Clearing the air, one city at a time

Public health workers Kristin McGuire, left, and Amber Tsujioka helped bring a new smoking ban to Compton.

Twenty-four years ago, when health advocates in Compton tried to restrict smoking, two City Council members defiantly lit cigarettes on the dais, then killed the plan before it could come to a vote.

We’ve come a long way, baby.

Last week, Compton passed a landmark ordinance to curb secondhand smoke in outdoor dining areas, parks, apartments and condos. Meanwhile, Hermosa Beach effectively outlawed outdoor smoking in virtually every part of the city where people gather.

On the other side of the 710 Freeway, the Downey City Council instructed staff to start drafting a law to restrict smoking in parks and other public places. This week, a tough, new, smoke-free housing measure was enacted in Baldwin Park.

The flurry of grassroots legislation—with more in the pipeline—isn’t accidental. For the past year and a half, the Los Angeles County Department of Public Health has been successfully leveraging a two-year, $16 million federal grant aimed at reducing smoking and exposure to secondhand smoke.

The initiative, known as Project TRUST and managed by the department’s Tobacco Control & Prevention Program, has been so successful that its efforts already have been extended under a new and broader Community Transformation Grant, underwritten by federal health care reform funding.

Although the Department of Public Health has long done educational campaigns to help communities discourage smoking, the federal money “has let us accelerate that work, and move into more challenging policy areas,” says Dr. Paul Simon, who heads the department’s Division of Chronic Disease and Injury Prevention. “We’re now getting into 10 or 15 cities a year.”

By law, the public health department cannot lobby, but it can educate the public, thus setting the stage for a community’s own advocacy. Under the grant, the county was able to hire six “community mobilization teams” and subcontract with nine community-based organizations to provide technical and educational support for local efforts to restrict smoking.

As the teams have fanned out in the past 18 months to do local polling, hand out literature and speak to community groups about tobacco, community activism has followed. Since the Project TRUST initiative hit the ground, local smoking ordinances have been revisited or broadened in Manhattan Beach, West Hollywood, Burbank, Los Angeles, South Pasadena, Santa Monica, Huntington Park, Torrance and Inglewood, as well as the aforementioned communities. Still other cities are in various stages of readying smoking ordinances for passage.

Particularly successful have been city-level efforts to cordon off no-smoking areas in apartment and condominium buildings, where secondhand smoke chronically plagues children and nonsmokers, particularly those with asthma. A recent policy brief from the UCLA Center for Health Policy Research found that nearly 1 million children in California are exposed to secondhand smoke every year.

Mandating smoke-free housing in apartment houses can be life-altering for families in rental units, but it has historically been a tough sell in lower-income areas, where smokers—who represent about 13% of California’s population—have tended to resist the notion that shared ventilation should keep them from lighting up in their own apartments.

A new state law that goes into effect Jan. 1 gives landlords the authority to ban smoking in rental units, but doesn’t mandate smoke-free apartments and condos. With the Compton and Baldwin Park votes last week, the county now has more than a half-dozen cities with smoke-free apartment ordinances, including Calabasas, which in 2006 pioneered the local movement.

And on November 16, Project TRUST will host a major policy forum on smoke-free apartments and condos in conjunction with the American Academy of Pediatrics and Children’s Hospital Los Angeles—a response to the growing number of local governments that are moving in that direction, says Project TRUST Director Robert Berger.

“It’s big,” says Berger. “We’ve reached a major tipping point in smoke-free housing here.”

Public health campaigns at all levels have for many years raised awareness of the dangers of tobacco, and state and federal restrictions have made dramatic inroads in the fight against tobacco-related illness. California was the first state to ban smoking in indoor workplaces in 1995.

But smoking still accounts for as many as 443,000 deaths a year nationally, including as many as 49,000 from exposure to secondhand smoke alone.  According to the Centers for Disease Control & Prevention, more deaths are caused each year by tobacco use than by all deaths from HIV, illegal drug use, alcohol use, motor vehicle injuries, suicides and murders combined.

While overall smoking rates have been trending downward, higher smoking rates persist in a number of vulnerable sub-populations, including African American, Latino and Asian men, people with low income and education, the homeless, substance abusers and people living with mental illness.

In some policy efforts, such as the one that led to smoke-free housing in Pasadena, the county has played more of a supportive than lead role. In others, Project TRUST has collaborated with subcontractors such as the National Council of Alcohol and Drug Dependence South Bay or Smoke-free Air for Everyone (SAFE).

In most instances, the County’s technical and educational assistance has been welcome, but in a few, it has been met with confusion. When a City Council discussion of a ban in Downey drew a standing-room audience and a blizzard of letters, for instance, one councilman accused another of manufacturing “a sexy political issue for your campaign next year for the assembly.” Another was quoted in the local press as saying he had “never received a letter or comment on this until the last three weeks.”

Much more common, however, have been experiences like the one that will now set aside smoke-free apartments and condos in Compton, where the county’s mobilization team—a pair of young Public Health contract employees named Kristin McGuire and Amber Tsujioka—did most of the groundwork, beginning with a survey last year to assess the community’s level of concern about smoking.

As the pair became ubiquitous at PTA meetings, churches, community groups, senior centers and health fairs, the community began to coalesce in favor of smoke-free housing. Letters began to arrive at City Hall. High school kids began to show up around town in “Smoke-free Compton” t-shirts.

“A lot of the community members were unfamiliar with the impact of secondhand smoke,” says McGuire. “And when they would ask about possible solutions, we’d tell them how other communities were able to educate each other and form coalitions.”

It didn’t hurt that Compton City Councilwoman Yvonne Arceneaux had a longstanding interest in the dangers of smoking.

“I had led a movement a number of years ago to ban alcohol and tobacco billboards in the city of Compton,” says Arceneaux, “and I had had a bad experience with my daughter in an apartment situation. She’s a non-smoker with two small children and she had lived in Texas in an apartment below two smokers.

“It was coming through the vents, and for the first time in their lives, they were experiencing problems with asthma. It was horrible.”

Within six months of the county’s involvement, Arceneaux says, an ordinance was drafted, with technical help from the county.

McGuire, the Project TRUST mobilization team member, says her work in Compton has been “very rewarding” and hopes she’ll be able to continue working with the city as it implements its new ordinance.

Arceneaux, meanwhile, says the mood in Compton couldn’t be more different from that meeting in 1987. The measure passed easily, to the cheers of an audience full of teenaged Smoke-free Compton supporters. And so far, she added, no one’s complaining.

“I think this time the community was ready for it,” she says.

Posted 11/3/11