Smoke/Tobacco-Free College Campuses: Policy Rationale and ... · •Smoke-Free means the use of...
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Smoke/Tobacco-Free College Campuses: Policy Rationale and Trends
ACHA 2016 Conference
San Francisco, CA
June 2, 2016
SMOKE/TOBACCO-FREE COLLEGE POLICIES
Policy Rationale
Kimberlee Homer Vagadori, MPH
June 2, 2016
Policy Definitions
Tobacco-Free Policy Rationale
Policy Recommendations
Preparing for Success(Preparing for Challenges)
Presentation Overview
• Smoke-Free means the use of cigarettes, pipes, cigars, and other “smoke” emanating products are prohibited on all campus grounds.
• Tobacco-Free means the use of cigarettes, pipes, cigars, smokeless tobacco, snus, and other tobacco products are prohibited on campus.
• Electronic cigarettes are not generally covered by 100% smoke or tobacco-free policy unless explicitly stated in the policy.
Definitions
New definitions on “tobacco products” and “smoking” from ChangeLab Solutions
“Tobacco Product” means: • Any product containing, made, or derived from tobacco or nicotine that is intended for
human consumption, whether smoked, heated, chewed, absorbed, dissolved, inhaled, snorted, sniffed, or ingested by any other means, including, but not limited to cigarettes, cigars, little cigars, chewing tobacco, pipe tobacco, snuff; and
• Any electronic device that delivers nicotine or other substances to the person inhaling from the device, including, but not limited to an electronic cigarette, cigar, pipe, or hookah.
• Notwithstanding any provision of subsections (a) and (b) to the contrary, “tobacco product” includes any component, part, or accessory of a tobacco product, whether or not sold separately. “Tobacco product” does not include any product that has been approved by the United States Food and Drug Administration for sale as a tobacco cessation product or for other therapeutic purposes where such product is marketed and sold solely for such an approved purpose.
“Smoking” means inhaling, exhaling, burning, or carrying any lighted, heated, or ignited cigar, cigarette, cigarillo, pipe, hookah, Electronic Smoking Device, or any plant product intended for human inhalation.
Definitions
http://changelabsolutions.org/publications/revised-definitions-e-smoking
• Increase in published scientific literature on the need for and benefit of 100% smoke/tobacco-free policies
• Findings reveal a decrease in tobacco use, exposure to secondhand smoke, and littered tobacco waste
Tobacco-Free Policy Rationale
• Decreased Tobacco Use
– Evidence that workplace and public smoke-free air policies are effective in reducing smoking behavior
– 100% smoke-free campus policies (college) are an effective intervention in reducing tobacco use among college students
• During same time period, one institution with a 100% smoke-free policy saw a decrease in smoking from 16.5% to 12.8% compared to an increase from 9.5% to 10.1% at an institution with a 30-ft policy (Seo et al, 2011)
Tobacco-Free Policy RationaleTobacco-Free Policy Rationale
• Decreased Exposure to Secondhand Smoke– Secondhand smoke is a known carcinogen. The
Surgeon General has concluded there is no risk-free level of exposure to secondhand smoke.
– Stanford study on outdoor tobacco smoke concluded that secondhand smoke exposure levels can be significant near an active smoker (Klepeis et al., 2007)
– AJPH study found as policy strength increased, exposure to secondhand smoke decreased (Fallin et al., 2014)
– Establishing smoke/tobacco-free environments is the only proven way to prevent exposure
Tobacco-Free Policy Rationale
• Decrease in Littered Tobacco Waste
– Beaches saw a decrease in littered tobacco waste after the adoption of smoke-free policies
– As policy strength increases, campuses see a significant decrease in tobacco waste
Tobacco-Free Policy Rationale
• 100% Smoke/tobacco-free policies are also effective in…
– Increasing quit attempts;
– Decreasing frequency of use;
– Preventing initiation;
– Protecting workers not protected by indoor air laws; and
– Changing social norms around tobacco use.
Tobacco-Free Policy Rationale
Adoption• 100% smoke/tobacco-free, including e-cigs and other new products• Work with students, faculty, and staff to take on issues• Encourage development of a diverse task force
Implementation• Give a lot of thought and time to implementation• Involve all members of campus community in the policy process• Anticipate and prepare for challenges
Enforcement• Prioritize policy education• Recommend a multi-component enforcement plans• If possible, write-in language that allows your college to cite with
fines
Policy Recommendations
Potential Challenges…
• Smoking Off Campus
– Challenges with neighbors
– Litter on city/county streets
– Clouds of smoke at entrances/exits
– Increased fire risk in wooded areas
• City-Owned Streets
– University unable to enforce policy on streets owned by the city or county
• Individuals regularly smoke in these areas
• Compliance and Enforcement
– There is no enforcement plan
– No one wants to enforce the policy
– People are purposefully violating the policy
Prepare for Success (by preparing for challenges)
Potential Challenges Continued…• Funding and Time
– Lack of funds to pay for implementation of new policy– Limited staff time to implement policy
• Demand for Cessation– Increased demand for services with limited staff– Fewer services for staff and faculty
• Support for policy– Advocates have graduated – Other issues appear to be more important – Individuals have lost their energy around the issue
• International students and faculty– Higher rates of tobacco use– Unclear of policy– Limited access to cessation services
Prepare for Success (by preparing for challenges)
Coming Soon….
Tobacco-Free College Campus Initiative (TFCCI)
June 2, 2016
Emily Claymore, MPHU.S. Department of Health & Human Services,
Region IX
Smoke vs. Tobacco-Free
WHAT ARE ENDS?
0
200
400
600
800
1000
1200
1400
1600
Spring 2008 Spring 2009 Spring 2010 Spring 2011 Spring 2012 Spring 2013 Spring 2014 Spring 2015 Spring 2016
Policy includes ENDS 100% Tobacco-Free 100% Smoke-Free
9/2009: ACHA Tobacco Position
Statement
11/2011: Updated ACHA Tobacco
Position Statement
9/2012: Tobacco Free College Campus Initiative (TFCCI)
Source: Americans for Non-Smokers’ Rights Foundation (ANRF)(ANRF’s historical lists may not show trends accurately)
National Trend
National Snapshot
1,483 Smoke and Tobacco Free Policies
(April 4, 2014)
1,483 Smoke and Tobacco Free Policies
(April 4, 2014)
Source: ANRF
24% Smoke-Free
76% Tobacco-Free
45% Do Not Prohibit ENDS
55% Prohibit
ENDS
Source: ANRF; Truth Initiative
National Snapshot
1,483 Smoke and Tobacco Free
Policies (April 4, 2014)
21% Associate Degree
Institutions(2-YR)
79% Bachelor’s Degree
Institutions(4-YR)
Region IX
Arizona, California, Hawaii, Nevada
Region IX Snapshot
Source: ANRF; California Youth Advocacy Network (CYAN); Tobacco Free College Campus Initiative (TFCCI)
187 public 4-year and 2-year degree granting schools
Region IX Snapshot
Source: ANRF; CYAN; TFCCI
70 Institutions(37%)
117 Institutions
(63%)
70 Smoke or Tobacco–Free Policies 117 Non-comprehensive Policies
Source: Americans for Non-Smokers’ Rights Foundation; California Youth Advocacy Network; Tobacco Free College Campus Initiative
70 Smoke or Tobacco–Free Policies 117 Non-comprehensive Policies
4-YR20 Institutions
(47% of all 4-yrs)
50 Institutions(34% of all 2-yrs)
22 institutions
95 institutions
Region IX Snapshot
2-YR
Source: Americans for Non-Smokers’ Rights Foundation; California Youth Advocacy Network; Tobacco Free College Campus Initiative
Region IX Snapshot
70 Smoke or Tobacco–Free Policies
Source: Americans for Non-Smokers’ Rights Foundation; California Youth Advocacy Network; Tobacco Free College Campus Initiative
Region IX Snapshot
15 Schools
(21%)
55 SchoolsTobacco-
Free Policy (79%)
70 Smoke or Tobacco–Free Policies
Source: Americans for Non-Smokers’ Rights Foundation; California Youth Advocacy Network; Tobacco Free College Campus Initiative
Region IX Snapshot
4-YR
2-YR
90% have Tobacco-Free policy
74% have Tobacco-Free policy
70 Smoke or Tobacco–Free Policies
Source: Americans for Non-Smokers’ Rights Foundation; California Youth Advocacy Network; Tobacco Free College Campus Initiative
Region IX Snapshot70 Smoke or Tobacco–Free Policies
Source: Americans for Non-Smokers’ Rights Foundation; California Youth Advocacy Network; Tobacco Free College Campus Initiative
Region IX Snapshot
13 SchoolsDon’t Include ENDS (19%)
57 SchoolsInclude
ENDS(81%)
70 Smoke or Tobacco–Free Policies
Source: Americans for Non-Smokers’ Rights Foundation; California Youth Advocacy Network; Tobacco Free College Campus Initiative
Region IX Snapshot
4-YR
2-YR
85% of policies prohibit ENDS
80% of policies prohibit ENDS
70 Smoke or Tobacco–Free Policies
Region IX Snapshot
Arizona(25)
California(145)
HI(10)
NV(7)
Region IX Snapshot
Arizona(55%)
California(36%)
HI(20%)
NV(14%)
Smoke or Tobacco–Free Policy
Percentages reflect institutions with smoke and tobacco-free policies as a % of all institutions in each state.
Community Colleges (2-yr Institutions)
• Less likely to be protected by a 100% Smoke or Tobacco-Free Policy
• Less likely to be protected by the stronger, tobacco-free policy
• Serve 45% of undergraduate students in the U.S. (12 million)
• People of color, low-income, first generation students• Populations suffer disproportionally from tobacco use
and consequences of secondhand smoke• 17.1% of Associate Degree holders smoke• 7.9% of Bachelor Degree holders smoke
BREATHE HEALTHY CCSF
Becky Perelli, RN, MSProgram Director, Student Health Services City College of San Francisco
CONSIDERATIONS TO BECOME A 100% SMOKE/TOBACCO FREE COLLEGE
Persistence . Patience . People . Processes
Windows of Opportunity
• Review of History
– Previous Survey –4/2012
– Campus Climate
– Enforcement
• Current Environment
– Federal/State/Local
– Higher Education
– Policy/Procedures
– Interested Individuals
– Grant Opportunity
CCSF Policy/Administrative Procedures
A. By State law, smoking is always prohibited inside buildings or within 20 feet of a main exit, entrance, or operable window of any campus building.
B. City College of San Francisco will further restrict smoking to only specific areas that are posted with a sign stating “Designated Smoking Area” including specific boundaries. This additional restriction is done in order to encourage respectfulness, consideration and cooperation of both tobacco users and non-tobacco users.
C. Smoking is defined as the use of cigarettes, cigars, pipes, hookahs, water pipes, vapor/vaporless equipment and similar devices.
D. The President shall approve the specific locations for “Designated Smoking Area” signs and the boundaries of same. A listing of the specific locations will be published in the college catalog and on the web site along with the details of the smoking policy and procedure.
E. The enforcement of this regulation focuses on educating the campus community regarding the policy while promoting cessation. Violation of this policy by students or employees will be addressed in a manner consistent with any other CCSF policy or procedure violation.
Interested Individuals aka - Champions• Campus Safety – Chief of Police
• Web Master
• Student Activities
• Student Leadership
• Sustainability Club (Student & Faculty)
• Facility Director
• Student Health Services Staff & Student Workers
• Participatory Governance Representation (Faculty, Classified, Admin)
• Community Members – LGBT Tobacco Ed Partnership, Breathe California, DHHS Tobacco-Free College Campus Initiative, CYAN
Grant OpportunityBreathe Healthy CCSF
4/2015 – 3/2016Overall Goal
Move CCSF toward the eventual adoption and implementation of a 100% smoke/tobacco-free policy at City College of San Francisco within two years after initial year of funding.
Major Objectives:
• Gather feedback from stakeholders (conduct college-wide survey)
• Conduct outreach education based on that information
• Offer cessation counseling and treatment resources and referrals
Breathe Healthy CCSF SurveyWe invite you to take part in a short CCSF college wide survey to express your views and behavior related to tobacco and secondhand smoke. Please complete by October 15, 2015. (This deadline maybe extended based on participation.)
•CCSF students and employees can enter for a gift drawing
•Summary of survey results will be made available and shared with the college community before the end of fall semester.
•To participate in the survey please scan the QR Code below or follow this link: http://goo.gl/forms/40SJNAi03I
•If you would like to complete this survey in Español or Chinese call 415.239.3110 for a language–specific survey. We will provide hard copy.
College-wide 1-Day-Stand
Focus Groups
Student Recommendations• community service/education
• fines
Employee Recommendations• community service/education
• fines
Breathe Healthy CCSFCCSF is going 100% Smoke/Tobacco Free
in Spring 2017
Join us at our next task force meeting to discuss and help us plan for implementation!
Setting policies up for success: From implementation to long-term compliance
Jenny Haubenreiser
Executive Director, Student Health Services
Oregon State University
Montana State University: Big Sky, Clean Air
• 3 years of advocacy needed prior to formal policy approval
• Student leadership served as primary policy advocates
• 9 months of intensive education/awareness prior to full implementation in August 2012
• “Soft” enforcement measures: increased signage, “friendly reminders”
• Campus law enforcement unwilling to serve as enforcers
• Dean of Students took a proactive role
• Most effective measures: high-visibility signage, targeted outreach, task force member conducting bicycle patrols
• Key compliance challenges (at the time of departure from MSU):
• Athletic staff establishing smoking areas for event visitors
• ‘Hot spots’ emerging on public sidewalks very near campus buildings
• Tobacco litter near trash cans
July 21, 2016
• Smoke-free policy passed in 2012
• After initial momentum compliance issues began to emerge
• Existing task force members began to drop off
• Specific compliance challenges:• Areas around international student living areas and business strip
• Smoke entering buildings that adjoin public sidewalks
• Litter around trash cans and sidewalks
• Questions re: where to place receptacles along campus boundaries
• Vocal community members creating a community relations problem
Smoke-free OSU
July 21, 2016
• Current compliance and other issues, cont. • International student groups not understanding
the policy nor seeing the policy being enforced
• Next steps:• Re-engage task force – identify members committed to current goals of
long-term sustainability and building a culture of respect
• Priority focus on facility and fire safety issues
• Engaging new media campaign and peer education program, including international student educators
• Strengthen partnership with campus sustainability and clean-up efforts
• Re-launching cessation promotion
Smoke-free OSU
July 21, 2016
Key considerations for compliance
• Over time, social norms will reduce the need for active enforcement
• Begin with the end in mind: build compliance strategy into the policy implementation plan
- Provide ample time to prepare the campus for policy change
- Shared responsibility – not just law enforcement or public safety
- Engage all members of the community, including smokers
Key considerations for compliance
• Connect tobacco policy to broader campus values: respect for others and the environment, social justice, pride in the campus grounds
• Communicate importance of compliance with all campus policies (academic misconduct, housing policies, etc.)
• Publicize policy to visitors: parking kiosk fliers, sandwich boards at games, community newspaper ads
• Determine firm and appropriate sanctions for non-compliance for both students and employees
Key considerations for compliance
• Language matters: Communicate accurate information in a respectful way, include positive messages that include community values, e.g., clean and healthy living and learning environments.
- policies should not perceived as “anti” anyone
• As with any culture change, this will take time. Messaging needs to be consistent, visible, culturally relevant to multiple populations on campus -- well past policy implementation.
It's not that I'm so smart, it's just that I stay with problems longer.
~ Albert Einstein
July 21, 2016
Questions? Comments?
Contact Us
Kimberlee Homer VagadoriCalifornia Youth Advocacy Network (CYAN)[email protected]
Becky PerelliCity College of San [email protected]
Emily ClaymoreTobacco-Free College Campus Initiative [email protected]
Jenny HaubenreiserOregon State [email protected]