by Jim Boyle
The suggestion of expanding Sherburne County Government Center’s status as a tobacco-free facility to include a tobacco-free grounds at a May 2 work session went nowhere in a hurry.
Two commissioners expressed opposition and third not in attendance might not be inclined to support such an endeavor.
Two expressed support.
When it became clear that the current county policy does not have designated smoking areas outside its tobacco-free facility, there was considerable discussion about doing some like that.
“I would be supportive of that,” said Commissioner Tim Dolan, who stated he was not supportive of spending another ounce of staff time on going completely smoke-free on its grounds.
Commissioner Ewald Peterson said he is not supportive of going tobacco-free with the entire government center campus, and he called attention to the state’s interest in moving this direction when it remains very dependent of tax revenue from cigarette sales.
Commissioners Lisa Fobbe and Board Chair Barb Burandt, with backgrounds in health care and social services were far more concerned about the ills of smoking, addiction and the rights of people who are impacted by smoking — secondhand and otherwise.
“A person has a right to smoke, but it does compromise people who may have a reaction or a consequence to secondhand smoke,” Burandt said. “We need to think seriously about the consequences of secondhand smoke.”
These divergent views were tossed around after a presentation by county public health officials and hearing from a representative of the Association of Non-Smokers, Minnesota Chapter.
Ultimately, board members directed County Administrator Steve Taylor and staff to come back with options and recommendations at a later date. June was expressed as a likely possibility.
The agenda item did not come out of nowhere, despite almost going nowhere.
In 2008, Minnesota lawmakers recognized controlling health care costs would require more than just changes in medical care. Additional investments in prevention would be needed.
The Statewide Health Improvement Partnership, or SHIP, was developed to improve health by reducing risk factors that contribute to chronic disease.
The county has been moving toward a tobacco-free campus since, county officials said.
In 2011 the Sherburne County Sheriff’s Office and Jail went smoke-free. One year later the County Board declared all buildings, facilities and vehicles of Sherburne County to be smoke and tobacco-free.
In March 2014, the County Board created a 25-foot setback of public building entrances for smoking and electronic cigarettes.
SHIP grants require counties to keep moving in this direction.
Kara Zoller, Sherburne County Health and Human Services health promotion supervisor, reported that a third of the counties in Minnesota have made their facilities and grounds tobacco-free. Southern Minnesota has been the leader. The latest county to go tobacco-free campuswide was Freeborn County.
In 2017, Sherburne County’s Health and Human Services staff again presented a plan to move forward on this issue. The plan included a staff survey, research on other counties’ policies, input and the composition of a comprehensive policy.
A presentation of the findings was the next step in this process.
For Sherburne County Public Health officials Mary Jo Cobb, the director of health and human service; Mark Lees, the community health coordinator; and Zoller, creating designated smoking areas has no appeal.
Zoller said smoking in designated areas will not support people who want to quit smoking. The issue of secondhand smoke still lingers. They are difficult to enforce. And they don’t send a strong message on the importance of health.
She said in her presentation that the No. 1 killer of Sherburne County residents is cancer, followed by heart disease, both of which are fueled by the risk factors that smoking creates.
Dolan said he couldn’t see there being a marked difference between the health impacts of offering up places to smoke versus making the entire grounds smoke free. People who smoke are still going to find a place to smoke. He said he would like to see data support this claim that there would be a difference.
“The county government center is different than a doctor’s office or a public school,” Dolan said. “We have people come here for a court case and they have to sit here for six hours. It’s not necessarily their choice to be here. If it’s legal, they should be able to do it.
“Don’t think that I am pro-smoking. I am not. I’m thinking adults can make their own decisions.”
Zoller, a tobacco control advocate, questioned how much of a decision it is for a teenager who is targeted by the cigarette industry to become a smoker.
“Tobacco addiction is not always a choice,” she said. “There are a lot of people who want to quit. It’s one of the hardest addictions to quit.”
Dolan said he’s not a smoker but he has a tough time with he addiction argument.
“If you want something bad enough, you can quit just about anything. Heroin addicts do it just about every day.”
Dolan said designated smoking areas would be reasonable and welcome.
“Designated smoking areas are a sufficient solution, letting everybody experience the grounds they are paying for.”
Taylor said talk of designated smoking areas brought about deja vu from his time in a previous county administrative position.
For that county, these restricted areas where smokers could go were called outposts. There were about three of them.
They were in inconvenient areas, especially when it was sleeting, snowing or very hot outside.
At this unnamed county, employees who wanted to smoke were eventually forced to do so behind the building.
Cobb said you can’t overlook the costs of tobacco use and their impact.
Studies have shown that health care costs for smokers are higher by $1,623 each year. Productivity on the job also goes way down.
Between absenteeism and smoke breaks, the costs of nonsmokers compared to smokers is nearly double: $2,623 per year vs. $4,430 per year.
Up to 8 percent of a smoker’s workday is lost on smoking-related activities and issues.
Fobbe said the financial impact can’t be overlooked.
“I sat in the back of a car as a 2-year-old without a seat belt, but it has been found over time — both financially and personally — car seats were a better choice. I think over time those benefits continued to outweigh. We don’t question that anymore.”
Cobb likened asking people not to smoke on the grounds of a county building to asking people to wear seat belts and asking people not to text and drive.
“Personal choices and laws affect people’s lives,” Cobb said.
Dolan said the difference between asking adults not to smoke and to wear a seat belt is there are laws against adults not using seat belts.
“But we do have a precedence to restrict people from doing things they want to do?” Cobb said.
Choice or addiction
Fobbe winced at Dolan’s description of addiction.
“I was raised in a recovering family and lost a brother to addiction and possibly a second,” she said. “That hit me hard, Mr. Dolan, but that’s a conversation for another day.”
Fobbe went on to express her appreciation for the presentation and the work that went into it.
Another issue that surfaced in an hourlong work session on the topic was the rights of smokers versus the rights of others who smoke and are struggling to quit.
“The bottom line for me is smoking is still the No. 1 cause of disease and death in our state and its costs us a lot of money in lost productivity and health care costs,” Zoller said.
While no one is in a hurry to change the county’s tobacco policies, the project to expand the government center about 100,000 square feet does provide a reason to make a decision sooner rather than a couple of years later when traffic in and out of the facility gets established.
Zoller said for her it’s all about policies to foster health, which will be in place long after people or positions are gone. The tagline she likes is “Make the healthy choices the easy choices.”
“It’s all about role modeling for young people,” she said. “We’re a young community.
“This is a policy that really does help people quit.”
Education vs. punishment
Emily Anderson of the Minnesota Association of Non-Smokers said the No. 1 question they field is how to enforce a tobacco-free grounds policy.
The association provides counties technical assistance and best practices to implement and enforce policies.
They provide everything from advice to free signage.
She said the answer is through education, not punishment.
By providing health education and cessation support instead of punishment, counties have found success.
“Under this approach, those who use tobacco feel supported rather than ostracized,” said, noting it’s an ongoing process. “It’s not a sprint. It’s a marathon.
“You might have someone who is ready to quit today, and you might have an employee who is ready to quit in two years.”
Success comes through offering resources that help people quit in their own way.
Dolan said he has a difficult time thinking a county can have one without the other, that you can support those that want to quit without ostracizing the ones that don’t want to quit.
“We have to acknowledge that it’s a choice,” he said. “It’s legal to do.”