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Smoke-Free Workplace Policies

Smoke-Free Workplace Policies. Their Role in Reducing Harm Caused by Tobacco Use. Janis M. Dauer Chronic Disease Conference Roanoke, VA April 5, 2005. Secondhand Smoke (SHS). 1986 Surgeon General’s Report: SHS identified as a cause of disease in non-smokers

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Smoke-Free Workplace Policies

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  1. Smoke-FreeWorkplace Policies Their Role in Reducing Harm Caused by Tobacco Use Janis M. Dauer Chronic Disease Conference Roanoke, VA April 5, 2005

  2. Secondhand Smoke (SHS) • 1986 Surgeon General’s Report: SHS identified as a cause of disease in non-smokers • 1993 EPA Report: SHS designated as a Class A (known human) carcinogen • Contains over 4,000 substances, more than 40 are known carcinogens

  3. Secondhand Smoke (SHS) • Health effects in nonsmoking adults: • lung cancer • heart disease • Health effects in children: • Asthma • Ear infections • Bronchitis and pneumonia • Sudden Infant Death Syndrome (SIDS)

  4. Secondhand Smoke (SHS) • Latest Cal EPA “causal effects” data: • Low birthweight • Pre-term delivery • Nasal sinus cancer • Breast cancer • Altered vascular properties California EPA draft report: http://www.arb.ca.gov/toxics/ets/dreport/dreport.htm

  5. Workplace Restrictions Significant increases since 1985 - • Immediate work area bans (allowed in designated common areas indoors): • 38% (1985) • 67% (1993) • Total indoor bans: • 3% (1986) • 71% (2002)! Even in Virginia…

  6. Trends in smoke-free policy protection among indoor workers,Virginia workforce vs U.S. workforce% of workers 15 y.o.a. and older reporting a smoke-free place of employment Percent 80 VA workers 71.2 70.9 70.6 69 US workers 63.4 60 62.2 46.2 43.7 40 20 0 1992-93 1995-96 1998-99 2001-02

  7. Smoke-free worksite trends in Virginiaby race and ethnicity * Percent 72.7 71.7 70.4 66.5 72.3 78 70.8 80 64.7 61.4 65 63.4 61 60 49.2 45.6 40 36.9 35.9 20 1992-93 1995-96 1998-99 2001-02 0 White Black Hispanic All others * Sample size for Hispanic and All other race workers very small (< 100 per year)

  8. Smoke-free policy trends among VirginiaMALES by age 1992-93 2001-02 38.3 51.9 15-24 38.3 69.3 25-39 44.4 67 40-54 38.8 81.3 55 + 100 80 60 40 20 0 20 40 60 80 100

  9. Changes in smoke-free workplace policy coverage among Virginia FEMALES by age 1992-93 2001-02 40.5 63.2 15-24 47.2 75.4 25-39 51.5 76.8 40-54 45.2 74.8 55+ 20 40 60 80 100 100 80 60 40 20 0

  10. Trends in smoke-free policies among Virginia workers by type of worker Percent 77.6 77 70.4 80 63.8 57.4 50.5 60 51.6 49.7 43 40 40.8 33.6 24.8 20 Blue collar Service White collar 0 1992-93 1995-96 1998-99 2001-02

  11. Trends in smoke-free employment in VA, by gender and major occupational group Percent 100 78.4 77.6 76.5 76 72.2 67.8 80 68.2 52.4 61.5 47.9 65.6 53.9 52 60 46.2 52.8 41.1 50.8 47.1 35.9 40 30.2 39.6 36.7 27.9 23.4 20 Blue collar Service White collar 0 92-93 95-96 98-99 01-02 92-93 95-96 98-99 01-02 MEN WOMEN

  12. Trends in smoke-free worksite coverage among indoor workers in the U.S. by gender and type of worker Percent 78.8 77.8 75 73.7 73.4 68.6 80 56.5 61.4 59.3 50.2 56.7 53.6 61.5 60 53 59.3 47.4 52.9 52.6 49.8 38.1 43 40 30 32.3 27 20 Blue collar Service White collar 0 1992-93 1995-96 1998-99 2001-02 1992-93 1995-96 1998-99 2001-02 MEN WOMEN

  13. Trends in smoke-free worksite coverage among various Food Service Occupations Percent 72.6 67.3 67.2 70.8 68.3 60 60.1 53.2 65.3 57.5 48.8 44.1 50.3 60 53.1 45.2 50.3 49 47.1 37.7 29.8 42.2 48 35.6 40 27.7 40 17 34.8 21 27 12.9 25.4 22.6 20 18.6 6.3 7.9 4 0 US workers Food counter Msc. food prep Waiter Asst BARTENDERS Cooks Kitchen Waiters Supervisors 1992-93 1995-96 1998-99 2001-02

  14. State of Virginia employment trends forbar and restaurant workers, 1990-2004 Source: Bureau of Labor Statistics www.bls.gov * Data for 2004 preliminary

  15. Non-compliance with smoke-free workplace policies% of VA workers who reported someone smoked in work area in last two weeks Percent 5 4 3 2 U.S. workers 1 VA workers 0 U.S. workers 5 3.9 3.2 VA workers 4.1 4.3 2.1 1995-96 1998-99 2001-02

  16. Public support for workplace smoking restrictions% VA residents favoring smoking restrictions for indoor work areas 67.1 55.4 75 61.9 100% 80% Smoke-free Allow only in certain areas Allow everywhere 60% 40% 42.7 36.3 31.5 24.4 20% 1.9 1.8 1.3 0.7 0% 1992-93 1995-96 1998-99 2001-02

  17. NO SMOKING No lit cigarettes, cigars or pipes allowed but snuff and chewing tobacco can be used. OUTDOORS ONLY Tobacco use/smoking is prohibited completely indoors but allowed outside the building. Workplace Policies NO TOBACCO USE • No smoking of tobacco or use of any smokeless tobacco product allowed. SMOKING “ROOM” • Tobacco use/smoking is limited to an indoor area that is designated as the “smoking room.”

  18. OUTDOORS, but… Tobacco use/smoking not allowed within a specific distance of entry/exit doors. NOT ON PROPERTY Tobacco use/smoking prohibited anywhere on company property. Workplace Policies OUTDOOR AREAS • Tobacco use/smoking allowed outdoors but only in specific areas/kiosks. INSIDE CARS • Tobacco use/smoking only allowed on workplace property inside a vehicle.

  19. ON COMPANY TIME NONSMOKERS ONLY Workplace Policies • Tobacco use/smoking not allowed on company property or anywhere else while employee is on company time. • No evidence of tobacco use/smoking is permitted while on company time, including: • Seeing tobacco use, tobacco products or paraphernalia • Smelling tobacco smoke or snuff/chewing tobacco. • Only nonsmokers will be allowed to work for the company • New hires must be nonsmokers • Current employees must quit • Employees who start, do not quit, or relapse will be fired. • Same as above for smokeless tobacco users.

  20. Why Restrict Smoking? • Reduce exposure to SHS (air pollution) • Reduce amount smoked • Increase quit attempts • Support those trying to quit

  21. Why Restrict Smoking? • Reduce craving & withdrawal • Increase successful quitting • Lower healthcare and/or insurance costs • Reduce youth initiation

  22. Why Restrict Smoking? • Increase community smoking restrictions • Promote pro-health message • Demonstrate caring/concern, sincere commitment • Customers’ (patients’) well-being comes first • Staff enjoyment of break areas

  23. Why Restrict Smoking? • Eliminate tacit approval/indifference • Improve company image • Increase productivity • Lower clean-up costs

  24. Common Issues • PLANNING • Essential • Top level support • Team approach • Timeline • Written policy • Educate

  25. Common Issues • ENFORCEMENT • Clearly defined consequences • Identify responsible person(s) • Educate and promote • Follow through

  26. Common Issues • HELPING USERS • Customers/Patients • Duration of visit • Company mission • Employees • Duty to assist • Cost-effective • Visitors/guests • Inform

  27. Common Issues • HELPING USERS • Withdrawal • Medications • Coping “tips” • Cessation • Provide service • Refer out • Support • Positive attitude

  28. Resources - Worksites • CDC Taking Action Against Secondhand Smoke www.cdc.gov/tobacco/ETS_Toolkit/worksites/intro.htm • Americans for Nonsmokers’ Rights www.no-smoke.org/goingsmokefree.php?dp=d12 • Secondhand Smoke: Clearing the Air in Enclosed and Public Work Places(ANR)www.ama-assn.org/ama/upload/mm/375/ 2ndhand_smoke_manual.doc • Tobacco Technical Assistance Consortium www.ttac.org/products/health_policy/index.html

  29. Resources - Worksites • Tobacco Cessation at the Worksite www.coloradohealthonline.com/tobacco/tobacco.htm • Secondhand Smoke: What You Can Do About Second-hand Smoke As Parents, Decisionmakers and Building Occupants www.epa.gov/smokefree/pubs/etsbro.html • Center for Tobacco Cessation • www.ctcinfo.org/resources/toolkits.asp# Guides_&_Toolkits_for_Employers • www.ctcinfo.org/resources/toolkits.asp# Resources_on_Smoking_Bans

  30. Resources - Hospitals • The Michigan Smoke-Free Hospitals project • Smoke-Free Environment Implementation Plan • “How-to” manual on CD for developing and implementing a smoke-free hospital campus • Tom Peterson, M.D., Medical Director, MMPCPh (616) 974-4455, tpeterson@mmpc.com • Smoke-Free Baltimore County • Smoke-Free Hospital Grounds • Smoke-Free Psychiatric Hospital Grounds • http://smokefreebc.org/content.php?ci=35

  31. Resources – Healthcare Providers • Becoming Tobacco-Free, A Guide for Healthcare Organizations www.mainehealth.com/mh_media/Tobacco8-Final.pdf • Treating Tobacco Use and Dependence: Practical Strategies to Help Your Patient Quit(with video) and • Treating Tobacco Use and Dependence in Hospitalized Smokers • Contact Sandy Keller 608-265-4869 slk@ctri.medicine.wisc.edu • Download: www.ctri.wisc.edu/main_dept/guide/guide_main.html#GuidelineTraining

  32. Resources – Healthcare Providers • USPHS clinical practice guideline: Treating Tobacco Use and Dependence www.surgeongeneral.gov/tobacco www.ahrq.gov/clinic/tobacco/order.pdf • Alliance for the Prevention and Treatment of Nicotine Addiction www.aptna.org/Related_Links.html • Online training courses • Sources of materials • Special populations resources • Links to other resources

  33. Resources – Cessation: Print • Employers’ Smoking Cessation Guide: Practical Approaches to a Costly Workplace Problem www.endsmoking.org/resources/employersguide/pdf/ employersguide-2nd-edition.pdf • Cessation Fact Sheets http://tobaccofreekids.org/research/ factsheets/index.php?CategoryID=25 • Free USPHS materials www.surgeongeneral.gov/tobacco www.ahrq.gov/clinic/tobacco/order.pdf

  34. Resources – Cessation: Online • ALA’s Freedom From Smoking® Online www.lungusa.org (scroll down to link) • Federal online program (NIH/CDC/NCI) www.smokefree.gov • Smokeless tobacco resource www.chewfree.com • Smoke-Free Virginia website www.smokefreevirginia.org • Directory of local programs • Links to other resources

  35. Resources – Cessation: Phone National Toll-Free Phone Assistance • National Network of Quitlines 1-800-QUIT NOW • NCI Smoking Cessation Quitline 1-877-44U QUIT • ALA Call Center 1-800-548-8252 • American Cancer Society 1-800-227-2345 • Great Start 1-866-66 START (pregnant women)

  36. Resources – Cessation: Phone Virginia Toll-Free Phone Assistance • Coming soon… VIRGINIA QUITLINE (via National Network number 1-800-QUIT NOW) • Smoke-Free Virginia Helpline 1-877-856-5177 • Recorded message • Free Quit Kit mailed • American Lung Assoc. 1-800-LUNG USA (local program information provided) • ALF Washington DC Quitline 1-800-399-5589

  37. Smoking Policies - Hospitals (National data provided by Tom Peterson, MMPC) • By the late 70’s-early 80’s: • Sales of tobacco products in hospitals eliminated • Smoke-free wards/areas introduced • By 1978, only: • 42% had any anti-smoking regulations • 1.2% had total indoor bans • 1988 survey: • 90% had some form of internal restrictions • 8% were smoke-free indoors • 1991: JCAHO standards issued, and… • 1993 inspections: 95.6% found compliant

  38. Smoke-Free Grounds • Over 80 hospitals in the USA have implemented smoke-free campus policies • In Virginia: • Major hospital in Southwest Virginia (5/05) • Danville Regional Medical Center (7/05) • Potomac Hospital • UVA Health System • Mary Washington Hospital • Major private university • Major health insurance company • Indian Creek Correctional Center • St. Bride’s Correctional Center • Botetourt Correctional Center

  39. Taking Action – At Work • Program integration – chronic diseases • Increase awareness of cessation resources • Promote cessation (staff, patients, community) • Incorporate brief intervention into system • Integrate – continuity of care • Other actions • Role model • Advocate for smoke-free grounds • Advocate for reimbursement/coverage • Advocate for funding/resources

  40. Taking Action – At Home • Prohibit smoking in your home and vehicle • Patronize smokefree establishments • Complain about secondhand smoke • Participate in advocacy activities • Join (or start) a local coalition • Support cessation

  41. Taking Action - Resources • Advocacy organizations • Virginians For a Healthy Future • Americans for Nonsmokers’ Rights • SmokeFree Action Network • Action alerts, national and for each state • E-mail lists with variety of topics (e.g., smokefree hospitals) www.smokefreevirginia.org/Additional-Resources.html • Cessation information • Association for the Treatment of Tobacco Use and Dependence: www.attud.org • Center for Tobacco Cessation e-newsletter: www.ctcinfo.org/enewsletter/default.asp

  42. The Tobacco Use Control Puzzle Promoting cessation Preventing youth initiation Increasing excise taxes Clean indoor air regulations

  43. The Chronic Disease Puzzle TOBACCO USE CONTROL

  44. Questions? Janis M. Dauer, MS, CAC Program Manager Alliance for the Prevention and Treatment of Nicotine Addiction 3557 Chesapeake Blvd, #1 Norfolk, VA 23513 (757) 858-9934 jdauer@aptna.org

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