The CDC report, which analyzed state smoking laws from 1999 through 2004, also found state smoking restrictions are becoming more stringent. The report updated a previous study that provided an update on state smoking laws and restrictions as of Dec. 31, 1998.
The analysis aims to assess CDC's progress toward the national health objective for 2010 of establishing laws in all 50 states and the District of Columbia that prohibit or restrict smoking in public places and worksites. (A related objective calls for all worksites to voluntarily implement policies that prohibit or restrict smoking.)
Combating Secondhand Smoke Starts at Work
CDC begins the report by pointing out that the U.S. Department of Health and Human Services considers secondhand tobacco smoke to be a carcinogen, and that the latter agency has determined that implementing policies that establish smoke-free environments is the most effective approach to reducing secondhand smoke exposure among non-smokers.
Among the CDC report's major findings:
- From 1999 through 2004, 10 states toughened smoking restrictions for private-sector worksites, nine states toughened smoking restrictions for restaurants and five states implemented more stringent smoking restrictions for bars.
- As of December 31, 1998, only one state (Maryland) banned smoking in private-sector worksites. As of December 31, 2004, six additional states (Delaware, Florida, Idaho, Massachusetts, New York and South Dakota) had done so.
- In 1998, no states required bars to be smoke-free. From 1999 through 2004, four states (Delaware, Maine, Massachusetts and New York) enacted laws that banned smoking in bars. In 1998, one state (California) required that bars restrict smoking to separately ventilated employee break rooms. In 2004, one additional state (Connecticut) had enacted a smoking restriction of this type.
- In 1998, two states (Utah and Vermont) banned smoking in restaurants. From 1999 through 2004, six additional states (Delaware, Florida, Idaho, Maine, Massachusetts and New York) did so. In 1998, one state (California) required that restaurants restrict smoking to separately ventilated employee break rooms. In 2004, one additional state (Connecticut) enacted a smoking restriction of this type.
- In 2004, three states (Delaware, Massachusetts and New York) banned smoking in all three settings private-sector worksites, restaurants and bars considered in this study, compared with no states in 1998.
- At the end of 2004, 16 states had no smoking restrictions in place in any of these three settings, compared with 19 states in 1998. Many other states had no restrictions, or restrictions that did not provide full protection, in some of these settings.
- Laws enacted before Dec. 31, 2004, but not effective until after that date are not reflected in the report. For example, Rhode Island enacted comprehensive smoke-free indoor air legislation in 2004 that did not take effect until 2005 and therefore was not included in this assessment.
- The report also does not reflect legislation enacted since the end of 2004. For example, from Jan. 1 through June 30, Georgia, Maine, Montana, North Dakota, Rhode Island and Vermont enacted smoking restrictions.
Many Workers Still Not Protected
While the July 8 Morbidity and Mortality Weekly Report cites research indicating that 69.3 percent of U.S. workers as of 1998-1999 reported that their workplace had an official policy prohibiting smoking in work areas and public or common areas up from 46.5 percent in 1993 it also says many workers still are not protected by smoke-free workplace policies.
Moreover, the proportion of workers covered by such policies during 1998-1999 varied by occupation, from 42.9 percent among food-preparation and food-service workers to 90.8 percent of primary-school teachers, according to the report, which cites research published in the Journal of Occupational and Environmental Medicine.
The proportion of waiters (27.7 percent) and bartenders (12.9 percent) who reported being covered by smoke-free policies was lower than the proportion of food-preparation and food-service workers overall. A previous study has indicated that food-service workers have a 50-percent greater risk for developing lung cancer than the general population, resulting in part from their higher level of occupational exposure to secondhand smoke.
As a result of continuing gaps in policy coverage for many private-sector worksites, restaurants and bars, a substantial portion of the U.S. non-smoking population remains at risk for exposure to a known carcinogen in these settings, either as employees or customers, according to the Morbidity and Mortality Weekly Report.
Benefits of a Smoke-Free Workplace
According to the Morbidity and Mortality Weekly Report, the benefits of smoke-free workplaces extend beyond protecting workers and patrons from exposure to secondhand smoke.
Smoke-free workplace policies also are associated with decreased cigarette consumption and possibly with increased cessation rates among workers and members of the general public. Peer-reviewed studies relying on objective indicators such as sales tax revenue and employment levels have consistently found that smoking restrictions do not have a negative economic impact on restaurants and bars. Studies also have reported high levels of public support for and compliance with these laws, the report says.