February 18, 2016 by Ann Haftl
Drexel University’s student led group Public Health in Action held its first ever town hall meeting Feb. 16 to broach a difficult subject — smoking on campus. The talk, titled “Tobacco-Free Campus College Initiative,” was accompanied by a knowledgeable panel of six public health leaders: former Philadelphia Health Commissioner James Buehler, Smoke Free Philly associate Ann Klassen, Arthur Frank, with a background in occupational exposures and environmental justice, University of the Sciences alumna Alicia Miller, Ryan Coffman, who is the Smoke Free Philly overseer and the Tobacco Policy and Control Program Manager at the Philadelphia Department of Public Health, and Drexel University School of Public Health alumnus Joshua Prasad, who is with the federal Department of Health of Human Services.
First year Master of Public Health candidate Vaishnavi Vaidya, who is the current Advocacy Initiative Manager for Public Health in Action, and second year MPH candidate Rosie Mae Henson were among the leaders from Philadelphia Health In Action who decided to begin a smoke-free campus initiative for Drexel. All members of PHIA are students in the Dornsife School of Public Health. Still fleshing out the ideas for what this initiative might entail, a town hall meeting to discuss the opinions of the student body and assisted by knowledgeable panelists, was a strong first step. A total of 41 students attended the meeting to hear some opening ideas about what it would be like if Drexel’s campus became smoke-free.
Henson explained that the initiative was given to her as a project to take over. Once the concept was in her hands, she decided to act through PHIA, which she helps lead. “We have the capacity to reach out to these colleagues and these students, and to bring students together to hear this voice. We don’t want this policy to just be ‘this is what we’re doing,’ we want input and feedback,” Henson explained.
The talk opened with a discussion about legal and ethical considerations. It was agreed that enforcing health policies in city-style campuses, like Drexel, is certainly a challenge. However, a reliance on the community to enforce these rules among peers is key, according to Prasad. Later in the conversation it was brought up that in some cases, public safety departments have actually been sources of push-back on campaigns like these, as all of the burden for enforcement may be seen to fall with such departments. However, the room agreed that realistically, a smoke-free campus initiative involves cooperation and reinforcement provided by the community, not just one entity. “If you see something, say something,” Miller insisted.
Some other ethical concerns brought up by the room included introducing the policy on campus, and how student smokers might react to the large change. Miller, who led the University of the Sciences campus into a smoke-free campaign, had some ideas to offer in light of these concerns. She discussed how, at its inception, the USciences campaign sent out two surveys to the students and staff of the university. The questions were aimed at finding out what opinions the University had on going smoke-free.
“What could we do to make sure that this policy is successful and that you are compliant with it?” Miller added, mentioning some of the survey questions. The survey also asked about what kinds of resources the community was looking for, and how they would best be able to comply with the new policies. Coffman took the opportunity to mention the importance of setting the right tone in the conversations which will likely follow the initiation of a smoke-free campaign.
“It’s to protect people from secondhand smoke exposure, knowing that no-smoking policies also help to reduce consumption, prevent initiation, encourage cessation, decrease litter…” Coffman delineated a list of positive aspects of a smoke-free campus. He continued, “Most smokers don’t want to be smokers, and we can use this opportunity to motivate them towards a quit attempt.”
This comment produced conversation about the responsibilities of the group producing the campaign to provide cessation and support resources to campus. The general consensus was that absolutely these responsibilities belonged to the group implementing the campaign, and was an opinion that the group shared. Coffman mentioned that some campuses which have smoke-free policies even extend those services to the surround community members.
There are other concerns about the potential impact of a smoke-free policy on the surrounding neighborhoods. A question raised in the discussion was whether Drexel’s smoke-free policies would push smokers into Powelton or Mantua. This could potentially increase the amount of litter and unwanted student traffic in those neighborhoods, which might cause animosity between Drexel’s campus and those communities.
However, Coffman suggested some easy solutions to this problem which focused on communication. He explained that on other model campuses implementing smoke-free or tobacco-free campaigns, it’s been very important to make sure that the communities are aware of what is happening, and of the changes taking place. There needs to be an open channel of discussion between the campaigning group and the communities, he explained.
The next question was whether or not this smoke-free initiative would take place on the entire Drexel campus, including the Queen Lane and Center City campuses, or just the main campus. The room seemed to agree that the best course of action would be to start small, and begin the initiative on main campus, but to eventually extend the campaign to all reaches of Drexel’s campus. Klassen was also quick to point out that the Hahnemann University Hospital’s campus is already 100 percent smoke-free and tobacco-free, and also that the current laws prohibits smoking in a radius of 20 feet around each public building. Signage on all University buildings indicates this law currently.
Frank took this discussion to a larger scope. “What do you do outside, on a public street, where somebody from 40th street is going to walk to 30th Street Station, smoking a cigarette as they walk down there?” He posed.
“What do you do about public space that is not private space owned by Drexel? It isn’t like it’s a university campus with gates; we’re here in the middle of a city,” Frank went on.
This insight caused some lengthy discussion about solutions for the integration of Drexel’s campus boundaries and public spaces. Again, Miller’s experience in implementing a smoke-free initiative on her own campus provided helpful ideas. “We created a map of our University and we highlighted areas that were clearly owned by the university and considered university campus property and we distributed them on campus,” Miller said.
“Anything outside of the borders that we drew we called a Good Neighbor zone,” she continued, explaining that in the “good neighbor zone” students were told that they should make sure they were properly disposing of cigarette litter as needed, but were also sure of the fact that they were allowed to smoke in these areas, as long as they were being courteous.
These comments were also an answer to some questions raised about the audience of where or how many cigarette disposals would remain on campus, since keeping them around could encourage smoking, but getting rid of them might encourage littering. Miller and Coffman both suggested a gradual movement of the receptacles away from the center of campus that would eventually result in a near removal of the receptacles from the campus grounds.
“It’s very hard to quit when all day long you see cues to smoking. You see cigarette debris, you see other people smoking,” Klassen said in response to concerns about cigarette disposal locations, supporting the eventual removal of those locations on campus. “Strike a balance between accessibility and visibility,” Coffman suggested.
Discussing more local and short-term fixes, Coffman suggested making signage of the current laws, specifically the 20-foot radius around buildings, more robust. “There is something to be said for circling back on existing smoke-free spaces and seeing what can be done to raise awareness and information about those spaces being smoke free as part and parcel of moving towards a smoke-free campus policy,” he commented. Similar statements were echoed by Miller, who said that this was the first step the USciences campaign took.
Another debate emerged on the use of non-traditional combustible tobacco products such as chewing tobacco and the newly emerged trend of vaping. New laws have recently been introduced that disallow the sale of vaporizers to minors, so the prohibition of vaporizers and other “e-cigs” may be an important aspect of the smoke-free campus campaign. Coffman also brought up the fact that a smoke-free initiative leaves a lot of room to change the policies as the campus adapts to the initial changes, leaving more room for later decisions on such issues as vaping.
As the discussion came to a close, all of the panelists echoed similar hopes that while the task of creating a smoke-free campus is daunting, it is definitely not impossible.
“Behavior change and changing norms in culture is a long struggle. Being an older ex-smoker, I remember smoking on airplanes, I remember smoking in bars and restaurants […] and any work you do here, you may not see the victory of it this year or before you graduate, but you’ll build something that other people will continue to build on,” Klassen shared.
“I wouldn’t be discouraged that the logistics seem a little murky right now. If you begin to work on it, it will go in the right direction,” she continued.
“Culture change is possible,” Coffman added in response.
Along the same lines, Miller added: “It’s important to keep in mind that the goal is not to get people to stop smoking, it’s to get them to stop smoking on campus. So as long as you focus on that it makes the project a little bit more manageable.”
Vaidya was pleased with the meeting. “I thought that the town hall went really well and that the panelists had a lot of great things to say and were very knowledgeable about the topic, and I think it piqued the interest of those who attended,” she said.
Looking forward at next steps for the initiative, the timeline of completion was discussed with the leaders after the meeting. Zach Hughes, MD and MPH candidate, also chimed in about a possible timeline for the initiative to really get underway. He said that on similar campuses introducing these types of initiatives, after approval, about a year was required to really get the policies set in place.
The first steps of the plan’s approval include bringing the idea to either the student government or directly to President John A. Fry. Once approved, following a feasibility analysis, PHIA can begin to implement the policy on campus.
“I think that this [meeting] was kind of an initiation into the whole campaign,” Vaidya said.
“Moving forward we do want to make this something that’s widespread, something that students are aware of, and we’re hoping to gain support for this initiative so that we can go on to the later stages of actually implementing this policy,” she concluded.