Smoke-Free Indoor Air:
Good for Health. Good for Business.
Frequently Asked Questions
Why has a local coalition formed?
The U.S. Surgeon General has determined that secondhand smoke exposure causes disease and premature death in nonsmokers. Secondhand smoke is a significant and largely preventable risk to health.
Our mission is to educate the community, provide tobacco cessation resources, and work with the community and policy makers to pursue a comprehensive smoke-free workplace ordinance including all bars, restaurants, and entertainment venues.
Why is an ordinance needed for public places and workplaces to be smoke-free?
It’s about good health for employees and the public.
Secondhand smoke is a cause for lung cancer, heart disease, stroke, emphysema and asthma among other diseases. Communities that have implemented smoke-free ordinances have seen substantial decreases in heart attacks and asthma attacks. Employees, both smokers and nonsmokers, have also reported fewer instances of respiratory and sensory symptoms of shortness of breath, wheezing, morning cough, phlegm production, and eye-nose-throat irritation.
An average 19% reduction in hospital admissions for heart attacks has been seen within the first year in communities implementing ordinances for smoke-free public places and workplaces.
Secondhand smoke is a major trigger for asthma attacks. Lexington, Kentucky experiences a 22% decline in hospital emergency room visits due to asthma attacks in the first 32 months after their smoke-free ordinance went into effect compared to the previous 32 months. Callaway County averages 171 emergency room visits per year due to asthma attacks. A smoke-free ordinance could potentially prevent 29 such emergency room visits.
Why should government mandate how a private business is operated?
Government already has regulations for private businesses, such as codes for electrical wiring, requiring fire exits, keeping foods at safe holding temperatures, maximum occupant loads, etc. These regulations are for the health and safety of the building occupants and the community. Especially with the solid science about the health effects of secondhand smoke, it is indeed appropriate for government to establish a regulation to prevent this totally unnecessary pollution of the air with a known cause of cancer and heart disease.
Won’t businesses be hurt if an ordinance requires them to go smoke-free? I heard that Columbia’s smoke-free ordinance put a lot of places out of business.
The potential loss of business is a very real fear for business owners. But the fear is without merit. However, this does not stop tobacco industry or their front groups from hyping this fear to alarm business owners.
Local governmental policymakers can be deluged with economic studies from proponents and opponents. A quick preliminary assessment of whether to believe a study can be made by asking three questions:
1. Did the study objectively measure what actually happened; or was it based on subjective predictions or assessments? [Sales tax receipts are good objective data].
2. Was the study published in a peer-reviewed journal?
3. Was the study funded by a source clearly independent of the tobacco industry?
A review of the studies that were available in 2003 concluded that those that met all three criteria found no negative economic impact on businesses following the enactment of smoke-free ordinances. In some cases, there were even slight increases. Of the studies that that did find negative economic impact, none were based on objective data; only one was peer-reviewed, and all were funded by the tobacco industry or one of their front groups. A growing number of subsequent studies meeting these criteria confirm this conclusion.
Despite the oft-made prediction that smoke-free ordinance will cause restaurants and bars to close, such was not evident for Columbia. While Missouri saw an increase of 5.8% in the number of restaurants and bars, Jefferson City saw a larger increase at 8.7%, but Columbia saw an increase of 18.3%, more than twice the percentage increase for Jefferson City and more than three times that for Missouri. In fact, the smallest number of restaurants and bars operating in Columbia after their smoke-free ordinance went into effect was never any lower than the highest number of restaurants and bars in operation before their ordinance.
Isn’t this simply a matter of choice? No one has to go into a restaurant or bar that allows smoking. There are plenty of smoke-free places to select from.
This avoids the issue that secondhand smoke is harmful.
Besides, it's often not a choice by infants and children brought into the establishment by others.
What if you’re invited to an event, such as a wedding rehearsal dinner, a company Christmas party, a charity fundraiser, etc., where your presence is expected … and it’s held at a place that allows smoking? Do you risk disappointing or offending the host and others; or do you resign yourself to going home smelling like an ashtray and exposing yourself to secondhand smoke? While you may deal with what you perceive to be a simple annoyance of a foul odor and eye-nose-throat irritation, what if you happened to be asthmatic, or have heart disease, or have bronchitis?
Visitors to Fulton would not likely know which restaurants/bars are smoking or smoke-free. It can be an onerous inconvenience for a visitor to go from place to place searching for a smoke-free place; often resigning one's self to request "non-smoking as far away from the smoking as possible". And what if this visitor had asthma, heart disease or bronchitis? Is this really the kind of impression we want to make on visitors?
Most importantly, what about the employees? A customer may have the choice to enter a place that allows smoking, but the employee is exposed to secondhand smoke for his entire shift. In this economy, it’s not that easy for some people to find jobs and they may have to choose between a paycheck or a preventable risk to their health. Restaurant and bar workers may be students that need flexible work hours; people needing a second job for extra income; or have less education and limited job opportunities. You may experience going home smelling like smoke and the resulting irritation of eyes, nose and throat. Imagine that happening every day you show up for work.
Rather than placing the responsibility upon the non-smoker to seek out a smoke-free place, wouldn’t it be more appropriate for smokers to act responsibly and simply step outside if they feel the craving for a cigarette?
Many restaurants and some bars are already smoke-free with more and more deciding to voluntarily go smoke-free. Shouldn’t we simply let the free market prevail?
The free market concept is fine in general for the selling of goods and products, but not when health is needlessly compromised. There are specific situations when it is appropriate for government intervention and not to be left to the free market. Protection of the public health and welfare is one such appropriate situation.
The free market would not have provided for:
- design of safer automobiles [remember when dashboards were not padded and seatbelts were not standard equipment?]
- proper treatment and disposal of pollutants [remember when cities would discharge raw sewage into rivers and other cities downstream would use the same river for their drinking water source?]
- required removal of friable asbestos from schools, worksites and public places
- improved worksite conditions for coal miners to lessen risk of black lung disease; or textile workers to lessen risk of brown lung disease – As it should for hospitality industry workers at risk for secondhand smoke-related diseases.
There are a lot of different causes of air pollution, why be so concerned about secondhand smoke?
By far, secondhand smoke is the largest source of indoor air pollution. Scores of air quality testing reports have shown more than 90% reductions in particulate matter pollution after implementation of smoke-free ordinances.
Unlike other sources, indoor air pollution from secondhand smoke can be very easily eliminated and without need of expensive and ineffective ventilation or air filtration systems by simply implementing a smoke-free policy.
Aren’t separate smoking and non-smoking sections good enough?
Simply stated, secondhand smoke doesn’t stay in smoking sections. Haven’t you ever experienced the odor of tobacco smoke even though you in the nonsmoking section?
A study of air quality in the smoking and nonsmoking sections of seventeen clubs found that levels of cancer-causing chemicals contained in secondhand smoke were still relatively high in the nonsmoking sections. In short, smoking and nonsmoking sections don’t work.
Would better ventilation systems, air cleaners and more efficient filters be a solution that could accommodate smokers and non-smokers?
The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) assembled a task force specifically to study if ventilation technology could adequately remove or clean secondhand smoke from a building. ASHRAE issued their Position Document in June of 2005 concluding that:
- The preponderance of credible evidence links passive smoking to specific diseases and other adverse health effects in people. No cognizant authorities have identified an acceptable level of environmental tobacco smoke (ETS) exposure, nor is there any expectation that further research will identify such a level.
- At present, the only means of effectively eliminating health risk associated with indoor exposure is to ban smoking activity.
- No other engineering approaches, including current and advanced dilution ventilation or air cleaning technologies, have been demonstrated or should be relied upon to control health risks from ETS exposure in spacing where smoking occurs.
- Because of ASHRAE’s mission to act for the benefit of the public, ASHRAE encourages elimination of smoking in the indoor environment as the optimal way to minimize ETS exposure.
In 2007 when the Illinois legislature was considering a smoke-free state law, the management of a newly constructed casino lobbied for an exemption claiming their multi-million dollar state-of-the-art ventilation system would produce air cleaner than what is found outdoors. The management said the ventilation system would eliminate the concerns about secondhand smoke exposure. However, measurements of particulate matter pollution inside the casino were found to be 16 times greater than found in outdoor air. According to the Environmental Protection Agency’s Air Quality Index, the outdoor air was in the “good” level, while the casino indoor air was in the “very unhealthy” level. Follow-up air quality measurements taken after the smoke-free law was in effect found the level of particulate matter greatly improved to be essentially the same as the outdoor air.
In sum, ventilation and health experts agree, the science is unequivocal. There is no safe level of exposure to SHS and no ventilation system can eliminate health risks presented by SHS.
Most of the more than 4,800 chemicals in secondhand smoke do not have an odor nor cause irritation (e.g. carbon monoxide). At best, ventilation systems, air purifiers and cleaners, and air filtration systems will remove the odor and irritants, but cannot remove or neutralize the more than 69 cancer-causing substances or the more than 200 toxins found in secondhand smoke.
Shouldn’t the business owner be free to choose how to run his/her own business?
We agree, as long as the choice is not one of harming the health and safety of the community, the public, the customers and the employees. Business owners’ rights aren't a license to endanger the public.
It is not left to the owner's discretion whether flaking asbestos can remain in the facility; whether a fire exit can be padlocked; if undersized wiring is acceptable for high amperage electrical equipment; etc. Government has established codes and ordinances to protect the health and safety of the community, the public, the customers, and the employees.
Surgeon General Richard Carmona, M.D. stated emphatically at a news conference in June of 2006 that "unequivocally ... the debate is over. The science is clear: secondhand smoke is not a mere annoyance, but a serious health hazard that causes premature death and disease in children and nonsmoking adults."
The Massachusetts Dept of Public Health found steeper declines in rates for fatal heart attacks among cities that had strong ordinances for smoke-free public places and workplaces. After a strong state law was implemented to have all the cities in the state to be smoke-free, rates for fatal heart attacks dropped nearly 30% in the first 18 months.
Isn’t this yet the loss of another freedom?
Whose freedoms are being infringed upon? 74% of Callaway County adults do not smoke and deserve to breathe indoor air that is not polluted with known cancer-causing chemicals. There is a general expectation for employees to be provided a safe work environment. Don’t employees deserve to breathe unpolluted air in their workplaces?
Is it an erosion of freedoms:
- to require children to be immunized against certain diseases before being admitted to our schools?
- to require use of seatbelts for motorists and passengers?
- to require buildings meet minimum standards for construction, fire safety, electrical wiring, plumbing, etc.?
Each of these examples has the overriding protection of the public good. Preventing the introduction of a known cause of diseases into public places and workplaces is also for the protection of the public good.
Rather than an erosion of freedoms, this is actually a restoration of a protecting a basic human necessity, the right to breathe clean air.
Smoking is a legal activity. If we ban smoking at public places, then what’s next, banning cheeseburgers?
The concern is when someone’s activity, legal or not, is causing harm to someone else. Your sitting next to me and eating a cheeseburger is not going to contribute to my risk for a heart attack; but, your smoking next to me will. The risk from secondhand smoke is real – the risk from secondhand fat isn’t.
Under effective policy, smokers can continue to smoke – just not in a manner to harm others.
Isn’t a smoking ban taking away smokers’ rights?
Smoking is almost never a private matter. Tobacco smoke spreads to everyone in the vicinity, willing or not. Don’t nonsmokers (both customers and employees) have a right to breathe air that is not fouled with chemicals known to cause heart disease and cancer … especially when it is so easy to not pollute the air to begin with? So, whose rights should prevail? Oliver Wendell Holmes, Jr. has been attributed as saying, “The right to swing my fist ends where the other man’s nose begins”; to paraphrase, the smoker’s right to blow smoke ends where another person’s lungs begin.
A smoke-free ordinance does not take away a smoker’s right to smoke. But it does establish the fact that smokers do not have the right to harm other people’s health. If all smokers were respectful of the wellbeing of others and behaved responsibly by going outside to smoke, there would be no need for an ordinance.
Smokers are a minority. Shouldn’t the rights of minorities be protected?
Smoking is not a constitutionally protected right, nor are smokers considered a legally protected minority classification, such as is recognized for race, ethnicity, religion, etc.
Smokers are not prevented from smoking, they are only restricted from smoking in a manner that pollutes the indoor air and endangers the health of others.
At worst, the smoker is inconvenienced to go outside to smoke rather than the nonsmoker employee having to endure this unnecessary air pollution.
Isn’t smoking is part of the culture for bars, bingo halls, bowling centers, etc.?
There is at least one non-fast food restaurant in Fulton that has been extremely successful operating under a smoke-free policy. In addition the local bowling alley has been smoke-free since its opening and still attracts business. Also, a bingo hall in St. Martins has been smoke-free since they’ve opened. Bowling centers in smoke-free cities such as Columbia and Kansas City are still operating. When the Jefferson City’s city council previously considered a smoke-free ordinance, one of the bar owners testified that smoking was part of the culture of an Irish pub. Shortly thereafter, Ireland implemented a smoke-free law for public places, including their famous pubs.
It is a myth that smoking is an integral and necessary part of such culture.
Aren’t most of the customers of bars, bingo halls, bowling centers, etc. smokers?
The management of a casino in the St. Louis area claimed that 70% of casino patrons smoke. Actual counts of smokers in this casino found that only 7% of the customers were smoking at any given time.
Actual counts during an air quality study of Fulton public places found that an average of less than 10% of people in smoking-permitted places where smoking at any given time.
Because visible smoke and its odor and irritants can quickly permeate an area, it is often perceived by many of those present that there was a greater number of people smoking than in reality. In essence, it doesn’t take many burning cigarettes to foul the air in the whole place.
Is there public support for a smoke-free ordinance?
In our county there are over 77% of adults who are non-smokers. This is the overwhelming majority of citizens in our county.
In addition, more than 600 people have signed on as supporting a strong ordinance for smoke-free public places and workplaces.
Organizations endorsing a strong smoke-free ordinance include:
Westminster College
Callaway County Health Department
YMCA of Callaway County
Fulton State Hospital
Callaway Community Hospital
References:
Adopted from Cole County Coalition Frequently asked questions.
[1]The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, U.S. Dept of Health & Human Services, Centers for Disease Control & Prevention, 2006
2 Sargent, Richard P., M.D., et.al, “Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study”, British Medical Journal, April 5, 2004.
3 Bartecchi, Carl, M.D., et.al., “Reduction in the Incidence of Acute Myocardial Infarction Associated with a Citywide Smoking Ordinance” Circulation, Oct 3, 2006.
4 Khuder, S.A., et.al., “The impact of a smoking ban on hospital admissions for coronary heart disease”, Prev Med (2007), doi:10.1016/j.ypmed.2007.03.011
5 Seo, Dong-Chul, et.al., “Reduced Admissions for Acute Myocardial Infarction Associated with a Public Smoking Ban: Matched Control Study”, J. Drug Education, 37(3) 217-226, 2007
6 Cronin E, Kearney P, Kearney P, Sullivan P. Impact of a national smoking ban on the rate of admissions to hospital with acute coronary syndromes. European Society of Cardiology 2007 Congress; September 4, 2007; Vienna, Austria. Poster 3506. [submitted by Dr Edward Cronin of Cork University for publication in peer-reviewed journal]
7 Pell, Jill P., M.D., et.al. “Smoke-free Legislation and Hospitalization for Acute Coronary Syndrome” N Engl J Med 2008: 359: 428-91
8 Rayens, Mary Kay, PhD,a,b, et.al., “Reduction in asthma-related emergency department visits after implementation of a smoke-free law” J Allergy Clin Immunol September 2008, Vol. 122, Issue 3, Pages 537-541.e3
9 Ayers, J.G., et.al., “Bar workers’ health and environmental tobacco smoke exposure (BHETSE): symptomatic improvement in bar staff following smoke-free legislation in Scotland” Occup Environ Med 2009;0:1-8, doi:10.1136/oem.2008.040211
10 http://www.dhss.mo.gov/InpatientHospitalizationMICA/ accessed August 20, 2009
11 M Scollo, et.al., “Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry”, Tobacco Control 2003;12:13-20
12 http://dorx.mo.gov/publicreports/ Accessed June 2, 2009
13 www.tobaccofreeair.com/results.php Accessed August 21, 2009
14Cains, T et. al. Designated “no smoking” areas provide from partial to no protection from environmental tobacco smoke. Tobacco Control 2004:13:17-22.
15“Environmental Tobacco Smoke” Position Document of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers, Inc. June 30, 2005. http://www.ashrae.org/content/ASHRAE/ASHRAE/ArticleAltFormat/20058211239_347.pdf
16 Travers, M.J., “Casino Air Monitoring Study, East St. Louis Illinois” Roswell Park Cancer Institute, September, 2007.
17 American Lung Association, “Roswell Park Cancer Institute Study Shows Very Unhealthy Air Quality Levels”, September 14, 2007.
18 Carmona, Richard, M.D., Remarks at press conference to launch Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, “The Health Effects of Secondhand Smoke”, Tuesday, June 27, 2006
19 Massachusetts Sees Fewer Heart Attack Deaths Since Implementation of Smoke-Free Workplace Law” Massachusetts Department of Public Health news release, November 12, 2008, http://www.mass.gov/?pageID=eohhs2pressrelease&L=4&L0=Home&L1=Government&L2=Departments+and+Divisions&L3=Department+of+Public+Health&sid=Eeohhs2&b=pressrelease&f=081112_heart_attack_deaths&csid=Eeohhs2
20 Missouri Department of Health & Senior Services, 2007 County Level Survey, www.dhss.mo.gov/County_level_study Accessed August 24, 2009
21 Cowan, S.R., Everett, K., Fulton Air Quality Study, September xx, 2009
22 Missouri Ethics Commission www.mec.mo.gov/EthicsWeb/CampaignFinance/ Accessed August 24, 2009
23 United States of America vs. Philip Morris, et.al., Case No. 99-2496 http://coop.dcd.uscourts.gov/99-2496-082006a.pdf