AMERICAN
                      LUNG
                      ASSOCIATION,
Secondhand Smoke
and Children:
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Secondhand Smoke and Children: Conducting Public Outreach Programs
     Secondhand Smoke
         and Children:
        Conducting Public
       Outreach Programs
 Indoor Air Programs, American Lung Association, 1726 M Street NW Suite 902, Washington, DC 20036 (202) 785-3355
ฉ1999 American Lung Association

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                                            Secondhand Smoke and Children: Conducting Public Outreach Programs
We need your support to fight lung disease, the third leading cause of death in the  U.S. call your local
American Lung Association to find out how you can help.

                                    Call l-800-LUNG-USA
                                        (1-800-5864872)
                                        www.lungusa.org

                                  When You Can't Breathe,
                                    Nothing Else Mattersฎ


Funding for this document provided through a cooperative agreement with the U.S. Environmental Protection Agency.

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Secondhand Smoke and Children: Conducting Public Outreach Programs
Contents
I. Introduction
Using This Guide 	5
The Goal of the Secondhand Smoke and Children Program	5
Terminology	6

II. The HeaDth Effects of Secondhand Smoke
Respiratory Illness in Children 	7
Onset and Exacerbation of Asthma  	8
Sudden Infant Death Syndrome	,	8

III. Conducting Successful Outreach Programs
Setting Goals	9
Target Audiences	10
Developing an Action Plan	13
Key Messages	15
Building Partnerships	16
Coordinating with Tobacco Control Programs	17

IV. Working with the Media
Media Relations 	19
Developing Media Spokespeople  	21
Media Tools	21
Targeting Minority Media Outlets  	23

V. ReplicabUe Programs
Outreach to Parents	28
   Secondhand Smoke Media Campaign	29
   Community Baby Shower	50
   Secondhand Smoke Helpline  	55
   Secondhand Smoke in Cars	55
Outreach to Daycare Providers	59
   Smoke-free Head Start	60
   Childcare Provider Training  	68
   Training Home-based "Provider Mothers"  	76

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Contents
                                         Secondhand Smoke and Children: Conducting Public Outreach Programs
Outreach Through Healthcare Providers	79
   Hospital-based Intervention and Education Project	80
   Healthy Beginnings  	86
   Protecting Children Through the WIC Program 	90
   Smoke Outside Campaign	91
Outreach Through Community Leaders	96
   African-American Church-based Project	97

VI. Funding Opportunities  	99

Appendix I. Health Effects References	103

Appendix II. Organizational Contacts
EPA Regional Offices	105
State Indoor Air Quality Contacts 	106
EPA Indoor Environments Cooperative Partner Network	107
State Tobacco Control Directors	109
IAQ Coalitions 	118
Daycare Organizations	118
WIC Program	119
Tobacco Control Organizations 	119

Appendix III. Program Materials	121

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Secondhand Smoke and Children: Conducting Public Outreach Programs
                                  Introduction
 Using This Guide
          r
           econdhand   Smoke   and   Children:
          k Conducting Public Outreach Programs has
             sn developed by the American Lung
           Association (ALA) to serve as a resource
 for organizations concerned about reducing children's
 exposure to secondhand smoke. The guidance offered
 here is the result of many years of experience educat-
 ing the public on secondhand smoke. ALA was the
 first voluntary health organization to speak out about
 the hazards of secondhand smoke, in an ALA board
 position on nonsmokers' rights in the early 1970s. We
 have pooled the information in this document from
 countless talented and dedicated individuals who have
 worked with us throughout our decades of leadership
 in tobacco control and indoor air quality issues.
       The primary objective of this document is
 to present successful outreach programs in a way in
 which they can be  effectively replicated by others.
 These are the "Replicable Programs" outlined in Part
 V. However, there is more to successful outreach
 than replicable programs. Other  sections  of the
 guide, which  are recommended reading for  the
 novice as well as the experienced outreach program
 manager, include: background on the health effects
 of secondhand smoke;  putting together effective
 public outreach programs; working with the media;
and funding opportunities. In addition, the appen-
dices contain reference information on developing
partnerships and locating resource materials.
       Reducing children's exposure  to  second-
hand smoke means  changing the smoking behavior
of adults. It is very challenging and often emotional-
ly-charged work that involves issues of addiction,
individual rights, power structure in families, sancti-
ty of the home and much more. Please use this doc-
ument as a source for some helpful tips if you are
experienced, and a springboard for action if you are
just getting started. The information in this guide is
offered with the understanding that we have a long
way to go to eliminate this serious threat to chil-
dren's health, and that the best way to get the work
done is through collaboration and through building
on each other's successes.

The Goal  of the Secondhand
Smoke and Children Program

           The goal of both the  ALA's Secondhand
           Smoke and Children program and of
           this document is to reduce the percent-
           age of homes nationally in which chil-
dren under the age of 6 are exposed to secondhand
smoke from 27%, in 1996, to 15%, by the year 2005.
Both the Environmental Protection Agency and the
U.S. Department of Health and Human Services
share this goal of reducing childhood exposure in the
home. Children are a vulnerable group which bears a
disproportionate health burden.  Children are more
likely than adults to become sick from secondhand
smoke, and their exposure is always involuntary. The
program focuses on reducing exposure primarily in
the home because that it is where the need is greatest
       This document is focused on reducing risk
from secondhand smoke as an indoor air pollutant.
It is not about getting people to quit smoking. A
great deal of advocacy work has been done on smok-

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Introduction
                                           Secondhand Smoke and Children: Conducting Public Outreach Programs
ing cessation and ensuring that public places are
smoke-free; ALA and other organizations will con-
tinue that fight. But eliminating or reducing smok-
ing in homes must be done by individuals, through
public education and voluntary behavior change.
       It is important to note that secondhand
smoke public education is  done for many reasons.
Some programs use it as a strategy to reduce smok-
ing rates. Others concentrate on creating smoke-free
public environments. All of these  are of course
worthwhile goals with enormous potential for public
health benefits, and they do not in any way conflict
with each other. The American Lung Association
pursues all of them in various ways. Coalition part-
ners may have different primary goals and still work
together successfully. But in order to achieve the out-
comes you are after, it is important that you and your
organization clarify your goals at the outset and tai-
lor your outreach program accordingly.
Terminology

           There are many terms for secondhand
           smoke,  including  environmental
           tobacco smoke (ETS), passive smoke,
           and sidestream smoke (although tech-
nically, that is only the portion of the smoke that
comes directly from the burning end of the ciga-
rette,  not  the exhaled portion). Experience with
public education has shown that the phrase "sec-
ondhand smoke" has the greatest public recogni-
tion and understanding. For that reason, the ALA
uses "secondhand smoke" in all our public outreach
materials,  and  you will see it used exclusively
throughout this guide. However, you will find that
the term "environmental tobacco smoke" is used
most  often in  the scientific literature and public
policy discussions, and may be more appropriate
for use with professional audiences.

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Secondhand Smoke and Children: Conducting Public Outreach Programs
                                  Health Effects

            The following is a brief summary of the
            major research findings on the health
            effects of secondhand smoke.  For
            additional information, refer to the
studies listed in Appendix I.
        In   1992,  the EPA  released  a  report,
Respiratory Health Effects of Passive Smoking: Lung
Cancer  and Other Disorders,  that  evaluated the
health impact  of breathing secondhand smoke. In
that report, the EPA  concluded that secondhand
smoke causes lung cancer in adult nonsmokers and
impairs the respiratory health of children. These
findings are very similar to ones made previously by
the National Academy of Sciences and the  U.S.
Surgeon General. Although the tobacco industry has
hotly contested  the conclusion  that secondhand
smoke is a human carcinogen, subsequent research
has confirmed the EPA's findings of its health risks to
children  and adults. Most recently, the California
EPA as well as health agencies in Australia, the U.K.,
and France have similarly concluded that second-
hand smoke causes lung cancer in nonsmokers.

Respiratory Illness  in Children

            The lungs of young children are partic-
            ularly  sensitive   to  environmental
            insults, including secondhand smoke.
            Exposures early in life while the lungs
are still growing can  affect normal development
and increase the risk for both acute and chronic res-
piratory illness.

+      150,000 to 300,000 lower respiratory
        infections
        Exposure to secondhand smoke decreases
lung efficiency and impairs breathing ability. Airways
become inflamed, and mucus production increases.
Children, whose airways are smaller and more sensi-
tive, are more likely than adults to suffer respiratory
symptoms like coughing and wheezing. They are also
more susceptible to infection. The EPA estimates that
every year, between 150,000 and 300,000 cases of
lower respiratory infections, such as bronchitis and
pneumonia, in children under 18 months of age are
attributable to breathing secondhand smoke.1 These
illnesses result in as many as 15,000 hospitalizations.
And although the rate of illness goes down as chil-
dren get older, there is still an increased risk.

•     Up to 1.6 million doctor visits for
       middle ear infections
       Secondhand smoke exposure also causes
inflammation of the eustachian tubes, which connect
the back of the nose to the middle ear. This swelling
blocks the natural drainage of the middle ear, resulting
in fluid build-up and increased risk of ear infections.
As many parents know, ear infections are a  major
cause of lost work and school, and are the most com-
mon cause of childhood hearing loss and of childhood
operations. Between 700,000 and 1.6 million visits to
1 US EPA Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders, 1992.

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 Health Effects
                                             Secondhand Smoke and Children: Conducting Public Outreach Programs
the doctor's office for childhood ear infections can be
linked with exposure to secondhand smoke.2

Onset and Exacerbation of
Asthma

+•      Up to 1,000,000 asthmatic children
        suffer
        Secondhand smoke irritates the lining of
the airways, and is a powerful trigger for many peo-
ple with asthma. According to a recent study by the
California  EPA,  the  condition  of approximately
400,000 to 1,000,000 asthmatic children is worsened
by  exposure to  secondhand smoke.3 Emergency
room visits are more  frequent in children  whose
parents smoke, and those children have been found
to need more medication to control their asthma
than do children of nonsmoking parents. In addi-
tion, secondhand smoke exposure has been shown
to increase the number of new asthma cases among
children who have not had previous  episodes.
  Sudden Infant Death
  Syndrome

  +     Associated with 1,900 to 2,700 SIDS deaths
         Sudden Infant  Death Syndrome (SIDS) is
  the most frequent cause of death in infants aged 1
  month to 1 year. More  than 3,000 infants annually
  die unexpectedly, during sleep, without significant
  evidence of fatal injury or illness. The cause or caus-
  es of these deaths are unknown. The most widely
  accepted hypotheses suggest that some form of res-
  piratory failure is involved in most cases.
         There  is a  long-established  correlation
  between maternal smoking during pregnancy and
  SIDS: infants of mothers who smoke are more than
  twice as likely to die of  SIDS  than children of non-
  smoking mothers. Recent evidence suggests that expo-
  sure to secondhand smoke may also  increase  an
  infant's risk of dying  from SIDS. The California EPA
  estimates between 1,900 and 2,700 SIDS deaths annu-
  ally are associated with secondhand smoke exposure.11
  ESTIMATED ANNUAL MORBIDITY AND MORTALITY IN NONSMOKERS ASSOCIATED WITH
  ENVIRONMENTAL TOBACCO SMOKE (ETS) EXPOSURE
  Condition
  Developmental Effects
     Low Birthweight
     Sudden Infant Death Syndrome
  Respiratory Effects in Children
     Middle Ear Infections
     Asthma Induction
     Asthma Exacerbation
  Bronchitis or Pneumonia in Infants & Toddlers
  (18 Months and Under)
  Cancer
     Lung
  Cardiovascular Effects
     Ischemic Heart Disease
Number of People or Cases in the United States

~ 9,700-18,600 cases
~ 1,900-2,700 deaths
0.7 to 1.6 million physician office visits
8,000 to 26,000 new cases
400,000 to 1,000,000 children
7,000 to 15,000 hospitalizations
136 to 212 deaths
3,000 deaths
                                                 35,000-62,000 deaths
 Source: California Environmental Protection Agency: Health Effects of Exposure to Environmental Tobacco Smoke, 1997
aUS EPA Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders, 1992.
' California EPA Health Effects of Exposure to Environmental Tobacco Smoke, 1997.
4 California EPA Health Effects of Exposure to Environmental Tobacco Smoke, 1997.

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Secondhand Smote and Children: Conducting Public Outreach Programs
         Conducting Successful Outreach Programs
      It is very hard to change human behavior. It
      takes the right message, delivered to the right
      people, at a time when they will be receptive.
      And it takes persistence — often years of sus-
tained effort to change cultural norms. The tobacco
control movement is a good example of a success-
ful,   long-term   public  education  campaign.
Cigarette smoking is perceived very differently in
our culture now than it was 30 years ago. But it has
taken several decades to  raise  awareness of the
health risks, reduce the  number of smokers to a
minority, and institutionalize smoke-free environ-
ments. And we still see backsliding, currently in the
form of rising smoking  rates among youth, and a
trendy interest in cigars and chewing tobacco.
        Successful outreach programs  all  share
some common elements, which are detailed in the
following sections. Putting these elements together
in advance of starting your actual outreach activities
requires time, a clarity of purpose, and some sus-
tained organizational  commitment. But it helps
ensure that you will end up with the finished prod-
uct you want.

Setting Coals

            Before you develop an action plan for
            your outreach program, the first thing
            you  need to  establish  is your goal.
            What is it you are trying to achieve?
Goals  are "big-picture"  actions or  outcomes.
Naturally, they should always conform with the
mission of your organization. They must be formu-
lated so that you can measure your results in con-
crete ways. "Increased awareness about secondhand
smoke" is not a measurable goal. Better examples
for the goals of a secondhand smoke outreach pro-
gram would be "Reducing the number of homes in
which children are exposed to secondhand smoke
in this community by X % in the next 5 years," or
"Institution of a smoke-free policy in X% of day-
care facilities in the county by September."
        The goals that you set will be determined in
part by the resources available to you. Although it is
important to set goals that are as broad and as health
outcome-oriented as possible, it is also important
that they be realistic. Setting a goal that you cannot
hope to achieve, or even measure, undermines your
likelihood for success (and looks bad to funders). It
is tempting to set a goal to, say, reduce the number of
emergency room visits by children with asthma. But
even if you do have a method to collect the hospital
data, it is very difficult and expensive to confirm a
statistically valid relationship between your particu-
lar outreach program and hospitalization rates.
        It is also important to set goals based on the
needs of your community. Who is most at risk?
What are the best channels for reaching them? What
other programs and services are out there that can
be built upon, but not duplicated? Some form of
needs assessment will help ensure that your pro-
gram is targeted where the need is greatest, and in a
way that it can be effective.

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            Conducting Successful Outreach Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
            Target Audiences

                           Although there is  some  benefit to
                           raising  general  awareness  about
                           the health impact of secondhand
                           smoke,  in the long run the only
            people who can actually prevent children from
            being exposed at home are the ones who are cur-
            rently smoking around  them. The most effective
            outreach programs will be those that are targeted to
            parents and other caregivers, or to those who are in
            a position to influence  them, such as doctors or
            members of the clergy. It is important to note that
            people are more likely to change  their behavior if
            they get multiple  messages  from a variety of
            sources. So although outreach needs to be targeted,
            it is best not to limit yourself to only one segment of
            the population.

            •             Demographics of Smoking
                           Data  from  the   Third  National
            Health  and  Nutrition  Examination  Survey
            (NHANES III) on reported exposure to second-
            hand smoke show that 43 percent of U.S. children
            aged 2 months through 11  years live in a home
            with at least one smoker. In 1995 there were 47
            million adult  smokers  in the United  States, or
            approximately 25% of people over 18.
                   Smoking rates vary within the population
            by gender, age, race and ethnicity:
            •  Gender [figure  1]. Smoking  rates are higher
              among men (27%) than among women (23%),
              although the  rate  of smoking among  young
              women is rising rapidly.
            •  Age [figure 2]. Smoking rates are highest among
              persons 25-44 years  of age (29%), which  are
              unfortunately also the prime child-bearing years.
                                                               Figure 1
L
         Percent of Adults (> 3.8 Years OldJWho Are Current Smokers,
            27.5           by Sex, 1995
            27.0 •
         ง 26.5 •
         f= 26.0 •
         3 25.5 •
         o. 25.0 i
         ฃ 24.5 •
         o 24.0 •
         fc 23.5 -,
         I 23.0 -|
         a. 22.5 -j
         I 22.o]
            21.5 4 —
                       \<^        ^
        Source: Certters for Disease Control and Prevention.
            Cigarette Smoking Among Adults—United States, 0395. MMWR Vol. 46 No. El
      Figure 2
         Percent of Adults (> 13 Years OldJWho Are Current Smokers,
                         by Age, 1995

         z 35.0-,
         2 30.0 !
         3, 25.0-]
         g 20.0
         O 15.0
         u
         s
10.0
 5.0 \
 0.0 1-
                   Total
                          18-24
                                25-44
                                             >65
        Source: Centers for Dleeaso Control end Prevention.
            Cigarette Smoking Among Adults—United States. 1395. MMWR Vol. 46 No. 61
      Figure 3
         Percent of Adults (> lil Years Old)Who Are Current Smokers,
                     by Race/Ethnicity, 1995
         z  40.0
         p  35.0  •'
         3  30.0  :   .1
         g  25.0  •  *
         g  20.0  •
         o  15'ฐ  :
         t-  10.0  •
         g  5.0  :
         g  0.0  •
        Source: Centers for Disease Control and Prevention
            Cigarette Smoking Amonu AduKa—United States, 1999. MMWR Vol 46 No
        Race and ethnicity [figure 3], Smoking rates are
        highest among  Native  Americans  (36%)  and
        African-Americans (26%), and  lowest among
        Asians and Pacific Islanders  (17%). Smoking

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 Secondhand Smoke and Children: Conducting Public Outreach Programs
         Conducting Successful Outreach Programs
 Figure 4
 Figure 5
   Percent of Adults (2 18 Years OldJWho Are Current Smokers,
                 by Education, 1995
       40.0
    I  35'ฐ
    3  30.0
    S  25.0
    ฃ  20.0
    ฐ  15.0
    g  10.0
    ฃ  5.0
    a.
       0.0
             Total   < 8   9-11
                                   13-15  >16
  Source: Canter* tor Dltease Control *nd Prevention.
      Cigarette Smoking Among Adultป—United State!, 1995. MMWR Vol. 46 No. 51
   Percent of Adults (a18 Years Old) Who Are Current Smokers,
               by Poverty Status w' 1995
    z 35-i
    230-
    3 26-
    Q.
    2a
    O 15-
    g 10-


             Total  ' At or Above '  Below  '  Unknown  '
                   POVERTY STATUS
  Source: Centers for Disease Control and Prevention.
      Cigarette Smoking Among Adults—United States, 1995. MMWR Vol. 48 No. 61
  NOTE: (1) Poverty statistics are based on definitions developed by the Social Security Administration.
   prevalence among Hispanics (18%) is lower than
   the national average. This is due to the small pro-
   portion of Hispanic women who report them-
   selves to be smokers (15%).
•  Socio-economic status  [figures 4, 5].  Smoking
   rates also can be correlated with education level
   and socio-economic status, with prevalence going
   down as education and  income increase.

•             Parents  and guardians
               Parents and guardians who smoke
or allow smoking in their homes are the primary tar-
gets for outreach to protect children from second-
hand  smoke, because homes are where most of the
exposure  takes  place.  Much of the secondhand
smoke outreach discussed in this guide focuses on
the mother. In the typical family she is the one who
spends the most time with the child. She interacts
more with  healthcare providers  throughout  her
pregnancy and post-natal period, and may well have
the primary responsibility for the child's health care.
And behavior studies have repeatedly shown that
women are more concerned about and receptive to
health messages.
       Although we could find  no examples of
programs targeted to fathers, a number of experi-
enced outreach workers interviewed for this docu-
ment thought it was a promising idea. Especially in
cultures that  are  traditionally patriarchal,  the
fathers are much more likely to be the ones that are
smoking at home. And in these homes, the moth-
ers are less empowered to enforce a smoke-free pol-
icy. The fathers are viewed as the protectors of their
families, and may be reachable through an appeal
to this role.
        Working  with  families  is  inextricably
linked with issues of culture and social structure. If
outreach to parents is  to be effective, it must be
culturally appropriate. For example,  you cannot
ask a young Asian mother from a traditional back-
ground to tell the family elders not to smoke when
they come to visit. You create a cultural conflict in
which there are no winners, and you will damage
your relationships  in  that community. Get  to
know your target population, seek out communi-
ty leaders, and provide programs and materials in
the primary language of the community whenev-
er possible. For more information about working
with  culturally diverse  populations, see ALA's
Building  Successful Indoor  Air  Quality  and
Environmental Justice Programs:  A   Program
Implementation Guide.

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 Conducting Successful Outreach Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
•             Daycare providers
               Any program geared toward young
children must take into account that many of them
are away from their home and parents much of the
day, in daycare. Providing secondhand smoke mes-
sages to daycare providers helps ensure that the day-
care environment itself is smoke-free, but it should
primarily be viewed as a channel through which to
reach parents. The relationship  between daycare
provider and parents is potentially a very rich one,
built upon trust,  information-sharing and mutual
concern for the well-being of the child.
        Daycare arrangements vary widely,  from
preschools and large institutional centers, through
small licensed home-based providers, to uncreden-
tialed neighbors and relatives. For the purposes of tar-
geted  outreach programs, we will deal only with
licensed  centers  and  home-based  providers.
Unlicensed providers are difficult to locate and may
be  wary of  cooperating with  outreach workers
because of their unofficial (and possibly illegal) status.
        Finding childcare providers is complicated
because the structure of local oversight varies so
much. Every jurisdiction has some form of regula-
tion and licensing, whether it  is  in the health
department or elsewhere. Locating that office usu-
ally provides access to mailing lists, as well as infor-
mation about training requirements and  continu-
ing education credits that may be useful. There are
also a  number of professional organizations for
daycare  providers,  including  the  National
Association for the Education of Young Children
and the National Association of Child  Care
Resource and Referral Agencies. The local chapters
of these national organizations can put you in touch
with their member providers through conferences
and newsletters.
      •             Healthcare providers
                     Healthcare providers  can include
      any medical professionals that provide services for
      children and families, including pediatricians, hospi-
      tal and emergency room personnel, visiting nurses,
      and WIC counselors. Like daycare providers, health-
      care workers are a trusted source of information for
      parents — people who are seen as knowledgeable
      and as having the best interest of the child in mind.
      Healthcare providers also have a good idea of which
      families may be at risk. They see the children that are
      getting sick, and  in the case of home healthcare
      providers, they see the environment the children live
      in as well. Unfortunately, not all healthcare providers
      are well informed about the health effects of second-
      hand smoke. The first role of outreach to this target
      group is to educate them about  the risk. Once they
      are informed, they can be encouraged to counsel
      their patients, and  use pledge cards or contracts as
      appropriate. Large institutional providers like HMOs
      and hospitals may be willing to establish policies that
      require intervention when a child has recurrent res-
      piratory infections or is hospitalized.
             Healthcare providers can be reached through
      their  professional  membership  organizations,
      newsletters and conferences. Many of them have pro-
      fessional requirements for continuing education, and
      are more likely to  attend a training on  secondhand
      smoke if they can get credit for it. As with any target
      audience, you can also increase the likelihood of par-
      ticipation if you provide food — as in a breakfast
      seminar — or offer other incentives. Another way to
      reach pediatricians  is though pharmaceutical repre-
      sentatives. They talk to lots of doctors, and appreciate
      having materials like informational  packets and pro-
      motional items like baby bibs (with smoke-free mes-
      sages) to leave behind after their visit.

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Secondhand Smoke and Children: Conducting Public Outreach Programs
         Conducting Successful Outreach Programs
•             Community leaders
               Religious leaders, prominent citizens
and respected elders are looked to as a source of guid-
ance within a community, and as such make powerful
messengers. Especially in minority communities that
are battling high rates of smoking and related disease,
as well as being targeted for marketing by the tobacco
industry, these community leaders may already be
sensitized to the issues, and can be readily persuaded to
take on secondhand smoke and children.

Developing an  Action Plan

                 Once you have assessed the needs
                 of your community, set  goals,
                 and  established a target audi-
                 ence,  it is time to develop the
action plan for your program: the "what, how and
when." ALA Indoor Air Programs uses a very help-
ful "pyramid model" for action planning (see figure
below). If it is applied during development of a pro-
gram, it can ensure integration of everyday activi-
ties with overall goals  and  focus  your thinking
about desired outcomes. The pyramid has four lev-
els: mission, goals, objectives, and tasks/activities.
When planning a program, it is recommended that
you start at the top and work down, as follows.
       At the very top of the pyramid is the mission
of the program. The mission is generally a broad
health-based statement of why you want to imple-
ment the program, such as, "To reduce the health risk
to children from exposure to secondhand smoke."
       The goals of a program, as discussed in the
preceding section, are  the  broad results that will
accomplish the mission. An  example for second-
hand smoke could be, "X number or percentage of
families with a child admitted to the hospital for a
respiratory illness will receive counseling."
                            'PYRAMID MODEL" FOR ACTION PLANNING
      WHY: The mission is a statement of "why" action should be
      taken  The mission is often the opposite of a stated problem
      WHAT: A goal is a broad statement of "what" is to be
      accomplished within a specific time frame. Goals are set
      in relation to priority areas.
      WHAT: An objective is a narrower statement of
      "what" discrete results or measurable targets will
      be achieved.  The results of the objectives,
      taken together, will accomplish a goal
     How: A task is an action that, alone or in
     combination with other tasks, constitutes
     "how" an objective will be accomplished.

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 Conducting Successful Outreach Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
        The  objectives  are  narrower and  more
 direct action statements coming out of the  goals,
 such as "Enlist two pediatricians to serve as spokes-
 people for the campaign" or "Secure smoke-free
 pledge cards  from 50 families by January." This is
 the  level  of the pyramid  that involves  seeking
 behavioral change.  Once you have outlined the
 possible objectives, you can then tailor them to fit
 your organization's resources and your communi-
 ty's  needs before you determine the appropriate
 tasks or activities.
       The tasks and activities are the "hows" that
 will accomplish the objectives. These are the day-to-
 day actions that make up the bulk of any program:
 the trainings, mailings, presentations, phone calls,
 etc If the pyramid model is used thoroughly, every
 activity you undertake will be directly related up the
 pyramid to the  mission. It can be tremendously
 empowering to know that your daily tasks are linked
 to a specific desired health outcome.

 •             Determining Measurable
               Outcomes
               Each level of the pyramid should
 include measurable outcomes and a way to evaluate
success. Measuring and evaluating tasks and activi-
ties is relatively easy. Basically, you measure every-
thing you can quantify, like numbers of brochures
distributed, numbers of daycare providers trained,
etc. If there is no way to measure the impact of an
activity, you may want to consider doing something
differently. Either reallocate resources to develop a
feedback mechanism so you can truly evaluate your
effectiveness, or move your  effort into something
you know is helping you attain your goals.
       Examples of results that should be tracked
include:
      •  Number of presentations given and how many
        people reached
      •  Number of pediatricians enlisted to do outreach
      •  Number of daycare centers  implementing  a
        smoke-free action plan, and how many families
        reached as a result
      •  Number of families educated through counseling
      •  Number of radio, TV and newspaper outlets run-
        ning PSAs, and how often
      •  Number of families committed to  not allowing
        smoking in the home
      •  Number of homes with children age 6 and under
        where smoking is not allowed

      As you move up the pyramid, measurement and
      evaluation gets more difficult. It can be practically
      impossible to measure behavioral change directly, so
      one must establish proxy measures. Proxy measures
      are indicators of the likelihood that you will have
      met your goal. Some proxies are better than others.
      For example, your goal of getting new mothers to
      smoke outside is impossible to measure directly. A
      good proxy measure would be the number of moth-
      ers who sign pledge cards not to smoke  in the home.
      A weaker measure would be the number of mothers
      who attended a presentation on secondhand smoke.
      The weakest measure would be the estimated num-
      ber of targeted individuals exposed to a mass media
      piece on secondhand smoke.

      •            Setting Standards  for
                   Success
                   Standards are  the numeric bench-
      marks that you set against which to evaluate the suc-
      cess of an activity. For example, if you  plan  to do a
      presentation on secondhand smoke and asthma for
      daycare providers, you decide that your standards for

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Secondhand Smoke and Children: Conducting Public Outreach Programs
         Conducting Successful Outreach Programs
success will be 25 participants, of whom 15 will actu-
ally use the distributed information packets for par-
ents. Once the presentation has been made, you can
go back and compare your results with your stan-
dard, with three possible outcomes: 1) the program
exceeded your standard, was a success and should be
replicated; 2) the program fell short of your stan-
dards, was not successful and should be revised or
dropped; or 3) you decide that your standard was not
appropriate,  and should  be  modified next time.
Standards are derived from intuition and past expe-
rience. In order for standards to be an effective tool,
they must be constantly revised and refined.

•             Tracking and Feedback
               Mechanisms
               Every outreach  activity  can and
should include some type of feedback mechanism.
Feedback mechanisms are really just ways to follow
up an activity: evaluation forms for presentations,
mail-back  usage   reports  for   public  service
announcement distribution, take-home pledge
cards for school activities etc. Feedback mechanisms
have several  benefits:  1) you  get  numbers, so you
know how many people you  have reached; 2) they
provide a second point of contact  between you and
your target audience, which can reinforce your mes-
sage and strengthen your relationship; and 3) some-
times it can provide  direct evaluation, as in an eval-
uation form for a training.

Key  Messages
              ey messages are the main points of
              a campaign — what you want peo-
              ple to remember. Because they are
              the essence of  your work, it is
important to get the key messages right, which is
not always easy. Ideally, key messages should be test-
ed for effectiveness, either through experience or
through behavioral research. Sometimes just a few
words or a slight shift in tone can make the differ-
ence between an effective message and one that is
ignored.
       Because consistency of message helps rein-
force  your objectives, there can be  great value in
adopting messages that are already in use. If a smok-
ing parent hears basically the same message from the
radio, the pediatrician, and his minister, he is more
likely to pay attention than  if he gets pieces of con-
flicting information. Following are a handful of key
messages that seem to work in a wide range of cir-
cumstances, regardless of the gender, cultural back-
ground or level of awareness of the audience.

•             Secondhand smoke can
               make  children sick
               Focus on the health of the child.
Those of us who work  on this issue tend to  forget
that many people simply do not know that second-
hand smoke is harmful to children's health. The EPA's
market research has shown that people respond best
to information about specific health effects, such as
asthma and ear infections, rather than broad gener-
alizations. Make the assumption in your message that
once parents know that their child is at risk, they will
want to do something about it Focus groups have
shown that smokers react negatively to messages that
invoke feelings of guilt, so keep it positive.

•             Protect your family
               Appeal  to parents'  protective
instincts. Avoiding smoking around children can
be associated with all the other things that parents

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            Conducting Successful Outreach Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
            do for their kids, like locking away matches and
            using seat belts. This may be the best way to reach
            men who view  themselves as the head  of the
            household.

            •             Take it outside
                          Be  specific  about  the  action
            requested. A health educator in  Kentucky once
            declared in exasperation, "When  you tell  people
            around here not to smoke in front of the baby,
            they think that means it's alright to smoke behind
            the baby!" If there  is any ambiguity in the mes-
            sage, like saying "Don't smoke around your chil-
            dren " smokers tend  to negotiate. The  first day
            they may smoke outside, then the next day go into
            the next room  with the window open, and so on
            until they convince themselves it  will  not hurt if
            they just turn their face away to exhale. The "Take
            it outside" message has tested very well in focus
            groups, especially when it is presented as a choice,
            not as a command.

            •             Even if you aren't ready to
                          quit smoking, quit  smoking
                          around your kids
                          Acknowledge the difficulty of quit-
            ting. Smokers are a difficult group of people to
            reach with health messages. They often feel besieged
           by dire warnings  and judgmental accusations. If
            they are not yet ready or are unable to quit smok-
            ing, they tend to shut out health messages as a self-
           preservation measure. The most effective way to get
            through to them about the health risks of second-
           hand smoke to their children is to completely sepa-
           rate  the  secondhand smoke messages from any
           stop-smoking message. Experienced secondhand
           smoke outreach workers say that you  can some-
      times see the relief on a smoker's face when she real-
      izes she is not being told to quit smoking. It is like a
     -door opening, and non-threatening  information
      being allowed to enter.

      Building Partnerships

                   Getting people to change their behav-
                   ior takes time, money, credibility,
                   consistency,  and  reinforcement.
                   Very few organizations have every-
      thing they need to do the job alone. Building a net-
      work of partners ertends your reach  by bringing
      access to additional resources, fresh ideas, and new
      audiences.
             Forming partnerships often comes about
      by happenstance — two people meet  at a confer-
      ence and see the potential  of working together.
      This can yield excellent results, but if it is the only
      way partnerships are formed,  it can leave the
      organization with needs that go unmet and audi-
      ences that go unreached. When formulating the
      goals for your program, think about the areas
      where you need help, and seek to establish  rela-
      tionships with groups that can fill those needs. If,
      for  example,  you want to  educate daycare
      providers about  secondhand  smoke, you will
      increase  your likelihood of success if you work
     with an organization that has access to and credi-
     bility with daycare providers.
            Most of us have the experience of partici-
     pating in various coalitions and stakeholder groups
     with other organizations that are nominally our
     partners. But sitting in meetings does not make an
     effective  partnership,  unless  it  results  in action.
     Having goals in common is important, although it is
     probably most beneficial to work with organizations
L

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Secondhand Smoke and Children: Conducting Public Outreach Programs
         Conducting Successful Outreach Programs
that have different, but complementary expertise. If
another organization's goals and audience are too
similar to your own, they bring nothing new to the
table. But clearly, partners need to be able to agree on
a set of common objectives, a timeline, and the
assignment of responsibilities.
       It is essential that a partner organization
be willing to assume responsibility for its share of
the work. Bringing someone on board just for the
logo on the  letterhead  may not be  worth  it. An
important factor in ensuring distribution of the
workload is to collaborate on a project from the
beginning, rather than approaching a potential
partner with a fully formed idea and asking them
to sign on.
       The  EPA  Indoor Environments  Division
has a well-established Cooperative Partner Network
of organizations with a mutual interest in protecting
the public from the health risks of indoor air pollu-
tion. These partners work together at the national
level, and every effort is made to facilitate network-
ing among groups at the local level. In 1997, the EPA
and several national partners began an initiative to
nurture the development of formal state and local
1AQ coalitions. Secondhand smoke is one of the pri-
ority areas for these coalitions. For lists of potential
partner organizations, see Appendix II.
Coordinating with Tobacco
Control  Efforts
                        developing  your sec-
                    ondhand smoke and  chil-
                    dren public outreach  pro-
                    gram, you may find it help-
ful to contact the groups in your community which
are working on tobacco control (see Appendix II for
a list of state tobacco control contacts).
       Tobacco control coalitions exist in every
state, and in many local communities as well. They
often have the support of the state health depart-
ment and access to funding from federal agencies
and major foundations. Coalitions may be working
on a wide  range  of tobacco control strategies,
including tobacco  use prevention and cessation,
curbs on tobacco  advertising, increased tobacco
taxes, and stricter enforcement of youth access laws.
But protecting the public from secondhand smoke
is always an important component of tobacco con-
trol,  and your local coalition  may be interested in
working with you in a coordinated effort. Even if
the coalition is focusing on a smoke-free restaurant
policy, for example, you may be able  to include
some information  especially  for parents in  their
campaign materials.

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          Conducting Successful Outreach Programs	Secondhand Smoke and Children: Conducting Public Outreach Programs
k_

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Secondhand Smoke and Children: Conducting Public Outreach Programs
                        Working with the Media

            For those of you who are just getting
            started with public outreach, or who
            have no communications experience,
            the following section is essentially a
"crash course" in working with the media. You will
also want to seek out colleagues, partners and coali-
tion members with experience in this area to save
you the frustration of reinventing the wheel.

Media  Relations

                 One of the most cost-effective ways
                 to reach large numbers of people
                 with  your secondhand  smoke
                 messages  is through  publicity.
Especially in the early stages of a campaign, when
public awareness levels are low, news stories and pub-
lic service advertising can really make a  difference.
But having an important message will not necessari-
ly  guarantee air time. The media play the role of
"gatekeeper."  Reporters,  editors  and  producers
receive a flood  of information, and  they  choose
which stories will pass through the gates of their par-
ticular media outlet to the public. The extent to
which your messages will be "let in the gate" depends
on the attractiveness of your product, the credibility
of your organization or coalition, and your personal
relationship with the decision-makers.

•              Being a News Resource
               To increase the  chance  that your
organization's secondhand smoke programs will be
covered by the media, you will need to work to build
relationships  with local reporters, and let them
know how you can help them with their work Some
suggestions for getting their attention:
•  Evaluate how your program connects with cur-
   rent news in your area. Take advantage of other
   events and secondhand smoke-related news to
   get your messages out.
•  Know your media targets. The best way to get to
   know your local media is to read the newspaper,
   listen to the radio and watch your local television
   programs.
•  Keep notes on which media outlets cover stories
   related to your issues. A "media contact record," a
   form to help you track your media relationships,
   is attached.
•  Find out if any of your coalition members, vol-
   unteers or sponsors have any local media con-
   tacts. Network through your contacts to cultivate
   your own relationships.

•             Pitching a Story
               Every time you have something to
offer a reporter by mail or fax, follow it up with a
phone call. Media relations is not just the act of get-
ting your messages into print or on television. It is
the  slow  development  of  relationships  with
reporters and editors. Eventually, your media con-
tacts will think of you when they are working on sto-
ries related to secondhand smoke.
        Some media pitching tips:
•  Be respectful  of a reporter's time. If he or she is on
   deadline and you take a long time explaining your
   story, or worse yet, never ask if he or she has time to
   talk, you may ruin a potentially good relationship.

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           Working with the Media
                      Secondhand Smoke and Children: Conducting Public Outreach Programs
L_
           DATE:
        SAMPLE MEDIA CONTACT FORM

       	     TIME:	    BY:
           CONTACT:.

           TITLE:	
           MEDIA AFFILIATION:  MEDIA
           NAME:	
                    TVQ

           PHONE NUMBER:

           FAX NUMBER: (  ).

           ADDRESS:	
    RADIO Q
      WIREQ
PRINT Q    CABLE Q
           DEADLINE:	

           RUN     DATE/TIME.
           REQUEST/ANGLE:,
           FORMAT:
           TAPED	
LIVE
ONE-ON-ONE
           PANEL DISCUSSION.

           SPOKESPEOPLE:
           NAME
           1.
           2.
           3.
         PHONE NO.
                    FAX
           {]Cigarette Smoking
           I JSecondhand Smoke
           [ JSmoking and Pregnancy
           [ JChildren's Anti-Smoking Materials
           [ ]Company Smoking Policies
           [ ]Air Pollution-Indoor
           [ ]Air Pollution-Outdoor
            Confirmation and background info sent
            Contact info updated in computer
            Entered on media summary report
               [ ]Asbestos
               [JRadon
               [ ]General Lung Disease
               [ ]Lung Cancer
               [ ]Tuberculosis
               [ jChronic Bronchitis
               [ JCommon Cold

                     DATE
                           ] Pneumonia
                           ]Flu
                           ]Emphysema
                           ]Asthma-Adult
                           ]Asthma-Pediatric
                           JOther (specify)

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 Secondhand Smoke and Children: Conducting Public Outreach Programs
                         Working with the Media
 •  Always ask reporters what they are interested in.
   You may uncover an opportunity you never knew
   existed.
 •  Be accurate.  If you  do not have  answers to
   reporters'  questions  immediately, offer to call
   them back as soon  as  you learn the answers.
   Making reporters wait a few minutes is better than
   providing inaccurate information or guessing.
 •  You may learn that you are talking to the wrong
   person. If that is the case, ask the reporter whom
   he or she would recommend that you call instead,
   and then end the call quickly and politely.

 Developing Media
 Spokespeople

            To effectively communicate your mes-
            sages to the media, you will need artic-
            ulate spokespeople who are willing to
            be interviewed and are familiar with
 your organization and your issues.

 •             Recruiting Spokespeopie
               Try to  recruit a diverse group of
 spokespeople for your organization who are recog-
 nized in the community and able to communicate
 to a wide variety of audiences. Depending on your
 circumstances, spokespeople can be key staff mem-
 bers, volunteers, or respected members of the com-
 munity  who  support your program. For second-
 hand smoke and children, good spokespeople would
 include pediatricians,  nurses,  parents, daycare
 providers, smoke-free business owners, and the chil-
dren themselves, especially kids with asthma.
        Bear  in mind that your spokespeople are
perceived by the  audience as an extension of your
organization.  It is important to choose them care-
 fully, get to know their strengths and weaknesses,
 and prepare them well for their tasks. Not everyone,
 no matter how well respected or sympathetic to your
 issues, can be a suitable spokesperson.

 •             Media Training
               Learning  to become an  effective
 media spokesperson takes training, time and prac-
 tice. After your spokespeople have become comfort-
 able with the goals and strategies of your program,
 take the time to coach them on key messages and
 practice interviews.
 Some tips to keep in mind are:
 •  Anticipate questions and responses. Prepare the
   spokesperson with as much information as possi-
   ble about the interview, the reporter, and any spe-
   cific angles that might be covered.
 •  Prepare  message points, or "sound bites"  in
   advance.  Message points should be brief, vivid
   examples that are easy to memorize.
 •  Answer all questions with a "yes" or "no," explain
   the answer, then transition to prepared messages
   using "bridge phrases" such as, "I would like to
   add..." or "Something else you should know..."
 •  Use simple lay terminology, free of jargon.
 •  Maintain  a  positive attitude,  turn "loaded"
   questions around to suit your key messages,
   and stay cool.

Media Tools

•             Media List
               Tool  number  one for effective
work with the media is a good, up-to-date media
list. This is a list of names, addresses, phone num-
bers  and  fax numbers of news organizations,
reporters, editors, and public service directors who

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Working with the Media
Secondhand Smoke and Children: Conducting Public Outreach Programs
are most likely to use the material you send them.
Build your list from local media directories; your
media contact sheets; coalition members or other
like-minded organizations that would be willing to
share; and calls to TV and radio stations and news-
papers to ask who covers your issues. Be sure to
keep the list current and complete. Sending out
press materials addressed to "Editor" is like throw-
ing it in the trash yourself.

•             Types of Media
               Radio
               Radio is one  of the most over-
looked and under-used media available, yet it is
excellent for targeting key audiences. News pro-
grams  and various talk and call-in shows provide
great opportunities for your spokespeople to pro-
mote your programs. Radio stations are also excel-
lent targets for public service announcement space.

               Television
               Television reaches a much broader
audience than radio. If your program is geared to a
specific local audience, television may be too broad-
reaching. When targeting television, be aware that
on-air  personalities usually do not decide who or
what goes on the air. Your release should be direct-
ed to the news assignment desk or program pro-
ducer. When pitching a story idea to a television
producer, be prepared to describe the visual ele-
ments of the story.

               Cable Television
               Local cable television stations are
hungry for local news and often reach a more nar-
rowly defined audience than the major networks.
When contacting your local cable stations, find out
      if they are equipped to air public service announce-
      ments and if they are seeking  calendar items for
      their "billboards."

                     Newspapers
                     Newspapers are a primary source
      of information in most communities. Before con-
      tacting a newspaper reporter, be familiar with the
      newspaper's format. Many smaller newspapers have
      one editor who covers a wide variety of subject areas.
      These editors usually like to receive written informa-
      tion that they can run as an article with only slight
      modifications. Larger newspapers usually have a dif-
      ferent  editor assigned  to each  section.  Reporters
      from these newspapers will often be interested in
      conducting their own  research and  writing their
      own stories.

      •             Editorial Board Meetings
                     Editorial board meetings offer an
      opportunity to relay your message to the editorial
      staff, in their offices, to discuss  your major issues.
      A meeting does not guarantee coverage  in  the
      paper,  but it improves your chances and  enables
      you to build relationships with  reporters and edi-
      tors over time.

      •             Press Briefings
                     For a press briefing,  you invite a
      group  of key reporters for a 1-2  hour session in
      which you can have several experts present informa-
      tion  on your issues and entertain reporters' ques-
      tions. A briefing is less formal than a  press confer-
      ence, and usually is used to provide background and
      build credibility, rather than to announce breaking
      news. Offering breakfast or lunch always helps boost
      attendance.

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Secondhand Smoke and Children: Conducting Public Outreach Programs
                        Working with the Media
•             Letters to the Editor
               Competition is fierce for the small
space available in each edition of a newspaper. By
some estimates, fewer than 1 in 10 letters submitted
ever make it into print. To improve your chances be
sure to be timely and concise; use credentials or affil-
iations that will enhance your credibility; include
some background for readers not familiar with the
issues; and concentrate on local stories.

•             Opinion Pieces
               An  opinion article on the editorial
page is considered one of the pinnacles of achievement
for coverage of a public policy issue. It offers great vis-
ibility and credibility for your organization and your
issues. Getting published requires careful planning and
cultivation of the editors who control the space. Before
you submit an article, be sure to find out about the
paper's policies, including length requirements  and
publication deadlines. Try to arrange a meeting with
the editorial staff to discuss their interest, and to  pro-
mote your ideas. And keep trying.

•             News Conferences
               News conferences should be held
only for  major announcements. You will need to
recruit and prepare  top quality speakers; select an
accessible and attractive site; incorporate visual ele-
ments that will appeal to television;  publicize the
event thoroughly; and be prepared to follow up with
the media by fulfilling interview requests and sup-
plying additional material.

•             Public Service
               Announcements
               Public  service  announcements
(PSAs) are designed  to communicate public educa-
tion messages on a specific issue. Unlike advertise-
ments, you do not have to pay for media space or
time, which can be extremely expensive. The down-
side is you have little control over when, or even if, a
station manager or public service director will use
your materials. Strong media relationships and a
compelling, well-produced piece can help you get
the results you are after.
        Here are some tips on getting your PSA
placed:
•  Localize the problem. Use state and local statistics
   and references whenever possible.
•  Don't scrimp. Try to get the best quality produc-
   tion assistance you can — perhaps you can find
   an ad agency that will donate its time. Or see if
   you  can adapt some existing  materials:  the
   Centers for Disease Control and Prevention has
   an extensive catalog of advertising materials in
   their Media Campaign Resource Book for Tobacco
   Control (see Appendix III).
•  Be prepared  to counter  negative  reactions.
   Anticipate typical  questions and  provide  the
   answers.
•  Ask when the public service director might be
   able to use the piece.
•  Be appreciative of any  interest or commitment.
   Send thank you notes.

Targeting Minority  Media
Outlets

              Because  minority  communities
              often  have higher smoking rates
              and less  access  to information
              about the health  risks of second-
hand smoke on children, it can be very beneficial
to include minority  media outlets in your out-

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Working with the Media
Secondhand Smoke and Children: Conducting Public Outreach Programs
reach. The following guidance is for the Hispanic
and African-American media  specifically, since
they represent the largest minority media outlets
nationwide. However, many ethnic and cultural
groups have their own media, which are much
respected and credible sources of information
within those communities. Many of these same
strategies will apply broadly. See the  description
of the Secondhand Smoke Media Campaign in
the  Replicable Programs  section  for sample
media materials.

•             Hispanic Media
               Hispanic media outlets, including
newspapers, radio, and television, often run smaller
operations than traditional media. This means that
more opportunities exist to build a  closer relation-
ship with the editors and journalists of these outlets.
Try to schedule personal visits. Since staffing at
Hispanic media outlets are usually smaller, it is ben-
eficial to personally meet with their staff. This helps
to build  media  relationships  and educate  the
Hispanic journalists on your issues. It also provides
an opportunity to clarify  any subject  and ensure
that the information relayed is accurate. The  fol-
lowing suggestions are based on professional expe-
riences and may not apply to all minority media,
but should provide some insight in working with
Hispanic media.

•  Inform in Spanish. The Hispanic news media
  often prefer to receive written information (pitch
  letters,  news releases) in Spanish and converse
  with contacts  in Spanish. However,  they  are
  receptive to pitches in English from those who do
  not speak Spanish. It is rare to find a Hispanic
  media outlet that is "Spanish only."
         Use a Hispanic spokesperson. When  avail-
         able, a  Spanish-speaking spokesperson will
         enhance media coverage for several reasons. He
         or she can prevent confusion and misinterpre-
         tation of messages that might be lost in trans-
         lation. Using a Spanish-speaking spokesperson
         shows a  greater sensitivity toward the expecta-
         tions of the audience.

         Keep the dialect neutral. Spanish-speaking peo-
         ple from different backgrounds and countries of
         origin speak in different dialects. If you are work-
         ing  in  a diverse Hispanic community  that
         includes, for example, Dominicans, Salvadorans,
         and Colombians, it  is important  to keep the
         dialect neutral so  that everyone can understand
         your  messages, and no one feels excluded. Ask
         your spokespeople and translators to guide you in
         what is  local  idiom  and what  is standard
         American Spanish.

         Go for third-party endorsement When making
         contact with local Hispanic organizations, try to
         obtain support from their staff. Encourage them
         to participate in addressing the media. This will
         help give  an unbiased third-party endorsement to
         your  campaign message. Sometimes, Hispanic
         community  organizations  already have a  good
         relationship with their local media. When that is
         the case, be sure to ask for their assistance in help-
         ing you reach the media.

         Obtain support from legislators and public
         officials.  When there is a Hispanic elected official
         in your state or local government, he or she may
        be another possible third-party endorser of your
        campaign.


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Secondhand Smoke and Children: Conducting Public Outreach Programs
                        Working with the Media
•  Use facts and figures. Using facts and figures that
  highlight the secondhand smoke problem in the
  Hispanic community helps to reinforce the mes-
  sage. Try to point out the percentage of Hispanics
  who suffer from the different kinds of illnesses
  related to secondhand smoke and why Hispanics
  in your area are more affected  than other por-
  tions of the general population.

•  Use radio  stations. Radio is  very important in
  the Hispanic community. Everyone can afford to
  own one. And it is more manageable for broad-
  casters to own and operate a radio station than a
  television station.  Many larger  markets have at
  least one all-Spanish radio station.

•  Make the message personal.  Introducing a per-
  sonal angle into your story always has a greater
  impact.  Testimony from Hispanic  community
  members affected by secondhand smoke or from
  Hispanic doctors working with  affected patients
  are powerful messages that will sell your story to
  the media and ultimately the Hispanic communi-
  ty in your local area.

To locate Hispanic media outlets you can look for
locally published newspapers in  bookstores and
newspaper  stands; contact news agency offices such
as your state news service, and find out if they have
staff who work with the Hispanic community; or
call the local Chamber  of Commerce's public rela-
tions  department and  request  a  list of Hispanic
media in  the area.  The National Association of
Hispanic Journalists (NAHJ) may also have a list of
registered journalists in your area. NAHJ's address is
National  Press Building,  Suite  1193, Washington,
DC 20045. Their telephone number is (202) 662-
7145. In communities with large Hispanic popula-
tions, there  are usually statewide associations  of
Hispanic journalists.

•            African-American Media
              Most of the African-American pop-
ulation is English-speaking, and do not have the lan-
guage barriers to accessing the mainstream media
that recent immigrant communities  do. African-
Americans are as likely to watch network news and
read the major papers as European Americans are.
But the minority media has a special place in African-
American communities. Surveys have demonstrated
that the African-American audience responds much
better to information that is disseminated in ways
other than the traditional white  media,  especially
when it is delivered by a highly visible member of
their community. When working with the African-
American media, keep the following tips in mind:

•  Use   African-American   spokespeople.
   Audiences are most receptive to spokespeople
   they can identify with. Using African-American
   spokespeople helps ensure that your  messages
   are delivered in a way that makes sense to the
   local community.  It also  is an indication that
   your organization has made an  effort to build
   bridges and be inclusive.

•  Be sensitive to the special needs of small media
   outlets. Many minority media outlets have a small
   staff and budget, but lots of issues to cover. Do not
   waste their time with issues that do not hold spe-
   cific interest for their audience. If you have any
   doubts about what is appropriate, just ask

•  Use radio stations. The highly segmented radio

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Working with the Media
Secondhand Smoke and Children: Conducting Public Outreach Programs
  market has created many radio stations with a
  largely African-American audience. This outlet
  provides a daily, direct link to large numbers of
  people. Popular music DJs are great to use as a
  draw for special events.

  Incorporate your message into current life
  issues. Publicity that reflects contemporary life
  and history can be an  important and effective
  vehicle if it is used properly to influence opinion.
  Determine what issues  are of concern in your
  local African-American community. Nationwide,
         two current "hot button" issues that tie to sec-
         ondhand smoke and children are the soaring rate
         of asthma in urban neighborhoods, and the race-
         specific  marketing strategies  of the tobacco
         industry.

      To locate your local African-American media outlets,
      refer to the strategies listed above for Hispanic media.
      In addition, you may be able to get some assistance
      from the National Association of Black Journalists.
      They are located at PO Box 4222, Reston, Virginia
      22091. Their telephone number is (703) 648-1270.


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Secondhand Smoke and Children: Conducting Public Outreach Programs
                            Replicable Programs
      It would be impossible to present a complete
      compendium of the creative, successful and
      replicable secondhand smoke and children
      outreach programs being done by local Lung
Associations and other organizations around the
country. Rather than try to be encyclopedic, we have
chosen to present in some detail a small collection of
programs that reach all of the target audiences cov-
ered in Section 3. In the hopes of providing some-
thing for everyone, we have included a wide diversi-
ty of activities: you should be able to find something
for a large budget or a small one; for a quick cam-
paign or a multi-year program; for general aware-
ness-raising or intensive one-on-one intervention.
In addition to replicating these examples as is, you
can "cut and paste" elements from several to create a
program that best suits your local circumstances.
       The characteristics that are shared by each
of the examples -  the  features that make them
replicable - are as follows:
• Compatible with the overall goals. Any program
  should be true to an organization's mission and
  overall goals,  in this  case  protecting children's
  health by reducing their exposure to secondhand
  smoke.
• Collaborative. Bringing together partners  to
  leverage resources and increase reach.
•  Measurable.  Program  outcomes  are  easily
  defined and evaluated.
•  Portable and adaptable. The program compo-
  nents are flexible enough to meet  the diverse
  needs of communities of different sizes and back-
  grounds.
Each program is presented in  a standard format,
with the details of the program organized by "Goal,"
"Program  Description,"  "Partners"  "Resources
Needed," "Measurable Outcomes and Evaluation"
and "Opportunities and Linkages." Please note that
in these examples the "Goal" sections do not include
specifics like numeric targets or timelines, in order
to be generally applicable; however, you should plan
on setting such specific targets  in your own action
plans. Sample materials that were developed for or
used in the programs are at the end of each section,
where  appropriate. Please note that the statistics
included in the attachments may not be the most
current available,  and should be verified  before
using. See also Appendix III for more information
on available program materials.
       If you would find it useful to talk with people
who have implemented similar programs, or you
would like to learn how to adapt a program to your
local area, contact the ALA Indoor Air Program staff
at (202) 785-3355 for references to project directors
who have conducted these programs at the local level.

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 Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreadi Programs
                      Outreach to  Parents
            Parents (along  with  grandparents,
            guardians and  other adults  who
            share their homes with young chil-
            dren) are the ultimate target of all
secondhand smoke and children outreach, since
they are the ones who have the most control of their
children's exposure to  secondhand smoke. Some
programs that reach parents directly are those that
go out to the general population, like media cam-
paigns, public meetings and health fairs. These are
valuable because of their broad reach, but may have
     the drawback of being difficult to measure and eval-
     uate. Other possible ways to directly reach families
     with young children are through community par-
     enting activities, like classes and newsletters.

         Please note that the programs in
        this section are not the only ones
        that reach parents. Many of the
        programs described in subsequent
        sections are intended to reach
        parents through an intermediary,
        which can be equally effective.

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Secondhand Smoke and Children: Conducting Public Outreach Programs
                           Replicable Programs
    Secondhand  Smoke  Media  Campaign
Goal: To increase awareness of the serious health
problems associated with secondhand smoke

Program Description: In 1994, when ALA launched
its ongoing Secondhand Smoke and Children pub-
lic outreach  program,  general awareness of  the
health risk associated with secondhand smoke was
low. A nationwide media campaign was developed,
with special emphasis on reaching low-income and
minority communities that are at high risk, but not
easily reached by programs developed for the gener-
al population.
       The "news hook" for the campaign was the
publication of ALA's Protecting Yourself and  Your
Family from Secondhand Smoke brochures for low-
income and minority populations: at last there was
an educational tool specifically created for these
under-served communities (see Appendix III for
more   information   on   these   brochures).
Components of the campaign included creation and
distribution of press releases and press kits to minor-
ity media outlets, production  and distribution of
radio public service announcements, and direct mail
outreach to national minority organizations.
       In  addition,  local  Lung  Associations
received media materials that they could localize for
their own markets, as well  as information about
locating and building relationships with minority
media outlets. The ALA of Virginia, Southwest Area,
for example, distributed press kits to all minority
media outlets in their area, resulting in a feature in
an African-American news program on a local net-
work affiliate, as well as other coverage.
       Media materials from the campaign includ-
ed as attachments:
•  General Population Radio PSAs
•  Hispanic Radio PSAs (English and Spanish ver-
  sions)
•  African-American Radio PSAs
•  Hispanic Press Release (English and Spanish ver-
  sions)
•  African-American Press Release
•  Localizable Hispanic Press Release (English and
  Spanish versions)
•  Localizable African-American Press Release
•  Media Fact Sheet (English and Spanish versions)

Partners: At both  the national  and local  level,
minority organizations were contacted with infor-
mation  about  secondhand smoke  and asked to
become  involved in the campaign.  Copies of the
ALA brochures were made  available in camera-
ready format so that partner organizations could
add their logo and distribute.
       One of the  keys to the success of this sec-
ondhand smoke media campaign was the broad par-
ticipation of African-American and Hispanic volun-
teer spokespeople, most of whom were physicians. A
number of newly recruited spokespeople then went
on to volunteer to bring other types  of secondhand
smoke outreach programs to their communities.

Resources Needed:
•  ALA's  Protecting Yourself and Your  Family
  brochures
•  Press kits for the media
•  Location and speakers for press conference, if
  appropriate
•  PSAs
•  Media releases

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Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
Measurable Outcomes and Evaluation: As with all
media campaigns, the most salient measurable out-
comes are the amount and kind of media coverage
you  receive, and  the number  of people  reached
through those media outlets. In a campaign like this
one, we could also measure the number of people
who attended the news conference, the number of
local Lung Associations that conducted their own
media campaigns, and the number of new spokes-
people recruited.
             The campaign could have been evaluated by
      comparing actual outcome measures against a pre-
      determined standard. Local Lung Associations also
      could have provided feedback on the quality of the
      media materials they received.

      Opportunities/Linkages: This type  of nationwide
      campaign on a compelling children's health issue
      could attract  a celebrity spokesperson who could
      bring considerable increased visibility.

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Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
           General Population Radio PSAs — Secondhand Smoke Media Campaign
       15 second PSA









       DID YOU KNOW THAT CHILDREN WHO BREATHE SECONDHAND SMOKE ARE MORE




       LIKELY TO SUFFER FROM LUNG DISEASE, EAR INFECTIONS AND ASTHMA?






       TO FIND OUT HOW TO PROTECT YOUR CHILDREN, CALL YOUR LOCAL AMERICAN




       LUNG ASSOCIATION AT 1-800-LUNG USA.
        30 second PSA









        THE AMERICAN LUNG ASSOCIATION URGES EVERYONE TO AVOID SECONDHAND




        SMOKE.  DONT LET ANYONE SMOKE IN YOUR HOME AND BE SURE NOT TO




        EXPOSE CHILDREN TO TOBACCO SMOKE.  CHILDREN WHO BREATHE




        SECONDHAND SMOKE ARE MORE LIKELY TO SUFFER FROM LUNG DISEASE, EAR




        INFECTIONS AND ASTHMA.









        FOR A FREE BROCHURE WITH TIPS ON AVOIDING SECONDHAND SMOKE, CALL




        YOUR LOCAL AMERICAN LUNG ASSOCIATION AT 1-800-LUNG USA. THAT'S 1-800-




        LUNG USA.






                                       **#

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           Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                  Hispanic Radio PSAs (English Translation) — Secondhand Smoke Media Campaign
L_
                      15 Sec

                      Hi I am Teresa Rodriguez. Secondhand smoke causes many respiratory
                      problems, especially for children. Don't allow anybody to smoke inside
                      your house.
                      For more information call your local American Lung Association at 1-800-
                      586-4872.

                      30  Sec
                       Hi, I am Teresa Rodriguez. Every year at least 3,000 non-smokers die of
                       lung cancer caused by secondhand smoke. Protect your family and
                       principally the children. Therefore don't allow anybody to smoke inside
                       your house.

                       For more information contact your local American Lung Association at 1-
                       800-586-4872, that's 1-800-586-4872

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Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
             Hispanic Radio PSAs (Spanish) — Secondhand Smoke Media Campaign
                   15  Sec    s

                   Hola, soy Teresa Rodriguez. El humo de segunda mano causa muchas
                   enfermedades, principalmente en los nines.  No deje que nadie fume dentro
                   de su casa.

                   Para mayor informacion llame a la Asociari6n Americana del Pulmon de
                   su localidad al 1-800-586-4872.

                   30  Sec
                   Hola soy Teresa Rodriguez. Cada ano por lo menos 3,000 personas no
                   fumadoras mueren de cincer pulmonar a consecuencia del faumo de
                   segunda mano. Proteja a su familia y principalmente a los ninos. Por lo
                   tanto no permita quc nadie fume dentro de su casa.
                                                      •
                   Para mayor informacion contacte La Asociacion Americana del Pulmon de
                   su localidad llamando al 1-800-586-4872, repito
                   1-800-586-4872.

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Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
           African-American Radio PSAs — Secondhand Smoke Media Campaign
         BREATHING SOMEONE ELSE'S CIGARETTE SMOKE - SECONDHAND SMOKE - IS




         VERY DANGEROUS.   IT HURTS YOU, YOUR FAMILY - ESPECIALLY YOUR




         CHILDREN. FIND OUT HOW TO PROTECT YOURSELF AND YOUR FAMILY FROM




         SECONDHAND SMOKE. CALL YOUR LOCAL AMERICAN LUNG ASSOCIATION FOR




         MORE INFORMATION.  1-800-LUNG-USA.
           30 second PSA






           BREATHING SOMEONE ELSE'S  CIGARETTE SMOKE "-"SECONDHAND SMOKE -




           HURTS  EVERYBODY, ESPECIALLY CHILDREN.   CHILDREN  WHO BREATHE




           SECONDHAND SMOKE HAVE MORE EAR INFECTIONS AND ARE MORE LIKELY TO




           SUFFER FROM PNEUMONIA, BRONCHmS AND OTHER LUNG DISEASE.  THREE




           THOUSAND PEOPLE DIE  EACH YEAR FROM LUNG CANCER  BECAUSE THEY




           BREATHED SOMEBODY ELSE'S SMOKE. FIND OUT HOW TO PROTECT YOURSELF




           AND YOUR FAMILY FROM SECONDHAND SMOKE. CALL YOUR LOCAL AMERICAN




           LUNG ASSOCIATION FOR MORE INFORMATION. 1-800-LUNG-USA.

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Secondhand Smoke and Children: Conducting Public Outreach Programs
                   Replicable Programs
       Hispanic Press Release (English Translation) — Secondhand Smoke Media Campaign
          FOR  TMMEPTATF. RELEASE
Contact: Hector Hereter
    Tel: 305-379-9020
              AMERICAN LUNG ASSOCIATION WARNS HISPANICS
             OF SECONDHAND SMOKE DANGERS IN NATIONWIDE
                                     CAMPAIGN
             NEW YORK, (xx xx, 1994)— The American Lung Association

          today launched a comprehensive nationwide campaign to increase

          awareness among Hispanics of the serious health problems that are

          associated with secondhand smoke.

             According to the American Lung Association, each year about' 3,000

          non-smokers die of lung cancer caused by inhalation of secondhand smoke,

          and Hispanics are among those affected.

             "The exposure to secondhand smoke, which unfortunately, is common

          in Hispanic homes, produces harmful health effects in individuals who do

          not smoke,  especially children," said Dr. Nelson L. Turcios, a pediatric

          physician and spokesperson for the ALA.

             "We see that during the first five years of life, healthy'children whose

          parents smoke show a higher frequency of chronic coughs, ear infections,

          nasal and chest congestions, in comparison to those children whose

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Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
  Hispanic Press Release (English Translation) — Secondhand Smoke Media Campaign (page 2)
                   parents do not smoke," Turcios added.

                      Studies have also shown that each year secondhand smoke leads to

                   approximately 150,000 to 300,000 cases of infections such as bronchitis

                   and pneumonia in infants and children under 18 months of age. These

                   illnesses result in between 7,500 and 15,000 hospitalizations annually.

                      Turcios believes that it's crucial for Hispanic non-smokers to

                   emphasize the fact that they have the right to care for their health and to

                   ask smokers to respect their desire to breathe clean air.

                      Secondhand smoke is the smoke exhaled by smokers and the smoke

                   which emanates from the burning of a  cigarette, cigar or pipe. Second-

                   hand smoking is  also called passive smoking, involuntary smoking,  or

                   environmental tobacco smoke.

                     The American Lung Association has produced an easy-to-read, Spanish-

                  language brochure designed to warn people of the dangers of secondhand

                  smoke. The brochure can be obtained by calling your local American
                  Lung

                  Association, toll-free, at 1-8000-LUNG-USA (1-800-586-4872).

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Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
            Hispanic Press Release (Spanish) — Secondhand Smoke Media Campaign
           PARA  SU  PUBLICACION INMEDIATA
                                                      Contacto: Hector Hereter
                                                               305-379-9020
               La American Lung Association inicia campana nacional
            para advertir a hispanos sobre el peligro del humo de  segunda
                                        mano
           NUEVA YORK, (XX XX, 1994) — La American Lung Association
           (ALA) inicid hoy una amplia campana a fin de aumentar la conciencia
           entre la poblacidn hispana sobre los series problemas de salud que causa el
           humo de segunda mano.
                Segun la American Lung Association, cada afio 3,000 personas que
           no fuman mueren de cdncer a consecuencia de la inhalacidn del humo de
           ssgunda mano, y los hispanos no son la excepcion.
                ซLa exposicidn al humo de segunda mano, que desafortunadamente,
           es comiin en los hogares hispanos, causa efectos daninos en la salud de
           aquellos individuos  que no fuman, especialmente los ninos,ป dijo el Dr.
           Nelson L. Turcios, medico pediatra y vocero de la American Lung
           Association.
                ซHemos detectado que durante los primeros cinco afios de vida, los
          ninos que nacen saludables y cuyos padres fuman presentan un cuadro
          cronico de tos, infecriones auditivas, congestion nasal y pulmonar en
          comparacidn con aquellos ninos cuyos padres no fuman,ป agreg6 Turcios.

                                        -sigue-

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            Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                   Hispanic Press Release (Spanish) — Secondhand Smoke Media Campaign (page 2)
L
                                 . 2
                             ALA/Segunda mano

                                   Los estudios tambien demuestran que cada ano el humo de segunda

                             mano conlleva a que se detecten entre 150.000 a 300,000 casos de

                             infecciones tales como bronquitis y neumonia en infantes y ninos menores

                             de 18 meses.  Estas enfermedades resultan en 7,500 a 15,000

                             hospitalizaciones al ano.

                                   Turcios considers crucial que aquellos hispanos que no fuman deben

                             defender su derecho a preservar su  salud y exigirle a los fumadores que

                             respeten su deseo de respirar un aire limpio.

                                   El humo de segunda mano son las emanaciones de los cigarrillos

                             encendidos, cigarros y pipas, y el humo que exhalan los fumadores. El

                             humo de segunda mano tambien se le denomina fumador pasivo o

                             contaminacion ambiental por humo del tabaco (denominado en ingles

                             Environmental Tobacco Smoke, ETS).

                                   La ALA creo un folleto de facil lectura en espanol disenado para

                             advertir a la gente sobre los peligros del humo de segunda mano. El

                             folleto puede  ser adquiiido de manera gratuita contactando las oficinas

                             locales de la ALA, o llamando al telefono libre de cargos 1-800-LUNG-

                             USA (1-800-586-4872).

                                                              I! Ii it                              •
                                   La American Lung Association ha luchado por espacio de 90 arios en
                             contra de las  enfennedades pulmonares.  A traves de la generosa aportacibn
                             del publico y  la ayuda de voluntaries, se ha avanzado inucho  en esta lucha.
                             A pesar de ello, nuestra labor todavia no ha finalizado. A medida que nos
                             acercamos al  inicio de otro siglo, continuaremos en nuestros  esfuerzos por
                             facilitar la respiracion de todos. Conjuntamente con nuestra divisi6n
                             midica,  la American Thoracic Society, proveemos programas educattvos,
                             servicios comunitarios, apoyo e investigacidn.   Las  actividades  de La
                             American Lung  Association "   —~ ซ" aooyo en las donaciones dadas  a  los
                             Christmas Seals y a otras            >.s voluntarias.

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Secondhand Smote and Children: Conducting Public Outreach Programs
Replicable Programs
            African-American Press Release — Secondhand Smoke Media Campaign
                                              For Immediate Release
                                              Contact:   Debbie Anbey
                                                        (305) 576-4914
         THE AMERICAN LUNG ASSOCIATION INVITES AFRICAN
         AMERICAN COMMUNITY TO JOIN NATIONAL CAMPAIGN
                       AGAINST  SECONDHAND SMOKE

         NEW YORK, N.Y. (xx-xx-94) - The American Lung Association invites
        African-American civic groups, organizations and associations from
        around the nation to join their campaign to inform families about the
        dangers of secondhand smoke. The campaign information for mass
        distribution has been especially created to encourage African Americans to
        get involved in educating their communities.
             According to Dr. Jean G. Ford, M.D., a clinical investigator/assistant
        professor at Columbia University and American Lung Association
        volunteer, "When you smoke or allow others to smoke around you, you are
        exposing yourself as well as 'others to dangerous substances that can easily
        affect everyone's health, especially the health of your children."
             Secondhand smoke comes from two places, smoke breathed out by
        the person who  smokes, and smoke from the end of a burning cigarette.
        Secondhand smoke contains over 4,000 chemicals, 200 are poisons, 43
        cause cancer.  In fact, secondhand smoke has been classified by the
        Environmental Protection Agency (EPA) as a known cause of cancer in
        humans.  Secondhand smoke causes 3,000 deaths each year from lung
        cancer in people who don't smoke. .
             Studies have also shown that children less than one year old whose
        parents smoke are more likely to  have middle-ear infections,  bronchitis
        and pneumonia than children of the same age whose parents do not smoke.
        In addition, children of smoking mothers are more likely than children of
        nonsmoking to have lung disease in general.

                                     -more-

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Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
        African-American Press Release — Secondhand Smoke Media Campaign (page 2)
                    Page Two

                          "Mothers who continue smoking have children who have increased
                    symptoms of coughing, mucus, wheezing and more frequent asthma
                    attacks.  As a society, we cannot accept the loss of one life to secondhand
                    smoke. We all have a responsibility to protect our most vulnerable assets,
                    our children and our future," added Dr. Ford, recipient of the Clinical
                    Investigator Award for Special Populations from the National Cancer
                    Institute.

                         The materials that will be distributed nationally among African-
                    American organizations emphasize the importance of protecting the health
                    of young children and their families from secondhand smoke.  EPA
                    estimates that secondhand smoke is responsible for between 150,000 and
                    300,000 lower respiratory tract infections in infants and children under 18
                    months of age annually, resulting in approximately 7,500 to 15,000
                    hospitalizations each year.

                         For more information on secondhand smoking or to obtain the
                   brochure "Protect Yourself and Your Family from Secondhand Smoke,"
                   contact your local American Lung Association at 1-800-LUNG-USA (1-
                   800-586-4872).
                   The American Lung Association  has been fighting long disease  for 90 years.  Witfa the
                   generous support of the public and toe help of oar volunteers,  we have  seen many
                   advances against lung disease.  However, our work is not  finished.  As  we  look
                   forward to our second centurj, we will continue to strive to make breathing easier for
                   everyone.  Along with our medical section, the American  Thoracic Society, we provide
                   programs of education, community service, advocacy and research.  The  Lung
                   Association's activities are supported fay donations  to Christmas Seals and other
                   voluntary  contributions.
                                                     ##*

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Secondhand Smoke and Children: Conducting Public Outreach Programs
               Replicable Programs
 Hispanic Localizable Press Release (English translation) — Secondhand Smoke Media Campaign
          FOR IMMEDIATE RELEASE
Contact:
    Tel:
               AMERICAN LUNG ASSOCIATION WARNS HISPANICS
          OF SECONDHAND SMOKE DANGERS IN NATIONWIDE
          CAMPAIGN


             	CITY ,(MM DD, 1994)— The American Lung Association today

          launched a comprehensive nationwide campaign to increase awareness

          among Hispanics of the serious health problems that are associated with

          secondhand smoke.

             According to the American Lung Association, each year about 3,000

          people die of lung cancer caused by inhalation of secondhand snioke, and

          Hispanics are among those affected.

             "The exposure to secondhand smoke, which unfortunately, is common

          in Hispanic homes, produces harmful health effects in individuals who do

          not smoke, especially children," said	spokesperson for the

          ALA.

             "We see that during the first five years of life, healthy children whose

          parents smoke show a higher frequency of chronic coughs, ear infections,

          nasal and chest congestions, in comparison to those children whose

          parents do not smoke," 	added.

             Studies have also shown that each year secondhand smoke leads to

-------
Replkable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
Hispanic Localizable Press Release (English translation) — Secondhand Smoke Media Campaign (page 2)
               approximately 150,000 to 300,000 cases of infections such as bronchitis

               and pneumonia in infants and children under 18 months of age. These

               illnesses result in between 7,500 and 15,000 hospitalizations annually.

                  	believes that it's crucial for Hispanic non-smokers to

               emphasize the fact that they have the right to care for their health and to

               ask smokers to respect their desire to breathe clean air.

                  Secondhand smoke is the smoke exhaled by smokers and the smoke

               which emanates from the burning of a cigarette, cigar or pipe. Second-

               hand smoking is also called passive smoking, invaluntary smoking, or

               environmental tobacco smoke.

                  The American Lung Association has produced an easy-to-read, Spanish-

               language brochure designed to warn people of the dangers of secondhand

               smoke. The brochure can be obtained by calling your local American
               Lung

               Association, toll-free, at 1-8000-LUNG-USA (1-800-586-4872).

                                               jf it ti
                  The American Lung Association has been fighting lung disease for 90
              years.  With the generous support of the public and the help of our
              volunteers, we have seen  many advances against lung disease.  However,
              our work is not finished.  As we look forward to our second century, we
              will continue to strive to make breathing easier  for everyone.  Along with
              our medical section, the American  Thoracic  Society, we provide programs
              of education, community service, advocacy and research.  The Lung
              Association's activities are supported by donations  to  Christmas Seals and
              other  voluntary contributions.

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
             Replicable Programs
      Hispanic Localizable Press Release (Spanish) — Secondhand Smoke Media Campaign
                    STJ  PTIBT.TrACTQN
Contacto:
Tel:
                 La American Lung  Association inicia  campana national
              para advertir a hispanos sobre el peligro  del bumo de segtmda
                                           mano
             	 (Ciudad), (XX XX, 1994) — La Asociacion Americana del
             Pulmdn (ALA por sus siglas en ingles) inicio hoy una amplia campana a fin
             de aumentar la conciencia entre la poblacion hispana sobre los series
             problemas de salud que causa el humo de segunda mano.
                   Segiin la Asociaci6n Americana del Pulm6n, cada ano 3,000 personas
             que no fuman mueren de cancer a consecuencia de la mhalas:6n del humo
             de segunda mano, y los hispanos no son la excepcion.  • -
                   ซLa exposicion al humo de segunda mano, que desafortunadameme,
             es comun en los hogares hispanos, causa efectos daninos en la salud en
             aquellos individuos que no fuman, especialmente los ninos,ป dijo -
             	 vocero del Asociaci6n.
                   ซHemos detectado que durante los primeros cinco afios de vida, los
             ninos que nacen saludables y cuyos padres fuman presentan un cuadro
             crdnico de tos, infecciones auditivas, congestion nasal y pulmonar en
             comparaci6n con aqueUos ninos cuyos padres no fuman,ป agrego
                                            -sigue-

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Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
  Hispanic Localizable Press Release (Spanish) — Secondhand Smoke Media Campaign (page 2)
                    Pag. 2
                    ALA/Segunda mano

                         Los estudios tambien demuestran que cada ano el humo de segunda

                    mano conlleva a que se detecten entre 150,000 a 300,000 casos de

                    infecciones tales como brbnquitis y neumorua en infantes y ninos menores

                    de 18 meses. Estos males tienen como resultado entre 7,500 a 1*5,000

                   hospitalizaciones al ano.

                         Turcios considera crucial que aquellos hispanos que no finnan deben

                   defender su derecho a preservar su salud y exigirle a los fumadores que

                   respeten su deseo de respirar un aire libre de contaminantes.

                         El humo de segunda mano son las emanaciones de los ciganillos

                   encendidos, cigairos y pipas, y el humo que exhalan los fumadores. El

                   humo de segunda mano tambien se le  denomina fumador pasivo o

                   contaminacion ambiental por humo del tabaco (denominado en ingles

                   Environmental Tobacco Smoke, ETS).

                        La ALA creo un folleto de facil lectura en espanol disenado para

                   advertir a la gente sobre los peligros del humo de segunda mano. El

                   folleto puede ser adquirido de mancra gratuita contactando las oficinas

                   locales de la ALA,  o llamando al telefono b'bre de cargos 1-800-LUNG-

                   USA (1-800-586-4872).
                                                   if tj f [


                        La Asociacidn Americana del Pulmdn  ha lucfaaclo por espacio de 90
                  anos en contra de las  enfennedades pulmonares.  A traves de la generosa
                  aportacidn del publico j la ayuda de voluntaries, se ha avanzado mucho  en
                  esta lucba.  A pesar  de ello, nuestra labor todavia no ha finalizado. A
                  medida que nos acercamos al  inicio de otro siglo, continuaremos en
                  nuestros esfuerzos por facilitar la respiracidn de todos. Conjuntamente con
                  nuestra divisidn mWica, la  Spciedad Toracica Americana, proveemos
                  prograrnas  educalivos, servicios comunitarios, apoyo  e investigacidn.  Las
                  actividades  de  La Asociacidn Americana del  Pulmdn basa su apoyo en las
                  donaciones  dadas a  los Christmas Sea! y otras contribuciones voluntaries.

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Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
            African-American Press Release — Secondhand Smoke Media Campaign
           THE AMERICAN LUNG  ASSOCIATION INVITES  AFRICAN-
           AMERICAN COMMUNITY TO JOIN NATIONAL CAMPAIGN
                         AGAINST SECONDHAND  SMOKE
           (LOCAL ) - The American Lung Association invites African-American
           civic groups, organizations and associations from around the nation to join
           their campaign to inform families about the dangers of secondhand smoke.
           The campaign information for mass distribution has been especially created
           to encourage African Americans to get involved in educating their
           communities.

           According to  (Spokesperson) an American Lung Association volunteer,^
           "When you smoke or allow others to smoke around you, you are exposing
           yourself as well as others to dangerous substances that can easily affect
           everyone's health, especially the health of your children."

           Secondhand smoke comes from two places, smoke breathed out by the
           person who smokes, and smoke from the end of a burning  cigarette.
           Secondhand smoke contains over 4,000 chemicals, 200 are poisons, 43
           cause cancer.  In fact, secondhand smoke has been classified by the
           Environmental Protection Agency (EPA) as a known cause of cancer in
           humans. Secondhand smoke causes 3,000 deaths each year from lung
           cancer in people who don't smoke.

           Studies have also shown that children less than one year old whose parents
           smoke are more likely to have middle-ear infections,  bronchitis and
           pneumonia than children of the  same age whose parents do not smoke. In
           addition, children of smoking mothers are more likely than children of
           nonsmoking mothers to have  lung disease in general.

           "Mothers  who continue smoking have children who have increased
           symptoms of coughing, mucus,  wheezing and more frequent asthma
           attacks.   As a society, we cannot accept the loss of one life to secondhand
           smoke. We all  have a responsibility to protect pur most vulnerable assets,
           our children and our future," added (Spokesperson).

                                         -more-

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            Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                   African-American Press Release — Secondhand Smoke Media Campaign (page 2)
L
                            Page Two


                            The materials that will be distributed nationally among African-American
                            organizations emphasize the importance of protecting the health of young
                            children and their families from secondhand smoke.  EPA estimates that
                            secondhand smoke is responsible for between 150,000 and 300,000 lower
                            respiratory tract infections in infants and children under 18 months of age
                            annually, resulting in approximately 7,500 to 15,000 hospitalizations each
                            year. For more information on secondhand smoking or to obtain the
                            brochure "Protect Yourself and Your Family from Secondhand Smoke,"
                            contact your local American Lung Association at 1-80Q-LUNG-USA (1-
                            800-586-4872).

                            The American Lung Association has been fighting lung disease for 90
                            years. With the generous support  of the public and the help of our
                            volunteers, we have seen many advances against lung disease.  However,
                            our work is not finished. As we look forward to our second century, we
                            will continue to strive to make breathing easier for everyone.  Along with
                            our medical section, the American Thoracic Society, we provide programs
                            of education, community service, advocacy and research. The Lung
                            Association's activities are supported by donations to Christmas Seals and
                            other voluntary contributions.

                                                             II II ;l
                                                             It!I it

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Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
                Media Fact Sheet (English) — Secondhand Smoke Media Campaign
                              AMERICAN LUNG ASSOCIATIONฎ

                               SECONDHAND SMOKE FACTS AND TIPS
          1)     Secondhand smoke comes from two places: smoke breathed out by the person who
                 smokes, and smoke from the end of a burning cigarette.

          2)     Secondhand smoke contains over 4,000 chemicals, 200 are poisons, 43 cause cancer.
                 Secondhand smoke has been classified by the Environmental Protection Agency (EPA)
                 as a known cause of cancer in humans (Group A carcinogen).

          3)     Secondhand smoke causes health problems and lung cancer in adults.  The
                 Environmental Protection Agency (EPA) estimates that secondhand smoke causes
                 approximately 3,000 lung cancer deaths in nonsmokers each year.

          4)     Secondhand smoke is especially harmful in young children.  EPA estimates that
                 secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory
                 tract infections in infants and children under 18 months of age annually, resulting in
                 between 7,500 and 15,000 hospitalizations each year,

          5)     Secondhand smoke is harmful to kids with asthma.  The Environmental Protection
                 Agency (EPA) estimates that between 200,000 and 1,000,000 asthmatic children have
                 their condition made worse by exposure to secondhand smoke.  Secondhand smoke
                 may also cause thousands of non-asthmatic children to develop asthma each year.

          6)     Secondhand smoke can make healthy children sick; it can  cause asthma, pneumonia,
                 ear infections, bronchitis, coughing, wheezing and  mucous.  According to the EPA,
                 the buildup of fluid in the middle ear,  often caused by secondhand smoke, is the most
                common cause of hospitalization of children for an operation.

          What the public can do about secondhand  srnoke:

                o     If you smoke, quit!
                o     Keep smoke away from you and your family by asking people not to smoke in
                      your home.
                o     Make sure your child's day care and schools have  no smoking rules.
                o     Use no smoking signs, buttons and stickers  at home, at work, and in your car.
                o     Ask for no smoking sections when you eat out.
                o     Support clean air laws that protect you from secondhand smoke.

          If you or anyone you know wants to quit smoking, the American  Lung Association can help,
          call 1-800-LUNG  USA.

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Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
             /Media Fact Sheet (Spanish) — Secondhand Smoke Media Campaign
                       AMERICAN LUNG ASSOCIATIONฎ

            RE ALIDADES Y DATQS SOBRE EL HTJMO r>F. SF.GTINDA
                                       MANO

         1)   El humo de segunda mano proviene de dos sitios: el humo quc exhala
              el fumador y el humo de la punta encendida del cigarrillo.

         2)   El humo de segunda mano contiene mas de 4,000 elementos
              qufmicos, de los cuales 200 son venenosos y 43 causan cancer. La
              Agencia de Proteccion Ambiental de Estados Unidos (EPA) clasifica
              al humo de segunda mano como un causante conocido dc cancer en
              los humanos (Grupo A cancerigeno).

         3)   El humo de segunda mano causa problemas de salud y cancer en los
              adultos. La Agencia de Proteccion Ambiental (EPA)  estima que el
              humo de segunda mano  causa aproximadamente 3,000 muertes al ano
              por cancer pulmonar en personas que no firman.

         4)   El humo de segunda mano es especialmente danino en los ninos. La
              EPA estima que el humo de segunda mano es responsable  dc •
              aproximadamente  150,000 a 300,000 infecciones respiratorias al ano
              en infantes y ninos menores de 18 meses de edad, con un resultado de
              7.500 a  15,000 hospitalizaciones al ano.

         5)   El humo de segunda mano es danino para los ninos con asma. La
              Agencia de  Proteccion Ambiental  (EPA) estima que  entrc 200,000 a
              1,000,000 de ninos asmaticos empeoran su condicion cuando se
              exponen al humo de segunda mano. El humo de segunda mano
              tambie'n puede causar cada ano el desarrollo de asma en miles de
              ninos que no sufren esta enfermedad.

         6)   El humo de  segunda mano puede enfermar a ninos que son sanos;
              puede causar asma, neumonia, infecciones en el oido, bronquius, IDS,
              difiultades para respirar y aumento de la mocosidad. Segun la EPA,
              la creacidn de fluido en el ofdo medio, por efecto del  humo de
              segunda mano, es la causa mas cormin del ingreso a hospitales de
              ninos que necesitan intervencion quinirgica.
                                      -sigue-

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Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
          Media Fact Sheet (Spanish) — Secondhand Smoke Media Campaign (Page 2)
                                                               Factsheet
  Hisp.
   2/2
                Que puede hacer el piiblico contra el humo de segunda mano:
                           Si fuma, deje de furnar de inmediato.
                           Mantega a su familia y a Ud, alejado del humo de segunda
                           mano pidiendole a sus amigos y familiares que no fumen
                           dentro de su casa.
                           Asegiirese que el centro de cuidado infantil de sus hijos tenga
                           reglas que prohiben fumar.
                           UtOice letreros, botones y calcomanias en contra del fumar en
                           su hogar, trabajo y carro.
                           Pida ser sentado en la seccion de no fumadores del restaurant
                           cuando saiga a comer.
                           Apoye las leyes que lo protegen a Ud. contra el humo de
                           segunda mano.

               Si Ud o cualquiera que Ud. conozca quiere dejar de fumar, la Asociacion
               Americana del Pulmdn puede ofrecerle ayuda gratuita.

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 Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                  Community  Baby  Shower
Goal:  To reduce parental smoking around young
children in low-income and minority households

Program Description: Community Baby Showers
are a combination of a party and a health fair. Lung
Associations around the country have successfully
used the community baby shower model to reach
low-income  and minority pregnant  women and
new parents with a wide range of health messages.
Sponsoring Lung Associations work in partnership
with local health departments, social service organi-
zations, medical  professionals, and women's and
children's interest groups to put together an attrac-
tive diversity of activities during the event Booths
and presentations cover many topics of interest to
new parents in addition to smoking  and second-
hand smoke. For example, topics such as breastfeed-
ing and nutrition, child safety, screening for lead,
high blood pressure and asthma are often included,
as well as information on locally available childcare
resources.

The appeal of Community Baby Showers over more
traditional health fairs is the addition of decorations,
refreshments, entertainment and give-aways, which
make the learning environment a fun atmosphere.
Lung Associations have used inspirational speakers,
musical performances, maternity fashion shows,
and prizes ranging from baby bibs to car seats to get-
away vacations as incentives to boost attendance and
make the events unique.
       As  an  example, the  ALA  of Virginia,
Piedmont Area held their "Greatest Baby Shower
Ever" at a major shopping mall on the outskirts of
Richmond. Their co-sponsors  included the mall
      management, a local hospital, TV and radio stations,
      and a grocery chain. Prizes were donated by area
      retailers. In order to ensure that party "guests" came
      away with some health information in addition to
      the goodies, the organizers set up a sort of treasure
      hunt,  in which participants  had  to get a  card
      stamped at certain booths to be  eligible for the
      major give-aways.
             The  Richmond  baby  shower was heavily
      promoted in the local media,  including a series of
      spots on the nightly news and an article in the local
      parent's magazine (see attached sample press release
      and flyer). Their radio station co-sponsor also con-
      ducted a call-in show staffed by physicians on site
      during the event. In addition, flyers and posters pro-
      moting the event were available at the mall, in health
      clinics and other public locations.
             Although the baby showers are open to the
      public, most Lung Associations target their publicity
      in ways that are most likely to reach low-income and
      minority families, such as articles in local minority
      newspapers, posters in health clinics, promotion
      through the WIC program, etc.

      Partners: There are many partnership opportuni-
      ties with this type of program. An important con-
      sideration is having enough diversity of sponsors
      and presenters to attract a broad audience. Most
      Lung Associations  have worked with  local public
      health agencies and clinics as primary partners.
      Other  partners that could offer funding  support
      and/or exhibit with health and safety information
      could include foundations interested in prenatal
      health issues, alternative high schools that serve
      pregnant  teens,  and organizations like the  La

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Secondhand Smoke and Children: Conducting Public Outreach Programs
                            Replicable Programs
Leche  League. Retail and  other businesses that
might be interested  in  donating  give-aways
and/or displaying their goods could  include toy
stores, baby furniture  and clothing outlets, and
diaper services.

Resources Needed:
•  An attractive and conveniently located facility like
  a shopping mall or a  community center
•  Promotional materials, including media releases,
  flyers and posters
•  Food, including healthy snacks and a cake
•  Presenters and entertainers
•  Decorations with a baby shower theme
•  Baby gifts,  including some large ones as door
  prizes and small ones for each guest
•  Educational materials, including ALA's Protecting
   Yourself and Your Family brochures for low-
  income and minority populations
•  Translation  services as appropriate

Measurable Outcomes and Evaluation:  For this
program, you will  want to track the number of part-
ners recruited, people  in  attendance, educational
materials distributed  and pledge cards signed. To
establish a  baseline  for  measuring  behavioral
change, administer a brief, pre-event survey to the
attendees as they enter. As the event draws to a close,
do a post-event survey to determine participant sat-
isfaction and to record any change in knowledge or
attitudes. Resources permitting, follow-up inter-
views/surveys can be conducted several months later
to measure retention of information and any posi-
tive behavior change. Overall evaluation of the event
is based on participant and partner satisfaction, as
well as how successful the program was in produc-
ing positive behavioral changes.

Opportunities and Linkages: Since this program is
extremely flexible, it can be used to showcase a num-
ber of health  issues. The Lung Association in
Richmond, for example, linked their baby shower to
the kick-off of a smoking cessation program for
pregnant women. As with any program for the gen-
eral public, you can improve the likelihood of get-
ting a good turnout if you work with programs that
already have a built-in audience, like a prenatal clin-
ic or the WIG program.

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Replicable Programs
                       Secondhand Smoke and Children: Conducting Public Outreach Programs
                          Sample Press Release — Community Baby Shower
   When You
   Can't Breathe,
   Nothing Else
   Matters'
      j, Boulevod
   Richmond, Viijinim
   23221*065
   Phone: (804)355.3295
   Fซ:(804)342-1062
   ToB Free: 1 800 LUNO USA
                                                                           f
                                                     AMERICAN
                                                     LUNG
                                                     ASSOCIATION.
                                                     of Virginia
 FOR IMMEDIATE RELEASE


 July 22, 1996
 Contact: Lauri Savage, 804-355-3295


 ANNOUNCING THE FIRST ANNUAL GREATEST BABY SHOWER
 EVER


 Richmond, Virginia - The First Annual Greatest Baby Shower Ever will take


 place on September 21, 1996 at Southpark Mall in Colonial Heights, Virginia.


 Presented by Your Neighborhood Columbia Hospitals to benefit the American


 Lung Association of Virginia, the event will provide information on good health


 habits during pregnancy.  Sponsors and vendors will offer health information and


 parenting tips, display products and services geared to young families, and offer


 door prizes.




 Media coverage includes a pre-event call in show on WRIC-TV 8, during which


 callers will be able to speak with physicians and obtain answers about individual


 health concerns. Lisa Schafiher, co-anchor,  will host the Greatest Baby Shower


 Ever on September 21.




One aspect of the health information will be to inform expectant mothers about


the harm that smoking during pregnancy can cause both them and their babies

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Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
                     Sample Press Release — Community Baby Shower (Page 2)
                             Lung disease and deaths from lung cancer are increasing among women, and




                             cigarette smoking is the likely cause for much of the increase, according to




                             studies presented at the recent American Lung Association/American Thoracic




                             Society International Conference. Currently, 22% of American women are




                             smokers; it is estimated that by the year 2000 women will smoke at the same rate




                             as men. Smoking during pregnancy accounts for an estimated 20-30% of low




                             birth weight babies, up to 14% of preterm deliveries and 10% of all infant deaths.









                             For more information on either the Greatest Baby Shower Ever or programs




                             to help smokers quit, contact the American Lung Association of Virginia at 804-




                             355-3295 or 1-800-LUNG-USA.

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Replicable Programs
                              Secondhand Smoke and Children: Conducting Public Outreach Programs
                  Sample Flyer And Poster — Community Baby Shower
              1996
    f
                                                         Presented by
                                Your Neighborhood Columbia Hospitals
                                                            to benefit
                               The American Lung Association of Virginia

                                   This premiere event offers tips for having
                                    a healthy family, loads of fun activities,
                               free gifts, exhibitor displays and access to free
                                   medical advice. Come hear talks on infant
                                 health, parenting and learn the importance
                                     of a smoke-free pregnancy and family.

                                    Lisa Schafmer, WRIC-TV 8,  will present
                                       "Challenges Working Mothers Face"

                                                      Talk to Physicians
                                              about Pregnancy Questions

                                  PLUS.,., Stroller aerobics.... Maternity and
                                child fashions.... Dad's diapering contest...
                                    Baby Olympics.... Biggest Shower Cake
                                    Ever.... Face painting.... and  much morel

                                               GRAND PRIZE DRAWING:
                                          4-Day, 3-Night Vacation Package

                                               For more information, call
                                       1-800-LDNG-USA or (804) 355-3295.
                                           Presented by...
 September 21,1996
       10am-4pm
      Southpark Mall
   Colonial Heights, VA

AMERICAN LUNG ASSOCIATION.
                        of Virginia
                                          Sponsors...
O COLUMBIA"
   Your Nttghtxxtmxl HotpHOf
   Chlppenham Medical Center
   Henrico Doctors' Hospital
   John Randolph Medical Center
   Johnston-Willis Hospital
   Retreat Hospital
   Hanover Outpatient Center
                                                                Q94

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Secondhand Smoke and Children: Conducting Public Outreach Programs
                           Replicable Programs
              Secondhand  Smoke  Helpline
Goal: To provide comprehensive  information on
secondhand smoke to the general public, including
its diverse populations

Program Description: The ALA  of Santa Clara/
San Benito Counties in California's Secondhand
Smoke Helpline is a hotline service that provides
answers to callers'  questions about  secondhand
smoke. The  hotline provides assistance in eight
different languages, reflecting the great diversity of
the local  population. Through  the use of volun-
teers and a collaborative arrangement with other
health and social service agencies, callers' ques-
tions  are answered, and  follow-up assistance is
provided if requested.
       Because callers can remain anonymous and
receive help with secondhand smoke problems, the
Helpline is especially attractive to  individuals who
fear retaliation from employers, landlords or family
members if they seek help. Although  the Helpline
has a  much broader focus than  just the residential
exposure of young children, it is an effective means
to reach  people who need help with developing
strategies for protecting their children, and feel they
have no where else to turn.
       The Helpline is promoted through flyers in
all the available languages, which  are distributed
through health  fairs, partner  organizations, and
other Lung Association programs for the target com-
munity. The Helpline number is also included in any
smoking-related releases sent out to the media.

Partners: The county health department was the orig-
inal sponsor of the Helpline, and continues to promote
it in their outreach. The Lung Association also works in
cooperation with a number of community-based
organizations to make sure their clients are aware of the
service. These organizations also provide the multi-lin-
gual staff, who are trained by the Lung Association to
help with translation and with the counseling of callers.

Resources Needed:
• Trained staff or volunteers to answer the phones
  and provide follow-up as needed
• Dedicated phone bank site and phone lines
• Secondhand smoke outreach materials for fol-
  low-up mailings, including  brochures and fact
  sheets in translation
• Postage for follow-up mailings
• Staff time and materials to publicize the Helpline
  services

Measurable Outcomes and Evaluation: The success
of this program is measured  by the number of
callers to the Helpline. The callers who give contact
information rather than remain anonymous receive
a follow-up survey, either by phone or mail, to deter-
mine their satisfaction with the service, and whether
or not they were able to resolve their problems.

Opportunities/Linkages:  Because this program
depends on people calling in, it can only succeed if
there is a certain level of community awareness of the
health risks associated with secondhand smoke. One
of the reasons this particular program has been so
successful is that the ALA of Santa Clara/San Benito
Counties has a very active, multi-tiered outreach pro-
gram, and is able to link all their programs together.

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            Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                           Secondhand  Smoke  in  Cars
           Goal: To protect children from exposure to second-
           hand smoke in cars

           Program Description: The amount of secondhand
           smoke exposure that children get in the family car is
           usually small compared with that in the home. But
           taking steps to stop smoking in the car is probably
           also easier than at home. The  ALA of Ohio,
           Akron/Canton Area conducted this targeted cam-
           paign on secondhand smoke and cars as part of a
           broader secondhand smoke program. But they saw
           it as a discrete opportunity to make a difference.
                  The Lung Association successfully engaged
           the local chapter of the American Automobile
           Association (AAA), which serves a large member-
           ship representing a cross-section of the community.
           AAA agreed to distribute secondhand smoke infor-
           mation to their members through mailings, Trip Kit
           distribution, and in their offices.
                  The ALA  of Ohio, Akron/Canton  Area
           developed two special items for the campaign: a very
           simple flyer on the health risk to children from sec-
           ondhand smoke in cars, and a static sticker with a
           smoke-free message that could be displayed on car
           windows (see attached). The pieces were sent to area
           auto dubs for distribution.

           Partners: The local chapter of the AAA was an
           invaluable partner in this program. They have access
           to a large membership, and an unrivalled credibility
           with the public on  automobile issues. Other car-
           related businesses to consider in a  partnership on
           children's health could include car dealerships, gas
      stations and repair shops. The local health depart-
      ment would also be a valuable ally, as they could
      offer support for die health messages.

      Resources Needed:
                        ,i                      i
      •  Educational materials, such as the flyer and stick-
        er attached
      •  A distribution mechanism, such as AAA's existing
        outlets in this case

      Measurable Outcomes and Evaluation:
      As done by the ALA of Ohio, Akron/Canton Area,
      the measurable outcomes for this program were the
      number of participating auto clubs, and the number
      of informational packets distributed. Evaluation was
      based on comparing the actual outcomes with the
      standards set at the outset of the program.
            To get a better measure of whether any driv-
      ers changed their behavior based on the information
      they received in this campaign, you could conduct a
      follow-up survey of selected recipients of the second-
      hand smoke materials. Or, the mailing could have
      included  a smoke-free cars pledge  card, and  a
      response form. Any recipients who  sent the response
      form back indicating that they had signed the pledge
     card would receive the window sticker as a thank you
     (and a reminder of their promise to their children).

     Opportunities/Linkages: Adding a media component
     could easily broaden the reach of this campaign without
     diluting the focus on cars. Also, of course, once a family
     has successfully gone smoke-free in their car, the logical
     next step is to ask them to go smoke-free at home.
L

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Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                                  Replicable Programs
                        2 Sample Flyers — Secondhand Smoke In Cars
      I
         Secondhand       ^

  Smoke... Is your child

          in danger?

  *  Secondhand smoke causes cancer; it is
     responsible for approximately 53,000 deaths
     each year.

  4  Secondhand smoke contains over 4, 000
     chemicals including 200 poisons such as tar,
     carbon monoxide and nicotine.

  *  Secondhand smoke trapped in a car for one
     hour exposes children to the equivalent of 3
     cigarettes per hour.

  *  Secondhand smoke in a home exposes
     children to the equivalent of 3 cigarettes a
     day,

  4   An estimated 9 million children are exposed
     to secondhand smoke 8 to 16 hours a day.

  4   Secondhand smoke can increase a child's
     risk for asthma, pneumonia, bronchitis and in
     some cases Sudden Infant Death Syndrome.
Hew to protect your child ...
  —   Give up active smoking
  ~   Make your car and home smoke - free
  ~  Never smoke while holding your child
  —  Sit in non-smoking areas when in restaurants
    and shopping centers
  ~  Encourage schools, child care centers and
    other public places to go smoke-free
  ~  Tell others not to smoke around your child.
    Remember, your child has the right to clean
    air1
       For more information:
     Call 1-800-LUNG-USA
'        You Smoke,

is your child in danger?


            YES!

  4 Secondhand smoke trapped
    in a car for one hour
    exposes your children to the
    equivalent of 3 cigarettes
    per hour.

  * Secondhand smoke
    increases your child's risk
    for asthma,  pneumonia,
    bronchitis and in some
    cases Sudden Infant Death
    Syndrome.

  * Secondhand smoke causes
    cancer and can eventually
    lead to death.

  Keep your kids smoke free!

      For more information:
    Call 1-800-LUNG-USA
                                                             tLUNG
                                                             ASSOCIATION.
                                                             of Ohio
                                                          AlLron/Canton Area Branch
                  Akron/Canton Area Branch

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Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                    Window Decal — Secondhand Smoke In Cars
                    AMERICAN
                                   I'uUlrLUiiHMJwA

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                       Replicable Programs
          Outreach  to  Daycare  Providers
             Daycare providers  have a dual
             role in protecting children from
             secondhand  smoke:, they can
             ensure a smoke-free environ-
ment while the children are  in their care, and
they can serve as a conduit for passing informa-
tion along to the parents. In addition to the pro-
grams detailed below, local Lung Associations
have reached daycare providers through partner-
ship with the YMCA; the offer of IAQ asses-
ments for home-based providers; the inclusion
of secondhand smoke education in asthma man-
agement  training;  and a media  campaign
informing parents of the  passage  of a new
smoke-free daycare law.

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 Repltcable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                     Smoke-free  Head  Start
Goal: To reduce Head Start children's exposure to
secondhand tobacco smoke in their homes, auto-
mobiles, and in preschool

Program Description: The Head Start program has
proven to be an ideal place for secondhand smoke and
children outreach for several reasons: its nationwide
reach into low-income and minority communities
with higher than average smoking rates; its federal
mandate to maintain smoke-free facilities; and the fact
that parents are required to participate in some Head
Start activities. The ALA of the East Bay in California
(formerly the ALA of Alameda County) has  been
refining  and expanding upon its Smoke-free Head
Start program for several years now, and it has already
become  a model for Lung Associations and other
organizations interested in replicating its success.
       The first task is to gain the cooperation of
the local Head Start program and to  help them
adopt the goal of reducing the exposure of the chil-
dren in  their care to secondhand smoke. Since all
Head Start facilities are required to be smoke-free,
program managers may see the ALA's efforts as help-
ing them adhere to that policy through education of
their staff and parents. The ALA of the East Bay
helps the Head Start programs they work with to
develop  and enforce a smoke-free policy statement
(see sample statement and signage attached).
       At the beginning of the school year, parents
are given a brief survey about their smoking behav-
ior as part of the Head Start intake process.  This
information is used for a baseline for the purposes of
program evaluation at the end of the year. In addi-
tion to the sample questionnaire attached, the ALA
of the East Bay has developed surveys in Spanish,
      Chinese, Vietnamese and Farsi.
             The Lung Association sets up a  series of
      trainings with the Head Start staff. But before train-
      ing begins, they ask I lead Start program managers
      to conduct a  survey  to  determine the  smoking
      prevalence among the staff, and whether or not they
      allow smoking in their own homes. The results of
      the survey are used to tailor the staff training to the
      audience. For example, if there is a high  smoking
      prevalence among staff and they allow smoking in
      their homes, the amount of training time allocated
      for discussion of the health risks from secondhand
      smoke is increased.
             The initial  overview training  involves all
      Head Start  staff, including clerical, janitorial, bus
      drivers and kitchen assistants. Follow-up training is
      provided  for family advocates on how to talk to
      parents about secondhand  smoke, and  for the
      teaching staff on how  they can incorporate basic
      secondhand smoke lessons into their  curriculum
      for the children. The staff members are provided
      with resource materials, including language-appro-
      priate brochures for the families.
             The family  advocates work with  families
      through presentations at parent meetings, including
      the video  Poisoning Your Children; one-on-one dis-
      cussion during family intake meetings; articles in the
      newsletter that goes home to parents; and if needed,
      counseling during home visits.

      Partners: The Head Start program, or any other day-
      care provider, is, of course, the essential partner. The
      ALA of the  East Bay has worked closely with  their
      county health department, which provided most of
      their  initial  funding. Since that time,  Smoke-free

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                            Replicable Programs
Head Start has been supported primarily by state
grants. Local businesses may help by providing
funding or in-kind services to assist with creating
printed materials, mailings, or holding meetings. In
addition, local medical or physicians' organizations,
or the local health department may be willing to
provide speakers or educational materials.

Resources Needed:
•  A facility for meetings and trainings
•  Educational materials for staff, parent advocates
   and parents, including videos, brochures and fact
   sheets
•  Incentives items for participation and feedback,
   such as certificates and coupons
•  Model policies for smoke-free daycare, if appro-
   priate

Measurable Outcomes and Evaluation:
Measurable outcomes  include  the  number of
Head Start facilities participating in the initiative,
and the number enforcing  smoke-free policies.
You also can track the number of staff and family
advocates trained; packets distributed to families;
and smoke-free pledges signed. Evaluation of the
program is done by the family advocates, who
administer pre- and-post intervention surveys to
the parents (see  attached). Parents are  given a
smoke-free pledge card (see attached) with their
post survey, and those parents signing a card
receive  a  "Welcome to Our  Smoke-free Home"
sign and a "No Smoking" sticker for their car. The
ALA of the East Bay has learned that they get a
much higher rate of return on their surveys if they
offer the family advocates small incentives like gift
certificates for the  prompt return of the parent
surveys that they complete.

Opportunities/linkages: This program was  devel-
oped specifically for Head Start families and their
children. It can be adapted to other daycare centers,
schools, and perhaps even community or  recre-
ational centers that serve children and their families,
like the YMCA and Boys and Girls Clubs.

-------
Replicabie Programs
                              Secondhand Smoke and Children: Conducting Public Outreach Programs
                      Sample Smoke-free Policy — Smoke-free Head Start
              OAKLAND HEAD  START SMOKE-FREE  POLICY AND
              PROCEDURE

              POLICY:
              Due to acknowledged hazards, both to adult nonsmokers and especially to
              young children arising from exposure to environmental tobacco smoke (ETS)
              it shall be the policy of OAKLAND HEAD START to provide a smoke-free
              environment for staff, children, and participants. This policy covers the
              smoking of any tobacco product and applies to both employees and non-
              employee participants  of OAKLAND HEAD START.

              OAKLAND HEAD START will serve as an example to other child care and
              community agencies. OAKLAND HEAD START staff and volunteers will
              serve as role models by not smoking in the presence of children, parents and
              participants.

              DEFINITION:
              1.     There will be no smoking in any OAKLAND HEAD START facility at
                    any time.

                    The decision to provide or not provide designated smoking areas
                    outside the building will be at the discretion of the program director or
                    local decision-making body.

                    The designated smoking area will be located out of children's sight,
                    away from the main entrances to the building, and at least 20 feet away
                    from the main entrance.

                    All smoking trash, including butts and matches, will be extinguished
                    and disposed of in appropriate containers.  Program supervisors will
                    ensure periodic clean-up of the designated smoking areas.  If the
                    designated smoking area is not properly maintained, it can be
                    eliminated at the discretion of the program director.

                   There will be no smoking in any OAKLAND HEAD START vehicle.

                   There will be no smoking in OAKLAND HEAD START vehicles at any
                   time.

                   There will be no tobacco use in personal vehicles when transporting
                   persons on OAKLAND HEAD START authorized business.

                   There will be no  smoking by staff or volunteers when children are
                   present. This includes both indoor and outdoor activities.

                   Field trips, walks, and other off-site activities will be smoke-free to the
                   fullest extent possible.  There will be no smoking by staff or volunteers
2.
3.

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Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
           Sample Sign for Smoke-free Facility — Smoke-free Head Start
               Oakland
               In keeping with Oakland He^d
                intent to provide a safe and healthy
                     working environment,
           SMOKING IS
                        throughout all
                  Oakland Head Start's work sites
             INCLUDING OUTDOOR AREAS
                that are used by1
                                       /x
               This policy applies equally to
                 all employees and visitors.

-------
                     Replicable Programs
                             Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                Sample Intake Survey — Smoke-free Head Start
                                 4.
                                 5.


                                 6.
                                 7.
                                       Head Start Site Name_
                                       Child's Name
                                                                             . Your Relationship to Child
                                                   Head Start Secondhand Smoke Intake Survey
                                        Dear Parents and Guardians, please take a few moments to Jill out this survey, answering every
                                        question honestly. The purpose of this survey is to determine how we can help Head Start parents
                                        and their children. The answers to these questions are confidential.
                                                                -The American Lung Association of Alameda County
                                        What is your ethnicity?
                                          I	| African American
                                          I	I Vietnamese
                                              Other
                            I	I  Cambodian
                            I	|  Laotian
                               :	I  Latino   |	| Chinese
                               Q  Filipino  Q Afghan
How many smokers live in your household?
 I — I  None    I _ I  One       I _ |Two
                                                                                   Three or more
                                 3.    Who smokes in the house? (Check all that apply.)
I _ I
No one
{_J
                   You
                                                                       Other Household member(s)  Q Guest(s)
Where is smoking allowed? (Check all that apply.)
 I — I  Child's bedroom                    I _ |   Other Bedrooms
 I — I  Living room                       | _ |   Bathroom
 I — I  Kitchen                           |_J
 I — I   Patio/porch/balcony
                                                                                    Dining room
                                                                                    Not INSIDE at all
Who smokes in your car? (Check all that apply.)
 Q  No one   Q  You      Q Other Household member(s)   [~~j Guest(s)

Does your child ever ride in a car where smoking is allowed? PI  Yes     I   I No
Do any of the children in your house have any of the following conditions?
 (Check all that apply.)
                                        I	I  Asthma
                                        I	|  Allergies
                                        I	I  Frequent Colds
                                         I	I   Frequent Ear Infections
                                         I	I   Frequent Coughs
                                         I	I   Other Lung Illnesses
.

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Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
                         Sample Pledge Card — Smoke-free Head Start
        Dear Parents,
        We are asking that all Head Start parents consider signing this smoke-free pledge for their
        families' health. This is a voluntary pledge. You are not required to sign this. If you do decide to
        make your home and car smoke-free and sign this pledge, we will be giving you some NO
        SMOKING signs and stickers and a certificate signed by the Alameda County Health Officer.
                                         -The American Lung Association of Alameda County
                                Start  Smoke-\Jree ^Pledge
                        (print name)
                                             hereby pledge to provide a
                        ^plllU I ION ICy
             smoke-free home and transportation for my children) because D love them
             and D voant to protect them from secondhand tobacco smoke.

             *~Bu signing this pledge,
             *D promise to forbid smoking in my car,
             *D promise to forbid smoking inside my house, and
             *D promise to  ask others not to smoke -whenever my children are present.

             .Tor smokers onl:
             U also promise to not smoke whenever my children are present including outdoors.
             Your Name (please print)
             Child's  Name 	
             Home Phone 	
             Head Start Site

             Signature 	
                                                         Date

-------
Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                 Sample Sign for Smoke-free Home — Smoke-free Head Start
                                                                           '

-------
Secondhand Smolse and Children: Conducting Public Outreach Programs
                                                                             Replicable Programs
                          Sample Follow-up Survey — Smoke-free Head Start
             2.

             3.
             5.


             6.

             7.
             9.
                    Head Start Site Name_

                    Child's Name	
                                           Your Relationship to Child_
                             Head Start Secondhand Smoke Follow-Up Survey

                    Dear Parents and Guardians, please take a few moments to fill out this survey, answering every
                    question honestly.  The purpose of this survey is to determine how we can help Head Start parents
                    and their children. The answers to these questions are confidential.
                                              --The American Lung Association of Alameda County
                    What is your ethnicity?
                   Q African American
                   Q Vietnamese
                            Q Cambodian
                            Q Filipino
                                       Q  Latino
                                       Q  Afghan
Chinese
Other
Laotian
       How many smokers live in your household?  Q None    Q One    Q Two   3 Three or more


                                                                   Q Guests
Who smokes in your house? (Check all that apply.)
  Q   No one    Q You        Q Other Household members
             4.      Where is smoking allowed in your house? (Check all that apply.)
                          Child's bedroom
                     Q    Living room
                     D    Kitchen
                     Q    Patio/porch/balcony
                                               a
                                               a
                                               a
                                               a
                                               Other Bedrooms
                                               Bathroom
                                               Dining room
                                               Not inside at all
      Who smokes in your car? (Check all that apply.)
          D  No one    Q You      Q  Other Household members       O Guests

      Does your child ever ride in a car where smoking is allowed?    Zl Yes        Q No

      How has the amount of smoking INSIDE your HOUSE changed during the last six months?
                     O    No change
                     D    Smoking allowed in fewer rooms
                                                Q   Smoking no longer allowed
                                                Q   Smoking allowed in more rooms
                    How has the amount of smoking inside your CAR changed during the last six months?
                     Q    No change
                     Q    Smoking allowed less often
                                                 D   Smoking no longer allowed
                                                 Q   Smoking allowed more often
      In the past 6 months, where did your family receive information
      about secondhand tobacco smoke? (Check all that apply.)
                    Q  Head Start       Q  Doctor
                    Q  Television/radio  Q  Other
                                         Q American Lung Association     Q Health Fair


10.    Did you see the video tape, "Poisoning Your Children"?  Q   Yes      G   No

-------
           Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                           Childcare  Provider Training
L
           Goal: To educate childcare providers about the dan-
           ger to young children from secondhand smoke.

           Program   Description:   Many  local  Lung
           Associations have conducted trainings on second-
           hand smote for daycare providers. The ALA of
           Kansas's program provides a good example of a
           multi-pronged outreach program designed to reach
           daycare providers in several different ways. First,
           they worked with the Kansas Department of Health
           and  the Environment to  adapt the National
           Resource Center for Health and Safety in Child Care
           (NRCHSCC) secondhand  smoke training module
           for daycare providers in Kansas. The modified mod-
           ules were then distributed to providers through the
           Kansas Child Care Resource and Referral Agency.
           Some sample materials from the modified training
           module are attached. [NRCHSCC's self-paced edu-
           cational program was originally developed with the
           intention that it be adapted and approved for con-
           tinuing education credits for daycare providers in
           each state, although it has since been  modified to
           make it more universally applicable—see Appendix
           in for more information]
                  The ALA of Kansas arranged to have  an
           information booth at two  large state-wide confer-
           ences for daycare providers: one specifically for
           Head Start, and the other organized by the Kansas
           chapter of the  National Association  for  the
           Education of Young Children. In addition to distrib-
           uting educational materials on secondhand smoke,
           they were able to promote the training module and
           conduct a needs assessment survey.
                  The following year, using the results of the
           needs assessment survey, the ALA of Kansas con-
      ducted training sessions on secondhand smoke at
      the annual conference of the Child Care Resource
      and Referral Agency, Head Start, and the Kansas
      Association for the Education of Young Children.

      Partners: This program is a  striking example of
      effective partnership. The ALA of Kansas established
      relationships with the major daycare organizations
      in their state, which enabled them to reach daycare
      providers through existing mechanisms. In  addi-
      tion, they worked closely with the state child care
      licensing   agency,  the  Kansas  State  Nursing
      Association, and the  indoor air program in the EPA
      Region 7 office, which provided funding support.

      Resources Needed:
      •  NRCHSCC  Secondhand  Smoke  Education
        Project module, to be adapted as needed for local
        requirements
      •  Educational materials for both daycare providers
                        i
        and parents (some of which are included in the
        module)
      •  Presentation  materials  for  training providers
        (some of which are included in the module)
                        i
      •  Funds to duplicate and distribute training module
      •  Display booth for  daycare conferences
                        I

      Measurable Outcomes and Evaluation:
      The success of the training module can be measured
      by the number of modules that  were distributed,
      and the number  of providers who used it and
      applied for  continuing education credits. The num-
      ber of providers reached through the information
      booths and presentations at the daycare conferences
      would be another outcome measure. You could also

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                         Replicable Programs
   do a pre- and post-test knowledge survey in con-
   junction with the training sessions.
          The  impact of the program is ultimately
   evaluated based on the number of families and the
   number of children reached by each center. This
   could be ascertained by a follow-up survey of pro-
   gram participants, or by having the providers keep a
   tally of families reached.
       Opportunities/Linkages:  By coincidence,
this program was launched at the same time that the
Kansas Health  Foundation was starting a major
media campaign asking smoking adults to "Take it
Outside." The confluence of messages proved very
beneficial, as daycare providers and parents heard
about secondhand smoke from two different angles,
thus enhancing the impact.

-------
Repllcable Programs
                               Secondhand Smoke and Children: Conducting Public Outreach Programs
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-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
            Replicable Programs
                   Brochure for Parents — Childcare Provider Training
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-------
                    Replicable Programs
                              Secondhand Smoke and Children: Conducting Public Outreach Programs
                                        Brochure for Parents — Childcare Provider Training (Page 2)
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-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                                    Replicable Programs
                       Training Module Self-Test — Childcare Provider Training
              Please make a copy of this form (front and back), complete and return it to: ETS Daycare Project,
              American Lung Association of Kansas, 4300 SW Dairy Ln, Topeka, KS 66604-2419 (800-586-4872)

              SECONDHAND SMOKE SELF-LEARNING MODULE — SELF TEST
              Name
              Address.

              City	
State.
Zip.
              Directions:    Circle the correct answer for each question. There is only one correct answer for
                           each question.

              1.    Tobacco smoke contains how many chemicals?
                   a.   more than 4,000
                   b.   less than 25
                   c.   900
                   d.   500

              2.    Children exposed to second-hand smoke are more likely to have which of the following
                   illnesses?
                   a.   ear infections
                   b.   asthma
                   c.   upper respiratory infections
                   d.   bronchitis and pneumonia
                   e.   all of the above

              3.    Children of parents who smoke are more likely to smoke.
                   a.   True
                   b.   False

              4.    Environmental tobacco smoke (ETS) is:
                   a.   smoke that is breathed out by the smoker
                   b.   smoke that comes from the tip of a burning cigarette
                   c.   pollution from smoke stacks and car exhaust
                   d.   a and b

              5.    Which of the following methods are effective in helping people quit smoking?
                   a.  Refer smokers to their own doctors for help
                   b.  Tell smokers they are bad people because they smoke
                   c.  Offer  alternatives to smoking like exercise or talking
                   d.  a and  c
                   e.  all of the above

              6.    Smoking causes yellow teeth and bad breath.
                   a.  True
                   b.  False
                                                                                        Turn over

-------
                     Replicable Programs
                              Secondhand Smoke and Children: Conducting Public Outreach Programs
                                       Training Module Self-Test — Childcare Provider Training (page 2)
                                  Page 2

                                  7.    Infants of women who smoke during pregnancy have a higher risk of:
                                       a.  Miscarriage
                                       b.  Sudden Infant Death Syndrome (SIDS)
                                       c.  Prematurity (a baby that is not fully developed)
                                       d.  Some childhood cancers
                                       e.  all of the above
                                  8.
                                 9.
Children should be able to:
a.  Tell an adult that smoke bothers them
b.  Tell a smoker or other adult how smoke makes them feel
c.  Leave a room when someone is smoking
d.  a and b
e.  all of the above

Children learn behaviors from aduit role models. Adults who smoke may be encouraging
children to smoke.
a.  True
b.  False
                                 10.   Second-hand smoke causes thousands of lung cancer deaths each year to people who don't
                                       smoke.
                                       a.   True
                                       b.   False

                                 Documentation of Completed Activities — Write a short description of what you did for the
                                       following activities:
                                 Parent Education
                                 Staff Education
                                Child Education.
                                ATTACH ADDITIONAL SHEETS IF NECESSARY
                                   D I would like to know how I scored.
_

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
                     Training Module Evaluation — Childcare Provider Training
Please make a copy of this form, complete and return it to: ETS Daycare Project, American Lung
Association of Kansas, 4300 SW Dmry Lane, Topeka, KS 66604-2419 (800-586-4872)
Secondhand Smoke Module Evaluation
NAMF
HOMF ArmRRSS
CITY STATF
COUNTY SSซ
HOMP PHOMF MT TlV/mPW
ZIP


In which type of child care setting do you work?
CD Center CD Group Home CD Family Child Care Home
Sex Education Racial/ethnic background
CD Female CD Less than High School Education CD White
D Male D High School Diploma/GED D African American
CD Non-credit Adult Education CD Hispanic/Latino
CD Early Childhood Certificate/Diploma CD Asian
D CDA Credential C3 Native American
CD College Credits Q Other
[ I College Degree
Tell Us What You Think
What did yon lik-p mrvot nhniit the module?



Was this module easy to understand? CD Yes CD No
Iฃ No, why not?

How much time did it take to complete this module?
How would you rate the level of difficulty of this module?
CD Very difficult CDSomewhat difficult CDEasy
What suggestions do you have for improving the module?


CD Very Easy





-------
 Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
 Training  Home-based  "Provider Mothers'"
Goal: To incorporate education on the benefits of
maintaining a smoke-free environment into the train-
ing and licensing of home-based daycare providers

Program Description: This program, from the ALA. of
Queens, New "fork, was established to target adults who
are in training to become registered with New York State
as "provider mothers."These provider mothers are home-
based daycare providers. The State University of New
\brk, which administers the provider mother program
statewide, her established contracts with local health and
human service agencies, which actually conduct the train-
ing. The ALA of Queens partnered with several of these
local agencies to include secondhand smoke in the health
and nutrition component of die curriculum. Each agency
held provider mother trainings several times a year.
       Presentations were made on the benefits of
maintaining  a smoke-free daycare environment
Literature was distributed and  a video on second-
hand smoke was shown. Because most of the trainees
were from low-income and minority communities
— where asthma rates are disproportionately high
— the presentations emphasized the particular dan-
gers of secondhand smoke to the asthmatic children
that would be left in their care. Trainings were con-
ducted in Spanish as well as English, as needed.
       Trainees were given room signs to display in
their homes, indicating that they were smoke-free,
as well as incentive items like baby bibs and spill-
proof cups that were printed with "Breathing is eas-
ier for me—my daycare is smoke-free!" The incen-
tive items, in addition to being a welcome source of
supplies, served as a reminder of what the provider
mothers had learned about secondhand smoke.
      Potential Partners: The provider mother program was
      a collaboration between the State University of New
      York and local health and human service agencies that
      implemented the training program. The ALA  of
      Queens also relied  on Spanish-speaking volunteers
      and community leaders to assist them with offering
      presentations to Spanish-speaking provider mothers.
                        i
      Resources Needed:
      •  Presentation materials
      •  Promotional and incentive items for providers,
        such as baby supplies
                        ii                      ;

      Measurable Outcomes and Evaluation: The meas-
                        i
      urable outcomes for the provider mother program
      were the number of trainees reached and how many
      of them  have  maintained a smoke-free environ-
      ment. The ALA of Queens asked each trainee to fill
      out a questionnaire at the end of the presentation.
      In addition to asking about the quality of the pro-
      gram, the questionnaire also asked if the trainees
      planned to keep their homes smoke-free (copy of
      questionnaire attached).

      Opportunities/Linkages:  In  1998 the provider
      mother training program switched over to provider
      education through centralized video-conferencing,
      instead of community-based  trainings. Although
      this will make direct community-based intervention
      like the ALA of Queens program more difficult, it
      may also offer the opportunity to reach more people
      with the same  resources.  The NRCHSCC daycare
      module would also be useful in reaching home-
      based provider mothers.

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                      Replicable Programs
               Sample Pledge Card — Training Home-based Provider Mothers
      CHILDREN'S
      LUNGS HAVE TO
     Dear Parents:
     We are asking parents to consider signing this smoke-free pledge for their families'
     health. This Is a voluntary pledge.  If you do decide to make your home and car smoke-
     free and sign this pledge, we will mail you a No-Smoking doorknob sign to easily display
     In your home.
      Vs%../ T^-*:fr^^

     I.
hereby pledge to provide a
          (print name)
     smoke-free home and transportation for my childCren) because I love them
     and I want to protect them from secondhand tobacco smoke.
                        B  Sinin  This Pledae:
                           promise to forbid smoking in my car.
                           promise to forbid smoking in my house.
     For smokers only:
     I also promise not to smoke whenever my children are present.
     Your Name (please print).
     CildCren) ages: 	
     Address:	
                                              Zip Code:.
                  fc^a;^
      Please check to see If your son/daughter's teacher Is collecting pledges OR mall to:
       American Lung Association of Queens
       Att:  Secondhand Smoke Project
       112-25 Queens Boulevard, Forest Hills. NY 11375

-------
Replicable Programs
                                Secondhand Smoke and Children: Conducting Public Outreach Programs
                   Evaluation Form — Training Home-based Provider Mothers
    f
AMERICAN LUNG ASSOCIATIONฎ of  Queens,  Inc.
                  "When You Can't Breathe, Nothing Else Matters"
                                  NYC SMOKEFREE AIR ACT
                                   (SECONDHAND SMOKE)
          1. Was the presentation informative?   yes	   no	

          2. How would you rate the following activities/materials? (Consider such factors as
            effectiveness, organization, clarity, usefulness, appearance, etc.)
                                EXCELLENT
                                       GOOD
FAIR
POOR
           Speaker              	
           Video                	
           Literature            	
           Promotional Items;
               Baby Cups       	
               Window Decals   	
               Buttons          	•           	    	    	
               Coloring Books

          3. Do you think the presentation will have any effects on your thinking, feelings, or
            actions?   yes	  no	

          4. If YES, what effects do you think it has has?
             (check all that apply)
             	increased knowledge on secondhand smoke
             	increased efforts to keep family smokefree
             	increased discussion among selves and family regarding secondhand smoke
             	Other	

          5. Do you or anyone in your household (or where you will be providing daycare)
             smoke?   yes	'  no	

          6. Do you allow smoking in your home?  yes	  no	

          7. Will you allow smoking in your home while you are providing daycare to children?
             yes	  no	

          8. Do you understand the New York City Smokefree Air Act as it applies to day care
             centers?  yes	  no	
                 112-25 Ouccns Boulevard. Forest Hills. New York 11375 (718) 263-5656

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                         Replicable Programs
       Outreach  to  Health  Care Providers
           You might expect that doctors, nurs-
           es, respiratory therapists and other
           health care providers that see sick
           children would already be talking to
their patients about secondhand smoke, but that
is not always the case. Educating providers helps
ensure  that information about secondhand
smoke gets to the families that are at the greatest
risk. And health care providers are credible mes-
sengers —people believe what they say, and usual-
ly make an effort to follow their counsel. In addi-
tion to the programs detailed here, local Lung
Associations have worked with training Visiting
Nurses, providing posters and brochures for doc-
tors' waiting rooms, patient counseling through
prenatal  clinics, and more. Another item worth
noting here is the speaker's kit developed by the
American Academy of Pediatrics for their mem-
bers who are interested in doing community pre-
sentations on secondhand smoke and children
(see Appendix III for more information).

-------
Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
          Hospital-based  Intervention and
                          Education  Project
Goal: To educate families of children admitted to the
hospital for respiratory illness about the dangers of
their child's exposure to  secondhand smoke and    gram, it has been expanded to 10 hospitals and din-
how to eliminate it, reducing his or her chances of   ics statewide, where it is now an institutionalized
                                                                 :|
subsequent illness.                                part of the services they provide.
      a reminder to maintain a smoke-free household.
             Since the initial development of the pro-

Program Description:  The ALA of Washington
worked with Children's Hospital and Medical Center
in Seattle on a pilot program with the intention of
institutionalizing secondhand smoke exposure inter-
vention as part of the treatment of all young children
admitted to the hospital for a respiratory illness.
       In the protocol  they developed, the attend-
ing nurse, as part of the standard discharge proce-
dure, questions the parent or  guardian about the
patient's secondhand smoke exposure in the home
and other environments. If the  parent/guardian
reports that exposure does in fact occur, the nurse
explains the health risks from  secondhand smoke,
helps the family to identify solutions to reduce expo-
sure, and provides the family with a packet of edu-
cational materials to take home.
       Tfae ALA  of Washington assembled a staff
resource manual for the nurses and respiratory thera-
pists who would be counseling families. The manual
includes an overview of the project, the discharge pro-
tocol, a worksheet on practical solutions for reducing
exposure  (see attached), a list  of public education
materials and other resources for the families, and ref-
erences on the health effects of secondhand smoke,
including copies of important research papers.
       The information packets that go home with
families include secondhand smoke brochures and
factsheets, in English and Spanish, as well as a "Litde
Lungs Breathing" refrigerator magnet that serves as
      Partners: The primary partner is a hospital that is
                        !l                      !
      willing to  take  on the program. The  ALA of
      Washington also worked with the state chapter of
      the American Academy of Pediatrics, the  state
      health department, and a local health-oriented
      foundation on the development of the brochure
      and poster. Other potential partners could include
      HMOs and other  professional  organizations for
      respiratory care providers.
                        i

      Resources Needed:
                        i
      •  Resource manuals for hospital staff
      •  Educational and promotional materials for farni-
                        i
        ly information packets
      •  Staff or volunteers for follow-up and evaluation
                        I                      i
      Measurable  Outcomes and Evaluation: A three-
      month evaluation is included in each resource man-
      ual for the hospital staff.

      Opportunities/Linkages: This type of intervention
      can be used for other kinds of health care providers
      who see sick children, including pediatricians, aller-
      gists and respiratory therapists. One piece of out-
      reach material that was not used in the ALA of
      Washington program, but could easily be incorpo-
      rated, is a "tickler" sticker that providers can put on
      their patients' charts to remind them to discuss sec-
      ondhand smoke.

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                                           Replicable Programs
                    Finding Solutions Worksheet — Hospital-based Intervention Project
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-------
                   Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                  Finding Solutions Worksheet — Hospital-based Intervention Project (Page 2)



















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Designate your home "smoke-free" by having
enough away from open doors and windows t
back inside. Let your visitors know your poll
Post your "No Smoking" refrigerator magnet
from the Lung Association - 441-5100) so your visi
"smoke-free."
Don't put out ashtrays.
Share with friends and relatives written mater
of secondhand smoke.
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Replace your cigarette lighter w/ a no smokin
Lung Association - 44 1-5 100)
Use your ashtray to hold gum or change.
Display a "No Smokhlg" sign or sticker (avails
Association -441-5 100)
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-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                         Replicable Programs
          Finding Solutions Worksheet — Hospital-based Intervention Project (Page 3)
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-------
Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                    3-Month Evaluation — Hospital-based Intervention Project
                                                      t
               AMERICAN
               LUNG
               ASSOCIATION.
               of Washington
                     Environmental Tobacco Smoke Intervention
                             and Education Project 1998-99
                                      3-Month Evaluation

    1. On average, how much time have you spent with each family going over the Secondhand Smoke Packet
      information?
                          < 1 minute
  2 to 5 minutes
                                                                  > 5 minutes
   2. Generally, how receptive were the families to the Secondhand Smoke Packets?

                          54321
                        Very
                      Receptive
  Not at all
  Receptive
   3. Did the families indicate that this was new information for them?

                          Yes            	No
                      Somewhat new
   4. Do you think this is an effective and useful way to instruct families about the hazards of Secondhand Smoke?

      	Yes
      	No, a better way would be to 	:	—•


   5. How would you improve this education effort?
   If you have additional comments and/or suggestions about this project, please write them on the back of
   this form. Thank You.


-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                                          Replicable Programs
                  Discharge Protocol — Hospital-based Intervention Project
                                                                 FOR OPTIONAL USE
                                                              BY MEDICAL FACILITY
                     Admitting / Discharge Protocol

             Secondhand Smoke Exposure Identification and Message Worksheet

           Patient                                    Date
               Questions for Parent(s)/Guardian (s)
           Is the child exposed at any time to
           secondhand smoke?
             YES
                           If yes, where?
                              Home
                           	Car
                           	Other's home (s)
                              Restaurants
                             _Day Care
              NO
                                  Education
                        1- Review Secondhand
                          Refrigerator Card (In Packet)
                        2- Discuss ways to eliminate
                          secondhand smoke exposure
                        3- Provide Secondhand Smoke
                          Packet
                        1- Give praise and encourage
                          him/her to continue protecting
                          the child from secondhand
                          smoke.
                        2- Provide Secondhand Smoke
                          Packet
           FOR HEALTH PROFESSIONAL USE

           Circle the most accurate responses.

           How well was this information, as a whole, received?

           Extremely well     Well       NeutralPoorly
                             Extremely poor
           Did the parent/guardian engage in constructive conversation about the child's exposure to
           secondhand smoke?
              Yes
No

-------
            Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                                     Healthy  Beginnings
L
            Goal: To educate pregnant women and new mothers
            about the risk of secondhand smoke to their newborns

            Program Description: "Healthy Beginnings" may be
            recognized by some as an ALA smoking cessation
            program for pregnant women that is no longer
            available.  The ALA  of  Texas, Dallas-Fort-Worth
            Region adapted it for their own secondhand smoke
            outreach. The focus of this program on pregnant
            women and new mothers reaches its target audience
            at a great "teachable moment" - a time when they
            are interacting closely with health care providers, are
            seeking information about caring for their babies,
            and may be more willing than usual to change their
            behavior. To best take advantage of this opportunity,
            the ALA of Texas, Dallas-Fort Worth Region worked
            with health care providers who offer one-on-one
            counseling to low-income and minority women.
                  The Lung Association prepared and distrib-
            uted information packets to hospitals, health clinics,
            and school-based health programs for pregnant
            teens. These providers agreed to distribute the kits to
            their patients as they came in for pre- and post-natal
            counseling, or for delivery. The packets included some
            simple secondhand smoke fact sheets and brochures,
            a "Nonsmoker Since the Day I Was Born" baby bib,
            and a "No Smoking — Baby Breathing" sign. The
            packets were available in English and in Spanish. The
            bib was especially well received by the health care
            providers and their patients, since it was a non-con-
            frontational way for these young mothers to ask their
            family members not to smoke around the baby.

           Partners: Any health care providers that work closely
           with pregnant women and new mothers would make
      suitable partners, as would the county health depart-
      ment Managed care organizations may find this pro-
      gram particularly attractive because it is self-con-
                         j                      :
      tained, low-cost, and totally preventive in nature. The
      ALA of Texas, Dallas-Fort Worth Region also had
      great success partnering with the public school sys-
      tem's Pregnancy, Education and Parenting Program.
      Baby-oriented businesses may be willing to provide
      support, including the donation of baby supplies.

      Resources Needed:
      •  Staff or volunteers to recruit providers and put
        together packets
      •  Educational  materials for packets, including
        brochures and fact sheets
      •  Baby supplies like bibs with secondhand smoke
        messages
                         i                      ,
      Measurable Outcomes and Evaluation:  As a way
      of measuring the number of women reached, par-
      ticipating health care providers were asked to track
      the number of information packets they distrib-
      uted. Hospitals, clinics and patients were  also
      asked to complete an evaluation form  (see
      attached), which gave the Lung Association feed-
      back on the program that was  used to refine it
      from one year to the next.

      Opportunities/Linkages: The ALA of Texas, Dallas-
      Fort Worth Region was able to expand the impact of
      its outreach by working with the public relations
      department of one of the participating hospitals to
      conduct a media campaign on secondhand smoke
      and  children, which ran concurrently with  their
      Healthy Beginnings program.

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                               Replicable Programs
                            Hospital Evaluation Form — Healthy Beginnings
                                      Healthy Beginnings Program
                                            Hospital Evaluation Form
                 Hospital Name
                 Address
                 Contact Person
Contact Phone
                 Please answer the following questions.
                 1.  Did you receive a sufficient number of Healthy Beginnings Packets?   D yes Q no
                 2.  Do you think the information was easy for the patients to understand?  D yes D no
                 3.  Was the information relevant and beneficial?                       D yes D no
                 4.  Do you think the patients received the message?                    D yes D no
                 5.  Were the packets easy to distribute?                              D yes D no
                 6.  Would your hospital participate again next year?                    D yes D no
                 7.  What did you like most about the program?
                 8.  What did you like least about the program?
                 9.  Suggestions for next year:
                 10. Additional Comments:

-------
Repiicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs



















1 '
Clinic Evaluation Form — Healthy Beginnings
Healthy Beginnings Program
Clinic Evaluation Form
Clinic Name
Address
Contact Person Contact Phnn*
ii
Please answer the following questions.
1 . Did you receive a sufficient number of Healthy Beginnings Packets? D yes D no
2. Do you think the information was easy for the patients to understand? D yes D no
3. Was the information relevant and beneficial? Dyes Dno
4. Do you think the patients received the message? , D yes D no
5. Were the packets easy to distribute? Q yes D no
6. Would your clinic participate again next year? Dyes Dno
7. What did you like most about the program?

8. What did you like least about the program?

9. Suggestions for next year:

10, Additional Comments:


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-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                                  Replicable Programs
                                 Patient Survey — Healthy Beginnings
                                        Healthy Beginnings Program

                                               Patient Survey
                Your Age:
                How far along are you in your pregnancy: D 1-12 weeks D 13-24 weeks D 25-36 weeks
                Ethnicity:    D Anglo-American
                            Q Hispanic
                            D Asian-American
  D African-American
  D Native-American
  D Other
                1.  Do you srnoke cigarettes?                                      DyesDno
                2.  Did you smoke cigarettes before you got pregnant?                 D yes D no
                3.  Do you live with anyone who smokes cigarettes?                   DyesDno
                4.  Was the information in the packet easy to understand?               D yes D no
                5.  Did you find the information helpful?                             0 yes D no
                6.  What did you like most about the Healthy Beginnings Packet?
                7.  What did you like feast about the Healthy Beginnings Packet?
                                                Detach Here

                Please send me more information:

                D Stop Smoking a Guide to Your Options    D How to Help a Friend Stop Smoking
                D Helping Smokers Get Ready to Quit       D Health Effects of Smoking on Children
                D Don't Let Your Dreams Go Up in Smoke

                D Freedom From Smoking for You and Your Baby:  A 10-Day Quit Smoking Program
                  for Pregnant Women ($10.50)
                Name
                Address

                City 	
Zip Code

-------
          Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                        Protecting  Children Through
                                    the WIC Program
          Goal: To reduce the risk of secondhand smoke expo-
          sure to young children through the WIC program

          Program  Description: The Women, Infants  and
          Children (WIC) program is a nationwide federally
          supported service for low-income mothers and their
          young children. Eligible families receive health and
          nutritional counseling in addition to vouchers for
          the purchase of infant formula, milk, juice and other
          nutritious foods. Because families can not get their
          vouchers without a session with the nurse, the WIC
          program provides a rich opportunity for interven-
          tion with low-income mothers  and  children who
          may not be receiving regular health care anywhere
          else. A number of local Lung  Associations have
          worked with the  WIC program on secondhand
          smoke education, all with positive results.
                 For example,  the  ALA   of Nebraska
          approached the WIC program in the Omaha metro
          area with secondhand smoke outreach as a way to
          prevent the onset and exacerbation  of asthma in
          young children. This not only tied in with the other
          goals of the local Lung Association, but also made it
          more appealing for providers and their clients to
          "buy in" to the program. There sometimes may be
          resistance to hearing about smoking and second-
          hand smoke, but mothers of children with asthma
          are always interested in information about improv-
          ing their kids' breathing.
                 First, the Lung Association conducted an in-
          service training session for all nurses and nutrition-
          ists that interacted directly with the families enrolled
          in the WIC program. The training included infor-
      mation on asthma and its link with secondhand
               •• •  .    '  '                     '  '
      smoke; strategies for removing asthma triggers from
               .  .    .  i   .                ..
      the home environment, including maintaining a
      smoke-free home; and management and treatment
      of asthma. Each participant in the training was given
      a packet of resources for his and her own reference,
      as well as materials for sharing with the patients.
             The WIC staff members were asked to coun-
      sel their patients on the health risks of secondhand
                        i •                     i .
      smoke as well as give out information packets and
      any related materials. Information was made avail-
      able in Spanish as well as in English. Nutritionists dis-
                        i                   •  ''	
      cussed secondhand smoke in the context of exposing
      the baby during pregnancy and breast-feeding. The
      nurses talked to the patients about the importance of
      maintaining a smoke-free environment to reduce the
      babies' risk of asthma and respiratory infection.
                        i  ,                   i    '
             The Lung Association made visits to local
      WIC clinics to observe counseling sessions and offer
                        'i
      follow-up support to the providers.

      Partners: The local WIC program is the only partner
      that is really necessary. However, the inclusion of
      asthma education in the outreach may interest phar-
      maceutical companies and drug reps, who may be
      willing to supply "asthma gadgets" like peak flow
      meters for the program participants.

      Resources Needed:
      •  Site for training
      •  Trainers
      •  Resource materials for providers
      •  Educational materials for families
^^k

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                           Replicable Programs
Measurable Outcomes and Evaluation: The ALA
of Nebraska measured the number of WIG staff
who attended its training, the number of clinics
that participated in its program, and the number of
families  counseled on  secondhand smoke. It
should also be  possible  to track the number of
clients who pledge to keep their homes smoke-free
through the use of pledge cards. Because of the
confidential  nature of the relationship between
health care providers and their patients, any track-
ing of and  follow-up on program participants
would have to be done by the providers; they can-
not release a list of their patients, or information
about their health status.
       Evaluation of  this program  was done
through feedback from the WIG staff, both after the
training and during follow-up visits to clinics.

Opportunities/Linkages: The asthma focus allowed
the Lung Association to promote its other asthma
programs, including its Family Asthma Day and the
Open Airways For Schools school-based asthma
management program to interested providers and
families.

-------
Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                 Smoke Outside Campaign
Goal: To deliver actionable secondhand smoke mes-
sages to mid-to-low literacy "dedicated" smoking
parents through their health care providers

Program Description: Kentucky is known as the
"Burley State," with a self-image that is linked to its
long history of tobacco production. It also has the
highest smoking  rate of any state in the nation.
When the ALA of Kentucky, in cooperation with
EPA Region 4, decided to launch an outreach cam-
paign on secondhand smoke and children, they real-
ized they had some special challenges ahead of them.
They decided to focus on some of the children at
highest risk — those in families with dedicated
smokers. These are individuals who have expressed
no interest in quitting smoking, and often smoke
heavily. Because it was especially important in this
program to separate the idea of protecting children's
health from the promotion of  cessation, pediatri-
cians were chosen as the best messenger.
       The Lung Association developed an attrac-
tive low-literacy brochure and poster with a simple
"Take It Outside" message  (see attached). The
brochure was designed so that it can also be used as
a tent card in the house to remind the residents and
their visitors to smoke outside. This was felt to be a
particular advantage with this target  audience
because heavy smokers tend to have family and
friends who are also heavy smokers, and the par-
ents may not feel able to make the request of their
visitors directly.
       The brochure and poster, along with a cover
letter, are currently being distributed to pediatricians,
family practice and emergency room physicians, and
public health nurses. Health care providers are being
      asked to display the posters and share the brochures
      with their patients along with sharing some counsel-
                         i
      ing about the importance of protecting their children
                         l!    '            r      .1 "I
      from secondhand smoke. Distribution has been cpn-
              <
      centrated in the economically disadvantaged parts of
                         •|                   	
      the state, both rural and urban.
                 .'       ll                '.      I ;.-
             The ALA of Kentucky will keep in periodic
      contact with the participating providers to ensure
      that they are using the materials, and  to replenish
      their supplies as needed.

      Partners: In addition to EPA Region 4, which pro-
      vided partial funding for the project,  the ALA of
      Kentucky has been able to attract a number of very
      valuable partners for this campaign, including local
      health departments, hospitals, HMOs, medical soci-
      eties, WIG centers, regional parenting centers, com-
      munity centers, and teen tobacco advocacy groups.

      Resources Needed:
      •  Design services for campaign materials
      •  Printing
      •  Postage for mailing
      •  Staff or volunteer time to distribute material and
        follow up with providers

                         I
      Measurable Outcomes and Evaluation: Measurable
                         i
      outcomes for this program are the  number of
      health care providers who distribute campaign
      materials to  their patients, and the  number of
      smoking parents  who receive the materials and
      accompanying counseling. Although it would be
      more difficult, there could be a component that
      measures the number of families that commit to
      smoking outside, through the use of pledge cards or


-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                            Replicable Programs
contracts with their providers. The measurement
and  evaluation is being done through follow-up
telephone surveys of providers, as well as through
occasional site visits.

Opportunities/Linkages: In addition to the out-
reach to providers, the Lung Association was able
to take  the graphics and messages developed for
the brochure and poster and adapt them to a tran-
sit  campaign, with  advertising placed  on  the
inside and outside of buses.
       An unexpected side benefit of the program
has been the creation of partnerships with health
and social service agencies  serving the African-
American community where the Lung Association
had previously lacked contacts. This has opened new
doors for some of its other programs, including
asthma education.

-------
Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                Brochure/Tent Card — Smoke Outside Campaign
                                        For Your
                                     Kid's Health

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
Replicable Programs
       Brochure/Tent Card — Smoke Outside Campaign (Page 2)
     Children breathe
 |ง?l^GpซfK6ปS^
  tobacco smoke when
 •H^'^.../^^^-.^^/'^^^^;:.^.??^^^         C1'-.'.^5rV ; V.;ปv '•' -.. •• : • .-.- J.y >'' • ,,!''th''ซ"''

 iMBixt illpiSl^
 adults smoke  indoors.

-------
               Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                                          ,1
                        Outreach to  Community  Leaders
                           Religious leaders, prominent citi-
                           zens and esteemed elders are all
                           excellent messengers, who  have
                           the respect of and concern for
               their communities. Raising their awareness of the
               toll that secondhand smoke takes on children in
     their neighborhoods can bring powerful allies to
     your work. In addition to extensive work with
     faith-based communities, as detailed below, local
     Lung Associations have worked with service
     sororities, civic clubs, and local chapters of organ-
     izations like the National  Council for Negro
     Women.
_

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Secondhand Smote and Children: Conducting Public Outreach Programs
                          Replicable Programs
  African-American  Church-based  Project
Goal: To enlist African-American clergy as leaders in
a secondhand smoke education campaign for their
congregants.

Program Description: In the early 1990s,  the
American Lung Association started a program to
partner with African-American clergy to help their
congregants quit smoking. Once the pilot program
got underway around the country, however, the ALA
was told that nonsmokers and young people wanted
to be involved somehow in reducing the devastating
impact of tobacco on their communities. So the pro-
gram was expanded to include secondhand smoke
education, and other tobacco-use prevention strate-
gies like limiting youth access to cigarettes.
       The key to success has been to recruit clergy
and congregations that are willing and able to take
ownership of the program. The ALA's role has been to
get them started and then facilitate their activities
along the way. The ALA of Florida, Big Bend Region,
for example, worked in partnership with the dynam-
ic leader of an interdenominational youth fellowship.
The church at which it was based already had some
small grants to do substance abuse outreach and was
interested in adding secondhand smoke to its pro-
gram. The activities included producing a special edi-
tion of the church newsletter, with testimonials from
the youth about the  effect of secondhand smoke on
their lives; development of public service announce-
ments that ran in the local newspaper and on TV;
public presentations; and a mailing to community
residents. The youth who gave of their time so enthu-
siastically were rewarded periodically with parties and
recognition ceremonies. Their accomplishments were
also regularly included in the church newsletter and
the pastor's remarks from the pulpit
       Throughout  the  program,  the  Lung
Association staff provided  support with technical
information, public education materials and some
financial assistance.

Partners: Many communities  have councils of
churches, boards of ministers, and other culturally
specific ministers' groups that are probably the best
way to locate pastors and congregations willing to
take on this type of program. Several churches may
be willing to work together through the type of
interdenominational fellowship  program that was
involved in Florida. Other  public health organiza-
tions may wish to donate educational materials or
provide speakers. Community-based organizations
— civic  groups, tobacco-control organizations,
chambers of commerce, etc. — may help as well.

Resources Needed:
•  Educational materials for the congregants
•  Media outreach materials such as media releases
   and PSAs
•  Incentive items, including food and awards
•  Speakers for church functions and public presen-
   tations
•  Staff and volunteers to  provide technical assis-
   tance to clergy and their  staff

Measurable Outcomes and  Evaluation:   Because
this program is so flexible, the outcomes will vary
with the specific activities. Certainly, you will want to
track the number of churches contacted, and those
that make a commitment to adopt the program. You
also can track the number of volunteers recruited,

-------
Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
the number of people reached through various activ-
ities, and the number of smoke-free pledges signed.
        Ideally you will be able to work with the
church leaders to collect some baseline information
about the health behavior and attitudes of the con-
gregation before you launch the program. A follow-
up survey can then be done afterwards, if it is a one-
time event, or after an ongoing program has been
underway for a while.  If you are planning an ongo-
ing relationship with a church, it is important to
maintain contact on a regular basis to track its activ-
ities and follow up on its progress.
             This program can be evaluated both on the
      quality and sustainability of the partnerships built
      with participating churches, and on the effectiveness
      of the program  in producing positive behavioral
      changes in the community members.
                          ii
      Opportunities/Linkages: This program was ini-
      tially developed for use  in  African-American
      churches. The basic concepts can be adapted, how-
      ever, to  any  religious  institution  or benevolent
      association that  involves itself in the health and
                          I                       . .
      well-being of its community.

-------
Secondhand Smoke and Children: Conducting Public Outreach Programs
                          Funding Opportunities
             Protecting children from secondhand
             smoke is a compelling program that
             addresses  a  serious health  threat.
             There are many potential sources of
funding  at  the  federal, state  and local levels.
Depending on how you present your program, you
may be able to  interest organizations that fund
indoor air quality, environmental justice, tobacco
control, pollution prevention, women's health and
children's health. The  suggestions that follow  are
merely a sampling of the possibilities.

•            U.S. Environmental
              Protection Agency
              Reducing children's exposure  to
secondhand smoke is one of the primary goals of the
EPA's Indoor Environments Division. To that end,
         Tobacco Use Prevention and Control Programs, 1997
                                                  VT
   J CDC- IMPACT f NCI- ASSIST
 •Robert Wood Johiaon FoimWon
they make a significant amount of funding available
through the EPA Regional Offices and their network
of cooperative partners. This discretionary funding
is distributed through cooperative agreements, not
through  a  formal  grant  application  process.
Inquiries should be made to the Indoor Air contact
in your EPA Region (see Appendix II).
       The EPA Office of Environmental Justice
has several grant programs that could potentially
support outreach in low-income and minority com-
munities that are at disproportionate risk from sec-
ondhand smoke. For more information, call the
environmental justice contact in your EPA Region,
or go to the Office of Environmental Justice website
at www.epa.gov/oeca/oejbutJitml.
              ASSIST, IMPACT and
              Smokeless States
                  These three programs all pro-
                  vide sizeable grants to states for
                  tobacco use prevention and
                  control. ASSIST is a program of
                  the National Cancer Institute
                  and the  American Cancer
                  Society. IMPACT is a program
                  of  the  Centers for Disease
                  Control's  (CDC)  Office  of
                  Smoking  and  Health,  and
                  Smokeless States is a program
                  of the Robert Wood Johnson
                  Foundation. In October 1999,
                  the two  federal  programs,
                  ASSIST and IMPACT, will be
                  combined  under the auspices
RWJFVNCI- ASSIST

-------
!	!"'T 'I	• •?•••>":;" !	jilt'1 '"'lit
    Funding Opportunities
Secondhand Smoke and Children: Conducting Public Outreach Programs
    of the CDC, and renamed the National Tobacco
    Control Program.
            Each of the 50 states receives support from
    at least one of these sources (see attached map). For
    the most part, the ASSIST and IMPACT grants are
    awarded to state agencies, and CDC has budgeted a
    29%  increase in funding for the new combined
    National Tobacco Control  Program. Smokeless
    States grants go to nonprofit organizations, includ-
    ing coalitions, and voluntary health organizations
    like the American  Lung  Association  and  the
    American Cancer Society. Organizations interested
    in doing local outreach on secondhand smoke and
    children may be eligible for some pass-through
    funds from these large grants.

    •             Healthy Start
                   The  Maternal and  Child Health
    Bureau of the US  Department of Health and
    Human Services provides funding for health care
    services and outreach for young children through its
    Healthy Start program. In 1998, Healthy Start fund-
    ed programs in over 60 under-served communities
    around the country. They are interested in commu-
    nity-based collaborative efforts with a goal of reduc-
    ing  infant mortality. Organizations interested in
    doing local outreach on secondhand smoke  and
    children may be eligible for some pass-through
    funds from these large grants.

    •             Healthy Child Care America
                   Campaign
                   The  Maternal  and  Child Health
    Bureau of the US Department of Health and Human
    Services awards grants to professionals and organiza-
    tions representing health and child care communities,
    for the purpose of coordinating local activities to pro-
                ,.,.' •; "        ii                      i  '
      mote the healthy development of children in child care,
      including increasing access to preventive health servic-
      es and  providing safe physical environments. The
      Healthy Child Care America Campaign is managed by
      the American Academy of Pediatrics, (888) 227-5409.

      •             State and Local Health
                     Departments
                     State and local health departments
      may have funding available for outreach on second-
      hand smoke and children, either through their
      maternal and child health programs, or through their
      tobacco use prevention or substance  abuse  pro-
      grams. If you need assistance locating the right per-
      son in your area, you can contact the Association of
      State and Territorial Health Officials or the National
                 '  '       'I          ,            I  ::
      Association of County  and City Health Officials,
      which are both  members of the EPA's  indoor  air
      cooperative partner network (see Appendix II).
                          i

      •             Foundations
                     Many local and  regional founda-
      tions support children's health issues and are a good
      source of support for nonprofit organizations doing
      local outreach. Most public libraries will have one or
      more   foundation  guides  published by  the
      Foundation Center or other companies, such as the
      TAFT Group, which produces a variety of directo-
      ries  listing a wide spectrum of funding sources.
      Some directories are specific, i.e., the Foundation
      Center's "National Guide to Funding for Children,
      Youth  and Families,"  while "The Foundation
      Directory"  (1999 Edition) includes up-to-date
      information on over  10,000 grantmakers. The
      Foundation  Center is  also  on  the Web  at
      http://www.fdncenter.org. This site will enable you
      to access websites of a variety of foundations. It will

-------
 Secondhand Smoke and Children: Conducting Public Outreach Programs
                          Funding Opportunities
also give you information, state by state, on libraries
that have larger than usual collections of its directo-
ries, as well as access to the Center's CD-ROM, "FC
Search." Complete Foundation Center libraries are
located in Atlanta, Cleveland, New York City, San
Francisco and Washington, DC.

•             Health Maintenance
               Organizations (HMOs)
               Managed care  organizations are
health care insurers  and  providers  that  deliver
patient services within a structure that seeks to con-
trol costs. Because patient education has been shown
to reduce costs, HMOs are potentially interested in
programs  that prevent illness, like reducing chil-
dren's exposure to secondhand smoke. Although
HMOs vary widely in their investment in preven-
tion and in their willingness to work  with outside
organizations, some have provided support for local
Lung Associations' patient education on second-
hand smoke.

•             Tobacco Settlement Funds
               In November 1998, the tobacco
industry settled out of court with a group of states'
attorneys general, seeking to recover the cost  of
health care for tobacco-related illness. Over the next
25 years all 50  states and some cities will receive
almost $246 billion in compensation. Ideally, at least
some of this money will be made available for tobac-
co-use prevention and control public education
programs, including  secondhand smoke and chil-
dren. Tobacco control coalitions and public health
advocates are actively working to ensure that these
programs are  funded. But each state is free to budg-
et the money  as it sees fit.

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Funding Opportunities
Secondhand Smoke and Children: Conducting Public Outreach Programs

-------
 Secondhand Smoke and Children: Conducting Public Outreach Programs
Appendix I

             he following references are just a few of the major research findings on the health effects of sec-
             ondhand smoke since 1993. Significant research done before 1993 was captured in the EPA
             report, "Respiratory Health Effects of Passive Smoking," which is included below.
California Environmental Protection Agency. Health Effects of Exposure to Environmental Tobacco Smoke.
Office of Environmental Health Hazard Assessment. 1997.

Cunningham  J  et al.  "Environmental Tobacco  Smoke, Wheezing,  and Asthma in Children in 24
Communities." Am J Respir Crit Care Med 1996; 153:218-224.

Gergen PJ et al. "The Burden of Environmental Tobacco Smoke Exposure on the Respiratory Health of
Children 2 Months Through 5 Years of Age in the United States: Third National Health and Nutrition
Examination Survey, 1988 to 1994." Pediatrics 1998;101.

Pirkle JL et al. "Exposure of the US Population to Environmental Tobacco Smoke: The Third National Health
and Nutritional Examination Survey, 1988 to 1991." JAMA 1996;275:1233-1240.

Tredaniel J et al. "Exposure to Environmental Tobacco Smoke and Risk of Lung Cancer: The Epiderniological
Evidence." Eur Respir J 1994; 7:1877-88.

US Environmental Protection Agency. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other
Disorders. Office of Research and Development. 1992.
Reviews done for the U.K.'s Scientific Committee on Tobacco and Health:

Anderson HR, and DG Cook. "Parental Smoking and Lower Respiratory Illness in Infancy and Early
Childhood." Thorax 1997; 52:905-914.

Cook DG and DP Strachan. "Parental Smoking and Prevalence of Respiratory Symptoms and Asthma in
School Age Children." Thorax 1997; 52:1081-1094.

-------
           Appendix I
Secondhand Smoke and Children: Conducting Public Outreach Programs
           Hadkshaw AK et al. "The Accumulated Evidence on Lung Cancer and Environmental Tobacco Smoke." BMJ
           1997; 315:980-8.
                       ."           '                                            n         •             !

           Strachan  DR and DG Cook. "Parental Smoking and  Lower Respiratory Illness  in Infancy and Early
           Childhood." Thorax 1997; 52:905-14.
                                                            '                  I         '             I  V  '-
                  :   .  ,,'                           '   '      •       ,   -  .       j      •              ..'I  ,-,. '.
           Strachan DR and DG Cook. "Parental Smoking, Middle Ear Disease and Adenotonsillectomy in Children."
           Thorax 1998; 53:50-6.
                                                                              i                      '
                                                                     :   •     • !                      !•'"  '.
                                                                              J
           Strachan DR and DG Cook. "Parental Smoking and Childhood Asthma: Longitudinal and Case-Control
           Studies." Thorax 1998; 53:204-12.
           International health organization reviews:
           Departments of Health (United Kingdom). Report of the Scientific Committee on Tobacco and Health. 1998.
                                                                     .!•    ,    I      ,    .          .  i  .j,
           National Academy of Medicine (France). "Tabagisme Passif." BullAcad Natle Med 1997; 181:4-5.
           National Health and Medical Research Council (Australia). The Health Effects of Passive Smoking. 1997
           World Health Organization. International Consultation on Environmental Tobacco Smoke and Child Health. 1999
^^V

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 Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                                                             Appendix II

 EPA Regional Offices

 US EPA Region 1
 John F. Kennedy Building (ATO)
 Boston, MA 02203
 Mary Beth Smuts
 Telephone # (617) 565-3232
 FAX #(617) 565-4940
 E-mail:
    smuts.marybeth@epamail.epa.gov
 (Region includes CT, ME, MA, NH,
 RI,VT)

 US EPA Region 2
 (2AWM-RAD)
 290 Broadway, 28th Floor
 New York, NY 10007-1866
 Larainne Koehler
 Telephone # (212) 637-4005
 Fax #(212) 637-4942
 E-mail:
   koehler.larainne@epamail.epa.gov
 (Region includes NJ, NY, PR, VI)

 US EPA Region 3
 (3AP23)
 841 Chestnut Building
 Philadelphia, PA 19107
 Fran Dougherty
Telephone* (215) 566-2083
Fax #(215) 566-7906
E-mail:
   dougherty.fran@epamail.epa.gov
 (Region includes DE, DC, MD, PA,
 VA,WV)
 US EPA Region 4
 100 Alabama Street, SW
 Atlanta, GA 30303
 Henry Slack
 Telephone # (404) 562-9143
 Fax # (404)  562-9095
 E-mail: slack.henry@epamail.epa.gov
 (Region includes AL, PL, GA, KY, MS,
 NC, SC, IN)

 US EPA  Region 5
 (AE-17J)
 77 W. Jackson Boulevard
 Chicago, IL 60604
 Sheila Batka
 Telephone* (312) 886-6053
 Fax #(312) 886-0617
 E-mail: batka.sheila@epamail.epa.gov
 (Region includes IL, IN, MI, MN, OH,
 WI)

 US EPA Region 6
 (6PD-T)
 1445 Ross Avenue
 Dallas, TX 75202-2733
 Joyce Stanton
 Telephone #  (214) 665-7547
 Fax #(214) 665-2162
 E-mail:
   stanton.joyce@epamail.epa.gov
 (Region includes AR, LA, NM, OK, TX)

 US EPA Region 7
 (ART/ARBR-RALI)
 726 Minnesota Avenue
 Kansas City, KS 66101
Michael Marshall
Telephone # (913) 551-7604
Fax #(913) 551-7065
Email:
   marshall.michael@epamail.epa.gov
 (Region includes LA, KS, MO, NE)
 US EPA Region 8
 (8ART-RP)
 999 18th Street, Suite 500
 Denver, CO 80202-2466
 Megan "Williams
 Telephone # (303) 312-6035
 Fax #(303) 312-6044
 E-mail:
   williams.megan@epamail.epa.gov
 (Region includes CO, MT, ND, SD,
 UT,WY)

 US EPA Region 9
 (Air-6)
 75 Hawthorne Street
 San Francisco, CA 94105
 Barbara Spark
 Telephone* (415) 744-1132
 Fax #(415) 744-1073
 E-mail:
   spark.barbara@epamail.epa.gov
 (Region includes AZ, CA, HI, NV,
 American Samoa,  Guam)

 US EPA Region 10
 (AT-082)
 1200 Sixth Avenue
 Seattle, WA 98101
 Brook Madrone
Telephone* (206) 553-2589
Fax #(206) 553-0110
Email:
   madrone.brook@epamail.epa.gov
 (Region includes AK, ID, OR, WA)

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Appendix II
                        Secondhand Smoke and Children: Conducting Public Outreach Programs
State Indoor Air Quality Contacts
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
 Rhode Island
 South Carolina
 South Dakota
 Tennessee
 Texas
 Utah
 Vermont
 Virginia
 Washington
 West Virginia
 Wisconsin
 Wyoming
Gary Jones
Janice Adair
Patricia Arreola
Stan Evans
Jed Waldman
Steve Fine
Marian Heyman
Gloria Boddie
Maria Rejai
Roger C. Inman
Richard Schreiber
Jerry Haruno
Russell Duke
Mike Moomey
Rudy Cansino
RickWelke
Jan Sides
George Schauberger
Kenneth Lanier
Bob Stilwell
Jim Lewis
Howard S. Wensley
Jim Bedford
Laura Oatman
Bruce Brackin
Daryl W.Roberts
Adrian Howe
Dr. Adi Pour
David Going
Teresa Ferrara
James A. Brownlee
Millicent FJdson
Fxiward Horn
William Pate
Michael Reiner
Steve Wagner
Finily D.Allen
Bill Anderson
Ralph Scalan
Rpbert Vanderslice
William P. Brantley
Mike Pochop
Jackie L. Waynick
 Quade R. Stahl
 Marvin H. Maxell
 Dr. William Bress
 Nancy Saylor
 TimHardin
 Anthony Turner
 Walt Smith
 Gerald Blackwell
(334) 613-5373
(907) 563-6529
(602) 230-5830
(501) 661-2986
(510) 540-2469
(303) 692-3164
(203) 566-8167
(202) 576-6339
(302) 739-4731
(904) 488-3385
(404) 657-6520
(808) 586-4700
(208) 334-4964
(217) 782-5830
(3l7) 383-6147
(515) 281-4928
(913) 296-1551
(502) 564-7360
(504) 568-8537
(207) 287-5676
(410) 631-3801
(617) 522-3700
(517) 335-9215
(651)215-0911
(601) 960-7725
(314)751-6102
(406) 444-3671
(402) 471-0507
(702) 687-5240
(603) 271-4676
(609) 984-2193
(505) 827-0006
(518) 458-6376
(919) 733-3410
(701) 328-5188
(614) 644-7630
(405) 528-1500 x350
(503) 731-4012
(717) 787-6548
(401) 277-3424
(803) 734-4554
(605) 773-3351
(615) 532-0570
(512) 834-6600
(801) 536-4000
(802) 863-7220
(802) 762-4421
(360) 664-8860
 (304) 558-2981
 (608) 266-2871
 (307) 777-7394

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 Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                        Appendix fl
  EPA Indoor Environments Cooperative Partner Network

  These national organizations work closely with the EPA on indoor air quality outreach, including secondhand smoke. They
    all have local chapters or affiliates that may be useful partners. For contact information on the local organization near
    you, call the national office.
 American Academy of
 Pediatrics
 141 Northwest Point Boulevard
 Elk Grove Village, IL 60007
 Mavis Prall
 Telephone*: (847) 981-6757
 Fax: #: (847) 228-7035
 Email: mprall@aap.org
 www.aap.org

 American Lung Association
 1726 M Street, NW, Suite 902
 Washington, DC 20036
 LeylaErkMcCurdy
 Telephone*: (202) 785-3355
 Fax: #(202) 452-1805
 Email: lmccurdy@lungusa.org
 www.lungusa.org

 Association of State and
 Territorial Health Officials
 1275 K Street, NW, Suite 800
 Washington, DC 20005
 Stephen Kukow
 Telephone #: (202) 371-9090
 Fax*: (202) 371-9797
 www.astho.org

 Association of Asian Pacific
 Community Health Officials
 1440 Broadway Avenue, Suite 510
 Oakland, CA 94080
 Katie Vu-Ng
Telephone*: (510) 272-9536
 Fax #=(510)272-0817
www.aapcho.org
 Consumer Federation of
 America Foundation
 1424 16th Street, NW, Suite 604
 Washington, DC 20036
 Mary Ellen Fise
 Telephone*: (401) 296-4290
 Fax #: (401) 296-4291
 Email: merf@home.com

 International City/County
 Management Association
 777 N Capitol Street, NE, Suite 500
 Washington, DC 20002
 Patricia I. Elliott
 Telephone*: (202) 962-3593
 Fax* (202) 962-3500
 Email: pelliott@icma.org
 www.icma.org

 National Association of
 County and City  Health
 Officials
 1100 17th Street, NW, 2nd  Floor
 Washington, DC 20036
 Phillip Bouton
 Telephone*: (202) 783-5550
 Fax #=(202)783-1583
Email: pbouton@naccho.org
www.naccho.org
 National Association of
 Counties
 440 First Street, NW
 Washington, DC 20001
 Lou Witt
 Telephone #: (202) 942-4261
 Fax #=(202)737-0480
 Email: jlwitt@spaceworks.com
 www.naco.org

 National Association of
 Service and Conservation
 Corps
 666 11th Street, NW, Suite 1000
 Washington, DC 20001
 Andrew Moore
 Telephone*: (202) 737-6272
 Fax*: (202) 737-6277
 Email: amoore@nascc.org
 www.nascc.org

 National Coalition of Hispanic
 Health and Human Services
 1501 16th Street, NW
Washington, DC 20036
RitaLawrie
Telephone #: (202) 797-4322
Fax #:(202)  797-4353
Email: rmcossmho@aol.com
www.cossmho.org

-------
          Appendix II
           Secondhand Smoke and Children: Conducting Public Outreach Programs
           National Conference of Negro
           Women
           633 Pennsylvania Ave, NW
           Washington, DC 20004
           KimLamphier
           Telephone*: (202) 383-9111
           Fax fc (202) 737-0476
           vnwf.ncnvf.com

           National Education
           Association Health
           Information Network
           1201 16thkreet^NW Suite 521
           Washington, DC 20004
           Michele Kodak
           Telephone*: (202) 822-7798
           Fax*: (202) 822-7775
           Email: mhodak@nea.org
           www.nea.6rg
National Environmental
Health Association
720 South Colorado Blvd, South
   Tower, Suite 970
Denver, CO 80246
Larry Marcum
Telephone*: (303) 756-9090
Fax*: (303) 691-9490
www.neha.org

National Parent Teacher
Association
330 N. Wabash Ave, Suite 2100
Chicago, IL 60611
Robert Jessup
Telephone*: (312) 670-6782
Fax*: (312) 670-6783
www.pta.org
National Safety Council
Environmental Health Center
1025 Connecticut Ave, NW
Suite 1200
Washington, DC 20036
David Thompson
Telephone #: (202) 293-2270
Fax'*: (202) 293-0032
Email: airqual@nsc.org
www.nsc.org

United States Department of
Agriculture
Cooperative State Research,
   Education, and Extension Services
Suite 329-N Aerospace Center
Washington, DC 20250
Joseph Wysocki
Telephone #: (202) 401-4980
Fax*: (202) 401-1706          |
Email: jwysocki@reeusda.gov
wwW.reeusda.gov
^^

-------
 Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                          Appendix II
  State Tobacco Control Directors

  (As of October 1999, the ASSIST and IMPACT programs will merge, which may affect some of these positions)
 Alabama

 Dianne Smith Yoder
 Mobile Co. Health Dept.
 Bureau of Health Promotion
 P.O. Box 2867
 Mobile, Alabama 36652
 Telephone #(334) 690-8186
 FAX #(334) 432-7443
 dfs7@cdc.gov

 Clifford J. Hataway, MD
 Division of Chronic Disease
   Prevention
 Department of Public Health
 201 Monroe Street, Suite 964
 Montgomery, AL 36130-3017
 Telephone #(334)206-5616
 FAX #(334) 206-5609
 hatal 00w@cdc.gov

 Dianne Beeson, M.B.A.
 Tobacco Prevention & Control
   Branch
 Department of Public Health
 Suite 992
 P.O. Box 303017
 Montgomery, AL 36130-3017
 Telephone #(334) 206-5560
 FAX #(334) 206-5324
 dbeeson@adph.state.al.us

 Larry Hardin, Ed.D.
 Alabama IMPACT Coordinator
 Jefferson Co. Health Dept.
 1400 Sixth Avenue South
 Birmingham, AL 35233-1598
Telephone* (205) 930-1500
 FAX #(205) 930-0243
lehardin@hotmail.com
 Alaska

 Susan Mason-Bouterse
 IMPACT Coordinator
 Department of Health and Social
    Services
 P.O. Box 110614
 Juneau,AK99811-0614
 Telephone #(907) 465-8618
 FAX #(907) 465-6861
 Smason2@health.state.akus

 Patricia Carr
 IMPACT Coordinator
 Department of Health and Social
   Services
 Section CHEMS, P.O. Box 110616
 350 Main Street, Alaska Office Bldg.,
   Pon.519
 Juneau,AK 99811-0616
 Telephone #(907) 465-8618
 FAX #(907) 465-6861
 Pcarr@health.state.akus
Arizona

Rim Kotchou
Acting IMPACT Coordinator
Office of Health Promotion and
   Education
1400 W. Washington
Phoenix, AZ 85007
Telephone #(602) 542-7291
FAX #(602) 542-4226
Kkotcho@hs.state.az.us
 Arkansas

 Joy Rockenbach
 Office of Tobacco Control and
    Prevention
 4815W.Markham,Slot3
 Little Rock, AR 72205
 Telephone #(501) 661-2783
 FAX #(501) 661-2082

 David Bourne, MD, MPH
 Arkansas Dept. of Health
 4815 West Markham Street, Slot #3
 Little Rock, AR 72205-3867
 Telephone #(501) 661-2168
 FAX #(501) 661-2468
 California

 Carol Russell
 California Department of Health
   Services
 601N 7th Street, P.O. Box 942732
 MS #555
 Sacramento, CA 94234-7320
 Telephone #(916) 327-5423
 FAX #(916) 327-5424
 crussel2@hwl.cahwnet.gov

 Dileep G. Bal, MD
 Chronic Disease Branch
 California Department of Health
   Services
 744 P Street, P.O. Box 942732
 Sacramento, CA 94234-7320
Telephone #(916) 322-4787
FAX #(916)  445-4940
dbal@hwLcahwnet.gov

-------
Appendix II
                                               Secondhand Smoke and Children: Conducting Public Outreach Programs
Colorado

Nancy Salas
ASSIST Project Manager
Colorado Department of Health
4300 Cherry Creek Drive South
Denver, CO 80222-1530
Telephone #(303) 692-2515
FAX #(303) 758-3448
nancy.salas@state.co.us
Connecticut

Tom Condren
Department of Public Health
410 Capitol Avenue, 1st Floor
P.O. Box 340308, MS #11HLS
Hartford, CT 06134-0308
Telephone #(860) 509-7803
FAX#(860)509-7854
condl06w@cdc.gov

Nancy Berger
Department of Public Health
410 Capitol Avenue, 1st Floor
MSfllHLS
Hartford, CT 06134-0308
Telephone #(860) 509-7803
FAX #(860)509-7854
 Delaware

 Fred Gatto
 IMPACT Program Coordinator
 Department of Health and Social
    Services
 P.O. Box 637
 Dover, DE19903
 Telephone #(302) 739-4724
 FAX #(302) 739-3839
 fgato@state.de.us
Fred Breukelman
Department of Health and Social
   Services
P.O. Box 637
Dover, DE 19903
Telephone #(302) 739-4724
FAX #(302) 739-3839
Fbreukelman@state.de.us
District of Columbia

Sam Ndubuisi
IMPACT Coordinator
Commission of Public Health
800 9th Street SW, 4th floor
Washington, DC 20024-2480
Telephone #(202)645-5578
FAX #(202)645-0454
sndubuisi@dchealth.com
 Florida

 Patti Spain, MA
 Prevention and Control Program
 Department of Health
 1317 Winewood Blvd.-HCH
 Tallahassee, FL 32399-0700
 Telephone #(904) 488-8041
 FAX #(904) 488-6495
 Patti_Spain@dcf.state.fl.us

 Mary (MR) Street
 Tobacco Prevention and Control
   Program
 Department of Health
 1317 Winewood Blvd.-HCH
 Tallahassee, FL 32399-0700
 Telephone* (904) 487-3220
 Fax #(904) 488-6495
 mary_street@doh.state.fl.us
Jennie Hefelfinger, MPH
Department of Health
1317 Winewood Blvd.
Bldg.5,Rooml06
Tallahassee, FL 32399-0700
Telephone #(850) 487-2772
FAX #(850) 410-2540
Jennie_hefelfinger@doh.state.fl.us
Georgia

Parri Eidson, M.Ed
Department of Human Resources
2 Peachtree Street, 6th Floor
Atlanta, GA 30303
Telephone #(404) 657-2570
FAX #(404) 657-6631

Mary Jane Mahans
Department of Human Resources
2 Peach Street, 6500
Atlanta, GA 30303-3186
Telephone #(404) 6576642
mjm0601 @dhr.state.ga.us
 Guam

 Eugene S. Santos
 Health Educator Administrator
 Department of Public Health and
   iSocial Services
 P.O. Box 2816
 Agana, Guam 96910
 Telephone #(671) 734-7129
 FAX #(671) 734-5910

 Angelina Mummert
 Health Services Administrator
 Department of Public Health
 P.O. Box 2816
 Agana, Guam 96910
 Telephone #(671) 734-7201
 FAX #(671) 734-5910

-------
  Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                                                               Appendix II
  Hawaii

  Julian Lipsher, M.P.H.
  IMPACT Coordinator
  Department of Health
  1250 Punchbowl Street, Room 217
  Honolulu, HI 96813
  Telephone #(808) 586-4662
  FAX (808) 586-8252
 jdlipshe@mail.health.state.hi.us
 Idaho

 Kristy Jones
 IMPACT Coordinator
 Idaho Department of Health &
    Welfare
 450 West State Street
 Boise, ID 83720-0036
 Telephone #(208) 334-4936
 FAX #(208) 334-6573
 Jonesk@dhw.state.id.us
 Illinois

 Julie Harvill
 Acting IMPACT Coordinator
 Illinois Department of Public Health
 535 West Jefferson Street
 Springfield, IL 62761
 Telephone #(217) 782-3300
 FAX #(217) 782-1235

 Cheryl Hunter
 IMPACT Coordinator
 Illinois Department of Public Health
 535 West Jefferson
Springfield, IL 62761
Telephone #(217) 785-4330
FAX #(217) 782-1235
Chuntere@idph.state.il.us
 Leah Rogers
 Illinois Department of Public Health
 33 East Congress Pkwy, Suite 532
 Chicago, IL 60625
 Telephone #(312) 814-2915
 FAX #(312) 814-1483/6898
 lrogers@idph.state.il.us
 Indiana

 Kelly Bishop Alley
 ASSIST/Smokefree Indiana
 5610 Crawfordville Road,
 Suite 1602
 Indianapolis, IN 46224
 Telephone #(317)241-6398/6387
 FAX #(317)241-6548
 kalley@wp.bsu.edu

 Mary Anne Hurrle
 Indiana Department of Health
 Office of Tobacco and Health
 Section 6B, 2 North Meridian - Room
   6A
 Indianapolis, IN 46204-3003
 Telephone #(317)233-7299
 FAX #(317)233-7641
 Imhurrle@isdh.state.in.us
Iowa

EdStrobl
IMPACT Coordinator
Department of Public Health
Lucas State Office Building, 3rd Floor
Des Moines, IA 50319-0075
Telephone #(515)242-5833
FAX #(515) 281-4535
estrobl@idph.state.ia.us
 Sally Kuhn
 Iowa Department of Public Health
 Lucas State Office Building, 3rd Floor
 Des Moines, IA 50319-0075
 Phone #(515) 2816779
 FAX #(515) 2814535
 skuhn@idph.state.ia.us
 Kansas

 Julia Francisco
 KSDept of Health
 900 SW Jackson
 Topeka, KS 66612-1290
 Telephone #(913) 296-1233
 FAX #(913) 296-8059
 jfranci529@aol.com

 Michael Lohmeyer
 KSDept. of Health
 900 SW Jackson
 Topeka, KS 66612-1290
 Telephone #(913)296-8058
 FAX #(913)296-8059
 lohmeyer@qnetworks.com

 Bill McCoy
 KS Dept of Health
 900 SW Jackson
 Topeka, KS 66612-1290
 Telephone #(913)296-1118
 FAX #(913)296-8059

 Paula R. Schaller, RN, MPH
 KSDept. of Health
 130 S. Market Street, #6050
 Wichita, KS 67202-3802
Telephone #(316) 337-6055
 FAX #(316) 337-6023
paularsc@feist.com

-------
Appendix II
           Secondhand Smoke and Children: Conducting Public Outreach Programs
Kentucky

Todd Warnick
Tobacco Control Coordinator
Kentucky Department for Public
   Health
275 East Main Street
Frankfort, KY 40621
Telephone #(502) 564-7996
FAX #(502) 564-6533
twarnick@mail.state.ky.us
Louisiana

Diane Hargrove-Roberson, M.S.W.
Louisiana Department of Health &
   Hospitals
325 Loyola Ave., Room 414
New Orleans, LA 70112
Telephone #(504) 568-7210
FAX #(504) 568-7005
drobinso@dhhmail.dhh.state.la.us

Josie White, MPH
LSUMC
S. Stanley Scott Cancer Center
2025 Gravier Street, Suite 612
New Orleans, LA 70112
Telephone #(504) 599-0529
 Maine

 Valorie Nybo, Ed.D.
 ASSIST Project
 Maine Department of Human
    Services
 151 Capitol Street, State House
    Station 11
 Augusta, ME 04333
 Telephone #(207) 287-4624
 FAX #(207) 287-4631
 valorie.nybo@state.me.us
Maryland

Dawn Weisenberger
Department of Health & Mental
   Hygiene
201 West Preston Street
Baltimore, MD 21201
Telephone #(410) 767-5528
FAX #(410) 333-7903
weisenbergerd@dhmh.state.md.us

Joan Stine
Chief, Division of Health Education
Department of Health & Mental
   Hygiene
201 West Preston Street
Baltimore, MD 21201
Telephone #(410)767-1362
FAX #(410) 333-7903
Massachusetts

Gregory N. Connolly, DMD, MPH
Director, ASSIST Project
Massachusetts Department of Public
   Health
250 Washington Street
Boston, MA 02108
Telephone #(617) 624-5901
FAX#(617)624-5921
greg.connolly@state.ma.us
Michigan
    ]•             ;           :  ••
John Beasley
ASSIST Project Director
Michigan Department of Public
   Health
3423 N. Logan Street, P.O. Box 30195
   -CHP
Lansing, MI 48909
Telephone #(517) 335-8380
FAX #(517) 335-9468
Beasleyj @stte.mi. us
Minnesota

Gretchen Griffin
ASSIST Project Manager
MNDept. of Health
717 SE Delaware Street
P.O. Box 9441
Minneapolis, MN 55440
612-623-5335(Ph)
612-623-5733(Fax)
Gretchen.Griffin@state.mn.us

Kim Miner
MNDept. of Health
Center for Health Promotion
717 SE Delaware Street
P.O. Box 9441
Minneapolis, MN 55440-9441
612-623-5334(Ph)
612-623-5775(Fax)
kim,miner@health.state.mn.us

Chris Hale
MNDept. of Health
Center for Health Promotion
717 SE Delaware Street
P.O. Box 9441
Minneapolis, MN 55440-9441
612-623-5114(Ph)
612-623-5775(Fax)
chrisitne.hale@health.state.mn.us

-------
 Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                         Appendix II
 Paul Martinez
 MNDept. of Health
 Center for Health Promotion
 717 SE Delaware Street
 P.O. Box 9441
 Minneapolis, MN 55440-9441
 612-676-575 l(Ph)
 612-676-5733(Fax)
 paul.martinez@health.state.mn.us
 Mississippi

 Ellen Jones
 Mississippi State Department of
   Health
 P.O. Box 1700
 Jackson, MS 39215-1700
 Telephone #(601) 960-7951
 FAX #(601) 354-6111
 ejones@unite.msdh.state.ms.us
Missouri

Michael G. Carter, MHA
ASSIST Project Director
Missouri Department of Health
101 Park DeVille Drive, Suite A
Columbia, MO 65203
Telephone #(573)876-3260
FAX #(573)446-8777
cartem@mail.health.state.mo.us
 Montana

 Chris Deveny
 IMPACT Coordinator
 Chronic Disease Prevention and
    Health Promotion
 1400 Broadway, Cogswell Bldg.,
    Room A206
 Helena, MT 59620
 Telephone # (406)444-2555
 FAX #(406)444-1861
 cdeveny@mt.gov

 Robert W. Moon, MPH
 Health Services Manager
 Department of Health and Env
   Sciences
 1400 Broadway, Cogswell Bldg., Rm
   C314
 Helena, MT 59620
 Telephone #(406) 444-4488
 FAX #(406) 444-2606
 moon@mt.gov
Nebraska

Judy Ashley Martin
IMPACT Coordinator
Nebraska Department of Health
301 Centennial Mall South, P.O. Box
   95044
Lincoln, NE 68509-5044
Telephone #(402) 471-2101
FAX#(402) 471-6446
doh5128@vmhost.cdp.state.ne.us
 Jim Dills (Director)
 Health Promotion & Education
 Nebraska Department of Health
 301 Centennial Mall South, P.O. Box
    95007
 Lincoln, NE 68509-5007
 Telephone #(402) 471-2101
 FAX#(402) 471-6446
 doh512 l@vmhost.cdp.state.ne.us
 Nevada

 Willie Edwards
 Tobacco Control IMPACT
   Coordinator
 Nevada Department of Human
   Resources
 505 East King St., Rm. 304
 Carson City, NV 89710
 Telephone #(702) 687-4800
 FAX #(702) 687-4988
 williel@powernet.net
New Hampshire

Ann Walls
Bureau of Health Promotion
New Hampshire Department of
   Health
6 Hazen Drive
Concord, NH 03301-6527
Telephone #(603) 271-6892
FAX #(603) 271-6116
awalls@dhhs.state.nh.us

-------
Appendix II
           Secondhand Smoke and Children: Conducting Public Outreach Programs
Barbara Metivier
Bureau of Health Promotion
Department of Health and Human
   Services
6 Hazen Drive
Concord, NH 03301-6527
Telephone #(603) 271-4551
FAX #(603) 271-3745
ElectronicMailbox:NH.RISK
New Jersey

Mianne Edwards
Acting ASSIST Project Manager
NJ Department of Health and Senior
   Services
 129 Hanover St-P.O. Box 362
Trenton, NJ 08625-0362
Telephone #(609) 292-4414
FAX #(609) 292-3816
me2@doh.state.nj.us

New Mexico
 Deborah Childs Borbely, MS, CHES
 Program Manager
 Tobacco Use Pripvention/ASSIST
 2329 Wisconsin NE, Suite A
 Albuquerque, NM 87110
 Telephone #(505) 841-8335, ext 18
 FAX #(505) 841-8333
 deborahb<|)doh.state.nm.us
New York

Steve Onderdonk
Tobacco Control Program, ASSIST
   Project
New York State Department of
   Health
Empire State Plaza, Room 710
Albany, NY 12237-0620
Telephone #(518) 474-1515
FAX #(518) 473-3356
sr03@health.state.ny.us

David Momrow
Director, Prevention and Health
   Promotion
New York State Department of
   Health
Empire State Plaza, Room 710
Albany, NY 12237-0620
Telephone #(518) 474-0512
FAX #(518) 473-2853
dcm02@health.state.ny.us
 North Carolina

 Sally Herndon Malek
 Division of Adult Health, ASSIST
   Project
 NC Dept. of Env., Health & Nad.
   Resources
 P.O. Box 27687
 Raleigh, NC 27611-7687
 Telephone #(919) 733-1676
 FAX #(919) 733-0488
 sally-malek@mial.ehnr.state.nc.us
North Dakota

   i                      •   i ',-
Jeannie Prom
IMPACT Coordinator
Tobacco Prevention and Control
   Program
600 E Boulevard Ave., Judicial Wing,
   2ndFl.
Bismarck, ND 58505-0200
Telephone #(701)328-3138
FAX #(701) 328-1412
msmail.jeannep@ranch.state.nd.us
   I
Sandra Adams, Director
Health Promotion & Education
   Division
North Dakota Department of Health
600 E Boulevard Ave., Judicial Wing,
   2nd Fl.
Bismarck, ND 58505-0200
Telephone #(701) 328-4517
FAX #(701) 328-4727
msmail.sandyadm@ranch.state.nd.us
 Ohio

 Ron Sherwood
 Ohio Department of Healdi
 246* N High Street, P.O. Box 118
 Columbus, OH 43266-0118
 Telephone #(614) 466-2144
 FAX #(614) 644-7740
 Rsherwoo@gw.odh.state.oh.us

 Julian Lewis
 Ohio Department of Health
 246 N High Street, P.O. Box 118
 Columbus, OH 43266-0118
 Telephone #(614) 466-2144
 FAX #(614) 644-7740
 Jlewis@gw.odh.state.oh.us

-------
  Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                                                              Appendix II
  Jan Stine
  Ohio Department of Health
  246 N High Street, P.O. Box 118
  Columbus, OH 43266-0118
  Telephone #(614) 466-2144
  FAX #(614) 644-7740
  Jstine@gw.odh.state.oh.us
 Oklahoma

 Doug Matheny
 IMPACT Coordinator
 Oklahoma State Department of
    Health
 1000 North East 10th Street
 Oklahoma City, OK 73117-1299
 Telephone #(405) 271-5601
 FAX #(405) 271-2865
 dougm@health.state.okus
 Oregon

 Gerry Odisio
 Tobacco Control Program Manager
 OR Department of Human
   Resources
 800 NE Oregon Street
 Portland, OR 97232
 Telephone #(503) 731-4273
 FAX #(503) 731-4082
 gerardine.m.odisio@state.or.us

 Jane M. Moore
 Chronic Disease Prevention
 800 NE Oregon Street
 Portland, OR 97232
 Telephone #(503) 731-4273
 FAX #(503) 731-4082
jane.m.moore@state.or.us
  Cynthia Campbell
  OR Department of Human
    Resources
  800 NE Oregon Street
  Portland, OR 97232
  Telephone #(503) 731-4273
  FAX #(503) 731-4082
 Pennsylvania

 Cheryl Wieder.RN
 Tobacco and Control Program
 Pennsylvania Department of Health
 P.O. Box 90, Rm. 1003
 Harrisburg, PA 17108
 Telephone #(717)787-5900
 FAX #(717) 783-5498
 eweider@health.state.pa.us

 Wes Ruhrig
 Pennsylvania Department of Health
 P.O. Box 90, Rm. 1003
 Harrisburg, PA 17108
 Telephone #(717)787-6600
 FAX #(717) 783-5498
 wruhrig@health.state.pa.us
 Puerto Rico

 Milagros Sanchez
 Puerto Rico Department of Health
 P.O. Box 70184
 San Juan, Puerto Rico 00936
 Telephone #(787)274-5671
 FAX #(787) 274-7824
 Secretary - 787/274-5641

 Horedel Febo Reyes, M.D.
 Puerto Rico Department of Health
 P.O. Box 70184
San Juan, Puerto Rico 00936
Telephone #(809) 754-6285
FAX #(809) 754-2729
 Rhode Island

 Elizabeth Harvey
 ASSIST Project
 Rhode Island Department of Health
 Cannon Bldg., 3 Capitol Hill, Rm 408
 Providence, RI02908-5097
 Telephone #(401) 277-3293
 FAX #(401) 277-4415
 South Carolina

 Thomas Gillette, MPH
 ASSIST DOH Project Manager
 South Carolina Dept of Health and
   Environment
 P.O. Box 101106
 Columbia, SC 29211
 Telephone #(803) 734-4128
 FAX #(803) 253-4001
 giUetrf@OTlumb61.dhec.state.sc.us
South Dakota

Hoby Abernathy
Division of Alcohol and Drug Abuse
Dept. of Human Services
3800 East Highway 34
Pierre, SD 57501
Telephone #(605) 773-3123
FAX #(605) 773-5483
hobya@dhs.state.sd.us

-------
Appendix ll
           Secondhand Smoke and Children: Conducting Public Outreach Programs
Tennessee

Maggie Maag
IMPACT Coordinator
Tennessee Department of Health
Cordell Hull Building, 6th Floor
425 5th Avenue North
Nashville, TN 37247-5201
Telephone #(615) 741-5379
FAX #(615) 532-8478
mmaag@mail.state.tn.us

JudyWomack
Director, Chronic Disease Prevention
   & Promotion
Tennessee Department of Health
Cordell Hull Building, 6th Floor
425 5th Avenue North
Nashville, TN 37247-5201
Telephone #(615) 741-0378
FAX #(615) 532-8478
Jwomack@mail.state.tn.us
 Texas

 Steven Tobias
 Office of Smoking & Health
 1100 West 49th Street
 Austin, TJC 78756-3199
 Telephone # (512) 458-7402
 FAX #(512)458-7618
 Steven.tobias@tdh.state.tx.us

 Dianne Satterwhite
 IMPACT Coordinator
 Texas Department of Health
 1100 West 49th Street
 Austin, TX 78756-3199
 Telephone # (512) 458-7111
 FAX #(512)458-7618
Utah

Rebecca Murphy
IMPACT Coordinator
Utah Department of Health
288 North 1460 West, P.O. Box
   142106
Salt Lake City, Utah 84116-2106
Telephone # (801)538-6270
FAX* (801538-8629
Murphy@doh.state.ut.us

Rebecca Giles
Utah Department of Health
288 North 1460 West, P.O. Box
   142106
Salt Lake City, Utah 84116-0660
Telephone* (801)538-6259
FAX* (801)538-6629
Rgiles@doh.state.ut.us
 Vermont

 Judy Stephany
 Vermont Department of Health
 P.O. Box 70
 Burlington, VT 05402
 Telephone* (802)-863-7355
 FAX #(802) 651-1634
 jstepha@vdhvax.vdh.state.vt.us

 Debbie Dameron, MPH
 Vermont Department of Health
 P.O. Box 70
 Burlington, VT 05402
 Telephone #(802) 863-7330
 FAX #(802) 863-7425
 ddamero@vdhvax.vdh.state.vt.us
Virgin Islands
Ann Hatcher
VI Dept of Social and Health
   Services
Charles Harword Complex, Rm. E-25
Christiansted, St. Croix, VI 00820
Telephone #(809)773-1311 ext 3056
FAX* (809)773-1376
Virginia
   i
Margaret Tate
Director, Div. Of Chronic Disease
Virginia Department of Health
1500 East Main Street
RichmondjVA23218
Telephone #(804) 692-0002
FAk #(804) 371-6152
Mtate@vdh.state. va. us
   i
Neal R. Graham, ASSIST Project
Virginia Department of Health
1500 East Main Street
Richmond, VA 23219
Telephone #(804) 786-3551
FAX #(804) 371-6152
Ngraham@vdh.state.va.us
 Washington

 Mary Frost
 Washington State Department of
    Health
 Airdustrial Park, #11, P.O. Box 47835
 Olympia, WA 98504-7835
 Telephone #(360) 238-3628
 FAX #(360) 664-2619
 Ikl0303@doh.wa.gov

-------
 Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                                                              Appendix II
 Susan Magazine
 Department of Social Health
 601 Main Street, Suite 301
 Vancouver, WA 98660
 Telephone #(360) 737-2196
 FAX #(360) 737-2198
West Virginia

Joyce Edwards-Holmes
ASSIST Project Manager
WV Dept of Health and Human
   Resources
1411 Virginia Street, East
Charleston, WV 25301
Telephone #(304) 558-0644
FAX #(304) 558-2183
hlomej@wvnet.edu
 Wisconsin

 Tom Conway, MBA
 Acting ASSIST Project Manager
 Wisconsin Division of Health
 1400 E. Washington Ave., Room 240
 Madison, WI 53703-3041
 Telephone #(608) 267-3860
 FAX #(608) 268-8925
 degelam@dhfs.state.wi.us

 Cynthia Musial
 Acting ASSIST Project Manager
 Wisconsin Department of Health and
 819 N. 6th Street, SE District
Milwaukee, WI 53202-1606
Telephone #(414) 227-3982
FAX #((414) 227-2010
musial@sprynet.com
Wyoming

Janet Martin
Program Manager
Health Risk Reduction
Wyoming Department of Health
Hathaway Building, 4th Floor
Cheyenne, WY 82002
Telephone #(307) 755-1413
Fax #(307) 745-8733
jmarti@missc.state.wy.us

-------
Appendix II
                                               Secondhand Smoke and Children: Conducting Public Outreach Programs
IAQ Coalitions

The National Association of Counties (NACo), in cooperation with the US EPA, has assisted members of the public health
community in starting and sustaining local IAQ coalitions that address major indoor air quality priority issues including
reducing children's exposure to secondhand smoke. NACo, EPA, ALA and several other partner organizations have worked
together to help establish these coalitions and to train local coalition members. As of early 1999, the following states have
active coalitions: CT, GA, IA, IL, KS, KY, MA, MI, MN, MT, NM, NY, OH, PA, VA, WA. For specific coalition information,
contact Lou Witt; Senior Program Manager, Radon/Indoor Air Project; NACo; 440 First Street, NW; Washington DC
20001-2080; phone (202)942-4261; fex (202)737-0480; jlwitt@naco.org.
 Daycare Organizations

 National Association of Child
 Care Resource and Referral
 Agencies
 1319 F Street NW, Suite 810
 Washington DC 20004-1106
 Telephone >. (202) 393-5501
 Website: http://www.naccrra.net

 National Center for Children
 in Poverty
 Columbia University School of Public
   Health
 154 Haven Avenue
 New York, NY 10032
 Telephone*: (212) 304-7100
 Website:
   http://cpmcnetcolumbia.edu/dept
   /nccp/
National Child Care
Information Center
243 Church Street NW, 2nd Floor
Vienna VA 22180
Telephone*: (800) 616-2242
Website: http://nccic.org

National Head Start
Association
1651 Prince Street
Alexandria, VA 22314
Telephone*: (703) 739-0875
Website: http://nhsa.org
National Resource Center for
Health and Safety in Child
Care
Health Sciences Center
University of Colorado
4200 East 9th Avenue, Box C287
Denver, CO 80262
Telephone: (800) 598-5437
Website: http://nrc.uchsc.edu

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 Secondhand Smoke and Children: Conducting Public Outreach Programs
                                                                                            Appendix II
 WIC Program

 The Special Supplemental Nutrition Program for Women, Infants and Children Program (WIC) is run nationwide under
 the auspices of state and local health departments. The program was created to improve the nutritional well-being of low-
 income pregnant, breastfeeding, and postpartum women, infants, and children by providing supplemental nutritious foods
 and nutrition education. WIC is also charged with serving as an adjunct to other health services, and can provide an excel-
 lent opportunity to counsel disadvantaged families with young children on the risks of secondhand smoke exposure. For
 more information contact:

 USDA Food and Nutrition Service Public Information Program
 3101 Park Center Drive
 Room 819
 Alexandria, VA 22302
 Telephone*: (703) 305-2286
 http://usda.gov/ms
 Tobacco Control Organizations
Action on Smoking and
Health (ASH)
2013 H Street NW
Washington DC 20006
Telephone*: (202) 659-4310
Website: www.ash.org

Americans for Nonsmokers'
Rights
2530 San Pablo Avenue, Suite J
Berkeley, CA 94702
Telephone*: (510) 841-3032
Website: www.no-smoke.org
 National Center for Tobacco-
 Free Kids
 1707 L Street NW, Suite 800
 Washington DC 20036
 Telephone #: (202)296-5469
 Website: www.tobaccofreekids.org

 Tobacco Control Resource
 Center
 102 The Fenway
 Suite 117
 Boston, MA 02115
Telephone #: (617)373-2026
Website: www.tobacco.neu.edu
Tobacco Education
Clearinghouse of California
P.O. Box 1830
Santa Cruz, CA 95061-1830
Telephone*: (408) 438-4822

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Appendix II
                                                 Secondhand Smoke and CMdren: Conducting Public Outreach Programs

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 Secondhand Smoke and Children: Conducting Public Outreach Programs
Appendix HI
 Brochures

 Environmental Tobacco Smoke: A Danger to Children. American Academy of Pediatrics. Available from AAP Division of
 Publications; 141 Northwest Point Blvd.; PO Box 927; Elk Grove Village, IL 60009-0927.

 It's All About Us: African-American Women Fighting Against Tobacco. ALA of San Francisco/San Mateo Counties (17
 page magazine). Available from ALA at (650) 994-5864.

 La Mujer, La Familia y El Cigarillo. ALA of San Francisco/San Mateo Counties, 1991 (32 page magazine, in Spanish).
 Available from ALA at (650) 994-5864.

 Not Smoking Makes Your Family Healthier. Tobacco Education Clearinghouse of California, (in Hmong). Available from the
 Clearinghouse at (831) 438-3618.

 Please Don't Smoke in  My House. Tobacco Education Clearinghouse of California, (available in Chinese, Cambodian,
 Korean and Vietnamese). Available from the Clearinghouse at (831) 438-3618.

 Protecting Yourself and Your Family From Secondhand Smoke. American Lung Association, 1994 (low-literacy general popu-
 lation version). Available from EPA through the National Service Center for Environmental Publications at (800) 490-9198.

 Protecting Yourself and Your Family From Secondhand Smoke. American Lung Association, 1994 (African-American version).
 Available from EPA through the National Service Center for Environmental Publications at (800) 490-9198.

 Proteja a Su Familia.. .Ese Humo es Una Amenaza. American Lung Association, 1994 (Spanish version). Available from EPA
 through the National Service Center for Environmental Publications at (800) 490-9198.

 Secondhand Smoke. US Environmental Protection Agency, 1995 (brochure, also available in Spanish and Chinese). Available
 from EPA through the National Service Center for Environmental Publications at (800) 490-9198.

 Smoking and Your Baby. Tobacco Education Clearinghouse of California, (available in Chinese, Cambodian, Korean and
 Vietnamese). Available from the Clearinghouse at (831) 438-3618.
Program Guides, Presentation Materials and Curricula

Building Successful IAQ and Environmental Justice Programs: A Program Implementation Guide. American Lung Association
Available from EPA through the National Service Center for Environmental Publications at (800) 490-9198.

Environmental Tobacco Smoke and Other Indoor Pollutants Affecting Our Children. The American Academy of Pediatrics
(speakers kit). Available to member pediatricians from American Academy of Pediatrics.

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               • I
                           < nil   'III
                    AppendixIII
Secondhand Smoke and Children: Conducting Public Outreach Programs
                    Fresh Air for Little Noses: Smoke-free Policies for Pre-Schools. ALA of the East Bay, CA (a how-to manual for childcare
                    providers on how and why to implement smoke-free policies, including parent education). Available from ALA of the East
                    Bay (510) 893-5474.
                             • i    • •••  :               .    .          .                               ii          •               :  •>;••
                    MQ Community Leader Kit National Safety Council Environmental Health Center (includes slides and Home Air Care
                    video; also available targeted to Hispanics, or to low-income women and children). Available from National Safety Council
                    at (202) 557-2366.

                    Secondhand Smoke Education Project. National Resource Center for Health and Safety in Child Care (self-guided curriculum
                    for daycare providers; includes Poisoning Our Children video). Available from EPA, call Alison Freeman at (202) 564-9455.
                    PSAs and Other Media Materials
                                                                                                 j                           .,
                    Go Out for Your Kids. EPA, American Medical Association and Consumer Federation of American Foundation (TV and
                    radio PSAs). Available to EPA Indoor Environments Cooperative Partner Network through EPA, contact Wendy Kammer at
                    (202) 564-9152. All others can obtain copies through CDC at (301) 231-7537 or
                    www.cdc.gov/nccdphp/osh/mcrc/index.htm).
                             	                                                              i                       	
                    Media Campaign Resource Book Centers for Disease Control (catalog of available advertising materials on secondhand
                    smoke and other tobacco control topics). Available from CDC at (301) 231-7537 or
                    www.cdcgov/nccdphp/osh/mcrc/index.htm).
                    Videos

                    A is for Asthma. American Lung Association, 1998 (Asthma management for pre-schoolers, includes mention of second-
                    hand smoke. In English and Spanish, with accompanying teaching materials). Available from your local Lung Association 1-
                    800-LUNG-USA.
                             ",    ,,,                      .                                        il                     , ,    i ""•
                    Fresh Air for Little Noses: Smoke-free Policies for Pre-Schools. ALA of the East Bay, CA, 1999 (12-minute video for childcare
                    providers on how and why to implement smoke-free policies, including parent education). Available from ALA of the East
                    Bay (510) 893-5474.

                    Home Air Care: Indoor Air Care and Your Health. American Lung Association Indoor Air Programs, 1995 (11  minutes of
                    general indoor air quality, including secondhand smoke; also available in Spanish). Available from ALA Indoor Air
                    Programs (202) 785-3355.

                    Poisoning Our Children: The Perils of Secondhand Smoke. The American Academy of Otolaryngology. Available from EPA
                    through NCEPI at (800) 490-9198.

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