- Kesha Abbananto
In looking over the multitude of bills being presented to the 2015 Regular Session of the Oklahoma State Legislature, many could be related to health. Health is affected by so many issues; one could ponder how an agricultural food labeling bill or a burn ban could potentially have negative consequence to one’s health. The amount of legislature presented in the 2015 session was a little daunting but quite educational. At this time, there is no shortage of health related bills in this state.
One such piece of legislation introduced deals with an issue affecting children nationwide: smoking while a child is passenger in a motor vehicle. Second-hand smoke causes numerous complications to the health of non-smokers; most of which are completely preventable. Children are vulnerable to the dangers of second-hand smoke, such as: asthma, bronchitis and lung infections (Rees & Connolly, 2006). Jarvie & Malone (2008) state effects of second hand smoke on children are sudden infant death syndrome, respiratory issues, lung cancer, and heart disease, to name a few. The authors go on to say, although, the issue of an adult’s right to smoke threatens autonomy, the children’s health and well-being should be the primary focus (Jarvie & Malone, 2008). Desapriya, Turcotte, Subzwari, & Pike (2009) explain that toxin concentrations within a motor vehicle containing cigarette smoke is twenty-three times greater than that of a bar and they further point out that many public areas already discourage or prohibit smoking due to the negative health effects of cigarette smoke. Murphy-Hoefer, Madden, Maines, & Coles (2014) report the prevalence smoking in car and home were significantly decreased after Maine passed its smoke-free vehicle law. This result is supportive of the implementation of laws such as Oklahoma H.B. 1341 (2015).
Oklahoma House Bill No. 1341 was introduced to the Oklahoma House of Representatives on February 2, 2015, where it was read for the first time in the House. The second reading occurred on February 3, 2015 and it was then then forwarded to the House Alcohol, Tobacco, and Controlled Substances Committee, where it remains. The bill was authored and sponsored by Oklahoma Representative Jason Dunnington. It would act as a new law under Crimes and Punishments within Title 21 and under Public Health and Safety within Title 63 (Oklahoma H.B. 1341, 2015 & The Oklahoma State Courts Network, 2014).
Oklahoma House Bill 1341 (2015) deals with the subject of an act relating to tobacco use that makes smoking in a vehicle while a minor child is present, unlawful. Violation penalty, defining terms, and effects on driving record are disclosed as well.
H.B. 1341 (2015) proposes that no person may smoke in a motor vehicle where a child is present. The result of this violation would be a fine of one hundred dollars. The bill defines a child as a person sixteen years old or younger and defines smoke as “the burning of, inhaling from, exhaling the smoke from or the possession of a lighted cigar, cigarette, pipe, or any other matter or substance which contains tobacco or any other matter that can be smoked” (Oklahoma H.B. 1341, 2015). The bill additionally states that the Department of Public Safety will not record points toward the driving record of a person when convicted of a violation of this law. The projected effective date of this bill is November 1, 2015.
The model design that would most effectively produce the desired results is the Kingdon model of agenda setting and policy formation. This model was developed in 1984 by Professor John Kingdon. He established three streams; problem, policy, and political that can facilitate government policy changes. When these three streams come together, a window of opportunity opens (Furlong, 2016).
The identified problem is the harmful effect secondhand smoke has on children in motor vehicles. Children usually do not have a choice of who they ride with and whether someone in the car smokes, yet they are at a greater risk of second-hand smoke damage due to a faster breathing rate and immune systems that are less developed (Clinical Digest, 2012). Even when windows are roll down the car window, the levels of toxic matter exceed maximum limits set for safety.
The policy stream is the proposed law of Oklahoma House Bill 1341 (2015). Research in the area of negative health effects of secondhand smoke to children support the need for mandates created for accountability of persons who smoke around children in the confines of a vehicle. Violation of this mandate should result in a fine.
The political stream is supported by non-smoking laws already passed by legislatures such as: Oklahoma Statutes on Smoking in Public Places and Indoor Workplaces which includes childcare facilities, the focus on preventive health measures in Obamacare, and for growing concern for the health rights of those that do not have a say in their exposure.
With the converging of these three streams, the window of opportunity for H.B. 1341 (2015) is open and it is likely public opinion on this subject will support change.
This bill could potentially change and/or improve the health of children in Oklahoma. The long term effects of healthier children will be healthier adults, thus projecting a future decrease in health care cost would be acceptable. Passing this legislation will be a step forward in protecting the rights of those who do not have a say. H.B. 1341 (2015) is currently in the House Alcohol, Tobacco, and Controlled Substances Committee. At this stage in the process, there is still time for nurses to become politically involved in support of this bill.
Lanier (2016) suggests strategies individuals can participate in advocacy of legislative change. Lobbying legislators by mail, social media, or personally are examples of advocacy. Since the bill has remained in the House Alcohol, Tobacco, and Controlled Substances Committee from February 3, 2015 to present, contact with this committee would be reasonable, followed by contact with your area Representatives.
Tips for communication in writing to a legislator, if a nurse chooses, include professionally worded personal letters with professional credentials and contact information added. Research articles that support your position on the bill are encouraged attachments. Phone calls or email can be used when making initial contact or follow up (Lanier, 2016).
Social media is an additional method of communication (Lanier, 2016). Organization online platforms, networking sites, blogs, and online media are great ways to draw support or attention to a topic and an efficient way to disperse information.
Additionally, in-person meetings are effective and can make a lasting impact on legislators, staff, and professional and layperson alike. If an in-person meeting is scheduled, remember to include credentials when identifying one self, structure your time well, and do not assume the legislator understands technical medical jargon (Lanier, 2016). Lanier further recommends to providing a one page summary of key points and to send a thank you note or email after the meeting (Lanier, 2016).
Education can and should be used in all of the above venues. Nurses can offer unique perspectives and insight to various topics due to the nature of their profession and all that nursing addresses when it comes to patient, community, and global issues. Nurses can also join professional peer committees and groups so one voice becomes many. The American Nurses Association is one such professional group that is politically active. The uniting of nurses to focus on specific issues is an effective way to support positive legislative change in healthcare.
Stakeholders in H.B. 1341 (2015) are in one of two groups; pro-tobacco stakeholders or anti-tobacco stakeholders. Both sides have interest in the outcome of this bill and those groups are listed below as identified by the Centers for Disease Control and Prevention, (2008):
- Tobacco growers
- Tobacco processing companies
- Tobacco manufacturers
- Cigarette manufacturers
- Smokers or right-to-smoke supporters
- Government agencies like public health departments and the Centers for Disease Control and Prevention
- State tobacco control programs
- Health care insurance providers
- Local smoke-free programs and laws
- Smoke-free associations and supporters
- Healthcare professionals
- Child health protection groups and supporters
Oklahoma H.B. 1341 (2015) would include anyone who smokes in a motor vehicle
while a child is present, children that are in vehicles while someone smokes, the healthcare system, and any of the above listed groups.
Excluded from this bill would be non-smokers, those that do not smoke while children are in the vehicle, children who do not ride in vehicles with a smoker, and those that do not care to get involved.
The evaluation of policy is a normal event in the political arena. Government funded programs, non-profit organizations, and many private foundations require regular evaluation of programs or policies to ensure programs are conducted properly, that set goals are being met, and that the outcomes are desirable (Sudduth, 2016). Advanced Practice Registered Nurses and nurses are accustomed to evaluation and have used this method to measure things such as programs, goals, self, clinical-based outcomes, and effectiveness of treatments. The evaluation of policy is a natural extension of this skill and one that comes in handy in politics. The evaluation of the bill presented in this paper, is listed below in five responses:
- The problem that needs to be addressed is children being exposed to second-hand smoke in motor vehicles, where they cannot get away from it.
- Although there aren’t effective tools for stopping this from happening at this time, laws have been made to limit or outlaw smoking in some public areas and facilities.
- Advantages of this bill are that it will not cost the state any additional funds to initiate and enforce this law and much of the public should accept this law due to the health risks to the child. Other positive outcomes are that fines from violations of the law should increase state funds and health risks from second-hand smoke should decrease as a result of this bill being signed into law.
- Disadvantages of H.B. 1341 (2015) are that some of the public may not support the law due to feelings of rights infringement and fines may prove too costly for some violators. The effectiveness of this law is only as good as the enforcement of said law, enforcement of not smoking in a vehicle with a child may be difficult to enforce. Also, police may be tied up ticketing this population, instead of fulfilling other lawful duties.
- Fines for smoking while a child is in the motor vehicle can be an effective tool in reducing this issue. However, law enforcement officer time directed toward upholding this law could leave other, more pressing matters unattended. Additionally, enforcement of this law may prove to be difficult, as smoking can be easily concealed.
During the course of this class and in writing this paper, I have realized how little I knew about politics and the amount of advocacy available for nurses to partake in. I have learned much but have volumes remaining to learn. The need for nurses to be advocates beyond the bedside is dire and educating nurses beyond nursing school of these opportunities are a must for effective healthcare changes to culminate from support and efforts of the profession. Participation in local or work-related political oriented events would be one way to increase knowledge, awareness, and empowerment of nurses. Issues like H.B. 1341 (2015) are easy to understand, easy to support, and the benefits to a child’s health is evident in research. These points make exposure to this piece of legislation the perfect starter for nurses that are new to politics.
The issue of smoking in a motor vehicle while a child is present is an international issue. Although this bill will only be an enforceable law in the state of Oklahoma, similar laws have already been passed in other cities, states, and countries. With the educational information available concerning this subject, I’m hopeful the importance of this issue is noted so this law will find support by legislators. The confinement of a car combined with smoking produces increased health risks for children. With all of the potential dangers out there, passing H.B. 1341 (2015) can help in controlling preventable health issues children face when subjected to second-hand smoke in a motor vehicle.
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