Establishing Smoke Free Environments for Children
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Transcript of Establishing Smoke Free Environments for Children
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Robert McMillen, PhDThe AAP Julius B. Richmond Center of Excellencehttp://www.aap.org/richmondcenter/
Establishing Smoke Free Environments for ChildrenEstablishing Smoke Free Environments for Children
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Learning Objectives
Ability to describe the health effects of secondhand smoke on children
Awareness of smoke free policies and community interventions
Understand the benefits of smoke free laws
Knowledge of smoke free strategies
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2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Secondhand Smoke is a Harmful Toxic Air Contaminant
There is no safe level of exposure to secondhand smoke (SHS) U.S. Surgeon General
There is also indisputable evidence that implementing 100% smoke-free environments is the only effective way to protect the population from the harmful effects of exposure to SHS World Health Organization
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2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Harms of SHS on Children’s Health
Increases risk of SIDS
Low birth weight
Ear infections
Harms lung development in children
Causes bronchitis and pneumonia in young children
More severe asthma
Impacts cardiovascular system
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Source: California EPA. (2005); Surgeon General Report. (2006); UICC. (2008).
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Children’s Exposure to Secondhand Smoke
40% (~15 million) of U.S. children live with one or more smokers
Almost one half of the world’s children breathe air polluted by tobacco smoke
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Image source: Adapted by CTLT from Pirkle, et al. (1996); The Tobacco Atlas. (2006).
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Adolescents Exposed to SHS in their Homes, 2002-2005
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Image source: Adapted by CTLT from European Environment and Health Information System, http://www.enhis.org/object_document/o4744n27382.html
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Policies Recommended by the World Health Organization
1. 100% smoke-free environment, not ventilation
2. Universal protection law
3. Proper implementation and adequate enforcement of the law
4. Public education to reduce secondhand smoke exposure in the home
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Source: World Health Organization. (2007).
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Global Smokefree Laws
Nationwide Ireland Scotland Wales Northern Ireland England New Zealand Uruguay Bermuda
State or local U.S. states and cities Canada provinces and
territories Australia states Argentina provinces
and cities
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Source: Global Smokefree Partnership. (2008).
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Smoke-Free Laws Improve Health
Pueblo, Colorado: 27% drop in heart attacks
Helena, Montana: 40% drop in heart attacks
Italy: fewer heart attacks
Norway: decline in the prevalence of respiratory symptoms
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Sources: Sources: Pueblo Heart Study Fact Sheet (2005); Barone-Adesi, et al. (2007); Fagan, et al. (2006).
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Source: Monitoring the future project, U.S., 1976-1986 senior classes.
Youth Who Start Smoking, Continue Smoking
2004: Ireland is the first country to implement 100% smoke-free legislation that included all enclosed workplaces, including restaurants and bars
Additional countries have now passed 100% smoke-free laws, including the UK, New Zealand, Uruguay, Bermuda, Bhutan, Iran, and Turkey
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RegionSupport for a ban on smoking in public places (%)
Eastern Mediterranean
82.8
Eastern Europe 82.1
Americas 80.4
Southeast Asia 75.3
Western Pacific 72.9
Africa 60.2
Total 76.1
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Smokefree Campaigns
USA: The EPA’s national
smoke-free homes and cars program
American Legacy Foundation’s 2005 “Don’t Pass Gas” media campaign
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Source: UICC and americanlegacy.org. (2008).
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
International Campaigns
Ontario, Canada, 2000: Breathing space: Community partners for smoke-free homes www.toronto.ca/health/smokefree
Norwegian Cancer Society, 1995
Salford, UK, 2007: Smoke-free homes promise campaign
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2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Effects on Youth Smoking
Lower rates of smoking initiation
Lower prevalence of smoking
More quit attempts
Higher rates of successful quit attempts
Lower consumption rates among continuing smokers
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2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Environments for Exposure
Home—no government restrictions
Vehicle—some policies developing
Childcare—many existing regulations
Schools—many existing regulations
Restaurants—many existing regulations
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2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Smoke-Free Homes
The prevalence of smoke-free homes in the U.S. has increased substantially in the past decade
The International Tobacco Control Four Country Survey
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Source: UICC. (2008).
Country
Reported home smoking ban among homes of smokers
Wave 1 Wave 2
Canada 27.3% 31.5%
U.S. 26.4% 27.9%
UK 15.3% 19.0%
Australia 34.1% 43.1%
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Smoking Ban in Vehicles with Children
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Source: UICC. (2008).
Jurisdiction Applicable age Date
Arkansas Under 6 or 60 pounds Enacted April 2006
California Under 17 In effect January 2008
Louisiana Under 17 In effect August 2006
Puerto Rico Under 13 In effect March 2007
Bangor, Maine Under 18 In effect January 2007
Keyport, New Jersey Under 18 Enacted April 2007
Rockland County, New York Under 18 Enacted June 2007
West Long Branch, New Jersey Under 18 Enacted June 2007
Cyprus Under 16 Enacted 2002
Nova Scotia, Canada Under age 19 In effect January 2008
South Australia Under 16 Enacted May 2007
Tasmania, Australia Under age 18 In effect January 1, 2008
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Childcare and Schools
Pro Children Act of 1994
European Public Health Alliance Austria, Denmark, the
Czech Republic, Estonia, Finland, Hungary, Iceland, Latvia, Portugal, and Slovenia
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Source: UICC. (2008).
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Community Strategies
1. Educate
2. Build coalitions
3. Identify a local champion
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2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Community Strategies
1. Educate
2. Build coalitions
3. Identify a local champion
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2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Mass Media Campaigns
Media Local newspaper Radio Television reporters
Free media Op-ed pieces and letters to
the editor
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Image source: (Top) Jane M. Sawyer, www.morguefile.com, (Bottom) npclark2k, www.morguefile.com
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Examples
Texas Letter writing campaign Earned media
Washington Mass media Radio, television, newspaper
Evaluate your budget
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Image source: Tobacco Control Branch, Government of Western Australia, Department of Health. (2008).
2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Grassroots-Community Coalitions, Community Leaders
Broad and inclusive
Meaningful representation
Hospitality workers and other employees
Community advocates
Medical professionals
Teachers
Youth groups
Supportive business owners
Health educators and others
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2009 Johns Hopkins Bloomberg School of Public Health;American Academy of Pediatrics Julius B. Richmond Center of Excellence
Summary
The health effects of secondhand smoke on children have been well-documented
Many nations and states have enacted smoke free policies
These smoke free policies have had immediate and long-term health benefits
There are several strategies to achieve successful smoke free policies
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