Kentucky Health Departments Association

Policy Position Paper

Smoke-free Indoor Air Policies  

The Kentucky Health Departments Association (KHDA) strongly recommends that local governments exercise their elected responsibility and adopt smoke-free air ordinances to protect workers and the general public.  KHDA supports the position that adopting local smoke-free indoor air laws is part of a recognized and established strategy to lower the incidence of tobacco-related disease.

Secondhand tobacco smoke (SHS) accounts for as many as 62,000 deaths annually in the United States among adult non-smokers.[i] There are numerous scientific studies showing SHS as the cause of serious respiratory ailments in children, such as asthma attacks and lower respiratory tract infections. SHS exposure has also been shown to increase the risk of sudden infant death syndrome (SIDS) and middle ear infections in children. [ii] [iii]

SHS, a Known Human (Group A) Carcinogen, causes lung cancer in adult non-smokers and impairs the respiratory health of children. Not only does SHS cause short-term health problems in children; there is clear evidence that SHS causes long-term serious public health threats. SHS has been linked to an increased risk of cardiovascular problems.[iv] The epidemiological evidence reveals a 30% increase in the risk of death from ischemic heart disease or heart attack among non-smokers who live with smokers. Additional studies that appeared in the Journal of the American Medical Association reveal levels of toxic SHS in restaurants and bars are 1.6 to 6 times higher than in office workplaces, and waiters and waitresses are at greater risk of developing lung cancer and heart disease compared to other occupations. [v]

There is no safe level of exposure to SHS. Creating separate smoking and non-smoking areas in a business, workplace or home will not prevent non-smokers from being exposed to the dangers of SHS.[vi]  The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) reports that existing ventilation systems cannot adequately remove all the toxins found in SHS.[vii]

Smoking-related illnesses account for almost $47 billion in lost productivity each year in the U.S. and more than 8% of work time is spent on smoking-related activities. Smokers are absent 6.5 days more than non-smokers and make approximately six more visits each year to health care providers. Insurance claims cost $300 more on average for smokers than nonsmokers and smokers utilize health insurance benefits 50% more.[viii] 

Local governments have the authority to enact smoke-free policies in Kentucky. There is no preemption by state law preventing local governments in Kentucky from enacting ordinances reasonably designed to promote the health and welfare of its citizens.                               On matters of public health, Kentucky law clearly acknowledges local government as having "broad discretion in determining for itself what is harmful."   There are a number of factors that suggest that a local legislative body may be more appropriately suited
to the controversial challenges involved in enacting local smoke-free policies.[ix] In the  words of the Kentucky Supreme Court… “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" (Lexington Fayette County Food and Beverage Association, Lexington Fayette Urban County Government, Supreme Court of Kentucky, 2004)

Research has clearly removed any doubt or debate regarding the harmful effects of secondhand smoke exposure. Based on nearly thirty studies there is no evidence that smoke-free policies adversely effect restaurant or bar business and many studies actually show improvement in business after smoke-free policies are implemented.[x] In addition, smoke-free policies provide public health benefits by decreasing cigarette consumption and increasing the number of quit attempts made among smokers. [xi]

The Kentucky Health Departments Association calls upon the citizens and all local officials of Kentucky to become aware that Smoke-free Public Policies protect non-smokers from the dangerous poisons found in SHS and DO NOT cause loss of revenue in the hospitality industry. KHDA supports local efforts to adopt Smoke-free Public Policies.

Approved by Membership November 17, 2004.

[i] U.S. Environmental Protection Agency (1994). Setting the record straight: secondhand smoke is a preventable health risk. EPA, 402-F-94-005.

[ii] California Environmental Protection Agency (1997). Health effects of exposure to environmental tobacco smoke: Final report. Berkeley, CA: California EPA, Office of Environmental Health Hazard Assessment.

[iii] National Cancer Institute (1999). Health effects of exposure to environmental tobacco smoke: the report of the California Environmental Protection Agency, smoking and tobacco control Monograph NO. 10. Bethesda, MD: U.S. Department of Health and Human Services.

[iv] Glantz and Parmley (1991). Passive smoking and heart disease: epidemiology, physiology, and biochemistry. Circulation, 83 (1), 1-12

[v] Siegal (1998) Smoking and bars: a guide for policy makers. Boston, MA:
Boston University School of Public Health.

[vi] Repace and Lowrey  (1990). Risk assessment methodologies for passive
smoking induced lung cancer. Risk Analysis, 10, 27-37.

[vii] ASHRAE (June, 2001). Indoor air quality: position document executive
summary. www.ashrae.org

[viii] Action on Smoking and Health (2001). Anti-smoking rules are not
costly. www.ash.org

[ix] Scott, P. (2001). Authority of local governments to protect the public
from secondhand smoke. Lexington, Kentucky: Greenebaum, Doll and McDonald.

[x] Glantz and Smith (1994). The effect of ordinances requiring smoke-free
restaurants and bars on revenues. AJPH, 84, 1081-1085.

[xi]  Campaign for Tobacco-Free Kids (May 2002). Clean indoor air laws
encourage smokers to quit and discourage youth from starting. Retrieved
September 2002 from the World Wide Web: http://tobaccofreekids.org