Sault Tribe Smoke-free Housing Initiative Creating Healthy Places for Generations to Come

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Sault Tribe Smoke-free Housing Initiative Creating Healthy Places for Generations to Come Donna Norkoli, B. S. CHES Sault Tribe Community Transformation Grant Project Coordinator

1. Coalition Building Sault Tribe Tobacco Task Force Chippewa County Tobacco-free Living Coalition Sault Tribe Housing Authority Smoke-free Environments Law Project November 2008

Other Key Partners Sault Tribe Youth Education and Activities Connection to tribal youth to assist with social marketing and media campaigns to gain support for smoke-free housing policies Local Media Inform public about the dangers of secondhand smoke and benefits of smoke-free housing Inform public about opportunities for training and advocacy Facilitate dissemination of our media campaign messages Michigan Department of Community Health Provide financial resources for social marketing campaign

Stakeholders Tribal Housing Tenants Assist with education and advocacy to demonstrate to the Housing Authority the demand and need for smoke-free housing Sault Tribe Housing Commission Board Development, adoption, and enforcement of a smoke-free housing policy Designation of additional smoke-free units Sault Tribe Board of Directors Support for smoke-free housing

Create an Action Plan Guide to implementing a smoke-free housing policy for the Sault Tribe Housing Authority. Flexible guide that was subject to many changes along the way. Measurable objectives and a timeline were critical to our success and kept us moving forward towards our goal of increasing the number of smoke-free housing units within the Sault Tribe Housing Authority. Our action plan is the comprehensive result of lessons learned along the journey to implementation.

2. Gather Data and Background Info Tenant Surveys CHANGE Assessment Education: Tenant Packets

140 Sault Tribe Housing Commission Tenant Survey Completed December 2008 119 of 470 Surveys Returned (25%) 120 100 98% 98% 86% 80 70% 64% YES NO 60 56% 40 44% 36% 30% 20 14% 0 In your opinion is second hand smoke a serious health hazard? Do you feel secondhand smoke is harmful to your children's health and that they should not be exposed to any secondhand smoke? If available, would you prefer to live in a smoke free building? Does cigarette smoke from other apartments ever enter your apartment and bother you or other family members? Do you or anyone you live with smoke? Do you know that smoke free apartment policies are legal?

CHANGE The Tobacco Use Module generated much discussion concerning the question Does your agency have a 24/7 tobacco free policy? From this question, it was determined that the staff work in smoke-free buildings, but the residents had no protection from secondhand smoke.

3. Demonstrate Need/Build Support January 2009 Meeting with Sault Tribe Housing staff to discuss results of the Tenant Survey Delivered an educational packet: Model Smoke-free Housing Policy Model Smoke-free Lease Addendum Sault Ste. Marie Housing Commission Policy Sample Tenant Letter Is There a Market for Smoke-free Housing? Clearing the Air Units Article

February 2009 Presentation to the Sault Tribe Housing Authority asking for a proposal to make some of the Sault Tribe Housing buildings smoke-free The Housing Authority decided to survey tenants individually to determine if they wanted their building to be designated smoke-free. This would be a voluntary decision. Conference call with Jim Bergman of the Smokefree Environmental Law Project to determine process and talking points for interviewing residents.

Building Support Through Connecting with Health Observances

4. Review sample policies/draft policy March 2010 Jim Bergman developed draft policies for Tribal Housing which were sent to Sault Tribe Housing Director for review Assistant Housing Director drafted a final policy and resolution with approval from the Housing Director

SAULT STE. MARIE TRIBE OF CHIPPEWA INDIANS HOUSING AUTHORITY SMOKE-FREE HOUSING POLICY SECTION 1. PURPOSE Numerous studies have found that tobacco smoke is a major contributor to indoor air pollution, and that breathing secondhand smoke (also known as environmental tobacco smoke) is a cause of disease in healthy non smokers. The Housing Authority Board of Commission has declared that certain Tribal Housing homes, located in the Seven- County service area of the Sault Ste. Marie Tribe of Chippewa Indians, shall be designated as smoke free. Smoking is not permitted in any inside area of the designated homes.

Sault Tribe Housing Director and Assistant Housing Director finalized the policy and resolution Presented to Housing Authority Board of Commission Policy passed in April 2010 and Resolution designating smokefree units passed in May 2010 5. Pass Policy

6. Enforcement/Evaluation Recognition Event Celebrate the Policy Signage/ Window Clings Cessation Opportunities Media and Education Evaluate the policy

Media Campaign The Michigan Department of Community Health partnered with the Sault Tribe to promote and increase smoke-free housing units through a media campaign. Included: Signage, Radio ads, TV ads, Thirdhand Smoke Brochure, Landlord and Tenant Tips Table Tents, and Tenant Surveys

Smoke-free Housing Recognition Event

Signage for designated smoke-free housing units

Smoke-free Housing Presentations and Reception

Thirdhand smoke radio ads recorded by Youth Education and Activities students TV ad creating awareness of dangers of thirdhand smoke

Smoke-free Housing Tenant Surveys January 2011 As a follow-up to the initial survey conducted in December 2008, in January 2011 a short survey was mailed to all 480 Sault Tribe Housing units. Incentives included a raffle for four $25 gift cards. 138 responses were collected by mid-february, for a response rate of 28.8%. This response rate was slightly higher than the 2008 survey, which had a response rate of 25.3%. Data analysis was done by the evaluation team at the Michigan Public Health Institute using statistical analysis software.

48.6% of survey respondent s reported smoking everyday or some days Current smoking status among survey respondents

Preference on Smoke-Free Housing Overall, half of respondents (50.7%) would ideally prefer to live in a smoke-free home or building. Among respondents who smoke every day, 14.3% would prefer to live in a smoke-free home. I do wish sites could all be smoke-free. My son has asthma and it is hard on him to be subjected to second-hand smoke. If you want to smoke, go outside especially for your children s sake!

August 2011 Sault Tribe Housing Commission Board designates one more duplex smoke-free! February 2013 Sault Tribe Housing Commission Board designates one more duplex smoke-free!

Key Steps in Policy Change IT TAKES TIME! November 2008. Ongoing