I need a webpage to hold easy to find information for this blog. The following draft pages have been
prepared. Your comments will be appreciated. I now have something worthwhile to
do in winter when I cannot work out on the Monarch Butterfly Sanctuary.
1.
New Website.
2.
Tobacco Free Pledge
3.
Definitions
4.
Together We Can
5.
Terminology
Two years at Provision Living at Columbia show a need to
rescue smokers and residents from tobacco smoke. Nicotine addiction is not a
private matter using cigarettes.
Cultural norms over the past 50 years have changed from
ancient customs of ceremonial use to a society becoming fully aware of the
health consequences of cigarettes designed for maximum addiction that thus yield
maximum profit.
The new norm is no exposure. Instant elimination of exposure
is now legally available from nicotine sources other than smoke.
The long term approach is culturally imbedded. It took 30
years for hospitals to discover they were health care facilities. And longer
for airlines to be smoke free
because it was more profitable. And 50 years for MU Health Care to be smoker free.
The general public is now smoking less, but 75% of smokers
still want to quit. Many do all by themselves. A pack-a-day smoker can save the
equivalent of a $1/hr raise. But most smokers need a close knit support group:
church, club, job site.
I think the following homework allows me to make a valid
comparison between tobacco free (if it exists) residential care in San Antonio
and a plan to develop such here if we remain in Columbia.
=============================================================
1. New Website
13Jan18
Three years ago I started www.residentialcarefortwo.blogspot
to record our search for a place for my wife and me. We have now lived for two
years in Provision Living at Columbia, MO, in assisted living and in memory
care.
Our family situation has changed. We are looking again. Columbia,
MO, is not a tobacco smoke free city. Employees can smoke on the job in
designated areas. San Antonio, TX, is a tobacco smoke free city. Many workplaces are smoke free.
This time we would like to find a site that is free from
third hand tobacco smoke. Tobacco smoke: first hand, second hand, and now third
hand, has been found to be equally damaging to health, in comparable amounts
(with the exception of triggering my allergies). Tobacco smoke has no place in
health care facilities including assisted living and memory care.
Unfortunately, big money still controls tobacco use at the
federal and stage level. Current smokers finance the infamous tobacco
settlement that pays states for 25 years for damages to health and to promote
non-smoking. That money, however, is not used to promote non-smoking but put
into the state general fund.
The tobacco tax is also seen as an important revenue source
for states; when governors worry about a loss in the tobacco tax as the price
of cigarettes is increased to reduce sales to minors. Missouri collects about
$20,000 per 20 cases of cigarettes. Most states collect about $180,000 for 20
cases. That is the value of one life lost from tobacco.
Protection of the general public then falls to the general
public, and to the advantage, companies see in declaring; first, smoke free,
then tobacco free, and finally, totally, smoker free (first hand, second hand,
and third hand smoke).
Provision Living at Columbia is a good [candidate]. It was
constructed with no tobacco use in the building. It is just two years old. It
has a skilled, experienced work force that includes many former smokers. It has
only one resident smoker who diligently goes outside, come whatever weather,
each morning.
This is a college town. This helps promote a high turnover
rate. The opportunity exists to expose a large number of people to an effective
smoke secession program as new hires are welcomed into productive [groups] (or
rejected).
Now to explore the status of tobacco in residential health care
facilities near Columbia, and not waste the effort, by posting what we find on
this [website]. We may move to San Antonio, for a year or two, or work at
clearing the air here.
=============================================================
--DRAFT-- 2.
Tobacco Free Pledge --DRAFT--
Your residential health care facility will be tobacco free
soon, if it has not already been established as tobacco free. Also help the 75%
of smokers who want to quite, to quite. This is easier to do in a model
Smoke-Free City.
San Antonio City Ordinance: 2010-08-19-0697, Chapter 36: (Bold my emphasis.)
WHEREAS, numerous studies have found that tobacco smoke is a
major contributor to indoor air pollution, and that breathing secondhand smoke is a cause of disease in
healthy nonsmokers, including heart disease, stroke, respiratory disease
and lung cancer; and
WHEREAS, secondhand
smoke is particularly hazardous to elderly people, individuals with
cardiovascular disease, and individuals with impaired respiratory function,
including asthmatics and those with obstructive airway disease; and
WHEREAS, the United States Surgeon General has stated that there is no risk-free level of exposure to
second-hand smoke (U.S. Surgeon General’s Report – 2006, The Health
Consequences of Involuntary Exposure to Tobacco Smoke);
Company: _____________________________________
Independent Living Assisted Living Memory
Care Skilled Nursing
Beds:
_____
_____ _____
_____
Date to be tobacco smoke free: _____________
Date to be a tobacco free site:
_____________
Date to be a smoker free site:
_____________
Date to be a clean air site: _____________
Address: _________________________________________________________
Phone: __________________
Email: __________________________________
Name: __________________________________ Date: ___________________
Comments:
Post
to: [www.residentialcarefortwo.org] (near Columbia, MO, and San Antonio, TX)
=========================================================================
3. Definitions
As detailed as these three definitions are, they still do no
state clearly current situations. This leaves the code open to interpretation.
Is a residential care facility such as Provision Living
ranked as a health care facility?
The tobacco free
status of the MU campus includes the medical center and all outdoor areas, including parking
lots and sidewalks.
Health care facility means an office or
institution providing care or treatment of diseases, whether physical, mental,
or emotional, or other medical, physiological, or psychological conditions,
including but not limited to, hospitals, rehabilitation hospitals or other
clinics, weight control clinics, nursing homes, homes for the aging or
chronically ill, laboratories, and offices of surgeons, chiropractors, physical
therapists, physicians, dentists, and all specialists within these professions.
This definition shall include all waiting rooms, hallways, private rooms,
semiprivate rooms, and wards within health care facilities.
Place of employment means an area under the
control of a public or private employer that employees normally frequent during
the course of employment, including, but not limited to, work areas, employee
lounges, restrooms, conference rooms, meeting rooms, classrooms, employee
cafeterias, hallways, and vehicles. A private residence is not a “place of
employment” unless is is used as a child care, adult day care, or health care
facility.
Public place means an enclosed area to
which the public is invited or in which the public is permitted, including but
not limited to, banks, bars, bingo facilities, educational facilities, gaming
facilities, health care facilities, hotels
and motels, laundromats, public transportation facilities, reception areas,
restaurants, retail food production and marketing establishments, retail
service establishments, retail stores, shopping malls, sports arenas, theaters,
and waiting rooms. A private residence is not a “public place” unless it is
used as a child care, adult day care, or health care facility.
Smoking means inhaling, exhaling, burning, or carrying any
lighted or heated cigar, cigarette, pipe, or any other lighted or heated
tobacco or plant product intended for inhalation.
The code does include exhaling
tobacco smoke; which may include third hand smoke: out-gassing from body, hair,
and clothing.
My one-week trip to San Antonio, nest week, should provide
some answers. What is said and what actually happens can be very different. The
following provides no protection from third hand tobacco smoke; only tobacco free does that.
“As for the smoking
free environment. Yes, we are smoke
free and nobody can smoke in the building. The only place that associates
can smoke outside is in designated area outside.”
=============================================================
--DRAFT--
4. Together We Can --DRAFT--
Employers and employees have an obligation to assist fellow
employees and new hires to gain control of their addiction to nicotine. It
gives a pack a day smoker about a $1/hr raise at little cost to the employer.
A. Set the terms for employees to be free
from nicotine addiction (as is, all other drug addictions are illegal and/or
grounds for dismissal).
There is no, risk-free, level of tobacco
smoke.
Nonsmokers enjoy better health and more
productive time.
Employer support includes nicotine
management supplies and services.
All new hires must take an active part in a
support team.
B. Organize employees to support one
another and recognize progress.
Organize employee support teams by job
locations.
Try to include a former smoker in each
team.
Award periodic prizes for progress.
Make provision for new hires.
Recognize arrival at smoke free and tobacco
free site rankings.
Celebrate success when smoker free (except
for new hires).
=============================================================
5. Terminology
Tobacco use has been a part of our culture for centuries.
Life was short. Baseball players spit tobacco. Cowboys smoked Marlboro. In the
past century they lived long enough to develop mouth cancer and lung cancer.
In 1964 the United States Surgeon General declared that
tobacco was the greatest cause of preventable illness and death in the country.
Our cultural assumption was it only involved tobacco users.
In 1994 seven tobacco company executives lied to congress,
“I do not believe that cigarettes are addictive,” and lost their jobs but
avoided jail time. Our culture learned that tobacco use is not a habit but a
means of delivering a powerful addictive drug. The cigarette is optimized to addict
and therefore to kill.
By 2006 the United States Surgeon General had determined
that there is no risk-free level of exposure to second hand smoke. Our cultural
response was to increase the isolation of addicted smokers and to declare
tobacco free areas.
A cultural response is needed today to assist tobacco
addicts to regain control of their own behavior. Tobacco companies and federal
regulations are of little help to addicts. The task of becoming tobacco free
falls to communities and work groups. I have experienced five levels of concern
in the past two years:
*Unregulated: San Antonio, TX, lives on top of its water
supply. Cigarette buts can contaminate that water.
*Smoke Free: No active smoking in the area (indoors and
outdoors). Dividing a room into smoking and nonsmoking was a political
maneuver. Addicts are temporarily provided an isolated smoking area (indoors or
outdoors) with self-extinguishing butt collectors.
*Tobacco Free: No tobacco products allowed on the area. No
butt collectors. Active therapy provided for addicts by health care services,
employers and employee support groups.
*Smoker Free: No smokers!! End of air quality problem? NO.
*Clean Air: The continuous injection of air contaminates
that mask or alter odder in residential care space without the consent or
knowledge of the occupants is not only unethical but a health hazard. It is one
more stress on people in poor health (our laundry can be marked: no softeners).
The marketing pitch is they increase sales in boutiques by about 10%. They may
have a clean air or fresh air effect for
some people but I know of none in
use that actually clean or refresh air.
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