On the smoking ban: An interview with Dr. Rima Nakkash, Chair of AUB’s Tobacco Free task force

Juliette Jabra

Following the beginning of the 2017 Fall semester and upon students returning a now ‘tobacco free’ campus, a multitude of questions and concerns have emerged in response to the recently implemented Tobacco Free 2018 campaign. Outlook recently met with Dr. Rima Nakkash, Associate Professor and Chair of the university-wide task force that is working towards eliminating smoking areas on campus, in order to discuss possible implications and potential solutions to the ban.

Can you please introduce the campaign, how the idea materialized and what it hopes to achieve?

“Sure. So, AUB has a non-smoking policy that began in 2008, which was an update to an earlier policy that started by banning smoking indoors, and then in 2008 it also banned smoking outdoors but kept it allowed in designated areas. The plan to go completely tobacco free is a mandate by Dr. Fadlo Khuri. When he took office as President of the university, one of his main announcements was that AUB would be going tobacco free, but it is a continuation of the value of moving towards a healthier campus. It is a comprehensive policy so it includes prohibiting the promotion and sale of tobacco products in AUB or at AUB sponsored events. Tobacco products mean any substance containing tobacco leaf, including but not limited to cigarettes, cigars, pipe tobacco, arghile, water-pipe tobacco, snuff, chewing tobacco, or any other product or formulation of matter containing biologically active amounts of nicotine so this includes e-cigarettes too.

In order to mobilize this, he formed a university wide task force of around 30 members that brought together faculty, staff, and students. We’ve been meeting since March. The charge of the task force is firstly to review evidence and experiences of other tobacco free campuses and how they went about doing it, to plan on how such an intervention can be implemented at AUB, to develop an evaluation of the approach, establish a communication campaign, and eventually implement it in January 2018.

A tobacco free campus provides the new generations of students who are coming in with a smoke free environment where it is less likely they will take up smoking. We know that many students who come in are non-smokers and sometimes take it up when they enter university. That, and the fact that the campaign is providing protection from second-hand smoke. If you just consider a group of five or six people smoking together all the time, they’re not only inhaling first-hand smoke but also second-hand smoke from the people around them. We are also providing a clean, healthy environment that models what a university is supposed to be all about. And of course, it promotes practicing the idea and the concept of respecting the rule of law, because it’s a policy and regardless of your opinion, whether you are a smoker or not, this policy has been instated for certain, rational reasons which means that it needs to be enforced. You must comply with this policy, so it is also sort of practicing the respectful rule of law inside the university, which should transfer to outside the university, ideally.”

The policy itself begins in 2018 but we have already started to see some changes around campus. Could you please clarify the reasons behind this?

“Right, the recommendations of the task force were that instead of it being a one-shot change, we should instead enforce a ‘phasing out’ approach. This means that we should start it gradually by decreasing the designated areas. The policy in 2008 had a certain number of allocated places where people could smoke, but those were slowly decreased and four locations were kept inside campus. At this stage up until January, there are these small locations for students, staff, and faculty to smoke in, and this allows for an information/communication period of three months where everybody in the community has had sufficient time to be informed about the changes that will take place, even practice the behaviour change that is needed to no longer smoke inside the campus, and basically unlearn the behaviour of going to a specific, designated area, and instead going outside to smoke, or quitting altogether if they wish. Resources at AUB are provided.”

Seeing as smoking is an addiction to some and a force of habit to others, many people will still be inclined to smoke, but will have to go off-campus to do so. Does this pose any security risks or threats?

“There has been a lot of debate in the task force, and this has been discussed. Of course, people are still going to smoke outside campus, but in the long run, the campaign should contribute and will contribute to decreasing the frequency of smoking and supporting those who wish to quit. Maybe it will also result in fewer smokers. As you said, though, smokers who don’t intend to quit will still want to go have a cigarette. There were some concerns about this in regards to security but for students that come from outside campus anyway, the idea is that they are already leaving university grounds for other reasons. The way that we also mitigated this is that for a specific period of time, we will have areas where students who live on campus will be able to smoke in the evening while still being viewed by the Protection Office, for safety reasons. But eventually those areas will also have to be removed.”

Do you have any comments on the claims that this ban infringes on personal freedom and choice?

“Yes. So, in this argument we always have to think about harm versus good, and the infringement of your rights stop when it also becomes an infringement on the rights of others. There is a counterargument from a non-smoker perspective, in that these non-smokers have the right to not be surrounded by smoke. Also, we are not obliging or requiring anyone by force to stop smoking. We are just asking them to do it outside because we know about what second-hand smoke does and we know about the negative health consequences of second-hand smoke, and we know about the negative consequences about being a permissive environment for smoking. We must always go back and think about the university, and the new students, and the new generations.”

There wasn’t really much dialogue with the students about this initiative, and it came as a shock to many. Is there anything you can say about this?

“There are representatives on the task force from the USFC and SRC. This is a mandate from the President so a participatory approach was not taken in the fact that students were not asked what they thought about this policy at the start.

The President has Town Hall meetings scheduled for students especially and for the whole community to talk about his rationale and his thinking behind it and the value of such an approach.

Students are also involved in a volunteer program that has been endorsed by the President. We have 18 members from the community, most being students but there are some staff and faculty, too. They are being trained to become monitoring volunteers so their role is to monitor the application and compliance of the policy on the ground in the upcoming three months and then later. They will also communicate the rules of the policy to violators in case they do not know about it. The monitoring began as soon as the ban was set in place because we want documented information regarding compliance and non-compliance, to see what is working and what is not. This is the objective of this group. In fact, they have an observation checklist and they’re collecting this information through the LimeSurvey database in order for us to have documented conclusions by the end of each week. Based on what we know from the volunteer group who has been roaming around campus, overall it looks like there is good compliance and that it has been successful to date.”

Has AUB established any treatment plans to help smokers? I have heard of the smoking cessation program if you’d like to expand on that.

“Yes, so AUBMC has, in the Wellness Center, a smoking cessation program. What the task force is adding to that now is that it is building the smoking cessation program in a way that makes it more accessible for staff, students, and faculty by providing medication and nicotine replacement therapy free of charge, for those who are interested. The medication is expensive and quite hard to acquire in Lebanon overall, so what we’re trying to do is make them available for those who choose to use them as one of the quitting strategies.”

Is the program itself covered by the Health Insurance Plan (HIP)?

“Yes, it is. They will not have to pay for doctors’ treatment or behavioural therapy sessions or anything. In addition to that, the medication will be provided for free. The program will be advertised separately and we will inform more people about it. Within the four current designated areas are several panels with information regarding the program, and how to get access to it. Information about the program will have to increase to inform staff, faculty, and students about it more. We do not expect every smoker to go through the program but it is an ethical obligation to provide further support because one step to supporting smokers who want to quit is providing them with the resources they need to do so.”

What action will be taken towards those who fail to comply with the policy?

“The current policy says that any violation by students will follow a certain course of action. What has happened in the past is that students who have been identified to violate the law have their information given to the Office of Student Affairs and then the Dean of Students acts upon the violation. The course begins with a first warning and a second then third are given if students continue to violate the rules. The code of conduct says that after the third warning comes expulsion, I think. So the new policy will also detail a similar approach but what we’re also aiming to do as a task force is to have this method but also to have consequences not only for students, but also for staff and faculty. All members of the community will be treated equally in terms of non-compliance. It is not expected to have a 100% success rate, especially at the beginning, but slowly as people get used to having to leave campus to smoke, it will definitely become less likely to see violators and what is important is that the task force is very serious about enforcing consequences. It does not make sense for anyone who knows about the repercussions of violating the policy to risk reaching expulsion. We would not want students to reach that stage, so this is why it is important to communicate during these three months.”

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