Smoking ban gets 'a good scrubbing' before Judiciary Committee

By Al Cross
Kentucky Health News

The bill for a statewide smoking ban is favored by three-fifths of Kentucky adults, but is dead for this session of the General Assembly. However, its supporters think they made some headway Monday as they laid groundwork for getting it through the state House a year from now.

The House Judiciary Committee held an informational hearing on House Bill 190 to "give it a good scrubbing" before a committee that is more skeptical of it than the Health and Welfare Committee, which approved it early in the session, the bill's sponsor, Rep, Susan Westrom, D-Lexington, said afterward.

Westrom said she was encouraged by the hearing because it exposed weaknesses in the bill that she will correct for the next regular session, beginning in January 2014. For example, she said, Rep. Steven Rudy, R-Paducah, argued that the bill's language would make it illegal to use smoke in barns to cure the dark tobacco grown in Western Kentucky, largely for smokeless consumption.

"This is about vetting," Westrom told Rudy. "You have a different mindset that I do sitting on the Health and Welfare Committee."

Rudy acknowledged that secondhand smoke is not beneficial, but asked, "Has there ever been a death certificate that secondhand smoke killed this person?"

Dr. Sylvia Cerel-Suhl, Central Kentucky president of the American Heart Association, replied that Lexington recorded a significant drop in acute heart attacks after enacting a smoking ban, and said "thousands of studies" of secondhand smoke have shown exposure to it can cause premature death.

"The evidence is absolutely overwhelming," she said, and asked if anyone else had any questions. No one did, but the committee was one member short of a quorum.

Advocates told the legislators that 37 jurisdictions, covering 34 percent of the state's population, limit smoking in some way. Mark Hayden, a trial lawyer and former Campbell County commissioner, said a statewide ban is needed because enacting ordinances, writing regulations and enforcing them is a burden for local officials.

The bill would give local health departments power to enforce the ban. Scott Lockard, president of the Kentucky Health Departments Association and the health director in Clark County, said his agency has issued no court charges, only warning citations, since its board passed a ban, and Woodford County has issued only three citations.

Others appearing at the hearing included Dr. Stephanie Mayfield, commissioner of the state Department of Public Health, and Lt. Gov. Jerry Abramson, who was invited by the Kentucky Smoke-Free Kentucky Coalition. He discussed enforcement of of the ban in Louisville, where he was mayor.

Rep. Tom Riner, D-Louisville, said the ban is "one of the most important pieces of legislation that has been brought before this body, because it literally affects every Kentuckian. . . perhaps the most important piece."

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

UK quickens drumbeat of tobacco-free policy through report line

The University of Kentucky promotes compliance and enforcement of its tobacco-free policy through a community report line, among many other measures.  Although the report line was established last spring, its mention in recent campus communications suggests a hightened emphasis on compliance measures. 

The line to report violations of the smoking ban engages the community in developing an environment in which compliance is expected, said Dr. Ellen Hahn, a nursing professor and co-chair of UK's Tobacco-free Taskforce and director of its Kentucky Center for Smoke-free Policy.

"Since these policies are self-enforcing, we need a mechanism by which everyone on campus can easily report violations," Hahn said. "Most people do not feel comfortable approaching a violator, so this is a way to encourage everyone to be involved in promoting compliance." She said the report line was a suggested "best practice" from other campuses with similar policies.

Implementation of the policy, the ultimate goal of the policy is to promote a healthy place to live, work and learn, has been a success, Hahn said: The air is healthier, and exposure to secondhand smoke has decreased. Also, since the policy was established in the fall of 2009, there has been a four-fold increase in the use of nicotine replacement to quit using tobacco, and UK has many low- or no-cost options to help students and employees do so.

Click here to report a violation of the tobacco-free policy, here for a tobacco-free brochure. 

Dollar General to sell tobacco in most of its stores by mid-2013, reflecting 'customer demand' and 'competition pressure'

By the middle of 2013, most of Dollar General's 10,000 U.S. stores will carry cigarettes and other tobacco products.. The company has made the decision in response to “competitive pressures” which came about when Family Dollar Stores, a key competitor, began adding cigarettes to its stores last year. In a press release issued by Dollar General, customer demand also drove the company's decision, citing their perception that their core customers -- mostly based in rural America -- are more likely to smoke than the national average.

A 2012 study by the American Lung Association indicated that while rural Americans do smoke more than urban Americans, geography is less a factor in determining who smokes than socioeconomic status. The study also found that pregnant rural women are far more likely to smoke than their urban counterparts. (See actual numbers from the Centers for Disease Control and the American Lung Association study here.)

G. Chambers Williams III of The Tennessean in Nashville reports that business analysts think the idea is a good one for the company, which tested the product placement last year in Nevada. Analyst Mark Montagna with Avondale Partners in Nashville explained that the company found that the average purchase per customer was $14 where tobacco was sold, versus an average of $11 otherwise. But, he added, the one challenge the company will face with tobacco products, additional shoplifting.
Anti-smoking advocates expressed regret at the business choice. (Read more)

Tobacco use higher in rural areas; several factors include tobacco companies' targeting of rural youth, Lung Assn. says

Tobacco use is higher among rural communities than in suburban and urban areas, and smokeless tobacco use is twice as common. According to the American Lung Association, rural youth are more likely to use tobacco and to start earlier than urban youth, perpetuating the cycle of tobacco addiction, death and disease.

In its latest health disparity report, “Cutting Tobacco’s Rural Roots: Tobacco Use in Rural Communities,” ALA says the increased tobacco use is associated with lower education levels and lower incomes, which are both common in rural areas where there may be fewer opportunities for educational and economic advancement.

The exposure to secondhand smoke is also likely to be higher, since rural communities are less likely to have smoke-free air laws in place, and that probably makes residents less likely to ask individuals not to smoke in their homes or other indoor places they control.

The report also pointed out that the tobacco industry "spends millions of dollars targeting rural youth," and "these young people are less likely to be exposed to tobacco counter-marketing campaigns. Rural tobacco users are also less likely to have access to tobacco-cessation programs and services to get the help they need to quit. Promotion of the availability of state counseling services by phone and online resources also lags in rural communities."

To read the full report, go here.

Smoking ban bill clears House committee for first time; but sponsor says she won't take it farther this session

A measure for a statewide smoking ban passed the House Health and Welfare Committee today, the first time such a bill has cleared committee in legislative history, Deborah Yetter reports for The Courier-Journal.

But House Bill 289 is not expected to be called for a vote this year, said its sponsor Rep. Susan Westrom, right, D-Lexington. "I'm not someone who wants to shove something down someone's throat," she said, adding she plans to reintroduce the measure next year.

Westrom predicts support will continue to grow as "people come to realize local smoking bans have worked well in cities, including Louisville, Lexington and Owensboro. Already, 23 states ban smoking statewide in indoor public spaces," Yetter reports.

Support for the bill was given a significant boost when the Kentucky Chamber of Commerce stepped behind it. President David Adkisson said the majority of business owners the chamber talked to support a ban. "We now feel like it needs to be statewide and not a patchwork," he said.

HB 289 passed with a 10-2 vote. Rep. Addia Wuchner, R-Burlington, a candidate for Congress in the Fourth District, was one of two Republicans to vote against the measure, calling it "well meaning" but too intrusive on people's rights. "It is not the role of the government to go this far," she said. (Read more)

Number of teens and young adults who smoke, use smokeless tobacco is on the rise

A "shocking" number of American teenagers smoke cigarettes and/or use smokeless tobacco, the first U.S. surgeon general's report on youth tobacco since 1994 has found. (Photo by Karen Bleier, AFP/Getty Images)

"The numbers are really shocking," Surgeon General Regina Benjamin said, noting the data show 1 in 4 high school seniors and 1 in 3 young adults under age 26 smoke. "It's a problem we have to solve."

Though there was dramatic progress in reducing youth smoking rates from 1997 to 2003, the 899-page report shows the decline has flattened. "Smokeless tobacco is up among white high school-age boys, and cigar smoking appears to be rising among black high school girls," reports David Brown for The Washington Post.

Data from the 2010 Kentucky Youth Tobacco Survey show that almost 25 percent of the state's high-school students are smokers. Although the prevalence of smoking among youth has declined in the past few years, the smoking prevalence among teenagers and young adults is higher than among other adult populations.

"Two people start smoking for every one who dies from the habit each year," Benjamin said. "Almost 90 percent of those 'replacement smokers' first try tobacco before they are 18."

The findings showed smoking can damage lung function at a very young age. One study of "nearly 700 children from East Boston found that those who started to smoke at age 15 exhaled 8 percent less air in one second — a key measure of lung function — than non-smoking teenagers. The growth of lung capacity stopped a year earlier in smokers — at 17 in girls and 19 in boys — than in non-smokers," Brown reports.

Another study showed how smoking affects the cardiovascular system. Researchers looked at autopsy results of white men ages 25 to 34 who were killed either by trauma or homicide. Smokers were two times as likely to have advanced damage of the abdominal aorta as non-smokers. "They also had somewhat greater damage to the blood vessel most often implicated in acute heart attacks," Brown reports.

Danny McGoldrick of the Campaign for Tobacco-Free Kids told USA Today's Wendy Koch tobacco marketing "is a big cause of the problem." He pointed to his organization's report revealing the tobacco industry's relationship with convenience stores to blatantly advertise and display tobacco products.

The industry's success in fighting increases in tobacco-related taxes is considered to be another factor. But industry officials like Ken Garcia of Altria Group, parent company of Philip Morris USA, said "there's already quite a (tax) burden on adult smokers." (Read more)

Replacing cigarettes with smokeless tobacco reduces disease risk, says U of L prof who's received tobacco-industry funding

Smokers can greatly reduce their risk of disease if they replace their cigarettes with spit-free smokeless tobacco or electronic cigarettes, University of Louisville professor Brad Rodu, right, said in a presentation at the annual meeting of the American Association for the Advancement of Science last week. It's the same message residents of Owensboro heard in an advertising campaign with which Rodu was involved late last year, one partly funded with grants from the tobacco industry.

"Quit or die: That's been the brutal message delivered to 45 million American smokers, and it has helped contribute to 443,000 deaths per year," Rodu said in a U of L press release. "The truth, however, is that total nicotine and tobacco abstinence is unattainable and unnecessary for many smokers."

Rodu's 20 years of research has reportedly shown that e-cigs and smokeless tobacco are relatively safe alternatives for smokers who can't or are unwilling to quit nicotine. "Nicotine is addictive, but it is not the cause of any smoking-related disease," he said. "Like caffeine, nicotine can be used safely by consumers."

Research has shown smokeless products are 98 percent safer than cigarettes, the press release states. A 2002 study in the United Kingdom found smokeless tobacco to be up to 1,000 times less hazardous than smoking.

As for whether smokeless tobacco can contribute to mouth cancer, Rodu said the risk "is extremely low." "The annual mortality rate among long-term dry snuff users is 12 deaths per 100,000 and the rate among users of more popular snus, moist snuff and chewing tobacco is much lower. For perspective, the death rate among automobile users is 11 per 100,000 according to the 2009 report from the National Highway Traffic Safety Administration. Compare those to the rate among smokers: more than 600 deaths per 100,000 per year." (Read more)

The Oral Cancer Foundation's website says about 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year and cause about 8,000 deaths. The foundation does not support the contention that smokeless tobacco is "safe." "Promoted by some as a safer alternative to smoking, it has in actuality not proven to be any safer to those who use it when referring to oral cancers," the website reads. "Campaigns to promote the safety of smokeless are being initiated, but it is clear that while it may reduce lung cancers, it has a negative effect on the rates of oral cancers."