Created by the Registered Nurses’
Association of Ontario

Social Determinants of Health

Social determinants of health:
• Economic status
• Education
• Housing
• Employment
• Single parenthood

Social deprivation is associated with high rates of smoking and low rates of cessation
(World Health Organization, 2003)
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During patient assessment it is important that nurses recognize the myriad factors that contribute to the health status of the client/patient

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Federal Tobacco Control Strategy:
A Framework for Action
• Health Canada
• Developed in 2001
• Revised in 2007
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Current goal  to reduce overall smoking from 19% to 12 % (by 2011)

National Tobacco Control –
New Objectives:
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Reduce prevalence of youth (ages 15 – 17) smokers from 15% to 9%
Increase number of adults who quit smoking to 1.5 million
Reduce prevalence of people exposed to second-hand smoke from 28% to 20%
Examine the next generation of tobacco control policy in Canada
Contribute to the global implementation of
WHO’s Framework Convention on Tobacco
Control
Monitor and assess contraband tobacco activities and enhance compliance

National Tobacco Control (cont.)
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Federal government regulates aspects of the sale of tobacco:
 Requirements for health messages
 Importation of tobacco products
 Control of advertising and sponsorship by tobacco companies

National Tobacco Control (cont.)
• Latest initiative  oblige tobacco companies to list more of cigarettes’ toxic ingredients on the package
Ingredient
Tar
Nicotine
Carbon Monoxide
Formaldehyde
Hydrogen cyanide
Benzene
(Health Canada, 2009b)
Emission levels for a cigarette sold in Canada
Previous Current *
8 mg 8 – 29 mg
1 mg
9 mg
1 – 2.6 mg
9 – 27 mg n/a n/a n/a
0.035 – 0.13 mg
0.073 – 0.25 mg
0.034 – 0.08 mg

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Each province has jurisdiction over tobacco products and their regulation
[Insert specific information here for your province/territory]

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Administered through the Ministry of Health
Promotion and Sport under the Chronic
Disease Prevention division
SFO’s Tobacco Control Act
• Regulates smoking in public spaces and workplaces
• Regulates the conditions of sale of tobacco products
• Prohibits the sale of tobacco to people under 19 years
• Protects children from second-hand smoke when in daycare programs
• Restricts smoking in and around health-care facilities
• Bans the use of point-of-sale advertising such as retail power walls
• Bans smoking in vehicles when children under 16 years are present

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Supports awareness and prevention programs through:
– Public health programs (e.g. high school programs)
– Monitoring access of minors to tobacco products
– Cessation programs:
• Smoker’s Helpline
• Leave The Pack Behind - campus program
• Driven to Quit Challenge - provincial contest
• Stop Smoking Treatment for Ontario Patients (STOP) – research study examining the effectiveness of NRT
• Training Enhancement in Applied Cessation Counselling and Health (TEACH) – certified training course for healthcare professionals

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Prevention
• Child/youth programs
• Restricted access to tobacco
Protection
 Legislation
 Smoke-free public spaces, workplaces etc.
Cessation
 Cessation programs
 Education for health-care professionals

Tobacco Awareness
Communication Campaign a) b) c) d) e) f) g) h)
Needs assessment
Choosing the community, topic, channels of communication
Assessing resources
Tailoring campaigns
Community development
Implementation
Evaluation
Creating a program logic model