Objective-To estimate the cost eVectiveness of the Lifesavers Residential Fire and Injury Prevention Program (LRFIPP), a smoke alarm giveaway program. Setting-In 1990, the LRFIPP distributed over 10 000 smoke alarms in an area of Oklahoma City at high risk for residential fire injuries. The program also included fire prevention education and battery replacement components. Methods-A cost eVectiveness analysis was conducted from the societal and health care systems perspectives. The study compared program costs with the total costs of medical treatment and productivity losses averted over a five year period. Fatal and non-fatal residential fire related injuries prevented were estimated from surveillance data. Medical costs were obtained from chart reviews of patients with fire related injuries that occurred during the pre-intervention period. Results-During the five years postintervention, it is estimated that the LRFIPP prevented 20 fatal and 24 nonfatal injuries. From the societal perspective, the total discounted cost of the program was $531 000. Total discounted net savings exceeded $15 million. From the health care system perspective, the total discounted net savings were almost $1 million and would have a net saving even if program eVectiveness was reduced by 64%. Conclusions-The program was eVective in reducing fatal and non-fatal residential fire related injuries and was cost saving. Similar programs in other high risk areas would be good investments even if program eVectiveness was lower than that achieved by the LRFIPP. (Injury Prevention 2001;7:276-281)

OBJECTIVES: This study determined the proportion of homes with functioning smoke alarms in a low-income area experiencing a high rate of residential fire-related injuries. METHODS: An on-site survey of households was conducted to confirm the results of a telephone survey. RESULTS: In the telephone survey, 71% of households reported having functioning smoke alarms. In the household survey, 66% of households reported having functioning alarms; however, when the alarms were tested, the percentage dropped to 49%. CONCLUSIONS: Telephone surveys may overestimate the presence of functioning smoke alarms in some populations. Thus, the use of telephone surveys to establish baseline measures could significantly affect the evaluation of smoke-alarm giveaway programs.

No abstract

Businesses changing their practices in ways that support tobacco control efforts recently have gained interest, as demonstrated by CVS Health’s voluntary policy to end tobacco sales. Point of sale (POS) advertisements are associated with youth smoking initiation, increased tobacco consumption, and reduced quit attempts among smokers. There is interest in encouraging retailers to limit tobacco POS advertisements voluntarily. This qualitative exploratory study describes Oklahoma tobacco retailers’ perspectives on a mutual benefit exchange approach, and preferred message and messenger qualities that would entice them to take voluntary action to limit tobacco POS advertisements. This study found mutual benefit exchange could be a viable option along with education and law as strategies to create behavior change among tobacco retailers. Many retailers stated that they would be willing to remove non-contractual POS advertisements for a six-month commitment period when presented with mutual exchange benefit, tailored message, and appropriate messenger. Mutual benefit exchange, as a behavior change strategy to encourage voluntary removal of POS tobacco advertisements, was acceptable to retailers, could enhance local tobacco control in states with preemption, and may contribute to setting the foundation for broader legislative efforts.

Policies that shield people from the harm of tobacco exposure are essential to protect the health of the population. Coalitions have often led the way in safeguarding community health by promoting social norm change though policy adoption. In some states, tobacco control laws are weak, in part because of a tobacco industry tactic of prohibiting or pre-empting communities from enacting ordinances that are more protective. In spite of strong state-level preemptions, local coalitions in Oklahoma have implemented hundreds of voluntary policies in tobacco control that have improved the protection and health of their communities while not violating preemption. Three case studies of policy change are presented that exemplify the key approach of local coalitions working with strong allies and informed decision makers to establish tobacco-free businesses, schools, and outdoor recreational areas. In each of the cases, the policy changes surpassed the protection provided by the state laws and inspired additional policy changes. The key strategies and lessons learned may help tobacco control coalitions in other states limited by preemption to garner more support and momentum for important policy changes within their communities and states.