by Rose Fischer

The Red River Tobacco Education Consortium (R2TEC), serving Greer, Harmon and Tillman counties, successfully spreads the word that tobacco kills 5,800 Oklahomans annually--more than alcohol, AIDS, suicides, murders, auto accidents and illegal drugs combined; as a result of R2TEC’s efforts, youth and adult smoking rates are declining in the three Southwest Oklahoma counties.

Operating as an agency of Southwest Oklahoma Community Action Group Inc., R2TEC is a Communities of Excellence Wave II grantee of the Oklahoma Tobacco Settlement Endowment Trust, established to promote smoke-free environments and the cessation and prevention of tobacco use. For more information about R2TEC, contact Mysti Reneau, program director, at Altus’ Wilson Center, 580-482-1290.

“Tobacco is the leading cause of preventable death, not only in Oklahoma but in the United States,” Reneau said. “It’s very addictive, unhealthy and also very financially draining for a lot of our families. Tobacco addiction is often prevalent in lower socio-economic, less-educated populations and some minority groups; and they, unfortunately, suffer disproportionately from the health effects of tobacco; that’s how Community Action got involved.”

In 2007, the Tobacco Settlement Endowment Trust awarded Communities of Excellence grants to the more heavily populated counties or consortiums of counties. By combining the three Southwest Oklahoma counties, R2TEC was awarded in 2007 and is now in the second year of implementation. Judy Forehand of Mangum, an initial grant writer, chairs the consortium board, comprised of 19 volunteers from the three counties—teachers, community leaders, healthcare specialists and others. The board develops an annual detailed strategic plan and holds monthly working group meetings in each county. “We have individual meetings in each county, but we still all work together,” Forehand said. “R2TEC makes the decisions about how we implement the grant.”

Youth Tobacco Prevention

The biennial 2009 Oklahoma Youth Tobacco Survey shows 10,000 fewer Oklahoma youths smoking now than two years ago. High school rates declined from 23.4 percent in 2007 to 20.2 percent in 2009. Nationally, 80 percent of smokers start by age 18. “That’s why we target youth with classroom prevention efforts,” Reneau said. “It helps, but we know that when you ask fifth graders if they should use tobacco products, they will say they know it is bad for their health; but when they get to be teenagers, many do it anyway, due to peer pressure and adult role modeling.”

After consortium members presented prevention information to school boards in the three counties, most of the boards adopted total no-smoking policies (in addition to the required 7 a.m. to 4 p.m.), including ballgames, extracurricular activities and anything that occurs on school property and in school vehicles: Tipton and Frederick Public Schools in Tillman County, Hollis Public Schools in Harmon County and Mangum Public Schools in Greer County. Great Plains Technology Center in Frederick also recently adopted a 24/7 no-tobacco policy.

The consortium sponsors youth-led Students Working Against Tobacco teams for grades six through 12 at the juvenile facility at Manitou; in schools at Mangum, Hollis and Tipton; and a start-up team through the after-school program at Frederick’s Community Action Development Corp. The organization empowers teens to stand up, speak out and take action against tobacco industry marketing that targets youth as replacement users.

Chewing tobacco usage by young males in Southwest Oklahoma is about twice the national average. Gruen Von Behrens, Illinois baseball player and oral cancer survivor, began using chewing tobacco at age 13 and later underwent more than 30 surgeries that removed most of his tongue, lymph nodes and part of his jaw. He visited Hollis, Mangum, Frederick, Tipton and Granite schools to talk about tobacco’s destructive effects.

Adult Cessation

General cessation programs for adults include free help through the Oklahoma Tobacco Helpline 1-800-QUIT NOW. When the helpline first launched, about 27 percent of the Oklahoma population smoked--down now to about 24 percent. Since receiving the grant in the three R2TEC counties, the number of helpline calls has doubled. For the first time ever, Oklahoma has as many former smokers as current smokers.

The consortium keeps physicians informed of new tobacco dependency guidelines and other information, such as new insurance benefits that cover both prescription and over-the-counter cessation medications. “It’s a very, very difficult addiction to overcome, so we are working hard to get insurance companies to understand that it usually takes more than one attempt,” Reneau said, “because many long-time habits associated with smoking must be broken, such as smoking a cigarette with a morning cup of coffee or in the car on the way to work.”

Secondhand Smoke

About 700 non-smoking Oklahomans die every year from tobacco-related diseases caused by secondhand smoke. “Obviously, we can’t tell people what they can do in their own home, but we really encourage them to make their homes and cars smoke free, especially if they have kids,” Reneau said.

The U.S. surgeon general determined that no safe level of secondhand smoke exists—smoke coming from the end of the cigarette and from air expelled by the smoker. Secondhand smoke is directly related to sudden infant death syndrome, ear infections, chronic bronchitis, asthma and heart disease. Many children who live with smokers make repeat emergency room visits.

The consortium designed and distributed decals—“Entering a Smoke-Free Home” for front doors and “I Provide a Smoke-Free Ride” for cars, as reminders to extinguish the cigarette.

Tobacco-Free Communities

Reneau and consortium volunteers visit city governments in all three counties to promote the adoption of smoke-free ordinances in city buildings and businesses, and they also encourage organizations to voluntarily go smoke free. “Initially, Oklahoma was a front runner in smoke-free laws, but we have been far surpassed by most other states,” Reneau said. “That is because our law doesn’t protect all Oklahoma workers, since it exempts certain facilities; and our law has what is called pre-emptive language,” Reneau said. “Preemption doesn’t allow municipalities to enforce or adopt ordinances that are stronger than the state laws, as far as fines, etc.; they can only mirror the state laws. So we encourage the cities to adopt their own smoke-free ordinances. Many states have significantly reduced the tobacco-use rate because municipalities have designated smoke-free areas; and studies have also shown a decrease in emergency room visits for heart attacks, strokes and lung cancer. We can directly relate this to municipalities being proactive in passing smoke-free ordinances.”

After a presentation by R2TEC, the city of Hollis in November passed two ordinances that make the city and its businesses smoke free and prohibit youth under age 18 from purchasing tobacco. Before Hollis adopted the ordinances, only Oklahoma ABLE Commission officials and sheriffs’ departments could make compliance checks; now local police can enforce the ordinances and make compliance checks. “If you’ve got customers coming in, you have to smoke outside--even if you own the business,” Reneau said. “There are a few exceptions for single owners, and restaurants are allowed to have smoking rooms if they install ventilators; but there are doubts as to whether or not the ventilation systems are really effective in protecting their workers and non-smokers.”

Volunteer adults and youth SWAT Teams make “Reward and Reminder” visits to retail stores. Youth attempt to purchase tobacco products; and if asked for identification, the adult gives the retailer a reward card. If the retailer neglects to require identification, the adult gives the retailer a reminder card.

Exposing the Tobacco Industry

R2TEC focuses on exposing the tobacco industry. “As part of the tobacco settlement agreement, the tobacco industry is not supposed to advertise to youth at all; but we still see ads placed 3 feet and under. That’s not aimed toward an adult,” Reneau said. “We encourage our kids to notice these marketing practices in the community and we work with local tobacco retailers to decrease the number of tobacco advertisements.”

According to Forehand, the consortium is working to replace the booth of a major Mangum Rattlesnake Derby sponsor that passes out free smokeless tobacco. “It’s illegal to pass out free cigarettes but somehow smokeless tobacco has fallen through the cracks,” she said. “That prolongs and discourages somebody trying to quit and sets a terrible role model for the community.”

Community Partnerships

Since its origin, the consortium has partnered with many local community groups, such as dentists, hospitals, pharmacies, schools and businesses. R2TEC worked with the State Department of Health to provide more than 250 long-lasting smoke detectors in eligible homes and partnered with fire departments in Mangum, Hollis, Frederick, Tipton and Grandfield for installation. “The firefighters advise the homeowners about dangers of smoking in the home; smoking is the number-one cause of home fire deaths because it often occurs while the residents are sleeping,” Reneau said.

Among other monthly activities, R2TEC partnered with Frederick on cleanup day for the Keep Oklahoma Beautiful Program by operating an educational booth, helping recruit youth and adults for the cleanup project and supplying special sacks for cigarette butts.

Because lung cancer comprises 80 percent of all cancers, R2TEC zeros in on the American Cancer Society’s national “Great American Smokeout” in November. “The kids drew chalk lines around each other like a crime scene investigation, because of the number of people who die from tobacco—16 per day in Oklahoma,” Forehand said. “We called it ‘Project 16.’”

R2TEC sponsored “Through with Chew” in February; and in March, the youth-oriented “Kick Butts Day” provided the SWAT Teams a fun activity, while encouraging residents to “kick butts” out of their lives. For “Earth Day” in April, SWAT Teams picked up butts at the courthouse in Mangum, and adults distributed decals--“Breathe Easy, No tobacco use on this property.” In September, R2TEC and SWAT conducted “Operation Storefront”; youth and adults made awareness surveys to determine the amount of tobacco industry advertising in the communities and to encourage tobacco retailers to limit cigarette ads.