The Challenge

The 2006 U.S. Surgeon General's Report, The Health Consequences of Involuntary Exposure to Tobacco Smoke, confirmed there is no risk-free level of exposure to secondhand smoke.¹ Each year in the United States, secondhand smoke causes 46,000 deaths from heart disease and 3,400 lung cancer deaths in otherwise healthy nonsmokers. In addition to these deaths, secondhand smoke can cause or exacerbate a wide range of other adverse health issues, including respiratory infections and asthma. Secondhand smoke is a serious health hazard, containing more than 60 known or probable carcinogens and more than 4,000 chemicals, including formaldehyde, arsenic, cyanide, and carbon monoxide.

As of March 1, 2010, 32 states plus the District of Columbia and Puerto Rico require 100 percent smoke-free workplaces and/or restaurants and/or bars. Additionally, more than 3,000 municipalities have local laws in effect that restrict where smoking is permitted. Combined, this represents more than two-thirds of the U.S. population.² In 2009 alone, North Carolina enacted a 100 percent smoke-free restaurant and bar law that went into effect on January 2, 2010, and Michigan and Wisconsin enacted laws that will make all workplaces, restaurants and bars smoke-free on May 1, 2010 in Michigan, and July 5, 2010 in Wisconsin. South Dakota also enacted a 100 percent smoke-free restaurant, bar, and gaming facilities law that was scheduled to go into effect on July 1, 2009, but has been suspended by a referendum placing the law on the ballot in November 2010, and will not go into effect unless approved by the voters. Additionally, Maine and Vermont strengthened their statewide smoke-free laws by eliminating the loophole that allowed non-hospitality workplace exemption.

Even with all of these legislative advances, specific segments of the population, such as hospitality and casino workers, continue to be denied their right to breathe smoke-free air. Low-income individuals are especially vulnerable. While the levels of serum cotinine, a biological measure for secondhand smoke exposure, decreased for all populations from 1988-1994 to 1999-2004, the decline was smaller for low-income individuals.³

The Facts⁴

• Tobacco costs our nation approximately $193 billion annually in medical costs and lost productivity.⁵
• Smoke-free laws reduce exposure to cancer-causing pollutants and the incidence of disease.
• Smoke-free laws encourage smokers to quit, increase the number of successful quit attempts, and reduce the total number of cigarettes smoked. For example, after Colorado's smoke-free law went into effect in 2006, calls to the state's tobacco cessation quitline increased by 1,400 percent in the month after implementation and by almost 600 percent after two months.⁶
• Smoke-free laws reduce health care spending and lost economic productivity for individuals, employers, and the government due to smokers who quit or cut back.

 

The Solution

Secondhand smoke affects the entire population in every aspect of life. The Institute of Medicine and the President's Cancer Panel recommend that comprehensive smoke-free laws cover all workplaces, including restaurants, bars, hospital and health care facilities, gaming facilities and correctional facilities.7  Implementing comprehensive smoke-free policies will have immediate health benefits for all citizens, especially those most at risk such as children, as well as casino, restaurant, and bar workers.

Across the country, elected officials at the state and local level are recognizing the health and economic benefits of comprehensive smoke-free laws. ACS CAN and the Society challenge state and local officials to pass comprehensive smoke-free laws in all workplaces, restaurants, bars, and gaming facilities, as well as to overturn existing preemption laws and prevent future preemption laws in order to protect the health of our citizens. Everyone has the right to breathe smoke-free air.

Success Story

For more than five years, advocates and staff in North Carolina have worked to educate state policymakers on the issue of secondhand smoke and the importance of smoke-free policies. On May 19, 2009, the hard work paid off as Governor Beverly Perdue signed into law 21 House Bill 2, which requires all restaurants and bars in North Carolina to be smoke-free beginning January 2, 2010. With passage of this bill, North Carolina became the first major tobacco growing state to approve a 100 percent statewide smoke-free restaurant and bar law.

While the law does not cover non-hospitality workplaces, it does grant communities local control to pass more comprehensive smoke-free local ordinances. Advocates and staff will continue to work on this issue until all workers in North Carolina are protected from secondhand smoke.

The smoke-free legislation was sponsored in the House by Representative Hugh Holliman (D-Davidson), a lung cancer survivor, and in the Senate by Senator Bill
Purcell (D-Anson, Richmond, Scotland, Stanly). A number of provisions to weaken the legislation were defeated prior to its final passage.

References

1. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention,
   Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006
2. American Non-smokers' Rights Foundation. Summary of 100 percent Smoke-free State Laws and Population Protected by 100 percent U.S. Smoke-free Laws, April 20, 2009.
3. CDC. Disparities in Secondhand Smoke Exposure – United States, 1988-2004 and 1999-2004. MMWR. 2008; 57: 744-747.
4. Eriksen, M. and F. Chaloupka. (2007). The Economic Impact of Clean Indoor Air Laws. CA: A Cancer Journal for Clinicians 57: 367-378.
5. CDC. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses – United States, 2000-2004. MMWR. 2008; 57(45): 1226-1228.
6. North American Quitline Consortium. Case Study: Colorado. www.naquitline.org/pdfs/CaseStudy-CO-Mar08.pdf. Accessed June 1, 2009
7. Institute of Medicine. 2007. Ending the tobacco problem: A blueprint for the nation. Washington, DC: The National Academies Press. U.S. Department of Health and Human Services. Promoting Healthy Lifestyles: Policy, Program and Personal Recommendations for Reducing Cancer Risk, 2006-2007 Annual Report of the President's Cancer Panel. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, President's Cancer Panel, 2007.

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