What are the Odds? Community Readiness for Smoke-Free Bingos in First Nation Communities

// // Posted in Vol 7 Issue 1

by Peter J. Hutchinson, Joan L. Bottorff, Natalie Chambers, Roberta Mowatt, Dennis Wardman, Debbie Sullivan, and Wanda Williams

Overview

First Nations communities are concerned about second-hand smoke exposure among young women and children. Tobacco control policies (TCPs) can significantly reduce second-hand smoke, but implementation varies from community to community. This research paper presents six communities’ experiences around establishing smoke-free policies, as well as three main factors that influence a community’s acceptance of TCPs. Also discussed is the community readiness model and how it can be refined for TCPs.

Factors affecting success of TCPs

After qualitatively analyzing participant interviews and observational data, the authors identified three main factors that influence the success of TCPs. These factors were most strongly illustrated in three different community halls used for bingo:

  • Economic drivers: Bingo generated valuable revenue for the community. There was no alternative source of revenue to support community activities and upkeep of the facility, so smoke-free policies were unsuccessful.
  • The Smoking majority: Bingos were held most days of the week and were well-attended by smokers. It became difficult to use the hall for other intended uses, e.g., children’s sports. However, smoking bans were not successful because bingo was considered to be more important than other activities.
  • Community and grassroots support: The band council consulted the community and decided to prohibit smoking during all events. Bingo attendance decreased initially but improved over time as community members became used to the smoke-free policy. However, since attendance did not reach previous levels, adapting the hall for other revenue-generating activities became a priority.

Community readiness model

The community readiness model is a useful tool for assessing a community’s overall stage of readiness for change, particularly those relating to health initiatives. For TCPs, the model needs to be refined to include socioeconomic factors, such as the three identified in the bingo halls. By refining the model to include these factors, First Nations communities can gain a better understanding of how to successfully implement TCPs in the future. In the authors’ words:

Using a comprehensive approach to assessing community readiness has the potential to increase success in implementing comprehensive TCPs and practices in First Nations communities in ways that are culturally relevant, address local conditions, and build on existing efforts.

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