Working against tobacco

By Nick Smith, Bismarck Tribune
Members of an interim legislative committee heard testimony about tobacco prevention efforts on reservations throughout the state Wednesday.
The interim Health Services Committee heard from health department officials as well as tribal leaders and tobacco prevention coordinators from on and off the state’s reservations.
Krista Fremming, Tobacco Prevention and Control Program director for the state Health Department, said the department collaborates with tribal tobacco program officials and in some cases shares facilities.
“On Dec. 13, 2013, the North Dakota Department of Health coordinated a tribal tobacco strategic session to discuss effective processes to reduce tribal tobacco use,” Fremming said. “Attendees agreed formal tribal tobacco strategic planning is needed to identify the best strategy to address tobacco use on the reservations.”
She said the North Dakota Indian Affairs Commission will be taking the lead on the strategic planning process.
Fremming said due to cessation and prevention programs nearly all schools and colleges on reservations now have tobacco-free and smoke-free policies in place.
Smoke-free tribal buildings are now a staple on reservations, she said, but housing and casinos are another matter.
“The North Dakota Department of Health is partnering with the Intertribal Tobacco Abuse Coalition to address the issue of smoke-free casinos on a statewide level,” Fremming said.
The Sky Dancer Casino in Belcourt has a no-smoking policy and the Four Bears Casino in New Town has a designated room for smoking.
Fremming said the idea is in the planning stages and it would likely take a year or two for any implementation to take place.
Another area of note, Fremming said, is enrollment in the NDQuits program. The NDQuits program pushes to keep people from starting to smoke and help people quit, using online sources, counselors andother services.
“In fiscal year 2013, a total of 152 enrollees were American Indian. In fiscal year 2014 there have already been 125 enrollees who were American Indian during the months of July through November,” Fremming said.
Also testifying Wednesday was Beth Hughes. She serves as executive committee chairman for the North Dakota Center for Tobacco Prevention and Control Policy.
Hughes said two-thirds of its $15.8 million budget is spent on a trio of statewide and community grant programs.
“The policies are to serve all residents both on and off American Indian reservations,” Hughes said. “The Center requires that funded programs show policy and health outcomes that can be documented by adoption of model comprehensive policies and, over time, show reduction in tobacco use.”
Hughes said among the center’s recommendations are continued funding of programs using the federal Centers for Disease Control and Prevention’s recommended best practices.
Chairman Sen. Judy Lee, R-West Fargo, questioned the recommendation. Lee said she believes the center comes off at times as being focusing too explicitly on CDC recommendations and not working as collaboratively as it could with other departments.
“The center is viewed as being a bit heavy-handed,” Lee said.
Lee said the reservations are sovereign nations and cultural sensitivity also needs to be kept in mind.
Hughes said she understood the criticism and it was something she would relay to center staff. She added that there is already a level of collaboration with other departments.
“There is no way that the center could do the work that it does without the other entities in the state,” Hughes said.
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