Marin County’s adult smoking population has dwindled to one of the lowest in the state. We owe this success to concerted community-wide effort over years, including Marin health care providers who daily reinforce tobacco education for patients and the public health advocates who support policies that limit community harm from tobacco.
The Smoke-Free Marin Coalition has targeted secondhand smoking and has supported some of the state’s most progressive policies to provide protection for residents in multi-unit housing (MUH) complexes. San Rafael set a new bar by restricting smoking in 100% of MUH complexes. Marin businesses are also generally supportive, with many adopting voluntary policies on outdoor smoking in response to customer demand. Ten of twelve jurisdictions now have designated smoke-free outdoor dining, with substantial progress made in the past two years.
Despite these successes, there is still progress to be made. One in ten Marin adults still smoke every day or “most days” (www.countyhealthrankings.org). In the 2013 annual American Lung Association Report Card, San Rafael and County unincorporated areas were the only areas in Marin to receive an “A” grade for their smoking policies and practices; Larkspur, Mill Valley, Novato and Sausalito earned “B’s”; Fairfax, Ross and Tiburon “C’s”; San Anselmo a “D”; and Belvedere and Corte Madera “F’s.” Communities lacking strong secondhand smoke regulations including both indoor and outdoor smoking limitations lose significant points in the grading system.
Persons with mental illness and Marin's youth are high priority populations for tobacco control efforts. The Marin Tobacco and Mental Health Collaborative brings together Marin-based mental health service providers, consumers, and tobacco control groups to offer effective and culturally competent cessation support to consumers in behavioral health programs. Efforts to reduce tobacco use among Marin County youth include support to colleges implementing campus-wide smoke-free policies, assistance to schools in securing federal funding for tobacco education, and partnership with community-based programs promoting healthy choices for young people.
Effective tobacco control hinges on cohesive and consistent messages from all health advocates. Marin health care providers can recommit to this effort by offering strong messaging to patients and families about the harms of tobacco use, supporting cessation for those using tobacco, and advocating for tobacco control policies when they are being considered. Resources for people seeking to cut down on tobacco use and for the providers supporting them can be accessed at Bay Area Community Resources (www.bacr.org/programs/tobacco).