The far-reaching effects of eliminating tobacco use on health campuses

Ten years ago, visitors to the Alaska Native Medical Center were greeted with a plume of cigarette smoke when they walked toward the main entrance. On top of the general health hazards associated with tobacco use—such as increased risk of developing emphysema, chronic bronchitis, and lung cancer—the smoke permeated the air and lingered on patients' and employees' clothing, creating an unhealthy environment even for non-smokers.

So, the Alaska Native Tribal Health Consortium, which co-manages ANMC* with Southcentral Foundation, took a bold step, becoming only the second health care organization in Alaska to create a completely tobacco-free facility, said Lakota R. M. Holman, senior program manager with ANTHC's Substance Abuse Prevention program. The policy encompassed not only those facilities located on Anchorage's Alaska Native Health Campus, but all properties owned, leased or managed by ANTHC throughout the state.

"We wanted people to know that the [campus] is a place for people to heal, and for sick people to get better, and for people to become more well," she said. "Having smoke or tobacco on campus wasn't part of that."

Celebrating 10 years tobacco-free

November 17 marks ANTHC's 10th anniversary of adopting a tobacco-free policy (it has been updated to include not only cigarettes and spit tobacco, but e-cigarettes as well). The anniversary coincides with the Great American Smokeout, a national event created by the American Cancer Society with the goal of encouraging communities and organizations to provide resources and activities that will help its members quit smoking, if even for one day, said Eliza Muse, deputy tobacco program manager with the State of Alaska's Tobacco Prevention Program.

"It lets organizations have the conversation about quitting tobacco if you're a tobacco user, and not starting using if you don't already," she said. Many organizations, like ANTHC, time the implementation of their tobacco-free policies to coincide with the annual event, which can provide further motivation for people to quit.

There are several Alaska activities scheduled in the weeks leading up to the anniversary, said Dana Diehl, program manager of ANTHC's Tobacco Prevention Program.

"We're collecting stores from people that have quit in the past, or that have never used tobacco, and highlighting them in a series of ads around campus and on Facebook," she said. "There will be educational tables weekly at [ANMC] to share information about quitting, to increase communication with patients about the resources we have to help them quit tobacco."

Those resources include two tobacco treatment specialists who provide care coordination with treatment specialists in a patient's village, Diehl said. If the village doesn't have a treatment program, ANTHC's specialists provide follow-up care and support for 52 weeks to increase the patient's chances of successfully quitting smoking. There is also a tobacco information line (907-729-4343) that provides information on additional resources available to help with smoking cessation efforts.

Alaska's  tobacco quit line (1-800-784-8669, alaskaquitline.com) is one of those additional resources, Muse said. Use of the quit line is free, and those who enroll will receive a packet of materials to help them in their quit attempt, including counseling online or on the phone and nicotine replacement aides like the patch, gum or lozenges.

"We know that the chances of quitting and staying quit are more effective when you utilize coaching, counseling and pharmacotherapy," Muse said.

ANTHC will also be handing out vouchers for free cold turkey sandwiches (redeemable at the ANMC cafeteria) for anyone who turns in a pack of cigarettes or can of chew on November 17, Diehl added. Yup'ik dancers and remarks from campus leadership on the impact and benefits of the tobacco-free policy will cap off the celebration at the ANMC Anchorage Native Primary Care Center lobby.

The long-range benefits

Data for Alaska shows a decline in the number of adult smokers. In 1996, 28 percent reported being smokers and that figure fell to 20 percent in 2014, which means roughly 38,700 fewer adult smokers, Muse said. She added that 71 percent of Alaskans who smoke want to quit.

Implementation of tobacco-free policies can help be the push that gets them to kick the habit.

"There's all kinds of evidence indicating that when you change the environment to make it harder for people to smoke, it makes them more likely to quit," Diehl said. "There's proven reductions in secondhand smoke exposure, and it typically will increase the number of people who make a quit attempt and then successfully quit."

While there are no hard numbers, Diehl said ANTHC noticed an uptick in calls to its tobacco information line following implementation of the policy.

Even those who aren't motivated to quit, or who never took up smoking in the first place, still benefit from tobacco-free policies, Holman added. In addition to reduced exposure to second- and third-hand smoke, the inability to light up at work means fewer cigarettes smoked overall. And patients recovering from surgery or other injuries heal much more quickly when they're not using tobacco, she said.

And the benefits of the tobacco-free policy reached beyond the medical campus.

"There was a domino effect of other health organizations across the state that were going tobacco free as well, so we weren't going it alone," Holman said.

But perhaps the policy's biggest benefit, Holman said, is the creation of an environment that supports employees and patients who want to stop using tobacco products, whether that's today or some day in the future.

"I'm really proud to work for a place that has been so supportive, and not punitive, of the [quitting] process," Holman said.

*Corrected to accurately reflect the relationship between ANTHC and ANMC.

This article was produced by the special content department of Alaska Dispatch News in collaboration with ANTHC. Contact the editor, Jamie Gonzales, at jgonzales@alaskadispatch.com. The ADN newsroom was not involved in its production.