Narinder Dhaliwal’s family hails from the Punjab via Fiji. Although her public health work effects the nation and the globe, she didn’t have any idea that she would some day guide a program that leads the world in controlling exposure to tobacco smoke.
Dhaliwal leads California’s efforts to reduce secondhand tobacco smoke exposure wherever it exists. Her program is called California’s Clean Air Project (CCAP), a statewide program of ETR Associates. It is funded through the California Department of Health Services—Tobacco Control Program. Support for CCAP and other tobacco control and smoking cessation programs comes from Proposition 99, the 1988 Tobacco Tax Initiative.
Dhaliwal is a native of Coventry, England, and alumnus of Warwick University. Her undergraduate studies focused on health and social sciences and her master’s degree on gerontology. “I’m proud of what we do and the emphasis is on we. Daily, I have the opportunity to work with public health allies in California’s 58 counties and three city public health departments, not to mention, other public health workers around the world as well. This work is making a difference.”
California’s smoking prevalence rate is down to just 14 percent. That is lower than all states except Utah. For anyone traveling out of California, the difference is unmistakable. However, today many states, provinces, and countries are emulating California’s successes. Workplaces and public places are becoming smoke-free all over the world.
After the passage and implementation of the California Smoke-Free Workplace Law in the 1990s, which included smoke-free bars, Dhaliwal was the tobacco control coordinator in Sutter County. Smoke-free bars were a challenge, especially in rural areas. Sutter County was no different. But the approach toward compliance was different. Dhaliwal enlisted the help of family members and friends to visit every venue and explain the importance of the law and asked the bar owners to respect it. Often bars were visited more than once. The approach worked and Sutter County has high compliance today.
Under Dhaliwal’s guidance, a statewide secondhand smoke policy database has been established. The database makes it possible for anyone—from a member of the public to a policymaker—to find out the types and locations of local tobacco control ordinances passed in cities and counties in the state.
As tobacco control advocacy expands in California, even more outdoor areas are becoming smoke-free. At the urging of the public, beaches, parks, equestrian trails, hiking trails, outdoor dining areas, waiting lines, and other outdoor public places are rapidly becoming smoke-free. Dhaliwal’s role in many of these policy activities is to share with city councils and boards of supervisors the “State of the State” in tobacco control. Each week, California cities and counties adopt groundbreaking and expanded policies. Dhaliwal is often asked to provide information to councils and boards on what types of policies are being adopted, the issues that are being addressed, enforcement concerns and requests for materials. She is clear that she provides information only and does not suggest how cities should adopt tobacco control policies.
“We follow the direction of the California public,” she states.
“Many members of the public are now clamoring for smoke-free multi-family housing units (apartments). The number of calls to CCAP from apartment dwellers about smoke entering their living space has increased exponentially.
“Smoke-free multi-family housing is becoming very popular. In fact, many renters see it as an amenity. It is healthier and safer,” says Dhaliwal.
Another new area for CCAP is tribal casinos, the only workplaces in California that are not smoke-free. According to Dhaliwal, casino employees call CCAP wanting to know about the health consequences of working eight hours a day around tobacco smoke or to talk about their respiratory problems and illnesses. CCAP has conducted a tribal casino billboard campaign and received many calls from casino patrons looking for smoke-free gaming.
Another emerging area in the world of tobacco is hookah pipe smoking. Young people are attracted to flavored tobacco such as double apple, cherry, and chocolate that is smoked through exotic water pipes known as hookah. However, hookah pipes are not a safe alternative to cigarette smoking. Smoking hookah pipes has been reported to cause oral, esophageal, and lung cancer as well as heart disease, chronic bronchitis, and of course, nicotine addiction. Hookah pipe smoking has also been advertised in devious ways. Ganesha has been pictured smoking a hookah pipe.
The work of tobacco control will continue in California, India, and elsewhere. When asked, what she thinks of recent changes in tobacco use, Dhaliwal responded, “Besides identifying the real dangers of tobacco use, I think California is paving the way to better health, And of course, who could have predicted smoke-free pubs in Ireland?”
For more information on CCAP-California’s Clean Air Project or to access the policy database visit www.ccap.etr.org. For free Quit Smoking information call 1-800-NO BUTTS. Dian Kiser, Ph.D., and Theresa Boschert, J.D., are tobacco education and advocacy officers for CCAP.