stomp—stop tobacco on my people statewide network of communities in new mexico to promote...
TRANSCRIPT
STOMP—Stop Tobacco On My People
Statewide Network of Communities in New Mexico
To promote awareness and action among New Mexicans disproportionately affected by tobacco in order to eliminate health disparities
Coletta Reid, Director
Debbie Vigil, Coordinator
PEOPLE WITH DISABILITIES &
TOBACCO CONTROL STRATEGIES
Prevalence of Smoking in New Mexico
No Disability—22% Disability that does not require assistance
—24.6% Disability that requires assistance—28.7% Disability that requires institutionalization
—even higher
Pressures to Smoke
Lack of recreational & exercise alternatives
Disenfranchisement & exclusion Social isolation Chronic pain Too much free time Feeling lonely & depressed
Pressures to Smoke
Wanting to “fit in” Issues of independence Advertising Stress and anger reduction technique Replace impulse to overeat Form of control
Increased Dangers: Secondary conditions
Difficult breathing Slow healing of skin wounds More likely to get pressure sores Increased chance of stomach ulcer
People with Disabilities
Higher rates of smoking More likely to be planning to quit More likely to have tried to quit Less likely to have successfully quit Smoke more cigarettes per day Smoke first cigarette sooner after waking Higher rates of exposure to secondhand
smoke in the home
Smoking associated with
More days of restricted activity—unable to go to work/school
More secondary conditions—breathing problems, pressure sores
Worsening health compared to prior year Poorer health status More physician visits Use of caffeine and other stimulants and
alcohol
Smokers with Disabilities, report more
Low self-esteem Depression Chronic pain Anxiety Fatigue Burns
STOMP
Mini-grants to rural Independent Living Center
Committee to plan Tobacco Forum Tobacco Forum in April, 2003 Tobacco survey at annual Disabilities
Conference Focus groups statewide Working with advocates to develop
strategic plan
Disability Culture: A Look at Different
Models
Mary Keener Beresford, Ph.D., DirectorNew Mexico Commission on Disability
Santa Fe, New Mexico
Charity Model
Pre WWII Charity of religions Institutionalization Focus of responsibility: Person with
Disability
Medical Model
Post WWII Disability as a medical condition Repair and send back out Focus of responsibility: Person with
Disability
Functional Limitation Model
Derived from Medical Model Rehabilitate after medical community
has done all they can Dealing with what person cannot do Focus of responsibility: Person with
Disability
Social Model
Post disability rights movement Independent living Integration into society Focus of Responsibility: Society
The Disability Movement
Sherry Watson, Executive DirectorSan Juan Center for Independence
Farmington, New Mexico
Independent Living
Inclusion Consumer control Consumer directed services Strength Self-empowerment
Independent Living Centers (ILC)
Gathering places for individuals with disabilities
People with disabilities 51% of board and staff
Serve all persons with a disability Committed to inclusion of diverse groups
ILC Core Services
Systems and individual advocacy Information and referral Peer support Independent living skills training
Tobacco Coalitions Partner with ILC’s Create clearinghouse for tobacco
information Meet with disability organizations Identify issues, concerns, &
recommendations Provide technical assistance and training Facilitate program planning and design Conduct public summits
“Martin Luther King had a dream.
We have a destiny, not a dream, a destiny to realize.
We shall have the right to choose how we live and where we live.”
--Mike Auberger, ADAPT
Access Issues for People with Disabilities
Larry Lorenzo, Disability ActivistAlliance for Disability Education
Albuquerque, New Mexico
Access Not Just Physical
Equitable outreach efforts Equal opportunity for prevention
information Equal access to services Inclusion in all coalitions, programs,
projects
Americans with Disability Act—ADA, 1990 Significant civil rights law Right to participation Recognition of 54 million people with
disabilities Title II
Gov’t-funded programs & services Title III
Public Places
Program Access
Policies and procedures Evaluation of your facility—TTY,
etc. Staffing patterns Program participant inclusion
Information/Accessible Materials Alternative formats
• Braille• Audio recordings• Computer disc• Large print/binders
Effective communication• Sign language interpreters• Computer-Assisted Realtime Translation
(CART)• TTY
Closed-captioned films and videos
Physical Access
Universal design Entrance and doors Public areas: counters, elevators, signage Public restrooms Meeting rooms Emergency exits and alarms
Transportation Parking and Pathways
Living Well with a Disability
Alice Ellison, Director of OperationsSan Juan Center for Independence
Farmington, New Mexico
Philosophy
Independent living Self-help and self-advocacy Peer relationships and peer role models Equal access to society Full choice in all matters concerning
themselves
Trends
Increase in disability among all age groups
Mainstreaming creates additional peer pressure on youth
Increase in obesity and lack of physical exercise (for everyone)
Growing need for public health programs
People with Disabilities who Smoke
Less visible Undercounted Underserved Ignored by tobacco prevention
movement
Developed Capacity to Address Tobacco Built Life Savers Coalition Trained tobacco-free support group
facilitators Created support groups Sponsored town hall meeting for
consumers, families & community Delivered smoke-free educational
presentations Distributed smoke-free materials
Tobacco Issues for People with Disabilities Taking away choice Have a lot worse health problems Independent form of pleasure, especially
for mobility impaired Have enough to deal with Isolation--“my best friend”
Opportunities Make standard in health promotion
programs Integrate into programs to prevent
secondary conditions Ally with physical activity projects Insure inclusion in peer support initiatives Train Personal Care Option consumers in
secondhand smoke issues Environmental interventions may be more
effective
Cigarette Smoking in Psychiatric Patients
Debra DermataLas Vegas Medical Center
Las Vegas, New Mexico
National Prevalence
Schizophrenia: 45%-93% Major depression: 74% Panic disorder: 55% Post traumatic stress disorder: 53%-
60% Phobias: 48% Generalized anxiety disorder: 47% Bi-polar disorder: 45%
Why the Higher Rates?
Stimulates release of dopamine, norepinephrine & 5-HT
Self-medication Attempt to reduce side effects Environmental influences
Nicotine Effects on Schizophrenia
Increased alertness Reduced anxiety Decreased depression Decreased lethargy Reduction in hallucinations
Environmental Influences
Lax policies in institutions Cigarette privileges as
rewards/punishments Smoking breaks used as “social time” Patients and staff smoke together as
bonding Helps patients feel “in control” in
uncontrollable environment
Nicotine and Medications
Speeds up metabolism (need higher doses of anti-psychotics)
Haldol may increase smoking Clozapine may decrease smoking
Quitting
Major difficulty for mentally ill Majority have desire to quit Timing crucial—medication
changes/highly symptomatic Reduction rather than cessation Modified materials to match cognitive
abilities
505-988-3473
National Council on Independent Living 1916 Wilson Blvd, Suite 209
Arlington, VA 22201
www.ncil.org
703-525-3406