Smoking Management Freedom Team

I have worked my way through tobacco control state laws, city ordinances, and company policies (there is no national law). All of these controls depend heavily upon self-compliance. And they work fairly well.

Consistent violators are reported, and shamed into compliance, by the rest of the endangered community. A peculiar behavior I have observed is that the bluff and bluster of an addicted smoker disappears after the community sets the effective date for the end of smoke exposure in some manner.

There is an explanation for this change in behavior. Over half of smokers living in multi-unit housing vote for tobacco smoke free exposure.

The often-quoted “70% of smokers wanting to quit” shows here. They see an environment free of smoke as an important aid in quitting. The smell of tobacco smoke is a powerful trigger.

So it turns out that the last grouping I need to consider is also the foundation for tobacco control compliance; that group is not just smokers. It is everyone in the community.

A group larger than five, needs to be divided into functional teams. Each team needs to have at least one smoker interested in managing his/her addiction.

The teams need names. This provides a sense of accountability for prizes without needing to publish names. (Many smokers feel rejected and isolated. It is important to feel part of a positive supportive team. This is the main function of a team.)

Suggested times for teams to celebrate:

1. Each member's first smoke free day, first week, first month.

3. Entire site first smoke free day, first week, first month.

Team prizes are important and should be significant (equal to $60 per month per employee reported at one company in town). The new non-smoker is the star, but as in all sports, it is the team that wins, that earns recognition for their support. [Consider traveling trophies between participating sites.]

Promote the formation of freedom teams. Then each member calls 1-800-LUNGUSA for a free copy of their “Freedom from Smoking” self-help workbooks, that guide the team to success. (it takes about a week for delivery).

[Also contact the local city/county health department and CDC 1-800-QUIT-NOW (1-800-784-8669) for free 2-week alternative nicotine supplies.] 

Viral bylaw: After becoming comfortable with my own nicotine management or becoming a non-smoker, I will assist in at least one more team, at this location or at another location.     

New Over the Counter Safe Nicotine Sources

Frequent Sales in a Competitive Market 

         

A New State Tobacco Control Law

The term “Tobacco Control” comes from the days of “Alcohol, Tobacco and Fire Arms. The emphasis was on controlling tax revenue.

A new law must be based on “tobacco smoke exposure”; a recently recognized public health problem of great importance, and continue with addiction as a serious illness.

Education has been the most successful tool in controlling the use of tobacco (1).

Well to do, educated, and tobacco knowledgeable people have self-regulated their exposure down to no tobacco smoke by living in totally tobacco free condominiums and multi-unit housing (2). This is comparable to the self-regulated single family occupants at all socio-economic levels (3).

Heavily regulated hospitals have now arrived at the “tobacco free” status that includes not hiring people who are addicted to nicotine; that they obtain from smoke or from alternative nicotine sources (4). The air is clear for employee and patient. [Hospitals (health care) have given themselves the same status (in Missouri law) as health promoters (American Lung Association, for example), by charging for smoking cessation consultations.]

Private pay, less regulated, assisted living and memory care, sites have not arrived at the “tobacco free” or “exposure free” status in Missouri (5). They are only “smoke free” workplaces (6). The public regards them as “free of smoke”.

Here is the problem: The low wage workers are drawn from lower socio-economic levels where up to 50% are heavily addicted to nicotine (7).  

Here is the result: A caregiver, needing to adjust blood nicotine levels, can step out of a “smoke free” area to smoke, and step back in. Within a minute the next resident could have just as well have been smoking too, but now from the third hand tobacco smoke released from hair, clothes, and body.

Transitional competitive market solution (0-90 days): Hire smokers who are given to understand that nicotine addiction is a serious illness that affects everyone exposed. No tobacco or smoke are allowed on the property. They must take part in an effective smoking cessation program directed by a qualified person to manage their addiction while at work, and to set a low stress quit date. The job is conditional until nicotine addiction is under control.

Fully funded and updated tobacco control law solution (2-5 years): The enemy is a profit-seeking cult (8) that holds onto 70% of its members (9) by addiction (10). Pass company non-smoker health insurance benefits into paychecks. Fund tobacco initiation and smoking cessation programs at the CDC recommended level. Encourage effective “exposure free” company policies (11) and city ordinances (12) that can support an effective state law.

For details please see: https://residentialcarefortwo.blogspot.com.

A Transition Tobacco-free Policy

The “Sample Tobacco-free Workplace Policy” is dated 2013. This is in the era of “tobacco free” property. The property placed a shield around “smoke free” areas. Thirdhand tobacco smoke (THS) had not risen to the regulatory level of public consciousness.

Areas and properties remain in place. THS is left behind or carried about with people. THS penetrates the assumed safe “tobacco free” property.

The terms 100%, tobacco, smoke, and free have been combined in several ways to distinguish advances in, and reasons for, tobacco control beyond a source of taxes. Tobacco free, tobacco-free, and tobaccofree have generally referred to workplaces, restaurants, and bars. They may apply to assisted living and memory care as a “workplace”, and more recently, to “multi-unit housing”.

Tobacco-free in 2013 did not include THS. The American Lung Association (ALA) policy uses “complete” (without THS). I am using “complete” with THS rather than “Final” or some other term signifying the end for a need for new names.

Line and a half spacing is used to increase readability. A clean one page draft policy is located at the end of this post in text and in an image. New, Original, and Deleted. Provision Living has been inserted for EMPLOYER and ORGANIZATION NAME as this is where my wife and I live in Columbia, MO.

I have learned that effective tobacco control legislation starts from the bottom up. I have also obtained many meaningful insights into how assisted living and memory care actually operate in the past 2.5 years. This is a good place to start.

Sample Provision Living Tobacco-free Workplace Policy

A tobacco-free environment An environment free of tobacco smoke helps create a safe and healthy living and workplace. Smoking, and secondhand and thirdhand smoke are known to cause serious lung diseases, heart disease, heart attacks, strokes and cancer. [Provision Living] recognizes the hazards caused by tobacco use and exposure to secondhand and thirdhand tobacco smoke. Our policy to provide an environment for all employees, residents, and visitors was established to keep a safe and healthy workplace environment; an ideal environment to break out of any nicotine addiction. This policy covers the smoking of any tobacco product and the use of oral tobacco products, “spit” tobacco and e-cigarettes, and it applies to both employees, residents, and non-employee visitors of Provision Living.

Definitions

Smoker: A person so ill (nicotine addicted) that a nicotine adjustment must be made during the time spent on the property.

Smoke free: an area in which there is no smoking, but which secondhand tobacco smoke can drift into. A “smoke free” sign signifies smoking somewhere.

Secondhand tobacco smoke: the smoke that is inhaled by non-smokers, is deposited everywhere, and can be carried about on hair, clothes and bodies as thirdhand tobacco smoke (THS) where it can become re-airborne in restricted areas.

Tobacco-free: a property onto which no tobacco nicotine materials can be brought, but which thirdhand tobacco smoke can be carried into.

THS Level 1: New hires using non-toxic nicotine replacements, as needed, to adjust nicotine levels during their shift (before arriving until after leaving the property).

THS Level 2: After quitting or 30 days, using non-toxic replacements, as needed, to adjust nicotine levels all 24 hours of the day. [Protects worker, workplace, and family; reduces sick call ins.]

Smoker free: All occupants (employees and residents) living and working on the property no longer smoke. [The ultimate goal of any smoking cessation program.] In time, this status may be included in "tobacco-free", plus the effective date.

Stealth smoking: A facility is presented to the public as an environment free of tobacco smoke and free of tobacco control signs, when in fact, smoking is occurring and may even be accommodated. We found this a common practice in assisted living facilities in MO and TX. It is one reason we selected Provision Living at Columbia.

Policies

OPTION 1 – COMPLETE TOBACCO-FREE POLICY

No use of tobacco products including cigarettes and “spit tobacco” or e-cigarettes is permitted within the facilities or on the property of [Provision Living] at any time.

OPTION2 – COMPLETE TOBACCO-FREE  IN DESIGNATED OUTDOOR AREAS ONLY POLICY

No use of tobacco products including cigarettes and “spit tobacco” or e-cigarettes is permitted within the facilities or on the property of [Provision Living] at any time. No third hand tobacco smoke (THS) is permitted after probationary period.

THS is managed at three levels on the property: THS 1 (on shift), THS 2 (24 hours), and Smoker Free (no smokers) to accommodate hiring smokers into a caring, radiant person, family type community that is mindful, of the stress involved in continuing and in curing an addictive illness, and the freedom and benefit of being cured: a new non-smoker. At no time is smoke generated on the property.

Procedure

1. Employees will be informed of the [Provision Living] Tobacco-free Policy through signs posted throughout properties owned and operated by [EMPLOYER] including company owned vehicles during regular staff meetings prior to 30 days of being effective.

[Smoking signs in an environment free of tobacco smoke are a constant reminder for those quitting to think about smoking as well as smokers getting ready to quit. These people need to feel how good it is to be free from smoke for 9 hours.]

2. Visitors will be informed of the [Provision Living] 100% Tobacco-free Policy by their hosts, the meeting invite and email correspondence and signs posted throughout the properties owned and operated by [ORGANIZATION NAME].

[The old tradition of asking permission to smoke is reviving again. A free lozenge is available for visitors needing to adjust their nicotine levels. Stealth smokers often act embarrassed when encountered.]

3. Provision Living will help employees who want to quit smoking by helping them prepare to quit, set a quit date, and access recommended smoking cessation programs and materials. This includes a Freedom Team of never smokers, former smokers, new hire quitting smokers and smoking cessation counselors. (Visit www.lung.org/stop-smoking for more information.)

4. Any violations of this policy will be handled through the standard disciplinary procedure.

____________________________________        ________________________

 SIGNATURE CEO or PRESIDENT                          DATE  

American Lung Association 2013 (fits on one page)

One Page Image

Draft                      Provision Living Tobacco-free Policy                Draft

An environment free of tobacco smoke helps create a safe and healthy living and work place. Smoking, secondhand and third hand smoke are known to cause serious lung diseases, heart disease, heart attacks, strokes and cancer. Provision Living recognizes the hazards caused by tobacco use and exposure to secondhand and third hand tobacco smoke. Our policy to provide an environment for all employees, residents, and visitors was established to keep a safe and healthy workplace environment; an ideal environment to break out of any nicotine addiction. This policy covers the smoking of any tobacco product and the use of oral tobacco products, “spit” tobacco and e-cigarettes, and it applies to employees, residents, and non-employee visitors of Provision Living.

Policies

OPTION 1 – TOBACCO-FREE POLICY

No use of tobacco products including cigarettes and “spit tobacco” or e-cigarettes is permitted within the facilities or on the property of Provision Living at any time.

OPTION2 – COMPLETE TOBACCO-FREE POLICY

No use of tobacco products including cigarettes and “spit tobacco” or e-cigarettes is permitted within the facilities or on the property of Provision Living at any time. No third hand tobacco smoke (THS) is permitted after probationary period.

THS is managed at three levels on the property: THS 1 (during shift), THS 2 (24 hours), and Smoker Free (no smokers), to accommodate hiring smokers into a caring, radiant person, family type community that is mindful, of the stress involved in continuing and in curing an addictive illness, and the freedom and benefit of being cured: a new non-smoker. At no time is smoke generated on the property.

Procedure

1. Employees will be informed of the Provision Living Tobacco-free Policy during regular staff meetings prior to 30 days of being effective.

2. Visitors will be informed of the Provision Living Tobacco-free Policy by their hosts, the meeting invite and email correspondence.

3. Provision Living will help employees prepare to quit, to set a quit date, and to access recommended smoking cessation programs and materials. This includes a Freedom Team of never smokers, former smokers, new hire quitting smokers and smoking cessation counselors. (Visit www.lung.org/stop-smoking for more information.)

4. Any violations of this policy will be handled through the standard disciplinary procedure.

____________________________________        ________________________

 SIGNATURE CEO or PRESIDENT                          DATE  

                                           American Lung Association 2013, edited 25 May 2018