THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT CALLS FOR SMOKE-FREE PUBLIC HOUSING

Proposed rule aims to reduce public housing residents' exposure to second-hand smoke, as well as reduce smoke-related maintenance costs and fire risk

New York, NY – Research conducted by the Centers for Disease Control and Prevention (CDC) demonstrates that secondhand smoke is an extremely prevalent problem in multi-unit housing. According to their July 2016 press release, tobacco smoke often travels from smokers’ units into those of non-smokers, as well as common areas such as hallways and lobbies. This puts all residents, especially children, at risk of exposure. According to U.S. Surgeon General Vivek H. Murthy, there is no safe level of exposure to tobacco smoke, and second-hand exposure to children can have devastating consequences, ranging from asthma to Sudden Infant Death Syndrome.

 In an effort to address this issue, approximately 600 of the nation’s 3,300 public housing authorities (PHAs) have made at least one of their buildings smoke-free. While this is a solid foundation to build upon for a completely smoke-free public housing environment, much of the country’s public housing remains largely unregulated. 

 On November 30th, 2016, Secretary Julián Castro of the U.S. Department of Housing and Urban Development (HUD) announced that a new rule had been implemented requiring all PHAs to now provide smoke-free environments for their residents within the following 18 months. Throughout the year, HUD has worked with PHAs, housing and health partners, and tenant advocates to create a final rule which prohibits combustible tobacco products such as cigarettes, cigars, or pipes in all public housing properties, as well as all outdoor areas within 25 feet of housing and administrative office buildings. This rule was created based out of the need to provide safe, smoke-free homes for children living in public housing units. Out of 2 million residents living in public housing, there are more than 760,000 children under the age of 18.

HUD’s smoke-free rule is not only expected to dramatically reduce second-hand smoke exposure, but decrease smoke-related maintenance and repair costs for PHAs as well. According to the Centers for Disease Control and Prevention (CDC), this rule will save agencies up to $153 million every year, including $94 million in health care costs, $43 million in renovation of smoking-permitted units, and $16 million in smoke-related fire reparations. 

“Exposure to secondhand smoke can mean the difference between a healthy childhood, and one spent taking recurrent trips to an emergency room to receive treatment for smoke-related health issues.” said Dawn Middleton, Project Director of the COE for HSI. “HUD’s new rule for smoke-free public housing would ensure that future generations can live healthier lives, free from the devastating consequences of secondhand smoke.”

For more information about the work of the COE for HSI, visit www.tobaccofreeny.org

About CAI: CAI is a global nonprofit organization dedicated to improving the health and well-being of underserved populations worldwide. Since 1979, CAI has provided customized capacity building services to health and human service organizations in more than 27 countries and in all 50 states. Offering more than 1,500 training programs annually, CAI’s passionate staff works to fulfill its mission: to use the transformative power of education and research to foster a more aware, healthy, compassionate and equitable world. For more information about CAI, visit our website: www.caiglobal.org.

About the Center of Excellence for Health Systems Improvement: With funding from the New York State Department of Health, Bureau of Tobacco Control, CAI serves as the Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free New York. The COE for HSI promotes large-scale systems and policy changes to support the universal provision of evidence-based tobacco dependence treatment services. The COE for HSI aims to support 10 regional contractors throughout New York State working with health care systems and organizations that serve those populations for which tobacco use prevalence rates have not decreased in recent years - adults with low incomes, less than a high school diploma, and/or serious mental illness. Focused on providing capacity-building assistance services around topics like how to engage and obtain buy-in from leadership to implement the kinds of systems-level changes that will result in identification and intervention with every tobacco user who seeks care, the COE for HSI also will offer materials and resources to support contractors in their regional work. For more information, visit www.tobaccofreeny.org.

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THE TOBACCO 21 LEGISLATION IS PROJECTED TO REDUCE SMOKING-RELATED DISEASES AND HEALTH CARE COSTS

Preventing early access to tobacco could reduce initiation and addiction to nicotine, subsequently saving billions in tobacco-related costs

New York, NY – The vast majority of adult tobacco users reportedly started for the first time in their early adolescent years. Throughout adolescence, brain development is an enduring process, making these youth particularly susceptible to the effects of nicotine. There is little doubt that peer pressure among fellow teens plays a large part in early exposure to tobacco. However, an equally large part is due to the shocking ease of access for young, vulnerable teens to obtain tobacco products.

According to a research study led by Dr. Joseph DiFranza, MD, of the Department of Family Medicine and Community Health at the University of Massachusetts, 89% of youths within 10 Massachusetts communities buy their cigarettes from a store. Tobacco 21 is a legislation that aims to combat these trends, and reduce the risk of teens and young adults developing an addiction to tobacco by raising the minimum legal age of sale (MLA) to 21. As reported by the United States Institute of Medicine (IOM), raising the MLA from 18 to 21 years would lead to a projected decrease in initiation among adolescent youth, resulting in lowered tobacco-related morbidity and mortality rates. Not only does the Tobacco 21 legislation prevent individuals ages 18-20 from purchasing tobacco products, but it may potentially reduce cigarette exposure to those under age 18 as well. According to a number of paper surveys and focus group discussions conducted by Dr. DiFranza, teenagers between ages 18 and 20 act as a major gateway to tobacco products for youth in their early to mid-teens. Therefore, fortifying the barrier to entry for obtaining cigarettes will effectively restrict access for younger groups indirectly.

Every year, the costs for tobacco-related health care in the United States approximate to an alarming $170 billion, with further economic losses due to smoke-related lost productivity in the form of smoking breaks and cigarette-related sick leaves approximating to more than $156 billion. For New Yorkers, these deficits amount to $10.4 billion and $6 billion respectively. With Tobacco 21 having a profound impact on the massive demographic of both the 18-20 age bracket, as well as individuals below the age of 18, the IOM expects this regulation to reduce smoking rate by 12 percent, and reduce smoking-related deaths by 10 percent. These changes are critical to addressing the losses to the American economy caused solely by tobacco-related health issues.

“Increasing the legal age to purchase tobacco from 18 to 21 years would be an important step to reducing the effects of tobacco use on the health care system.” said Marcy Hager, Director of the COE for HSI. “This would ensure that another generation does not have to suffer the high consequences of tobacco use on their generation’s overall health”


For more information about the work of the COE for HSI, visit www.tobaccofreeny.org

About CAI: CAI is a global nonprofit organization dedicated to improving the health and well-being of underserved populations worldwide. Since 1979, CAI has provided customized capacity building services to health and human service organizations in more than 27 countries and in all 50 states. Offering more than 1,500 training programs annually, CAI’s passionate staff works to fulfill its mission: to use the transformative power of education and research to foster a more aware, healthy, compassionate and equitable world. For more information about CAI, visit our website: www.caiglobal.org.

About the Center of Excellence for Health Systems Improvement: With funding from the New York State Department of Health, Bureau of Tobacco Control, CAI serves as the Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free New York. The COE for HSI promotes large-scale systems and policy changes to support the universal provision of evidence-based tobacco dependence treatment services. The COE for HSI aims to support 10 regional contractors throughout New York State working with health care systems and organizations that serve those populations for which tobacco use prevalence rates have not decreased in recent years - adults with low incomes, less than a high school diploma, and/or serious mental illness. Focused on providing capacity-building assistance services around topics like how to engage and obtain buy-in from leadership to implement the kinds of systems-level changes that will result in identification and intervention with every tobacco user who seeks care, the COE for HSI also will offer materials and resources to support contractors in their regional work. For more information, visit www.tobaccofreeny.org.

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HOPE Buffalo Initiative Launched

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Goal to Reduce Teen Pregnancy Rates by 30% by 2020

ERIE COUNTY, NY— At a kickoff event today, the HOPE Buffalo initiative was announced to the community and media. This collaborative project, involving a diverse coalition of Erie County stakeholders, has a primary goal to reduce the rate of teen pregnancy in select Erie County zip codes (14201, 14204, 14206, 14207, 14208, 14209, 142011, 14213, and 14215) by 30% by the year 2020.

In the target zip code areas, the average teen birth rate in 2012 was 61.3 per 1,000 females between the ages of 15 and 19. This is more than 3 times greater than New York State’s (excluding New York City) average of 18.5 per 1,000 and the 2013 national teen birth rate of 26.5 per 1,000 females.

HOPE Buffalo will:      

  • Advocate for the prevention of teen pregnancy, sexually transmitted infections and HIV/AIDS among Buffalo's youth
  • Promote equitable access to comprehensive sexuality education and reproductive health
  • Empower youth to make informed decisions about their health

The community coalition of organizations supporting HOPE Buffalo will:

  • Ensure that teens have access to both health education and healthcare providers
  • Respect teens’ right to make their own decisions and set their own goals  
  • Help teens achieve their goals

HOPE Buffalo is supported by a grant from the U.S. Department of Health and Human Services Office of Adolescent Health (“OAH”) to the Erie County Department of Health and CAI (Cicatelli Associates Inc.)

“I am tremendously excited about this new outreach effort to provide necessary information to Buffalo’s youth to help them make informed decisions so they can achieve their goals,” said Dr. Gale Burstein, Commissioner, Erie County Department of Health. “With involvement from our strong community partners and financial support from the Office of Adolescent Health, we believe we can make a measurable impact in the lives of these teens. We are working to ensure that our youth have access to health education and healthcare providers, which will improve their health and build a healthy future for our community.”

To learn more about HOPE Buffalo, please click here.

NEW TOOLKIT RELEASED TO BUILD THE CAPACITY OF HEALTHCARE ORGANIZATIONS TO TACKLE THEIR PATIENTS’ TOBACCO USE

Implementation of Evidence-Based Care in New York State

New York, NY – The Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free New York is pleased to announce the release of its new toolkit Supporting Evidence-Based Tobacco Dependence Screening & Treatment. This important resource fills a previous gap, and can be used by healthcare organizations to train their staff on evidence-based best practices for tobacco dependence treatment on an ongoing basis. The goal of the toolkit is to build the capacity of entire care teams to screen and treat tobacco dependence in order to minimize missed opportunities to treat tobacco users who visit their providers for other needs. More than 70 percent of tobacco users visit a healthcare provider each year, and each of these visits is an opportunity for providers to treat a patient’s tobacco use.1

This new toolkit features training resources that have been developed for all levels of healthcare staff, including frontline staff, prescribing clinicians, counseling staff, and staff with responsibilities for quality improvement. The toolkit includes three training curricula, including lesson plans, slide decks, handouts, and a video. Quality improvement tools have been designed to assist healthcare organizations to institutionalize systems for assuring all patients, regardless of the reason for their visit, are screened for tobacco dependence and provided with evidence-based treatment, if desired.

“Every staff member in the healthcare organization has an important role to play in treating their patients for tobacco dependence,” said Marcy Hager, Director of the COE for HSI. “The COE for HSI toolkit will ensure that staff members are continuously trained on evidence-based best practices for tobacco dependence and that staff members know their roles and responsibility within the healthcare organization to provide continuous life-saving tobacco dependence screening and treatment.”

The COE for HSI is working across New York State with regional contractors to engage health care organizations that serve populations disproportionately impacted by tobacco use, including: New Yorkers with low incomes; individuals with less than a high school education; and those who report having serious mental illness. The toolkit has been released to ten regional contractors across the New York State who work with healthcare organizations that serve these priority populations, including federally qualified health centers, community health centers, and other safety net providers.

For more information about the work of the COE for HSI, visit www.tobaccofreeny.org.


1 Fiore et al. Treating Tobacco Use and Dependence: 2008 Update. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, 2008.


About CAI: CAI is a global nonprofit organization dedicated to improving the health and well-being of underserved populations worldwide. For 36 years CAI has provided customized capacity building services to health and human service organizations in more than 27 countries and in all 50 states. Offering more than 1,500 training programs annually, CAI’s passionate staff works to fulfill its mission: to use the transformative power of education and research to foster a more aware, healthy, compassionate and equitable world. For more information about CAI, visit our website: www.caiglobal.org.

About the Center of Excellence for Health Systems Improvement: With funding from the New York State Department of Health, Bureau of Tobacco Control, CAI serves as the Center of Excellence for Health Systems Improvement (COE for HSI) for a Tobacco-Free New York. The COE for HSI promotes large-scale systems and policy changes to support the universal provision of evidence-based tobacco dependence treatment services. The COE for HSI aims to support 10 regional contractors throughout New York State working with health care systems and organizations that serve those populations for which tobacco use prevalence rates have not decreased in recent years - adults with low incomes, less than a high school diploma, and/or serious mental illness. Focused on providing capacity-building assistance services around topics like how to engage and obtain buy-in from leadership to implement the kinds of systems-level changes that will result in identification and intervention with every tobacco user who seeks care, the COE for HSI also will offer materials and resources to support contractors in their regional work. For more information, click here to visit the project website.

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"PLAN C" A VITAL OPTION FOR WOMEN WANTING TO REDUCE THE CHANCE OF UNINTENDED PREGNANCY

New Resource Promotes Increased Provision of Most Effective Method of Emergency Contraception

New York, NY – Nearly one in every two pregnancies is unintended, with 53% of unintended pregnancies due to non-use of a contraceptive method and 43% due to incorrect contraceptive use.1,2 In New York State, efforts are underway to support women and their partners to reduce the chance of pregnancy after unprotected sex by promoting the use of the copper intrauterine device (IUD) as emergency contraception (EC). In addition to being one of the most effective forms of contraception, the copper IUD is the most effective form of EC, with a failure rate of less than 0.1%.3

The New York State Center of Excellence for Family Planning and Reproductive Health Services, a project of CAI, has produced an implementation toolkit to support the successful implementation of the copper IUD as EC in health care settings—the first of its kind. The toolkit was developed for agencies that receive Title X Family Planning Program funding through the New York State Department of Health’s Comprehensive Family Planning and Reproductive Health Care Services Program, as well as other sexual and reproductive health care providers in New York State and beyond.

Traditionally, the term “EC” has referred mostly to Plan B or Ella. Both of these EC options, while effective, only protect against an unintended pregnancy one time following unprotected sex. In offering the copper IUD as EC for immediate and long-term use, family planning providers have an opportunity to support a woman who has experienced a contraceptive emergency while helping her to prevent future unintended pregnancy for up to 10-12 years.4  

“In New York State, we are extremely fortunate to have an infrastructure in place to provide those women who select the IUD with their contraceptive method of choice,” stated Elizabeth Jones, Director of the New York State Center of Excellence for Family Planning and Reproductive Health Services. “However, offering the copper IUD same-day as EC has operational implications for health care providers. This toolkit helps sexual and reproductive health providers to leverage and adapt their current systems and begin offering this innovative, evidence-based service.”

The toolkit includes background information about the copper IUD, the rationale for offering it to clients, and implementation tools for administrators, clinicians, and frontline staff. The toolkit is available to download by health care providers here.

 

For more information about the work of the New York State Center of Excellence for Family Planning and Reproductive Health Services, visit nysfamilyplanningcoe.org.


1. Finer LB, Zolna MR, Declines in unintended pregnancy in the United States, 2008-2011. New England Journal of Medicine, 2016; 374:843-52. 
2. Frost JJ, Darroch JE, Factors associated with contraceptive choice and inconsistent method use, US, 2004. Perspectives on Sexual and Reproductive Health, 2008; 40(2):94-104. 
3. Intrauterine Contraception. (2015). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm#Intrauterine-Contraception-IUD-IUS.
4. While the on-label use of the copper IUD is up to 10 years, current evidence-based, best practice supports the use of the copper IUD up to 12 years.


About CAI: CAI is a global nonprofit organization dedicated to improving the health and well-being of underserved populations worldwide. For more than 35 years CAI has provided customized capacity building services to health and human service organizations in more than 27 countries and in all 50 states. Offering more than 1,500 training programs annually, CAI’s passionate staff works to fulfill its mission: to use the transformative power of education and research to foster a more aware, healthy, compassionate and equitable world. For more information about CAI, visit our website: www.caiglobal.org

About the Center of Excellence for Family Planning and Reproductive Health Services (NYS COE): Since its establishment in 2011, the NYS COE has delivered capacity-building support to the New York State Department of Health’s (NYS DOH) Title X network of 48 sub-recipient agencies in two key areas: implementation of operational best practices to ensure sustainability in the changing health care environment; and delivery of quality family planning services through the adoption of evidence-based practices and continuous quality improvement activities. For more information about the NYS COE, visit nysfamilyplanningcoe.org

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