Serving Smoke-Free Air: Reframing the Public Debate for Passage of a Smoke-Free Restaurants and Bars law in N.C. Ann Houston Staples, CHES Tobacco Prevention & Control Branch NC Division of Public Health

Gillings School of Global Public Health University of North Carolina – Chapel Hill The heavy lifting for this report was done by: Erin Bunger, Allie Lieberman, Menaka Mohan, Lauren Toledo Public Health Graduate Students The Capstone Project

What was happening in NC? What did we do to respond to the challenge? How did we measure it? What did we learn?

Overnight success? Full of folks who come from other places? Not really Southern?

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In both 2007 and 2009, a comprehensive smoke-free worksite, restaurants and bars bill was introduced. Both bills were weakened to cover restaurants and bars only. In 2007, an age-provision was added to exempt many bars, and the bill failed narrowly in the House. In 2009, a similar age-provision was added in the House, removed by the Senate, and the Senate bill was adopted by the House.

Bill was signed by Gov. Perdue and went into effect January 2, 2010 Very few exceptions: private clubs and country clubs that are non-profit and cigar bars open to 21-and- older.

In 2007 and 2009 Supportive Poll Data Strong Editorial Board Support Surgeon Generals Report Hands-Off Governor House Majority Leader and cancer survivor as bill sponsor

Restaurant & Lodging Association Not Actively Supporting More discussion of local control More effort around LTEs rather than Op/Eds Editorial support from nearly all major dailies Restaurant & Lodging Association in Support SHS Health Care Cost Study Bi-Partisan Sponsorship Hard work on supportive Op/Eds Editorial Board Memos

We worked with the Capstone Team to try and determine what strategies might have made a difference in news coverage of the 2009 bill over the 2007 bill, and, ultimately, help with the passage. What Worked?

Daily keyword search using Google News Alert and Tobacco.org about 2007 and 2009 Legislative sessions Keywords: Smoking+NC, Tobacco+NC, Holliman 360 newspaper articles received: : : 269

357 daily newspaper articles included in the sample : : 260 Modified Sample Not relevant to House Bill 2 Message Board comments Press Release Multiple articles in one document

Identified Each article using the following categories: Type of Article - eg. News, Editorial, Letter to Editor, Op-Ed, Column Topics Mentioned (Codes) – eg. Holliman, Legislation, Secondhand Smoke Sources of Quotes and Affiliations – eg. Public Health Leader, Restaurant and Bar owner Point of View – eg. Pro-Bill, Anti-Bill, Neutral For Opinion Articles: Frame – eg. Economic, Pro-Health, Personal Rights

Collapsing Codes Codes and Affiliations Related topic codes were combined into 8 main codes Calculated frequencies and cross-tabulations

Tobacco Industry Legislation Setting and People Health Money Ideology Federal Initiatives Other

Pro-Bill Anti-Bill Neutral Unsure

2007 n= n=140

Property Rights Personal Rights Economic Free Market Pro-Health Worker Health Government Protection Unsure

Costs of Secondhand Smoke Study based on the BCBS of Minnesota model Developing a media committee/strategy that Follows news media and strategically plans responses to misinformation and negative opinion writing. Selects specific newspapers to place op/eds in, based on where legislative support is needed Recruits strong local authors for op/eds and assists in writing and placing them (docs, LHD) Distributes editorial board memos as needed

Have a Strategy for Dealing with Property Rights issue Bring Restaurant Association on-board Counter with strongest possible arguments Focus on strongest arguments Reducing Health Effects of SHS Reducing Health Care Costs