The Indian smoke-free law: An overview of the Worksite Wellness resource kit and posters

1. The Indian smoke-free law: An overview of the Worksite Wellness resource kit and posters Monika Arora Head: Health Promotion and Tobacco Control, PHFI & Director HRIDAY

2. Overview of presentation • Smoke-free law • Smoke-free workplaces tool-kit • Smoke-free posters • Statement of commitment

3. “Ever since I have been grown up, I have never desired to smoke and have always regarded the habit of smoking as barbarous, dirty and harmful. I have never understood why there is such a rage for smoking throughout the world. I cannot bear to travel in a compartment full of people smoking. I become choked.” • Mahatma Gandhi THE STORY OF MY EXPERIMENTS WITH TRUTH PART 1, CHAPTER VIII And it took us nearly a century to realize this fact.

4. Why Smoke-free…? • Scientific evidence has unequivocally established that tobacco consumption and exposure to tobacco smoke causes death, disease and disability. • There is clear scientific evidence that prenatal exposure to tobacco smoke causes adverse health and developmental conditions for children. • The right of everyone to the enjoyment of the highest attainable standard of physical and mental health is recognized under ICESCR, WHO Constitution, CEDAW and the CRC • The constitution of India recognises right of every person to pollution free clean air. • Supreme Court declared it as law of the land since 2001.

5. Secondhand smoke exposure causes heart disease and lung cancer in nonsmoking adults. Nonsmokers who are exposed to secondhand smoke at home or work increase their heart disease risk by 25–30% and their lung cancer risk by 20–30%. Harms the cardiovascular system that can increase the risk of heart attack. People who already have heart disease are at especially high risk. Causes respiratory symptoms in children and slows their lung growth. Causes sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, and more frequent and severe asthma attacks in children. There is no risk-free level of secondhand smoke exposure. In the USA, most exposure to tobacco smoke occurs in homes and workplaces. Hazards of Second Hand Smoke

7. India is now free from tobacco smoke • On October 2nd 2008, India introduced new regulations to make virtually all public places and workplaces in the country smoke-free. • Section 4 of the Cigarette and Other Tobacco Products Act categorically provides that: “No person shall smoke in a public place” • Section 3 (l) of the Act defined Public place to mean: “any place to which the public have access, whether as of right or not, and includes auditorium, hospital buildings, railway waiting room, amusement centres, restaurants, public offices, court buildings, educational institutions, libraries, public conveyances and the like which are visited by general public but does not include any open space” • However, the rules first notified in 2004 and again in 2008 covered important open public palaces by providing that “open space” “shall not include any place visited by the public such as open auditorium, stadium, railway station, bus stop and such other places”

8. Salient features of the smoke-free law • A law in consonance with international obligation under Article 8 of the WHO Framework Convention on Tobacco Control • With broad objectives to: • Protect non-smokers’ right to pollution free clean air • Impose progressive restrictions • Improve public health. • And appropriate punishments for violations

9. Smoke-free is possible • Nearly 335 million people globally live in smoke-free environments. • Smoke-free air laws work. They are popular, effective, good for the business, and compliance rates are very high. • No wonder they are spreading so quickly worldwide.

10. Smoke-free works • The Health and Economic Impact of New York’s Clean Indoor Air Act revealed that: • Exposure to SHS declined markedly among hospitality workers as did self-reported sensory irritation (eye, nose, and throat). • The law has not had an adverse financial impact on bars and restaurants. • A Study in Helena, Montana revealed: • during the 6 months in which the law was implemented, the number of admissions for AMI decreased significantly compared with levels before the law was implemented and after the law was suspended (about 40%).

11. The Smoke-Free New York City: A One-Year Review • Business tax receipts in restaurants and bars are up 8.7%; • Employment in restaurants and bars has increased by 10,600 jobs (about 2,800 seasonally adjusted jobs) since the law’s enactment; • 97% of restaurants and bars are smoke-free; • New Yorkers overwhelmingly support the law; • Air quality in bars and restaurants has improved dramatically; • Levels of cotinine, a by-product of tobacco, decreased by 85% in nonsmoking workers in bars and restaurants; and • 150,000 fewer New Yorkers are exposed to second-hand smoke on the job.

12. auditorium, • hospital buildings, • railway waiting room, • amusement centres, • restaurants, • bars, • discotheques, • refreshment rooms, • banquet halls, • canteen, • coffee house, • pubs, • airport lounge (airports can have a facility of providing separate smoking lounge) • public offices, • court buildings, • educational institutions, • libraries, • WORKPLACES (PRIVATE OFFICES) • banks • shopping malls • cinema halls • open auditorium • historical monuments • public parks • stadium • railway station • bus stop • public conveyances • And the like which are visited by general public Public Places (as per sec.4)

13. Public place must have the following Sign Board

14. At every…!! • Entrance; • Floor; • Staircase; • Entrance of the Lift; and • Conspicuous place(s) inside • Prominently display the name of the person to whom a complaint may be made in case of violation of the regulations. • No Ashtray, Matchsticks, lighters or other things are placed to facilitate smoking

15. Authorized by the Central Government

16. Prototype of a challan

17. Responsibility of the In-charge at Workplaces • Ensure that correct signages are displayed at appropriate places within the workplace. • A person is designated to attend to any complaint of violation of the smoke-free rules. • Ensure that appropriate action is taken in case of any violation on site. • Delhi High Court has already laid that under the new rules in-charge of a public place (including workplaces) is competent to issue challan and collect fines and deposit the same to exchequer.

18. Toolkit on Smoke-free Healthy Workplaces

19. Section I: Smoke- free Workplaces • Need for “Workplace Wellness Initiative” • Obligation under FCTC and COTPA (Indian Law) • Adverse health effects of tobacco smoking at workplaces • Occupational diseases • Cardiovascular • Cancer • Impact on women • Impact on children • Respiratory and Lung diseases

20. Contd… • Benefits of smoke-free workplaces • For employers • For Employees • Strategies to make workplaces smoke-free • Build a smoke-free policy • Create a supportive workplace environment • Provide occupational health services • Myths and Realities about smoke-free workplaces • Myth created by the tobacco industry and the reality proved by research

21. Section II: Case Studies on Smoke-free Workplaces • Workplaces Johnson and Johnson- March, 2008 • Rajasthan Police Academy- May 2008 • Dell India- October, 2008 • Bangalore Metropolitan Road Transport Corp- November, 2005

22. Contd… • Best smoke-free global practices • Around 20 countries have implemented smoke-free policies in all public places to a great extent • Frequently Asked Questions • Answers to apprehensions which a workplace might have

23. Section III: Workplace Tobacco Cessation • Helping employees quit tobacco use • Employers have a responsibility to provide cessation information/support to employees • Options available for tobacco cessation • Quitline by American Cancer Society

24. Workplace Smoke-free Posters • PHFI and HRIDAY in consultation with other partners is developing series of posters targeted to multi-audiences from different worksite setups, including but not restricted to: • Cafeterias - Working floors • Factories - Mines • Hospitals - Banks • Board rooms - Airports • Garages - Hotels and Restaurants • Malls - Indoor construction sites

25. Statement of commitment • We look forward to a long term partnership with the corporate houses in promoting wellness at worksites and hope that there is expressed a commitment to this initiative. • We propose that this is documented and expressed at an appropriate fora like the 14thWCTOH in Mumbai. • We believe we would have corporate houses committing their support to: • Smoke-free workplaces • Facilitating cessation services at worksites • Health promotion activities

26. Thank You