Knowledge exchange webinars

Canada and British Columbia have had tremendous success in reducing tobacco use. Yet despite this, more than 6000 British Columbians die each year from tobacco-related causes. New strategies are required to address this major, preventable cause of illness and death.

A report prepared for the Clean Air Coalition of BC by Garry Curtis, PhD Consulting calls for the Provincial Government to adopt a strategy to reduce the points of sale of tobacco products. The keystone recommendation is to establish a Provincial Target level for the number of points of sale well below the current 6000. In addition, it is recommended that a freeze on the current number be adopted along with a Strategy to reach the reduced Target Level. The Strategy is to include a series of steps that fall into four broad categories: Prohibitions on the Sale of Tobacco Products; Restrictions on the Sale of Tobacco Products; Enforcement; and Administration and Implementation. The Clean Air Coalition is seeking input and advice on the Report’s recommendations and on ways to implement them. Please see below to view report.

Speaker

Garry Curtis, Ph.D. Consulting: Garry has over 25 years of experience with provincial governments at the Assistant Deputy Minister equivalent, Executive Director and Director levels in program and project management and administration; health and social policy analysis, planning and development; including 7 years of leadership in intergovernmental relations. Since 2007, Garry has worked as an independent consultant for the Government of British Columbia, the Government of Canada, the Provincial/Territorial Deputy Ministers of Health, the Federal/Provincial/Territorial Deputy Ministers of Health, the Canadian Institute for Health Information, the Clean Air Coalition of British Columbia and the Heart and Stroke Foundation. The range of topic/issue areas addressed includes: Canada’s Public Health Network, federal/provincial health funding negotiations, electronic medical records, international education, prosthetic and orthotic benefits, health promotion, childhood obesity, and tobacco control.  email: garrycurtis@shaw.ca

Thanks to American lawsuits, millions of previously-secret tobacco industry documents are now freely available on the internet, including for non-American global cigarette makers like British American Tobacco and Gallaher.

Stan Glantz once called the tobacco industry documents the human genome equivalent for corporations, because they help us deconstruct and understand how the world’s most embattled corporations think and act, and anticipate actions they are likely to take in the future. We’ll take a look at how to access the documents, some of the interesting information they reveal, and resources for finding research and analysis already done on industry documents.

Speaker

Anne Landman:  From 1999-2006, Anne worked as a tobacco document research specialist, and published several studies on tobacco industry behavior in medical journals. She has testified against the tobacco industry, and served as a national and international speaker on corporate PR strategies and tactics. After observing similarities between the way the tobacco industry operates and the PR strategies and behaviors other big industries are now adopting, since 2006 Anne’s interests gave expanded to corporate, government and political PR strategies, including tactics like greenwashing, pinkwashing, healthwashing, greedwashing, use of front groups and so-called “corporate social responsibility.” From 2006 until 2012 she worked for the Center for Media and Democracy, publisher of PRWatch.org and SourceWatch.org. While there, she started SourceWatch’s Tobacco portal and served as Managing Editor of PRWatch and SourceWatch. In addition to corporate behavior, Anne also is interested in local, state and national political shenanigans, consumer scams, and more. This blog contains news and views that Anne finds of interest, as well as her own original writing and observations.

David Sweanor, B.A., J.D.
Adjunct Professor, Faculty of Law, University of Ottawa
Special Lecturer, Division of Epidemiology and Public Health, University of Nottingham

David received an undergraduate degree from the University of Western Ontario in 1978, his law degree from the University of Toronto in 1981, and was called to the bar of the Law Society of Upper Canada in 1983. Since that time he has worked in public health efforts, specializing in tobacco issues and focusing on how legal measures can greatly impact upon population health. As part of that work, and to raise a family and pursue his interest in outdoor activities, he moved to Ottawa in 1989.

He has played a key role in Canadian efforts on, among other things, tobacco taxation, advertising restrictions, package labelling, environmental tobacco smoke, smoking cessation, litigation and product regulation. During the time of his active involvement in successfully advocating for public policy changes in Canada per capita cigarette consumption in the country declined by roughly 60%, much of which can be directly tied to policy interventions. The Non-Smokers’ Rights Association where he did most of his Canadian work in his capacity as counsel, received significant international recognition for many ground-breaking public health advances.

David has also been active on a similar range of global issues, working with bodies such as the International Union Against Cancer, World Health Organization, World Bank, Pan American Health Organization and numerous governments, foundations, law firms, companies making smoking cessation products and national non-governmental organizations.

In pursuing his primary interest in the interaction of law and economics as a determinant of public health, he has spent much time in recent years on tax policy, contraband tobacco, litigation strategies, the provision of tobacco dependence treatment products and the changing landscape of harm reduction products. Anticipated future death rates from cigarette smoking can be reduced through prevention of onset, protection of non-smokers from environmental tobacco smoke, cessation of smoking and substitution of less toxic alternative products for those who are not ready, willing and able to quit. As those last two areas of interventions are currently the most controversial (but likely also the most effective) ones currently available to counter smoking’s toll, they are now David’s favourite topics. This involves efforts to apply rational public policies that recognize that there is much more that can be done to facilitate smoking cessation. It also involves recognizing that there are a vast range of risks associated with nicotine intake depending upon the delivery system, that many alternative nicotine products have comparatively minor risks, and that harm reduction principles have enormous potential to transform the epidemic of tobacco-caused death and disease.

He has been widely published in peer-reviewed scientific journals as well as having authored work for major national and international health and social service organizations. He has spoken at conferences in numerous cities around the world, and has been a frequent guest on major media in Canada and other countries. He has testified before parliamentary committees in Canada and elsewhere and before both Senate and House committees in the United States. He has received various awards for his work, including a ‘Public Health Hero’ lifetime achievement award from the Pan-American Health Organization.

email: dsweanor@uottawa.ca

Evidence linking smoking and second-hand smoke (SHS) exposure with premenopausal breast cancer (BC) reinforces the need to prevent young women’s exposure to tobacco. The purpose of this study was to develop and evaluate the effectiveness of tailored, gender-sensitive web-based messages in raising awareness about tobacco exposure as a modifiable risk factor for BC in four target groups: Aboriginal girls, non-Aboriginal girls, Aboriginal boys, and non-Aboriginal boys.

Message development was informed by focus group findings, recognized gender norms, and the literature. The messages were evaluated in a sample of youth (n=1499; 56% female; 11% Aboriginal) participating in a longitudinal, web-based cohort study in British Columbia. The youth, stratified by gender and Aboriginal status, were randomized either to the intervention (tailored message regarding BC and smoking) or control group (standard message about smoking and cancer). In this presentation we will share results of the message development and evaluation phases of this study and outline our planned use of the internet in the knowledge translation and exchange activities derived from this project.

Speakers

Dr. Joan L. Bottorff, University of British Columbia Okanagan, School of Nursing:  Dr. Bottorff is a Professor at the School of Nursing, University of British Columbia’s Okanagan campus, and Co-Principal Investigator for the START (Supporting Tailored Approaches to Reducing Tobacco) Research project with Dr. Chris G. Richardson. She is also Director of the Institute for Healthy Living and Chronic Disease Prevention at UBC’s Okanagan campus. Her research on health promotion and cancer prevention is primarily focused on gender influences, particularly in the context of tobacco control.

Dr. Chris G. Richardson, University of British Columbia, School of Population and Public Health:  Dr. Richardson is an Associate Professor in the School of Population and Public Health at the University of British Columbia and Co-Principal Investigator for the START (Supporting Tailored Approaches to Reducing Tobacco) Research project with Dr. Joan Bottorff. His research is focused on investigating the bio-psycho-social mechanisms associated with the initiation and escalation of substance use in adolescents.

In the past three years, electronic cigarettes or ‘e-cigarettes’ have gone from an illegal curiosity only available over the internet or ‘under the counter’ to a much-talked-about sensation, openly available at a myriad of retail outlets across Canada. While shedding light on the legality of e-cigarettes, this presentation will provide participants with timely and accurate information to enable informed discussion on whether e-cigarettes represent a breakthrough for those wanting to quit smoking or a significant threat to tobacco control.

Speaker

Melodie Tilson, Non-Smokers’ Rights Association:  Melodie has been working in tobacco control for the past 22 years: as Director of Public Issues with the Heart and Stroke Foundation of Canada, as an independent consultant, and for the past four years as Director of Policy with the Non-Smokers’ Rights Association. Melodie’s responsibilities at the NSRA include monitoring, analyzing, and providing strategic responses to current and emerging issues. Melodie has developed and facilitated workshops on a wide variety of topics and has authored in-depth policy analyses on issues ranging from youth access laws to tobacco display bans to plain packaging and most recently retail reform and electronic cigarettes. Melodie has been a plenary speaker at provincial, national, and international conferences and in 2006 received The Heather Crowe Award for community leadership in promoting a Smoke-Free Ontario.
email: mtilson@nsra-adnf.ca

On September 1, 2010, the Vancouver Board of Parks and Recreation introduced a smoke-free bylaw for the parks and beaches in the city. Smoke-free bylaws in outdoor public spaces such as parks and beaches are becoming increasingly common; at last count, 67 jurisdictions in Canada had some sort of bylaw in place. The primary goals of such policies are the reduction of second-hand smoke exposure, smoke-free role-modeling for children and young adults, and reduction of potential environmental hazards such as fire and litter. The Smoking on the Margins project is a Canadian Institutes of Health Research-funded study housed at the British Columbia Centre of Excellence for Women’s Health that is examining the health and health equity impacts of Vancouver’s smoke-free beach and park policy.

We employed a mixed-methods approach to understand the policy in context through several sub-projects: a) parks and beaches observational study b) population survey c) focus groups with Park Rangers d) key informant interviews e) content analysis of print and electronic media f) beach litter study, and g) by-law citations analysis. While outdoor smoke-free bylaws are an important, emerging tool for tobacco control, it is important to consider their health and health equity impacts to ensure that such policies, while achieving their intended goals, do not produce health inequities within their targeted populations.

This presentation will provide an overview of the results obtained thus far by the Smoking on the Margins team. The results of this study will assist in enhancing other outdoor smoke-free bylaws by providing directions and considerations to help make similar policies more equitable.

Speakers

Dr. Chizimuzo T.C. Okoli, University of Kentucky, College of Nursing:  Dr. Okoli is an Assistant Professor in the University of Kentucky College of Nursing in Lexington, Kentucky, and directs the Tobacco Treatment and Prevention Division of the Tobacco Policy Research Program. He has been involved in several studies addressing second-hand tobacco smoke exposure policy in indoor and outdoor public spaces. More recently, he has conducted several studies examining second-hand smoke exposure and tobacco use among marginalized populations, often individuals with substance use disorders and/or psychiatric disorders. email: ctokol1@uky.edu

Ann Pederson, British Columbia Centre of Excellence for Women’s Health: Ann Pederson is Director of Management and Policy at the BC Centre of Excellence for Women’s Health and is involved in both research and knowledge translation on health care reform and health promotion for women. She has co-edited three books on Health Promotion in Canada and created numerous guides, curricula and training packages on gender-inclusive health planning and sex, gender and diversity-based analysis in the health field. She also supports BC Women’s Hospital & Health Centre in its population and public health activities.
email: apederson@cw.bc.ca

In collaboration with the Heart and Stroke Foundation and the BC Lung Association, the Vancouver Island Health Authority geographically mapped retail outlets on Vancouver Island and plotted them in relation to schools with grades 9 through 12 students. GIS is an effective tool to provide pictorial evidence on the locations and density of tobacco retailers. The presentation will identify the benefits of implementing GIS mapping related to retail density and working in a collaborative relationship with stakeholders. This work leads us to ask what can and should be done to address retail density near schools. Some recommendations are provided respecting the roles/actions that can be taken by: groups and individuals; Health Authorities; schools, school boards, parents, teachers and students; and the Government of British Columbia.

Speakers

Kim Bruce, Vancouver Island Health Authority:  Kim is the Regional Manager for the Tobacco Prevention and Control and Community Care Facilities Licensing Programs at the Vancouver Island Health Authority (VIHA). When Kim started in the Tobacco position at VIHA, she was able to transfer her learning from Licensing by implementing the GIS mapping of tobacco retailers. email: kim.bruce@viha.ca

Garry Curtis, Ph.D. Consulting:  Garry has over 25 years of experience with provincial governments at the Assistant Deputy Minister equivalent, Executive Director and Director levels in program and project management and administration; health and social policy analysis, planning and development; including 7 years of leadership in intergovernmental relations. Since 2007, Garry has worked as an independent consultant for the Government of British Columbia, the Government of Canada, the Provincial/Territorial Deputy Ministers of Health, the Federal/Provincial/Territorial Deputy Ministers of Health, the Canadian Institute for Health Information, and the Clean Air Coalition of B.C. The range of topic/issue areas addressed includes: Canada’s Public Health Network, federal/provincial health funding negotiations, electronic medical records, international education, prosthetic and orthotic benefits, health promotion, and tobacco control. email: garrycurtis@shaw.ca

Dr. Joy Johnson, University of British Columbia School of Nursing:

Joy Johnson is a Professor in the School of Nursing at the University of British Columbia (UBC) with long standing interest and leadership in the field of gender and health. She served on the inaugural steering committee for the BC Centre of Excellence for Women’s Health and was a co-leader on the BC Network for Women’s Health Research. Dr. Johnson founded and co-directed the highly successful multidisciplinary research unit NEXUS, dedicated to research, knowledge translation, and training in the social contexts of health behaviour. She was also a founder and principal investigator for the UBC Centre for Nursing and Health Behaviour Research. She served as the Chair of the Research Advisory Committee of Michael Smith Foundation for Health Research. She has served on and chaired research review panels for the Canadian Institutes of Health Research and the National Cancer Institute of Canada.

Dr. Johnson has a highly productive program of research focusing on health promotion and health behaviour change. Drawing on a broad array of theoretical perspectives her work explores the social, structural and individual factors that influence the health behaviour of individuals. A major thrust of her work focuses on sex and gender issues in substance use and mental health. She has obtained millions of dollars in research funding from national funding organizations and has published over 140 papers in peer-reviewed journals. Dr. Johnson’s work has been recognized with numerous awards including the UBC Killam Research Prize. In 2010, she was recognized as one of British Columbia’s 100 Women of Influence.

Dr. Johnson was appointed Scientific Director of the CIHR Institute of Gender and Health commencing January 2008. In this role she works with the Canadian gender, sex and health research community and stakeholders to identify research priorities, develop research funding opportunities, strengthen research capacity, build partnerships and translate research evidence to improve the health of Canadians.

email: joyjohnson@exchange.ubc.ca

This presentation will explore cannabis from a public health perspective, beginning with a brief history of medical and cultural uses of the plant and how it has become a modern public policy issue. It will review the possible health risks, harms and benefits of cannabis use, and how these can help inform health promotion and harm reduction interventions. The epidemiology of cannabis dependence will inform discussion on treatment for those individuals who may self-identify as wanting to reduce or stop their cannabis use (and how to engage those who may not). Finally, it will conclude with some discussion of how public resources can best be mobilized and used to address cannabis use in Canada, drawing on lessons learned from the success of tobacco reduction and control.

Speakers

Kenneth Tupper, BC Ministry of Health:  Kenneth Tupper is Director, Problematic Substance Use Prevention in the Population and Public Health Division of the British Columbia Ministry of Health, a position he has held since 2003. In this role, Kenneth assists in the development, implementation and monitoring of provincial health policy to respond to non-medical psychoactive substance use and associated harms, including most recently Healthy Minds, Healthy People: A Ten-Year Plan to Address Mental Health and Substance Use in British Columbia. In May 2011, Kenneth completed a Ph.D. in Educational Studies from the University of British Columbia, where his research interests focused on the cross-cultural and historical uses of psychoactive substances; public, professional and school-based drug education; and creating healthy public policy to maximize benefits and minimize harms from currently illegal drugs.
 email: kenneth dot tupper (a) gov dot bc dot ca

Dan Reist, Centre for Addictions Research of BC, University of Victoria:  Dan Reist has provided leadership to the knowledge exchange team at the Centre for Addictions Research of BC, University of Victoria since it was created in 2004. He is committed to communicating current evidence in a way that supports the evolution of effective policy and practice, has contributed to policy dialogues in British Columbia related to substance use and addictive behaviours, and has represented BC in several national and international discussions. Dan is actively involved in helping schools, communities and families effectively address substance use from a health promotion perspective. His team is actively developing tools and supporting implementation.  email: dreist@uvic.ca

Smoking is common among persons living with HIV (PLWH) with estimates suggesting prevalence as high as 70%. This alarming data requires further exploration in an effort to explicate the reasons for such high rates among persons who have a high propensity for deleterious health outcomes. There is evidence that historically, there was recognition of the deleterious effects of HIV and smoking.

Furthermore, PLWH and health care providers (HCP) may have believed that because smoking was not the most important priority if someone was going to die anyway. This thinking remains among some PLWH and may exist among HCP as well. This is problematic however, because of the medical advances that transitioned HIV from a terminal illness to a manageable chronic illness for persons who have access to ART and adequate health care.

Antiretroviral therapy (ART) and the widespread use of multiple drug regimens have yielded significant health benefits for many PLWH, but those who smoke have increased risk for cardiovascular, neoplastic, pulmonary, infectious and other complications. ART non-adherence and other health risk behaviours including alcohol and illegal drug use have been observed among PLWH who smoke. Knowledge gaps exist about smoking patterns and practices among PLWH.

Further, what might constitute effective targeted strategies for tobacco cessation (TC) among diverse sub-populations of PLWH are poorly understood. In British Columbia (BC), as in other settings, PLWH are a diverse group with complex health issues (e.g., poly-substance use, psychological distress, and mental and physical co-morbidities) that are often intertwined with HIV specific challenges. Pathways to health care services for PLWH who smoke are also poorly understood, and consensus prevails among PLWH and HCPs that TR effort should be thoughtfully constructed to engage both patients and service providers.

The purpose of this presentation is to describe evidence obtained from a sequential three part environmental scan to better understand the connections between smoking and PLWH as a key step to identifying, and evaluating the feasibility of accessing and supporting the TC efforts of specific sub-populations of PLWH who smoke. Quantitative findings among Vancouver’s PLWH community that were collected as part of an international HIV/AIDS nursing research collaborative will be discussed. Qualitative interview findings with PLWH and HCP conducted in Vancouver and Kelowna provide evidence of the importance each constituent group places on addressing the issue of TC among PLWH. Recommendations for future research and strategies for the development of tailored TC interventions for PLWH will be provided.

Speaker

Dr. J. Craig Phillips, PhD, LLM, RN, ARNP (US), PMHCNS-BC, ACRN, School of Nursing, University of British Columbia: Dr. Phillips is a Tenure-Track Assistant Professor of Nursing at the University of British Columbia (UBC). He has a Master of Laws (LLM) in Intercultural Human Rights Law with a concentration in health as a human right. He was the first PhD in Nursing graduate from Florida International University, Miami, Florida. He has extensive research and clinical experience over the last 15 years in community settings in Florida, Botswana, and British Columbia, Canada. His dissertation research was funded by a prestigious American Nurses Foundation predoctoral research award to study social factors influencing ART adherence among Black men living with HIV who use illicit drugs. He has experience as a research nurse and co-investigator on two U. S. National Institutes on Drug Abuse funded clinical trials. He is the Vancouver, Canada PI for an international nursing research collaborative study to explore the effects of self-compassion, self-efficacy, and self-esteem on managing HIV and adherence. He was the Nominated Principle Investigator of a CIHR funded community collaborative environmental scan of HIV+ smokers in British Columbia and a gender based tobacco reduction interventions (iTAG) team investigator. His research program, titled the ecosocial environment of health as a human right, combines his nursing and legal training and uses social epidemiological methods to build on ecosocial theory.

He is actively engaged in advocacy and service activities internationally. He co-chaired the task force that developed and is currently revising the HIV Nursing: Scope and Standards of Practice. He is a Director-at-Large with the Association of Nurses in AIDS Care and received the 2010 Journal of the Association of Nurses in AIDS Care Editor’s Award for his contributions to the journal as a guest editor, reviewer and contributor.

email: craig.phillips@nursing.ubc.ca