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Methodology

The American Lung Association State of Tobacco Control 2003 is a report card that evaluates state tobacco control laws against recognized criteria and translates each state’s relative progress into a letter grade A, B, C, D or F. A grade of A is assigned for excellent state policy, while an F indicates inadequate state laws. Certainly some states have made progress and recently have passed new measures. While helpful in some cases, this progress nevertheless fails to achieve the results needed to adequately reduce tobacco morbidity and mortality.

The principal reference for all state tobacco laws is State Legislated Actions on Tobacco Issues, 2003 Edition. The American Lung Association has published this compendium of state tobacco laws since 1988.

Calculation

Smokefree Air Laws

The Smokefree Air Laws grading system is based on the criteria developed by an advisory committee convened by the National Cancer Institute. The criteria were presented in the article "Application of a rating system to state clean indoor air laws (USA)" (J.F. Chriqui et. al, Tobacco Control 2002;11:26-34). This approach provides scoring in nine categories: Government Workplaces, Private Workplaces, Schools, Childcare Facilities, Restaurants, Retail Stores, Recreational/Cultural Facilities, Penalties and Enforcement. All laws are open to interpretation and our analysis may differ from those of the authors noted in the above study. In addition, there have been significant changes in state laws since the publication of this paper.

The Smokefree Air Laws grades are based on the performance of three states, California, Delaware and New York, which have perfect scores of 36.1 Grades were given following the standard grade-school system. States receiving scores in the top 10 percent of the standard (90–100 percent) got an A.
Those receiving scores that fell between 80–89 percent got a grade of B, between 70–79 percent a C, and between 60–69 percent a D. Those that fell below 60 percent received an F.

The grades break down as follows:

A = 33 to 36
B = 29 to 32
C = 26 to 28
D = 22 to 25
F = 21 and below

The exceptions to the grading system:

Preemption: State preemption of stricter local ordinances is penalized by a reduction of one letter grade. States with preemption that score a perfect score of 36 points are not penalized for preemption.

Local Ordinances: Comprehensive smokefree air local ordinances that include all workplaces (excluding bars) are considered according to the percentage of population covered. States with over 90 percent of their population covered by comprehensive smokefree ordinances will receive an A, over 80 percent a B, over 70 percent a C, over 60 percent a D and anything under 59 percent will not be considered.2

Key to Smokefree Laws Ratings by Category

For all categories, laws that require that smoking be permitted or laws without any restrictions for the particular category receive a score of zero (0).

1) Government Workplaces (4 points): Target is "government workplaces are 100 percent smokefree, no exemptions." Score was lowered if restriction depended on type of ventilation and/or location of smoking area. A bonus point (+1) was available if the laws met the target criteria and required the grounds or a specified distance from entries/exits to be smokefree.

2) Private Workplaces (4 points): Target is "private workplaces are 100 percent smokefree, no exemptions." Score was lowered if restriction depended on type of ventilation and/or location of smoking area. A bonus point (+1) was available if the laws met the target criteria and required the grounds or a specified distance from entries/exits to be smokefree.

3) Schools (4 points): Target is "no smoking permitted in schools during school hours or while school activities are being conducted." Score was lowered if restriction depended on school hours, type of ventilation and/or location of smoking area. A bonus point (+1) was available if the laws met the target criteria and extended the smoking ban to any time in school facilities including buildings, grounds, etc.

4) Childcare Facilities (4 points): Target is "no smoking permitted during operating hours in childcare facilities (explicitly including licensed, homebased facilities)." Score was lowered if restriction depended on ventilation standards, or location of smoking areas or provided exemptions for certain types of facilities.

5) Restaurants (4 points): Target is "restaurants (explicitly including bar areas of restaurants) are 100 percent smokefree. Score was lowered if restriction depended on type of ventilation and/or location of smoking areas, and exemptions for some restaurants. A bonus point (+1) was available if the laws met the target criteria and extended the ban to bars and taverns, including outdoor seating.

6) Retail Stores (4 points): Target is "retail stores or retail businesses open to the public are 100 percent smokefree." Score was lowered if restriction depended on ventilation standards and/or location of smoking area, and if laws only applied to some but not all retail stores or businesses open to the public.

7) Recreational/Cultural Facilities (4 points): Target is "recreational and cultural facilities are 100 percent smokefree." Score was lowered if restriction depended on ventilation standards and/or location of smoking area, and if laws only applied to some but not all recreational and/or cultural facilities.

8) Penalties (4 points): Target is "penalties or fines, applicable to smokers and to proprietors/employers, for any violation of clean indoor air legislation." Score was lowered if penalties included possibilities for delay, exceptions for either the smokers or the proprietors/employers, or penalties that only applied to some but not all offenses. Intent requirement or affirmative defenses reduced the score by one (1) point. A bonus point (+1) was available if the laws met the target criteria and the penalties or fines were graduated for repeated violations.

9) Enforcement (4 points): Target is "designate an enforcement authority for clean indoor air and require sign posting." Score was lowered if there was no requirement for sign posting, enforcement authority only applied to some sites, or an enforcement authority or sign requirement existed, but not both. A bonus point (+1) was available if the laws met the target criteria and required the enforcement authority to conduct compliance inspections.

Methodology Continued ...

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