e-cigarette act & tobacco programming 2015

© Windsor-Essex County Health Unit, February, 2016

CHRONIC DISEASE AND INJURY PREVENTION DEPARTMENT - E-CIGARETTE ACT & TOBACCO

PROGRAMMING 2015

KRISTY MCBETH, Director, Knowledge Management ERIC NADALIN, Health Promotion Specialist, Chronic Disease and Injury

Prevention


TOBACCO PROGRAM – STAFFING OVERVIEW

• 1 Health Promotion Specialist

• 1 Public Health Nurse (Cessation focus)

• 1 Youth Engagement Specialist

• 6 Tobacco Enforcement Officers

• Designated under both SFOA and the ECA (provincial)

• Designated to enforce following municipal smoke free outdoor space by-laws

• Town of Lakeshore

• Town of Tecumseh

• Town of Essex

• Town of Kingsville

• Town of Leamington

• Town of LaSalle


ELECTRONIC CIGARETTES ACT, 2016

Effective Jan 1, 2016

• Prohibiting the sale and supply of e-cigarettes to anyone less than 19 years of age;

• Prohibiting the sale and supply of e-cigarettes to any person who appears to be less than 25 years old without asking for identification;

• Prohibiting the use of false identification to purchase an e-cigarette; • Prohibiting the sale of e-cigarettes in retail settings if prescribed signs

are not posted; • Prohibiting the sale of e-cigarettes in vending machines; and • Prohibit an employer from retaliating against an employee because

the employee has acted in accordance with the Act. *The government delayed proclamation of the use provisions under the ECA to a future date.


TOBACCO PROTECTION 2015 - ENFORCEMENT

Workplaces & Public Places

Restaurants & Bars

Tobacco Vendors – Youth Access

Tobacco Vendors – Display, Promotion & Handling

TOTALS

Total # inspections

696 667 671 434 2468

Total # Charges

52 22 47 2 123

Total # Warnings

48 84 0 21 153


PROTECTION – ENFORCEMENT STATS Sell/Supply to a

person who is less

than 19 years of

age/OR appears to be

under 25 years

Section 3(1)

Smoke/Hold

Lighted Tobacco

in Workplace or

Prohibited Space

9(1), 9(2)

Failure of Employer

to comply

9(3)(a,b,c,d,e,f)

Failure of Proprietor

to Comply

9(6)(a,b,c,d,e,f)

Display/Promo

te Tobacco

Products

3.1(a)(b), 3.1

(2)(3)

Failure to Post No

Smoking Signs 10

Sell/Offer/Display

improper packaged

tobacco 5(1)(a)(b), 5(2)

Obstruction Totals

2006 34 8 6 14 33 4 5 0 104

2007 41 22 9 6 14 0 9 0 101

2008 32 18 1 4 3 1 2 0 61

2009 28 14 4 0 3 0 0 0 49

2010 55 11 9 1 1 1 2 2 82

2011 69 6 2 1 1 0 0 1 80

2012 33 2 4 1 4 0 0 0 44

2013 26 1 7 0 0 0 0 0 34

2014 23 11 3 2 0 0 0 0 39

2015 47 54 16 1 2 3 0 0 123

TOTALS 388 147 61 30 61 9 18 3 717

• 34% increase in sales/supply to minor

• 66% increase in smoking in prohibited spaces

• 68% increase in failure of employer to comply

Overall increase of 52% in total charges from 2014 to 2015


93.75 95.29

97.63

96.65

90.31

86

88

90

92

94

96

98

100

2011 2012 2013 2014 2015

Youth Access Compliance Rate 2011-2015

Actual Compliance Rate Target Compliance Rate or higher


2015 DECREASED COMPLIANCE –EXPLANATIONS

• Increased number of smoke free spaces under the SFOA amendments (playgrounds, sports fields, patios)

• Although education was the priority, non-compliance resulted in charges where appropriate

• Increased number of seasonal inspections from May-October

• Increased surveillance during evenings and weekends

• 100% complaint follow-up policy – 240 complaints/follow-up inspections at workplaces/public

places (indoors & outdoors)


2015 DECREASED COMPLIANCE –EXPLANATIONS

• Increased sales to minor rate difficult to account for but creates need for proactive strategies to increase compliance in 2016

• The provincially calculated compliance rate uses the rate of compliance at the time of the last inspection

• All owners/operators are notified of a sale to minor through the sale notification letter (whether or not they are present at the time of the illegal sale)

• Tobacco vendors are visited by for enforcement activities a minimum of 3 times per year

• Promotion of Not to Kids Binder and regional website SFOAtraining.com

• Annually provide “year” stickers that show the year of when someone would need to have been born in order to be 19

• Continue to run our education based “Under 25” campaign in the Spring and offer on-site education sessions for staff


2016 ENFORCEMENT PLAN

Other Enforcement Priorities

• Ongoing prohibited spaces enforcement

Workplaces & public places indoors

Patios, fairs and festivals

Outdoor recreation spaces (by-law and SFOA)

• New areas of enforcement for 2016:

Smoke free hospital grounds

Flavoured tobacco ban (excluding menthol until Jan 1, 2017)


There’s more to it than just enforcement and regulation…

• Enforcement and protection activities and policies are effective strategies to move people along the stages of change

• Need to also provide support once people are ready to quit


CESSATION OUTCOMES

• Protection and enforcement goals tie closely to health outcomes • Impact quit attempts.


WECHU SMOKING CESSATION PROGRAM

• Commenced in February 2015

• Funding for Nicotine Replacement Therapy (NRT) received through one time Ministry request process

• TEACH trained staff in CDIP and Healthy Families treating clients

• In depth initial assessment to determine eligibility and referral ready status

• To date 67 clients since February 2015


WECHU SMOKING CESSATION PROGRAM

• Follow-up at 2, 4, 6, 8 , 12 and 16 week intervals. 6 month long term follow-up

• Approximately 53% drop out after first appt.

• Attrition attributed to: • Return to smoking (i.e., not ready/willing to change behaviour)

• Quit and no longer interested in NRT/Counselling

• Death

• Contact lost to follow-up

• To date, 29 clients eligible for 6 month follow-up • 13 clients consented to complete 6 month follow-up

• 5 quit; 2 smoked >50cpd

• Follow-up ongoing for remaining clients (enrolled late in 2015)


CESSATION 2015 – CONT'D

Campaign/Initiative Enrollment (W/E)

NRT Services

WouldURather 728 168 registrants ordered NRT

• Link to LTPB which offers education materials

Driven2Quit 285 Linked through referral to SHL

• Referral to SHL

Smokers’ Helpline 245* Referred externally to NRT sources

• Individualized quit counselling by trained cessation coach

STOP on the Road 200 5-weeks of NRT provided to all participants

• Educational workshop from WECHU PHN

*Unique referrals through WECHU services

• 658 Quit Attempts from WECHU promoted initiatives in 2015

• SOTR – 200; Clinic – 67; WUR – 106; D2Q - 285


2016 CESSATION PLAN

• Host monthly community (Smoking Treatment for Ontario Patients) STOP sessions

• Engagement of local health care providers to support integration of minimal contact intervention policies

• Support local health care providers interested in smoking cessation services by hosting a Community of Practice

• Maintain community services locator to ensure up to date inventory of smoking cessation services available in Windsor-Essex


PROVINCIAL CESSATION CAMPAIGNS

• Promotion of MOHLTC media compaign

• Promotion/implementation of provincial

cessation campaigns


QUESTIONS

e-cigarette act & tobacco programming 2015

Healthcare