Healthy Living in the North

Happy World No Tobacco Day 2019!

World No Tobacco Day graphicI’ve been a registered nurse with Northern Health (NH) for over 13 years. During that time, I’ve had the privilege to care for the health and well-being of people living in this region and our diverse communities. Unfortunately I’ve seen first-hand, the long-term effects that commercial tobacco use has on people in the North.

Tobacco disease affects families

Growing up, I witnessed the complications tobacco use had on my childhood friend’s father; he passed away from lung cancer when we were only 12 years old. Tobacco disease affects the whole family. I know my friend wishes her father was there to watch her graduate, walk her down the aisle, and meet her three children.

Reducing tobacco use

In my role as the Regional Lead for Tobacco Reduction for NH, I try to understand a person’s experience, and I work to reduce disease within our communities through awareness and prevention. This year, the goal of 2019 World No Tobacco Day is to limit the intake of tobacco products and second-hand smoke for ideal lung health.

Do you know these facts about tobacco use?

  • Smoking is the leading cause of preventable disease and premature death in Canada.
  • Tobacco use kills almost 7,000 British Columbians each year. Over 100 of these British Columbians are non-smokers.
  • Children exposed to second-hand smoke are at risk for lung damage.

How to keep your family’s lungs in peak condition:

  • The best thing you can do for your health is to quit smoking. If, at first, you don’t succeed, keep trying. You’re not alone, there’s help: Call 1-800-QUIT-NOW or visit ca for free help.
  • Avoid letting anyone smoke in your house. If you smoke, wear a “smoking shirt,” and remove it before coming back inside.
  • Never smoke in the car, especially when a child is the passenger.

The BC Provincial Smoking Cessation Program includes information for eligible BC residents who wish to stop smoking or using tobacco products. To access your free Nicotine Replacement Therapy, go to the BC Smoking Cessation Program or speak to your local pharmacist.

Other helpful resources:

Note: in this story, as in most public health messages, “tobacco use” refers to the use of commercial tobacco products like cigarettes and chewing tobacco as opposed to traditional uses of tobacco.

Lindsay Willoner

About Lindsay Willoner

Originally from Ontario, Lindsay started her nursing career with Northern Health in 2006 as a public health nurse. Since then, Lindsay has branched out in a variety of leadership roles both within and outside NH, including as a public health resource nurse, working with Options for Sexual Health, community influenza contracts, BCNU stewardship, and working at the local long-term care facility. Lindsay currently works as Regional Nursing Lead for Tobacco Reduction based out of the Terrace Health Unit.


Only in history

Ten year old Miranda Googles the word ‘tobacco’. When the page opens on her tablet, she sees that there are a lot of references there. Old images show people with small, round, tubular objects between their lips called cigarettes. The pictures also show smoke coming from these objects. She wonders how people lived with tobacco in the past.

Delhi Tobacco Museum & Heritage Centre

Imagine if our future generations learn about tobacco only from history books and museums!

Imagine if this scenario could be true. If our future generations learn about tobacco* only from history books and archives on Google!

The number of lives saved from tobacco-related deaths would be upwards of 7 million a year worldwide. Chronic diseases related to tobacco use would be non-existent. Imagine!

Join us this World No Tobacco Day in helping to make commercial tobacco use a thing of the past.

Here’s what you can do:

  • Tell one person you know who uses commercial tobacco that quitting is the best thing they can do for their health.
  • Support them to reach out to and the BC Lung Association for education and support on quitting tobacco use. The person can also go to any pharmacy and enroll for 12 weeks free nicotine replacement therapy (NRT).
  • Tell one person you don’t know that smoking in outdoor spaces closer than 6 metres to doors and windows is affecting the health of others. That within minutes of a few people smoking outdoors, the second-hand smoke concentration equals that of indoors.
  • Provide education and support about outdoor smoke- and vape-free spaces.
  • Check to see if your community has a bylaw that supports smoke- and vape-free outdoor spaces.

Currently, commercial tobacco use rates are about 20% in the north. We have a lot of work to do to help make commercial tobacco use history!

Let’s all work together to make Miranda’s experience a reality.

*In this story, as in most public health messages, “tobacco use” refers to the use of commercial tobacco products like cigarettes and chewing tobacco as opposed to traditional uses of tobacco. Northern Health supports the cultural and ceremonial uses of tobacco and recognizes that the benefits of traditional uses can outweigh the potential harms.


Changes in the air

This blog was co-written by Reg Wulff & Doreen Bond

You know, it wasn’t that long ago that things were a lot different when it came to where a person can smoke. I can remember when smoking was allowed anywhere and anytime. It wasn’t considered hazardous to light up cigarettes in cars with children, in the office, or at a restaurant. You could even smoke on Northern Health property back in the day.

Fort St. John hospital

Northern Health is rolling out a new and improved Smoke Free Grounds policy that will go into effect at all facilities soon!

However, things have changed and now we recognize that a smoke free environment reduces many health risks for smokers and bystanders. Northern Health took action to create a smoke free environment by implementing a Smoke Free Grounds policy back in 2008. After a few years and a few tweaks (such as e-cigarettes and other vapour devices being included in the policy), Northern Health is rolling out a new and improved Smoke Free Grounds policy that will go into effect soon!

While some people might disagree with the idea of asking smokers to move off Northern Health property if they choose to smoke, the policy is supported by valid reasons:

The Smoke Free Grounds policy …

It doesn’t matter whether you work for Northern Health, are a patient in-facility, or are visiting someone in the hospital. For the Smoke Free Grounds policy to be successful, everyone is going to have a role to play!

If you’re a staff member

  • Use Brief Intervention to identify tobacco users and address tobacco as a standard of care using the Nicotine Withdrawal Protocol and Registered Nurse Initiated Action.
  • Be a role model and adhere to the Smoke Free Grounds policy.
  • Use nicotine replacement therapy (NRT) products at work.
  • Let your patients know about the policy and support them in using nicotine replacement therapy products to manage withdrawal symptoms.
  • If you see someone smoking on Northern Health property, tell them about the policy. If you’re unsure of how to approach someone and talk to them about smoking on Northern Health property, ask a tobacco reduction coordinator.

If you’re a patient

  • Respect and adhere to the policy.
  • Ask your nurse about getting nicotine replacement therapy products while you’re in-facility. You can get help to manage nicotine withdrawal symptoms.
  • Look at this as a chance to go without tobacco. When you discover that your health improves by not using tobacco, it might lead to you considering quitting altogether. It’s also important to remember that by not using tobacco, you’ll heal quicker and get home faster!
  • If you do choose to use tobacco, remember that you need to leave Northern Health property to do so.

If you’re a visitor or contractor working on Northern Health property

  • Remember, the Smoke Free Grounds policy applied to everyone. Please respect and adhere to the policy.

At the end of the day, the Smoke Free Grounds policy is an important part of Northern Health’s efforts to create a healthy space for everyone.

What will you do to support the policy and ensure its success?


Reg Wulff

About Reg Wulff

Reg is a licensing officer with Northern Health and has his BA in Health Science. Previously, he worked as a Recreation Therapist with Mental Health and Addictions Services in Terrace as well as a Regional Tobacco Reduction Coordinator. Originally from Revelstoke, Reg enjoys the outdoor activities that Terrace offers, like mountain biking and fishing. Reg also likes playing hockey, working out, and creative writing. He is married and has two sons and believes strongly in a work/life balance as family time is important to him.


The challenge of quitting smoking during pregnancy and staying quit after delivery

Woman smoking beside a field.

Avoiding tobacco use will improve the health of your whole family before, during and after pregnancy.

Want to improve your own health and protect your developing baby from the harmful effects of tobacco and tobacco smoke? Women and their partners who use tobacco during pregnancy are encouraged to quit!

Why quit?

Maternal smoking and exposure to second-hand smoke during pregnancy may increase the risk of miscarriage, preterm birth and early detachment of the placenta. Smoking is also linked to growth restriction during pregnancy and low birth weight. Although a smaller baby may mean an easier labour and delivery, low birth weight is a predictor of decreased newborn health and survival.

After a child is born, infants of women who smoke are three times more likely to die from sudden infant death syndrome. Children who are exposed to second-hand smoke have an increased risk of respiratory problems and increased severity of asthma.

When to quit?

Ideally, women and their partners should quit using tobacco prior to pregnancy but if not, then it is important to quit anytime during pregnancy. Every day is a good day to quit smoking!

Support to help you quit smoking and protect your family

Although tobacco dependence is a complex addiction with many factors that make it difficult to quit, many women have been able to quit during their pregnancy.

Women are aware that smoking is not good for their health or the health of their babies and so many are very motivated to quit. It’s sometimes difficult to quit during pregnancy because:

  • Pregnancy speeds up a woman’s metabolism and she may find that she is smoking even more to relieve her cravings.
  • Pregnancy is sometimes a stressful time.
  • A woman’s social network may use tobacco and she may feel left out.

Understanding these factors may help in the development of plan to quit smoking.

Many women wonder if they can use nicotine replacement therapy such as the nicotine patch, gum, lozenge or inhalers when they are pregnant. Opinions vary on the use of these products in pregnancy so women should discuss the use of these products with their physician or pharmacist. Intermittent dosing of nicotine replacement therapies such as lozenges, gum or inhaler are preferred over continuous dosing of the patch.

It is likely that nicotine replacement therapy is safer than cigarette smoking as the mother and baby are only exposed to nicotine and none of the other 8,000+ chemicals in cigarette smoke. If you use nicotine replacement therapy instead of smoking cigarettes, the mother and baby are not exposed to the carbon monoxide that reduces oxygen uptake and flow to the developing baby.

Many women are able to quit during their pregnancy and enjoy the positive health effects that come with quitting. It’s important to plan how to stay quit once the baby is delivered as relapse is common after the baby is born.

For information and free support to help you quit, visit QuitNow, call 1-877-455-2233, or ask your pharmacist about the BC Smoking Cessation Program. Do you or a loved one have a quit story? Share it for your chance to win a Fitbit!

Let’s raise children in tobacco free families!

This article was first published in the Summer 2016 issue of Healthier You magazine. Check out the full issue below!


Nancy Viney

About Nancy Viney

Nancy is a registered nurse working in Northern Health’s population health team. She often imagines a day when no one in northern British Columbia suffers from the harmful effects of tobacco. In her time off, she enjoys spending time with her family and friends, especially her two little grandchildren! Nancy also enjoys quilting, knitting, crocheting and many other home spun crafts.


Third-hand smoke, have you heard of it?

Woman lighting a cigarette

The health impacts of smoking and second-hand smoke are relatively well-known, but do you know about the dangers of third-hand smoke?

Third-hand smoke is the stale, smoky odour that lingers in the air that is left behind after a cigarette is extinguished. Electronic cigarettes and other vapourizing devices also leave behind chemicals for others to breathe.

It’s now common knowledge that smoking is harmful and breathing in second-hand smoke is equally harmful to the non-smoker. However, third-hand smoke could be harmful as well.

Like second-hand smoke, third-hand smoke is composed of toxic carcinogens like arsenic, lead, and cyanide as well as heavy metals. Although the visible cigarette smoke is gone, its particles can be deposited onto every surface of a home or vehicle. Sticky, highly toxic particulates can cling to clothes, furniture, flooring, ceilings, walls, hair, skin, toys and bedding. Gases can be absorbed into carpets, draperies, and other upholstery or even incorporated into the environment’s dust. These gases can still be inhaled long after a cigarette has been extinguished.

Third-hand smoke residue is a health hazard for children. Children breathe faster and can inhale more of the toxins. They also crawl on, play on, or are closer to the dusty, contaminated surfaces where the toxic chemicals lay in wait. This increases children’s exposure and puts them at greater risk from the harmful effects of third-hand smoke.

Third-hand smoke is also resistant to normal cleaning. Simply airing out rooms, opening windows, using fans or air conditioners, or confining smoking to only certain areas of a home does not remove the residue left behind from third-hand smoke.

Making homes, vehicles and schools smoke-free is the best way to avoid third-hand smoke.

Avoid exposure to third-hand smoke with these tips:

  • Do not smoke tobacco around children.
  • Shower and wash your hands after smoking.
  • Keep all surfaces clean.
  • Identify your home as smoke-free and do not allow people to smoke in your house or car.
  • Consider wearing a jacket or shirt that can be removed after smoking, especially when holding a child.
  • If you are a tobacco user, quit! Visit QuitNow for resources to help you quit.
Doreen Bond

About Doreen Bond

A true Northerner, Doreen was born and raised in Prince Rupert and has lived in the north her whole life. She works in at the Public Health Unit in Prince Rupert as a Regional Tobacco Reduction Coordinator with Northern Health’s Population Health team. Doreen is passionate about tobacco reduction and has a strong interest in community development. Once contemplating a move to Vancouver Island, she chose to stay in Prince Rupert to raise her sons with everything the north has to offer. In her spare time, she loves sport fishing on the ocean, beachcombing on the white sandy beaches and hiking outdoors on the pristine mountain trails. When not at work, Doreen can be found at home, spending quality time with her family and friends and taking the odd bellydancing class.


NH smoke-free grounds policy: Let’s do it right too!

At the end of 2012, Vancouver Coastal Health authority launched their fantastic new video to promote their tobacco reduction messages, using the music of Tom Lavin.

When I saw the video for the first time, I thought, we need a video like this for Northern Health! The music is great and everyone is involved.

Watch the Vancouver Coastal Health video:

Northern Health’s smoke-free grounds policy was developed to protect everyone from the harmful effects of second hand smoke. There is no safe level of exposure to second hand smoke and even the odour of smoke on clothing (third hand smoke) is harmful. It’s important for staff, physicians, patients and visitors to ensure that our facilities provide a safe environment for health and healing without tobacco smoke and the lingering toxic odour of smoke.

So what is it like for patients who normally smoke? The average smoker will start having cravings to smoke within 30-60 minutes of admission. They may develop a headache, restlessness, irritability, inability to concentrate and other discomforts of withdrawal.

When our patients who smoke are admitted to our facilities, it’s important to minimize the discomfort of their withdrawal symptoms. The Nicotine Withdrawal Protocol should be implemented on admission; patients are offered Nicotine Replacement Therapy products (NRT), such as patches, gum and/or inhalers to decrease their withdrawal symptoms. If cravings persist, the dose can be increased or the patch can be combined with the gum or inhaler. It’s like pain control and withdrawal should be treated like pain!

Patients who experience comfort without the constant need to smoke may even decide to quit, but for now they will feel better and heal faster. Being in an environment where no one is smoking also reduces the desire to smoke!

Tobacco kills half of all its users and many of the patients in our facilities are there because of tobacco-related illnesses. Let’s all work together to escape the harmful effects of tobacco and tobacco smoke.

What can staff do?

  • Ask all patients about tobacco and treatment for withdrawal – make it a standard of care.
  • Use the 5A’s approach: Ask, Advise, Assess, Assist and Arrange.
  • If you smoke, do not smoke on the hospital grounds. Remind your co-workers to smoke off NH property.
  • Ask yourself: Do my clothes smell like smoke? If they do, consider changing after breaks.
  • Consider using NRT or cessation medications while at work.
  • Think about quitting – you can do it!

What can patients do?

  • Ask for the nicotine patch, gum and or inhaler to help you feel more comfortable.
  • Refrain from smoking on the hospital grounds.
  • Think about quitting.
  • Phone Healthlink BC at 8-1-1 for free patches or gum.
  • Visit

If you like videos, Dr. Mike Evans from Toronto has a good one that might help you quit: “What is the single most important thing you can do to quit smoking?”

Enjoy and live tobacco free!

Nancy Viney

About Nancy Viney

Nancy is a registered nurse working in Northern Health’s population health team. She often imagines a day when no one in northern British Columbia suffers from the harmful effects of tobacco. In her time off, she enjoys spending time with her family and friends, especially her two little grandchildren! Nancy also enjoys quilting, knitting, crocheting and many other home spun crafts.


Facing the silent attack of second-hand smoke

Avoiding the trap of second-hand smoke. (Illustration by Andrew Burton)

I recently visited Ireland and Scotland, and I can tell you that every street bench and every corner and every doorway on Argyll Street in Glasgow or Grafton Street in Dublin felt like a Venus fly trap to me, luring me near and attempting to entrap the ex-smoker in me. On the streets, I could hold my breath for 10 seconds max, just long enough to walk from one doorway to another, cough again, inhale, hold my breath and repeat the procedure. I would walk to the nearest bench, breathing relief, and then after a second, there it would be again – a mobile Venus fly trap as someone would sit beside me and light up their cigarette.

The Northern Health guidelines (position paper) on tobacco reduction state that there is no safe level of exposure to second hand smoke. This, for me, is rather personal. My greatest fear is breathing in tobacco smoke. Not just for health reasons, but for that aromatic erotic hit on the senses that says “more!” Yes, dangerous, I know

I am filled with remorse; as a health care professional, shouldn’t I be standing up on a soap box and shouting, “Cigarettes, your end is near, careful you don’t burn your fingers!’? The truth is, there are hundreds of smokers on these streets and their smoke is a real health threat to me. Then I remember the feeling of desperation and anxiety that I used to experience in the absence of a cigarette. I understand this for what it is. It’s the addiction, it’s chronic and it’s relapsing; I fear it – one puff and there is no going back.

This is my job and these people, standing on the streets smoking, are my target audience. I could roll up into the foetal position or stand on the soap box, but neither of these solutions is valuable today. My real job is winning souls, one at a time if necessary, and in helping others to understand the desperate plight of the addict. I can make a difference by quiet perseverance. We now know that the soap box approach doesn’t work. Addicts don’t respond to fear tactics. We are very immune to it, but in the quiet of our hearts, a man walking past us wearing his oxygen, fills us with a feeling which we understand only too well. In addition to this and with the greatest respect to all those who suffer the terrible addiction to tobacco, perhaps it’s time to take it off the streets as well.

For more information on tobacco reduction, both for smokers and those wanting to avoid second-hand smoke, visit the NH tobacco reduction website.

How do you avoid second-hand smoke?

[Editor’s note: Don’t forget to enter the Healthy Living Week 4 Challenge and tell us about how you source local food for your chance to win a great mini freezer!]

Jim Coyle

About Jim Coyle

Jim is a tobacco reduction coordinator with the men’s health program, and has a background in psychiatry and care of the elderly. In former times, Jim was director of care at Simon Fraser Lodge and clinical coordinator at the Brain Injury Group. He came to Canada from Glasgow, Scotland 20 years ago and, when not at work, Jim plays in the band Out of Alba and spends time with his family.