the big picture: what are the key approaches to making smoke-free multi-unit dwellings the norm (as...

The Big Picture: What Are the Key Approaches to Making Smoke-free Multi-Unit Dwellings the Norm (as

quickly as possible): The California Experience

Joanne Wellman-Benson, RDH, MPHCalifornia Department of Public Health, Tobacco Control Section

(TCS)National Conference on Tobacco or Health

Ancillary MeetingOctober 23, 2007

How do you define “as quickly as possible?”

It’s all relative!

TCS Infrastructure:A Comprehensive Decentralized

Approach to Create Social Norm Change•

• Local Programs (61 health departments-LLAs, 67 community-based organizations)

• Statewide media campaign

• Clearinghouse of educational and promotional materials

• Workgroups provide direction

• Training and TA for local programs

• Cessation Helpline

• Surveillance and evaluation

• TCS sets guidelines for grantees to conduct needs assessments by using Communities of Excellence (CX) indicators based on priority areas, of which SHS is one.

Take into Consideration…

1. Where you are in the tobacco control movement– TCS started in 1999, after passage of a

tobacco tax

2. If you have a statewide smoke-free workplace law or not– The CA Smoke-free Workplace Law was

enacted in 1995, smoke-free bars enacted in 1998

Need to Consider (cont.)

3. How long your statewide workplace law has been in effect– Californians have had smoke-free workplaces for

almost 13 years and smoke-free bars for almost 10 years

4. If you had a critical mass of local policies prior to the passage of the statewide smoke-free workplace law– 286 policies had been enacted at the local level prior

to the statewide smoke-free workplace law– Program interventions need to be designed mainly to

facilitate change at the community level

Need to Consider (cont.)

5. If smoke-free outdoor areas have become (or are becoming) a social norm– Smoke-free playgrounds and doorways (state law)

outdoor entertainment venues, parks, beaches (voluntary and local policies)

6. What do public opinion polls show? – increasingly favorable attitudes re: smoke-free

apartments - the % of smokers in 2006 was the same % as the overall sample in 2001!

Attitude Shift* for Smoke-free Multi-unit Housing

40

45

50

55

60

65

70

75

80

2001 (Field) 63.2 71.6 43.9

2004 (Field) 69.0 73.2 52.4

2006 (CATS) 76.2 78.1 63.0

Overall Nonsmoker Smoker

*Note: This table consists of data compiled from different surveys with varied survey methodologies.Prepared by: California Department of Public Health, Tobacco Control Section, July 2007

A Natural Progression• Local smoke-free workplace policies, including restaurants and bars

• Statewide smoke-free workplace law

• Local voluntary outdoor tobacco smoke policies

• Locally-mandated outdoor tobacco smoke policies

• Statewide outdoor tobacco smoke laws (playgrounds and doorways of

government buildings)

• Local voluntary MUH policies

• Locally-mandated MUH policies

• Statewide MUH law?

Where We Were in 2004…

2004-2007 LLA plans could choose between 3 MUH CX indicators (indoor

common areas, outdoor common areas, or units.) These were for

voluntary policies.

2007-2010 LLA Plans Are a Different Story!

• Seven SHS MUH Indicators that include both voluntary and legislative policies which include: – Indoor common areas (primarily covered by the

state law)– Outdoor common areas– Units-required to assess– Zoning– Disclosure– Nuisance– Enforcement provisions

Comparison of LLA MUH Objectives - 2005-2010

0

10

20

30

40

50

60

70

Percent

LLA 04-07 LLA 07-10

TotalIndoorOutdoorUnitsVoluntaryMandatory

Comparison of LLA MUH Objectives - 2005-2010

0

10

20

30

40

50

60

70

%

Total Ind Outd Units Vol. Mand

LLA 04-07 LLA 07-10

There are many local voluntary MUH policies that are virtually impossible to completely track

Eighteen Local Communities Have Passed Smoke-free MUH Ordinances and/or

Resolutions

• 12 for outdoor common areas• 8 for units• 4 nuisance• 2 resolutions (non-binding)-County (50% of

units) and City of Sacramento (25% of units)• 4 Public Housing: 1000 Oaks, Rancho Mirage,

Santa Barbara-a senior housing complex, Madera

Tools for Success for Local Programs

• Local health departments required to assess CX indicator pertaining to units

• MUH Workgroup meets monthly - provides direction to TCS

• Training opportunities and technical assistance calls

• Statewide technical assistance grants (legal, policy, education/advocacy, low SES)

• Media-billboards, TV ads, media tool kit

• Public opinion polls of tenants and managers/owners

• Educational materials-brochures, fact sheets, tool kit

• Use the science to your advantage! (SHS is a toxic air contaminant, there is no safe level of exposure to SHS, third hand smoke, economic benefits, etc.)

For additional information..

Joanne Wellman-Benson

(916) 449-5482

Joanne.wellman-benson@cdph.ca.gov