Affecting Policy Change on a City Level

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Affecting Policy Change on a City Level

• Kenny Kwong, CSW
• Health Education Special Projects Manger
• Charles B. Wang Community Health Center
• 10th Anniversary APPEAL National
• Leadership Summit/Conference
• September 9-10, 2004
• Washington DC

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Affecting Policy Change on a City Level

• NYC Smoke Free Air Act 2002 - success,
  celebrations, and challenges
• What did NYC Coalition For a Smoke-Free City do?
• What did NYs AAPI Tobacco Control Network do?
• The Garbage Can Model
• My Reflection

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NYC Smoke Free Air Act of 2002

• Smoke-Free Successes, Celebrations and
  Challenges
• New Yorks Asian American
• Pacific Islander
• Tobacco Control Network

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Why The Law is Needed

• Tobacco use is the leading epidemic of our time
• More than 440,000 Americans die every year from
  tobacco use
• Each year in NYC, we lose 8,600 friends,
  neighbors and family members to diseases caused
  by smoking they die from lung cancer..heart
  diseaseand more
• 400 New Yorkers, who never smoked, die each year
  from exposure to the tobacco smoke of others

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Secondhand Smoke and HealthThe Real Facts

• The EPA , the Surgeon General and the CDC agree
  Secondhand smoke is a Class A carcinogen not
  safe at any level like radon, asbestos and
  benzene
• Each year 60,000 non-smokers in the US die from
• breathing the smoke from other peoples
  cigarettes
• 1,000 of the victims are from our neighborhoods
• Secondhand smoke causes heart disease, asthma
• attacks, sinus and bronchial irritations,
  especially in
• children and seniors.

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Secondhand Smoke

• It causes cancerheart diseaselung disease and
  death
• 1 in 4 NYC smokers is forced to breathe this
  poison on the job
• Dont all workers deserve equal protections?
• Its About Our Rights to Breathe Clean Air!

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Intent of the Law

• An amendment to the 1995 NYC Smoke Free Air Act
• Protect ALL New York City workers from on-the-job
  exposure to secondhand smoke
• - Secondhand smoke is a known carcinogen,
• not safe at any level
• - All workers deserve a safe, clean,
• smoke-free workplace

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Who Will be Smoke-Free?

• All food service establishments, restaurants and
  catering halls
• All bars, including bars in restaurants
• Membership Associations
• All areas of theaters
• Banks, educational and health care facilities,
  and child day care centers
• Shopping malls and retail stores
• All offices
• Sports Arenas, roller ice rinks, billiard
  parlors, bingo halls, bowling alleys and similar
  places of recreation
• Public transportation facilities, reception areas
  and waiting rooms

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Goal to Support Strong, On-going Efforts in
Community Tobacco Control with

• The real facts on secondhand smoke
• How Smoke-Free Workplace laws are enacted
• Tobacco Industry opposition to Smoke-Free
  Workplaces
• Tools to win-back Smoke-free Communities

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Whos At Greatest Risk?

• More than 1million NYC workers like bartenders,
  wait-staff whose jobs expose them to hours of
  secondhand smoke
• 1 working shift can smoking ½ pack of
  cigarettes
• Studies show that bartenders and waitresses have
  a 50 greater chance of getting lung cancer than
  other workers
• NO ONE SHOULD HAVE TO BREATHE A KNOWN CARCINOGEN
  IN ORDER TO KEEP
• A JOB!

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The Mayors Proposalto Protect ALL Workers

• According to Intro 256
• Smoke Free Workplace Act of 2002
• Smoking will not be permitted in
• Restaurants indoors, outdoors bars within
• All bars taverns
• Offices
• Lobbies
• Sports Arenas
• Places Smoking Permitted
• In your car
• In your home
• Many outdoor areas

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How NYC Gets Smoke-Free Workplaces The
Political Process

• On August 12, 2002, Mayor Michael R. Bloomberg
  Announced NYCs intention to go Smoke-Free!
• Sponsors sought
• Proposal given to City Council Health Committee
• Health and community advocates meet with Health
  Committee to educate them on the bills health
  benefits

• The Health Committee holds public hearings on the
  proposed legislation
• Health advocates, workers and the community have
  a chance to testify
• The tobacco industry front groups will also
  testify
• Following public hearings, meetings with health
  advocates and messages from constituents, the
  Health Committee votes on the bill
• Then, City Councils 51 members must vote on the
  bill26 votes in favor are needed to win.

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The Tobacco Industry Fire Storm How Big
tobacco responds to the threat of new tobacco
control legislation

• Media The tobacco industry will use the media
  to combat new tobacco control legislation
• Community Groups The tobacco companies try to
  buy community support through sponsorships,
  incentives and payouts
• Lobbying - The tobacco companies will use front
  groups to lobby for support i.e. bodega
  owners. They will contend that tobacco
  legislation hurts businesses in poorer
  communities
• High Profile Spokespersons - The tobacco industry
  will look for high profile spokespersons to
  counter tobacco control legislation
• FOIL The tobacco companies will look for legal
  loopholes to sue organizations that work to enact
  tobacco control legislation
• Studies The tobacco companies pay medical and
  health experts to produce documentation that
  refutes tobacco use as a health risk

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Clean Indoor Air Myths Myth Busters

• Industry Myths
• Its a personal choice issue
• Restaurants and bars will lose business, people
  will lose jobs
• Restaurant and Bar workers can choose to work
  elsewhere
• State of the art ventilation systems can
  effectively eliminate
• secondhand smoke

• Myth Busters
• Its a health issue personal choice ends when it
  harms others
• Sales receipts from smoke-free communities show
  no harm to businesses
• The flexible hours in the hospitality industry
  are the only jobs suitable for many workers
• There is no know ventilation system that can
  protect workers

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Opponents Say

• The do-gooders are winning out people who have
  never had a fun time are trying to take all the
  fun out of life Newsday 8/16
• Government regulations and lawsuits are
  taking away everyones freedom NY Post 8/16
• Whats next fast food?

• People just like a smoke with their drink
• Newsday 8/16
• the anti-smoking agenda seems to be driven by
  zealots. - Staten Island Advance 8/18

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Major Newspapers Say

• Ban Smoking in City Bars? Yes, for Healths
  Sake THE NEW YORK TIMES Editorial 8/12
• there is no denying that in saying that
  non-smoking bar and restaurant employees should
  be protected from secondhand smoke, the
  administration is on solid ground. STATEN ISLAND
  ADVANCE 8/18
• Secondhand smoke is harmful and the proposition
  that the ever-shrinking minority has a right to
  inflict it on bartenders and other employees or
  other patrons is increasingly difficult to
  defend. CHICAGO TRIBUNE 8/29

• The City Council should rapidly enact Mayor
  Michael Bloombergs plan to outlaw smoking in all
  the citys workplaces on two simple grounds
  Secondhand smoke is a threat to people who dons
  smoke, and outlawing smoking has no adverse
  economic effect. CRAINS NEW YORK BUSINESS
  8/26-9/1
• A Complete ban on smoking in restaurants and
  bars has proved not just practical, but also good
  for business. Jane Brody, THE NEW YORK TIMES
  8/27

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GET THE WORD OUT!

• Organize educate the community
• Help us find people to testify at hearings
• Place articles in community newsletters
• Help educate policy makers on the hazards of
  secondhand smoke
• Distribute our flyers
• (Training materials provided as needed)

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What Does NYs AAPI Tobacco Control Network Do

• Attended the Mayors Press Conference
• Mobilized the Asian communities to attend City
  Council hearings to monitor the passage of the
  law and show supports in the new legislations
• Published news articles in ethnic-specific media
  to increase community awareness
• Published a letter to editor at New York Times

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What Does NYs AAPI Tobacco Control Network Do

• Translated and distributed a fact sheet
  specifically developed for Asian American
  Restaurant/Bar Owners and Employees
• Translated an information booklet for the NYC
  Department of Health on the NYC Smoke-Free Air
  Act 2002
• Conducted educational sessions to inform
  community members on the regulations of the
  Smoke-Free Air Act
• Co-sponsored panel discussions on the
  implementation of the Smoke-Free Air Act
  targeting business and restaurant owners in the
  Chinese and Korean communities

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TAKE ACTION

• Sign Advocacy Petitions
• Sign postcards and mail them to City Council
• Call or visit your elected official
• - Tell them 73 of New Yorkers want smoke-free
  workplaces
• (a recent poll of 1,000 New Yorkers ½
  with a smoking history ½ non-smokers,
• showed that 73 supported smoke-free
  workplaces
• - Tell them 76 of NY State restaurant
  owners want
• smoke free restaurants (from a NY State
  Restaurant Assoc. survey)
• And most importantly, tell them that YOU want
  smoke-free workplaces, too!

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Key Forces

• A Supportive Mayor and Health Commissioner
• Championship of City Council Health Chair,
  Christine Quinn
• Voices of diverse Communities
• Voices of Workers

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Current Public Acceptance Compliance
SFFAA Attitudes and Compliance Intercepts
May 1st May 20th 2003

• Polls show public in favor of law 2-1
• Compliance rates are high

Are you in favor of this new law that prohibits
smoking in all workplaces? Yes 65 No
21 Dont care/ no response 14
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Current Challenges

• Media - Doom and Gloom reporting
• Opposition tactics Doom and Gloom messaging

Cig Ban leaves lots of empties Deserted city
bars fall on hard times as biz drops off NY
Post 5/12/03
Cig ban killed him Bouncer knifed as he boots
smoker NY Post 4/14/03
Smoking Ban Clogs New York City Sidewalks
NY Newsday 5/03
Let's call Bloomberg's plot what it really is -
The SMOKER-Free City Act. Audrey Silk 8/26/02
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What We must Continue to Do

• I love Smoke-Free NY! Campaign
• Letters to the Editor
• Postcards
• Produce and Publish Real Data

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Where We Go from Here
Continued Support of Smoke-Free Legislation New
Challenges - Contraband cigarette sales to
minors - Smoke Free Homes - Cessation
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Historic Timeline
August 12th Mayor Proposes sweeping smoke-free
legislation. December 18th City Council votes
in favor of slightly amended bill, 44-7. December
30th Mayor Bloomberg signs the Smoke-Free Air
Act of 2002. March 26th - State passes new
sweeping statewide smoke-free legislation. March
30th City SFAA enacted. July 24th State law
goes into effect.
Mayor Michael Bloomberg
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Affecting Policy Change - What Model to Use

• Comprehensive Rational Decision Making Model
• Define goals clearly
• Set the levels of achievement of these goals
• Select many alternatives that might achieve these
  goals
• Compare alternatives systematically
• Assess costs and benefits of each alternative
• Choose the alternatives to achieve the goals at
  the least cost
• Does this ideal model accurately describe
  reality?

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Affecting Policy Change - What Model to Use

• The Garbage Can Model
• Adapted from Cohen, March, and Olsen (1972) A
  garbage can model of organizational choice.
  Administrative Science Quarterly, 17, 1-25.

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The Garbage Can Model

• Organizations or Decision Structures
• Problems
• Solutions
• Participants
• Choice Opportunities

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The Garbage Can Model

• There is a kind of organization that
• is a collection of choices looking for
  problems, issues and feelings looking for
  decision situations in which they might be aired,
  solutions looking for issues to which they might
  be the answer, and decision makers looking for
  work
• Cohen, March, and Olsen (1972) A garbage can
  model of organizational choice. Administrative
  Science Quarterly, 17, 1-25.

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The Garbage Can Model

• The choice opportunity is thus a garbage can in
  which various kinds of problems and solutions are
  dumped by participants as they are generated. Mix
  of garbage in a particular can depends on
• The mix of other cans around
• Labels attached to the alternative cans
• What garbage is currently being produced
• How soon garbage is being collected or removed
  from the scene

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The Garbage Can Model

• The flow of fairly separate streams of problems,
  solutions, interaction among participants
  available choices
• Outcomes heavily depends on the coupling of the
  streams such as coupling of solutions to problems
  etc.
• The change process is not necessarily incremental
  

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A Revised Garbage Can Model

• Federal government agenda settings
• Problems - recognition, attention
• Policies and Proposals - Bureaucrats, planning
  staff, academics, interest groups, researchers
• Politics national mood, public opinion,
  election results, changes of administration,
  lobbyists
• John Kingdon (1984). Agendas, Alternatives, and
  Public Policies. Harper Collins Publishers

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A Revised Garbage Can Model

• Three streams of processes (problems, policies,
  and politics) develop and operate largely
  independently of one another, however, not
  absolutely independent
• Each of the actors and processes operate either
  as an impetus or as constraints
• The key to understanding agenda and policy change
  is the coupling of these independent streams
• Policy window - the conditions to push a given
  subject higher on the policy agenda are right
  is open for a short while, and then it closes
• John Kingdon (1984). Agendas, Alternatives, and
  Public Policies. Harper Collins Publishers

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What do We Learn

• Facilitate the three streams of processes
  arousing attention on problems, working closely
  with policy makers, and dealing with politics
• Manage the agenda setting process
• Assess impetus and constraints
• Build alliance and collaborate with partners
• Seize the policy window once it opens
• Be consistent and persistent, never give up

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Thank You!!
New Yorks Asian American Pacific Islander
Tobacco Control Network
Hundreds of community-based organizations and
advocacy groups