Transcript for:
Key Insights on Public Health Advocacy

welcome everyone my name is Les Hagen I'm an Adjunct professor at the school of Public Health and I'm the executive director of action on smoking and health which is one of Canada's leading Tobacco Control organizations so I'm happy to be here today and uh you're in good hands with Dr Lou and Patrick uh and welcome to the world of Public Health I know you're you've been in this for a few weeks now and it's a pleasure to uh chat with you today about some of the uh principles and practices of public health advocacy and what I'm going to do is I'm going to give you a combination of theory and uh and application today actual practice and and walk you through a campaign one of many that we've been involved with over the years while at the same time giving you a solid grounding in the in the theory and the science around public health advocacy uh and there certainly is a a science base to this um but uh I would say that the application of that science is very much an art form uh and there's no no better way to learn than handson uh and Louie and I teach a graduate class on public health advocacy and in fact that's exactly what we do we put the students through a real life Hands-On exponential learning experience uh uh with respect to uh Public Health uh advocacy and they choose the campaign the topic uh they put all of the elements of The Campaign together and within 13 weeks they are executing and uh running a real life news conference uh meeting with public officials uh putting position papers together and making the case for improved public policy and in fact we even have a few examples of of where the students have in achieved within a 13 week period some meaningful policy development so once you get past your uh get your undergrad degree yeah we'll invite you to come and take our graduate course in public health advocacy but today you're just going to get a a taste and and hopefully uh a good a good uh overview of how all of this work happens and if your goal in life is to maximize your human potential then you're definitely in the right class because this will put you on a path uh to maximizing your impact uh on the planet uh during your short period of time and uh hopefully you're up to the challenge but all we can do is is just give you some uh information some lessons some ideas share the science share some practice and and hopefully you put that to good use uh so uh I'm going to share my slides here and we'll get started all right so uh health advocacy 101 uh hopefully give you a good grounding in public health advocacy and and the elements uh of advocacy campaigns and the tools that we use now I'm going to try to advance my slides our learning objectives today are to describe public health advocacy and its various applications uh we want you to come out of this uh by being able to describe three key elements of successful advocacy campaigns uh to describe media advocacy and its role in shaping policy development and building public support and awareness for various measures and issues and then finally uh to describe healthy public policy and how it differs from Health policy uh two very different things and you'll find out why so yes we do have uh the health advocacy is grounded in science and there is a science base H and in fact there's even at least one model that's been developed for public health advocacy and it's known as the christofel model and this was published quite some time ago but it's still the standing model um there are models uh in uh policy development and Community mobilization and public Communications uh and of course it's possible to combine all of these models but right now there's only one theoretical model uh that's published at least uh to deal with public health advocacy and from that model here are some uh examples of changes uh regarding intermediate products of public health advocacy and you can see they have two different effects and one is at the individual or family level and the other one is at the extended family or Community level and uh we're talking here about uh policy measures or or issues uh for instance in public health right substance abuse unsafe sex speeding and then uh from a uh that's at an individual level at a community level would be talking about speed limits uh and gun controls uh and regulation of um you know perhaps providing a STD education information and and policy measures uh with respect to healthy diet at an individual level uh we'd be talking about uh in improving uh the food supply and food security and uh offering um uh School uh uh Health uh food access programs in schools we' be talking about making sure that uh the homeless have access to food and uh and and kitchens and whatnot uh so and and then when we look at uh stress reduction you know mental health huge public health issue uh there are a number of policy measures uh that we can Implement to improve uh mental health at a community or a societal level uh So within the christoffel conceptual advocacy framework uh we have several stages that uh this author has identified uh the information stage of policy development their public health advocacy which means the ability to ENT identify describe and quantify the problem and a lot of people honestly get hung up right here who are developing or implementing health advocacy campaigns they fail to properly describe the problem in a manner that's either a going to get in public attention or Inspire the public to to get engaged or B to get the government's attention and and to encourage the government uh to uh make an issue of priority and quite often the the step that people Miss is lining up um the uh potential benefits of you of advancing your issue with the benefits of the government implementing its own priorities and there's lots of alignment there you know there every government uh that I'm aware of uh at least in uh in in in democratic government is focused on improving the quality of life and enhancing the quality of life and improving productivity uh you know so those uh right there there is a tremendous opportunity for those of us working in public health to actually work with governments and to find ways of working together to achieve common results uh a lot of people think advocacy is is adversarial uh it can be and it often is um but it doesn't have to be and uh you know I can just talk to you about a number of campaigns we've undertaken over the years where the governments and health organizations and and stakeholders we were all aligned and and wanted the same objectives we might have thought that there was it might have had differences and opinion opinions about how to get to the same end result but fundamentally we were all aligned and you know the Alberta Government and every government in Canada for instance is committed to Tobacco reduction and they all have tobacco reduction goals and strategies in place um are they doing everything they could be doing no are are they doing everything that is aligned with the Public Health Community or with the science no um but the intentions are there and and there have been a number of important uh steps taken over the years even here in Alberta we have some of the strongest tobacco laws in the world and Canada and here in Alberta uh and it's because we have been able to work with government uh and when uh We've when the situation has required us to be adversarial um we're not opposed to that um uh but it's it's a it's a strategy right and sometimes you have to use the carrot sometimes you have to use the stick sometimes you have to use both and and really it's whatever strategy is required to achieve the uh result well at the same time not Burning Bridges because uh this issue is not going away and you have to work with the government of the day whether you like them like it or not uh and you you uh have to link arms and and figure out a way to move the agenda forward together uh so uh now the strategy stage uh this is my favorite part after Gathering all the information developing your position papers and putting it in terms and and frames that the public and the media and the government can understand then it's about developing a strategy on how to get to war your end result and we're going to describe that today what the elements of an effective lobbying or advocacy strategy looks like and then action I guess that's a I enjoy that as well because that means execution uh and I've thrown an evaluation there because if you're not evaluating your efforts as you go along uh you're not maximizing your uh ability to uh achieve change or or or to get the results you were looking for in in a in an effective and efficient means so uh as mentioned earlier what I'm going to do today is I'm going to inject all of this Theory with practical examples from the world of Tobacco Control and uh tobacco we've made huge strides in in tobacco control over the past 30 40 years and in fact uh tobacco reduction is a huge Public Health success story I I think for the last half century one of the biggest Public Health success stories on the planet uh and uh there are some reasons why I mean it's not accidental uh we you know well while fighting a really uh nasty industry that's very well financed um and and certainly knows how to Market its products uh we've been able to achieve achiev some very very meaningful results and when I say we I'm talking about the Public Health Community uh uh in Canada and globally uh and those of us within Public Health who are working on Tobacco production um now the quick answer is to all of that success is so why the why were we so successful why have we been so successful on Tobacco Control well it's because we got political and and one of the reasons we got political is because all the pamphlets and puppet shows and posters uh that were uh used over the years certainly in the first two or three decades in fighting tobac none of that stuff really had much of a meaningful impact so it was out of frustration and and then of course realizing that the tobacco industry was skating circles around the Public Health Community and uh because they had huge advertising campaigns and enormous budgets uh and any there there's no degree of puppet shows and posters and pamphlets that were was going to over overcome the barrage of tobacco industry marketing uh uh strategies so uh out of desperation and enforcement desperation uh and frustration uh the health groups back in the early 80s decided to get political and to take a public policy approach to Tobacco reduction uh and to use publicity as a strategy to get our message out rather than papeto and and the like um because publicity sets the public agenda if if you're not on the public agenda you don't exist as far as the polit governments are concerned and if you're not generating publicity you're not on the public agenda you're not on the radar um we also uh and the broad we right we also and engaged coalitions and Broad networks of health organizations and Professionals in our efforts to reduce and prevent tobacco use that was very successful especially for a small organization like ash we're we're very small but we've got some very big Partners like then the biggest Health Charities and the biggest Health Professions in the country and uh by working with all of these folks we've been able to achieve some meaningful results in Alberta and Beyond uh lobbying is an essential element which you know the nice word is government relations and that just means working with government hopefully in a in a collaborative way to advance public health and your public health policy outcomes and then mobilizing the broader Community mobilizing the public getting the public engaged the emails the letters the phone calls uh the meetings and so that um the politicians feel the heat you know they feel they know that that when they go door knocking they're hearing about your issue and when they attend public events hopefully they're hearing about your issue on a regular basis or again you don't exist uh so in the world of Tobacco Control we have some science that dictates what our best practices and policies are and we've got lots of it because tobacco is one of the most widely P published public health issues in existence uh over 50,000 published peer-reviewed articles exist in very ious Health journals on Tobacco reduction Tobacco Control tobacco use and all of those uh all that research tells us that tax increases are the single most effective means of reducing and preventing tobacco use and this is basic economics for those of you who taken economics classes you know that uh uh that price reduces demand uh the higher the price the less demand the lower the price the more demand so um there are limits you know it's uh we can't tax a tobacco rate out of existence because we could if we do that too quickly we would create an illegal market so we have to do that uh a little more gradually and apply some of our other measures at the same time effective measures like smoking bands and smoking bands uh have have been are a Cornerstone of the success we've had in reducing and preventing tobacco use because it renormalizes smoking and it protects non-smokers and it protects kids from modeling being exposed to smoking in public places in vaping so smoking bands are critical uh marketing restrictions you know putting restrictions on the tobacco companies themselves and how they can Market their products uh and addressing the entire marketing mix the price Place promotion and the product itself and we we have to address the full mix the full marketing mix or the industry will just apply its uh lot you know its un unlimited resources uh if if we just clamp down on promotion then it's going to apply its resources to the product to package design and even to pricing strategies so we have to be consistent and we have to uh tackle all of these marketing issues at the same time it's like a we call it the the balloon effect where you just push on one side of the balloon and the industry will go you know uh put put its time and money in into other strategies so we really have to uh take the air out of the Balloon by limiting all all of the possible strategies the industry can use to Market its products and there still are a number of that strategies legal strategies by which they can Market their products to this very day and then of course a Reliance on evidencebased programs and now I'm talking about getting away from the puppet show and the posters and the pamphlets and and undertaking meaningful and evidence-based health promotion programs that have been proven to reduce and prevent tobacco use including prevention programs um not only in schools but in the greater communities where where people live and smoking cessation treatment uh and programs and again there are some that work and some that don't and we really have to focus on applying those that do work uh this chart uh shows the shows tobacco consumption per capit tobacco consumption in Canada for the past 100 years and you can see it's looks like a a mountain and uh on the from the early 20s until the early 60s there's very a very steep rise in per capita tobacco consumption uh that went along with uh aggressive industry marketing the Advent of the uh of of the manufactured cigarette itself and uh the production high volume production of cigarettes and The Branding and marketing of cig you know the think of the classic B Brands like Marlboro and Lucky Strike and others out of the US and here in Canada players de morier uh export a those have been the big Brands though the Canadian brands are very similar to the uh British Brands that's what our that's why you don't see a lot of Marl burs and Lucky Strikes in Canada because our Brands come from British American Tobacco which is the number one uh tobacco company in Canada and in Britain uh second largest worldwide it's a there are three large tobacco companies globally uh Philip MO is number one they Market Marlboro which is the number one cigarette brand in the world and then British American Tobacco and then Japan tobacco which used to be RJ Reynolds and was bought by uh Japan tobacco about 20 years ago so those are the big three and uh they uh the the tobacco industry had a tremendous amount of success uh right from the early 20s to the early 60s aided and embedded by the industries uh giving away of cigarettes uh in the first and second world wars uh all the troops that had at least in the commonwealth countries had a daily ration of cigarettes uh and you know at the time the we didn't know about the health hazards of smoking or at least didn't know they were as deadly as uh we we subsequently found out they were uh smoking kills one in every two long-term users 47,000 Canadians annually more than any all other forms of substance you combined and it is the leading avoidable cost CA of premature death disability and uh disease in Canada and in the industrial world so it's a huge killer and uh so and and then the other thing that aided the increase in tobacco consumption between the early 20s and the early 60s was the industry's promotion of cigarettes to women because in in the early 20s the earlier part of the last century it was mainly a male uh behav Behavior activity smoking and the industry realized it was losing half the market or wasn't addressing half the market so they came up with specific Brands like Lucky Strike and uh Virginia Slims and others just to Target women uh and to increase their market share and uh sadly of course they were successful and then in the early 60s you notice that there's an Abrupt uh uh halt in the steady decline of tobacco consumption uh and that halt coincided with a number of major health authorities coming to the conclusion that cigarettes were a cause of illness and disease among smokers including lung cancer heart disease and and lung disease and and there were a number of major reports from the U health authorities like the US Surgeon General uh here in Canada from the minister of Health in written from the Royal Society of Physicians uh so these reports were being released and Then followed mainly by public education campaigns for the next 20 years uh at in the 60s to the industry uh was under pressure to remove their advertising from television and and they did um in the US and Canada they because they were going to be it was going to be legislated if they didn't so there was the voluntary removal of at least television advertising in this in the early 60s or late 60s and then of course for the next 20 years as I mentioned mainly public education efforts by governments and uh health organizations Health Charities just telling the people that smoking is harmful and all the risks Associated and you know admittedly that had some impact and at least it it contained uh prevented the steady increase it it it stopped the steady increase of cigarette consumption um but we really didn't start making meaningful progress on Tobacco reduction until the early 80s and this is where if I'm in a class live and in person this is when I ask for hands in the air does anyone know why we saw a sudden decline in tobacco consumption in the early 80s and the answer is really in the title of the slide itself it's because we started to introduce some meaningful policy measures to reduce and prevent tobacco use so smoking bands tax increases marketing restrictions Health warnings on cigarettes uh this is when we started to see the introduction of all these policy measures and when health organizations started to get political and to use public health advocacy as a tool to fight tobacco use instead of just using public education campaigns and where we work uh challenged governments to fight the industry and to introduce regulations to control that industry uh so it's been a pretty steady decline ever since uh a couple of aberration in between um but generally speaking uh we've been making pretty good progress especially in Canada Canada is a global leader in tobacco reduction um we're one of the handful of countries in in the world that is providing Le steady leadership uh but there's still a lot more that we can do so now I'm going to Define give you the difference between Health policy and healthy public policy and there is a world of difference between the two when you hear about health policy or you take a health policy class you're going to hear a lot about supply side solutions to the Health Care system for the Health Care System itself and how health care is delivered and implemented solutions that are focused on service delivery that make the patient care a top priority um and focus on disease management managing illness rather than preventing illness that's what health policy is concerned with really just supply side Solutions uh it's important but in terms of making the population healthier making people healthier the Health Care System itself has has a very little impact on the health of the population uh external factors what we call broad Health determinant or social and environmental determinant have a much greater impact than the Health Care System itself and think talking here about things like income and poverty and homelessness and public policies what we're talking about today um uh Health inequities or social inequities gender inequities literacy education these are all things that influence public health and uh if you look at there are various authors out there experts who've come up with the V various lists of social determinants or you know broad determinants of health and every list I've seen so far puts the Health Care System itself on the bottom of the various measures that can be used to increase the health of the population so keep that in mind uh the Health Care System itself can only move the needle so far uh and you know right now uh with the public health pandemic covid-19 pandemic you know the Health Care system does play a pretty meaningful role uh on the communicable disease side of the equation um uh but I mean it didn't prevent the pandemic right so we could still say that much more can be done to prevent communicable disease and I you know I think we were all hoping we had learned a few more lessons when with the SARS outbreak 15 years ago but uh you know unfortunately here we are in the middle of a a communicable disease infectious disease pandemic um none nonetheless the Health Care system is playing a meaningful role in the public health structure so it's you know one example but the horse is out of the barn right I mean now we're just dealing with mitigating the problem it's here and uh preventing the problem means it would never have come here to begin with or if it did um we would have been able to control it uh with track and Trace like we do other uh uh uh infectious disease outbreaks whether it's measles or tuberculosis or what have you but now we're talking about Community spread and Broad Community spread uh so uh the solutions for health uh when we're talking about healthy public policy the solutions rest in the in the broader community and largely in the hands of policy makers um so the solutions are focused on reducing demands on health care and more importantly much much more importantly actually improving the health of the population and a healthy population is a productive population a healthy population is one that doesn't need to access health care hey here's a novel concept you don't have to go to the doctor you don't have to go to the hospital that's only for sick people right and so if if we can all stay healthy we don't need to rely on the Health Care System uh we and we can use those precious funds to improve the quality of life in the community overall better education better infrastructure you know better recreational opportunities all of that right but right now we're spending close to half of our provincial budgets on health care pro providing health care and that just takes away from everything else we could be doing uh now uh like I said before I'm going to give you some Theory and I'm going to throw some uh real life experience into it uh here in Alberta we've got some special challenges uh when we're talking about public healthy public policy and encouraging governments to to take effective action and here in Alberta uh we have a cowboy culture uh that's historical and it has to do with how this uh uh this uh how Europeans settled this part of Canada or took it over or colonized it and uh they they you know it was largely ranching and trapping and uh you know uh PE individuals entrepreneurs whe they ranchers of Trappers coming in and uh claiming their own territory or their own ranch or Farm or or or trop line and uh get taking advantage of not having any government uh regulations or taxes or or anything else and uh to this very day Alberta maintains the lowest overall taxes in Canada we have the least regulation of uh of any province in in the country we're the only province that doesn't have a provincial sales tax so a lot of these things persist from the days of the Wild Wild West and uh you know along with this Cowboy culture goes risk-taking this attitude of Live and Let Live um uh Work Hard Play Hard Don't Fence Me In low taxes less government all of that right so that makes it harder for people like me who who are trying to get meaningful public policies in place in other words to play put restrictions on the private sector in this case the tobacco industry and on public so and on social behavior such as smoking and vaping in public places that that makes it harder right for for health organizations and health professionals to try to get to the government to to move the needle having said that we've had tremendous progress here in Alberta uh and it's it's taken some time and we've had to be very strategic and we've had to uh uh work a little harder than our colleagues in other provinces uh but we have been able to work with the various uh governments in Alberta uh local and provincial uh to uh reduce and prevent tobacco use and this slide this is a this is a uh front page article it was in the globe in mail uh back in 2007 when Alberta passed one of the most comprehensive tobacco control laws in the world and uh and we that law is still in place uh and that it at the time it baned smoking in all workplaces and public establishments or in the vast majority of public establishments including bars and restaurants it uh outlawed um tobacco sales in pharmacies Healthcare settings and even in postsecondary institutions uh it um placed restrictions on uh retail s retail sale and display and promotion of tobacco products uh and at the time there were only a handful of countries globally that had taken similar measures and and a handful of provinces so it was very uh Progressive legislation passed by a conservative government back in 2007 it it took uh it took a long time to get it but we got it and at the time it was significant it still is very significant legislation and now getting back uh to the rules of the game I talked earlier about the need to set the public agenda uh because if your issue is not on the public agenda it doesn't exist and you don't exist and the public agenda is just kind of broadly defined is what's on the radar what's in the news these days and if your issue isn't regularly in the news and and on the radar of politicians and the media and the general public uh then your chance of success is very very low um so uh we set about deliberately uh to undertake strategies to keep our issue on the public agenda primarily through publicity and and what we call Media advocacy uh and uh we do it in a very deliberate and strategic way we we have defined frames and me messages that we use over and over and repeat while at the same time trying to keep the issue fresh fresh and newsworthy uh now uh you're I believe you're all pursuing careers in in Health Sciences which is good uh and uh you should take comfort in knowing that uh at any given time for the past 30 years that I've been working in uh Public Health uh that the number one issue on the minds of Canadians uh for the greater for the span of that 30 years with a few uh interruptions here and there the number one issue on the minds of Canadians is health care it's a it's a social value and we Canadians we value our Universal Health Care system and we know what the Alternatives look like right because you just have to look South at the border to know what it's like not to have Universal Health Care and and to uh pay dearly uh for private insurance and uh you know and and millions tens of millions of people have no meaningful Health Care coverage at all in the US uh but here in Canada we we have Universal coverage and it does vary from Province to Province right and certainly from illness to illness and treatment to treatment but uh generally speaking we we treasure the system and we value this system and it is a top priority uh it is on the radar it's always on the radar uh and it's often the number one issue and of course right now it is the number one issue in Canada uh because covid-19 is the number one issue in Canada and that means that Health Care is the number one issue in Canada right now and will certainly continue to be until this pandemic is over and Beyond um and sometimes other issues bubble up to the top of the list uh from time to time climate change bubbles up I know when the par Paris Accord was being debated uh uh for a few months uh climate change was at the top of the agenda in terms of the polls right public opinion polls and then at other times like when the economy is tanking uh the economy and jobs uh will come to the top of the list right and we're going to see that we are seeing that too in Canada right now and I'd say after covid-19 the economy is right up there in terms of a public priority but what this means is for those of us working in public health um what we have to do to get our message out and to get the Public's attention and the media and the government's attention is to continually align our public health issues with the health care issues and that's what we do so you know by promoting tobacco reduction we are protecting Public Health we are also protecting and preserving our health care System right so we talk a lot two of our biggest frames our most successful frames in tobacco use uh three protecting Public Health protecting kids and protecting the Health Care System those three have gone a long way uh for us in being able to make the strides we've made in reducing and preventing tobacco use and getting the policy measures in place at at the local provincial and federal levels over the last 203 years uh so what is advocacy two dirty words these are two dirty words in public health historically people don't like to use them uh I love them because without them we wouldn't make the strides we've been able to make but uh people you know rail against politics right but uh think of it this way you know no one likes to uh change bed pens no one likes to give needles to screaming babies right why why why do health professionals do that why do they do that dirty work well because it's a professional responsibility that's why and and I argue that health advocacy is a professional responsibility if you work in the Health Professions and in fact if you look at the code of conduct or code of ethics for a given health profession you will in fact find advocacy on the list so not only is that a professional responsibility but it's in go likely going to be in your own professional code of conduct if you pursue a career in Health Sciences so think about that uh so you actually have a duty to perform health advocacy uh and advocacy in general there's lots of definitions out there and I I've seen definitions that occupy several paragraphs but the easiest way to explain advocacy it's simply the process of achieving change and that change can be as simple as uh getting someone to shovel the walk or getting someone to make dinner um but it's the process of achieving change and lighting a fire and getting someone to do something about a given issue and what is lobbying well lobbying is simply advocacy with policy makers present in the room so you know you're actually trying to convince a politician or a public servant uh to in to take steps uh specific measures uh to influence uh policy and public health outcomes now here are some basic Street rules on advocacy because we can we can talk about Theory until the cows come home and and I can give you lots of reading material um but on the street uh here's how it's executed uh first of all you have to be there that means you have to bear witness right to regardless of of of how nauseating the issue may be and how disturbing you have to be there to understand it you have to feel it you have to live it you have to know what people are going going through you have to visit the cancer WS right you have to talk to the docs and and and and health professionals who are involved you have to you have to engage with the victims and the families you have to know what's going on you have to really understand the issue and the depth of the issue and all of D Dynamics surrounding that issue you need to exercise persistence and perseverance you can't go into something and say well we're going to give it a shot and see what happens and then uh if it doesn't work well then we'll uh you know we're done you you you got to go into it and say you got to have the mindset that we are going to see this thing through to the end whatever that looks like and we're going to take whatever success we can get um along the way and we're not going to take no for an answer um but we're going to play by the rules here and we're you know like ash we don't engage in Civil Disobedience for example I don't have any I don't have a criminal record I I haven't had to tie myself to anything you know like um it's a strategy and hey I you know I get it you know if you know and some organizations have had to rely on that but it's not a very successful strategy in reality because you what you do is you alienate folks who would otherwise support your cause you know you don't want people you want to bring people with you right it's like running you're running your issue for political office and you don't want to turn people off you don't want people to say well I really support their cause but I don't support what they're doing I don't think they should be tying themselves to a bridge you know I can't support that um but I think they've got a good cause you know you you want to bring people with you and you can do it through a legal means it's it sometimes it's it takes a little longer um but uh you know that's where the persistence and perseverance comes in uh you also have to use the evidence right and especi look you're pursuing a a career in Health Sciences right like use the science and there's lots of science uh to deploy uh in public health uh including health advocacy so let's let's learn from others let's not reinvent any there's no need to reinvent anything here and there's good science and bad right and best practices and and and bad practices and just use the best science you have at your disposal uh there's a Hu uh building alliances W with uh organizations and individuals like I mentioned before Ash we're a tiny organization my annual budget is typically less than a half a million I've got about six staff right now uh so we're small uh compared to the major health Charities who have hundreds of Staff across gate but um we work with big these big organizations so we are able to reach out to tens of thousands of people and donors and volunteers for these organizations and their members right so that gives us a lot more uh influence and impact back and then the go name of the game here is to build public support you're trying to move that dial so you know I can give you any number of issues over the years that the public has not supported you know and when I got going and started in this game no one supported the public did not support a ban on smoking in bars for example you know that that was down at about 30 only 30% of people 20 or 30% of people uh when I got started in this business supported as smoking ban and bars so we had to deliberately Implement publicity strategies to move that dial and and to build public support and it again it's like running for election and it's kind of the same principles that you have to get your your name out there to get your message out there you have to use U messages and strategies that will build public uh support and and understanding of what your issue is and it takes time you know it's going to take uh at least several months in most cases if not years to to move the dial on a on on a certain issue to increase public support and you can measure these things through public opinion BS um and publicity is a huge strategy we're talk a little more about that uh again just another example uh this one's getting a little dated but uh we've been able to implement all of these measures uh in Alberta uh over the years and uh we but uh back in July 2011 the these were all none of these measures were implemented and we had to set about to convince the government uh to and and these folks by the way uh you're looking at uh the CEOs of the Cancer Society heart and stroke uh The Lung Association uh and others uh and these with thanks with and the medical association so thanks to all these folks um and their support we were able within uh just a few years to give get all within three years to get all of these measures implemented here in Alber so we were very deliberate and very strategic and very organized now here are some more some rules basic rules of advocacy uh the need to stay focused on key priorities and you have to set out your key priorities right from the beginning and the fewer you have the better uh you know I I like to work in threes maybe because I can only remember three things at a time I believe in the rule of three and three is plenty if if you're pursuing a policy objective you know whether let's say a tax increase expanding smoking restrictions and um getting more restrictions on retail sales I mean that you know our first bill in Alberta that's basically what it achieved right so that those were the big three and that was plenty uh and advocacy 2 advocacy it's all about repeating your key messages not to the point of turning people off and you have to keep the message fresh but to the point of selling right and uh in in in uh the academic world which which you're involved with right now uh the you know the the common commonly held belief is well if I tell you something once that's plenty and if you miss that particular class or that slide or you weren't paying attention that's your own damn fault and you know if you get if you get that question wrong on your on your next exam well that's your that's your fault that's your problem but in the world of health advocacy it's like the world of marketing you really can't say something over you can't say something enough you just have to come up with a clever way to say it you know and one of the things we keep repeating here in Alberta is that Alberta kids deserve first class protection from tobacco products and vaping products we and we keep keep saying that in different ways you know but the first class protection right that means a they're not getting first class protection and B that there is first class protection that they're not you know so it leads us into well here's what first class protection looks like but it's also a widely held social value right who's who's against protecting kids even even tobacco companies won't aren't that dumb won't aren't dumb enough to come out and say well we don't think kids should be protected but what they say is well we think kids should be protected but that's parents that's the job of parents that's not the job of governance you know because parents don't regulate tobacco companies right so they're they're okay with parents uh telling their kids not to smoke but uh and then I talked earlier too about aligning with relevant government priorities and there is no government in Canada I don't care what political stripe it is there is no government in Canada that is that is opposed to improving the quality of life and you may or may not agree you you will you won't agree with every government's philosophies you won't agree with every policies every party's priorities and and neither do I but but I look for we look for the common ground and the Common Ground are these widely held social values preserving Health Care protecting kids improving Health outcomes improving productivity health and productivity go up hand in hand we can't talk about the economy without talking about productivity we can't talk about productivity without talking about health you just have to make all these linkages and and and you have to then you have to communicate these langages and and work people through this including policy makers whether they're politicians or public servants uh you have to understand government processes and we'll talk more about that um here's one one rule of thumb um uh I like to use if if we are working we have to work with uh public servants right people who are working within government and they have to maintain objectivity they can't be seen to be favoring our organization versus another um they fortunately they don't see the need uh to um help the tobacco industry which is good uh I don't think there's any love there lost um U have however uh the best way the here's how you win the support of a public servant who is trying to be objective and just do their job and represent their employer here's the secret you do the work for them you do the work for them you you develop the briefs the arguments uh all the background materials you compile it all you put it in nice binders you put it all together for them and make it dirt simple for them to advance and your cause and and to make all the right arguments and to have all the evidence available when they hear when they when their political Masters the the the elected officials and the minister come to them and say okay we we need to do something on vaping what should we be doing well by the time the minister gets to that public servant you've already given them everything they need and you and you're the hero and and and it's all your stuff and you're already directing the outcome because you've already got them on board you already have them understanding what the solutions are to achieve results do the work for them uh because they're already doing way they've already got too much work on their plate and uh you know they're they're they're having a hard time just keeping up with what they've got in front of them right now every new issue that comes along is just more work so just do the work for it and they they'll be a friend uh don't cross the adversarial boundary that's another rule of thumb and I talked earlier about Civil Disobedience that's a good example when you know you're risking a criminal prosecution from your advocacy work uh you'll turn a lot of people off including a lot of government folks um but also the adversarial boundary is um you know let's you want to hit above the belt if you're you know you you you have to pull you have you have to throw some punches you do you just do you know and you have to tell it like it is uh sometimes people don't like the truth right it can be it can be very painful you know think of residential schools that's a hard truth right that we we all have to live with right but if we're not telling the truth how do we resolve that how how do we um improve the situation how do we decolonize this country right so we have to face some pretty hard truths and sometimes they're not comfortable but the adversarial boundary they things like when you're name calling and getting partisan um you know uh uh when we're delivering criticism I always say the Alberta Government needs to do this and that the Alberta Government is falling short in this we don't say that this political party is falling short we don't say that this particular MLA or the health minister is Premier is falling short we we refrain from that and we just talk about the Alberta Government is falling short rather than to single people out um but also you know uh it's it's always all of government Health ministers come and go governments come and go right so you you got to think long term and there is a way to be a strong Advocate without turning people off and one of my philosophies it it's a simple one is what uh you know every we we we have a lot of meetings we meet with a lot of uh public servants and with a lot of elected officials and my attitude going into a meeting well and and not every meeting is successful I wish right in fact they would say most meetings are not you know there there's it's a process it's every meeting is kind of a step and a no of course in the marketing world no is just the first step toward a yes for those of you who've taken some marketing right um and uh my basic rule of thumb is that if I can't win your support at least in this meeting I will win your respect and uh because then once you've built respect you're also building trust and you're building a relationship so you want to walk out of that meeting with the MLA or Member of Parliament thinking well I I don't support their position on Banning flavored baby right I don't support it but I respect what they have to say boy they put a strong case together they are true professionals you know this you know know that I I really have a lot of respect for who they are and what they're doing even if I can't support that particular issue that's what you want them to think and that's how you build that relationship and that way and that way you can come back too right H they'll let you back in because they know you're respectful and abide by the protocols and that um you you always have a reason professional argument to make the other thing I talk about is M maintaining a moral High ground and it just means not getting down into the mud and rolling around but you know doing the kind of Party politics you really have to avoid part partisan politics don't go there parties come and go governments come and go um they're they're unrelated they're un I have seen every party do U take some phenomenal actions to reduce tobacco use and I have seen every single party fail to take meaningful action on this issue so it's really not about Party politics and we there's been lots of political analysis done on which party supports this and that and and generally speaking in Canada we've had good support from all parties generally speaking with with a few exceptions here and there and again it's because we all support the fundamental outcomes here improving Public Health protecting kids protecting healthare uh improving productivity protecting the economy we're all on the same game uh here's another practical example of a campaign uh that we launched to fight the tobacco industry here in Alberta and uh I actually have my slides reversed here so I'm going to go to the next slide oh no never mind okay I won't make that point this time but I I just um what we were up we're often up against dozens of lobbyists and multi-million dollar advocacy campaigns on the other side and you know there's there just no way we can hire as many lobbyists as the industry or spend as much money as they do so sometimes we just shortcircuit all of that we just call it out we just say hey they've hired 30 lobbyists they they're spending millions of dollars hey all we've got is just one teenager which just have one teenager to stand up against this industry and tell you the truth right and and what does that do well that that creates a media Firestorm that's what it does one teenager you know the you know like Gianna Mar she's like the Greta tumberg of flavored tobacco in Alberta and thanks to Gian we got a flavored tobacco band you know she played a huge role one teenager grade 11 student from Lloyd Minster Alberta who played a huge role and getting uh a flavor band in Alberta on cigarettes um the the second jurisdiction in the world on the planet to ban flavor tobacco uh and the first one was just Nova Scotia just a few months ahead of us and and they just beat us on a technicality otherwise we would have been the first province in Canada the first jurisdiction on the planet to ban all forms of flavor tobacco including menthol cigarettes so uh you know that this is an example of some of the strategies we employ when we're up against the huge giant uh now more rules of lobbying uh developing briefs and position papers uh is essential uh uh now we're getting into lobbying let me switch scares here we were talking about advocacy now we're getting into lobbying which means advocacy with policy makers right so now we're talking about government relations and working with governments I talked earlier about doing the work for for public service well that means developing all the briefs and position papers in advance this also allows you to Define your issue and to Define your messages so it's a good thing to walk before you get engaged with an issue develop a a two-page position paper and Louie and I that's what our advocacy class does the first one of the first things they do is just develop a position paper on an issue and they Define the issue put together some messaging around the issue uh what the policy Solutions are you always have to present Solutions you can't just be out there calling you know making noise about an issue without calling for Solutions that's a waste of time um I've already talked about meeting with public servants uh you know you have to meet with the your key servants and with your key elected officials your ministers Health critics don't get partisan you can be still meet with all the parties but you don't have to be partisan you give everyone the same information you you you treat everyone the same name do not get partisan you know I run a registered charity registered Charities we cannot be partisan or we get our charitable license ped um labor unions can be partisan because they're not registered Charities and they often are um uh Health Professions can be partisan uh it's not illegal um but they it happens but it's not as common uh but registered Charities we cannot be partisan and it's just as well because that's the being taking a partisan positions I call that the short game you know kind of working with the party of the day or the flavor of the day the government of the day that's the short game the long game is working with whatever government you have to advance a longer agenda right something that and Tobacco Control it's more than a four-year election cycle here right I mean we've been this is decades where right and and public policy in general and certainly public health is these Solutions are often decades in the making uh your arguments have to be convincing and compelling and you have to put them in practicable terms that people understand right and sometimes that those aren't your terms and get away from the jargon right you know uh there's a lot of jargon in in health sciences and public health get you know if you're talking to the public politicians get away from the jargon just use plain language um and uh again try not to be partisan or adversarial there is a way to do it and it means you know if you're gonna if you're going to punch hit above the belt and don't don't make it personal and um make be reasonable and and uh but you know you can still be very very strong and Resolute uh without being adversarial unnecessarily having said that we've held lots of news conference over the years calling people out and governments out um but in a in a very uh professional respectful manner now we're going to talk a little more about the structure of developing public policy uh this slide is a mess and that's on purpose so you can see uh all of the various influences on government decisions uh you know with the premier and cabinet at the center of that uh decision making mess right um but what you can also see is uh like these are all push buttons um for influencing government and which in Canada means cabinet for the most part um or the governing caucus you know the governing party uh and the more of those buttons you can push simultaneously uh the more likely you are to achieve success having said that honestly it's hard to push them all and you don't need to you know uh I talk a lot about critical mass you know it's not about making every argument it's not about meeting with every politician or engaging every person and organization who needs to be engaged it's not about uh getting U attention and every uh getting coverage in every uh newspaper it's about creating critical mass so enough pressure uh uh in in in all with all of those do um Dynamics uh to achieve the results you're looking for but you can see the all the pressures on government which include opposition parties and opposition members don't exclude them but just you know don't be partisan uh the various legislature and parliamentary committees other interest groups you know we like to throw cast our net widely and involve as many organizations as we can we've worked with labor unions we've worked with Chambers of Commerce we've worked with all the Health Professions uh we've worked with youth organizations parent organizations the education stakeholders we've worked with an awful lot of people over the years to advance our our common agenda and sometimes we get asked for help too right especially because we've got a track record of success so uh you know people come to us and ask for our advice on on how they can move the needle um but anyway this this is a messy slide that's the point and uh do you need to know that uh there are a number of influence and here's another interesting thing that I picked up early on when I got involved with this even the government itself even the premier doesn't call all the shots they really don't um they might have an idea in mind uh and they might float that idea and that might that idea might might sink like a ship right you know so you know and i' I've seen I remember at one point uh we had a deputy Premier who was opposed to Banning smoking and bars and um you know he was a you know we kind of he was kind of leading the charge against us for a couple of years and then all of a sudden there there there we were in the legislature with the government putting its hands in the air to support a smoking band in bars there was a deputy Premier with his hand in the air you know like we had just created so much critical even though I knew in principal he wasn't supporting it he was pressured to support it by his own caucus members and by the tremendous amount of critical mass we had created but through news coverage working with other health organizations all the letters and phone calls to the point where he couldn't he had to uh hold his nose and vote in favor of a smoking band right so that was quite interesting uh but my point here is that at the end of the day no one has full control over the policy agenda you you do have the ability uh if you apply yourself uh to influence policy outcomes even if they go against the the grain of the government or what you what what the government says it likes to do right you might recall this government uh is very opposed to public spending you might recall that uh but look at all the public spending we've had since covid-19 right governments have to respond to to to to the situation at hand they have to they have to govern and if that means going against their fundamental principles of reducing public spending they will do a 180 uh with with with within the first outbreak in a hospital they will do a 180 you have seen that you have that use this covid experience this is a life experience for all of us right and what governments can do if they need to to address a public health problem um oh here's how to deliver uh punches respectfully here's how you know and effective criticism uh because you're gonna have to there's no way around it uh but there's a way to do it that you where you can still uh win respect if not support among the public policy makers and the media never make it personal you know never say Jason Kenny should do this or that you hear that a lot in the media that's all partisan stuff don't play the partisan game don't the government needs to do this or that not Jason Kenny and and the next Premier who replaces Jason Kenny will also need right I mean these people come and go uh never make it partisan again uh registered Charities I I will lose my license my charitable license if I so I can't but I don't think it's a good idea anyway if you're playing the long game uh always back up your criticism with sound arguments you just can't you know you you have to be able to make a strong argument that the public and media will understand they will walk away saying you know they've got a good point I understand you know that's it's valid criticism um and if you have public support some polling to support what you're saying always use that so you're you know you're saying well three out of four albertans think the government should be doing this we do too too bad the Alberta Government doesn't see it that way but we will continue to work with this government and all of the the mlaas to achieve this goal and we know eventually we will get there right that's the kind of message you have to deliver um you always want to give a heads up so if you if you're going to deliver some criticism we send our news releases out in advance right to the minister or the premier whoever why uh again it's this game of respect right give them some time to prepare their own arguments uh yeah you know it might we know they're going to try to take some stuffing out of our message but we we we're also prepared for that too and we're we're crafting a message that we know is is is going to withstand whatever they come back with so we just have to sharpen our message right and then of course you have to he keep on praise when they do something right you know we got a tax increase on tobacco products last October after just a few months of the government coming in saying well we're not planning to increase taxes we're well within a few months we got a tobacco tax increase right so they're being practical pragmatic they weren't being ideological they are understanding that uh there there are good taxes and bad taxes and the toac tobacco taxes are great taxes because they improve public health and they reduce demand especially among kids uh now uh you know from time to time we do have to call people out but we do it in a respectful way and you know this is a good example we had a health Minister who is also former mayor of Edmonton um who was opposed to a ban a full ban on flavored tobacco products which included a ban on menthol cigarettes which was the most popular flavor tobacco product and uh one one of the people one of the key people who was fighting the ban on Flavor tobacco products was his former campaign manager well we can't sit on that uh people need you know people deserve to know that the former campaign manager of the health minister is fighting a flavor ban right so you know in in cases like this we we have to let people know and uh you know it's it's not about name calling it's it's about uh telling sharing the facts and the truth and letting people know and especially in media that there are some uh evil forces at work and that the industry will use relationships like this to advance its own agenda um you always have to make a business case as well in this day and age if you're trying to convince governments to do anything uh and the main uh point to make is that health and productivity go hand in hand a healthy population is a productive population and produ productivity and the economy right I mean Canada has productivity issues uh we have one of the lowest productivity rates among the oecd countries um so productivity is a source source spot here in Canada uh where the US believe it or not has one is one of the most productive countries you you can criticize them for for a lot of things but uh you know they're a pretty strong economic Powerhouse right and be because they are very productive on a per capita basis very productive and um but Canada we struggle uh so one way to overcome that is to create a healthier population and having a he having a robust Health Care system is not enough we already talked about that that's not NE that's not going to create a healthy population that's just going to patch people up until they get sick again that's all that's going to do to keep people healthy you have to keep them away from the Health Care System away from Dr lot and health professionals right uh the business case quality of life and prevention is is hugely important uh you know the with tobacco use and chronic disease in general the a lot of the burden of chronic disease falls directly on employ ERS and they feel it but reduced increased absenteeism sick leave uh people taking short long-term disability so their insurance costs go up like employers feel this stuff they feel it every day the impact of chronic disease and they're certainly feeling the impact of covid right now my goodness right and you know like we're going to see thousands of businesses are going bankrupt as we speak in Canada right because of of a public health uh pandemic and it's a tragedy uh because it also means that millions of people are unemployed which means that we're going to have a Public Health crisis that continues for many many years uh because of this pandemic um keep in mind though that your strongest arguments are never your e never economic arguments uh yes prevention will reduce demands on Health Care yes it will will it reduce costs not necessarily because every time you can talk to Dr Le about this uh every time you save a dollar on Health Care spending uh in the system there are 10 people lined up who know where to spend that where that dollar should be reapplied whether it's to another procedure or a new drug or a new MRI right and until the government says or the health minister or the deputy Minister until they say every dollar we save is is is going to be reinvested in Social determinant not healthare until they say that and do that um the system will continue to be mismanaged and we will continue to have a spending problem uh until we reinvest those dollars in meaningful prevention activities um dollars saved on healthare uh so you also have to be familiar with the economic literature surrounding your issue whatever it is and there is lots of economic articles on Tobacco For example Tobacco Control tobacco use and uh but again recognize that at the end of the day your best arguments are Health arguments because we can reduce demands on health care but we can't necessarily say we can't claim to save costs because the system doesn't work that way the system is mismanaged that's the fundamental problem here not that it's overused or over taxed the system is mismanaged and governments aren't spending enough time and energy keeping people away from the Health Care system and in the workforce being productive and paying their taxes you would think they would have a vested interest in doing that but maybe that's too short long term right that that's long-term thinking and and a lot of governments are thinking in terms of four-year election Cycles uh now I want to talk about the value of external Partnerships especially for tiny advocacy groups and a lot of advocacy groups are tiny uh and but we have to bring in big partners and and we do and it demonstrates uh that we've got broad-based community support right when we can bring in uh teachers and the Physicians and the nurses and the big Health Charities and even the Chambers of Commerce and other uh you know parent councils um we can bring in other big uh stakeholders to support our efforts it helps to legitimize the cause obviously because now it's not just about a a little noisy advocacy organization now it's a it's a major uh uh effort that is supported by many many stakeholders and a greater Community uh working with these stakeholders can increase your OB obviously your influence and visibility and for me it's not about Ash we you know it's not about branding it's about our messaging right that's where a lot of health organizations a lot of organizations lose it too is they think advancing their cause means branding you know they got to get their organization's name out there and then everyone's going to support there that's not what it's about no it's about getting framing the issue getting your messages out there and if you're in the media you will get name recognition that's a guarantee the more you're in the media the more name recognition you get the less you're in the media the less you are a household P it's that simple and there are a lot of larger organizations who are envious of our profile and wonder how we do it because we don't have an advertising budget we just get a lot of publicity and and and and that's that's a lot of name recognition um of course you're going to build your skills and capacity if you're working with other organizations who've got a lot of strengths a lot of these big organizations have their own Communications shop sometimes they have their own government relations people uh you know they've got a lot of tools and resources that we don't have that we can deploy at at their you know at their upon request um and of course we can share resources and knowledge you know the more people you're working with the greater your your knowledge and experience base right so uh and of course it Fosters cooperation and Goodwill so today's Su you know we work on a campaign today thats sets us up nicely and we achieve some success that sets us up nicely for our next campaign two years down the road or what have you because we all had a good relationship experience one thing I like to do I like to focus on quick hits you know espe if we're working with a new partner a new player I'll we'll just say well uh yeah we have this long-term objective in mind but here's something we can do just within the next two or three months here's a a quick hit a policy objective it's very simple very easy we can get a tobacco tax increase within the next six months that's what we're working on right now right so let's just work on and and work together and see what happens and um then we'll take it from there if we're successful right and and and then everyone and then we have a little celebration you know after that and uh and everyone feels good and says well this wasn't so bad now we can all work together and we achieve something uh tangible and useful and we want to do more now that we know what advocacy looks like and what Ash is all about let's do more and of course the external Partnerships working with others it helps to sustain activity because people will always come and go and organizations have various priorities you know like trying to work with the medical association when and every four years or whatever they have to renegotiate their fees Lou can tell you and when they're in that negotiation period forget about it like don't don't you know go on to your next partner because that is their top priority and same with the teachers right have these negotiating years and they're far less likely to take on external issues um when when they're focused on getting some uh more pay or benefits or what have have you for their own members and they are member-based organizations right and their members are their customers so we have to respect that and that's why we have many players and if someone can't come in can't come to the party this week well maybe they can come to our party next week or next next year right uh again I'm just bringing in some elements of successful campaigns from the past and you get a taste for some of the things we've done excuse the pond because we're talking about flavors here uh but uh this was our effort to get the flavor band here in Alberta second jurisdiction in the world to ban flavor tobacco products and um uh we undertook a number ises hey we even had a poster campaign just to show you I'm not totally against posters but they have their place and uh you know these these were out in high schools we were engaging high schools and engaging uh um teachers parents other health organizations uh in trying to get uh the Alberta Government to ban flavor tobacco products uh and here are the components of that campaign and here are the components of all of of our advocacy campaigns it comes down to the these three items uh to have a strong Communications campaign and we have to do that primarily through publicity because we don't have a big advertising budget like the tobacco industry there are pros and cons to publicity but at least it's cheap you don't have as much control over the message as you do when you pay for advertising or exposure but um you there are strategies you can Undertake and that's another class on how to ensure that your your strategy is getting properly communicated through publicity efforts uh government relations which is lobbying is the second element of a successful advocacy campaign whether that and that involves elected officials but it also involves public servants and in fact I would say for every hour we spend with an elected official we probably spend two hours with the um public servants in inside um you you know you might think that advocacy is all about elected officials uh or government relations but it's not you uh they're key but so are the people working on the inside within the Departments and Ministries you have to spend a lot of time with these folks and then mobilizing right and um through these big uh Partnerships we can mobilize a lot of folks like all the donors and members of the Health Professions and the Charities but also like to engage the public in general and we do that through a variety of measures including social media strategies but letter writing campaigns and uh uh the like you know so uh and you know we've been able to do some cool things over the years like you know shut down call effectively shut down call centers at City Hall o overwhelm the system with with letters and phone calls and emails uh you know we we've been able to pull that off from time to time uh and because of the big Partners we've been able to engage with this issue um you know this is again just interjecting some elements of our flavored tobacco campaign the importance of visual Imaging and images and messages right and here's we call this the candy jar and there was actually we had a couple of candy jars that look just like this we carried them around to all the news conferences and media events we took them with us in our Med with mlas we would just set down that candy jar right down on the desk and start talking about FY tobacco and how much it looks like candy and what it you know how objectionable it is that the leading avoidable killer in the country is candy now available in all the kids favorite flavors right so uh it really helped to convey get the message across the picture is worth a thousand words that is so true oh yeah now here's all the folks we were up against these were the industry lobbyists we were facing uh uh we only had a handful of full-time lobbyists on our side with the health Charities to fight all these people um but uh they're on the wrong side so they're you know we and we are on the right side and we we we implemented uh a number of successful strategies uh but you know there were three rounds in that debate one the first round was getting the legislation passed and that happened in 2013 we got the we got the bill passed the second round was to get the regulations implemented uh a year later that would actually invoke a flavor band we lost that round uh there was a change in Premier and a change in leadership and the industry was able to side itself with the health minister to uh and uh so the government uh even though it passed the legislation to enable a full flavor band the year prior they only decided to implement a partial flavor band that excluded menthol cigarettes the number one flavored product in the year follow so we lost that round but fortunately we Lo we won the third round uh and that was uh after that government oh yeah and this is was the health critic at the time you might know MLA David aen he went on to become education Minister um but at the time was Health critic for the official opposition and he he said that when the government rolled back the Menthol Banner wouldn't implement it he called it a Triumph of insiders so is his example of the opposition parties doing their job and sometimes it all comes together and this was one the criticism all came together the media was questioning well why would they leave out manthal the public was questioning it everyone was because we we had done such a good job over the previous couple of years convincing everyone the public and uh the politicians everyone except the a few key people within government who were heavily lobbied and influenced by the tobacco industry uh we had pretty much convinced everyone that we needed if we're going to ban flavored tobacco we had to ban menthol cigarettes um but uh we won the third round and here we are uh the government I mentioned government's coming go parties come and go and guess what that government uh that party came and went you know even we uh the previous party the conservatives they we actually enjoyed a lot of support from the conservatives over the years we we had a bad experience with the last Premier but for he he was only in office for six months uh before he got TRC at the polls and you know got a new government and one of the very first things they did when they formed government is they said hey you know that Menthol B at the previous Bunch the previous gang uh woodn't templ min well we're going to do that we're going to do that as part of our top 10 list uh of actions in the first 30 days of government so this was the health Minister's very first news conference announcing a menal ban for Alberta and the second jurisdiction in the world to do that to ban all flavored tobacco products including menal cigarettes so that was pretty cool that was national press um so here are the key elements of success uh for advocacy campaigns uh and certainly in our efforts in Tobacco Control and I I can't emphasize any of them over they're all important a supportive bureaucracy working with the public service right and and like I said doing the work for them giving them all the briefs well in advance all the information in advance don't don't try not to surprise anyone let everyone know where you stand what your positions are give them all your arguments give them all your studies all your position you know arm them just arm them with the best knowledge and information they you have and uh then they will be ready for what comes their way uh having a supportive Health Minister Andor Premier is also essential it's it's an uphill battle it's really hard to overcome um a premier who's opposed to your measures or a health minister so we spend the time to develop these relationships and and first and foremost to win their re expect right as I mentioned earlier that comes first and secondly to win and to build and win their support uh and political will which means uh you know just in general are governments prepared to move okay so you've got a supported Premier or government but now is this a top priority for all of the elected officials and for the government as a whole that's also important is the government prepared to move on this issue right now or are there other competing priorities you know what we run into on Tobacco Control is we generally find that governments want to move the needle but they are distracted constantly like there's other issues and priorities that bubble up so they might have a tobacco bill in mind for next session but it gets bumped right by covid or gets bumped by something else we were pretty shocked when Bill 19 made it onto the order paper this spring Albert the new vaping Act in ALA because we thought for sure that it was going to get bumped until the fall or later because of covid-19 but I have to hand it to the uh Alberta Government they took on a full legislative agenda whether you like their policies or not and you know you're going to like some of them right and you're gonna hate some of them and that's with any government um but uh you know they did they put in a lot of work I mean they're not afraid of work these people and they ran a full Jason keny's not afraid of work they put in a full legislative agenda uh during the pandemic and I don't think any other provincial government did that um so we actually got a a vaping Bill and a good one passed uh over the in the early days of the co pandemic here in Alberta uh and again you know uh here in Alberta you know the Canada cowboy country right Canada's world world world country we've made tremendous progress uh and can't underscore the need for an effective Coalition as well and especially for a tiny organization but really if you're trying to advance any cause the more stakeholders and organ organizations coalitions you can put together and build a meaningful front uh to the more likely you are to achieve success and and to have that critical mass of support to advance your agenda uh so now just to review um public health advocacy is focused on healthy public policy which is not Health policy they are they are not the same Health policy is concerned about the delivery of Health Care and on supply side issues that involve healthare healthy public policy involves keeping people away from the hospital keeping people healthy uh improving Health outcomes improving productivity improving quality of life who's against quality of life right it's a widely held social value and we like to align our messages with widely held social value no one's against the quality of life no one's against protecting kids no one is against protecting Health Care no one is and if they are they're not prepared to say that in front of a microphone uh so another today we talk about models and cre including christofel and there are other models in policy development um um but there are models which are science that help us to drive our advocacy activities and then there is the practice of advocacy which is an art form so you really have to marry if you're going to be successful you have to marry the science and the knowledge with the art of execution and the practice of health advocacy uh not like medicine right uh there's a science based to medicine and there's a practice and and the practice looks more like an art form in in many cases uh and has to do with the experience and knowledge of the practitioner um than it it does with the you know medical journals right and science itself you actually need both uh the key elements of advocacy campaigns uh We've we just talked about that keep those things in mind uh so uh having a supportive minister or Premier uh having the political will um uh be having an effective publicity strategy keeping your issue on the public agenda and then mobilizing uh your your people and putting a strong Coalition together and a final message I want to leave with uh that Louis and I leave with all of our graduate students who go through our public health advocacy course is that advocacy if you're working if you're planning a career in public health or in the Health Professions advoc advocacy is actually a professional responsibility right and even if you don't like politics um and you know who likes giving needles to screaming babies who likes changing bed pants no you right but it's a necessity and a professional Duty uh for you to practice health advocacy and if you can't do it at work because your employer won't let you uh then you get involved with other outside organizations like ash or the Public Health Association there are other avenues for you to get engaged as a citizen and to use your Democratic rights and principles and privileges uh to help improve our overall quality of life if you're getting into Health Sciences you obviously are concerned about public health and about health overall well make it meaningful increase your human potential get engaged make it uh make it a a career make it a make your career a passion and it'll be 10 times easier for you to get up in the morning and to get your work done if you are passionate about what you do uh on the job and on off the job uh and I'm all I'm into work life balance as well that's that's you know and it's important to keep a mental strong mental health uh but you have to uh absolutely see advocacy as a professional responsibility uh if you truly want to get engaged with public health if you truly want to maximize your career potential uh so that's it thank you very much it's been a pleasure uh thank you Lou and Patrick for the opportunity uh I give everyone my cell phone I give everyone my email uh if if you want to be influential you know if you if if if you want to engage with people you got to mean it feel free to call me feel free to send me an email I wish you all the best in this class and in your future studies goodbye