Reducing Environmental and Occupational Cancer Risks Toolkit

6. Combine Interventions For Maximum Impact

The majority of intervention strategy examples offered are single interventions. However, we know from experience with tobacco control and related cancer risks that it is not just one intervention that can claim responsibility for the reductions we now see in lung cancer death rates. Multiple interventions at multiple scales have been recommended by the Community Guide, such as:  

  • Individual-level interventions – smoking cessation programs, including quitlines and mobile phone text messages.
  • Policy interventions – smoke-free policies and increasing the unit price for tobacco products. 
  • Comprehensive tobacco control programs — a combination of evidence-based strategies at multiple levels to reduce tobacco use and secondhand smoke exposure. 

Multiple interventions at multiple scales are also why we are seeing improvements associated with reductions in carcinogenic air pollution although further reductions are needed across the country. For example:

  • Individual-level interventions – increasing awareness of and adherence to air quality alerts.
  • Institutional interventions – use of air filtration devices to improve indoor air quality compromised by the penetration of polluted outdoor air; ride share programs; use of substitution as a pollution prevention technique to minimize use of toxic chemicals and mitigate air emissions.
  • Policy-level interventions: improved emission standards; use of clean air zones and other zoning changes; converting vehicle fleets to electric engines; increasing public transportation infrastructure.
 

The Toxics Use Reduction Act in Massachusetts as described in Section 5 of this Module is also an example of a multi-level intervention. For example, the policy includes:

  • Individual-level interventions that educate professionals in the industry about the health impacts of toxic chemicals and strategies to support reducing use. 
  • Institution-level interventions that focus on providing direct technical support to industrial facilities to reduce the use of toxins by assisting with redesigning processes and testing substitutes to find feasible and safer alternatives. 
  • Policy-level interventions that require industrial users to pay a fee based on their use of toxic chemicals and to report amounts used. The fee supports technical assistance programs and requires education and training about toxic use reduction strategies.

The use of single interventions will make incremental gains. Multiple interventions are likely to catalyze more change. Taking a step back with a systems lens to examine the collection of interventions and their likely impacts can help illuminate both gaps and opportunities to support change at the scale needed.

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