Just Launched! TobaccoFreeCO.org

Coloradans have a new place to find facts and resources aimed at creating tobacco-free communities. The Colorado Department of Public Health and Environment launched www.TobaccoFreeCO.org in August 2013. The online web hub connects visitors to a variety of resources and topics including cessation services, information on preventing secondhand smoke exposure and youth smoking prevention.

You may also notice new ads popping up around the state. The “I Am Tobacco” ad campaign will promote the new web hub by depicting the some of the harmful effects associated with tobacco use. Gas stations, restaurants, liquor stores and bus shelters will feature ads with radio spots and internet ads appearing as well.

New Study Confirms Impact of CO Smoke-Free Laws

The evidence supporting smoke-free policies is overwhelming and continues to grow. A first-of-its-kind health study has demonstrated again that the health benefits of smoke-free laws are significant and immediate. In the latest edition of the American Heart Association scientific journal Circulation, a new study found ambulance calls to Gilpin County casinos (Black Hawk and Central City) decreased by about 20 percent in the year following the implementation of the state smoke-free casino law in 2008. This was the first study to look at ambulance calls before and after a smoke-free law. The ambulance study, conducted by Stanton Glantz, Ph.D., of the University of California of San Francisco, analyzed the number of ambulance calls over 12 years in Gilpin County. Glantz is one the nation’s leading experts on tobacco use, secondhand smoke and its impact on heart disease.

This news follows two other Colorado studies that showed the dramatic impact smoke-free laws have on heart disease. A landmark 2005 study demonstrated that in the 18 months following the adoption of a local smoke-free law in Pueblo Colorado, hospital admissions for heart attacks dropped 27 percent. At that time, the Pueblo Heart Study was just the second in the world to demonstrate a reduction in hospital heart attack admissions following the implementation of a smoke-free law. Since then, more than 40 such studies have been conducted worldwide with similar results, including two more in Colorado. An additional Pueblo study showed a 41 percent reduction in heart attack admissions three years following the implementation of Pueblo’s law. A Greeley, Colorado study following the implementation of a smoke-free law there showed a 27 percent reduction in heart attack admissions in the next year, with the greatest reduction in heart attack admissions of 56% for people who smoke.

Coalitions Creating Movement Through Dialogue

Beginning in the 1960s, after the release of the first Surgeon General Report, Smoking and Health, people concerned about the dangers of tobacco, secondhand smoke and the tobacco industry’s tactics to promote tobacco use formed coalitions and other advocacy groups across the United States. Over the years, these groups have developed into what many of us know to be the most important force for change in tobacco prevention and control. Working at the grassroots, coalitions are accountable for changing policies which help prevent tobacco-related disease and premature death.

In 2004, one of the first local tobacco prevention coalitions in Jefferson County, Citizens Against Unhealthy, Smoke-filled Environments (CAUSE), successfully advocated for the passage of Arvada’s smoke-free public places law. Since then, more than six adult community coalitions and three youth coalitions have taken up the charge to reduce tobacco’s toll through policy change in Jefferson County. This past year has been no exception. Thanks to the work of the Breathe Easy Wheat Ridge Coalition and the 2013 Smoke-Free Parks Rule, youth, adults, residents and visitors will be able to enjoy smoke-free parks, playgrounds and open spaces in Wheat Ridge. The Breathe Easy Wheat Ridge Coalition worked with both the council and commission while educating the public about the benefit of smoke-free protections. The coalition reported that more people would visit Wheat Ridge parks, bars and restaurants if outdoor areas were smoke-free. Additionally, a group of youth in Wheat Ridge organized a cigarette butt pick-up in Wheat Ridge area parks to raise awareness about the problem of tobacco-related litter. To find out more about the coalition and to get involved, please email breatheasywheatridge@gmail.com.

The Healthy Unincorporated Jefferson County Coalition (Healthy UJC) has been working for more than two years to see a stronger smoke-free public places law in the unincorporated areas of Jefferson County. In the spring of 2013, Snip Young, Chair of Tobacco-Free Jeffco and member of the Healthy UJC Coalition joined Dr. Mark Johnson to present the case for a strong, local smoke-free policy to the Jefferson County Commissioners. To find out more about this coalition and to get involved, email healthyunincorpjc@gmail.com.

Thanks to the advocacy work of the Lakewood Coalition, light rail riders who take the new RTD rail line that goes west of Denver will enjoy a smoke-free stop in Lakewood. Last year, following a comprehensive education campaign by the Lakewood Coalition, the city council adopted a local ordinance to make outdoor transit waiting areas smoke-free. This includes light rail and bus waiting areas, stops and platforms. Finally, one more smoke-free celebration for a Jefferson County neighbor, Gilpin County. This past January, Colorado celebrated the five year anniversary of its smoke-free casino law, which made all of Gilpin County’s gaming establishments smoke-free in 2008.

New Text Messaging Program for Young Adult Cessation

Many young adults who smoke have the desire to quit, but do not always have the right information or resources. The CO Quit Mobile system is an innovative and free text message based cessation program designed for an 18-24 year-old population.

CO Quit Mobile sends messages that are specific to the user and their smoking habits in order to provide the best coaching available. The user is then able to prepare, make a plan and start the quitting process with support. Those with smartphones can take advantage of a companion app that provides additional tools for help. The system is available 24 hours a day, seven days a week and it provides up to 30 days of counseling.

Great American Spit-Out 2013

BE Team representatives spoke with students about the harms of tobacco at the Great American Spit Out.
This year’s Great American Spit Out (GASpO) was on February 21, 2013. The GASpO is a one-day challenge that encourages smokeless tobacco users to skip the dip and go just one day without tobacco. Inspiring students to quit is made a little easier when facts about spit tobacco use are shared. A 2008 study from the WHO International Agency for Research on Cancer concluded that smokeless tobacco users have an 80 percent higher risk of developing oral cancer and a 60 percent higher risk of developing pancreatic and esophageal cancer. Another fact, included in The S.T.O.P. Guide (The Smokeless Tobacco Outreach and Prevention Guide) states that “Leukoplakia, which can lead to oral cancer, occurs in more than half of all users in the first three years of use, with more than 60 percent of spit tobacco users experiencing these oral lesions.” Click here for the National Cancer Institute's fact sheet on smokeless tobacco and the cancer risks associated with spit tobacco usage.

The Lakewood High School’s Breathe Easy (BE) Team – a group of students working to reduce tobacco's toll through education, outreach and advocacy – helped organize a quit challenge for the GASpO. Twelve students signed up for the quit challenge and received a quit kit and support throughout the day. Many of the students had a hard time, but stuck with it. One student told Nicole Swaggerty, Youth Engagement Specialist for the Tobacco Prevention Initiative at Jefferson County Public Health, he was offered dip five times by his peers during the day, but he declined their offers. Another student who pledged to quit for the day said it was hard but the sunflower seeds, toothpicks, text messages and web-based cessation resources such as MyLastDip and ChewFree encouraged him to stay tobacco-free. Throughout the day, students came by the GASpO table and received education about the dangers of smokeless tobacco. For more information about youth tobacco prevention in Jefferson County contact Nicole Swaggerty at 303-239-7007 or nswagger@jeffco.us

BE Team Health Champions

As one of the main targets of the tobacco industry's marketing tactics, the youth population plays a significant role in the battle against tobacco. Despite the tobacco industry’s efforts to counter life-saving tobacco prevention policies, young people continue to demonstrate the power behind their voices. One way young people in Jefferson County are becoming engaged in tobacco prevention efforts is by joining local Breathe Easy (BE) teams. BE teams have made significant gains in shaping tobacco-free norms and decreasing youth access to tobacco products in Jefferson County communities.

Three particularly engaged young people were recognized as Public Health Champions this year at a luncheon held by the Jefferson County Public Health Department. Hannah Fritz and Beau Hogan, of the Golden High School BE Team and Carissa Leeper of the Lakewood High School BE Team, joined several community coalition chairs as Public Health Champions, a testament to their dedication and the powerful impact they make through their work.

Right: Golden BE team member Hannah Fritz smiles with fellow Public Health Champions, Breathe Easy Wheat Ridge and Healthy Unincorporated Jeffco coalition chairs Lynnette Namba and John Coles.
Golden's BE team, represented by recent graduates Fritz and Hogan, successfully advocated for an ordinance reducing youth access to tobacco. The Golden ordinance requires licensing of tobacco retailers and proof of identification for all tobacco purchases, regardless of customer age, for non-cigarette tobacco. The ordinance also requires that clerks selling non-cigarette tobacco be at least 18 years of age.

Lakewood's BE Team, represented by senior Carissa Leeper, successfully advocated for a stronger smoke-free ordinance in the Lakewood community. The Lakewood ordinance extends smoke-free entranceways to 25 feet and requires that all outdoor transit waiting areas, playgrounds, athletic fields and gathering places in parks and city events be smoke-free.

These three tobacco prevention youth Public Health Champions have helped to reduce the toll of tobacco on our communities and helped shape tobacco-free norms, making tobacco not only less desirable and less acceptable, but also less accessible. An enormous congratulations to Hannah, Beau and Carissa, for their meaningful contributions to the movement for healthier communities. The honor is well-deserved! To learn more about opportunities to get involved, please contact Nicole at nswagger@jeffco.us or 303-239-7007.

Lakewood High School Students Use Art to Kick Butts

This year’s Kick Butts Day was the biggest in history with over 1,300 events across the country. In Jefferson County, one of those events took place at Lakewood High School (LHS). Hannah Bendiksen, a National Art Honor Society student at LHS, created a powerful art piece to display at the school for Kick Butts Day. Students that visited the booth where Hannah’s art was displayed learned about Kick Butts Day – a day when youth are encouraged and empowered to stand out, speak up and seize control against Big Tobacco.

Left: Hannah Bendiksen stands next to her artwork for Kick Butts Day. Hannah’s message is that when one smokes, they hold more in their hands than a cigarette. She hopes that her art causes pause and sparks an understanding, if not a full desire for change. Right: Students prepare their statements for a speak-out against Big Tobacco.
The students who viewed Hannah’s art also learned about how the tobacco industry focuses on youth and young adult populations with their deceptive marketing tactics and how youth are three times more sensitive to tobacco marketing than adults. The students were then able to make a statement to speak out against big tobacco. One student wrote, “Get a life and stop stealing ours!” Another student pronounced “We should stop production altogether. Smoking kills and it puts an emotional burden not only on the one who smokes, but the ones who are exposed to it every day.”

A recent report of the Surgeon General states that nearly all tobacco use begins in youth and young adulthood and that young adults are a prime target for tobacco advertising and marketing activities. It is clear that young people have something to say about being the prime targets for tobacco advertising and want to take a stand. There is an urgent need to continue engaging youth and young adults in standing up and speaking out against tobacco companies. Tobacco companies know who composes the next generation of smokers. Youth in Jefferson County are saying no. Click here to read more in an article from the Lakewood Sentinel.

2013 Cigarette Butt Pick-Up

A group of Vivian Elementary Students proudly show the butts they picked up at the Earth Day event.
The production and consumption of tobacco leaves a wake of devastation for both people and the planet. On May 3rd, students from several Wheat Ridge area schools participated in the cleanup of Crown Hill and Discovery Parks during the 3rd annual Cigarette Butt Pick-Up organized by Jeffco PTA and Jeffco Public Health. Collectively, the students picked up: 4,996 cigarette butts from two parks in 45 minutes! The Butt Pick-Up helped to raise awareness about the impact of tobacco on the environment and to involve young people in the movement to create a healthier, tobacco-free community in Wheat Ridge. By participating in the event, students had the opportunity to engage with their community, connect to the natural world by cleaning up their local park and hear about leadership opportunities. Click here to check out more photos from the event. This event also highlighted the negative impact that tobacco production and litter have on our natural environment:

• It is estimated that several trillion cigarette butts are littered worldwide every year, ¹ flicked one at a time on our sidewalks, beaches, nature trails, gardens and other public places. In fact, cigarette butts are the most littered item in the world with an estimated 845,000 tons of butts littered globally each year.²
• Cigarette filters are made of cellulose acetate tow, not cotton and they can take decades to degrade.³ Not only does cigarette litter ruin even the most picturesque setting, but the toxic residue in cigarette filters is damaging to the environment and dangerous for animals and people. In addition, littered butts cause numerous fires every year, some of them fatal.
• Research conducted by the U.S. National Oceanic and Atmospheric Administration estimated that cigarette debris is responsible for killing at least one million sea birds and 100,000 mammals annually,⁴ and a recent study led by Elli Slaughter of San Diego State University shows that when cigarette butts enter the water supply, they are deadly to fish and marine life. ⁵
• Tobacco production is also responsible for global deforestation, requiring nearly 600 million trees annually to provide fuel for drying tobacco. That means one tree is destroyed for every 300 cigarettes produced. ⁶

For more information about youth tobacco prevention or the BE Team in Jefferson County contact Nicole Swaggerty at 303-239-7007 or nswagger@jeffco.us

Debunking E-Cigarette Myths

If you have been paying attention to the media surrounding tobacco consumption over the past year, you have probably heard of e-cigarettes. Electronic cigarettes are devices designed to look similar to cigarettes in shape, size and general appearance. They operate by vaporizing a nicotine solution into an inhalable mist and activating an indicator light that simulates burning ash. Sold by popular brand names including “blu” and “NJOY,” e-cigarette cartridges are available in various flavors and claim to contain varying levels of nicotine.

Many predicted it wouldn’t take long for the makers of “combustible” cigarettes to get into the e-cigarette business and it looks like that day has come. RJ Reynolds American, Inc., the maker of Camel tobacco products, plans to test market a new line of e-cigarettes in Colorado. According to a recent article, Colorado will become the first stop in the national rollout of Vuse, a digital vapor cigarette by R.J. Reynolds Vapor Co. (RJRV), a new subsidiary of the company. Click here to read the article and see a 2 minute video that discusses the development of Vuse by RJ Reynolds.

While proponents of e-cigarettes claim that they can be used for cessation from tobacco products, most public health and tobacco control advocates believe that use of e-cigarettes can actually undermine a quit attempt, exacerbate nicotine dependence and contribute to the normalization and glamorization of smoking and tobacco use. Because of the lack of adequate research and regulation on these products, many communities are banning their use in places where smoking is prohibited. World No Tobacco Day, May 31, 2013, marked the country of France’s decision to ban e-cigarette use in public places. In response to questions about this decision France's Health Minister, Marisol Touraine stated, "This is no ordinary product because it encourages mimicking and could promote taking up smoking."

The following highlights some of the concerns shared by opponents of e-cigarettes:

1. Unreliable research: There have been no long-term studies to date on the effects of using e-cigarettes and very few reliable studies of their contents exist. The risks associated with inhaling the mix of chemicals under these circumstances are not known.
   
2. Inconsistent doses: Mis-labeled and inconsistent levels of nicotine in e-cigarettes may increase nicotine consumption and dependence, contributing to a stronger psychological compulsion to smoke.
   
3. Social acceptability: Use of e-cigarettes in public places may not be regulated, allowing them to be used where smoking may otherwise be prohibited, creating a sense of social acceptability and normalization.
   
4. Risk of dual use and increased intake of nicotine: Because of the delivery method, lack of regulation on where use can occur and levels of nicotine in e-cigarettes, it is possible that users will continue to smoke combustible cigarettes and use the e-cigarette, increasing both physical and psychological dependence.
   
5. Misconceptions in the media: The perception is that e-cigarettes are "safer" or "smarter." Along with the increase in e-cigarette commercials on television and in print media, recent quitters, those attempting to quit and current tobacco users are likely to face a significant increase in the number of triggers to smoke (combustible and/or e-cigarettes).
   
6. Undetectable: Because these devices can be used largely without detection, intervention in the early stages of use when addiction is easiest to prevent/break may become difficult. This poses a greater challenge for parents, teachers and others working to prevent youth tobacco use and addiction.

Click here for a one page information sheet on e-cigarettes from the Colorado Department of Public Health and Environment.

Graphic Cigarette Labels Soon Required by FDA

The U.S. Supreme Court took a major step to help prevent and reduce tobacco use at the end of April, when it agreed with an appellate court ruling that upholds the landmark 2009 law granting the FDA authority over tobacco products. Most notably, the decision allows the FDA to move forward with the development of new cigarette warning labels that include large, graphic images and strong messages.

Despite the studies showing that graphic and emotionally evocative warning labels are effective, the 2009 law that requires these warning labels to cover the top half of the front and back of cigarette packs as well as 20 percent of cigarette ads, has yet to be implemented due to opposition from the tobacco industry. Currently, tobacco products feature text-only warnings that have not been updated since 1983. Susan Liss, Executive Director of Campaign for Tobacco-Free Kids, recently made a statement describing the labels that currently serve as warnings on tobacco products as “stale and unnoticed.”

Dealing a blow to the tobacco industry’s interests, the Sixth Circuit Court ruling found that the graphic warning label requirement is reasonable and related to the government’s interest in preventing consumer deception and is therefore constitutional. By upholding the law to use the graphic labels, the United States will join more than 60 other countries already using the labels.

Instead of blandly stating the risks behind tobacco use as current labels do, the new labels are expected to increase awareness of the incontestable health consequences of using tobacco. According to a study done by the International Tobacco Control Policy Evaluation Project on tobacco warning labels, adult and youth smokers report that large, comprehensive warning labels reduce smoking consumption, increase motivation to quit and increase the likelihood that they will remain abstinent following a quit attempt. For more information about this and other studies showing the effectiveness of graphic warning labels, find fact sheets online at Campaign for Tobacco-Free Kids.

Consistent with the intention behind these labels to reduce consumption and prevalence, the new cigarette warnings will also include a hotline for tobacco users who are ready to quit. Find out more about this story in a recent Washington Post article.

Red Rocks Quit Coaches Support Student Cessation

Part of our ongoing work to reach young adults includes a partnership at Red Rocks Community College (RRCC), where students have reported a noticeable tobacco presence on campus. We are excited to feature the Peer Quit Coach Program, which currently includes four trained peer coaches who are supporting 14 RRCC students in breaking free from tobacco dependence.

The Peer Quit Program is an innovative peer support resource through which students who want to quit can partner with peer coaches who support them through the cessation process. After a thorough training process around health behavior change and cessation, four students were interviewed and selected to specialize in coaching tobacco cessation. All of the coaches in the program are former smokers who are incredibly passionate about inspiring and supporting others in quitting tobacco. They attended our county-wide coalition meetings, introduced themselves and shared about their inspiring stories as well as the work they have been doing at Red Rocks.

RRCC Peer Quit Coaches 2013.

In addition to the peer coaching program, a comprehensive media campaign has also been launched on the Red Rocks campus including posters, social media, a page on the RRCC website about tobacco cessation and campus newsletter articles. Student groups on campus are also being encouraged to support better enforcement of a smoke-free campus policy by creating photo-voice projects addressing tobacco litter. On Earth Day, students collected 2,500 cigarette butts that would have otherwise continued to litter the campus. In addition to a support group, a Tobacco-Free Campus Exploratory Committee was created consisting of several students and faculty members who have begun meeting to strategize around how to continue reducing the presence of tobacco on campus.

Red Rocks student holding bag of cigarette litter after butt pick-up.

The Tobacco Prevention Initiative would like to thank and congratulate the RRCC Peer Quit Coach Program on their wonderful accomplishments in reducing the presence and impact of tobacco on the RRCC campus.