supporting youth to be tobacco free trish hill, interior health andrea winckers, bc cancer agency
TRANSCRIPT
Supporting Youth to be Tobacco Free
Trish Hill, Interior HealthAndrea Winckers, BC Cancer Agency
Learning Outcomes
At the end of the session, participants will have an increased understanding of:· The latest evidence on youth and tobacco use· Cessation medications and ways to support successful quitting· Tobacco industry marketing tactics o youth· Environmental damage and social justice issues And will have greater confidence in:· Addressing tobacco with youth/young adults who smoke· Using interactive tools to educate and motivate youth to take action on tobacco
Tobacco Facts
Tobacco kills 6000 people a year in B.C. including about 110 non-smokers
Kills ½ of long term users when used exactly as intended by the manufacturer
Causes twice as many deaths as vehicle crashes, alcohol, suicide, homicide, and HIV combined
4,000 + chemicals in cigarette smoke, more than 50 are cancer-causing
Reduces immunity and interferes with wound healing, even among younger users
Tobacco Facts
Youth and Tobacco Products
Nicotine is one of the most addictive substances known
Youth often underestimate their
dependence
Tobacco dependence is associated
with addiction to other substances
Treatment of other addictions is more
successful if tobacco is included
Support Youth
Youth are increasingly asking for help to quit
but are not well supported
Young people are subjected to multi-million
dollar marketing campaigns by tobacco
companies
85% of current smokers started before age
18
Tobacco Use in BC
Rates in Interior region are higher than the provincial average (15%), at 17% (106,500 smokers)
Youth Tobacco Use in BC
BC youth smoking rates are lower than the national average
11% for BC youth aged 15-19 (BC Stats 2008)
31% for aboriginal youth (BC Stats
2008)
Higher prevalence among those with lower socio-economic levels, mental health and addictions issues
Youth Feedback
Ever Thought of Quitting Video
Support at school – West Kootenay Youth Forum Feedback
Not being supported Give out gum – gum therapy Refer to Freedom Quest Incentives – not nec. Works Teachers put stress on students Support for stress More contact with youth workers - busy
Gross Vid 1
http://www.youtube.com/watch?v=5qYh2tosxos
Forms of Tobacco
Cigarettes, pipes or cigars
Smokeless tobacco (chew or snuff)
Newer alternatives:
Paan (betel nut and candy)
Dissolvable tobacco products
Electronic cigarettes
The CigaretteHundreds of additives are used to:
Increase uptake of nicotine to the brain (ammonia)
Keep the cigarette from going out
Mask the taste (sugars, cocoa, other flavourings)
Make smoke more tolerable to the lungs (bronchodilators)
Combustion (CO) and chemicals from soil, fertilizers and pesticides
Cigarillos
New legislation regulates flavourings, packaging and size but loopholes are appearing
Packaged to look like lip gloss and markers.
Smokeless Tobacco
Snuff (3.6 mg of nicotine after 30 min)
Chew tobacco (4.5 mg after 30 min)
Snus (new in Canada)
Cigarettes: 1 mg nicotine
Smokeless is not Harmless
Oral cancer
Leukoplakia
Periodontal disease and dental
cavities
Target Consumers
Athletes
Male
Youth
Smokers
Gross Vid 2
http://www.youtube.com/watch?v=1MF4sCvkAAA&NR=1
Psychological Effects
More likely to have depression
More likely to have other addictions
More severely dependent
Often lack effective alternative coping skills
Depression and Smoking
The 5 most Effective Interventions:
1. Increase price
2. Reduce tobacco promotions
3. Create smoke-free public places
4. Counter-advertising
5. Cessation supports for tobacco users*
Support and Respect
Tobacco addiction should be considered a chronic condition which requires ongoing support and repeated intervention
Tobacco users should be treated with respect, dignity and sensitivity when they are offered tobacco intervention
Tobacco users have the right to decide whether, when, and how they will stop using
Positive Influences
Mentoring by successful youth quitters
Create trust by using a non-judgemental, supportive approach
Recommendations by peers to quit
Perception that their tobacco use is hurting someone else (e.g. exposing a younger sibling to second-hand smoke, modeling tobacco use to younger students)
Brief Interventions are Effective
Minimal interventions lasting less than three minutes increase overall quit rates – teachable momentSmoking cessation interventions delivered by multiple types of service providers markedly increase cessation ratesStopping is a process which may take several attempts – brief Interventions support this processThere are many opportunities to support youth to be smoke-free
• http://www.youtube.com/watch?v=oAoUeIDQsoo
The 3 A’s of Tobacco Cessation:
Ask … Advise … Assist
Designed for use by non-healthcare professionals
Coaches the practitioner how to communicate effectively to help with the difficult process of changing behavior and overcoming addiction
TEAMTobacco Education & Action Module
Tailored Interventions
Goal setting, development of coping skills and self efficacy, cognitive reframing, problem solving, positive reinforcement – Developing a Quit Plan - TEAM
Stop Smoking Medications
NRT: patches, gum, lozenges, inhaler
Bupropion (Zyban)
Varenicline (Champix)
Insufficient evidence that they are effective for general youth population, yet effective in adult populations to increase odds of quitting
Advise heavily addicted youth to discuss medications with their physician or pharmacist
MotivationSocial injustice
Environmental devastation
Marketing to youth
Formerly emphasis was on the dangers of tobacco
Traditional use of tobacco: a positive model for aboriginal and non-aboriginal youth
I’ll tell you why I like the cigarette business. It costs a penny to make. Sell it for a dollar. It’s addictive. And there’s fantastic brand loyalty.
http://www.youtube.com/watch?v=JndtG8Y7yfw
A Global Epidemic
Tobacco is grown in over 120 countries on more than 4 million hectares of the world’s agricultural land
Tobacco companies use exploited labour
Child labour is very inexpensive…
Environmental Impacts
Pesticide and fertilizer runoff from fields
Massive deforestation associated with tobacco curing
Workers suffer:
Pesticide poisoning
Green tobacco sickness
Lung damage
Environmental Impacts
Worldwide, an estimated 3/4 of a billion kilograms of cigarette butts are disposed of every year
They deposit nicotine, heavy metals, plastic fibers, benzene and other carcinogens into our environment
Cigarette butts can take up to 15 years to break down
Scenarios
1. You are a youth worker. Tyler (16) is in your office talking about an incident where he lost his temper. During the discussion he lets you know that he’s really trying hard to quit smoking and it’s turned him into a bit of a jerk.
2. You are a family friend. Christy is an 18 year-old who’s just found out that she’s two months pregnant. At a backyard BBQ, you notice that she’s on her 4th cigarette of the evening. She sits down beside you and starts to talk about her pregnancy.
Traditions
Please respect traditional use of tobacco
Social Ecosystem
Public Policy
Community( resources, norms)
Organizational(social, economic, political)
institutions)Interpersonal
(family, friends, social networks)
Individual (knowledge,
attitudes, skills, genetics)
Research states:
That fear-based just-say-no approaches to drug education do not work, and they never have. To date, traditional drug education programs have failed to have any significant influence on student behaviours.
Similarly, zero-tolerance drug policies have failed to solve student drug issues (instead they isolate the students who need connection with peers and caring adults the most).
Centre for Addictions Research of BC
Research States
Creating healthy physical and social environments for learning that builds connections. Benefits both academic and social development. Reduce engagement in high risk behaviours.
Developing health literacy – understanding skills and confidence needed to survive and thrive in world where substance use is common.
Asset – focused approach seeks to build on supporting personal capacity. 40 Developmental Assets.
Cognizant of risk – what factors about the environment contribute to risk? Important to know how to address risk and compensate for it.
Interactive Activity
Bullring Activity – Each string represents an asset and a risk your school currently has in regards to tobacco use.
Multiple uses: triggers, supports, personal assets etc…
Whole School Approach
Involves 3 interconnected areas for action that address student’s needs for: a healthy environment to learn and grow; healthy relationships and connections with peers, teachers and other school staff, and exposure to learning environments that help gain the knowledge and skills required to maximize their health and wellbeing. (Dan Reist)
Areas for Action: Utilizing the 4 Pillars framework: Policy; Parnership & Sevices; Social & Physical Environment; Teaching & Learning
Utilizing the 4 Pillars Framework:
Brainstorm for each pillar what your school could do to address tobacco use.
How does your school function to promote wellbeing?
How does your school address building personal capacity?
Resources
QuitNow:1-877-455-2233 www.quitnow.ca
Click on “Resources for Health Professionals”
http://www.becomeanex.org/
www.bccancer.bc.ca/PPI/Prevention/tobacco
www.interiorhealth.ca >choose health> tobacco reduction
www.otru.org→ Training → Online Course → Tobacco and Public Health: from Theory to Practice.
http://www.healthyheart.bc.ca/clinicalprevention
More Links
Global social justice issues: http://www.globalissues.org/article/533/tobacco http://www.eclt.org/ http://www.who.int/tobacco/resources/publications/rights_child/en/ http://www.corpwatch.org/article.php?id=14947 Environmental Impacts: http://www.nsra-adnf.ca/cms/file/pdf/factsheet.pdf http://www.ash.org.uk/files/documents/ASH_127.pdf http://www.who.int/tobacco/en/atlas16.pdf
Tobacco Free Youth