Chronic Disease, Injury Prevention and Substance Misuse October 2015 – October 2016

Chronic Disease, Injury Prevention and Substance Misuse

Tobacco Report – Health Promotion
October 2015 – October 2016

AREA OF FOCUS APPLIES? YES/NO
Strategic Plan Direction/Goal Yes
Ontario Public Health Standard, 2008 (OPHS) Yes

Manager: Jennifer McCorriston

Director: Rita Sethi

Division: Community Health and Wellness

Summary of Strategic Plan Goal and Operational Plan Objective(s)

STRATEGIC DIRECTION

Building Healthy Communities - We will work with communities to support the health and well-being of everyone.

STRATEGIC GOAL(S)

We will promote healthy environments that support physical and mental health and well-being.

We will advocate for development of policies that address health inequities.

PROGRAM OPERATIONAL OBJECTIVE

1) Work with school boards and/or staff of elementary, secondary and post-secondary educational settings to influence the development and implementation of healthy policies, and the creation or enhancement of supportive environments in comprehensive tobacco control.

2) Work with municipalities to support healthy public policies and the creation or enhancement of supportive environments in comprehensive tobacco control.

3) Increase the capacity of community partners to coordinate and develop regional/local programs and services related to comprehensive tobacco control.

4) Ensure the provision of tobacco use cessation programs and services for priority populations.

IS THIS A NEW INITIATIVE OR UPDATE OF EXISTING INITIATIVE?

Existing Initiative/Program Update

Summary of OPHS Program Requirement(s):

OPHS PROGRAM

Chronic Disease Prevention

GOAL

To reduce the burden of preventable chronic diseases of public health importance.

STRATEGY

Health Promotion and Policy Development

Disease Prevention

Health Protection

Assessment and Surveillance

REQUIREMENTS

Chronic Disease Requirements: 1, 3, 4, 6, 7, 9, 11 & 12

ACCOUNTABILITY INDICATOR(S)

*CCHS 2014 is the most current data available.

Accountability Indicators

2009-10

2011-12

2013-14

2015

2016 mid-
year

% of youth (12 - 18) who have never smoked a whole cigarette

83.6%

85.7%

80.3%

N/A*

N/A*

HAS A PERFORMANCE VARIANCE OR DISCREPANCY BEEN IDENTIFIED

Yes ☒

No ☐

Based upon the Acountability Indicator, it would appear that there is a variance. However, the CCHS accountability data may not be a perfect reflection of youth smoking rates in WDG. The WDG Youth Survey data below may provide more accurate information on local youth smoking rates.

Percentage of youth reporting ever smoking (even a puff)
 

No

Yes

2011-12

88.8%

11.2%

2014-15

90.4%

9.6%

Percentage of youth who report currently smoking cigarettes
 

I do not smoke

Less than once per
week

At least once per
week but not every
day

Every day

2011-12

95.7%

1.4%

0.8%

2.2%

2014-15

94.6%

2.2%

0.8%

2.4%

Based on the WDG Youth Survey data, it is evident that the smoking rate among youth in WDG has remained fairly stable from 2011 to 2014. In addition, the Accountability Indicator may not be the best representation of the tobacco work at Wellington-Dufferin-Guelph Public Health (WDGPH), as the indicator is influenced by many partners, settings and factors beyond the control of Public Health. 

HIGHLIGHTS

Prevention

Smoke-Free Movies

A report by OTRU that analyzed exposure to onscreen tobacco in movies released from 2004-2013 found that 86% of movies with tobacco were youth-rated in Ontario. Over the seven years (2005, 2007-2012) where data were available, it is estimated that, on average, 13,241 current smokers in Ontario aged 12-17 were recruited to smoking in a year because of watching smoking in movies. It is projected that, on average, 4,237 of these smokers will die prematurely as a result of tobacco imagery in movies.1

With the good evidence that smoking scenes in movies cause youth to become established smokers2 it is reasonable to assume that preventing any further smoking scenes in youth-rated movies will prevent youth from becoming established smokers. WDGPH continues to support the Central West Tobacco Control Area Network (TCAN) on a project aiming to eliminate smoking from youth rated movies. This work includes targeting parents through social media and an advocacy campaign aimed at changing movie ratings.

Central West & South West TCAN Social Branding Project

According to the most recent Youth Smoking Survey, 7.4% of Ontario youth in grades 10-12 smoke cigarettes.3 While this low youth prevalence rate is to be celebrated, it means that future tobacco prevention efforts must be tailored to reach the small sub-population of Ontario youth who continue to use tobacco. Social Branding presents a promising new strategy for tobacco prevention. Social Branding applies social marketing principles to develop ‘brands’ that market particular behaviours to youth who identify with specific peer crowds.4

Since 2013, the Central West and South West TCANs have been working with Rescue: The Behavior Change Agency to design and implement a Social Branding campaign for youth who identify with the Alternative peer crowd. This Social Branding campaign is the first of its kind in Canada. WDGPH is co-leading this project with the Perth District Health Unit.

At the end of 2015, the tobacco-free brand, UPRISE, was developed. This brand was promoted at four regional alternative music events with a potential reach of 107,500 youth. Social media results indicated that there were 824 fans on Facebook and 17,290 video views on YouTube. 
Moving forward, the goal is to continue to increase social media presence and engagement of alternative youth through UPRISE social media channels and events.  

Protection

Smoke-Free Housing

Ontarians are protected from second-hand smoke in virtually all enclosed workplaces and public places as well as many outdoor public spaces, yet many remain unwillingly exposed in their own homes as a result of smoke from neighbouring units. Second-hand smoke harms children and adults, and the only way to fully protect non-smokers is to eliminate smoking in all homes. 

WDGPH is currently working with social, not-for-profit, and private housing providers to implement smoke-free policies. To date, we have completed a social housing resident survey in Dufferin and delivered several presentations to private and not-for-profit housing providers. In 2016, two not-for-profit housing providers have passed board resolutions to enact smoke-free policies.

Cessation

Increasing Quit Attempts

Research has shown that increasing quit attempts among smokers has the greatest impact on the cessation rate at a population health level.5 On average, it takes 30 quit attempts for a smoker to quit successfully, and yet smokers may try to quit only once a year.6

In 2015, a WDG smoking cessation gaps analysis was completed to gain insight into local facilitators and barriers to quitting. The report demonstrated that just under half of respondents did not make a single quit attempt in the past year, –highlighting the need to continue working to increase quit attempts and ensuring access to proper cessation supports. 7

Currently, we work with local health care providers to increase capacity and systematize cessation protocols through trainings and consultations. Five consultations and one Fundamentals of Tobacco workshop were completed in 2015. We support two local Communities of Practice that meet twice a year (one in Waterloo-Wellington and one in Dufferin). We support provincial cessation campaigns/contests to reach tobacco users and encourage quit attempts (e.g., 158 community members registered in the 2015 Driven to Quit contest). We have also started to offer STOP on the Road workshops in partnership with the Centre for Addiction and Mental Health (CAMH) to support smokers in their quit attempts and address access to equitable services. One workshop was held in Dufferin in September 2016. Looking forward, we are working on a media campaign in partnership with the CW TCAN targeted to male smokers 24-35 years old.  The campaign will encourage quit attempts through a testimonial approach.

Related Board or WDGPH reports

Board of Health Report BH.01.DEC0215.R36 – Second-Hand Tobacco Smoke in Multi-Unit Dwellings of Social Housing

https://www.wdgpublichealth.ca/sites/default/files/wdgphfiles/BH_01_DEC0…(1).pdf

REFERENCES

  1. Babayan A, Luk R, Schwartz R. Exposure to Onscreen Tobacco in Movies among Ontario Youth, 2004-2013. Toronto, ON: Ontario Tobacco Research Unit, May 2014. Available at http://otru.org/wpcontent/uploads/2014/05/OTRU-Smoking-in-Movies.pdf. Accessed: April 1, 2015.
     
  2. Dalton MA, Beach ML, Adachi-Mejia AM, Longacre MR, Matzkin AL, Sargent JD, et al. Early exposure to movie smoking predicts established smoking by older teens and young adults. Pediatrics. 2009:123(4):e551-e558.
     
  3. Canada. Health Canada. Supplementary tables: youth smoking survey 2012-2013 [Internet]. 2014 June 3. [cited 2015 Mar 2] Available from: http://www.hc-sc.gc.ca/hc-ps/tobac-tabac/research-recherche/stat/_survey…
     
  4. Jordan J. The social branding dogma. 1st ed. China: TSE Worldwide Press, Inc.; 2006.
     
  5. Zhu SH, Lee M, Zhuang YL, Gamst A, Wolfson T. Interventions to Increase Smoking Cessation at the Population Level: How Much Progress Has Been Made in the Last Two Decades? Tob Control 2012; 21(2):110-118.
     
  6. Ontario Tobacco Research Unit. Infographic – Smoking Cessation in Ontario, 2013. Available at: http://otru.org/quitting-smoking-in-ontario/
     
  7. Wellington-Dufferin-Guelph Public Health (2015). Quitting Smoking in Wellington-Dufferin-Guelph, Fergus, Ontario. Available at: https://www.wdgpublichealth.ca/sites/default/files/wdgphfiles/Quitting%2…