Resources to Support Smoke-Free Policies

Presented by the Tobacco Prevention and Control Branch

The Tobacco Quiz

•  Hookahs have less nicotine than cigarettes. True or False

•  What is the most addictive drug: nicotine, heroin or barbiturates?

•  What percent of air flow in multiple-unit housing come from other units?

•  PHA residents have less interest in quitting than residents in private housing. True of False

•  E-cigarettes are safer than regular cigarettes. True or False

•  Which of the following health conditions are caused by smoking: cancer, diabetes, cataracts?

8/27/17 2

Presentation Objectives

•  Provide up-to-date information about dangers of tobacco.

•  Provide resources to help implement a smoke-free policy.

•  Provide resources on evidence-based quit smoking programs.

•  Provide resources to help engage residents in developing a smoke-free policy.

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Smoke-Free HUD Rule

•  Aligns with HUD mission of providing safe, decent and sanitary housing.

•  Bans lit tobacco products and hookahs in units & within 25 feet of any building.

•  Local PHAs with input from resident advisory boards, have flexibility to:

•  Enact more restrictive smoking policies •  Establish designated smoking areas •  Write enforcement & complaint procedures •  Educate residents about affordable tobacco treatment services

8/27/17 Portal.hud.gov/hudportal/documents/huddoc?id= smokefree final rule.pdf 4

Stages of Policy Implementation

5

Stage 1: Educate staff/residents

Stage 2: Select type of policy

Stage 3: Develop a timeline

Stage 4: Sustain the policy

Role of DSHS Statewide Contractor

•  University of Texas El Paso (UTEP) survey of 1,168 PHA residents paved the way for city-wide policy.

•  73 percent of residents worried about secondhand smoke intrusion.

•  88 percent of residents wanted a smoke-free policy.

•  UTEP will assist PHAs by: •  Sharing “lessons learned” through webinars. •  Offering technical assistance to implement smoking policies. •  Developing a shared policy data base.

8/27/17 Mata H, Flores M, Castaneda E, Medina-Jemez Smith C, Olvera H. Health, hope and human

development: building capacity in the U.S.-Mexico Border. Journal of Health Care for the Poor and Underserved 24 (4): Nov. 2013: 1432-1439 6

Tools to Simplify Policy Development Process

Resource provided by a smoke-free Paso Del Norte. Paso Del Norte Health Foundation

Role of 8 DSHS Regional Coordinators

• Help support PHAs by: •  Assessing smoke-free policy technical assistance

needs. •  Connecting local PHA staff with training

opportunities. •  Providing additional training on tobacco

cessation services and making referrals to the Quitline.

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HUD & DSHS Regional Map

8/27/17 Source: Office of Surveillance, Evaluation and Research. Texas DSHS 9

Tobacco and Secondhand Smoke

A presentation for Public Housing Authority Residents

Smoke-Free HUD Rule

•  Bans lit tobacco products (for example, cigarettes, cigars, pipes, and hookahs) inside units & within 25 feet of any building

•  Includes balconies, parking lots (if they are within 25 feet of a building), hallways, and other indoor common areas

•  Aligns with HUD’s mission of providing safe, decent, and sanitary housing.

8/27/17 Portal.hud.gov/hudportal/documents/huddoc?id= smokefree final rule.pdf 11

3,841

4,048

4,370

5,503

8,892

9,941

10,216

10,470

39,018

43,133

0 10,000 20,000 30,000 40,000 50,000

Chronic Liver Disease & Cirrhosis

Kidney diseases

Infection in blood

Diabetes

Alzheimer's Disease

Accidents

Respiratory diseases such as bronchitis, asthma, and emphysema

Stroke

Cancer

Diseases of the Heart

Number of Deaths

Texas Leading Causes of Death, 2015

https://www.dshs.texas.gov/chs/vstat/vs14/t16.aspx

Burden of Tobacco Use

•  1 American dies every 67 seconds due to a cigarette-related disease.1

•  1 Texan dies every 19 minutes due to a

cigarette-related disease.2

•  In the US, for every 5 people that die, one died from a cigarette-related disease.³

(1) https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/ (2) https://nccd.cdc.gov/STATESystem/rdPage.aspx?rdReport=OSH_STATE.Highlights (3) Centers for Disease Control and Prevention. Smoking & Tobacco Use: Health Effects of Cigarette Smoking. Available: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm#estimates

Tobacco Use in Texas

•  15.2% of adults currently smoke.2

•  5.2% of middle school

students currently smoke.1

•  10.6% of high school students currently smoke.1

(1)  2016 Youth Tobacco Survey (2)  2015 Behavioral Risk Factor Surveillance System

Rate of Current Cigarette Use by Household Income in Texas, 2015

15

Data Source: 2011-2015 Texas Behavioral Risk Factor Survey Current cigarette smoking among adults is defined as "yes" responses to the survey question, "Have you smoked at least 100 cigarettes in your entire life?" and responses of "everyday" or "some days" to the survey question, "Do you now smoke cigarettes every day, some days, or not at all?".

78.4%

21.6%

Smoking Rates for adults by annual household income less

than $35,000, TX 2015

Non-smoker Smoker

90.9%

9.1%

Smoking Rate for adults by household income over $75,000,

TX 2015

Non Smoker Smoker

Smoking rates, HUD Residents US 2006-2012

66.5%

33.5%

Smoking Rates for adults living in HUD housing, US 2006-2012

Non-smoker Smoker

78.0%

22.0%

Smoking Rate for adults not living in HUD housing, US 2006-2012

Non Smoker Smoker

Source: A health picture of HUD-Assisted Adults 2006-2012

Smoking and Health

17

.

Tobacco Use and Pregnancy

1.  Texas Pregnancy Risk Assessment Monitoring System (PRAMS) 2014, Retrieved on June 28, 2017 from http://www.dshs.texas.gov/mch/PRAMS.aspx?terms=PRAMS 2.  Center for Disease Control and Prevention (CDC) PRAMS 2013. Retrieved on June 28,2017 from https://www.cdc.gov/prams/pramstat/pdfs/mch-indicators/PRAMS-All-

Sites_508tagged.pdf 3.  U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department

of Health and Human Services, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. 4.  Sharma et al. Lifestyle factors and reproductive health: taking control of your fertility Reproductive Biology and Endocrinology 2013, 11:66. Retrieved on June 29, 2017 from

http://www.rbej.com/content/11/1/66

Pregnant women who smoke are more likely to: •  miscarry •  give birth early •  give birth to a low birth weight baby (a baby that

weighs less than 5 pounds 7 oz. when born).³ Babies born to a mother who smokes during or after pregnancy are 4 to 5 times more likely to die of Sudden Infant Death Syndrome (or SIDS) than babies born to a mother who doesn’t smoke. Almost half (40%) of women who quit smoking while pregnant, start back within 6 months of giving birth.²

Smoking and Pregnancy

Multiunit Housing Secondhand Smoke

Multiunit Housing Secondhand Smoke

Secondhand Smoke and the Health of Your Family