Tobacco Policies For Colleges g & Universities Fayetta Royal, MA Tobacco Prevention & Control Coordinator Alabama Department of Public Health Area 3

Wh Implement Why I l Tobacco T b Free F Policies P li i ? ‡

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The 2006 U.S. Surgeon g General’s Report p on the Health Consequences of Involuntary Exposure to Tobacco Smoke. Th American The A i College C ll Health H lth A Association i ti (ACHA) Position Statement on Tobacco on College and University Campuses, September, 2009. Findings from the National College Health Assessments

Source: Centers for Disease Control & Prevention American College Health Association

Th 2006 U.S. The U S Surgeon S General’s G l’ Report R ‡

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Secondhand smoke exposure p causes disease and premature death in children and adults who do not smoke. Child Children exposed d tto secondhand dh d smoke k are att an increased risk for sudden infant death syndrome (SIDS), acute respiratory problems, ear infections, and asthma attacks, and that smoking by parents causes respiratory symptoms and slows lung growth in their children.

Source: Centers for Disease Control and Prevention

Th 2006 U.S. The U S Surgeon S General’s G l’ Report R ‡

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Exposure of adults to secondhand smoke has immediate and d adverse d effects ff on the h cardiovascular di l system and d causes coronary heart disease and lung cancer. There is no risk-free level of exposure to secondhand smoke. k Establishing smoke-free workplaces is the only effective way to ensure that secondhand smoke exposure does n t occur not ur in th the workplace, rkpl because b u ventilation ntil ti n and nd other air cleaning technologies cannot completely control exposure to nonsmokers to secondhand smoke.

Source: Centers for Disease Control & Prevention

A American i College C ll H Health lhA Association i i ‡

ACHA ((American College g Health Association)) acknowledges and supports the finding of the Surgeon General that tobacco use in any form, active and/or passive is significant health hazard. passive, hazard

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ACHA recognizes g that environmental tobacco smoke has been classified as a Class-A carcinogen and that there is no safe level of exposure to environmental tobacco smoke (ETS), (ETS) a recognized toxic air contaminant. contaminant

Source: American College Health Association

A American i College C ll H Health lhA Association i i ‡

ACHA in light g of these health risks,, adopted p a NO TOBACCO USE policy and encourages colleges and universities to be diligent in their efforts to achieve 100% indoor and outdoor campus-wide campus wide tobacco free environments.

Source: American College Health Association

N i l College National C ll H Health lhA Assessments ‡

ACHA ((American College g Health Association)) 2008 National College Health Assessments showed that 83% of college students described themselves as non-smokers (never smoked or have not smoked cigarettes in the last 30 days); 90% reported being non-smokers for hookah/water pipes (never used or have not used in the l 30 d last days); ) and d 97% described d ib d themselves h l as non-users of smokeless tobacco (never used or have not used in the last 30 days.) y )

Source: American College Health Association

T b Tobacco Policy P li Implementation I pl t ti ‡

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Develop a strongly worded tobacco policy that reflects the h b best practices i iin tobacco b prevention, i cessation, i and d control. Inform all members of the campus community by widely id l distributing di t ib ti th the campus ttobacco b policy li on an annual basis. The tobacco policy is clearly posted in the employee and student handbooks, on the college/university website website, and in other relevant publications. Key components of the policy are also shared with parents, alumni/ae, and visitors. The general p g policy y should be included in p prospective p student materials in both printed and electronic formats.

Source: American College Health Association

T b Tobacco Policy P li Implementation I pl t ti ‡

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Offer and promote prevention and education initiatives that h actively i l support non-use and d address dd the h risks i k off all ll forms of tobacco use. Offer and promote programs and services that include practical, ti l evidence-based id b d approaches h tto end d ttobacco b use, including screenings through health and counseling services, free/reduced-cost tobacco-cessation counseling, free/reduced-cost nicotine replacement therapy, therapy and medication options on campus. Advocate for the inclusion of tobacco use cessation products medications, products, medications and services in student health insurance plans. materials in both printed and electronic formats. Source: American College Health Association

T b Tobacco Policy P li Implementation I pl t ti ‡

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Provide a comprehensive p marketing g and signage g g effort to ensure that all college/university visitors, vendors, guests, and others arriving on property owned or leased by the institution are aware of the tobacco-free tobacco free policy. policy Plan, maintain, and support effective and timely implementation, administration, and consistent enforcement if all college/university tobacco-related policies, rules, regulations, and practices. Provide a wellpublicized reporting system for violations. violations Source: American College g Health Association

T b Tobacco Policy P li Implementation I pl t ti ‡

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Collaborate with local,, state,, and national p public health entities and tobacco prevention and control public, private, and national non-profit tobacco-related organizations in support of maintaining a healthy tobacco-free environment, Develop and maintain a tobacco task force on campus to identify and address needs and concerns related to tobacco policy, compliance, enforcement, and cessation.

Source: American College Health Association

T b Tobacco Policy P li Implementation I pl t ti ‡

Key y individuals and departments p to invite/include: / „ „ „ „ „ „ „

Undergraduate and graduate students (particularly from student-elected/representative organizations) Health and counseling center professionals Faculty (including faculty senate or other faculty governing bodies) Residence life/housing Judicial affairs Campus safety/police Human resources

g Health Association Source: American College

T b Tobacco Policy P li Implementation I pl t ti „ „ „ „ „

Campus p safety/police y/p Human resources Neighborhood liaisons Facilities Other important stakeholders specific to your campus

Source: American College Health Association

T b Tobacco Free F Policy P li Implementation I l i ‡

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Combines traditional tobacco education/cessation / programs with efforts to create a physical, social, and policy environment that supports tobacco-free campuses I di id ll f Individually-focused d programs (e.g. ( education d ti and d cessation programs) with environmental management strategies (e.g. creating a tobacco-free normative environment, developing and enforcing tobacco-related rules and policies) to create a campus environment that promotes healthful decisions about tobacco use Source: Tobacco Technical Assistance Consortium College g Tobacco Prevention Resource

Str t i for Strategies f r Comprehensive C pr h i P Policy li ‡ ‡ ‡ ‡ ‡

Create a tobacco-free normative environment Restrict tobacco sales, advertising, and promotion Increase and enforce sound tobacco-related rules and policies Educate students about tobacco prevention Offer tobacco cessation programs g designed g for college g students

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

Create a tobacco-free normative environment i ‡ ‡ ‡ ‡

Changing g g the p physical y environment so that campus building are tobacco-free Make resident halls tobacco-free Move tobacco use users away from building entrances. Prohibiting tobacco use on all university property, i l di including outdoor td areas.

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

Create a tobacco-free normative environment i ‡

Implement p social norms marketing g campaigns p g designed to correct misconceptions about the prevalence of tobacco use on campus

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

Restrict tobacco sales, advertising, and promotion i ‡

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Ban tobacco advertising on campus, including the school newspaper and d other h publications bli i (e.g. ( ads d for f products, d tobacco promotions at bar, and tobacco company sponsored events) and at campus events. B distribution Ban di t ib ti off ttobacco-related b l t d products, d t paraphernalia with tobacco logos, or coupons on campus. B n tobacco Ban t b sales l on n campus: mpu vending nding m machines, hin campus store.

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

Increase and enforce tobacco-related rules l andd policies li i ‡

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Develop p sound tobacco-related rules, p policies, and related sanctions with input from all stakeholders: students, faculty, administration, staff, and parents. Publicize tobacco tobacco-related related rules, policies and sanctions. Enforce sanctions for violating tobacco-related rules and policies.

Source: Tobacco Technical Assistance Consortium College g Tobacco Prevention Resource

Educate students about tobacco prevention i ‡ ‡

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Implement campus-wide high quality tobacco prevention i education d i programs. Implement targeted tobacco prevention education programs for high-risk groups such as athletes (chew t b tobacco), ) freshmen, f h ffraternity t it and d sorority it members, b students concerned with weight loss, art and theater students, and Lesbian, Gay Bisexual and Transgender students. students Work with professors to implement curriculum infusion Involve students as peer educators and leaders

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

Offer tobacco cessation programs d i d fforr college designed ll students t d t ‡

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Offer a full-range g of high-quality g q y tobacco cessation programs-such as individual and group counseling, nicotine replacement therapy, referrals to local programs internet-based programs, internet based programs that are easily accessible and well-publicized. Offer programs geared towards the unique needs of college students.

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

Offer tobacco cessation programs d i d fforr college designed ll students t d t ‡

Track student tobacco use status at every college health service i visit, i i and d offer ff tobacco b users regular l reminders i d of campus tobacco cessation options.

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Train health care providers in motivational interviewing techniques so they can conduct effective interventions at each health center visit for students who smoke.

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Lobby for insurance coverage of cessation services for students,, faculty, y, and staff.

Source: Tobacco Technical Assistance Consortium C ll College T Tobacco b Prevention P ti R Resource

Offer tobacco cessation programs designed f college for ll students d ‡

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Train health care p providers in motivational interviewing g techniques so they can conduct effective interventions at each health center visit for students who smoke. L bb for Lobby f iinsurance coverage off cessation ti services i ffor students, faculty, and staff.

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

T ki Action Taking A ti on Your Y r Campus C p ‡ ‡ ‡ ‡ ‡

Conduct a Problem Analysis y Set Goals and Objectives Select Strategies Implement Change Evaluate Efforts

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

C d t a Problem Conduct Pr bl Analysis A l i ‡

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Taking g a comprehensive p look at tobacco use and prevention on your campus will help you to identify needs, wants, allies, resources, and barriers. L k beyond Look b d your campus to t learn l the th b basic i C College ll Tobacco Facts, review recommended campus tobacco prevention policies and models and find out what other campuses are dong with respect to tobacco.

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

C d t a Problem Conduct Pr bl Analysis A l i ‡

Some key questions to consider in the problem analysis stage: „ What are the tobacco use rates and trends on your campus? How do they compare with those on other campuses?? „ What are students attitudes and perceptions related to tobacco use? Do students have an exaggerated perception of the number of students who smoke? „ What are the current campus tobacco policies and enforcement strategies? Are current policies enforced? By whom?

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

S t Goals Set G l andd Objectives Obj ti ‡ ‡ ‡ ‡

Goals should be broad, y yet realistic and appropriate pp p for your campus at the time. Each goal should be linked to one or more objectives. Objectives should have a clear indication of what changes are planned. Objectives should be measurable and specific in numerical i l terms t when h possible. ibl

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

S t Goals Set G l andd Objectives Obj ti ‡

Goals and objective j links and resources: „ American Cancer Society’s Smoke-Free New England Campus Initiative Advocating for a Smoke-Free Campus: A Manual for College and University Students. „ Healthy People 2010 Toolkit: Setting Health Priorities and Establishing Objectives „ Centers for Disease Control and Prevention, Planned Approach to Community Health Guide. Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

S l t Strategies Select Str t i ‡

Some key yq questions to consider when selecting g strategies g and developing an action plan: „ „ „ „ „

Will the proposed changes help with you reach your stated goals and objectives? What actual tasks will need to be taken to implement the proposed changes? What level of support (e.g. (e g financial, financial personnel) will be necessary to carry out these changes? Is official approval of the plan necessary before the plan can be put into action? What groups will need to be involved in the change process?

Source: Tobacco Technical Assistance College Tobacco Prevention Resource

I pl Implement t Change Ch ‡ ‡

Implementation is the process of putting a new policy or program into i effect. ff Some key questions to consider when implementing change „ Who should comprise a working group or committee to execute the plan? „ How long g a time p period should there be from authorization h off new policies l to implementation? l „ Who should the message about a major policy change come from? The President, The Director of Health S i Services, The Th President P id off Student S d Government? G ? „ How will change be advertised? Does signage need to be made? Source: Tobacco Technical Assistance College Tobacco Prevention Resource

E l t Efforts Evaluate Eff rt ‡

Conduct p process and out come evaluations „ Process evaluation ‡

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Addressing questions about whether a program was carried p out as planned. Conducting short interviews or surveys with the students to assess whether the communication channels were effective in reaching them.

Outcome evaluation ‡

Addressing whether or nor policy or program objectives were met.

Source: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

E l ti Efforts Evaluation Eff rt ‡

Some key questions to consider when evaluating efforts: „ „ „ „ „ „ „ „

What was the impact of the implemented changes? Were the programs/policies implemented as planned? How did the program/policy affect different groups on campus? Did unforeseen f problems bl arise i during d i the h implementation? i l i ? If so, what were they? Did we meet our objectives? What other factors may have contributed to the effectiveness of the program or policy? What additional steps are necessary to reach the stated goals? What did we learn that can guide us in the future efforts

Sources: Tobacco Technical Assistance Consortium College Tobacco Prevention Resource

Oth r IIssues tto Consider Other C id r ‡ ‡ ‡ ‡ ‡ ‡

Coalition Building g Presidential Leadership Enforcement Issues Student Involvement Faculty/Staff Support M di Coverage Media C

Source: Tobacco Technical Assistance Consortium College g Tobacco Prevention Resource

R f r References &R Resources r ‡

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American Cancer Society’s Smoke-Free New England C Campus I ii i Initiative. Ad Advocating i ffor a Smoke S k Free F Campus: A Manual for College and University Students. Chapter 2, “Action Plan”. 2001. A American i College C ll Health H lth A Association i ti website: b it www.acha.org/Topics/atodlcfm ANR (American Non-Rights ) Americans for Nonsmokers' Right is Rights i the th leading l ding national n ti n l lobbying l bb ing organization rg ni ti n (501 (c) 4), dedicated to nonsmokers' rights, taking on the tobacco industry at all levels of government, protecting nonsmokers from exposure to secondhand smoke smoke, and preventing tobacco addiction among youth. ANR pursues an action-oriented program of policy and g Website: www.No-Smoke.org g legislation.

R f r References &R Resources r ‡

ttac ((Tobacco Technical Assistance Consortium College g Tobacco Prevention Resource) website: www.ttac.org/college/model /approach.html)

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TobaccoFreeU.org is the official Bacchus website devoted to tobacco control with college g and university y campuses and young adults. TobaccoFreeU.org has information about types of tobacco, policy change, data collection and evaluation evaluation, and sample campus and community programs.

C t t Information Contact I f r ti Fayetta y Royal, y , MA Tobacco Prevention & Control Coordinator Alabama Department of Public Health Area 3 2350 Hargrove Road East Tuscaloosa, AL 35405 Ph Phone: (205) 554-4558 554 4558 Fax: (205) 556-2701 Email: Fayetta.Royal Fayetta Royal @adph.state.al.us @adph state al us