Our Business, Our Health

State: NV Type: Model Practice Year: 2007

Our Business, Our Health targets the Latino population living in Washoe County and addresses the issue of secondhand smoke exposure. This practice focuses on educating, promoting, and implementing comprehensive tobacco free workplace policies among Latino owned businesses in order to protect Latino employees and customers. The goal of the program is to increase the number of tobacco free businesses in the Latino Community in Washoe County and has two main objectives: Objective 1: Implement tobacco free workplace policies in at least 35 Latino owned Washoe County businesses by December 1, 2006. Objective 2: Increase the level of support among Latino business owners, employees, and consumers for smoke-free policies in Nevada. Outcomes of the program include: 36 businesses within the Washoe County Latino community adopted comprehensive tobacco-free policies due to this practice; 78% (28 businesses) were owned by Latino immigrants. 194 employees have been protected from secondhand smoke as a result of the practice; 78% (151 employees) of these employees were of Latino descent. In addition, the practice protects 20,664 customers per month from secondhand smoke, an estimated 71% (14,632 customers) of which are of Latino descent.
For years, Nevada has been considered the smokiest state in the nation. Smoking has been commonplace wherever there is gambling, including grocery and convenience stores. This further translates into Nevada’s work force being subjected to secondhand smoke. According to the 2002 Nevada Adult Tobacco Survey, 44.5% of Nevadans were exposed to secondhand smoke at work. 39.8% reported that their workplace did not have an official anti-smoking policy. Also in Nevada, smoking related deaths are alarmingly common and higher than the national average. In 1999, the Centers for Disease Control and Prevention (CDC) reported that 3,359 Nevadans died of smoking related illnesses. In the nation, Nevada, and Washoe County, tobacco use remains the single leading cause of preventable death. All Nevadans are significantly affected by tobacco use and tobacco-related diseases, such as lung cancer and coronary heart disease. However, this practice targets Washoe County's Latino population for two reasons: their rise in smoking rates as well as rapid Latino population growth. First, while smoking rates are declining in most target groups in Nevada and nationwide, the CDC reports that Nevada’s Latino population is experiencing a disproportionate rise in smoking rates. Nationally in 2004, 16% of all Latino adults smoke, but, in Nevada, 22% of Latinos smokes. Second, the rapid growth of the Latino population in Nevada has been extraordinary, rising 2.5 times faster than the national rate. In 2000, 16.6% of Washoe County’s population was Latino. In 2001, that number increased to 18% or 65,167 individuals. About 40% of Washoe County Latinos work in a service industry, and about 563 Washoe County Latinos own their own business. In 2006, the U.S. Surgeon General concluded that there is no safe level of secondhand smoke exposure. Furthermore, the Centers for Disease Control and Prevention (CDC) reports that a significant portion of exposure to secondhand smoke occurs in the workplace. Many businesses and communities have implemented tobacco control policies to eliminate this health hazard. This had lead to significant evidence to support the effectiveness of tobacco control policies in the workplace as a means for eliminating secondhand smoke exposure among employees, business owners, and customers. This existing practice was adapted to be used with the Latino community due to high rates of tobacco use in this population, which are positively correlated with secondhand smoke exposure. Furthermore, since many Latino business owners are also viewed as leaders in the Washoe County community, this practice modeled the way for other Washoe County businesses to adopt tobacco-free policies and for Latino community members to adopt personal smoke-free declarations. This practice differs from other approaches used to address this issue in two ways. First, the cornerstone of this project lays in its secured collaborative partnerships; in this case, the partnerships between the Washoe County District Health Department (DHD), the Washoe County Latino Health Collaborative, and the Hispanic Chamber of Commerce of Northern Nevada (HCCNN). Furthermore, outreach efforts specifically targeted the Latino population, emphasizing cultural protective factors.
Agency Community RolesThis practice was conducted statewide as a collaboration between the DHD, the Nevada Tobacco Prevention Coalition, and the Southern Nevada Health District (SNHD). In this collaborative partnership, the DHD focused on educating, promoting, and implementing comprehensive tobacco free workplace policies among Latino owned businesses in Washoe County, the SNHD focused their efforts on Clark County, and the Nevada Tobacco Prevention Coalition focused on the remaining rural counties of Nevada. The DHD also collaborated locally with business representatives on the Washoe County Latino Health Collaborative and the HCCNN to identify appropriate businesses, provide focus group data, and assist in the development of policies for the businesses. The DHD also worked with the HCCNN to coordinate and host a special "sharing of successes" event recognizing the efforts of the Latino business community in providing healthy smokefree environments to their employees and patrons. The Washoe County Latino Health Collaborative is a local coalition of community leaders and health advocates who meet monthly to discuss emerging Latino health issues, establish Latino health priorities, and collaborate on local Latino health. The Collaborative supported the project, disseminated messages, and provided outlets for in-kind radio airtime. The HCCNN is the statewide professional association for Latino business owners and is recognized by the local Latino community as the key influencer of Latino business owners. The HCCNN marketed and advertised the campaign and provided on-going support and technical assistance. The HCCNN also provided meeting rooms and space as an in-kind service. The cornerstone of this practice was its collaboration with these stakeholders. Without this, it is doubtful the practice would have been effective in the Latino business community. Costs and ExpendituresFunding for this practice was supplied through the Robert Wood Johnson Foundation and implementation costs totaled $23,300.  ImplementationThe following specific tasks were taken to achieve the practice's goals and objectives: Identified Latino owned businesses (e.g. those with 25% or more Latino employees) and those with a high Latino customer base without current comprehensive tobacco policies by building a list of appropriate businesses through existing surveys, databases, and recruitment at partner membership meetings;  Developed a smoking awareness campaign, ensuring cultural appropriateness and message effectiveness;  Created a grassroots promotion and began dissemination of project materials to identified businesses;  Created a media campaign of radio and television announcements, newspaper releases, and placement of brochures in local outlets;  Assisted businesses in writing and implementing policies by following American Cancer Society’s “Making Your Workplace Smokefree”;  Tracked completed policies and provided incentives; and  Shared program success with stakeholders and the community. The timeframe for carrying out these tasks was February 2006 - December 2006.
Objective 1: By December 1, 2006, implement tobacco free workplace policies in at least 35 Latino owned Washoe County businesses without current comprehensive tobacco policies.   Performance Measures:Identify the number of Latino-owned businesses without a tobacco-free policy.  Implement a culturally-appropriate smoking awareness campaign by March 2006.  Disseminate project materials to targeted businesses by June 2006.  Assist in development of tobacco-free policies by November 2006.  Track number of incentives provided for policy implementation throughout practice. Coordinate event to share program successes with stakeholders and community by December 2006. Outcome: 36 businesses registered for the program and implemented tobacco free workplaces. 78% (28 businesses) were owned by Latino immigrants. The program protected a total of 194 employees, 78% (151 employees) were of Latino descent. In addition, the program now protects a total of 20,664 customers from secondhand smoke each month, 71% (14632 customers) of Latino descent. Objective 2: Increase the level of support among Latino business owners, employees and consumers for smokefree policies in Nevada. Performance Measure: Number of participants at the sharing of successes event, which was an opportunity to network and coordinate grassroots policy efforts designed to meet the interests and abilities of Latino business owners and constituents. Outcome: In Northern Nevada, the Our Business, Our Health program was highlighted during the Hispanic Chamber’s 2006 Candidate Forum with over 240 attendees. Program participants shared the importance of having a tobacco free business with other members of the Latino business community; An indirect outcome was that participating businesses owners supported the Nevada Clean Indoor Act.
SustainabilityThe practice was self-sustaining within a short period of time primarily due to the project partner infrastructure. Once the groundwork for the project had been laid, the partner groups continued to carry the project goals forward. Second, the passage of the Nevada Clean Indoor Air Act in the 2006 Nevada general election further increased the sustainability of this practice by banning smoking in most indoor spaces and places of employment. Lessons learned include: DHD received the data results and shared with stakeholders throughout the year to gain input. At the end of the year, DHD shared program success with stakeholders and the community through a special event, organized by the HCCNN, recognizing the efforts of the Latino business community in providing healthy smokefree environments to their employees and patrons. During implementation, the HCCNN revised their membership questionnaire to include a question about tobacco free workplace to improve tracking. The event participants could have been surveyed to assess the level of support for smokefree policies in Nevada.