Tobacco-Free Policy in Helena's City Parks: Improving Public Health

1. Montana Public Health Association ConferenceKaren G. LaneOctober 14, 2015 Tobacco Free Policy in Helena’s Developed City Parks

2. Health Impacts from Tobacco Tobacco use • leading preventable cause of death in the United States, >400,000 deaths each year. • 1,400 Montanans die from tobacco-related diseases cardiopulmonary disease, some cancers, and other illnesses as a result of their tobacco addiction. • On average, adults who smoke die 13 to 14 years earlier than nonsmokers.

3. Health Factors for the Non Tobacco User“Secondhand smoke” • 3rd leading cause of preventable death - killing 53,000 people in the U.S. each year. • It contributes to lung disease, aggravates asthma, impairs blood circulation, bronchitis and pneumonia. • In children - increased severity and number of asthma attacks, bronchitis and middle ear infections. • Infants - increased the risk of Sudden Infant Death Syndrome. • Secondhand smoke is a known human cancer-causing agent and scientific studies have demonstrated a direct relationship between exposure to secondhand smoke and lung cancer as well as heart and other diseases. • Nonsmokers are exposed to over 4,500 chemicals and 50 carcinogens in secondhand smoke. These chemicals include formaldehyde carbon monoxide, methane, lead and benzene.

4. Health Status Changes Among Persons Who Quit Smoking9 AFTERPHYSICAL BENEFITS • 2 Weeks Lung function and circulation improve • 9 months Lungs improve capacity to clear and reduce infection • 1 year Risk of heart disease drops to half that of a smoker • 5-15 years Risk of stroke is the same as that of a nonsmoker • 10 years Risk of lung cancer is half that of a smoker • 15 years Risk of heart disease is similar to that of someone who never smoked 9. The Cost of Smoking to Business.‖ American Cancer Society. www.cancer.org/docroot/NWS/content/NWS_2_1x_The_Cost_of_ Smoking_to_Business.asp

5. Outdoor 2nd Hand Smoke • No safe level of outdoor 2nd hand smoke • Outdoor levels may be as high as indoor levels and a health risk to people in close proximity • Exposure causes SIDS, asthma, cleft palate and premature death in children • People who begin smoking during adolescence frequently are addicted by age 20 and are more likely to continue as adults. • Role modeling unhealthy behaviors to young people. • Cigarette trash causes fires and wildfires • Small children playing in parks and on city rec grounds are more likely to ingest cigarette butts. Birds, fish eat tobacco trash. • Toxins in the tobacco products and wrappings pollute air, soil and water. - Lewis and Clark Co Board of Health Resolution

6. Tobacco-Free Outdoor Spaces • Mount Helena Music Festival • Symphony Under the Stars • Alive@Five • Shakespeare in the Park • Chalk Up Helena • City-County Health Department • Helena Youth Soccer Association • Tobacco Free Schools of Excellence • Blue Cross Blue Shield • YMCA • YWCA • St. Peter’s Hospital • Helena Food Share • Helena Housing Authority • Rocky Mountain Development Council • Helena Brewers • Centennial Park

7. Steps to Tobacco Free City Parks Policy Centennial Park>All developed parks Two Rounds of Assessment (2012 ,2014) Methods: 1) Community survey 2) Observational survey- YMCA Kid’s Camp, park clean-up 3) User groups phone interviews 4) Staff in-person interviews

9. Community Tobacco Survey Results 2012 Tobacco use should be prohibited in the following places:: % Total Outdoor Public Places

10. Park Cleanup 70+ K-5th graders

11. An hour’s worth of cigarette cleanup at Nature and Hill Parks *Two, 2-liter containers

12. LEWIS AND CLARKCITY-COUNTY BOARD OF HEALTHTO: Members of the City of Helena Commission: Mayor Jim Smith, Commissioner Dan Ellison,Commissioner Matt Elsaesser, Commissioner Katherine Haque-Hausrath, Commissioner Dick ThweattFROM: Lewis and Clark City-County Board of Health, Ken Wallace, Vice ChairRE: Recommendation to designate Centennial Park Tobacco FreeDATE: July 26, 2012On July 11, 2012, the City/County Parks Board voted unanimously to recommend to the City Commission that Centennial Park be designated Tobacco Free. The Lewis and Clark City-County Board of Health supports this recommendation. On July 26, 2012, the Board of Health passed a resolution to recommend that theCity of Helena and Lewis and Clark County pass policy that designates all public parks as tobacco free.

13. Tobacco-Free Centennial Park • City Commission • Adopted resolution • Tobacco-Free policy Centennial Park • December 3rd, 2012

14. Centennial Park Tobacco Free! • “You are receiving this message because you have been involved (in one way or another!) with some aspect or future project at Centennial Park. As you know we will be celebrating the "new and improved" Centennial Park on August 21, 2012. • The event will be a rededication of the park as well as recognition of the 10th Anniversary of Old Glory Landmark, held in conjunction with an Alive @ Five event in the park. I wanted to highlight two upcoming opportunities for you to promote your project, committee/organization and involvement in the park.” -Amy Teegarden, Director of Helena Parks and Recreation

15. Signs are Key

16. Centennial Park Tobacco Free 2012 Pilot > Promised to assess after initial period Second Round of Assessing Summer 2014 • 1) Community survey – added 2 questions • 2) Observational survey- YMCA Kid’s Camp, park clean-up • 3) User groups phone interviews • 4) Staff in-person interviews

17. Community Survey

18. Parks Clean-up YMCA Kid’s Camp

19. ONE hour of clean-up!!!

20. Results Suggested: • Broad acceptance of the policy when they are aware of it • Lack of awareness of the policy • More signs needed particularly in parking area, entrances, ball field and skate board park • More public education on an ongoing basis is needed • Continue to have T-F requirement in User Group contracts and add that they provide education to their constituents

21. City-County Parks Board • September 3rd meeting • Following this presentation and a discussion, the Board unanimously approved recommending to the City Commission continued tobacco-free policy at Centennial Park and expansion to the other developed City parks.

22. Presentations • City County Parks Board • Helena Administrative meeting –commissioners voted to include proposed resolution on Commission agenda • Board of Health meetings • Gathered Supporters for the City Commission meeting • Commission unanimously adopted the resolution for Tobacco Free Developed City Parks!

23. Again,Signs are Key

25. 150 signs Partnership Montana Department of Public Health and Human Services +HelenaParks and Recreation Department + Lewis and Clark Public Health

26. An Education and Awareness Campaign is Essential • Community involvement in planning and communication • Messages in multiple media & venues • Focus on the health and safety of everyone, not individual rights (not a protected class). • Give tips/role model on how to respond to violations • Publicize cessation resources-QuitLine

27. Think About ITHealthy Communities Coalition exercise*What would a Tobacco Free Park experience be like? *How would it feel, look, and smell?

28. What would you do if you saw someone smoking or spitting tobacco in the park? • Remembering your vision, how would you respond? What would you say?

29. What will you do to communicate to the public about our tobacco free parks? • Attend the launch events? • Bring family, friends, clients to the launch events? • Put articles or announcements in your newsletter? • Write a letter to the editor? • Be interviewed by the media?

30. Cultural/traditional use v. commercial/recreational use: MT Clean Indoor Air Act exemption: (e) a site that is being used in connection with the practice of cultural activities by American Indians that is in accordance with the American Indian Religious Freedom Act, 42 U.S.C. 1996 and 1996a.

31. What Else?

32. What successes and challenges have you experienced?

33. Contact information:Karen Lane, 406-457-8960klane@lccountymt.gov

34. Montana CIAA Protocol for Lewis and Clark County 11/16/2009, 3 of 4 Within the Act, the following definitions apply: 1) “Board” means the Lewis and Clark City-County Board of Health and its designees (Lewis & Clark County Tobacco Use Prevention Program). (2) “Cigarette” includes any electronic device, including but not limited to “electronic cigarettes,” that can deliver inhaled doses of nicotine by delivering a vaporized solution. (7) “Smoke” means: (a) the gaseous products (which carry airborne toxic particles) of burning tobacco or something similar to tobacco, or (b) the fumes and/or vapor (which carry airborne toxic particles) resulting from the action of heat on a liquid such as occurs in an ecigarette. 4 of 4 (8) "Smoking" or "to smoke" includes inhaling and exhaling the fumes of tobacco or something similar to tobacco or the act of lighting, smoking, or carrying a lighted cigar, cigarette, pipe, or any smokeable product.

35. LEWIS AND CLARK CITY-COUNTY HEALTH DEPARTMENT BOARD OF HEALTH - MINUTES 316 N. Park, Room 309, HELENA, MONTANA 59601 May 24, 2012 Ratification of the Montana Clean Indoor Air Act (CIAA) Implementation Protocols for Lewis and Clark County: Dorothy Bradshaw, Division Administrator, requested ratification of the Montana Clean Indoor Air Act Implementation Protocol for Lewis and Clark County, on pages 12-15 of the board packet. Dorothy highlighted the protocol definitions for reasonable distance, enclosed space, partially open space and the clarification of definitions for “cigarette” and “smoke.” Dorothy noted that the protocols were developed to further clarify the Montana Clean Indoor Air Act for businesses in Lewis and Clark County. Jeremy Gersovitz, deputy county attorney for Lewis and Clark County, stated that he was the prosecutor for the first case in Montana to go to trial under the Montana Clean Indoor Air Act. He asked the Board to ratify the Montana Clean Indoor Air Act Implementation Protocols that the Health Department adopted in November 2009. Jeremy stated that the County Attorney’s Office recommends formal ratification of the CIAA protocols by the Board of Health as the enforcing body of the CIAA law. Ratification is part of a general effort to make enforcement and documentation concerning the CIAA more efficient and clear. Commissioner Hunthausen made a motion to ratify, approve, and confirm the Montana Clean Indoor Air Act Implementation Protocol for Lewis and Clark County. Mayor Strainer seconded the motion. The motion carried 5-0.