1. A View From Above: The National Perspective on Becoming Smokefree American Public Health Association Conference November 8, 2006 Cynthia Hallett, MPH Executive Director

3. Status of Smokefree Air 45.7% of the U.S. population protected by local or state law with smokefree provisions (as of 10/6/06) 45.7% of the U.S. population protected by local or state law with smokefree provisions (as of 10/6/06) –519 communities and 18 states; in addition 13 countries have a smokefree regulation in effect Westin and Marriott hotel chains have gone smokefree in North America Westin and Marriott hotel chains have gone smokefree in North America Many hospitals and government buildings are smokefree Many hospitals and government buildings are smokefree 17 state and national organizations have adopted policies or resolutions to hold meetings in smokefree municipalities 17 state and national organizations have adopted policies or resolutions to hold meetings in smokefree municipalities

4. From Sections to Smokefree 1980’s = Smokefree Sections 1980’s = Smokefree Sections 1990’s = Smokefree Policies 1990’s = Smokefree Policies –Separately enclosed, separately ventilated rooms 2000 = 100% Smokefree Indoor Environments 2000 = 100% Smokefree Indoor Environments These shifts toward stronger provisions were supported by a combination of public demand and the science on the health effects of secondhand smoke.

5. **As of October 6, 2006

6. Why Work on Smokefree Issues? “There is no risk-free level of exposure to secondhand smoke.” “There is no risk-free level of exposure to secondhand smoke.” U.S. Surgeon General Richard Carmona, June 2006 Secondhand smoke is a toxic air contaminant, an air pollutant which may cause or contribute to an increase in deaths or in serious illness, or which may pose a present or potential hazard to human health. Secondhand smoke is a toxic air contaminant, an air pollutant which may cause or contribute to an increase in deaths or in serious illness, or which may pose a present or potential hazard to human health. California Air Resources Board, January 2006 California Air Resources Board, January 2006

7. Annual Deaths Due to Secondhand Smoke Source: Wells,1998 37,000 13,000 3,000

8. What Policies Are Effective? “Smokefree workplace policies are the only effective way to eliminate secondhand smoke exposure in the workplace. Separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate exposure.” Source: The Health Consequences of Involuntary Exposure to Environmental Tobacco Smoke, 2006 Any law that calls for a 100% smokefree provision is progress, even if one has to take an incremental approach toward comprehensive coverage (e.g., workplaces, then restaurants, bars, casinos, and beyond).

9. Ventilation is NOT a solution ASHRAE Board Policy Statement affirms that ASHRAE Board Policy Statement affirms that Ventilation cannot eliminate all the health risks caused by secondhand smoke exposure. The 2006 Surgeon General’s Report confirms and reiterates this finding.

10. From Local to State Successful trend has been to start at local level, then progress to state law. Successful trend has been to start at local level, then progress to state law. Benefits of local smokefree laws are: »Public Education »Community buy-in »Easier to enforce »Buildup of community support »Power at the local level Leads to stronger states laws and power to defeat tobacco industry interests in state Capitols; this rule changes in preemption states

11. Why not a Federal Regulation? Politically risky – The likelihood of getting a strong, 100% smokefree regulation is low given tobacco interests and lobbyists in Capital. Politically risky – The likelihood of getting a strong, 100% smokefree regulation is low given tobacco interests and lobbyists in Capital. Federal rules would preempt future state and local laws, and may supercede existing, strong smokefree laws. Federal rules would preempt future state and local laws, and may supercede existing, strong smokefree laws. Greatest successes have been at the local level, historically. First state law was passed in CA in 1994 after massive local action. Eight years later, DE and NY passed laws in 2002 and 2003, respectively. Greatest successes have been at the local level, historically. First state law was passed in CA in 1994 after massive local action. Eight years later, DE and NY passed laws in 2002 and 2003, respectively.

12. Industry Response to Smokefree Successes Oppose all smokefree and related tobacco- prevention legislation by any means necessary Oppose all smokefree and related tobacco- prevention legislation by any means necessary –Legal threats, public relations blitz, financial contributions to allied parties Current examples Current examples –R.J. Reynolds is sponsoring opposing “Smokefree” Initiatives in Ohio and Arizona –Philip Morris/Altria is contributing millions against California’s Tobacco Tax Initiative –Ongoing attempts to pass Preemptive legislation in state legislatures

14. Movement Continues at Rapid Pace Three Smokefree Ballot Initiatives in 2006: Ohio, Arizona, and Nevada Three Smokefree Ballot Initiatives in 2006: Ohio, Arizona, and Nevada Hundreds of localities are considering or in the process of a smokefree campaign Hundreds of localities are considering or in the process of a smokefree campaign –Current leaders at local level are Mid-Western states: IL and IN current leaders with the most new local laws so far in 2006 race for ANR’s Smokefree Air Challenge award More states likely to consider and successfully pass laws, particularly those with significant local coverage; Risk of Preemption is High More states likely to consider and successfully pass laws, particularly those with significant local coverage; Risk of Preemption is High

15. How can YOU contribute to smokefree successes? Get involved! Get involved! –Is your community smokefree? Does it have a weak law that needs strengthening? –If not, is smokefree an issue yet? –Is there a coalition, and are YOU a member (e.g., citizen or professional capacity)? –Does your organization have a Smokefree Cities meeting policy? APHA, NCI, NIDA, CDC-OSH do! Speak Up! Speak Up! –Provide professional leadership on the issue in your organization, with colleagues and friends, with media (re: health effects and benefits of smokefree environments). Contact ANR/F for information on how to start or improve the smokefree effort in your area, model legislation, combat tobacco industry interference, referrals to other partners and more. Contact ANR/F for information on how to start or improve the smokefree effort in your area, model legislation, combat tobacco industry interference, referrals to other partners and more.

16. Tools for Success

17. Thank you Cynthia Hallett, MPH Executive Director Cynthia.Hallett@no-smoke.org (510) 841-3045 www.no-smoke.org www.protectlocalcontrol.org