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Secondhand Smoke
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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 AdultsUnited 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 AdultsUnited 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 AduKaUnited 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 AdultปUnited 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 AdultsUnited 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.
-------
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).
-------
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.
-------
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-
-------
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
-------
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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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
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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
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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.
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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.
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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 applicablesee 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
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Replicable Programs
Secondhand Smoke and Children: Conducting Public Outreach Programs
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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 memy 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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Designate your vehicle "smoke-free." Let oth
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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Choose a child care provider or babysitter wh
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Share the pamphlet in your packet with your c
babysitter.
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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:
^y^jff^S^^^i^^^ ^jir^'^P'^^ ^^^^^^^^^^^^^^^^^^g^^^^^^^gj"^^^|^^^^^^s^j^^^^^j^^^^^^^^t>y
-------
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
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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
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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
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tobacco smoke when
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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.
-------
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)
-------
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
-------
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
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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
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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
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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
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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
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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
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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
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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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HIP!111!1" I"! i"'11!!'!:'1'
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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