Background on Environment & Policy
What are environment and policy strategies?
- Interventions that help create healthy places and practices to support healthy community members.
- Environmental interventions are designed to modify structures and physical surroundings in order to influence an individual’s capacity to make healthy choices that can impact their own health or the health of those around them.
- Policy interventions are laws or regulations that are put in place to achieve a goal, including organizational policies or public policies at the local, state or national levels. Policies are an important way to focus on the social, economic, and environmental factors that enable health problems related to tobacco use.
- Environment and policy interventions are intended to improve behaviors and environments in order to address tobacco use. These interventions are attractive because they have the potential to reach all community members and create community changes that last much longer than most other types of interventions. Many have argued that changes in environments and policies have been critical to creating broad based changes in tobacco use.
Why are environment and policy strategies useful?
- They have the potential to reach all community members and create community changes that last much longer than most other types of interventions.
- Changes in environments and policies may be critical to creating broad based changes tobacco use.
- Tobacco environment and policy interventions include those to restrict youth access to tobacco, smoking bans and restrictions, increasing the unit price of tobacco, and reducing patient costs for treatment.
How can I use environments and policy strategies in my tobacco intervention?
- Youth access restriction environment and policy interventions have been enacted to reduce tobacco product sales to minors. These restrictions have included point-of-purchase materials (e.g., signs in the store indicating that tobacco cannot be sold to individuals under 18 years of age); educating tobacco vendors, owners, managers and employees (e.g., written, phone or in-person communications about methods to reduce sales to youth and laws with associated penalties) and enforcing policies by having health department personnel visit the local retailers to ensure compliance. Violators of these policies have been penalized through warnings and fines.
- Smoking bans and restrictions are another set of environment and policy interventions that have been used to decrease tobacco use and reduce exposure to environmental tobacco smoke. The policies usually involve regulations that limit smoking to certain areas of restaurants, bars, workplaces and other places or policies to ban tobacco use within the entire premises. For these interventions, tobacco use has been framed in terms of tobacco smoke as an environmental agent that causes a disease as opposed to an issue between individuals who choose to smoke or not to smoke. In this case, the harmful effects of tobacco smoke must be regulated. When implemented, these interventions also provide signs to post as a reminder that the ban or restriction is in place. These materials have been created in English as well as in other languages depending on the populations that make use of the facility.
- Increasing the unit price of tobacco is another policy initiative that has been used to decrease tobacco use. These policies have placed an additional tax on each package of cigarettes. Some states have earmarked the increased revenue raised for health education programs to reduce tobacco use.
- Reducing patient costs for treatment is a policy initiative that helps to reduce financial barriers preventing individuals from using cessation therapies (e.g., group education sessions, nicotine replacement therapy [NRT]). Specific activities include providing NRT or other pharmacologic therapies as part of routine care from health care providers, insurance coverage for cessation therapies or reimbursement for expenditures related to cessation therapies.
With whom should I work to develop and implement environment and policy strategies in my tobacco intervention?
- In order to create policies and environments that support decrease tobacco use and exposure in your organization, you may need to work with management and decision-makers to decide what makes sense for the organization.
- In the community, you may want to meet with local organizations (e.g., businesses, educational institutions, community organizations) to decide what can be implemented to decrease tobacco use as well as policy- and decision-makers to develop, enforce, and evaluate these policies and changes to the environment.
- It is also critical to work with local businesses that can help to implement these interventions (e.g., worksites, schools, health care facilities, local government, or other community destinations).
- You might consider working with experts in public policy, law, advocacy, law enforcement, community organizing, insurance or other partners to decide what changes can be made to improve the community as well as how these changes can be promoted.
How can I enhance environment and policy strategies in my tobacco intervention?
- Intervention strategies such as group education and campaigns and promotions are often used in conjunction with environment and policy interventions. These strategies can be used to provide information to vendors, restaurants, bars, workplaces or other places on the harmful effects of tobacco and how to enforce the policies as well as to community members to let them know about the restrictions (e.g., newspaper, radio and television ads).