SECONDHAND SECONDHAND SMOKE, SMOKE-SMOKE, SMOKE-FREE LAWS, AND FREE LAWS, AND

YOUR COMMUNITYYOUR COMMUNITY

Nothing Kills Like Nothing Kills Like TobaccoTobacco

Yearly Deaths in the U.S.A.

Cigarettes

Alcohol

2nd Hand Smoke

Car Accidents

Suicide

AIDS

Homicides

430,000

105,095

53,000

46,30030,906

29,93924,932

Source: Centers for Disease Control and Prevention (CDC)

Is Secondhand Smoke Is Secondhand Smoke a Mere Annoyance?a Mere Annoyance?

Secondhand smoke causes approximately 3,000 lung cancer deaths per year in nonsmoking adults.

Secondhand smoke causes approximately 46,000 heart disease deaths per year in nonsmoking adults.

Secondhand smoke causes approximately 430 SIDS deaths per year in newborns.

Source: U.S. Surgeon General, 2006

Why is SecondhandWhy is SecondhandTobacco Smoke so Tobacco Smoke so

Toxic?Toxic?

Methanol Carbon Monoxide Hydrogen Cyanide Acetone Tar DDT Naphthalene Vinyl Chloride Benzene

There is no risk-free level of exposure to firsthand or secondhand tobacco smoke

SHS contains at least 250 toxic chemicals

Formaldehyde

Mercury Lead Arsenic Toluene Cadmium Ammonia Butane Ethanol

Heart disease Lung cancer Sudden Infant Death Syndrome (SIDS) Low birth weight Asthma Otitis Media (ear infections) in children Slowing of lung growth in children Bronchitis and pneumonia Breast cancer in pre-menopausal women Increased risk of cervical cancer Cognitive deficits among children even at

extremely low levels of exposure

How Does It Harm Your How Does It Harm Your Body?Body?

Does Even a Little Bit Hurt Your Does Even a Little Bit Hurt Your Heart?Heart?

5 minutes of exposure stiffens the aorta (harder for the heart to pump blood).

20 minutes of exposure causes excess blood clotting (increasing risk of heart attack and stroke).

30 minutes of exposure limits the ability of the blood to manage LDL ("bad") cholesterol leading to the build up of arterial fat deposits (increasing risk of heart attack and stroke).

2 hours of exposure can speed up the heart rate and lead to abnormal heart rhythms (which may cause death).

In April 2004, the Centers for Disease Control and Prevention issued a warning that all patients with heart disease should avoid exposure to secondhand smoke.

Why are Some Workers Why are Some Workers Affected More Than Affected More Than

Others?Others? Levels of

secondhand tobacco smoke in restaurants and bars is 1.6 to 6 times higher than in office workplaces.

Servers have the greatest risk of developing lung cancer and heart disease compared to other occupations.

Bar Workers Benefited the Bar Workers Benefited the Most from Lexington’s Smoke-Most from Lexington’s Smoke-

free Lawfree Law

0

1

2

3

4

5

6

7

8

Bar Restaurant

Med

ian

hair

nico

tine

leve

l*

Average decrease in hair nicotine, post-law

*adjusted for cigarettes smoked per day

““No one should have to breathe No one should have to breathe tobacco smoke to hold a job.”tobacco smoke to hold a job.”

Suzanne H Suzanne H Cocktail Waitress for 14 yearsCocktail Waitress for 14 yearsEmphysema attributed to Emphysema attributed to

secondhand smoke at worksecondhand smoke at work

What Does the What Does the Tobacco IndustryTobacco Industry Say Say

About the Health Effects?About the Health Effects?

““It is our view that, the scientific evidence is not sufficient to establish that environmental tobacco smoke is a cause of lung cancer, heart disease or other chronic diseases.” Brown & Williamson Tobacco, 2003

How Many Kentucky Adults are How Many Kentucky Adults are Exposed to First & Secondhand Exposed to First & Secondhand

Smoke?Smoke?Most (72%) do NOT Most (72%) do NOT smoke cigarettes.smoke cigarettes.

Exposed Not Exposed

91%

9%

Yet nearly all (91%) ARE Yet nearly all (91%) ARE exposed to secondhand smoke.exposed to secondhand smoke.

28%

72%

Smokers Nonsmokers

Sign in Sign in Chicago where Chicago where there is a there is a weak, weak, confusing confusing ordinanceordinance

What are the Public Health What are the Public Health Benefits of Smoke-Free Benefits of Smoke-Free

Laws?Laws? Nonsmokers protectedNonsmokers protected Fewer children start to smokeFewer children start to smoke Smokers consume fewer cigarettesSmokers consume fewer cigarettes More smokers quitMore smokers quit

How did Support for How did Support for Lexington’s Lexington’s

Smoke-free Law Change Post-Smoke-free Law Change Post-law?law?

56.764.0

70.274.7

0

20

40

60

80

100

Public Support SHS as Health Risk

Pre-lawPost-law

Public support for the law increased significantly.

What Does the What Does the Tobacco Tobacco IndustryIndustry Think about Think about

Smoke-free Laws?Smoke-free Laws?

“Smoking bans are the biggest challenge we have ever faced. Quit rates go from 5% to 21% when smokers work in non-smoking environments.” (Bates # 2054893642/3656; Legacy Tobacco Documents (Bates # 2054893642/3656; Legacy Tobacco Documents Library; 1994. Library; 1994. hhttp://legacy.library.ucsf.edu/tid/nttp://legacy.library.ucsf.edu/tid/nyg12a00)yg12a00)

Is it Government’s Role Is it Government’s Role to Enact Smoke-free to Enact Smoke-free

Laws?Laws?“Among the police powers of the government, the power to promote and safeguard public health ranks at the top…….. The real issue is whether the public health regulation [Lexington’s smoke-free law] is reasonable….. In this case we must conclude that it is.”

Kentucky Supreme Court Decision, April 2004

What Difference Do What Difference Do Smoke-free Laws Smoke-free Laws

Make?Make?Average Fine Particle Air Pollution in Three Kentucky Communities

67

199

86

17 18 20

0

50

100

150

200

250

Letcher County Lexington Georgetown

Pre-Law

Post-Law

0

0.5

1

1.5

2

2.5

3

Pre-law 3 months Post-law

Med

ian

hai

r n

ico

tin

e le

vel

How Do We Know that How Do We Know that Smoke-free Laws Smoke-free Laws Protect Workers?Protect Workers?

Worker hair nicotine dropped 56% post-law

Ventilation Does Not Ventilation Does Not WorkWork

• Heating, ventilation, and air conditioning systems distribute secondhand smoke throughout a building.• Conventional air cleaning systems remove large particles, but not the smaller particles or gases in secondhand smoke.• Simple separation AND ventilation do NOT work!

Enclosed Smoking Rooms Enclosed Smoking Rooms Do Not WorkDo Not Work

Average Fine Air Particle Pollution in One Louisville Venue with a Smoking and Non-Smoking Area, 2006

181 178

0

50

100

150

200

250

300

350

Smoking Area Non-Smoking Area

PM

2.5

ug

/m3

The Truth The Truth about about Indoor Indoor

Smoking Smoking AreasAreas

What Does the What Does the Tobacco Tobacco IndustryIndustry Say About Say About

Ventilation?Ventilation?

“Business owners should have some flexibility in deciding how best to address the preferences of non-smokers and smokers through separation, separate rooms and/or high quality ventilation.”

Philip MorrisPhilip Morris, 2002, 2002

How Do Smoke-free Laws How Do Smoke-free Laws Affect Business?Affect Business?

Numerous scientific studies show business improves or remains the same.

The only reports showing a downturn in business have been funded by the tobacco, alcohol, and/or gaming industries.

How Did Lexington’s Smoke-How Did Lexington’s Smoke-free Law Impact Business?free Law Impact Business?

An average of 400 additional An average of 400 additional restaurant employees per month (3% restaurant employees per month (3% of total restaurant employment)of total restaurant employment)

Bar employment stable Bar employment stable No change in business openings or No change in business openings or

closingsclosings

Why Does the Why Does the Tobacco Tobacco IndustryIndustry Fight Smoke-free Fight Smoke-free

Laws?Laws? “Financial impact of smoking bans will

be tremendous – 3 to 5 fewer cigarettes per day per smoker will reduce annual manufacturer profits a billion dollars plus per year.”

A Smoker’s Alliance, A Smoker’s Alliance, Phillip Morris, Phillip Morris, 8/1/938/1/93

What are the Costs of What are the Costs of Exposure toExposure to

Secondhand Smoke?Secondhand Smoke?

Over $5 billion in direct medical costs per year in the U.S.

Over $5 billion in indirect costs per year in the U.S.

Are We Making Are We Making Progress?Progress?

There has been a 70% reduction in secondhand smoke exposure in U.S. nonsmokers since 1988, due in large part to smoke-free laws.

Unfortunately, more than 3.6 million Kentuckians (91%) are still exposed to secondhand smoke in public places and workplaces.

Source: U.S. Surgeon General, 2006