CHANGE
II TOBACCO PREVENTION AND CONTROL
t
I
cce Reversing the trend of tobacco use in Hawai’i BY HAWAI’I COMMUNITY FOUNDATION
D
but the addiction would take over.” Fast forward two years, three months and one day from May 17, 2016, when Donita Garcia went smoke free. “I feel 100 percent better. I can breathe now, without the inhaler. I can smell again. I sleep better. I can walk further, and up hills. I have more energy, and I rarely think about smoking. The obsession is gone. I don’t have the fear anymore.” What enabled Donita to quit after her past —
Donita Garcia uring the 46 years smoked cigarettes, both of her parents died early from tobacco—related illnesses, a younger brother had triple bypass surgery and her sister pulled an oxygen tank to manage COPD. Donita herself carried two different inhalers and couldn’t walk very far or manage even a slight hill. “I couldn’t breathe. This would put me in a panic,” she says. “My biggest fear was wanting a cigarette. I hated smoking, the smell, the cost, being a slave to it
attempts failed? The simple answer is, this time she had access to more tools. Through trial and error, services from Adventist Health Castle and the Hawai’i Tobacco Quitline, she found the right combination that worked for her. “I started on the nicotine patch, then the gum, but I didn’t want another addiction so I stopped. I didn’t want to gain weight, so Ijoined the gym. I went to the Wellness Center. I tried every tool in the book.”
“Our keiki deserve to live long, he€~Ithy livesfreefrom the harms of ti@l~zc@@.”
Donita discovered that getting past the first seven minutes of a craving made all the difference. When she couldn’t exercise, change her mind frame or distract herself, she reached out for help. “The Hawai’i Tobacco Quitline understood what I was going through. They talked me through the critical moments, day or night. I wouldn’t have been able to quit if I didn’t have all those tools to help me.” Success stories like Donita are the culmination of an ambitious colla boration by the state, nonprofit groups, medical providers and individuals to make a difference in the community and illustrates the power of working together to enable residents to lead healthier, more productive lives. Over two decades ago, the Hawai’i Department of Health created the Tobacco Prevention and Control Trust Fund from tobacco settlement money. DOH contracted the —
LARISSA KICK
/ 1
~iu.~s II.~
BACCO PREVENTION AND CONTROL
II CHANGE
[ ~
~
2016-2019 Tobacco Cessation Grantee cohort with staff from the Hawaii Department of Health and HCF.
Hawai’i Community Foundation to administer the Trust Fund. HCF has supported tobacco prevention and cessation community grant programs, the Hawai’i Tobacco Quitline, advocacy efforts and a statewide communications campaign. Trust Fund programs, along with many other tobacco control efforts across Hawai’i, have made a huge difference. Today, Hawai’i has the third—lowest smoking rate in the nation (13 percent) with 73,300 fewer smokers than in 2000. Over the same period, DOH reports a corresponding drop in heart disease (34 percent), stroke (41 percent) and lung cancer (ii percent). Among high school students, smoking has dropped 71 percent. “The air we breathe is cleaner today. Fewer people are smoking and suffering from smoke-related diseases. More families can share the happy story of a loved one quitting the habit,” says Larissa Kick, senior program officer for Community Grants & Investments at HCF. “The $151.4 million spent by Hawai’i from 2000-20 17 to curb smoking has saved an estimated $1 billion in health care costs,” she adds.
“That’s a phenomenal return on investment.”
MOVING FORWARD The Tobacco Prevention and Control Trust Fund has already begun a campaign against e—cigarettes and the retailers that target young people. F—cigarettes contain highly addictive nicotine that can harm brain development, and are a gateway to combustible cigarettes, according to the Centers for Disease Control and Prevention and a UH Cancer Center study. In 2017, more than 1 in 4 (25.5 percent) public high school students and 1 in 6 public middle school students in Hawai’i reported using e—cigarettes. To combat this new trend, the Hawai’i Community Foundation, through the Trust Fund, is supporting efforts that educate youth and their families on the harms of tobacco and e—cigarettes. One current effort is a media campaign developed by youth, for youth, and distributed largely through social media. “Our work isn’t done, but we’re thinking big,” Kick says. “Our keiki deserve to live long, healthy lives free from the harms of tobacco. We must help Hawai’i become tobacco free.” •
THE POWER OF POLICY
Changes to state Laws on smoking do more than encourage better health. They also signal a shift in culture and attitudes toward tobacco. If we continue this trend, and our keiki reinforce the education among peers and to their own keiki, smoking might someday be a relic of the past, found only in old movies.
2001 / AlL counties pass a restaurant smoking ban 2003/ Smoking is banned at all public schools 2005 / Tobacco retailers must obtain a permit that
includes inspection, investigation and penalties 2006 / The clean indoor air law expands smoke free restrictions to restaurants, worksites, shopping malls, multi-unit housing common areas, health care facilities, public areas and airports
/ Hawaii county bans smoking at all beaches, parks and recreational facilities, as well as in 2008-2010
vehicles with children 2012 / Honolulu bans smoking at city and county parks and beaches, and bus stops Hawaii prohibits the sale and purchase of electronic smoking devices (Ems) by minors 2015 / Hawaii becomes the first state in the nation to raise the legal smoking age from 18 to 21, including vaping (Ems) 1999-2017 / Hawaii raises the excise tax on cigarettes to an all-time high of 16 cents per cigarette, or $3.20 per pack 2017 / Honolulu prohibits smoking in vehicles with children and expands the definition of tobacco products to include E50s, thus prohibiting ESD use in all sites where smoking is prohibited
HAWAII Given Back 27