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Coalition Meeting

September 13, 2018 @ 12:00 am

On the agenda: an update on workplan.

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Date:: September 13, 2018
Time:: 12:00 am
Event Category:: Meeting

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- 8 Strategies to Make Quitting Easier
  Ready to break away from tobacco? Quitting smoking is tough. Nicotine is highly addictive. It reaches a smoker’s brain in 7-10 seconds, triggering a release of adrenaline. When the effects of nicotine wear off, it leaves the smoker agitated. This leads to lighting up another, then another. There are many ways to get through the stages of withdrawal. When a craving hits, try redirecting your attention. Find something to replace the cigarette. Trust that the urge to smoke will be gone within moments. Even the simplest things can jolt you out of a habit triggering moment and interrupt negative thought patterns as you try to break your nicotine addiction. You are not alone Feelings of isolation are common when you tackle such a big life change. Get ahead of this by making time to interact with people you can talk to about what you are going through. Sometimes a simple conversation about everyday life can be just the lift you need. The best thing you can do for yourself is take advantage of free smoking cessation resources. Talk to your health care provider about science-based options, such as Freedom from Smoking ® (group support) or 1-800-Quit-Now (individual coaching over the phone.) Call a friend. Tell someone you love how much they mean to you. Spend time with a child. Write an old-fashioned, hand-written letter to someone you care about. Sign up to volunteer in your community. (Consider volunteering with one of our supporting organizations.) Call your mother or grandmother. You know they love to hear from you! Write a list of people in your life who nourish your feelings of gratitude. 5-Minute Craving Busters Plan some quick and easy things to do at a moment’s notice. These should not take a lot of effort or time. They should be just enough to replace the habit of lighting up. Drink a glass of water. This works surprisingly well. Snack on a dill pickle or few salty nuts. Suck on a piece of tart candy. Eat some sweet fruit (crunchy apple, handful of juicy grapes, peeled orange). Chew sugarless mint gum. Floss and brush your teeth. Spin around in your office chair. Practice your dance moves. Do some jumping jacks. Jog or march in place. Engage your abdominals with a 30-second plank. (Work up to longer sessions.) Crank up the radio and sing at the top of your lungs (works great while driving). Slather on creamy scented hand lotion! It keeps fingers busy and reminds you how nice it is that they don’t smell like tobacco. Lavender, chamomile, and bergamot scented lotions or essential oils promote relaxation. Focus on Your Reasons to Quit When changing a habit, it is easy to dwell on the things you miss. This only heightens feelings of withdrawal. Turn the tables on that thinking and concentrate on the advantages of not smoking. Think about the good things you look forward to doing or having—or the bad things you might avoid—by not smoking. Remind yourself why you made this decision. Did you quit for your family? Place a family photo where your ashtray used to be. Did you quit for your health? Maybe bike riding is your thing. Look up mountain bikes online. Did you get tired of the cost of smoking? Start dropping $5 (just about the cost of a pack of cigarettes) in a jar everyday. You get the idea. Write a goodbye letter to cigarettes. Your body starts repairing itself within hours after that last cigarette. Pay attention to the changes you notice. You also get back your sense of smell and taste. Enjoy some new healthier recipes. Make a list of treats—no matter how small— to give yourself every day you stay quit. Distract Yourself at Home The truth is often smokers isolate themselves by sneaking a cigarette in the garage or standing outside the restaurant, away from non-smoking family and friends. When you stop spending so much time smoking, it is amazing how much more you can do. This is your chance to knock out your to-do list around the house. Some chores are just busy work. However, they do keep your hands busy and offer a brief distraction. Besides, when things are organized and you finished your checklist, you feel better. If a chore seems too big, try breaking it down to 15-20 minutes. You may get yourself on a roll! Wash the car. Check your car’s tire pressure. Clean the inside of the car. Clean a corner of the basement or garage. Mop the floor. Do the laundry. Clean out a closet or “junk” drawer. Organize your boxes of pictures. Alphabetize your bookshelves. Organize the junk drawer. Pull some weeds. Start a vegetable garden. Make a to-do list for the week ahead. Start a home budget (look at the money you saved not smoking!) Fire up your shredder and clear some old files. Start planning a vacation funded by the money saved by not smoking for a year. Plan next week’s dinners and make a shopping list to match. Bake a cake for a neighbor. Chop up veggies for a stir-fry or quick, healthy snacking. Wash the dog. Play with the cat. Read a book. Keep Your Hands and Mind Busy Many ex-smokers find they not only need to break the physical addiction, but they also need to find ways to keep their hands busy. Smoking keeps your hands busy, after all. Now may be a great time to take up a new hobby. Knit a scarf. Learning to knit or crochet is one of the top recommendations from ex-smokers. Start a sewing project. Start a blog. Write a poem or short story. Paint a picture. Grab crayons or colored pencils to color a picture. Get your camera out and take some photos. Scan the old family photos or favorite family recipes (in Grandma’s handwriting!), and save them to the Cloud. Spend some time scrapbooking. Build something with wood. Refinish or reupholster a piece of furniture. Do a jigsaw or crossword puzzle. Play a game on your smart phone. Be Active Many people fear gaining weight when they quit smoking. You can avoid packing on pounds by doing small things to stay active. These are also great ways to distract yourself when cravings hit! Go for a walk. Join a gym and work out. Try mindful practice, like yoga. Jump on the treadmill and work up a sweat. Head to the beach for a swim. Get Out and About A change of scenery can do wonders for the mind. When you’re tired of hanging around the house, step outside and find somewhere to go. It’s a lot of fun and can be very relaxing. Window shop at the mall. It’s a great place to walk, too. Take a new route home from work. It keeps your mind engaged and you may find new places to visit when you have time. Take a day trip. Go out to lunch or dinner. Visit a museum. Get out into nature. Go out to the movies. Donate blood. Can’t get out? Rearrange the room. Embrace Relaxation and Treat Yourself Possibly more important than anything else, do what you can to take care of your mental and physical health. Learning how to relax (and actually enjoy it) can do wonders for your outlook during this transition. Take some time for yourself and enjoy the moment, the rest you get will do you good. Practice smiling in the mirror because it releases endorphins that make you happy. Stop and really smell the roses. Take a long hot shower or a candle-lit bath. Listen to a relaxation tape or some favorite music. Do some deep breathing for a few minutes. Practice meditation. Take a nap. Treat yourself to a spa day. Let someone else cook supper for you. ...
- Quitting Season is here!
  The new year is here, and it’s a great time for fresh starts. If you’re a tobacco user, the best thing you can do this year is to make a quit plan. Smoking is still the number one cause of preventable death in Indiana. Making the decision to quit in 2019 can dramatically reduce your risk for life threatening diseases and even make all of your holiday meals taste better. Visit our website for a list of resources in this area. Quit plans: Combine quit smoking strategies to keep you focused, confident, and motivated to quit Help identify challenges you will face as you quit and ways to overcome them Can improve your chances of quitting smoking for good A trained quit coach at 1-800-Quit-Now can help with a quit plan. SmokeFree.gov suggests the following steps for having a successful quit plan: Pick a quit date Let loved ones know you are quitting Remove reminders of smoking Identify your reasons to quit smoking Identify your smoking triggers Develop coping strategies Have places you can turn to for immediate help Set up rewards for Quit Milestones Free, confidential help is available at 1-800-Quit-Now or QuitNowIndiana.com. Make 2019 your best year yet by making the decision to quit. ...
- What is the cost in the workplace when employees smoke?
  If you could have a safer workplace, a cleaner workplace, a healthier workplace, a more productive workplace—and it wouldn’t cost you a dime, would you? If you could save thousands of dollars a year, would you? Making your workplace smoke-free can do all that, and more. Every business, large and small businesses alike, is trying to find ways to make their companies more productive. Health insurance costs impact the revenue of all companies. In comes down to this: the healthier your staff and workplace environment, the healthier your profits. What does it cost you to have smokers in your workforce? There are two types of employer costs to consider caused by tobacco use in the workplace. Direct Costs are those dollars spent on health services. Direct costs include payments made by the company for healthcare benefits, disability, and workers’ compensation. Indirect Costs are expenses not immediately related to treatment of disease. They include lost wages, lost workdays, costs related to using replacement workers, overtime expenditures, productivity losses related to absenteeism, and productivity losses of workers on the job. Since tobacco use is the number one preventable health issue in the U.S., encouraging workers to quit gives companies the opportunity to improve employees’ health, decrease health insurance costs and increase productivity. Smoking cigarettes comes with many steep costs. It costs many smokers their health, their money and their time with friends and family. The consequences do not stop there. Employers are paying the price as well. Tobacco use in Indiana is a heavy burden on employers. Average annual healthcare costs due to tobacco use total an estimated $2.9 billion. Tobacco use costs Hoosiers an additional $3.2 billion in lost productivity. Scientific evidence is painting a clear picture of smoking’s effect on workplace productivity. One study of more than 14,000 workers in Sweden found smokers took an average of 11 more sick days than nonsmokers. Additionally, research published in the prestigious British Medical Journal confirmed “workplace productivity is increased and absenteeism is decreased among former smokers as compared to current smokers.” Presenteeism, Productivity, and Insurance Costs Another cost to employers from smoking employees is ‘presenteeism’— lower on-the-job productivity that results from nicotine addiction. Certainly, all employees are occasionally unproductive in one way or another. However, research suggests smoking negatively affects productivity, losing work time due to smoke breaks and absenteeism. This is because nicotine is a powerfully addictive drug. Although cigarettes satisfy a smoker’s need for nicotine, the effect wears off quickly. While the smoker is craving a cigarette, it is difficult for the employee to concentrate on work. Within 30 minutes after finishing the last inhalation, the smoker may already be beginning to feel symptoms of both physical and psychological withdrawal. Productivity loss due to smoking breaks is by far the largest single cost that a private employer incurs from a smoking employee. Fortunately, quitting smoking completely eliminates this cost. Healthcare Costs and Absenteeism Higher Among Former Smokers versus Never-smokers It’s not only lost productivity that hurts businesses. The increased health care costs of having employees who smoke is another hit to the budget. For an employer, insuring someone who smokes costs $2,000 more every year than insuring a non-smoker. A typical smoker racks up an additional $16,000 in lifetime medical bills. A national survey of over 29,000 workers found tobacco use caused more loss of productivity than alcohol abuse or family emergencies. In sum, between losses in productivity and extra health care costs, an employee who smokes costs a business an average $5,816 per year. Another example is found when an employee’s disability is exacerbated by second-hand smoke, such as asthma. Employers may need to create a smoke-free work environment under the Americans with Disabilities Act (ADA). The ADA requires employers with 15 or more employees to make reasonable accommodations to allow employees with disabilities to do their jobs. Additionally, allowing smoking on the work property increases the risk of fires and accidental injuries, which impacts the employer’s insurance costs. Some smoke-free businesses pay 25-30% lower fire and property insurance premiums and reduce cleaning or maintenance costs. Certainly, less time is spent cleaning ashtrays and picking up butts in the parking lot. Legal Liabilities to Consider According to the CDC, nonsmokers filed lawsuits when harmed by secondhand smoke and won disability claims against businesses. As early as 1990, a non-smoker working in a California restaurant won a settlement for $95,000 after suffering a heart attack due to working in a smoke filled restaurant. McDonald’s banned smoking in all its corporate-owned restaurants after plaintiffs claimed in federal court argued tobacco smoke violated the American with Disabilities Act. Some companies and organizations are going beyond the Indiana Tobacco-Free Law by extending their tobacco-free policy to include outside property, parking lots, and even personal vehicles. Saint Joseph Health System staff follow a tobacco-free work-day, not using any tobacco products on any day they work. Many employers are creating 100% tobacco-free initiatives, supported by a comprehensive program of benefits to help smokers quit. Potentially, these policies decrease health insurance costs while increasing not only the health and productivity of those who quit, also encourage a healthy lifestyle among all workers. Employers increasingly recognize helping their employees quit smoking provides a noticeable boost to their bottom line. Many workplaces are introducing smoking cessation programs benefitting everyone involved. There are four key elements to the gold standard for promoting a smoke-free workplace: Implement a smoke-free workplace policy. Indiana state law prohibits smoking inside most workplaces, but employers can extend smoking bans to the surrounding areas of an office building to protect employees from the deadly effects of secondhand smoke and encourage smokers to quit. Additionally, though the city of South Bend has a model smoke free air policy, smoking is allowed in bars & clubs serving patrons over age 21 throughout the rest of St Joseph and Elkhart Counties. Clear policies. Whether providing coverage for counseling and medication, or providing materials and information about how to quit smoking, there are many ways to motive smokers to attempt to quit. The money spent supporting these efforts is far less than the costs of productivity loss and health care associated with employees who smoke. Cessation initiatives. Many employers offer financial incentives and rewards to those who quit smoking successfully and remain smoke-free. When coupled with other healthy habits such as maintaining a balanced diet and exercising regularly, these incentives support other office-wide wellness initiatives. Work with health care providers. Teaming up with physicians and other health care providers can amplify the impact of cessation initiatives. While creating new workplace programs, particularly regarding health and wellness, can often be a daunting task, many employees appreciate the support. Around 70% of smokers say they want to quit, but only five percent quit in a given year. By supporting effective smoke free workplace initiatives, employers help people quit successfully While proven, the financial benefits of helping employees quit smoking complement the human benefit of helping a person make a choice that forever improves quality of life. Employers often develop strong friendships and bonds with their employees. Seeing colleagues live happy and healthy means much more than financial rewards. Adopting a smoke-free policy is not passing judgment on smokers. It doesn’t mean workers who smoke are unwelcome. Referring smokers who try to quit to the help they need may ease push back on the policy. It is also the best way to make sure that your business maximizes the potential health benefits, and cost savings, of your smoke-free policy. There is no greater way to repay employees’ hard work and dedication than to support them on the long, difficult, but valuable journey to quit smoking. How do you get started? Start where you are. First, quantify your current costs for employees who smoke. To find out how much an employee’s tobacco use costs your company each year, you need to ask a few questions and do some math. See the following survey as examples of worksheets and an Return on Investment (ROI) Calculator to make this process easier. Here are the questions to ask: How many of your employees currently smoke? Determine this through a survey or focus groups. Find out about the level of interest in quitting and what your employees know about current health plan benefits. How much is tobacco use costing your company each year? Once you know the number of employees who smoke, use the worksheet or enter the information into the ROI Calculator to determine your company’s direct and indirect costs related to tobacco use. How much would a tobacco cessation benefit cost you? To calculate the approximate cost of offering a comprehensive tobacco cessation benefit that covers medicine and counseling, use the worksheet provided or enter the required information into the ROI Calculator. STEP 1: Employee Survey (sample) Do you currently use tobacco? YES NO If so, do you want to quit? YES NO When do you want to quit? Now Next Month 2-6 Months 6-12 Months Not Sure Which of the following methods would you consider using to help you quit? Doctor Visit Classes Counseling Telephone Helpline Medication None Support Group Other_______________ What is your health insurance/plan? __________________________________________________ Does your plan provide help to quit smoking? YES NO Don’t know If so, what do you think your plan provides? Doctor Visit Classes Counseling Nothing Medication Support Group Other_______________ Where would you be most likely to get information on tobacco-cessation benefits? Self-Help Materials Company Meetings Posters Mailed Home HR Intranet Other What information would help you?____________________________________________________ What can this company do to help you quit?____________________________________________ Step 2: Do the Math What are your tobacco-related costs? __________________ x _____________________ = _________________________ Total # of Employees MA Adult Smoking Rate Number of Smokers __________________ x _____________________ = _________________________ Number of Smokers Estimated Health Costs Total Health Care Costs __________________ x _____________________ = _________________________ Number of Smokers Lost Productivity Costs Total Lost Productivity Costs Your Total Cost Per Smoker: __________________ x _____________________ = _________________________ Total Health Care Total Lost Productivity Total Cost per Smoker STEP 3: How much would a tobacco cessation benefit cost you? Number of Employees: ___________________ 33¢* per Month: ___________________ Total Cost per Year: ___________________ * cost of medication and/or phone counseling varies with health insurance contract, assuming no co-pay and 5% employee benefit use Healthy benefits for your employees. Healthy savings on your Health Plan. Research shows that paying for tobacco cessation treatments through your plan is the most cost-effective health insurance benefit you can provide for your employees. Offering full cessation benefits: is cost-saving or cost-neutral, as you are likely to break even in 3 years and save money in 5 years costs between 10 and 40 cents per member per month depending on utilization and dependent coverage is more cost effective than other commonly covered disease prevention interventions such as high blood pressure. increases the use of effective treatments and increases successful quit attempts. Next: Review and evaluate what you have in place. Look at your company’s health plan and assess the tobacco cessation benefits. Evaluate your company’s tobacco-free policies and support their enforcement. Review any smoking cessation programs you may offer your employees. Now you’re ready to begin the process of expanding, revising and implementing the 3 essential components of an integrated smoking cessation plan at your company: Health Plan, Smoking Policies and Support Programs. Move beyond a smoke-free workplace to establishing a tobacco-free workforce: Step 1: Review the tobacco-free policies currently in place. Make sure you are in compliance with both state law and local laws. Outline current policies and practices including where employees and visitors may smoke (if any), like just outside the door, the parking lot, in vehicles or in designated areas on your campus. Step 2: Define your company’s approach to becoming tobacco-free. How will encouraging your workforce to go tobacco-free fit with your corporate or organizational culture? This part of the process is often the responsibility of mid and upper level management. Step 3: Develop your goals and objectives for your tobacco-free policies. These could include improving the health of employees that smoke, cost-savings on healthcare premiums and other insurance policies and increased productivity. Step 4: Establish a committee or workgroup made up of members from various departments throughout the company including representatives from Human Resources, Employee Benefits, Facilities and Operations, Health and Safety, Corporate Medical, Training and Communications. Include smokers, non-smokers and former smokers. The information they gather and their input will give decision makers a clear view of workers’ perceptions of the current policies as well as any concerns they may have about new tobacco-free policies. Step 5: Draft your company’s tobacco-free policies with a timeline for implementation. Every company is different. Think about a timeline that makes sense for your corporate culture. Take into consideration that preparing your company for policy change is usually an educational process. Encouraging your workforce to go tobacco-free is more than building an awareness and understanding of the change. You are asking employees to change their behavior and manage long term habits along with physical addiction. Allow about 4 months to lay the groundwork for the implementation; consider longer if you are a large company. To maximize motivation, plan to implement the policy in conjunction with national events like the American Cancer Society’s Great American Smokeout in November or around New Year’s Day when people are making New Year’s resolutions. Developing and rolling out a clear communications plan that will encourage and support your employees in their effort to quit is critical for success. What would a workplace tobacco-free policy cover? The purpose of the policy A link between the tobacco-free policy and the company’s overall mission and workforce/ human resource management strategy Where smoking is prohibited Where smoking is permitted (outside the building or on the grounds, if allowed) Enforcement methods and consequences of non-compliance Support available for smokers who want to quit, including counseling, health plan coverage Contact person who can answer questions on the new policy (name, telephone number, email) Effective date* Sources: http://www.mass.gov/eohhs/docs/dph/tobacco-control/employers-toolkit.pdf ...
- Smokefree air policies have broad support
  Smokefree air policies primarily affect the non-smoker. In St. Joseph County, 77% of residents are nonsmokers. That is more than 3 out of 4, and means smokefree air policies support the majority of people by a huge margin. Secondhand smoke significantly exposes non-smokers to tobacco particles and reduces their lung function. There is no risk-free level of exposure to secondhand smoke. It presents an immediate and serious health threat, due to effects from tobacco smoke inhalation in enclosed areas. Regulating smoking in public and work places eliminates this threat. – 2010 Report of the U.S. Surgeon General In 1972, U.S. Surgeon General Jesse L. Steinfeld started a movement for non-smokers’ rights to clean indoor air. “Nonsmokers have as much right to clean air and wholesome air as smokers have to their so-called right to smoke, which I would define as a ‘right to pollute.’ It is high time to ban smoking from all confined public places such as restaurants, theaters, airplanes, trains, and buses.” The 1986 Surgeon General’s report on the dangers of passive smoking was also an important milestone in the fight against smoking. Then U.S. Surgeon General C. Everett Koop concluded secondhand smoke causes lung cancer in non-smokers and is associated with respiratory conditions in children. In 2006, U.S. Surgeon General Richard Carmona declared, “the debate is over” and “the science is clear.” Nonsmokers need protection through the restriction of smoking in public places and workplaces. According to the Environmental Protection Agency, widespread exposure to secondhand smoke presents a serious and substantial public health problem. From a workplace perspective, flight attendants in the 1980s sued the industry to ban smoking in the workplace. The International Commission on Occupational Health states, “employees at their workplace must not breathe air contaminated by tobacco smoke.” The only way to achieve smokefree workplaces is through legislation, implementation and enforcement. Typically, arguments against smokefree policies follow a similar pattern. Opponents argue their employees and customers do not support smokefree air policies. They believe such policies lead to revenue loss. Besides, they claim, ventilation can prevent exposure to nonsmokers. Frequently, these arguments are encouraged and supported by tobacco industry research. However, each of these points can be tested objectively. Methodologically sound studies of the economic impact of smokefree policies on the hospitality industry consistently demonstrate that such policies have no adverse impact on businesses The vast majority of the population prefers smokefree policies, compliance is the norm and implementation is smooth. Studies show business indicators (i.e., revenue, new business openings, job growth) typically continue along current trends. Further, the potential benefits of such policies far exceed potential costs. Smoking imposes considerable costs on businesses, including increased health care costs, lost productivity, higher insurance premiums, and increased maintenance/cleaning costs. Creating separate smoking areas and adding ventilation is far more cost-prohibitive than going completely smokefree. Importantly, studies show a decrease in the rate of heart attacks after a smoking ban was implemented. Those decreases ranged from six percent to 47 percent, depending on the study and the form of analysis. (Source: Institute of Medicine, Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence, October 2009) Therefore, smokefree air policies not only reduce costs for business owners, they lower healthcare costs for bar and restaurant patrons, smokers and nonsmokers alike. People have a right to breathe clean air. Businesses have an interest in reducing costs. Policy makers answer to both. Smokefree air policies are a win-win. ...
- Cessation September
  September is a great time to quit smoking! Although it can be difficult to overcome nicotine addiction, Hoosiers do quit tobacco use every day. Today, there are more former smokers than current smokers. Surveys found nearly 70% of all cigarette smokers want to quit, and research shows quitting at any age has health benefits. Through the end of September, the Indiana Tobacco Quitline is offering free medication to help Hoosiers quit tobacco use. To take advantage of the free offer, tobacco users simply enroll in the Indiana Tobacco Quitline. A trained coach will work with enrollees to make a personalized quit plan. Once enrolled, users receive a two-week supply of free medication, including gum and patches, while supplies last. Counseling, including Quitline coaching, and medication are both effective in helping tobacco users quit. Using them together is more effective than using either one alone. Medications help tobacco users quit by decreasing urges to use tobacco products and easing withdrawal symptoms. Quit Now Indiana provides free services and a built-in community of people like you who want to quit tobacco for life. What’s great about the Indiana Tobacco Quitline, you can quit at your own pace. With professional help and support you can quit for good! Real Life Testimonial from Hoosier Tammy Crum: I was 13 when I started smoking. I could walk right into a store and buy a pack without anyone questioning me. Why not? Everyone smoked: my friends, my family, movie stars—everyone! Health had never been an issue for me. I looked healthy; everything seemed in good health despite my smoking. Plenty of people smoked more than me, I only smoked a pack a day, then I had a heart attack. I was only 38 years old! The doctor attributes the heart attack to my smoking. It was a scary experience and I was very lucky. An angiogram showed major plaque buildup in my femoral artery and evidence of damage from what they believe to be two prior heart attacks that went undiagnosed. I smoked my last cigarette six days after I got out of the hospital. My kids were my biggest motivation, I want to be a good role model for them and I wanted to be alive to see them married and have children of their own one day. Quitting smoking was the best thing I could do for my health and the best gift I could have ever given to my family. Take the first step toward quitting smoking and get free help by calling the Indiana Tobacco Quitline at 1-800-QUIT-NOW or by going to QuitNowIndiana.com. ...
- Smoke-Free Casinos are Real Unicorns
  The mythological unicorn has come to describe something wistfully desirable, but rarely seen. More than four out of 5 people (including casino goers) do not smoke. Many say they would enjoy a casino experience more if it were smoke free. At Ho Chunk Casino in Madison Wisconsin, the fable became a reality! The sovereign tribal casino successfully transformed into a smokefree facility. As both a business decision and to protect the health of tribal members and guests, the smokefree indoor air policy made business better than ever! While attending training with the American Non-smokers Rights Foundation, Karl Nichols and Latorya Greene of Smoke Free St Joe joined the 3rd anniversary celebration. They learned the tribe honors their culture and traditions by keeping tobacco sacred while eliminating commercial tobacco use within the casino. The result (almost as unimaginable as a unicorn to the common perception): the Madison casino is the most profitable of the Ho Chunk casinos! RESTORING TRADITIONS, REDUCING HARMS According to a publication called Walking Toward the Sacred: Our Great Lakes Tobacco Story, sacred tobacco is a separate species from commercial tobacco. Traditional tobacco has a very high nicotine content, and is not inhaled during ceremonies. Sadly, the use of commercially-manufactured tobacco among native people is very high compared to other populations. Some attribute this dismal fact to lax attitudes toward tobacco use among those living on Reservations. By keeping use of tobacco to sacred practices only, they hope to reduce the mortality rate due to smoking. The Great Lakes Inter-Tribal Epidemiology Center believes restoring traditional tobacco use and their sacred way of life creates a healthier environment for their children. If you would like to learn more about smokefree indoor air policies in the hospitality industry, please contact us at smokefreestjoe@gmail.com....
- Maximizing the Effectiveness of Tobacco Excise Taxes
  Around the world, tobacco taxation and tax administration used by WHO formed a set of ‘best practices’ for maximizing the effectiveness of tobacco excise taxes. “Sugar, rum, and tobacco, are commodities which are no where necessaries of life, which are become objects of almost universal consumption, and which are therefore extremely proper subjects of taxation.” Adam Smith, The Wealth of Nations, 1776 . Well over 100 studies, including a growing number from low-income and middle-income countries, clearly demonstrate tobacco excise taxes are a powerful tool for reducing tobacco use while at the same time providing a reliable source of government revenues. Tobacco excise taxes are a powerful tool for improving health and a reliable source of government revenues. Significantly increasing tobacco excise taxes encourages current tobacco users to stop using, prevents potential users from taking up tobacco use, and reduces consumption among those that continue to use. The greatest impact is on the young and the poor. As a result, higher tobacco excise taxes effectively reduce early death, disease, and economic costs caused by tobacco use. The positive health impact is even greater when some of the revenues generated by tobacco tax increases support tobacco control, health promotion and/or other health-related activities and programs. Around the world, extensive evidence with the variety of and changes to taxes and tax structures applied to tobacco products identifies these best practices in tobacco taxation: simple tax system applying equivalent taxes to all tobacco products; taxes exceeding increases in consumer prices and incomes so as to reduce the affordability of tobacco products; remove incentives for tobacco users to switch to cheaper brands or products in response to tax increases; and, reduced opportunities for tax avoidance and evasion. Tobacco excise taxes have the greatest public health impact, while simultaneously producing a reliable stream of tax revenues. Despite the evidence on the beneficial revenue and public health impact of higher tobacco taxes, economic arguments create barriers to increasing tobacco taxes. These range from concerns about the macroeconomic effects of higher taxes (eg, on employment and inflation) to concerns about the regressivity of tobacco taxes and the impact of higher taxes on the poor. In general, these arguments are false or overstated. Increasing tobacco taxes has not lead to net job losses in most countries, but rather to job gains as resources shift to more labor intensive sectors of the economy. Similarly overstated, tax increases have little impact on inflation in most countries. The progressive nature of the health benefits of reduced tobacco use in response to higher taxes overcomes concerns about the impact on the poor. Even more, earmarking some revenues generated from tobacco taxes to pay for programs targeting youth and the poor answers these concerns. (Chaloupka FJ, 2012) Work Cited Chaloupka FJ, Y. A. (2012). Tobacco taxes as a tobacco control strategy. Tobacco Control, 172-180. ...
- Want to Know More About JUUL?
  Vaping is the use of an electronic cigarette—a device which heats water, along with a flavor, nicotine and other chemicals, to a boiling point to allow inhalation of the vapor. The JUUL device, introduced in 2015 and now leading the market with over 40% of all sales of vaping products, is a special hit with teens. They find the devices to be discrete, and come ready to use, packaged with multiple flavors – mint, tobacco, mango, crème brulee and fruit. Like other e-cigarettes, JUUL is very accessible. Speedway and other tobacco retailers conveniently offer discounts and rebates. Though a consumer must be 18 years of age to purchase tobacco legally at a retail store, purchasing these products online is easy for anyone with a credit card, including teens. The law requires tobacco websites to ask users to self-verify they are over the age of 18 by clicking a box on the entry page. Social media has no such oversight. Sites such as Instagram and YouTube serve as platforms for online vape-trick displays, encouraging electronic cigarette use. E-cigs aren’t just easier to purchase; they’re also easier to conceal. On Twitter, teens post about their usage in school. The most brazen of them fire up their e-cigarettes while the teachers’ backs are turned. Snapchat is full of kids in locker rooms or school bathrooms showing off tricks. In fact, according to the CDC, high school students use e-cigarettes more than adults do. E-cigarette producers ignore absolutely everything ever agreed to around smoking advertisements in the Master Settlement of 1998. Vaping ads commonly include misleading and targeted messages, peddling everything from fake health claims to kid-friendly candy flavors and “back to school” sales. E-cigarettes show up in movies, on television shows, and in radio ads. The real question is, ‘Is vaping better than using no tobacco products?’ And the answer is no. Since e-cigarettes have not been around long enough for scientific (and peer-reviewed) studies, we must view all suggestions that use is not dangerous with a high degree of skepticism. E-cigarettes renormalize smoking, which has become less and less socially acceptable over the past 20 years. Though many advocates cite emerging reports vaping can help smokers quit, in fact, most adult smokers are dual users (both cigarettes and e-cigs). Keep in mind, this argument is traditional tobacco consumers switching to e-cigs may smoke less, not that teens starting with e-cigs won’t switch to tobacco or other smoking. For teens, vaping potentially acts as a gateway to cigarettes. Some suggest the use of e-cigarettes by young people might “protect” them from using cigarettes. There is no evidence to support this claim. A study published last year in Pediatrics magazine asked 808 students if they used e-cigarettes or tobacco cigarettes in the past month, returning each year between 2013 and 2015 to ask again. The first year, 8.9% of students used a vape pen and 4.8% of students smoked cigarettes in the last month. Those who used e-cigarettes were 7 times more likely to smoke cigarettes by the second survey, and almost 4 times more likely by the third survey. In Indiana, the Campaign for Tobacco-Free Kids reports 8.7% of high school students smoke but 10.5 % use e-cigarettes. However, NPR interviewed students for a story this past December, in which one student claimed 50-60% of her friends use JUUL. The CDC says nicotine exposure during adolescence causes addiction and harms the developing brain. The use of vaping juice leads to a dependence on nicotine (which is in most e-juices). Users may find over time e-cigarette use not meeting their growing addiction needs. The Truth Initiative (a national tobacco prevention counter-marketing group) reports: • 25% of 15-24 year olds recognize a JUUL device when shown a photo of the product; • Kids know using the device as “JUULing,” meaning this product is so distinctive; it is its own category; and, • 63% of JUUL users do not know this product always contains nicotine. Also, evidence suggests e-cigarette use is linked to alcohol use and other substance use. Modified e-cigarette products can deliver other drugs, like marijuana. Smoking bans, however, do reduce smoking. Where comprehensive bans are in place, users have higher rates of quit attempts and lower rates of relapse. We encourage all communities, workplaces, schools, multi-unit housing properties, and venues include e-cigarettes in no-smoking policies. If you would like help developing these policies, please contact Smoke Free St Joe, email us at smokefreestjoe@gmail.com, connect with us on Facebook or Twitter, or call (574) 335-4684....
- Let’s Beat Cancer Sooner
  Tobacco use causes at least 14 types of cancer. In the United States, smoking leads to 172,800 cancers each year. These include cancers of the lung, esophagus, pancreas, mouth & upper throat, bladder, bowel, kidney, larynx, stomach, liver, ovary, cervix, leukemia, and nose/sinus, says the National Cancer Institute at the National Institutes of Health. According to the Lung Association, smoking is the main cause of lung cancer. Between 80-90% of all lung cancer deaths are smoking related (an average of 130,659 annually.) Additionally, roughly 7,330 lung cancer deaths are attributable to secondhand smoke. Most frequently, cancer is first diagnosed among people aged 65-74. Diagnosis of cancers of the larynx, liver, oral cavity, and ovaries – each exasperated by tobacco use – often comes as much as 10 years earlier. Researchers at the American Cancer Society believe the DNA-damaging chemicals in tobacco increase the risk of oral cancer (lips, gums, tongue, and mouth). Most oral cancer patients are – or were – tobacco users, whether combustible (cigarettes, cigars, pipe) or non-combustible (chew, snuff). Tobacco, researchers found, damaged the lining of the mouth, causing rapid growth of abnormal cells. (University of Miami Health System) Tobacco use is also listed as the greatest risk factor for head and neck cancers (laryngeal cancer). Some studies from the American Cancer Society find extended exposure to secondhand smoke may increase the risk of laryngeal cancer. (American Cancer Society) Currently, no routine screenings exist for laryngeal or oral cavity cancers. Early cancers of the ovaries and lungs generally show no indications either. Patients with ovarian cancer report nonspecific irritable bowel symptoms. Normally the first sign of lung (or laryngeal) cancer is hoarseness and coughing. Often people presume the reason for these signal other (temporary) conditions. “Usually symptoms of lung cancer do not appear until the disease is already at an advanced, non-curable stage,” according to the American Lung Association Lung Cancer Fact Sheet. Avoiding tobacco use altogether is an important step in preventing the onset of cancer. Quitting smoking entirely is the only proven strategy for reducing tobacco-related cancer risks. (US Surgeon General) Smoke Free St. Joe is a coalition of health organizations, civic groups, businesses, schools, and individuals focused on reducing the burden of tobacco in our community and increasing quality of life for all. We work with the Indiana Tobacco Quit Line to offer resources to smokers ready to quit. Lead agencies, Saint Joseph Health System and Community Wellness Partners, offer training to healthcare providers, employers, and organizations working with marginalized populations: pregnant women, LGBT communities, veterans, and youths. To prevent exposure to secondhand smoke and the normalization of tobacco and vaping use among youth, we reach out to school board members, staff, parents, students, and other community members in support of comprehensive smoke free campuses. Through cessation resources and pre-emptive policies, our goal is to beat cancer sooner, by preventing the leading cause....
- The cigarette giants were essentially trying to kill you all along
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