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Smoke-Free Air Policy Strategies

This module provides an introduction to the importance of comprehensive smoke-free air laws in China, the dangers of secondhand smoke, and the implementation and enforcement of smoke-free policies. Learn the impact of tobacco use in China, the Framework Convention on Tobacco Control, and the essential elements of effective smoke-free laws.

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Smoke-Free Air Policy Strategies

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  1. Smoke-Free Air Policy Strategies

  2. Module 3: Smoke Free Air Policy Strategies Introductions • Name • Background • Reason for being involved with tobacco control

  3. Module 3: Smoke Free Air Policy Strategies Ice Breaker Expectations

  4. Module 3: Smoke Free Air Policy Strategies About This Module • Smoking is very much a part of Chinese culture, where overall tobacco consumption continues to increase. • Comprehensive smoke-free laws are critical for preventing the dangerous effects of secondhand smoke • The FCTC guidelines can provide the direction needed to institute successful city wide comprehensive smoke-free air policies • Well enforced smoke-free air laws save lives, are popular, change social norms, and produce a harmonious society

  5. Module 3: Smoke Free Air Policy Strategies Learning Objectives At the end of this module, you will be able to: • Describe the current and projected impact of tobacco use in China • Explain the purpose of the Framework Convention on Tobacco Control • Describe the dangers of secondhand smoke and why smoke-free policy is critical for preventing its harmful effects • Describe the seven essential policy elements that should be included in effective smoke-free law. • Identify the elements required to implement and enforce smoke-free air policies • Define realities that will refute myths related to tobacco use.

  6. Module 3: Smoke Free Air Policy Strategies Module Sections Section 1: The Big Picture: Problem and Solutions Section 2: Essential Elements of Model Policy Section 3: Model Policy Implementation and Enforcement Section 4: Myths and Realities

  7. Module 3: Smoke Free Air Policy Strategies Agenda

  8. Module 3: Smoke Free Air Policy Strategies Logistics • Parking, bathrooms, schedule • Participation • Group rules • Certification • Participant Guide

  9. Module 3: Smoke Free Air Policy Strategies Section 1: The Big Picture: Problem and Solutions

  10. Current Cigarette Consumption – Top 5 Countries Section 1: Big Picture: Problem and Solutions These five countries consume more than half of the world’s cigarettes. Source: Tobacco Atlas 4th edition, tobaccoatlas.org

  11. Section 1: Big Picture: Problem and Solutions Growth of the Tobacco Epidemic in China since 1953 1534.1 SOURCE: WHO National Tobacco Control Office

  12. GATS China 2010 Key Findings Section 1: Big Picture: Problem and Solutions 301 Million Current Smokers .

  13. Tobacco Industry in China Section 1: Big Picture: Problem and Solutions Tobacco Industry is Large Part of Economy • 33 province companies • 57 enterprises of cigarette industry • More than 1000 commerce agencies • 510,000 staff • 16,530 retail shops • Contributions to social causes Output and Sale of cigarette • Increased 16% since Chinese government signed FCTC • Some estimate that consumption is almost 2 trillion cigarettes per year

  14. China Projected Tobacco-related Deaths Section 1: Big Picture: Problem and Solutions • Resource: MOH White Paper p.8

  15. Section 1: Big Picture: Problem and Solutions What are some possible solutions to the challenges cities face to reduce tobacco use?

  16. Framework Convention on Tobacco Control Section 1: Big Picture: Problem and Solutions • Developed in response to global tobacco epidemic • Evidence-based treaty • First international health treaty • Signed by 176 countries • Became effective in China in January 2006

  17. MPOWER Section 1: Big Picture: Problem and Solutions http://www.who.int/tobacco/mpower/publications/zh_tfi_mpower_m.pdf

  18. MPOWER Section 1: Big Picture: Problem and Solutions • Protect everyone from secondhand smoke. • Prompt more smokers to quit. • Increase the number of successful quit attempts. • Reduce the number of cigarettes smoked. • Discourage kids from starting to smoke. Protect people from tobacco smoke

  19. Section 1: Big Picture: Problem and Solutions Smoke-Free Laws: Global Progress WHO Report on the Global Tobacco Epidemic, 2009: Implementing Smoke-Free Environments Source: The Tobacco Atlas, 3rd Edition, 2008.

  20. Section 1: Big Picture: Problem and Solutions What is secondhand smoke? What are the dangers of secondhand smoke? What is Smoke-free Policy? What are the health benefits of smoke-free laws? How do these laws change society’s attitudes and smoking behavior? Fundamentals Of Secondhand Smoke & Smoke-free Policies

  21. Section 1: Big Picture: Problem and Solutions Secondhand Smoke & Smoke-free Policies What is secondhand smoke?

  22. What is secondhand smoke? Section 1: Big Picture: Problem and Solutions • Secondhand smoke is mixture of smoke released by the cigarette, cigar, or pipe AND exhaled smoke by the smoker. • Secondhand smoke contains over 2,000 chemicals produced when tobacco products burn. • National Cancer Institute. Monograph No. 10. 1999; p. 12

  23. Section 1: Big Picture: Problem and Solutions What is secondhand smoke? Toxins in SHS (cont.) • DDT • Formaldehyde • Hydrogen cyanide • Carbon monoxide Plus many others. • National Cancer Institute. Monograph No. 10. 1999; pp. 14 -16

  24. Section 1: Big Picture: Problem and Solutions Secondhand Smoke & Smoke-free Policies 2. What are the dangers of secondhand smoke?

  25. Section 1: Big Picture: Problem and Solutions Dangers of Secondhand Smoke Secondhand Smoke causes: SHS increases risk of: Sudden Infant Death Respiratory Infections Ear Problems • Lung Cancer • Heart Disease Deaths • Asthma • Pneumonia • Bronchitis • Low birth weight babies Scientific evidence shows that there is no safe level of exposure to secondhand smoke.

  26. Section 1: Big Picture: Problem and Solutions Dangers of Secondhand Smoke • SHS endangers everyone • Certain groups are at special risk • Children • Pregnant women • People with asthma or cardiovascular disease

  27. Section 1: Big Picture: Problem and Solutions Dangers of Secondhand Smoke Harm to Non-Smokers • Exposure to secondhand smoke is not as deadly as active smoking, but it still kills. • Chronic exposure to secondhand smoke causes the same diseases as active smoking, as well as additional diseases and conditions in children. • In China it is estimated that more women die from exposure to passive smoking than die from active smoking.

  28. Section 1: Big Picture: Problem and Solutions Dangers of Secondhand Smoke Why protection from secondhand smoke is critical: • Exposure to secondhand smoke is widespread • Most nonsmokers do not choose to be exposed • Secondhand smoke exposure is completely preventable

  29. Section 1: Big Picture: Problem and Solutions Secondhand Smoke & Smoke-free Policies 3. What is smoke-free policy?

  30. What is a Smoke-free City? Section 1: Big Picture: Problem and Solutions A “smoke-free city” is a city that has adopted and implemented legislation that prohibits smoking in all indoor workplaces, all indoor public places, and all public transportation, with no (or very limited) exceptions. -- World Health Organization Guide: Making Cities Smokefree 2012

  31. Section 1: Big Picture: Problem and Solutions What is Smoke-free City? Smoke-Free Policies: Mandate 100% smoke-free indoor environments to minimize confusion and facilitate compliance • Worksites • Transportation – subways, buses, taxis • Hospitals • Restaurants • Bars/Pubs Schools – elementary, middle, high schools Universities/Colleges Public places – stadiums and sports venues, movie theaters, museums, libraries, shopping malls

  32. Expected Outcomes of Smoke-Free Policies Section 1: Big Picture: Problem and Solutions • Smoke-free policy will apply to indoor worksites and public places • Smokers will comply with this smoke-free policy • Sites will experience improvements in air quality • Secondhand smoke exposure will be reduced among employees, customers and visitors

  33. Section 1: Big Picture: Problem and Solutions Secondhand Smoke & Smoke-free Policies 4. What are the health benefits of smoke-free policy?

  34. Health Benefits of Smoke-free Policies Section 1: Big Picture: Problem and Solutions International Agency for Research on Cancer (IARC) Report: Evaluating the Effectiveness of Smoke-free Policies (2009) Smoke-free workplace policies lead to: • Substantial decline in SHS exposure • Decreased respiratory symptoms (e.g., coughing, wheezing) in workers • Reduced cigarette consumption among continuing smokers

  35. Section 1: Big Picture: Problem and Solutions Health Benefits of Smoke-free Policies Institute of Medicine Report: Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence (2009) • Secondhand smoke causes acute coronary events, including heart attacks • A brief exposure to secondhand smoke can trigger an acute coronary event • Smoke-free laws cause a decrease in acute coronary events

  36. Section 1: Big Picture: Problem and Solutions Health Benefits of Smoke-free Policies New England Journal of Medicine (2001) • Smoke-free laws reduced hospital admissions for asthma among children • Although smoke-free laws aimed at adult workplaces and public places, children were also safer • Smoke-free policies resulted in more homes becoming smoke-free

  37. Section 1: Big Picture: Problem and Solutions Secondhand Smoke & Smoke-free Policies 5. What are other benefits of smoke-free policies?

  38. Other Benefits of Smoke-Free Policies, from Global Experience Section 1: Big Picture: Problem and Solutions • Change visual messages • Set a positive example for youth • Change social norms • Engage nonsmokers and ex-smokers • Build support for comprehensive tobacco control

  39. Accelerated Social Change Section 1: Big Picture: Problem and Solutions With tobacco control in other countries, social change has taken decades. The challenge in China is to accelerate social change so that it happens in years, not decades

  40. China’s Progress Section 1: Big Picture: Problem and Solutions • FCTC in effect in China: January, 2006 • Existing laws since 1987: ad bans, smoke-free areas, health warnings, health education • Active organizations/people • Data: prevalence, mortality, economic • Prevalence trends: Now some ex-smokers • No smoking: Great Hall, Olympics and World Expo, city initiatives

  41. China’s Progress Section 1: Big Picture: Problem and Solutions Authors: adopted by the Conference of the Parties to the WHO FCTC Number of pages: 9 Publication date: 2007 Languages: Arabic, Chinese, English, French, Russian, Spanish

  42. Article 8 Guidelines:Protection from Secondhand Smoke Section 1: Big Picture: Problem and Solutions • Consistent with science on secondhand smoke • Include all key elements in a model law • Apply best practices in implementation from global experiences • Simple, clear, enforceable, and comprehensive

  43. FCTC Principle 1: Section 1: Big Picture: Problem and Solutions Article 8 Guidelines: Protection from Secondhand Smoke Total elimination of smoking and tobacco smoke in a particular space or environment. • Other approaches ineffective • No exemptions  Science: No safe level of exposure

  44. FCTC Principle 2: Section 1: Big Picture: Problem and Solutions Article 8 Guidelines: Protection from Secondhand Smoke All people should be protected from exposure to tobacco smoke.

  45. Section 1: Big Picture: Problem and Solutions Article 8 Guidelines: Protection from Secondhand Smoke Laws are necessary to protect people from secondhand smoke exposure. FCTC Principle 3:

  46. Section 1: Big Picture: Problem and Solutions Article 8 Guidelines: Protection from Secondhand Smoke Good planning and adequate resources are essential for successful implementation and enforcement of smoke-free policies. FCTC Principle 4:

  47. Section 1: Big Picture: Problem and Solutions Article 8 Guidelines: Protection from Secondhand Smoke Civil Society has a central role in building support for and ensuring compliance with smoke-free policies. • Raise public awareness about secondhand smoke • Create support for smoke-free policies FCTC Principle 5:

  48. Section 1: Big Picture: Problem and Solutions Article 8 Guidelines: Protection from Secondhand Smoke The implementation of policies, compliance, and impact should be monitored and evaluated. FCTC Principle 6:

  49. Section 1: Big Picture: Problem and Solutions Article 8 Guidelines: Protection from Secondhand Smoke The protection of people from exposure to tobacco smoke should be strengthened and expanded as new scientific evidence and experiences indicate. FCTC Principle 7:

  50. Section 1: Big Picture: Problem and Solutions • Check Your Understanding • What are the strongest reasons to create smoke-free workplace policies? • Who do you think would benefit most from smoke-free workplace policies? • How has the World Health Organization’s Framework Convention on Tobacco Control created an international smoke-free movement? • What challenges do Chinese cities need to overcome to become smoke-free?

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