Key Findings
State Tobacco Control Policy cont'd
Smokefree Air
Health Impact
Cigarettes don’t just harm the people who smoke—they also harm the people around them. Secondhand smoke causes or exacerbates a wide range of adverse health effects. Tobacco smoke contains more than 4,800 chemicals: 200 are poisons; 69 cause cancer in humans and animals.14 In June 2002, the International Agency for Research on Cancer (IARC) of the World Health Organization concluded that secondhand smoke causes lung cancer and other health problems and classified secondhand smoke as a cancer-causing agent in humans.15
Secondhand smoke costs the U.S. economy nearly $10 billion a year, ranging from medical bills to lost hours on the job.16
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Exposure to secondhand smoke causes approximately 35,000 heart disease deaths and 3,000 lung cancer deaths among nonsmokers every year.17 A 2004 study in the British Medical Journal found that secondhand smoke increased the risk of heart disease in nonsmokers by as much as 60 percent.18 The danger from heart disease is so severe that the CDC issued a warning to people at risk for coronary heart disease to avoid exposure to secondhand smoke.19
Secondhand smoke is especially harmful to young children because they breathe in more air than adults and their bodies are still developing. Babies and toddlers are at increased risk—secondhand smoke can contribute to the development of pneumonia, ear infections, bronchitis, coughing, wheezing, and increased mucus production in healthy children less than 18 months of age.20 Children with asthma are especially at risk from exposure to secondhand smoke. The Environmental Protection Agency (EPA) has estimated that exposure to secondhand smoke worsens the conditions of between 200,000 to one million children who have asthma.21
Who Is At Risk?
Progress has been made in educating parents about the dangers of secondhand smoke. The number of youth exposed to secondhand smoke in the home declined by 40 percent between 1999 and 2003.22 Despite the decline there are still more than four million youth between the ages of 12 and 17 (16 percent of all youth) exposed to secondhand smoke in the home.23 A 2005 CDC study found that the levels of cotinine, a chemical marker for secondhand smoke exposure, in children have dropped significantly over the past decade. However, children’s cotinine levels are still more than twice that of adults.24
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Smokefree Air
Results from Helena, MT
A study conducted in Helena, MT, found that the number of heart attacks fell by 40 percent during a six-month period in 2002 when the city’s comprehensive smokefree air law was in effect.
Source: Sargent RP, Shepard RM, Glantz SA. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. BMJ. 2004;328:977-206
Note: Helena, MT’s smokefree ordinance was in effect June 2002 through December 2002. The law has been preempted by state law. |
For adult nonsmokers, the workplace is the primary source of secondhand smoke exposure.25 Though approximately 70 percent of the U.S. workforce was covered by a smokefree workplace policy in 1999, there is great disparity in smokefree workplace policies among specific occupations.26 Food service workers are the least likely group to be covered by smokefree policies. Only 43 percent of food service workers (28 percent of waiters and 13 percent of bartenders) are covered by smokefree workplace policies, compared to 76 percent of white-collar workers.27
Levels of secondhand smoke in restaurants and bars are approximately 1.6 times greater and 7.6 times greater, respectively, than in office workplaces.28 Food service workers have a 50 percent greater risk of dying from lung cancer than the general population.29 However, at the end of 2005, 15 states still had no restrictions on smoking in private worksites, restaurants and bars.30
According to National Cancer Institute (NCI) data, people of color have higher rates of occupational exposure to secondhand smoke; Latinos and Native Americans have the highest rates.31 These high rates stem in part from the fact that people of color are disproportionately employed in food service, manual labor and factory jobs, where rates of exposure to secondhand smoke are highest.32
Benefits of Smokefree Air Policies
Comprehensive smokefree air laws have been effective not only in reducing exposure to secondhand smoke but in increasing the number of people who quit and discouraging kids from starting to smoke. The NCI found that being employed in a workplace where smoking is prohibited is associated with a reduction in the number of cigarettes smoked per day and an increase in the success rate of smokers who are attempting to quit.33
Prohibiting smoking in the workplace can have an immediate and dramatic impact on the health of workers and patrons. A study in the August 2005 issue of Tobacco Control found that since New York’s workplace smoking ban went into effect, bar and restaurant workers are suffering fewer sore throats, runny noses and irritated eyes. The study also found that cotinine levels in study participants declined by 78 percent within the first year after the law went into effect.34
Numerous studies have shown that smokefree air laws have either no effect or a positive effect on the economy. In Florida, a study by the Bureau of Economic and Business Research at the University of Florida found that the statewide smokefree law, which took effect July 1, 2003, has not hurt sales or employment in the hotel, restaurant and tourism industries.35 In Delaware, which has the strongest smokefree air law in the nation, business has remained steady. In fact, data from the Delaware Department of Public Health and the Alcohol Beverage Control Commission show there has been an increase in the number of restaurants and taproom licenses since the smoking ban took effect.36 In New York City, a study found that its smokefree air law had a positive effect on the economy. Since the smokefree air law took effect, business receipts for restaurants and bars have increased 8.7 percent, employment has risen (2,800 seasonally adjusted jobs), and cotinine levels in non-smoking workers have decreased by 85 percent.37
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Smokefree Air Challenge
Smokefree States*
California (1998)
Connecticut (2004)
Delaware (2002)
Maine (2003)
Massachusetts (2004)
New York (2003)
Rhode Island (2004)
Vermont (2005)
Washington (2005)
*Smokefree States prohibit smoking in almost all workplaces, including restaurants and bars. |
Smokefree air laws are also very popular with the public. A 2005 Gallup poll found that a majority of Americans support smokefree policies including a total ban on smoking in restaurants.38 A survey of registered voters in New York City found that the smokefree workplace law is very popular—more popular than the New York Yankees, Coney Island, and even Krispy Kreme donuts.39
2005 Highlights
Statewide smokefree air laws continued to be tightened as six states— Georgia, Montana, North Dakota, Rhode Island, Vermont and Washington—strengthened their smokefree air laws.
Vermont led the way by prohibiting smoking in bars and private clubs. Voters in Washington overwhelmingly voted to make their state smokefree. Vermont and Washington join California, Connecticut, Delaware, Maine, Massachusetts, New York, and Rhode Island as Smokefree States, states that prohibit smoking in almost all public places and workplaces, including restaurants and bars.
Montana’s law prohibits smoking in workplaces, including restaurants. Bars in Montana are required to go smokefree in 2009. North Dakota’s law prohibits smoking in public places and workplaces but excludes bars. Georgia’s law prohibits smoking in public places and most workplaces but includes exemptions for restaurants and bars.
Illinois became the first state to pass a stand-alone bill repealing preemption of its smokefree air law. Communities in Illinois are now able to pass laws that protect people from secondhand smoke. Unfortunately, 20 states partially or totally preempt local communities from passing smokefree air ordinances. 40
Thirty states, Puerto Rico and the District of Columbia received an F for smokefree air. That translates into millions of Americans still exposed to secondhand smoke in restaurants, workplaces, and other public places. The American Lung Association is concerned with the health of everyone. Everyone has the right to breathe clean, smokefree air in all public places and workplaces.
Looking Ahead
The American Lung Association Smokefree Air 2010 Challenge calls on all states and communities to enact smokefree air laws that cover everyone. The momentum toward a smokefree society will continue as more states and communities act to protect all of their citizens by adopting comprehensive smokefree air laws.
Key Findings Continued... |
