintendent Mike Ward. Policy advocacy efforts also resulted in a
State Board of Education Resolution encouraging all local school boards to
adopt a 100% tobacco free school policy. ·
Youth involvement and empowerment – Three regional Youth Summits to
reach the teens and adult leaders in the western, central and eastern regions
of the state are being implemented. It is anticipated that they will attract
up to 600-900 diverse youth leaders – 200-300 in each of the three regions of
the state. The Youth Summits will empower youth in carrying out tobacco use
prevention and control initiatives known to be effective in their schools;
build the capacity of schools and community agencies to work effectively with
youth; help youth enhance existing tobacco use prevention efforts in schools;
and create youth-driven and adult-supported workplans with the goal of
creating a positive impact on the schools and communities in each region. In
addition, efforts to involve diverse youth in advocating for 100% tobacco
free schools are underway in events such as the Ujima Youth Retreat for
African American youth, the American Indian Youth Summit and the El Foro
Youth Leadership workshops for Hispanic/Latino youth. ·
Media advocacy and social
marketing – Our radio and newspaper ad campaign reached youth and adults in
the major media markets across the state with a strong message encouraging
local action to advance a 100% tobacco free school policy. The tobacco free schools media campaign targeting youth resulted in
28 youth groups developing 60-second tobacco free school radio messages. One
of the radio messages was aired across the state on youth-oriented stations. ·
Collaboration – Statewide
collaboration is achieved through the Tobacco Free Schools Task Force – which
includes multiple partner agencies and individuals such as the Department of
Public Instruction, local school principals, state and local Safe and Drug
Free School Coordinators, regional School Nurses, local health departments,
Substance Abuse Services, American Lung Association, American Heart
Association and American Cancer Society. ·
Training and technical assistance
– Six regional Tobacco Free Schools training workshops have been conducted
across the state over the past two years – reaching 48 school and community
teams. Three more are planned for
Fall of 2002. The workshops provide a clear rationale for a 100% TFS policy;
identify models and strategies for becoming a 100% TFS district; identify
programs to support enforcement of the policy; and support the development of
an action plan to advance the policy within the school district. In addition,
this project has supported 6 workshops to train staff to conduct the Teens
Against Tobacco Use (TATU) Program and the Alternatives to Suspension (ATS)
program. Consultation and technical assistance is provided to school
districts and communities across the state as they advance the policy. Finally, our Grassroots Guide to Tobacco
Free Schools located on the web at www.communityhealth.dhhs.state.nc.us
provides a blueprint to school districts working to develop and enforce this
policy. We have also developed a
nationally recognized youth-focused website for youth tobacco use prevention
–www.stepupnc.com – that has a strong focus on tobacco free schools. |
|
Cost
of the initiative: Media campaign: $627,000
for media ad creation, public relations and placement for radio and newspaper
ads; Ongoing training and technical assistance: Approximately $120,000 for
program budget and dedicated staff time. Establishing a state-level full-time
equivalent (FTE) Tobacco Free Schools Director staff position is key to
overall management and collaboration in this policy initiative. The cost of
the initiative does not include estimated time from other Branch staff that
may contribute to the campaign over the year. |
|
Evaluation
results: An overall evaluation of the Tobacco Free
Schools Program has not been conducted.
Evaluation of some of the program components are as follows: ·
Policy advocacy: Positive outcomes include the recent passage of a
State Board of Education Resolution that encourages NC school districts to
adopt a tobacco free school policy; the Health and Wellness Trust Fund
Commission (established through the Tobacco Settlement Funds) will fund $2
million per year over the next 3 years to school and community partnership
grants that will include tobacco free school policy and program efforts; and the
letters from a former Governor and the state's current Governor, Lt. Governor
and the State Superintendent of Schools. ·
Radio campaign: The overall awareness of the media campaign was 24
percent; Half of respondents who had heard the campaign were aware that many
public schools were not tobacco free – as compared to one-third of all
others; an impressive number indicated having had conversations with friends,
colleagues and their children about the spots or the campaign’s website. ·
Policy workshops: Of the 48
teams that attended the first round of policy workshops, nearly all report
significant accomplishments towards advancing the policy at the 6 month
follow-up survey and have activities planned to continue their efforts over
the next three months. Three more
regional policy training workshops will be implemented fall 2002. ·
School District Policy Results: The number of school districts that
are 100% tobacco free has increased from 5 to 16 100% tobacco free school
districts over the past two years with 37 additional school districts
actively working to advance the policy. Contact Information: Suzanne DePalma, Tobacco Free Schools Director,
North Carolina Tobacco Prevention and Control Branch, at 919-733-1340 or suzanne.depalma@ncmail.net.
|
Local
Policy Initiative: Shoals Area Work Site Policy, Alabama
Supports
CDC Program Goal: Eliminate exposure to environmental tobacco smoke and promote
quitting among adults
Impacts
these Healthy People 2010 Objectives: 27-1. Reduce tobacco use by adults. 27-5. Increase smoking cessation attempts by
adult smokers. 27-10. Reduce the proportion of nonsmokers exposed to
environmental tobacco smoke. 27-12.
Increase the proportion of worksites with formal smoking policies that prohibit
smoking or limit it to separately ventilated areas.
Evidence
base for the initiative: The February 2001 American Journal of Preventive Medicine
article “Reviews of Evidence Regarding Interventions to Reduce Tobacco Use and
Exposure to Environmental Tobacco Smoke” concluded in their Guide to Community
Preventive Services: Tobacco Use Prevention and Control that there is strong
scientific evidence that smoking bans and restrictions reduce exposure to ETS
in the workplace and a strongly recommended intervention.
Description
of initiative:
The Partnership for a Tobacco Free Shoals, with the leadership of the Tobacco
Prevention and Control Division’s Area 1 Tobacco Control Coordinator, Ms. Pat Mackey,
the American Cancer Society, Bethesda Cancer Center, and the Eliza Coffee
Memorial Hospital, utilized the CDC’s “Decision Maker’s Guide to Making Your
Workplace Smoke Free” and the American Cancer Society’s materials to assist the
owner of the E.S. Robbins Corporation, a producer of consumer plastic products,
to establish a smoke free workplace.
The 150 employees of the plant were required to attend a one hour
presentation by Pat Mackey and the Bethesda Cancer Center, which included
viewing the “Smoking: Truth or Dare” video and information on the effects of
tobacco use and costs of tobacco use to the employer and the employee. Helen
Keller Hospital is providing Freedom From Smoking cessation classes on
the worksite. If employees completes
the eight week series of classes, the $50 fee will be reimbursed by the
company. No smoking is allowed at the
worksite.
Cost
of project:
Staff time for the employees to attend the meeting totaled $1,000.
Evaluation: Two employees have stopped
smoking. An additional three employees
have enrolled in the classes. After
hearing of the E.S. Robbins program, another company in the area has changed
their policy and now only allows employees to smoke outside. The Partnership for a Tobacco Free Shoals
plans to contact this company about conducting a presentation with their
employees and staff and encouraging the worksite to go smoke-free and offer
cessation classes to their employees.
Contact
Information: Pat Mackey, RN,
Tobacco Prevention Coordinator, Colbert County Health Department,
256-383-1231 or patmackey@adph.state.al.us.
Local Policy Initiative: Upper
Peninsula’s Regional Media Campaign, Michigan
Supports CDC Program Goal:
Eliminate Exposure to Secondhand Smoke
Impacts these Healthy People 2010 Objectives: 27-1: Reduce tobacco use by adolescents. 27-2:
Reduce the initiation of tobacco use among children and
adolescents. 27-10: Reduce the proportion of nonsmokers exposed
to environmental tobacco smoke.
27-17: Increase adolescents’
disapproval of smoking.
Evidence Base for the initiative: The Centers for Disease Control and
Prevention/Office on Smoking and Health, has determined that to effect behavior
change, a public media campaign must spend $1/per capita per campaign. This
means that a message must reach 90 percent of the population a minimum of 21
times during the campaign in order to effect behavior change.
Description of Initiative or Project: In January
through May 2002, a secondhand smoke media campaign was designed and
implemented by six coalitions in Michigan’s 13 counties in the upper peninsula
(UP). Each coalition was responsible in the months preceding the campaign for
fund-raising from their local Community Foundations and other local funding
entities, to raise at least $3,000 for a local secondhand smoke educational
media campaign. Marquette County led
the UP initiative, and was able to raise enough funding (Blue Cross/Blue Shield
of Michigan and Tobacco Free Michigan) for their own local initiative, in
addition to providing matching funds for other UP localities. The purpose of
the secondhand smoke media campaign was to educate the public on the harmful
effects of secondhand smoke and to expose the advertising tactics and practices
of the tobacco industry. A secondary goal was to involve youth and adults in
projects and activities that enhanced and supported the media messages. During the 4-5 month campaign, the UP media
campaign generated over 5,000 cable TV ads, 5,000 radio ads, 40 billboards, and
40 print ads. On-the-ground support
activities included three local “Rip It out!” campaigns, and smoke-free
restaurant and business initiatives. Fashioned after the Marquette model,
several local coalitions formed “Youth for Truth” groups, who participated in
choosing ads, talking with local media, planning community activities and
events, and participating in the final evaluation segment. To evaluate
effectiveness of the media campaign, "Youth for Truth" groups in Marquette
and Chippewa counties conducted surveys of community elected officials (County
and City Commissioners, Boards of Health, etc.). In Marquette County, "Youth for Truth" representatives
visited each of the five public meetings, and reported the results of the
survey during the Public Comments session of the agenda, thus earning media
coverage for their issue. All coalitions will participate again in the coming
year to fine tune the media campaign and community interventions, and complete
the evaluation component. This model
can be replicated for a statewide media campaign.
Cost of project: Media for Marquette Co. only, population 65,000,
was $49,000 cash + $51,117 in-kind media match = $100,117 (other counties’
costs did not reach 1:1 per capita spending ratio)
Evaluation:
Survey results (for
Marquette Co. only):
96% of
respondents were aware of the Secondhand Smoke Media Campaign;
40% indicated
their knowledge of the health risks of secondhand smoke increased;
88% believe secondhand smoke is harmful.
Contact Information: Jim Harrington, Marquette County Health Department, at jharrington@hline.org.
Local Policy Initiative: Advisory
Questions on Clean Indoor Air, Nevada
Supports CDC Program Goal:
Eliminate Exposure to Secondhand Smoke
Impacts these Healthy People 2010 Objectives: 27-19: Eliminate laws that preempt stronger tobacco
control laws
Evidence Base for the initiative:
The Guide to Community Preventive Services found strong scientific evidence
that smoking bans and restrictions reduce exposure to secondhand smoke.
Description of Initiative or Project: Washoe County,
Nevada, was able to place two advisory questions in regarding tobacco use
and control on the November 2002 ballot. They are as follows:
Washoe County Ballot Question #8:
Shall the Washoe County District Board of Health have the
authority to adopt regulations that are more stringent than state law in order
to protect people from secondhand smoke?
(This would not include businesses that exclude persons under the
age of 21)
Washoe County Ballot Question #9:
Shall state law completely prohibit secondhand smoke in places
frequented by children?
(i.e., schools, grocery stores, restaurants, and government
buildings?)
This was a big accomplishment for Nevada, where preemption
exists. Although the questions faced no
opposition at the Board of Health meetings, the opposition used stall tactics
at the County Commissioners meeting. In doing research on another ballot
question, the lawyer for the County gave the local health department a legal
opinion that the Board of Health could send the questions directly to the
Registrar of Voters. The tobacco questions were pulled from the agenda,
an emergency meeting of the Board of Health was held, and the questions were
unanimously forwarded to the Registrar of Voters.
The questions were legally challenged by gambling and retail
associations in Clark County, Nevada and the Nevada Supreme Court ruled that
the questions would stay on the ballot, as they "did not warrant an
intervention at this point". This
is a small step in a long process. The
local health department is educating the public and legislature, once again,
regarding the importance of tobacco control.
Cost of project: Unavailable at
this time
Evaluation: Unavailable at this time
IDENTIFY AND ELIMINATE DISPARITIES