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CDHD smokefree parks 11_3_10 MeridianPlaying Smoke - Free: Smoke-Free Policies for Outdoor Recreation Areas Joanne Graff, Health Education Specialist Central District Health Department 1 Tobacco Prevention and Control Program Build partnerships to work on tobacco prevention & policy Assist groups in creating tobacco-free environments to model and promote healthful lifestyles 2 Smoke-Free Parks ProjectFunding Source Idaho Health and Welfare contracted with all 7 Idaho Public Health Districts to work on Smoke-Free Park Policy using grant money from Centers for Disease Control and Prevention. 3 Smoke-Free vs Tobacco-Free Smoke-Free: Definition of “smoking” includes the possession of any lighted tobacco product in any form. Tobacco-Free: Includes both smoking and smokeless tobacco. “smoke” or “smoking” means and includes: possession, carrying, or holding a lighted pipe, cigar, or cigarette of any kine, or any other lighted smoking equipment, or the lighting or emitting or exhaling of smoke of a pipe, cigar, or cigarette of any kind, or of any other lighted smoking equipment. Smoking: The World Has Changed In 1965, 1/2 of adult men and 1/3 of adult women in the U.S. smoked And they did so… At work On airplanes During college classes In hotels and theaters In restaurants & bars Source of historical data: Lung cancer and smoking trends in the United States over the past 25 years L. Garfinkel and E. Silverberg CA Cancer Journal for Clinicians 1991;41;137-145 Updated June 11, 2007 CA: A Cancer Journal for Clinicians © American Cancer Society, Inc. Cigarette Smoking Rates Now 17.5% of Idaho adults living within Ada, Boise, Elmore, and Valley Counties Smoke. 19.1% Idaho Adults Smoke 2007 Behavioral Risk Factor Surveillance System (BRFSS) 14.5% of Idaho High School Students Smoke. 2009 Youth Risk Behavioral Surveillance (YRBS) The majority of Idaho residents do not smoke! 6 Tobacco Policy Now… Worksites: BSU-smoke-free campus CDHD, Blue Cross of ID, area hospitals - tobacco-free campus = smoking or smokeless tobacco use not permitted Schools – tobacco-free Outdoor Recreation – Bogus Basin – smoke-free Hotels 79% of Idaho homes have “smoke-free rules” Many workplaces have tobacco-free campus wide policies that prohibit use even outside Treasure Valley Hospitals – Spring 2005 Central District Health Department – 7/1/2008 Smoke-free policy - Boise State University Fall 2009 Smoke-free Mountain – Bogus Basin Nov 20, 2009 news release. Designated smoking areas away from general publc Phasing in was considered by area hospitals, BSU, and CDHD. Decided against because it keeps the topic a hot button, education must occur with each phase, signange must be re-done for each phase. Schools have tobacco-free campus wide policies Bogus Basin has a smoke-free policy Even hotels have smoke-free polices: Marriott, Westin, Sheraton, Walt Disney, Comfort Suites 79% of Idaho homes have “smoke-free rules” Smokefree Households: State-Specific Prevalence of Smoke-Free Home Rules --- United States, 1992--2003 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5620a3.htm Why Consider a Smoke-Free Policy? Parks promote healthy activities Children model adult behaviors Secondhand smoke is dangerous Cigarette butt litter is harmful Tobacco-free environments protect the health, safety, and welfare of the community. The purpose of public park areas is to promote community wellness, and tobacco-free policies fit with this idea. Most school districts prohibit tobacco use on their entire grounds, including athletic fields, and having a policy for city parks provides consistency. Welcome to Meridian Parks and Recreation Our Mission:The Parks and Recreation Department’s mission is to enhance the community’s quality of life by providing well-designed and properly maintained parks and recreational opportunities for all citizens. 9 Welcome to Meridian Parks and Recreation April 5, 2010 The City of Meridian takes great pride in its park system to include amenities, open space, and an acceptable environment for use of all our facilities. 10 Why Consider a Smoke-Free Policy? 6.4% increase in cessation with policies implemented in workplaces and designated community public areas Smokefree Policies to Reduce Tobacco Use, Am J Prev Med 2010 Even non-smokers in Idaho pay $539 a year for everyone who does. Campaign for Tobacco Free Kids, based on taxes per Idaho household needed to cover federal and state government smoking-caused expenditures. Eleven studies measured differences in tobacco-use cessation among tobacco users exposed to a smokefree policy compared with tobacco users not exposed to a smokefree policy. Median absolute change was an increase in cessation of 6.4 percentage points. American Journal of Preventive Medicine:38(2s)S275-S289. Secondhand Tobacco Smoke is a mixture of gases and fine particles that includes— Smoke from a burning cigarette, cigar, or pipe tip Smoke that has been exhaled or breathed out by the person or people smoking At least 250 toxic chemicals, including more than 50 that can cause cancer - Centers for Disease Control and Prevention Secondhand Smoke Fact Sheet Secondhand smoke contains more than 4,0000 chemical compounds. Forty nine of these compounds cause cancer in animals and are possibly carcinogenic to humans and 11 compounds are known to cause cancer in humans. From “Public Support for Some-Free Outdoor Public Places. Robert McMillen, Ph.D. 662.325.2742. Robert.McMillen@ssrc.msstate.edu. mstobaccodata.org Secondhand Tobacco Smoke There is no safe level of exposure Exposure has immediate health consequences (heart & lungs) Cancer, Asthma, SIDS Infants, children and older people especially vulnerable 2006 U.S. Surgeon General’s Report :The Health Consequences of Involuntary Exposure to Tobacco Smoke Causes cancer (lung cancer, breast cancer, and other cancers), heart disease, asthma, Sudden Infant Death Syndrome, pre-term births, and other illnesses and health problems. Outdoor Secondhand Tobacco Smoke During smoking, outdoor smoke levels may be as high as indoor smoke levels. Repace JL. Exposure to Secondhand Smoke. Exposure Analysis 2006 Being upwind from smoker outdoors does not eliminate the chemicals from the air. Klepeis, et al. (2007) Real-Time Measurement of Outdoor Tobacco Smoke Particles, J. Air & Waste Manage. Assoc. People are exposed to higher level of cancer-causing chemicals in outdoor areas when smoking is occurring. Repace JL and Rupprecht AA. Outdoor Air Pollution From Secondhand Smoke. Presented at the 13th World Conference on Tobacco or Health, Washington, DC, 2006. 14 Outdoor Secondhand Tobacco Smoke When active smoking was taking place in outdoor settings, people could be exposed to levels of secondhand smoke comparable to indoor concentrations where smoking is permitted. California Air Resources Board, 2003 As secondhand smoke rises into the air, it becomes invisible and drops down to a lower level where people breathe in toxins from the unseen smoke. Stanford University 15 Costly to clean up Swallowed by kids Cigarette butts are the most common litter in parks. An estimated 4.5 trillion cigarette butts are tossed each year worldwide producing a significant amount of litter which is causing environmental harm Cigarette filters are made of cellulose acetate, a plastic, that is slow to degrade in the environment (10 years). 16 Is The Smoke-Free Park Concept New? • Nationally Smoke-Free Parks are not a new concept. • According to the American Nonsmoker’s Rights Foundation (www.no-smoke.org) there are over 470 municipalities with Smokefree Park Laws that cover the total park area. New York – Smoke free playgrounds. Mayor recently announced moving toward total smoke-free parks. Minneapolis – Tobacco use prohibited within 100 feet of any playground, beach, wading pool, or water play area; not within the bleachers or stands, or within 50 feet of any youth athletic field or youth athletic contest. Tacoma – Smoke Free parks 17 Smoke-Free Parks in Idaho Ordinance: Ammon Emmett Hayden Rexburg Policy: Melba Payette Twin Falls Wilder Ammon- smoking/infraction Coeur d’Alene - Emmett – Ordinance, smoking (15 feet from playgrounds, infraction: $100 fine Hayden – Ordinance – Infraction $50 fine Melba – Resolution/Policy Payette – Resolution/Policy, tobacco (playground, restrooms, public event, Greenway) Rexburg - Ordinance, smoking (within 50 feet of any structure, bleacher, playground, or water facility), misdemeanor fine $25-$300, or jail max 30 days Twin Falls – Policy; enforcement; smoking – signs and peer pressure. No fines or police patrols Wilder- Resolution/Policy, smoking Policy or Ordinance? Park Policies Rules No fine Asked to refrain from using tobacco or leave the premises Ordinance Local government enactments Regulate people or property Penalty such as a fine 19 Components of a Successful Policy/Ordinance Rationale List of all facilities/locations it covers What forms of tobacco use are prohibited? Enforcement plan User and staff notification signage Policies outline the specific outdoor recreational facilities that are covered (playgrounds, ball fields, etc.). Policies prohibit spectators and participants from using tobacco / smoking. Policies describe how facility users will be notified (user mailings, policy guidebooks, etc.). Policies outline how enforcement will occur. Which areas could be covered? Parks Playgrounds Athletic fields Skate/bike parks Trails Picnic Grounds Parking lots Other areas? 21 21 Meridian Parks and Recreation Settlers Park already has a smoke-free policy in the playground area. 22 Meridian Parks and Recreation Tully Park already has a smoke-free policy in the skate area. 23 It’s Good Public Policy!!!! Promote positive role modeling Ensure that participants and spectators are not exposed to secondhand smoke Reduce harmful cigarette butt litter The public supports these policies 24 Public Support in Ada County 58% of Boise residents recommend the City of Boise ban smoking in city parks & facilities. Boise Parks & Recreation 2009 Comprehensive System Plan Survey 68% Ada County survey responses supported tobacco-free city parks. 85% Ada County survey responses supported tobacco-free playground areas within parks. Central District Health Department, 2010: 754 surveys at 5 venues within Ada County 25 Public Support in Idaho More than half of Idahoans surveyed support smoke free outdoor areas, especially when children are present. Department of Health and Welfare 2009 78% of South Central Public Health District Survey responses supported tobacco-free parks. South Central Public Health District, June 2010 80% of North Central Public Health District Survey responses supported tobacco-free parks. North Central Public Health District, August 2010 26 Public Support in U.S. 79.2% supported “Smoking should not be allowed at all in outdoor children’s playgrounds/sports fields.” Tobacco Use Supplement to the Current Population Survey (TUS-CPS) U.S. National Institutes of Health. Surveyed: 167,046; 2006-07 No data collected on support of total park policy Recreation Groups that Support Tobacco-Free Policies The National Alliance for Youth Sports and the National Youth Sports Safety Foundation state that parents must demand a tobacco, drug and alcohol-free environment. The National Youth Sports Coaches Association Code of Ethics states that each coach should provide a sports environment that is free of tobacco, drugs, and alcohol. 28 How are these policies enforced? Similar to other park policies, such as alcohol and litter policies, primary enforcement tool is signs. Educate & inform on Parks and Rec web-site, newsletters, activity brochures, policy manual. San Jose, CA experience – Ordinance – easier to enforce with a code on bottom of signage 85% - 95% compliance with signage Officers liked – could check out situation if looked suspicious Reason to approach Identified many with multiple warrants for arrest 29 How are these policies enforced? Reminders at coaches’ or parents’ meetings, or signed statements from teams, participants, coaches, and parents. Some ask violators to leave the park area for the remainder of the event. Most rely on peer enforcement, not police. 30 Sample Bookmark & Policy Notification 31 Sample Bookmark & Policy Notification 32 Common ConcernssurroundingSmoke-Free Policy Enforcement/Compliance Personal Rights Discrimination What will be prohibited next? 33 Are existing tobacco-free policies working? 2004 University of Minnesota survey of park directors in 100 Minnesota cities and counties with tobacco-free park policies. 88% reported no change in park usage 71% reported less smoking in parks 58% reported cleaner park areas 74% reported no problems with park users violating the policy 90% would recommend tobacco free policies to other communities 34 Ammon, IDTheir Smoke-Free Park Experience Ordinance - Park wide – 2 years Signage in high traffic areas only of parks larger than 1 acre (ball diamonds, playground equipment, shelters, swimming pools.) Most people comply Compliance enforced by patrons Employees are requested but not required to enforce. No confrontation. (Referrals to Ken are minimal) Employees not allowed to smoke in parks Would suggest policy for high traffic areas; because although their policy is park wide, they only enforce high traffic areas. May overlook if a patron is by themselves and not harming anyone. 7/22/10 Phone interview with Ken Knoch, Parks and Rec Director 35 Rexburg, IDTheir Smoke-Free Park Experience Ordinance - 50 feet from structure, bleacher, playground, or water facility – around 2 ½ - 3 years Signage: multiple signs for each park, facing each street. Suggested adding phone number to call if violation observed. Citizens happy with policy – no complaints or opposition Even the smoker’s support Majority of people comply – visitors more likely to be non-compliant Complianc e enforced by police department. Normal park surveillance Work off of complaints Typically start with verbal warning Employees not allowed to smoke in parks (only 2% smoke) 8/10/10 Phone interview with Natalie, Rexburg Complaints Officer 36 Tacoma, WATheir Smoke-Free Park Experience Population: 203,400; 75 parks Park Dept Resolution; then City Ordinance so could enforce; since August 09 Most people compliant with signage. Police liaison attends quarterly Parks Dept meetings and has never mentioned problem with enforcement Few complaints – local media attempted to stir up dissent when policy first discussed Parks Staff Communication Educational meetings regarding policy enforcement expectations using signage; avoid confrontation Public Communication Neighborhood council meetings Newspaper Signage at large acreage parks and sports complexes, larger volume parks Website Originally considered playground areas only/ designated smoking areas but decided to support total smoke-free parks to support health concept 10/15/10 Phone interview with Jennifer Bowman, Metro Parks Tacoma 37 Salt Lake County, UT Their Smoke-Free Park Experience Ordinance – since 2008; over 70 parks; park-wide policy; excludes: parking lots, golf courses, Native American Ceremonies Employee education Inform & educate others: “Did you know that this park is smoke-free? Could you please help us maintain a smoke-free environment for all park visitors?” Signage Main entrance – within park rules sign Added additional smoke-free signs – enough to inform about policy; but not too much so they ignore. Post where people tend to gather. 38 39 There is No Constitutional Right to Smoke Smokers are not a “protected class” such as race or gender It is not a violation of anti-discrimination laws to prohibit smoking. Smoking is a behavior – not a condition of birth -- so it is not protected from discrimination There is No Constitutional Right to Smoke: 2008 by Samantha K. Graff http:www.tobaccolawcenter.com/documents/constitutional-right.pdf 39 What’s Next? Outlawing Twinkies? “The health problems with sugar, fat, salt and alcohol stem from the misuse, overuse and abuse of these products. Tobacco is the ONLY product that when used properly, as directed, leads to severe illness and premature death.” Ferd Schlapper Former Executive Director Health, Wellness and Counseling Services Boise State University 2008 40 Options to Consider Tobacco-Free or Smoke-Free? Policy or Ordinance? Park-wide or specific area? Playground, concession area, restrooms, bleachers Park-wide excluding parking lots No change Park-wide smoke-free policy in all parks or pilot in one park Available Resources from CDHD Policy Development & Implementation Resources Model Policy Examples of Existing Policies Public Information Examples Free Outdoor Signage 42 Free Signs! Aluminum 12” x 18” Wording can be customized Contact Central District Health 327-8543 43 Free Signs! Aluminum 12” x 18” Wording can be customized Contact Central District Health 327-8543 44 Free Signs! Aluminum 18” square 27” on point Contact Central District Health 327-8543 45 Free Signs! Aluminum 18” square 27” on point Contact Central District Health 327-8543 46 Free Signs! Aluminum 18” square 27” on point Can be customized Contact Central District Health 327-8543 47 Consider the impact…. Tobacco-free environments promote positive community role modeling and protect the health, safety, and welfare of community members. 48 49 For more information, contact: Joanne Graff, Health Educator Central District Health Department Jgraff@cdhd.idaho.gov Phone: 327-8543 Serving Ada, Boise, Elmore, and Valley Counties “Healthy People in Healthy Communities” 50 Effect of Smokefree Air Ordinance on Smoking Prevalence and Cessation Adolescents who worked in a smokefree workplace were found to be 32% less likely to smoke than adolescents who worked in a workplace with no smoking restrictions. Household smoking restrictions were also found to significantly reduce adolescent cigarette consumption and increase cessation rates. Journal of American Medical Association, August 9, 2000. 51 Effect of Smokefree Air Ordinance on Smoking Prevalence and Cessation “Total prohibition of smoking in the workplace strongly affects industry volume. Smokers facing these restriction consumer 11 – 15% less than average and quit at a rate that is 84% higher than average…Milder workplace restrictions have much less impact on quitting rates and very little effect on consumption.” Philip Morris (1992) 52 Effect of Smokefree Air Ordinance on Smoking Prevalence and Cessation “The immediate implication for our business is clear: if our consumers have fewer opportunities to enjoy our products, they will use them less frequently and the result will be an adverse impact on our bottom line.” Philip Morris, July 8, 1994 53 Examples Perimeter for PolicyIdaho’s Clean Indoor Air LawApril 2, 2004 Hospitals – twenty (20) foot non-smoking restriction at public entrances and exits to facilities. Schools – (private, public, elementary, secondary, and educational facilities including dorms) – twenty (20) foot non-smoking restriction at all of the entrances and exits of such building or facilities. Idaho Statutes. Title 39 Health and Safety. Chapter 55 Clean Indoor Air 54 Public Place DefinedIdaho’s Clean Indoor Air LawApril 2, 2004 “Public Place” means any enclosed indoor place or business, commerce, banking, financial service or other service-related activity, whether publicly or privately owned and whether operation for profit or not, to which persons not employed at the public place have general and regular access or which the public uses. Idaho Statutes. Title 39 Health and Safety. Chapter 55 Clean Indoor Air 55 Smoking DefinedIdaho’s Clean Indoor Air LawApril 2, 2004 “Smoking” includes the possession of any lighted tobacco product in any form. “Smoking area” means a designated area in which smoking is permitted. Idaho Statutes. Title 39 Health and Safety. Chapter 55 Clean Indoor Air 56 ViolationsIdaho’s Clean Indoor Air LawApril 2, 2004 Asked to extinguish all lighted tobacco products. Asked to leave the premises. Refuses: infraction and subject of fine not to exceed $50. Violation may be reported to law enforcement officer. Idaho Statutes. Title 39 Health and Safety. Chapter 55 Clean Indoor Air 57 Local ProvisionIdaho’s Clean Indoor Air LawApril 2, 2004 Nothing in this chapter shall be interpreted to prevent local, county or municipal governments from adopting ordinances or regulations more restrictive than the provisions contained herein. Idaho Statutes. Title 39 Health and Safety. Chapter 55 Clean Indoor Air 58 59