Transcript DASH Template - Iowa Cancer Consortium

Centers for Disease Control and Prevention
Division of Adolescent and School Health
Policy! Policy! Policy!!
Workplace and School
Jane Pritzl
CDC - Division of Adolescent and School Health
Iowa 04
POLICY
1. A method or course of action adopted by a
government, business organization, etc. designed
to influence and determine decisions
2. A guiding principal or procedure
Individual
Environmental
Elements of a Policy Initiative
1. Belief or Mandate - What’s driving us? Protection from second-hand smoke
2. A team
3. Data - What’s our situation?
4. Strategy - What’s our plan?

Educate and Advocate – a
communication plan

Assist, Reduce Barriers,

Monitor and Provide Feedback

Advocate
What Workplaces??

Start with a clear goal and a clear target
Think broadly about worksites
1. Consider numbers, proportion - During the normal workday you can find 20% of the
population in schools – where else are you’re people
government buildings
hospitals
airports
2. Consider vulnerable populations – children, elderly
rec centers
shopping centers
restaurants
prisons
Workplace Policies
 Tobacco-free buildings
 Smoke-free buildings, that disallow smoking near
entrances, windows, and air intake units,
 Separate, contained indoor smoking areas that are
under negative pressure relative to non-smoking areas
 Smoking restricted campuses
The Team
 Make it a group effort
You can bring in a crowd faster with a choir than with a solo
1.
Committee – standing or ad hoc
2.
Identify partners close to the action,
shared mission
3.
Collect testimony
The Data
 CPS Data (Current Population Survey)
69.9% - no smoking in common areas and work areas
National average 69%
 State Dept of Labor – Labor Market Info
can sort by name, industry, size
 Chamber
 State or Regional Organizational Training Organizations
 Specifc Industry Associations - BOMA
A. Educate and Advocate
 Compelling argument? Sales pitch? Your message?
 Broad brush – your media campaign – second hand smoke
 Targeting can be a challenge – different channels, different
plans
Organizations don’t innovate or implement change,
individuals do.
 Who are the individuals?
Relationship, Relationship, Relationship
Who do you have to reach and
where do you need to be
 Rotary
 Lions Clubs
 Hospital Association Conferences
 Human Resource Management Meeting
 Restaurant Associations
 Recreation Association Meetings
 Small Business Association
 Be Where The Tobacco Industry Is
Who’s the
Audience?
Rocky
Mountain Emp
Association
City Rec
Center Board
Restaurant
Association
Rotary
What do
they need
to hear?
What do
they need to
hear?
From
whom
should the
message
come?
Who’s
responsible
for making
this
happen?
Results?
B. Assist, Reduce Barriers, Make it Easy
 Before you get out there –
cessation programs
signage - restaurants
testimony
model policies
workplace implementation guides
TA, handholding
 keep you ear to the ground
C. Monitoring or Tracking: Be Thinking . . .
 CPS
 Local tracking –

Large employers

Restaurants – GASP

Public Places –

Employer’s Organization - survey

BOMA
Testimony  “I don’t mind the policy coming in, it will help
me quit”
 “ I think it’s cleaner around here.”
 “I feel I’ve reduced my liability as an employer and overall
most employees are much happier.”
Elements of a Policy Initiative
1. Belief or Mandate - What’s driving us? Protection from second-hand smoke
2. A team
3. Data - What’s our situation?
4. Strategy - What’s our plan?

Educate and Advocate – a
communication plan

Assist, Reduce Barriers,

Monitor and Provide Feedback

Advocate
At the Outset. …..…Our Mission Our Network
 Start with a clear goal and a clear target/ channel
100% Tobacco-Free Schools
 Make it a group effort
You can bring in a crowd faster with a choir than with a solo
1.
Committee – standing or ad hoc
2.
Identify partners close to the action, shared mission
3.
Collect testimony
 No person shall permit smoking within any
Pro-Children
Act
indoor facility utilized for services to
kindergarten, elementary, or secondary
education or library services to children. Also
included is children’s services for routine
health care or day care or early childhood
development.
 This applies to all schools and programs that
are funded by the Federal Government or
through State or local Governments by Federal
grant, loan, loan guarantee or contract
programs.
 …penalty not to exceed $1000 ….each day
Comprehensive School Tobacco Policy
1.
Rationale
2.
Tobacco-Free Environment
3.
Advertising and promotion
4.
Tobacco prevention instruction
5.
Tobacco use cessation
6.
Communication plan
7.
Enforcement plan
Collaboration With the Private Sector
 Is there a fit between mission and priorities?
 What is the effect of the potential partner’s products or services
on health?
 What is the behavior of the potential private partner?
 How would a collaboration fit with our public image?
School Tobacco Policy
Tobacco-Free Environment
Prohibits

tobacco use
on school property,
in
school vehicles,
at
school- sponsored
events (on and off school
property)
for
students, staff, and
visitors
Bottom Line ………
1. Protect all occupants from second-hand
smoke
2. Eliminate the opportunity to participate
in tobacco use
3. Eliminate access to tobacco
4. Reduce the instances to observe
use by peers or adults
Our Data, Baseline – Local Level
Colorado
North Carolina
New York
Georgia
Oregon
Wisconsin
grantees
Dear Superintendent;
1.
Do you have a district-wide tobacco use policy?……………………..…….yes
no
2.
If you have a policy, what areas does it cover and for whom? Please check all that apply.
Students Staff
Prohibits tobacco use in all school buildings by
Prohibits tobacco use on all school property including, grounds,
parking lots, play fields
Prohibits tobacco use in school vehicles, buses, etc.
Prohibits tobacco use at all school sponsored events,
on and off school property, athletic events, concerts,
field trips
3. Is your policy in effect at all times?………………………………………..yes
no
Visitors
A. Educate and Advocate
 Compelling argument? Your Message??
 Broad brush
 Presentations at conferences?
 Endorsement of State Dept of Ed?
 National School Association – local?
 very targeted personal presentations
How To Work With Schools
 Identify decision makers
 Respect the hierarchy but keep things moving
 Schools share a mission to develop health but are rewarded for academic
achievement

What’s in it for them?
 Relationship, relationship
 Be brief, be positive, be prepared to deal with objections
 Timing has an impact
 Be persistent
Review of The Case
(1) Preventing tobacco use and promoting a tobacco-free lifestyle
is a critical public health priority.
(2) Preventing tobacco use and promoting a tobacco-free lifestyle
among youth is essential.
(3) Promoting the health of youth, especially preventing tobacco
use among youth is an important educational priority.
Causes of All Deaths in the U.S., 1998
Cardiovascular
Disease
39%
Other Causes
30%
Diabetes
3%
COPD
5%
Cancer
23%
This is equivalent to three jumbo jets crashing each day!
Source: CDC, National Vital Statistics Reports 2000: 48(11)
Actual Causes of Death
in the United States, 1990
500,000
400,000
400,000
300,000
300,000
200,000
100,000
100,000
90,000
30,000
20,000
Sexual
behavior
Illicit use of
drugs
0
Tobacco
Diet/Activity
Alcohol
Source: McGinnis JM, Foege WH. JAMA 1993;270:2207-12.
Microbial
agents
Causes of Death
United States, 2000
Actual Causes of Death†
Leading Causes of Death*
Heart Disease
Tobacco
Cancer
Poor diet/lack of exercise
Stroke
Chronic lower
respiratory disease
Alcohol
Infectious agents
Unintentional Injuries
Pollutants/toxins
Diabetes
Firearms
Pneumonia/influenza
Sexual behavior
Alzheimer’s disease
Motor vehicles
Kidney Disease
Illicit drug use
0
5
10
15
20
25
30
35
Percentage (of all deaths)
0
5
10
15
20
Percentage (of all deaths)
* National Center for Health Statistics. Mortality Report. Hyattsville, MD: US Department of Health
and Human Services; 2002
† Adapted from McGinnis Foege, updated by Mokdad et. al.
Why Focus on Youth?
•
•
80% of adult smokers started
smoking before they finished
1
high school.
25% of high school students
smoked a whole cigarette
2
before age 13.
Sources: (1) U.S. DHHS. Surgeon General’s Report: Preventing Tobacco Use Among Young
People, 1994
(2) CDC, National Youth Risk Behavior Survey, 1997
Why Focus on Youth?
• If current patterns of smoking
behaviors continue, an estimated
6.4 million of today’s children can
be expected to die prematurely
from a smoking-related disease
Percentage of Adults and High School Students Who
Smoked Cigarettes*, 1991-2001
45
40
35
percent
30
25
20
15
10
5
0
1991
1993
1995
1997
1999
years
Adults (1)
High School Students (2)
*Any use in the past 30 days
Source: (1) SAMHSA, National Household Survey on Drug Abuse
(2) CDC, Youth risk Behavior Surveillance System
2001
Percentage of Adults and Youth Who Smoked Cigarettes*,
1990-2001
45
Youth age 1826 1
no change
40
Percent
35
High School
Seniors 2
no change
30
25
Adults (35
and older)1
-16%
20
15
Youth age 12
thru 17 1
-37%
10
5
0
90
91
92
93
94
95
96
Year
97
*Any use in the past 30 days
Source: (1) SAMHSA, National Household Survey on Drug Abuse
(2) Monitoring the Future Study, Univ. of Michigan
98
99
2000
2001
Average Percentage of Respondents Who Said
Students Should Definitely Know or Be Able to Do
Subject Standards by High School Graduation
Rank
Subject
1
2
3
4
5
6
7
8
9
10
11
Average % of
“Definitely” responses
Health
Work Skills
Language Arts
Technology
Mathematics
Thinking and Reasoning
Science
Civics
Behavioral Studies
Physical Education
Economics
History
12
Source: McREL. What Americans Believe Students Should Know, 1999
73.9
62.6
59.4
57.4
50.1
49.8
49.0
48.7
48.2
44.2
42.5
40.8
Who’s the
Audience?
School
Board
Superinten
dents
Principals
(HS)
Parents
Students
Youth
Advisory
Group
What do
they need to
hear?
What do they
need to hear?
From
whom
should the
message
come?
Who’s
Results?
responsible
for making
this
happen?
Objections to Tobacco Free Schools
1. We stick with the law and don’t go beyond that
2. I’m not about to offend parents and visitors
3. It’s not the norm around here
4. I’m not going to pull a chaw out of some cowboys’ jaw
5. This will never work for the alternative school kids, this is their last
chance and if a policy like this goes in, they won’t come to school
6. I don’t want kids crossing the street, creating a safety hazard for
themselves and a liability issue for me
7. I don’t want kids out in the neighborhood. I’ll get complaints
8. I don’t want kids over in the park where they will be exposed to gangs and
drugs.
B. Assist, Reduce Barriers, Make it Easy
 Before you get out there –
alternative to suspension
cessation programs
signage
testimony
model policies
 keep you ear to the ground
C. Monitoring or Tracking: Be Thinking . . .
 YRBS / YTS
 CDC’s School Health Profiles
 State Assessment directed to
Policy Makers or
Safe & Drug Free School Coordinators or ….
 On-site surveillance by official types
 Reported compliance by parents or insiders
 Recording contacts via data base or contact management software
Testimony  "I really expected to have problems with
enforcing it. I have been surprised that there
have been no real difficulties at all. I announce it at every
game- and so far there has been maybe one time that
someone lit up before they left campus." Principal
 “ I hear administrators complaining that implementing a
tobacco free policy is hard. Heck! Teaching math is hard!
Doesn’t mean we shouldn’t be doing it.” Principal
 “Anyone who says they can’t enforce this is just whining”
Principal
Schools could do more than perhaps
any other single institution in society
to help young people, and the adults
they will become, to live healthier,
longer, more satisfying, and more
productive lives.
Carnegie Council on Adolescent Development
 I in 20, 000 for airplane crash
 Second hand smoke 1 in 55