Transcript The Journey to Smoke Free - University of North Carolina

Presented by
Gayle Harris, MPH, RN
April 26, 2012
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Provide a summary of the Durham County
experience
Discuss lessons learned
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Concept presented to BOH on July 8, 2010
◦ Occupancy of new facility to begin in 2011
◦ Department directors desired smoke-free policy
◦ Policy to cover county property on two city blocks
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Request from Duke University Hospital in
September 2010
•
BOH meeting September 2010
– Introduction of request from Duke
– Presentation by Sally Herndon
• HB – 2 clause that allows BOH to establish stricter rules
• Statewide compliance with HB -2 in bars and
restaurants
• Services available from Tobacco Prevention and
Control Branch
– Board’s concern regarding authority “to take
smoking rights away from citizens”
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BOH meeting in November 2010
◦ Introduction of Frieden’s Health Impact Pyramid
•
BOH meeting in November 2010
– Frieden’s Health Impact Pyramid
– Draft Rule
• “Regulation of Smoking and the use of Other Tobacco
Products in Durham County Health Department
buildings, on Durham County Health Department
grounds, in The Durham Center, on the Durham Center
Grounds, in Healthcare Facilities, in Veterinary Offices,
in Pharmacies, in City or County Bus stops and on
Abutting Sidewalks”
– Discussion and lots of it
– Subcommittee appointed
– Inclusion of other public places
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BOH meeting January – May 2011
- Board discussions to refine the proposed Rule
- Decision to hold a written public comment period
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May 2011
- Written public comment period (May 16th – June15th)
advertised
- Links to the Rule and CDC’s website (“How Tobacco
Smoke Causes Death” and “Facts about Tobacco
Smoke and How It Impacts Your Health”) posted on
website.
- Mailing and e-mail addresses posted on website
- Newspaper article (“Ban Smoking in Public?”) and
story on blog site (“County health department
proposes outdoor smoking restrictions…”)
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BOH meeting in July 2011
- Public comments reviewed
- Subcommittee to reconvene to consider impact of
comments
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BOH meeting in August 2011
- Subcommittee reports no changes to Rule
- Proposed amended Ordinance presented
- Mock-up of proposed signage and educational
tools, budget, and Awareness Campaign presented
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Presentations to Elected Officials
- November 15th – Joint City County Meeting
- November 22nd – City Council Worksession
- December 5th – BOCC Worksession

Official comments from City staff via City
Manager
- Agreed to make entire park system and shelters at bus
stops smoke-free
- Did not agree with authority to address sidewalk
maintained by the City in State right-of-way
- Recommended an enforcement strategy with designated
staff rather than involving law enforcement
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BOH Subcommittee reconvened in December
2011 to consider feedback received and
made adjustments to the Rule.
BOH meeting in January 2012 changes to Rule
approved.
Individual meetings held with BOCC members
to review the changes (January 18th – 19th)
Local governments may restrict smoking in public places.
(a)
Except as otherwise provided in subsection (b1) of this section, and
notwithstanding any other provision of Article 64 of Chapter 143 of the General
Statutes to the contrary, a local government may adopt and enforce
ordinances, board of health rules, and policies restricting or prohibiting
smoking that are more restrictive than State law and that apply in local
government buildings, on local government grounds, in local vehicles, or in
public places. A rule or policy adopted on and after July 1, 2009 pursuant to
this subsection by a local board of health or an entity exercising the powers of
a local board of health must be approved by an ordinance adopted by the
Board of County Commissioners of the county to which the rule applies. The
definitions set forth in G.S. 130A-492 in Part 1A of this Article apply to this
section and shall apply to any local ordinance, rule, or law adopted by a local
government under this section.

(e)
A county ordinance adopted under this section is
subject to the provisions of G.S. 153A-122. (2007-193, ss.
2, 3.1; 2007-484, s. 31.7; 2008-95, s. 1; 2008-149, s. 4;
2009-27, s. 1.)
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February 13, 2012 BOCC regular meeting
The Board adopted the Board of Health
Smoking Rule with an effective date of
August 1, 2012
“Smokers’ worlds are shrinking, yet again, and
it happened in Durham without so much as a
raised eyebrow. That in and of itself may be a
sign that we have reached a tipping point in
our city in the anti-smoking movement…We
applaud the County Commissioners
unanimous support of the measure…We’re
glad commissioners have made it a smaller
world.”
The Herald-Sun
February 15, 2012
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Where you start is just that – where you start.
This is an iterative process.
Use all available resources.
Communication and education are key
components in the process.