Tobacco
• Smoke-free
   environments
• Youth Access

Iniatives
• Alcohol
• Marijuana
• Prescription and OTC
• Other drugs

Tobacco

Tobacco use is the number one cause of preventable death in the United States. It is responsible for approximately one in five deaths, or about 443,000 deaths per year. Worldwide, tobacco use causes more than 5 million deaths annually. Approximately 80% of all adult smokers in the United States started smoking before the age of 18.

The good news in that premature death and disability is drastically reduced when a smokers quits. A 2004 report from the U.S. Surgeon General showed that after one year of not smoking, the excess risk of coronary heart disease is reduced by half.

Four key public health policies have been very effective reducing the rate of smoking:

• Price increase through state and federal taxes
• Clean indoor and outdoor air policies
• Counter-marketing campaigns
• Smoking cessation messages and /or programs

The Tobacco Tax and Health Promotion Act (Proposition 99) implemented a 25 cent tax on cigarettes and created the California Tobacco Control Program, and is recognized as one of the most successful public health programs in the County and Worldwide. 

Changing policy is the beginning of the lengthy process of community norm change. Community norm change that continues to demoralize smoking will result in a reduction in tobacco use and less tobacco-related mortality and morbidity.

Communities Against Substance Abuse takes the lead in East County to enact voluntary and legislative tobacco control policies that begin the lengthy process of community norm change. These policies include the creation of smoke-free environments and programs that reduce youth access to tobacco. Through completing the process of assessment, community organizing, youth development, policy, media advocacy and evaluation, Communities Against Substance Abuse has experience working on many different tobacco control campaigns.

Smoke-Free Environments
Establishing smoke-free environments are the number one way to reduce exposure to secondhand smoke.  The 2006 Surgeon General’s report finds that there are no safe levels of exposure to secondhand smoke. Secondhand smoke causes premature death and disease in children and adults that do not smoke.

Policies that restrict where people can smoke reduces exposure to secondhand smoke and reduces tobacco use overtime, by demoralizing smoking.

Examples of policies are:

• Smoke-free parks
• Smoke-free healthcare campuses
• Smoke-free community college campuses
• Smoke-free public places
• Smoke-free outdoor dining areas
• Smoke-free multi-unit housing

Smoke-Free Parks

• Secondhand smoke is especially harmful to young children. In California alone, exposure to secondhand smoke is responsible for 18,000 to 36,000 children being hospitalized with respiratory diseases and 900 to 1,800 children being hospitalized with bronchitis or pneumonia each year.
• Cigarette butts are the most littered item in the world. In just one day, 230,000 cigarette butts were collected on California beaches.
• When children see adults smoking in a family-friendly place like a park, they think smoking is acceptable and are more likely to copy the behavior.

Did you know that�In the East Region, Communities Against Substance Abuse assisted in the development of El Cajon smoke-free parks (2004), La Mesa smoke-free parks (2006) and Lemon Grove smoke-free parks (2009).

Smoke-Free Healthcare Campuses

• Healthcare professionals and facilities set the example that a healthy society reflects upon.
• Smoking is a risk factor for perioperative cardiovascular, respiratory, and wound healing complications such as pneumonia, myocardial infarction, and surgical site infections.
• Healthcare facilities are a vital service for the community, especially the unwell who may already have respiratory illness.
• Designating smoking areas are not enough. Simple separation of smokers within the same airspace does not eliminate exposure to secondhand smoke. Providing a space to smoke does not assist patients with quitting or provide a healthier environment. Building and maintaining smoking huts sends a message of approval for smoking.

Did you know that�Communities Against Substance Abuse successfully guided two multi-facility healthcare districts and two independent hospital campuses in San Diego County to adopt smoke-free environments; Sharp Healthcare System (2005), Palomar Pomerado Health (2007), Tri-City Medical Center (2008), and Alvarado Hospital (2009). More than half of San Diego County healthcare organizations have 100% smoke-free policies.

Smoke-Free Community College Campuses

• Young adults aged 18-24 remain the group with the highest smoking prevalence rate. In 2003, a prevalence rate of 23.6% means that out of the 3,551,495 Californians between the ages of 18 and 24, nearly 840,000 of them are smokers.
• According to the American Legacy Foundation’s Tracking Tobacco Industry Marketing to College Youth report issues 2003, 75% of bars in close proximity to colleges specifically serve the college community. More than half (53%) of the 117 bars observed nationwide had tobacco promotional items available or on display.
• Creating smoke-free environments can deter smoking behaviors for college-aged students and give young people a greater chance of living their lives tobacco free.
• 60% of young women (ages 16-24) tried to quit smoking in 2002, but less than 3% succeeded in quitting for at least a year.
• Young adults encounter the tobacco industry and its adverse effects everywhere they turn, including colleges, bars, alternative newspapers, magazines and in the military.

Did you know that�Communities Against Substance Abuse successfully orchestrated the adoption of mandatory tobacco-free college campuses at the Grossmont-Cuyamaca Community College District in East San Diego County, the first multiple campus college district in the State to do so (2008), Mesa Community College in the City of San Diego (2006) and Southwestern Community College in the City of Chula Vista (2009).

Smoke-Free Public Places

• 92.3% of Californians strongly agree that inhaling smoke from someone else’s cigarette causes lung cancer according to The Center for Tobacco Policy and Organizing Survey from 2008 of 600 California voters.
• The City of El Cajon in 2007 instituted a comprehensive secondhand smoke ordinance that extends smoke-free environments to all public areas, including sidewalks, shopping centers, wait lines and streets.

Smoke-Free Outdoor Dining Areas

• Studies have shown that people spending time near outdoor smokers over multiple hours, such as waiters or dinner guests can receive exposure that exceeds the current U.S. EPA limits on fine particle pollution.
• Research has shown that being within a few feet of a smoker while being outdoors may expose one to air pollution levels comparable to indoor levels in a home or tavern.
• A scientific review of hundreds of studies has concluded that smoke-free policies do not decrease the business activity of the restaurants and bar industry. (International Agency for Research on Cancer 2008).
• Labor Code 6404.5, the California Smoke-Free Workplace Act, prohibits smoking in enclosed places of employment to reduce employee’s exposure to secondhand smoke. Employees who work in outdoor dining areas were excluded from this protection. Creating smoke-free outdoor dining areas will protect the thousands of employees who are now exposed.

Smoke-Free Multi-Unit Housing

• Smoking restrictions in multi-unit housing complexes do not violate anti-discrimination law. It is illegal to discriminate against specially protected groups of people, such as a person’s race, religion or gender. People who smoke are NOT considered a specially protected group. Smoking is a habit, not an unchangeable characteristic.
• Prohibiting smoking in multi-unit housing common areas and inside individual units is similar to other lease restrictions such as not allowing pets or loud noise.
• Adopting a non-smoking policy protects the public health and helps a property owner/manager save money by lessening liability and possibly insurance costs as well as decreasing risks of fire damage.
• Smoking restrictions also decrease costs to clean and repair the unit, which can range from $2,000 up to $10,000 for a two bedroom two bathroom apartment.
• Cigarettes are a leading cause of home fire fatalities in the United States, killing 700 to 900 people - smokers and nonsmokers alike - per year. Property losses from smoking-material fires total hundreds of millions of dollars each year (National Fire Protection Agency, 2008).

Youth Access to Tobacco
It has been illegal under California law to sell tobacco to minors for more than 100 years but the State lacks the resources to adequately enforce these laws. Local municipalities can pass tobacco retailer licensing ordinances to regulate and enforce tobacco sales to minors.

A retail tobacco license requires retailers to obtain a license to sell tobacco products. If the retailer sells tobacco to minors, or violates other local and state laws relating to tobacco, the license can be suspended or revoked. The license fee reflects the costs of administering and enforcing the licensing program; retailers can be charged a required flat fee or a fee based on the volume of tobacco they sell.

The City of El Cajon was the first municipal tobacco retailer licensing ordinance in the County of San Diego (2004), which increased consequences for retailers that sell to minors and reduced youth access. Communities Against Substance Abuse provides support and resources to the City of El Cajon to evaluate the impact of their ordinance utilizing trained youth from Students Together Against Alcohol and Drugs. The most recent enforcement survey resulted in an overall 88% reduction in sales to minors since the adoption of the tobacco retail license ordinance in 2004.

Reporting Violations of Tobacco Control Laws
Violations of all local and state tobacco control laws may be reported to the San Diego County Tobacco Control Resource Program (TCRP) by telephone at 1-800-NOSMOKE.

A sale of tobacco to a minor may also be reported at the following phone number at the California Department of Public Health: 1-800-5 ASK-4-ID

Resources
Resources are also available to individuals that wish to stop smoking, click here for a list of resources.

To find up to date information on adult and youth tobacco use please visit one of the following websites.

www.cdc.gov/tobacco
www.tobaccofreekids.org
smokingcessationleadership.ucsf.edu
www.tobaccofreeca.com
www.cdph.ca.gov/programs/Tobacco
www.tobaccowatchdog.org
www.smokefreesandiego.org