The Nuts and Bolts of Implementing and Evaluating a Tobacco-free Campus Using the 3Ts Model

Transcription

1 The Nuts and Bolts of Implementing and Evaluating a Tobacco-free Campus Using the 3Ts Model Ellen J. Hahn, PhD, RN, FAAN Professor and Director Kentucky Center for Smoke-free Policy University of Kentucky College of Nursing Co-Chair, Tobacco-free Campus Task Force November 19, 2009 Getting the right people to the table 3 T s Model for implementing and evaluating tobacco-free campus policies Using effective methods to evaluate the policy 1

2 UK Administrative Regulation 6:5 The use of all tobacco products is prohibited in all owned, operated, leased, occupied, or controlled University buildings and structures, grounds, parking structures, enclosed bridges and walkways, sidewalks, streets, parking lots, and vehicles, as well as personal vehicles in these areas. These Tobacco Products are NOT Allowed on UK Property Cigarettes E-cigarettes* Cigars Snuff Chew *The FDA considers electronic cigarettes a tobacco product, not a way to quit smoking. Snus Water Pipes Pipes Hookahs And any other noncombustible tobacco product 2

3 Why E-Cigarettes are Prohibited E-cigs are derived from tobacco and an inhaled product that emits fine particles into the air. For this reason, they should be covered under smoke-free policies. Vaping creates a dense mix of vapor and fine particles that smells and looks like tobacco smoke. If exempt from smoke-free policies, the smoky look and smell creates confusion with enforcement. E-cigs may pollute the air less than conventional cigarettes but they still pollute the air. Making it Happen Get administrative support Lead on public health matters; don t poll Planned, deliberate planning, implementation, and evaluation approach Take time to create buy-in 9-12 months planning phase prior to implementation Get the right people around the table Sustain a tobacco-free infrastructure beyond implementation 3

4 Get the Right People to the Table Faculty Senate Staff Senate Student Government Auxillary Services Athletics University Health Services University Architect Student Affairs Public Affairs Office of Legal Counsel Real Property Office UK HealthCare External Affairs Enrollment Management Dean s Council College of Agriculture Dining Services Testing & Counseling University Neighborhood Advisory Council Human Resources Physical Plant Division Bluegrass Community Technical College Graduate Student Congress Research Resident Student Association Residence Life Hilary J. Boone Center UK Libraries Committees Facilities/Boundaries/Signage Communications/Marketing Tobacco Treatment/Addiction Management Compliance Good Neighbor 4

5 The 3 Ts of Tobacco-free Policy Implementation TELL about the policy via good signage, branding, and integrated, consistent communication Treat tobacco users by providing free NRT and a menu of counseling/behavioral support Train staff and volunteers in firm yet compassionate scripting in handling violators Hahn, E.J., Fallin, A., Darville, A., Kercsmar, S.E., McCann, M., Record, R. (2012). The Three T s of adopting tobacco-free policies on college campuses. Nursing Clinics of North America, 47(1), Tell: Put Signage Where People See It! Brand the policy with the goal in mind: Welcome to our Tobacco-free Campus: A healthy place to live, work, and learn 5

6 NRT instead of tobacco! Sidewalks & Streets The policy covers the University-controlled streets and sidewalks. For those sidewalks adjacent to streets not controlled by the University, we ask that you respect the pedestrians and our efforts to provide a healthier environment by refraining from tobacco use on those sidewalks. 6

7 Tell: More About the Tobacco-free Policy, Help to Quit, and Reporting Violators: Follow us on Twitter & Tell: All Dorm Residents Get this Card at Check-In Front Back 7

8 Tell: Targeted Messaging for Visitors on our Medical Campus Front of the Card Back of the Card Tell: Build Tobaccofree into Health & Wellness Activities Partner with others on campus to sponsor wellness activities. Be sure to include the Tobacco-free Policy Campaign brand. Host fitness walks/runs on your tobacco-free campus (e.g., Lung Cancer Walk) Leverage unpaid media about the policy before, during, and after these events. 8

9 Tell: Building Tobaccofree Into the Green/Sustainability Movement Cigarette butt pick up by student environmental groups Display during Sustainability Expo Treat: Access to Evidence-based Treatment and Symptom Management Menu of treatment options NRT (12 weeks) for employees, sponsored dependents, and students; behavioral component required Discounted NRT available for purchase at corner stores for symptom management 9

10 Help to Manage Cravings Promotes Compliance and Quitting Free nicotine replacement products (gum and patches) for employees, sponsored dependents, and students who participate in behavioral support. To help manage cravings, low-cost nicotine replacement products are available for purchase at convenient on-campus locations. Train: Creating a Culture of Compliance Compliance is achieved through communicating a universal, consistent message via scripting and policy and tobacco treatment education. Use a firm, polite, and compassionate approach! Electronic reporting: ReportTFviolation@uky.edu 10

11 Compliance is Everyone s Business. Tobacco-free Take Action! is a team of employees and students who are committed to improving compliance with our tobacco-free policy. Ickes, M.J., Hahn, E.J., McCann, M., & Kercsmar, S. (2013). Tobacco-free Take Action! Increasing policy adherence on a college campus. World Medical and Health Policy, 5(1), Become a Tobacco-free Ambassador! You will be prepared and empowered to politely approach and advise violators about the policy using kind, yet firm scripts. You will learn proper ways of reporting violators. As an Ambassador, you will be the agent of change for a healthy environment. 11

12 HELPFUL TIPS WHEN APPROACHING TOBACCO USERS ON CAMPUS Always be very friendly and polite. Stay positive and introduce yourself. Remind them to throw away their cigarette butt and not just throw it on the ground. Remember you have nothing to lose by approaching someone violating the tobaccofree policy. The majority of those approached comply and respond in a positive manner. Universal Scripting Hello, my name is (your name) and I am a(n) (position) at UK. Our campus is completely tobacco-free so I need to ask you to please put out your cigarette. Thank you for respecting our policy! 12

13 Ambassadors Enforcement Frame as creating a culture of compliance via constant messaging, scripted reminders. Integrate into existing corrective action procedures Partner closely with tobacco treatment resources to help violators comply. 13

14 Report violators of the tobacco-free policy to: OR submit via the online form on our website Corrective Action Students report to the Dean of Students Subject to corrective action according to Student Code of Conduct Employees report to supervisor, Human Resources Employee Relations, Faculty Affairs Subject to corrective action according to HR Policies & Procedures Campus Visitors may be asked to leave campus See for more information 14

15 Average # of cigarette butts 10/3/2013 Evaluating the Policy Figure 1. Average Number of Butts by Whether or Not Location Covered by Policy * Covered by Policy n=216 Not covered by policy n=72 *p = < Fallin, A., Murrey, M., Johnson, A.O., Riker, C.A., Rayens, M.K., & Hahn, E.J. (2012). Measuring compliance with tobacco-free campus policy. Journal of American College Health, 60:7, Figure 1. Request for Tobacco Treatment and NRT Coupons Redeemed Pre- and Post Tobacco-free Policy Note. Pre-policy, 11/08-11/09. Post-policy, 10/09-09/11 4-fold increase in quit attempts. An average of 3 enrolled in cessation programs per month before to 11 after the policy. 4-fold increase in treatment utilization. An average of 10 NRT coupons redeemed per month before to 41 after the policy. Only 1.4-fold increase in cost per 2-week NRT coupon. An average of $ per month before to $ per month after the policy. Lower cost per NRT coupon negotiated by UK Pharmacy after policy took effect. $47.60 per coupon before to $17.15 after the policy. 15

16 TFTA! How Effective Is It? Location Cigarette Butts Reduced by 51% Overall # Butts Pre Day # Butts Pre Total # Butts Post Day # Butts Post - Total Percent Change Hotspot A % Hotspot B % Hotspot C % Hotspot % D Hotspot E % Most People Positive When Approached From April 16 to May 18, Violators Observed 388 Approached (83%) 93% Positive Response TOTAL % Evaluating Compliance Interventions Large scale awareness campaign Distributed 5,900 message cards Four high-traffic locations for three days All individuals passing offered a card Fallin, A., Johnson, A.O., Riker, C.A., Cohen, E., Rayens, M.K., & Hahn, E.J. (2013). An intervention to increase compliance with a tobacco-free university policy. American Journal of Health Promotion, 27(3):

17 Take Home Messages Be patient and persistent. Tobacco-free policy implementation involves culture change. Change takes time! Brand your policy with the goal in mind. The goal is to provide a healthy environment! Look for ways to build tobacco-free into existing activities and systems! Compliance is Everyone s Business. Create Buy-In through a Broad-based Task Force and Report Line. Tobacco-free Campus Policy Changes the Culture of Expectations 17

18 Contact Us! UK Tobacco-free Campus Initiative Co-Chairs: Ellen Hahn: and Anthany Beatty: Policy website: Follow Like us at Tobacco-free Take Action Kentucky Center for Smoke-free Policy Find us on Twitter and 18