Creating Tobacco-Free Colleges and Universities with Inspiration from the Great American Smokeout

Creating Tobacco-Free Colleges and Universities with Inspiration from the Great American Smokeout

August 24, 2019 0 By Stanley Isaacs


Good afternoon everyone. My name is Josh Berry and I have the pleasure
to be joined today by my colleague at NACCHO who is my cohost for this webinar. I work with the Association of State and Territorial
Health Officials where I am an analyst of Health Promotion and Disease Prevention. I am very excited and looking forward to the
rich information that will be shared on today’s webinar, creating tobacco-free colleges and
universities with inspiration from the Great American Smokeout. My name is Megan Jourdan. I work with the National Association of County
and City Health Officials, NACCHO, and I also focus on tobacco and chronic-disease preventions. We welcome you to today’s interactive webinar. So as all of you can see we have a full agenda
to cover and we also have a number of meeting objectives. Our goals on this webinar are to learn more
about the 2016 Great American Smokeout and its focus on tobacco-free colleges and universities
to explore success stories on the implementation of tobacco-free colleges and universities
from health-department and college-university perspectives and to discuss how national events
like the Great American Smokeout can be leveraged to build support for tobacco-free colleges
and universities. ASTHO is the national nonprofit organization
representing public-health agencies and the United States, the US Territories and the
District of Columbia and over 100,000 public-health professionals this agency has employed. ASTHO members, the chief health officials
to these jurisdictions formulate and influence sound public-health policies and ensure excellent
in state-based public-health practice. ASTHO’s primary function is to track, devaluate
and advise members on the impact and formation of public or private health policy, which
may affect them and to provide them with guidance and technical assistance on improving the
nation’s health. NACCHO is the voice of approximately 2,800
local health departments across the country. This city, county, metropolitan districts
and tribal departments work to protect and improve the health of all people and all communities. NACCHO provides resources to help local health-department
leaders develop public-health policies and programs to ensure the communities have access
to the vital programs and services. People need to keep them protective from disease
and disaster. Additional NACCHO advocates on behalf of health
departments and federal-policy makers for adequate resources, appropriate public-health
legislation and sensible policies to address the myriad of challenges, faiths and communities. NACCHO is a nonprofit 501(c)(3) membership
organization located in Washington, DC. I serve as the Director for Community Health
Promotion for NACCHO. Thank you Megan, and a quick note on webinar
logistics: All phone lines for participants have been muted during this webinar and so
you are able to use your computer speakers or phone but not both to listen to today’s
webinar. If you have a question during our speaker
presenters please post it to the chat box on your screen at any time. These questions will be used during the Q&A
sessions following today’s presentations. A recording of this webinar will be posted
on the NACCHO and ASTHO websites within two weeks. The addresses to these websites will be available
at the webinar. Following the conclusion of the webinar you
will be automatically directed to an evaluation survey. Please take a few minutes to provide your
feedback. We look forward to receiving your comments. Joining us first on today’s webinar is Bidisha
Sinha from the American Cancer Society. Bidisha is the Director of Tobacco Control
Initiatives at the American Cancer Society’s Center for Tobacco Control. Previously Bidisha served in the US Department
of Health and Human Services Office of the Assistant Secretary for Health as Regional
Director working on Tobacco Prevention on Colleges and its Regional Advisor for Let’s
Move!, cities, towns and counties working to help lower childhood obesity. Bidisha Sinha received her Master’s in Public
health from Columbia University in New York, Bidisha thank you for joining us this afternoon. Good afternoon everyone. Thank you Josh for having me on the webinar
today and Megan for the introduction, I’m thrilled to be here to share with you all
a very exciting and new initiative at the American Cancer Society and to present a little
bit about the Great American Smokeout. First however I would like to share a little
bit of the background that provides the rationale for doing tobacco prevention on college campuses. If you look at a graph – if you look at this
graph that I have up right now – of “100% Smoke-Free Campuses” since 2005, you can see
a near-linear growth. In fact according to Americans for Nonsmokers
Rights Foundation as of October of this year at least 1,700 campuses are 100-percent smoke-free
and, of those, 1,400 have 100-percent tobacco-free policy. So you may as the question, “Why is this work
so necessary?” Well first there are over 4,500 colleges and
universities in the US so we have a long way to go. Secondly we know that there are over 20 million
college and university students in the US and more than a million of them are projected
to die prematurely from tobacco use. Essentially this is a campaign to save more
than a million lives. We also know that 90 percent of smokers begin
smoking by the age of 18 and fully 99 percent begin by age 26, highlighting, again, the
importance of supporting the college-aged and young-adult age groups with more and effective
tobacco prevention organization efforts. Why work on colleges specifically? College campuses are just fertile ground for
this work. You can change social norms by using the existing
educational environment to promote healthy behaviors that will last a lifetime. By using campus leadership, student-group
leaders, educational institutions have a valuable opportunity to shape future behaviors but
not only students but staff, faculty, administration and even visitors. We understand that campus leadership and college
health professionals have many pressing public-health priorities to address that effects student
safety and academic success, including alcohol and drug use, violence and sexual assault. While tobacco use and/or exposure may not
appear to demand the same level of urgent attention, cigarette smoking by using young
adults have immediate and long-term adverse health effects, including addiction and acceleration
and development of chronic diseases across a whole lifespan. To help prevent tobacco use on campuses our
initiatives ask that campuses adopt 100-percent smoke and tobacco-free policies. As mentioned earlier a lot of campuses are
already going 100-percent tobacco free, prohibiting the use of any and all tobacco products instead
of just combustibles on any and all campus grounds and properties, including residential
buildings, both indoors and out at all times by students, faculty, staff and visitors. Hundred-percent tobacco-free policies are
the gold standard because, again, they prohibit the use of all tobacco products, including
smokeless and spit tobacco, which contain nicotine and are addictive. They are not a safe alternative to cigarette
smoking. Many of the products cause oral, esophageal,
pancreatic cancer, gum recession, gum disease and tooth loss. They also increase risk of fatal heart attacks
and strokes. A lot of college policies that I mentioned
earlier now include e-cigarettes and that’s because they are seen as drug-delivery devices
that are used to inhale nicotine, which is the addictive agent in cigarettes and many
other potentially harmful substances. E-cig aerosol contains carcinogens such as
formaldehyde and acetaldehyde, to name a few. Use of e-cigarettes subject bystanders to
second-hand exposure, it creates confusion around enforcement and it may renormalize
the act of smoking. Permitting e-cigs on campus enables the dual-usage
with cigarettes, which can, as with smokeless-tobacco dual usage, perpetuate addiction and impede
cessation. Finally e-cigarettes may be a gateway to cigarette
smoking and so past the addictive substance nicotine; e-cig users can become dependent
and move on to cigarettes. Very quickly it’s also important to include
e-cigs on campuses because we have a lot of work to do especially to counter the industry,
which much like the traditional tobacco industry targets youth, tempting them with ads that
glamorize the usage of these products and also offering products that appeal to this
demographic. Another reason to go tobacco-free and I’m
skipping a few slides here, sorry for the confusion, so another reason to go tobacco-free
is an environmental one: 5.6 trillion cigarette butts are dumped into the global environment
annually. Butts are the single most commonly-collected
waste item in campus, park and beach cleanup. One-percent smoke-free policies result in
much less butt litter near campus buildings compared to campuses with limited or no restrictions. Studies found that 77 percent or more fewer
cigarette butts on campuses with 100-percent smoke-free campus-wide policies and lastly
going tobacco-free is just good economics. It reduces employee healthcare costs and increases
employee productivity. Numerous studies demonstrate that employees
who smoke tobacco have higher level of absenteeism and healthcare costs in comparison to employees
who do not smoke. Going tobacco-free reduces costs for grounds-and-building
maintenance, the costs of cleaning up this extensive pollution are borne entirely by
communities and institutions and not by tobacco manufacturers or their customers and it also
obviously reduces fire risk to buildings-and-grounds. I will now go back. I wanted to take some time to show you some
examples of campuses that have adopted policies that work. This is a 2011 study from Preventive Medicine,
which compared undergraduate smoking behaviors and attitudes of two Big 10 campuses with
similar demographics, that’s Indiana University and Perdue University. Indiana U implemented tobacco-free policy
in 2008 and reduced smoking problems by almost 4 percentage points in 2 years. Perdue had no comprehensive policy and saw
an increase in smoking problems from 9.5 percent in 2007 to 10.1 in 2009. High-use consumption rate also fell while
Perdue’s increased. The study also showed support for smoke-free
environments grew among IU students so you might come across some resistance into policy-adoption
states but if you continue to educate and provide adequate information throughout and
to everyone on campus, and establish enough support for those on campus who are trying
to quit, you will eventually see acceptance. Another great example is University of Michigan. Sixteen months after 100-percent smoke-free
policy was implemented in June of 2011, smoking by both faculty and staff dropped from 6 to
4 percent. Sixteen percent of students who smoked before
the policy influenced them to quit or attempt to quit and 29 percent of smokers reduced
consumption, all of this is obviously very significant. The policy in the University of Michigan is
strong because it includes residence halls and sporting venues. The policy endorsed throughout the campuses
and even during sporting events and there’s ample cessation support of students and beneficiaries. Quickly another great example is Ohio State
University. They have 100-percent tobacco and vapor free
policy implemented in 2014, a strong policy, again, that includes residence halls and sporting
venues and a policy enforced throughout campus and even during sporting and concerts – sporting
events and concerts – with signage and guards. Vendors in fact are given contracts, which
include information about the policy so they are not surprised when they come on campus. There’re a lot of resources out there to help
you do this work. The US Department of Health and Human Services
created the Tobacco-Free College Campus Initiative in 2012 to promote and support the implementation
of tobacco-free policies at universities and colleges in the US with wonderful, free online
resources that have helpful things such as toolkits, healthy templates and examples. You can visit them at tobaccofreecampus.org. TFGCI also sponsors the 1Day Stand, typically
twice-a-year when students are encouraged to quit using tobacco for the day with an
aim to quit for good. It raises awareness of the benefits of tobacco-free
campus policies and provides resources, such as how-to guides, et cetera, on their website,
which is 1daystand.org. Finally after having gone through some of
the backgrounds I’m excited to share another great new resource that will be beneficial
to this movement of going tobacco-free on campuses. The Center for Tobacco Control at the American
Cancer Society recently launched the Tobacco-Free Generation Campus Initiative or TFGCI for
short to accelerate the adoption and implementation of 100-percent smoke and tobacco-free policies
in colleges and universities across the nation. The new initiative addresses the critical
need and is being supported by the CVS Health Foundation as part of their Be the First Campaign,
which is a big campaign, a 5-year, $50 million commitment to deliver the first tobacco-free
generation. TFGCI our initiative at ACS features a grand
program, which I’ll be going over and will have a cessation-support component and also
will have assessment capacity. TFGCI will provide grants, ranging from $10,000.00
to $20,000.00 to 125 colleges over the next 3 years. In addition to grants the Society will provide
technical assistance and other resources to grantees. Funding is available to public or private,
nonprofit, higher secondary institutions that are accredited. In addition to other institutions of higher
learning this will include community and technical colleges, historically black colleges and
universities (HBCUs), tribal colleges and universities and vocational schools. Both institutions with partial smoke-and/or
tobacco-free policies and those without any policy are eligible to apply, but preference
will be given to those institutions that currently have neither a 100-percnet smoke nor a 100-percent
tobacco-free policy. Focus is on adoption on new policy so implementation
and enforcement only applications are not eligible. Our first round of applications or RFP was
focused on 19 states, from which we received 33 applications. The application opened earlier this year. Our first cohort of grantees includes 20 institutions
ranging from small, private colleges to large research institutions. Rounds two and three I’m excited to announce
will be open to all 50 states and our goal is to provide at least another 100 grants
over the next 2 grant cycles. For more information about the new RFP that’s
out today you can visit cacncer.org/tfgci. I also want to take a few minutes here to
highlight another wonderful ACS annual event, the Great American Smokeout or GASO. This year – ever year – GASO encourages smokers
to quit for a day, quit for good or make a plan to quit and raises awareness around the
many tools and resources they can use to help them quit. 2016 marks the 41st Annual Great American
Smokeout. The first Great American Smokeout occurred
on November 18, in 1976, when the California Division of the American Cancer Society got
nearly 1 million smokers to quit for the day. The Society took the program nationwide in
1977. Again you might wonder why GASO is so important
and why we’re increasing our efforts around this event this year. Tobacco use again remains the single-largest
preventable cause of disease and premature death in the US and tobacco kills more than
half and potentially as high as two thirds of long-term users and 42 million adults currently
smoke cigarettes and tobacco is responsible for nearly 1 in 5 deaths in the US. This year GASO is taking place on November
17 in conjunction with the announcement of our new grant program, which happened again
this morning. GASO will focus this year on 2 audiences,
the general audience as it does every year and also in the college, college audience. As usual we have developed many social media
for GASO. We also have a paid campaign this year targeting
youth and young adults and placing tweets, Facebook posts and Instagram messages in the
evenings when this group is likely to be out socializing. We also have tools and resources such as fliers,
table tents, social media graphics, GASO One Pagers, on cancer.org/smoekoutresources.com. Sorry smokeoutresources and again they’re
developed both for the general audience and also for college campuses so states do take
a look. The website again is cancer.org/smokeoutresources
and I encourage you to all please spread the word about the new initiative, about the new
grant program, please use all of our resources for GASO this year and I hope to receive applications
from you and your partners early next year. Thank you so much for your time. Thank you so much Bidisha for getting us started
with that wonderful presentation and so now I’d like to take an opportunity to introduce
Kathy Nichols who is the Associate Director of the University of Florida Area Health Education
Centers Program and the Immediate Past Chair of the University of Florida Tobacco-Free
Task Force. Since 2007 Ms. Nichols has directed a tobacco-training,
cessation and systems-change program that serves 37 counties in the northern part of
the State of Florida under the auspices of Tobacco-Free Florida. She is a certified tobacco-treatment specialist
and a certified health-education specialist. She received a Bachelor’s Degree with a Double
Major in Sociology and English from Jacksonville University and a Master’s Degree in Health
Education and Behavior from the University of Florida. Kathy thank you for joining us and the floor
is yours. Thank you. Thank you so much. It’s a pleasure to be here. I appreciate the opportunity. We’re going to dive quickly through my presentation
because I have a lot of slides. The first couple are sort of soundbites or
brief information on the University of Florida, some stats on us, our employees and student
information. I have a lot of slides that are a little text-heavy
but I’m going to jump through them knowing that you all should be receiving these slides
after the presentation and can review those at your leisure later but to do that let’s
keep going so you can, like I said, check these, check these out later. In sort we are a very large land, sea and
states-grant university. We’re in about a 2,000-acre campus in Gainesville,
Florida. We’re also home to the country’s only academic
health center with six health-related colleges on a single contiguous campus and we were
the first large-scale state university to go tobacco-free in Florida. So I’ve created a timeline to sort of give
you the process that we went through to go tobacco-free. As you can see you can kind of start the process
back in 2002 but really the activity began around 2007 through 2010 when we actually
went tobacco-free and we’ll come back to this periodically as you’re seeing now. So the 50-Foot Rule: We had one of those that
was implanted May 20 of 2002. The no-smoking policy went into effect for
indoor areas but it also allowed for no-smoking areas to be established within 50 feet of
campus buildings. Again you can read this later at your leisure
if you like. These are the signs that were posted and only
on the buildings, though, that were designated for that 50-foot rule and the outdoor ban
was only for select buildings, which typically meant that the person who managed that building
had to initiate a request for it so, in short, we didn’t see enough activity in that direction
to have most of our buildings even and nowhere near that, as a matter of fact, eventually
have this 50-foot destination — about 44 in all — by the end of the period of time
when we move forward and passed a stricter policy. This was a smoking hut as we commonly kind
of called them. Some of you might have seen these on other
campuses and this was constructed to allow for smokers to congregate and smoke sort of
away from the buildings but, again, they’re still in the general flow of traffic at times. So that brings to 2005. This was the Healthy Gators Coalition was
created to address more than just tobacco. They were actually created to address more
than just tobacco. They’re actually created to address the same
kinds of health indicators and concerns that Healthy People 2010 was also created to address
and but it focused on the UF population here at the University of Florida and we had a
really fabulous set of people who were in this group and that’s my first, really, pointer
is that you need to have for any situation where you’re trying to pass tobacco-free policy
you’ve gotta be really strategic and gather a great group of people together to spearhead
that. Champions are vitally important to the process
and we were fortunate to have had some excellent champions here at UF. You can see them listed. You’ll see the name at the top, Chris Machen,
who is chair. She was particularly influential. She also happened to be and she was very beneficial
to the process. She was the wife of our then president Bernie
Machen so – and which she also had tobacco at heart in terms of wanting people to be
healthy and not use tobacco and wanting our campus to be a healthy campus for everybody
to enjoy. She along with some other angels I’ll point
out, Jill Varnes also in the center that was very critical and Jane Emmeree at the bottom
right, I’ll mention her again in a few moments. So that group started and then we had – and
they made a difference. The 50-Foot Rule I mentioned a bit ago with
the help of Healthy Gators, another milestone was reached January 22 of 2007 when that was
expanded to include all buildings so the outdoor, outside building smoking restrictions were
expanded to include all buildings on the campus and the approval process for that included
Environmental Health and Safety Committee, Faculty Senate, the Administrative and Professional
Assembly and Student Government so it wasn’t done in a vacuum. It was absolutely with knowledge and approval
around campus as well. These are the signs that were posted at the
time, “No Smoking within 50 feet of Any Campus Building” and it was really nice. You can see that they kinda gave people an
idea about 20 paces or 3 car lengths or 15 yards on a football field was equivalent to
approximately 50 feet to try and help them gage how far away they needed to be from the
building but, as you can also kinda gage, that’s not really that far to have people
be away when you think about it but the other thing that came along that was great was cessation
opportunities for people so people were encouraged if they were interested in quitting using
tobacco of any kind that they can come and get help to do that. And compliance-wise we mostly relied on public
education. The building officials were critical to be
supporting that and keeping people backed away from the building that far if they were
using tobacco. Environmental Health and Safety assisted if
we had questions or concerns. Peer pressure: It’s still peer pressure model
but there were a few other issues that were of concern because we still had if you can
see there, those are cigarette butts at the time. These are old pictures thankfully and as you
can see quite a bunch there on the ground. And a little research done I mean gave us
some good insight into just how deleterious those tobacco and cigarette butts could be. We were talking millions over the course of
a year that would be on campus and cause problems, potentially, by leaching into the ground in
addition to fire hazards so those kinda concerns lead us each to the next part, which was that
Healthy Gators group produced a Tobacco Prevention Institution Task Force and this group was
created to create recommendations and action plan to reduce the use of tobacco among faculty,
staff, and students by 2010 so that was their goal. So this is the list of people who were critical
to that, the Chair, Jane Emmeree, I mentioned her a few moments ago, is listed at the top. I’m somewhere in there in the middle area. We had a really great group of people who
gathered together to brainstorm and figure out ways to move ahead to be able to have
more of a complete ban on tobacco on the campus and that leads us to a little bit of what
I do, which I won’t dwell on too long but I worked for the University of Florida Area
Health Education Centers Program and, at that time, and all these things just came together
wonderfully. I don’t think we could’ve recreated it if
we tried, our AHEC Tobacco Training and Cessation Program were funded through Tobacco-Free Florida. We’re very fortunate that we’re here on campus
however we’re also a statewide entity and it provides cessation in-person services throughout
the state for Tobacco-free Florida and we were established in 2007 and began providing
tobacco-cessation classes and we train healthcare professionals and healthcare profession students
to also work with patients to help them quit, in addition to systems-change activity that
we do. So this was incredibly tied in to what we
were doing on-campus at that time trying to push forward with our tobacco-free policy. We had easily, readily and free services on-site
here at UF for people who were interested in quitting. There’s sort of our brochure, one of our early
brochures as a matter of fact, which kinda shows what we do and that moves on to – from
there to – the Task Force’s recommendations so those – that group – the Tobacco Prevention
and Cessation Task Force and after all our meetings we ended up with a really solid document
that was then presented to the president in September of 2008: Very, very strong convincing
evidence of why our university should go tobacco-free and that went through an approval process
as well and so none of this is done that quickly. It’s great now in retrospect. It was definitely a process getting there
but, truly, because we had the champions in place and the wisdom of a lot of people involved
in this process it could’ve been a lot more difficult I would think in retrospect and
it was really wonderful. So the president and vice-president approved,
the General Counsel’s Office agreed and drafted the policy, the Board of Trustees, the Faculty
Senate, the A&P Assembly that I mentioned before and Student Government all approved
the tobacco-free policy that the campus enjoys now. The campus policy itself had a staggered implementation. You can see here that – and always – this
is a second kind of or third maybe at this point you know to make, which is you’ve got
to publicize this in advance and let people know so they’re aware so they can seek services
if they choose to or know how, figure out a way that they can make it through the day
without tobacco if they’re trying to do that and you know because ideally we help people
quit. That’s the goal but we can’t force them as
far as what they do off-campus. We’re just enforcing a policy that’s privy
to when they are on-campus so you’ll see some of the marketing that went out with internal
and external here for when this was going on and first we had the Academic Health Center,
which includes you know it also helps Cheyenne Hospital and the surrounding areas, the Academic
Health Center, as well as Ben Hill Griffin Stadium and Tobacco Free First and the very
first one was September 5, 2009, our large stadiums, we’re very big in football here
in Florida, Florida Gators (go Gators) [laughs] we had our first game on September 5 of that
year and knowing that it was coming, they were anticipating a July 1 rollout the next
year, they went ahead and did it early and we were really impressed and thrilled with
that happening and then the Health Science Center that I mentioned, November 1, very
shortly thereafter, went tobacco-free, again communications and marketing critical to the
process. You can see this is the poster that was everywhere
[laughs] at that time in terms of November 1, 2009, Tobacco-Free Together, et cetera,
and, again, we need help quitting so those are really critical. Make sure that you are able to point people
to services to quit if they have that interest and would like to quit. We – sorry I’m going to go back 2 seconds
– the entire campus went tobacco-free in July 1 of 2010 and this was the poster that was
related to that and these were everywhere, including around campus because we have over
a million visitors who come to UF annually for the games and other activities on campus
so at hotels and area businesses it’s a big effort to get these out, Florida Bridgewater-Alford
at University Relations was critical to that process and really helped move everything
along in terms of everyone knowing about the process. We did some preparatory tabling events. That’s me. [Laughs] There’s Florida, the one on the right
there, doing events beforehand to give people notice on-campus that it was coming, counting
down from 30 days to the actual event when we went tobacco-free, did a little carbon-monoxide
monitoring for people, and this is the actual recognition ceremony. It was so exciting that day. The room was just – it was just wonderful
and that’s Jane doing her presentation there and you can see some of the campus signage
in the upper-right corner. Again being prepared is important. Our County Health Department you can see in
the upper-right where it says “The Tobacco-Free Campus” in the black and the yellow there
provided an award for the university for going tobacco-free and helpful signage in a couple
other instances as well but that recognition was really wonderful and so with our policies
we’re still a peer-pressure model but we have incredible success considering how huge we
are and how widespread we are on this area but about a year afterward we started thinking
we need to keep supporting it because of those new-student influx and the million visitors,
et cetera, so we ended up making a second task force. This one’s focused specifically on the policy
that was passed, called the Tobacco-Free Task Force and so I was sort of – I was definitely
– involved in this and our Department of Health at the state level had some mini grants that
they were providing and they asked if we could participate or if we would be interested in
participating or trying to get one and I said, “Well, we’ve already got a policy passed,
it’d be great if we had support.” She said, “No, we’re doing that. We’re going to have funding not just to establish
a policy but actually but actually maintain and support policies. That’s wonderful. We would definitely like to participate. We applied and were awarded grants, a grant
that year, and in subsequent years it has been valuable, incredibly valuable to keep
the process going, keep it strong, and help us think of new ideas and work in new directions
as we’ve needed to. You can see the purpose for our task force
there “to support and sustain the policy and promote existing campus, community, and statewide
tobacco cessation resources.” You can see a little bit of what we do with
that. We have – I have – some pictures there showing
some things that we’ve done. You’ll see in the bottom-left, the Great American
Smokeout. That really is a critical one that we do,
annually. I think every year we’ve done that, some things
for Great American Smokeout, sometimes very large events. We’ve had over 1,500 people reached in one
of those events, in particular. Most years we have had students participate. Health professional students in particular
are interested in doing that. We give them a script. They go out and talk to people and provide
them with information about the campus resources that are available for people who’d like to
quit and we encourage them to become advocates and to approach people who are using tobacco. We have gotten some bystander videos that
are almost done and ready for release right now. You can see other events we’ve participated
in. In the upper-right there is the – that’s the
– signage that we’ve put around campus on posts everywhere, the “UF is tobacco free
EVERYWHERE”.” In the upper-left is the website related to
the Tobacco-Free Taskforce and the faculty campus activities. Other things are we of course publicize the
policy more, encourage enforcement and we – like I said, we – really encourage people
and educate them on how to interact with anybody that they might come across. I think that’s the majority of what I wanted
to tell you today. It was definitely “due to the vision and perseverance
of some very talented and committed individuals,” so, again, I would if you engage in this process
seek to find those who can support it and work with you to get a wonderful result and
you just keep plugging, Jane said, when we kept working on the document that was the
proposed changes, she said, “Just the document. We gotta just keep working on the document.” That was sort of and that was an excellent
way to just keep swimming and it worked and I’m really pleased to be able to report those
results to you so thank you for your time. Thank you Kathy for your presentation, that
was great. Our final speaker is Dr. Kevin Frentz. Dr. Frentz has over 35 years of experience
working in both higher education and public-health settings as a health advocate for both physical
and mental health. As a tobacco-prevention specialist for the
Florida Department of Health in Leon County, Dr. Frentz directed the Tobacco Program and
supervises the Healthiest Weight and Breast and Cervical Cancer Early-Detection Programs
for the County and as a health educator he is proud to serve as a teacher, coach, mentor,
cheerleader, role model and friend. In that vein as an aside I will say when I
served as tobacco-prevention specialist in Sarasota County, Florida ten years ago, Dr.
Frentz very patiently walked us through this process for our college campuses there. Thank you, Dr. Frentz, for joining us this
afternoon. Okay well thank you very much. I mean that’s how I would like to begin is
by just thanking everyone for this opportunity to share some of the insights I gained while
having helped implement the tobacco-free policy at FSU. We implemented our policy on January 1 of
2014 and after listening to what Kathy had to say what we did in many ways mirrors what
UF did and for a reason because many times I’d pick the brains of the people, like University
of Florida in relationship to thaw they were doing and – but – then in so many ways we
it just doesn’t. Our program did reflect what they did but,
in some ways, it didn’t because the culture at FSU is different. In fact when I met with one of the higher-level
administrators, they – I – pointed that well UF’s gone tobacco-free, what about FSU? And they said, “Well first of all you know
we’re different than the University of Florida, we’re going to have to take our culture and
our politics into consideration” and so that’s one of the things that made our effort different
is that we didn’t have as much support, initially. We had to go out and get buy-in and earn support
from faculty, staff and students and, as a result, our effort took a little bit longer
than University of Florida. We did get it done. Our effort took eight years of meetings, seemingly
endless, endless back-and-forth negotiations, developing partnerships, planning, having
activities and events and I hope no one else’s will take that long but that’s the thing I’d
like to point out, up-front, is I’m also now working with – I have left FSU and I’m working
with the Leon County Health Department and one of the priorities was to have University
of Florida A&M go tobacco-free as well as Tallahassee Community College and I’m really
being reminded of how each campus has to take its own approach to this. Everything definitely needs to be tailored
to the needs of each individual campus so, with that said, this has just been – this
is – a great opportunity for me to be able to not only review what we did at FSU, but
also to put into perspective what we’re about to start real. Well we’re in the process and we are going
to be doing and working with Florida A&M as well as TCC. Next slide please. All right when I was first asked to participate
in today’s webinar, my – I just spontaneously sat down and reflected on FSU policy effort
and, besides the specific activities and events, the thing that really first came to my mind,
which is what I thought would be good to share to someone who’s contemplating or putting
tobacco-free policy into place for their campus or either thinking about it or already doing
it is the things that really jumped out at me just as an initial covering or review of
what I’d done and working with others at FSU was something that was taught to me by a past
administrator or a person I worked for when we were talking about policy initiatives. It was reinforced that we follow the 3 P’s,
which is “Patience, Persistence and Perseverance.” I noticed that Kathy mentioned that and that
couldn’t be more true. I know we had to work long and hard to be
able to earn the support from key on-campus stakeholders, decision-makers and we had – it
went in – fits-and-starts and sometimes it would be great and things would be humming
along and then something would throw a monkey wrench into the works and so it’s those. That’s what got us through is constantly reminding
ourselves that other campuses have done this. We can do it too but we just need to not get
ahead of ourselves and not make any missteps but, at the same time, just stick with it
and persevere. The other thing that came back to me was – besides
that earning our support from campus key stakeholders, decision makers was just getting information
and support from other campus as well health association professionals, both on-campus
as well as at the national level. There’s all kinds of stuff available on the
websites and some – and finally on the last thing that came up, I was reminded of, is
just how often it’s just sometimes a matter of timing that you’re at the right place at
the right time but sometimes it’s because you put yourself at the right place at the
right time and that’s why having done the research you need to do, by making the contacts,
by developing partnerships, et cetera, and so, again, I — Kathy mentioned it and I – can’t
emphasize it any more is that we need to get – they need to get — buy-in and support from
campus stakeholders and decision makers and this just requires dogged determination, in
some instances, and some people will actually come to you. They’ll hear about what you’re trying to do
after you start getting the word out and that’s very reinforcing. Ill also have to admit that het experience
with the Tobacco-Free FSU Policy Initiative resulted in some of the highest of highs and
some of the lowest of lows in my professional career. I think I’ve heard that form other people. I’ve tried to take this initiative at their
campuses but, again, you have to take all of it in stride but one thing I never doubted
was whether or not it was worth it. I mean if we look at my background as a health
educator and if we remind ourselves is the leading preventable cause of death and illness
and we’re educating young minds and for them not to have a full career as a result of a
habit they picked up while they were on the college campus, that’s just unacceptable and
so that would give me the renewed initiative and energy to work in this direction and stay
on-track even when we were having pushback and then also when I was most frustrated and/or
demoralized it always seems like a new opportunity would present itself so I guess I’m saying
stick with it, don’t give up, giving up and not sticking with it is what the tobacco industry
has depended on and thrived upon so that’s one of the things we need to do is not allow
that tobacco industry to have that – make it that – let �em be that – easy for them
to do what they’re doing and continue doing. All right going along: Next slide, please. Other reflections is in hindsight is that
we did get some resistance. There was skepticism about “wait a minute,
we’re in an institution of higher education and why this public-health initiative? We’ve got a lot of other things, bigger fish
to fry in relationship to problem on campus” and some of it was just a conflict avoidance
from upper-level administrators and, of course, there’s conflict-avoidance from all levels
but mostly from people who just didn’t want to have something that’s conflictual getting
into the media and so part of it was making sure we took the approach that we were trying
to be inclusive and that we weren’t trying to violate anyone’s rights. I mean people do have the right to choose
but we kept pointing out that the environment, the campus, should not be – make it – easy
for people. We didn’t want to be enablers and that was
a difficult message to give out sometimes but that’s where our student leaders came
into play. We had student leaders and student volunteers
that helped us promote those messages so, going along with the messages, I would say
one of the things we need to do in fighting that resistance of skepticism, the conflict-avoidance
is conduct assessments of opinions, attitudes and behaviors with respect to tobacco use
on your campus, you know? We’ve got – we want to have – faculty, student
and staff surveys and meetings with selected VP’s to be able to just really get a good
feel for exactly where all your support is, objectively, where your support is and where
the resistance is. Understand the culture and politics and the
readiness for change on your campus so, again, this is more of a perspective that I’m taking
rather than a prescribed, step-by-step. It’s more you know identify your supporters
and thoroughly listen to the issues and concerns so that you can develop a reasoned and reasonable
response and I can’t emphasize that enough. One of the things we had to deal with were
students who came and joined our effort and they were very enthusiastic and sometimes
a little bit too enthusiastic and they took the approach that they would go and – without
our knowing about it but – make more of a conflictual or of a conflict with attacking
or being derogatory to smokers and we had to let them know that that’s part of our campus
population. They deserve respect and be treated with dignity
as well as everyone. So we started off like UF with designated
smoking areas and with the idea of eventually working toward tobacco-free policy for the
entire campus and we had 53 no-smoking zones and we basically put all our energy to doing
outreach, developing contacts and partnerships because you never know when you might need
and benefit from the support and inspiration they can provide. I was so many times surprised. In fact one instance we were really worried
when we found out that the new chair of the Faculty Senate was a two-to-three-a-day smoker
and we thought, “Oh my gosh that’s going to be the end of our efforts” because we had
already been stopped before with another campus organization because of someone who was a
smoker so we went and talked to him with an open mind and let him know that we’re not
going to take an aggressive approach, it was more to just try to protect people’s health,
he became one of our staunchest, most-loyal advocates. He said that well he wished someone would’ve
been there for him when he was a youth in college that could’ve maybe helped him never
use tobacco or provide smoking-cessation services and aids like we eventually started doing
as a result of somewhat with his help. So and the last thing on this slide is just
talking about preemption in Florida and many other states. There is preemptions what doesn’t allow you
to have policies at the local level that are more stringent than what’s allowed by legislature
and so we did get some resistance to that but, basically, I want to say is make sure
that you still make an effort because there are campuses at – in – Florida, as a preemption
state, that do have policies into place and do actually have enforcement and UF has done
a great job on – at – making sure everyone feels that the policy applies to them and
they’ve also done a great job of making the entire campus community proud of being a tobacco-free
campus and so that’s one of the things I recommend and in Florida International University also
has enforcement of their policies, in spite of the preemption. At FSU our General Counsel wasn’t willing
to allow us to have enforcement because they thought that stepped over the line of preemption
but we’re not working with, like I said, FAMU and FAMU is very open to the idea of having
enforcement in their policy. Again it’s not enforcement of relationship
defining but it’s having people go to an education class and be informed about the negative consequences
to others and of course the detrimental consequences that are on campus. Next slide, please. Hi Kevin this is Josh at ASTHO. I’m so sorry to cut you short but we need
to move on to Q&A for this afternoon’s webinar. Oh. As a reminder to folks who have been wondering,
we will be getting a recording of this meeting to you as well as the full slide deck so you’ll
be able to go through Dr. Frentz’s slides on your own time so thank you, Dr. Frentz,
for joining us. Okay thank you. Much appreciated and so now that we’ve had
a chance to hear from our three dynamic speakers we’re going to open the Q&A session and so
I would like to remind everyone if they have a question to ask for any of our presenters
please submit that in the chat box and we have a couple questions already flagged up
so I’d like to get those out to our speakers. So the first question we have is for Bidisha
at American Cancer Society. Bidisha, does the grant program that you discussed
include Hispanic-serving institutions, HSI’s? Yes hi Josh. Thanks for that question and absolutely. It’s open to all minority-serving institutions,
including Hispanic-serving institutions so yes and then again the grant, the RFP, is
open now at – on – cancer.org/tfgci. All right thank you so much Bidisha for that
response. We have another question as well and this
can go to Kathy to Dr. Frentz as well. This person is interested in what metrics
were determined up-front to track progress in tobacco-cessation initiatives on-campus? Well this is Kathy. I can tell you a little bit about what we’ve
determined here or what we’ve used to be persuasive. Part of it was the – and I don’t have this
data in front of me but we actually have a report that I could provide that was the – one
that was provided to our — the – president of our university at the time from the group
that had come up with the plan for how to go tobacco-free or have the policy taxed but
we definitely took a look at the use rates on-campus for students. We have the Healthy Gator Survey that’s sent
every 2 to 3 years that produced the percentage rates for daily and current use, which is
usually 30 days, is how that’s assessed. People have used tobacco in 30 days. That was helpful for us. We also had to gage it by the state’s data
for the use for – among – employees, which is significantly higher than the student use. We’re very fortunate that way. We’ve more recently been collecting data on
other products that at the time weren’t being used and I know those are being assessed right
now including e-cigarette use and hookahs, for instance, and some of that was mentioned
earlier in the program so we’re continuing to gage success and what with those measures,
the other interesting thing that was done at UF was and I kind of mentioned this but
that we had a researcher here who collected. He had students collect cigarette butts before
the policy was passed to, again, determine the deleterious effects on the campus and
came up with very – a very – good estimate of what that equated to. Those were off the top of my head but, like
I said, I’m happy to provide to Josh and if that’s possible I could provide that for them
to access later, would that be feasible, the report, that was actually written [crosstalk]
–? Yeah Kathy absolutely. Okay. And so thank you for your response. That cigarette-butt part is very interesting. Dr. Frentz, do you have anything to add to
that? Yeah just briefly we at FSU we utilize the
National College Health Assessment, which is from the American College Health Association
and plus we added some supplemental questions to that and then we also had a lot of focus
groups and smaller surveys that were conducted by the SGA itself in relationship to keeping
on top of how things are progressing. Tremendous, thank you so much, we have another
question that I’d like to direct to you, Dr. Frentz, and then maybe turn to Kathy as well. Do you have any schools thinking about amending
their policies to include fines along with the peer-pressure model? I – the only one I’ve heard that had considered
was FIU. I don’t know of any other schools that have
fines or contemplated having fines. Does anyone else know, Kathy, do you know
of any? I think actually and I don’t want to misstate
but I think that a local college here – Santa Fe College – at least in the past they’d had
fines but they also don’t have a completely tobacco-free campus at this point. I know the Health Department is working closely
with them and working toward that goal and but I believe they have signs if they are
smoking on-campus outside of the designated smoking area. I don’t think they’re incredibly high fines
but maybe $20.00 or $30.00 or something like that? So again I’d need to confirm that but I think
that’s accurate and I – we – we’re definitely not looking at that at UF right now. It’s kinda funny, one of the comments that
I like to note is that when people say, “Well what if you still find people? Obviously you’re addressing the use if you’re
seeing people,” what’s often now is to have the comparison from the between, you know,
before-and-after. I mean when I used to walk around campus,
you had smoking in your face constantly. With the 50-foot rule in place it didn’t matter,
it was still – you were still – subject to being exposed to tobacco smoke versus now
when there may be some clandestine area where somebody is going, which is still better in
terms of the exposure to others but it’s night-and-day between then-and-now and so we’re not, at
this point, interested in extending beyond the peer-pressure model right now. Sure thank you for that question and so I
believe we have time for one more question and I would like to pose this to Bidisha. What can health departments do to best celebrate
Great American Smokeout and to promote tobacco cessation? Yeah Josh again we do have – as I mentioned
earlier, we do have – a ton of resources available on our website, which is – gimme one second
– it’s cancer.org/smokeoutresources. Again it’s meant – we developed a whole bunch
of things such as tool kits, easy-to-use fliers and posters. We also have materials available for a Spanish
audience. Again we do have things targeted for a college
audience but we do have the general-audience materials that folks can use. I just want to mention that there’s infographics,
there’s badge graphic, there’s social media, things that you can use, it’s all available
and would be very easy if you are interested in pushing that out to colleges in your area
that you know may want to do this with you or that you already have partnerships with
so I’d definitely strongly encourage you to check all of those resources out and use them
or Gas Out, which, again, in just in a couple of days on the seventeenth. All right now thank you so much, Bidisha and
thank you everyone joining us for your questions and thanks, one more time, to Bidisha and
Kathy and Dr. Frentz for joining us and giving us remarks this afternoon and so before we
conclude we would like to briefly share tobacco resources that are available to you on the
ASTHO and NACCHO websites and so, Megan, I’d like to turn the floor over to you. Thank you, Josh. NACCHO collaborates with national, federal,
state and local organizations to provide local health departments with the resources needed
to reduce tobacco use and exposure. Our resources cover a broad range of issues,
including tobacco cessation, prevention of youth initiation, second-hand smoke prevention,
electronic smoking devices and other emerging products. We’re also collaborating with the American
Cancer Society to present a smoke-free housing webinar early next year and we’ll keep you
updated as to the exact date of that webinar. Additionally I would suggest that those interested
in any of the resources I just mentioned go to our website, www.naccho.org. We’ve just created new factsheets on e-cigarettes. We have an article coming out in January on
– in – The Journal of Public Health Management and Practice on how local health departments
can reduce exposure to – second-hand smoke exposure to – e-cigarettes and those interested
can also look through our Library of Model Practices to see how other health departments
have incorporated tobacco prevention, control, and other interventions in their communities. And so this is Josh again from ASTHO, and
so ASTHO’s tobacco-control program serves as a resource on perspectives, capacities,
challenges and opportunities to implement state-base tobacco control and prevention
initiatives and so we have a wide range of materials and resources on our tobacco webpage,
which you see there at the top of the screen and for more assistance you can contact myself,
Alicia Smith or Talyah Sands. You can also reach out to the Tobacco Control
Network by emailing [email protected] The Tobacco Control Network is an ASTHO peer
network comprised of tobacco-control program managers, additional tobacco-control programs
and additional staff from each state and territory and the District of Columbia and this wide
representation allows the network to access a wealth of expertise and experience from
across the country and so our partnership with TCN provides a valuable linkage to tobacco
programs across the nation and their partnership assists ASTHO in achieving our goals in tobacco
prevention and control with accurate state-level perspective and so the TCN continues to update
its website with new resources pertaining to state and territorial levels of tobacco
control and so we invite you to visit those resources at tobaccocontrolnetwork.org. So we do again have an evaluation survey that
you’ll be directed to in a moment and so we do value your contributions about today’s
webinar and so as we approach the top of the hour, this concludes today’s webinar and so,
once again, ASTHO and NACCHO would like to thank all today’s speakers for joining us
as well our staff who helped prepare the information shared on today’s webinar. A recording of today’s webinar will be available
on the ASTHO and NACCHO websites within the next 2 weeks at the web addresses seen on
your screen now and they will also be sent to you via email if you registered to join
us this afternoon. And if you have any follow-up questions about
today’s webinar please feel free to contact the respective teams at ASTHO and NACCHO so
thank you so much for joining us and please enjoy the rest of your day. [End of Audio]