Transcript Model Workplace Tobacco Policy

Using and Disseminating the
Results of Smoke-free Policy
Surveillance
Ellen J. Hahn, DNS, RN
Professor
Kentucky Center for Smoke-free Policy
Linking Data to Policy Change
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Share data with coalition and
manufacturers.
Present data at interested worksites.
Use data as a media opportunity, if
appropriate. Meet with media leaders.
Identify local newsletter/neighborhood
bulletins for a summary of the results.
Specify and evaluate targets using baseline
data.
Manufacturers Expressing Interest
in Changing Policy
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Although most manufacturers were satisfied
with their current policy, many expressed
interest in changing policy and asked for
assistance (2004).
The opportunity exists to motivate and help
with voluntary policy change that can then
promote community readiness for a smokefree ordinance campaign.
Find your friends!
How to Frame the Issue with
Manufacturing Facilities
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Health effects of SHS justify smoke-free policy
Other good reasons include:
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Cuts cleaning and maintenance costs
Improves employee morale
Provides an incentive to stop smoking
Providing cessation resources demonstrates the
manufacturer’s commitment to employees
Reinforcement of non-smoking norm helps the
community by increasing public awareness of
the dangers of smoking (Evans, 1999).
Model Workplace Tobacco Policy
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Rationale for Policy (Effects of SHS)
Types of Tobacco Product Covered
Cigarettes, Cigars, Pipes, and Spit
When and Where Tobacco Allowed
Breaks? Lunch?
Exact locations of Designated Areas
Vehicles
How Policy is Communicated
How Violators are Handled
What Department Provides Cessation Resources
To Whom it Applies
Employees, Visitors, Clients, Contractors
Employer Action Steps (CDC, 2003)
http://www.cdc.gov/tobacco/ETS_Toolkit/worksites /employer.htm
1. Plan your approach
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Designate key staff person to study, plan and
propose the policy
Communicate SHS info to influential personnel
from key areas (smokers and non-smokers)
Consult with union, if applicable
Take a sympathetic approach to smokers and
offer cessation help
Focus on Secondhand Smoke (SHS), not
smokers
Employer Action Steps
2. Gather facts and information on:
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SHS
Ventilation science
Costs and consequences (business, health,
liability)
Benefits of going smoke free
Support for smokers, including cessation
resources and insurance coverage for cessation
Model Policy
Employer Action Steps
3. Assess readiness
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Conduct survey to help tailor efforts and plan
education, policy and enforcement mechanisms.
4. Educate
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Take into account organizational readiness and
level of knowledge
Employer Action Steps
5. Implement the plan
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Complete implementation is key; incomplete
implementation leads to confusion.
Give 4 weeks notice
Emphasize protection of employee’s health
Distribute the complete policy, with a letter
from the CEO
Post signs at all entrances and stairwells
Conduct awareness programs and distribute
materials clearly describing all procedures
Employer Action Steps
6. Enforce the policy
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Be fair and equitable
Give all new employees written information on
the policy to read and sign
Manufacturers with Unions
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Unions are interested in meeting the needs of
all employees (smokers, non-smokers, and
those who want to quit).
Target both the manufacturers and their
unions for assessment of policy and
discussion of policy options.
Americans with Disabilities Act (ADA):
Motivating Policy Change
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Employ federal anti-discrimination laws to
protect people with disabilities caused or
worsened by exposure to secondhand smoke
Applicable Federal Laws
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The 1990 Americans With Disabilities Act
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Title I: Employment
Title II: State and Local Governments
Title III: Public Accommodations
The Rehabilitation Act of 1973
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Section 504: Entities Receiving Federal
Funds
Definition of “disability
Substantial limitation of major life
activities:
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Breathing
Working
Walking, hearing, speaking, seeing, etc.
Examples of “smoke sensitive”
disabilities
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Heart disease
Breathing conditions
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Asthma
Emphysema
Cystic fibrosis
Severe bronchitis
Allergies (e.g., sinusitis, hay fever)
Cancer-related ailments
“Secondhand smoke can precipitate breathing distress
or failure in sensitive nonsmokers.”
Reasonable accommodations and
removal of discriminatory barriers
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Complete elimination of smoking in
buildings
Eliminate of smoking within a reasonable
distance from doorways or openings to the
building(s).
Federal Anti-discrimination
Laws: Good Preemption
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Federal protections overrule weaker
state and local laws governing
smoking policies that discriminate
against people with disabilities
caused or worsened by exposure to
secondhand smoke.
Advocates Role in Assisting
People with Disabilities
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Key Role as Educator
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Patients
Employers
Policymakers
Public
Types of Assistance
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Identify & explain smoke-sensitive disabilities
Explain “reasonable workplace accommodation”
Explain public place smoking policy
“modifications”
Eliminating Discrimination: Step 1
Document the disability
Physician letter with medical advice to avoid SHS
 Disability determination
Need Documentation of:
 The patient’s disability
 Limitations in major life activities
 How exposure to SHS worsens the disability & major life
activity
 Explain reasonable workplace “accommodations” and
smoking policy “modifications” in public areas
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Eliminating Discrimination: Step 2
Who should Mail an Educational Letter?
 The individual with the disability and
impairment of a major life activity caused
by SHS
 A third party (physician, activist,
community organization)
 All the Above (co-sign)
Keep the focus on civil rights
Step 2: Mailing an Educational
Letter
The letter should describe…
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The individual’s smoke sensitive disability &
and impairment caused by SHS exposure
How the smoking policy is discriminatory
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SHS as a health hazard
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Explain federal anti-discrimination laws
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Step 2: Mailing an Educational Letter
The letter should describe…
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The appropriate remedy— “reasonable
accommodation” in the workplace or
“modification” of the smoking policy in public
areas
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The need for a timely response
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The consequences of non-compliance or
inaction
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Widespread community support
Step 3: File an Administrative
Complaint (if needed)
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An individual has the option of pursuing a
lawsuit in federal or state court and/or filing
an administrative complaint
An administrative complaint is NOT a
lawsuit
The federal agency will investigate the
allegation(s) of discrimination
Step 3: File an Administrative
Complaint (if needed)
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If discrimination exists, the federal agency
will attempt to negotiate a settlement
If negotiations fail, the matter will be
referred to the U.S. Department of Justice
for possible litigation
Step 3: File an Administrative Complaint
(if needed)
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A person or a specific class of individuals or
their representative may file a complaint
alleging discrimination on the basis of
disability
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For additional information about filing an
administrative complaint, contact a regional
resource center on the ADA
1-800-949-4232
Advantages of using ADA
Laws
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A civil right issue that is not
specifically gender, religion, or
race-related
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Empowerment for people with
“hidden disabilities” & who have
long suffered in silence
More Advantages
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Provides owners/managers a legal
justification for banning or severely
restricting smoking
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A civil rights controversy attracts
attention
Disseminating Knowledge about the
Effects and Benefits of Smoke-free
Laws
Air Pollution Before and After
Lexington’s Smoke-free Law
•Indoor air pollution in
restaurants, bars, and
other entertainment
venues was 3 times the
outdoor air pollution
standard, but dropped
91% after Lexington’s
smoke-free law took
effect.
PM 2.5 microgram per cubic meter
250
200
B EFORE
150
100
50
A FTER
0
Indoor air pollution dropped 78% in Georgetown’s
restaurants within 1 week after smoke-free law
PM2.5 (microgram per cubic meter)
400
350
Before Smokefree Ordinance
300
After Smokefree Ordinance
250
200
150
100
91
65
50
20
0
Federal
Outdoor
Standard
Georgetow n
Restaurants
Lexington
Restaurants
Louisville
Restaurants
Georgetow n
Restaurants
Lexington
Restaurants
Prepared by Kiyoung Lee, ScD, CIH
Assistant Professor
University of Kentucky
Indoor air pollution in the Bingo Hall was 11 and 4.9 times
higher than the Federal Outdoor Standard after the Smokefree Law
PM2.5(microgram per cubic meter)
800
740
700
Before Smokefree Ordinance
600
After Smokefree Ordinance
500
400
300
200
316
293
227
65
100
0
Federal
Standard
Georgetow n
Bingo Hall
Lexington
Bars
Georgetow n
restaurants
Georgetow n
Bingo Hall
Georgetow n
Bingo Hall
Lexington
Bars
Prepared by Kiyoung Lee, ScD, CIH
Assistant Professor
University of Kentucky
After Lexington’s Smoke-free Law,
Hair Nicotine Dropped by 56%
Median hair nicotine level
3
2.5
2
1.5
1
0.5
0
Pre-law
3 months Post-law
The Average Decrease in Hair
Nicotine Was Greater in Bar Workers
Geometric means for hair nicotine (ng/mg)
5
Bar
Restaurant
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
Pre-law
3-months post-law
Figure 2. Geometric means by establishment type and time,
adjusted for cigarettes per day
Pueblo Heart Study (November, 2005)
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Heart attack rates in Pueblo, CO decreased
by 27 percent after implementation of the
city’s smoke-free ordinance.
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1½ years pre-law: 399 heart attack patients
admitted to Pueblo’s two primary hospitals.
1½ years post-law: 291 heart attack admissions
Similar to Helena, Montana study: 40% drop
in hospital admissions for heart attacks within
six-months post-law.
Lexington’s Public Support and Knowledge
of Health Risks Before and After the Law
100
Pre-law
Post-law
80
70.2
60
74.7
64.0
56.7
40
20
0
Public Support
SHS as Health Risk
Public support for the law increased significantly
Economic Impact of Lexington’s Law on
Fayette County Restaurants and Bars
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3% increase in restaurant employment
Bar employment remained stable
No change in payroll withholding taxes in
restaurants or bars
No change in business openings or closures
in alcohol-serving establishments or at nonalcohol serving establishments
Why the Thalheimer Report
is Flawed
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Analyzed only on-premise wholesale alcohol sales
and found a 9.8%-13.3% drop post-law
Significant effect found in only 2 of the 9 distributors in
Fayette County (only examined data from 3 of the 9)
No information on types of alcoholic beverages sold
Report does not account for change in alcohol price
over time
No audit of data provided by distributors (traditionally
close allies of the tobacco industry)
Report not peer-reviewed or independently evaluated
Employee Turnover and Smoke-free
Laws
60
50
40
Went NS
NS
Smoke
30
20
10
0
Tenure (wks)
Hrs Bimonthly
Average Tenure and Hours Workers Per Week, 1999-May 2004
Note. Average tenure reflects those with an end date
Kentucky Supreme Court
Decision, April 2004
“Among the police powers of the
government, the power to promote
and safeguard public health ranks
at the top…….. The real issue is
whether the public health regulation
[Lexington’s smoke-free law] is
reasonable….. In this case we must
conclude that it is.”
Contact Us!
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University of Kentucky Tobacco Policy
Research Program
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www.mc.uky.edu/tobaccopolicy
[email protected]
859-257-2358
Kentucky Center for Smoke-free Policy
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www.kcsp.uky.edu
[email protected]