4. In which ways is the initiative creative and innovative?
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Teen-oriented and teen-participation initiative
(1) Community-Wide Tobacco Mapping for Teens: using mobile technology for anti-smoking efforts for the first time in Korea
The tobacco mapping program broke free of the mold of merely lecturing teens on the harms of smoking, and instead actively sought the participation of teens and local communities to use mobile technology to map environments that encourage smoking. The results of volunteers’ work were relayed to the Seocho-gu District Office to improve its anti-smoking awareness and regulatory programs for teens.
(2) Health Youth Program (Tobacco Industry Expose): the first-ever program in Korea to make smoking “abnormal” to students
The Health Youth Program (Tobacco Industry Expose), the first of its kind ever tried in Korea, was introduced out of a need for a new paradigm in anti-smoking education that could achieve “a smoke-free next generation.” The program intends to show students how smoking and the tobacco industry are “abnormal” by exposing the marketing tricks and lobbying efforts of tobacco industries, thus enlightening them on what tobacco companies do to try to keep people hooked on smoking.
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5. Who implemented the initiative and what is the size of the population affected by this initiative?
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An extensive and effective network of cooperation led by public healthcare clinics
The Seocho-gu District Office’s anti-smoking policy is implemented along an extensive and effective network of cooperation led by public healthcare clinics and various departments of the district office. Health promotion teams at public healthcare clinics oversee anti-smoking efforts for teens, such as the Community-Wide Tobacco Mapping for Teens Program and the Health Youth Program (Tobacco Industry Expose). They relay feedback from participants of the Community-Wide Tobacco Mapping for Teens Program to various responsible departments of the district office, including the Urban Planning, Roads, and Public Hygiene Administration Divisions. Smoker management teams at public healthcare clinics oversee the prohibition of smoking in smoke-free zones, while the Job Creation & Economy Divisionis responsible for minimizing the creation of new tobacco retailers. And the Nineteen⑲ Campaign has been carried out with the ongoing cooperation of the district’s community service centers.
Freeing over a million citizens daily from the harms of secondhand smoke
While public healthcare clinics are officially in charge of designating smoke-free zones and keeping them smoke free, citizens’ own participation in various district programs and campaigns forms the core of the Seocho-gu District Office’s anti-smoking efforts. Gangnam-daero is the busiest and most crowded commercial street in Korea, visited by over a million Koreans and international tourists every day. Seocho’s designation of the boulevard as a smoke-free zone thus frees a million people from the harms of secondhand smoke daily.
Greater support for smokers
The Seocho-gu District Office’s anti-smoking clinic, which opened its doors in 2005, helps 2,000 to 4,000 smokers (three to six percent of all local smokers) quit smoking annually. The clinic also runs the Anti-Smoking Clinic on the Go program, which conducts over 100 visits a year to local businesses, university campuses, military posts, and police stations.
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6. How was the strategy implemented and what resources were mobilized?
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Pre-designation public opinion polls on smoke-free zones
In an effort to minimize the public controversy and resistance to the designation of smoke-free zones in public areas, the Seocho-gu District Office surveyed locals for their opinions (with respect to secondhand smoke, the designation of smoke-free zones, and the creation of smoking booths, etc.) to identify policy needs and strengthen support for the policy.
Research on anti-smoking efforts
In developing the Health Youth Program (Tobacco Industry Expose) to enlighten teens of the dubious activities of tobacco companies and present smoking as “abnormal,” the Seocho-gu District Office contracted the research service of Inje University’s Industrial-Academic Collaboration Group, and hired anti-smoking counselors from Seocho’s anti-smoking clinic as instructors for school class presentations.
The Seoul National University’s Institute for Health and the Environment was also commissioned to analyze the air quality inside the airtight smoking booths at Gangnam Central Express Bus Terminal and elsewhere in March 2013. The analysis revealed that smokers in airtight booths were exposed to concentrations of PM2.5 fine particles in the range of 453.9 ± 412.2㎍/㎥, almost 3.5 times higher than was the case for smokers in open booths. As a result, Seocho-gu installed ventilated smoking booths at Sadang Subway Station and elsewhere to better protect the health of smokers.
Effective cooperation with local communities
Local communities actively participated in the Seocho-gu District Office’s anti-smoking campaigns, with local police precincts, education offices, convenience stores and residents volunteering for the Nineteen⑲ Campaign, students of Baekseok Arts University designing an anti-smoking mascot and organizing street performances for smoke-free zones, and the Korean Association on Smoking and Health and other NGOs organizing diverse ceremonies and events toward fostering a smoke-free street culture.
Korea’s first-ever municipal anti-smoking task force
In an effort to enhance the effectiveness of its anti-smoking policy, the Seocho-gu District Office assembled a task force in March 2012, the first of its kind in Korea. It also hired 18 anti-smoking monitoring agents, all on full-time regular government service contracts, to monitor smoking in smoke-free zones day and night.
Efficient fiscal management: Using donations from businesses, collected fines, and public healthcare clinic budgets
Under an agreement with the JW Foundation to provide incentives for people to quit smoking, the Seocho-gu District Office awards 16 participants in the Seocho Anti-Smoking Retreat Program every year with KRW 10 million each.
It has also hired 18 anti-smoking monitoring agents (amounting to KRW 460.72 million in annual labor costs), without increasing its fiscal burden, by drawing upon the monetary fines collected (totaling KRW 698.17 million in 2016) for their salaries.
Other funds from the surplus public healthcare clinic budget are used for the display of anti-smoking messages on billboards, banners, and signboards and to produce community maps showing where smoke-free zones are located.
Seocho Smoke-Free Zone App
Under an agreement with Seoul National University, the Seocho-gu District Office developed the Seocho Smoke-Free Zone App in November 2012. The mobile application sends out sound and text to alert a user if she or he is 20 meters away from a smoke-free zone and it also provides a map on the 298 smoke-free zones in Seocho, while warning users against smoking in those zones.
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7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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Public healthcare clinics and departments of the Seocho-gu District Office
The anti-smoking campaign first began with public healthcare clinics participating as sole actors. Over time, however, an extensive system of interdepartmental collaboration was developed, connecting all related departments in the district office. The Job Creation & Economy Divisionhandles rule changes for reducing the number of tobacco retailors; the City Planning, Roads, and Cleaning Administration Divisions, deal with feedback from the community-wide mapping program; the Informatization Support Division, connects the community-wide tobacco maps to the Seocho Map, a ubiquitous community app; the local community service centers and the Resident Administration Division, manage the Nineteen⑲ Campaign and its promotion; and the Seniors and Youth, as well as the Jobs and Economy divisions, crack down on illegal tobacco sales by taking appropriate administrative actions.
Local residents, civil organizations, and communities
The Seocho-gu District Office’s anti-smoking campaign for teens crucially depends upon local communities’ participation. The Community-wide Tobacco Mapping for Teens Program involves the participation of schools and youth centers; the Nineteen⑲ Campaign involves local police precincts, the education office, convenience stores, and local residents.
Moreover, the Seocho-gu District Office enlisted the participation of Inje University’s Graduate School of Health as well as the Industrial-Academic Collaboration Group to design, operate, and monitor the Health Youth Program (Tobacco Industry Expose), with students of medical administration from Baekseok University also involved as assistants. Also, to ensure effective anti-smoking education for teens in school, the Seocho-gu District Office has held multiple discussions, meetings, and workshops with education support offices, school nurses, and classroom anti-smoking trainers. Finally, the district’s anti-smoking clinic assisted smokers who repeatedly failed to quit smoking by referring them to nicotine addiction clinics for formal medical opinions, or to the anti-smoking camp of the Seoul Non-Smoking Support Center for in-depth addiction treatment.
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8. What were the most successful outputs and why was the initiative effective?
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Fostering a non-smoking culture in the streets
The Seocho-gu District Office’s designation of Gangnam-daero as a smoke-free zone has induced positive change in the behavior of smokers, who used to see smoking as a natural part of walking down the street. The district now has 1,208 smoke-free zones, including Gangnam-daero, the Central Express Bus Terminal Plaza, and the areas around nurseries and kindergartens. The district’s anti-smoking agents caught and fined 78,703 smokers from 2012 to 2016. Keeping Gangnam-daero and the Central Express Bus Terminal, by far the two most crowded locations in Korea, smoke-free had a significant effect on fostering and spreading a non-smoking culture, encouraging non-smoking not only in Seoul, but also nationwide.
Boasting the lowest smoking rate across Korea
The adult smoking rate in the Seocho district was 16.5 percent in 2015, well below Seoul’s citywide average of 19.4 percent and the nationwide average of 22.2 percent. A youth health survey conducted in 2015 also revealed that Seocho had a lower smoking rate among teens (6.1 percent) than the nationwide average (7.8 percent).
Eliminating the harms of smoking with smoke-free environments
Surveys on tobacco products being illegally sold to teenagers in Seocho revealed that the rate of such illegal sales dropped from 60.6 percent in 2012 to 37.6 percent in 2015, a decline of 23 percentage points. Meanwhile, the ratio of convenience stores displaying anti-smoking signs increased from 60.9 percent in 2011 to 83.6 percent by 2015, helping foster an environment that discourages teens from smoking.
In 2016, the Community-Wide Tobacco Mapping for Teens Project revealed that there were 159 harmful environments in need of improvement. The responsible departments of the Seocho-gu District Office completed necessary improvements at 42 of these environments, or 26 percent of the total. They also reinforced monitoring and campaigns against the illegal disposal of garbage and cigarette butts at 68 of the environments, or 43 percent.
Ensuring compliance with the FCTC
As South Korea has been a signatory of the FCTC since 2005 and thereby pledges to the international community to work toward reducing smoking, the Seocho-gu District Office decided to actively carry out anti-smoking efforts that have included non-price measures (designating and expanding smoke-free zones) and demand-reducing measures (banning tobacco sales to minors and reducing the number of new tobacco retailers). In fact, Seocho is the first municipality in Korea to specifically develop and implement policies that comply with the FCTC.
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9. What were the main obstacles encountered and how were they overcome?
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Smokers’ resistance to the designation of smoke-free zones
In the early days of the smoke-free zones, there were many occasions when smokers openly complained about and refused to comply with the enforcement of the anti-smoking law, as they lacked awareness of the new anti-smoking policy. The Seocho-gu District Office sought to minimize smokers’ resistance by creating smoking booths around the Gangnam Subway Station. In addition, there was a trial period of three months before fines were actually levied on smokers, so that the public would be more aware of the introduction of the new anti-smoking law. A total of 2,067 volunteers participated in 162 monitoring sessions, warning 4,391 smokers against the new regulation in total.
Tobacco retailers’ resistance
The amendment to the Rules on the Authorization of Tobacco Retailers, with the goal of reducing the number of new tobacco retailers, incurred resistance from tobacco and retail industries. The Seocho-gu District Office therefore comprehensively educated the public on why public health had a priority over the freedom of business. It highlighted that tobacco retailers were not ordinary commercial enterprises whose ownership could be transferred or sold, and that the Tobacco Business Act was not designed to protect tobacco retailers. Thanks to the district office’s continued campaign in the media and press, most residents in Seocho today are even aware that a distance of at least 100 meters is mandatory between any two tobacco retailers.
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