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Key Findings: Smokefree Air

View State Rankings for Smokefree Air.

Cigarettes don’t just harm the people who smoke—they also harm the people around them. Secondhand smoke causes or exacerbates a wide range of adverse health effects, including cancer, respiratory infections, asthma and heart disease.

Secondhand smoke contains over 4,000 chemicals: 200 are poisons; 43 cause cancer. In June 2002, the International Agency for Research on Cancer (IARC) of the World Health Organization oncluded that secondhand smoke causes lung cancer and other health problems. The IARC classified secondhand smoke as a cancer-causing agent in humans.12 In 1997, the California Environmental Protection Agency estimated that secondhand smoke caused approximately 35,000 to 62,000 deaths from heart disease in nonsmokers each year.13 Secondhand smoke is especially harmful to young children. The EPA estimates that secondhand smoke is annually responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year. Children with asthma are especially at risk from exposure to secondhand smoke. The EPA estimates that exposure to secondhand smoke worsens the conditions of between 200,000 and one million children who have asthma. Babies are also at increased risk—secondhand smoke can make healthy children less than 18 months of age develop pneumonia, ear infections, bronchitis, coughing, wheezing and increased mucus production. According to the EPA, secondhand smoke can lead to the buildup of fluid in the middle ear, the most common cause of operations on children.14

Smokefree Air: Bright Spots

Delaware achieved a major victory for smokefree air in 2002, when the state’s Clean Indoor Air Act was amended. On November 27, 2002, when the law went into effect, Delaware joined California as a state with the most protective smokefree air legislation in the country. The Delaware law prohibits smoking in most indoor public places including restaurants, bars, casinos, all workplaces, day care facilities (including those in private homes), bowling alleys, pool halls and all common-use areas such as hallways, restrooms, lobbies, etc. In addition, 75 percent of hotel rooms in Delaware must be smokefree. Delaware also is the first state to repeal preemption from their smokefree air law.

California’s statutes include numerous tobacco control laws that protect the public, employees and children from the effects of tobacco use. These laws include a statewide smokefree workplace policy that eliminates smoking in nearly all enclosed public and private workplaces (including restaurants, bars and taverns).

Several states have local ordinances that help clear the air. In Massachusetts, more than 200 communities have enacted their own smokefree air policies, including many with total or near total bans on indoor public smoking, including restaurants and bars. In Arizona, voters in Tempe approved one of the most stringent smokefree air ordinances in the country, that prohibits smoking in all public places including restaurants, bars and bowling alleys. Tucson strengthened its smokefree air ordinance by passing amendments that would require all restaurants to be smokefree. Pima County (where Tucson is located) followed suit a year later with a county-wide smokefree ordinance. In Michigan, in 2002, Ingham County, home of the state capital Lansing, became the first county in the state to pass a regulation that severely restricts smoking in private worksites and public places. As a result of this action, several communities are working toward passing similar measures.

Citizens in every region across the country have come to expect smokefree environments. This report shows how far behind too many states are in protecting public health and addressing this public demand.

Smokefree Air: Work to Do

Smokefree air clearly is the area of tobacco control needing the most improvement: 43 states and the
District of Columbia received an F. That means that most Americans are still exposed to secondhand smoke in restaurants and other public places. The American Lung Association is concerned with the health of nonsmokers, especially children. Nonsmokers have the right to breathe clean, smokefree air in public places. (View Appendix A: The Smokefree Air Chart.)

Smokefree Air: Looking Ahead

More and more people around the country are demanding smokefree air in the places where they work, play and socialize. New York City’s Mayor passed legislation to ban smoking in all public places, including bars and restaurants which currently operate under more lenient laws. A similar measure passed in Boston to make all restaurants and bars smokefree.

Smokefree Air: Policy Goals

The American Lung Association advocates for the enactment and enforcement of measures to eliminate
the exposure of children and adults to secondhand smoke, with emphasis on work sites. Areas of special concern include schools, day care centers, health care facilities, and publicly owned buildings and facilities. The American Lung Association statewide legislation should NOT preempt local authority, but instead establish a minimum standard that local governments can build upon to provide additional protection.

Key Findings continued...

The information contained in this American Lung Association� website is not a substitute for medical advice or treatment, and the ALA recommends consultation with your doctor or health care professional.