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Leading by example – and with the support of the community

Several years ago, a number of communities in Cape Breton found themselves in an unusual, and smoky, situation. The merger of several communities to form the Cape Breton District Municipality meant that there was no longer a by-law in place to address smoking in public places. The local health authority decided to tackle that problem – and in the process, lead the way for the rest of Nova Scotia. Three key lessons were learned, says John Malcom, CEO of the Cape Breton District Health Authority. “First,” he stresses, “you have to have a commitment to leadership. You have to be willing to stand up and take the criticism.

Staff at the district health authority stood tall and made it a priority to get an effective, and comprehensive, smoking by-law in place for their community. Medical staff even got on the phone with local councillors to convince them that the proposed new by-law – at the time the toughest in the province – was good for the health of the community and would not harm the health of local businesses.

Malcom remembers the council session where the by-law was leadingbyexamplebeing discussed. “It was packed with health professionals,” he says. Those individuals spoke from experience – and from the heart. One councillor, opposed to the by-law, changed his position after his family doctor said to him, simply, “Do the right thing.”

The right thing translated into a by-law that moved beyond simply dividing buildings into smoking and non-smoking

L-R: Dr. M Naqvi, Medical Director & Chief of Staff and Mr. Don Ferguson, Former Board Chair, Cape Breton District Health Authority
areas. The right thing was also the best thing for the Island as a whole and the neighbouring district health authority, the Guysborough Antigonish Strait Health Authority. A commitment was made to roll out the by-law throughout the Island and beyond.

“The Island went smoke-free,” recalls Malcom proudly. “It’s the first time an Island has gone smoke free, and we had the highest rates of cancer in the province.”

“Our goal,” he adds, “was to reduce the percentage of smokers from 30 percent to 25 percent in five years. The rate fell to 24 percent in three years.”

The second lesson learned by the district health authority was the importance of getting involved and taking leadership. Cancer Care Nova Scotia recently honoured the district with the first Leadership Excellence Award for its work in this area.

Leadership and involvement by CBDHA continued even after the by-law was passed. In the following municipal elections, there was serious concern that some candidates would oppose the by-law if elected. The district health authority conducted a survey of Cape Bretoners. That poll found that 77 percent of residents were in favour of the by-law. And two weeks after that, the entire province of Nova Scotia went smoke free.

Enforcement was not an issue, noted Malcom, although there had been some apprehension that the by-law would not work once passed. However, the by-law was put forward as something that was good for everyone on the Island, and not merely a way to curtail smoking.

As a result, says Malcom, “almost instantly people complied. Cape Bretoners will move heaven and earth for their family and neighbours. That is a Cape Breton tradition.”

So is celebrating success is another Cape Breton tradition and the third lesson learned. “We hosted a special event at the Canso Causeway to acknowledge the hard work that went into this effort and to thank everyone involved.”

That tradition of celebrating – and community involvement – continues today. Enhancing healthy eating and physical activity is now the challenge, and John Malcom has personally risen to that challenge. The medical staff have bought him a bicycle, which will be auctioned off later this year, and Malcom has set a goal of cycling from Glace Bay to the Regional Hospital in Sydney. In the process, he hopes to lose 10 per cent of his body weight.

“We have to prove we mean what we say,” he says.

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