More than half of Americans live in states with comprehensive laws protecting them from exposure to secondhand smoke, but none of these people live in the southeastern United States, according to new data from the U.S. Centers for Disease Control.
A decade after the Surgeon General released a report highlighting the health dangers of secondhand smoke exposure, no single state in the Southeast has passed comprehensive statewide smoke free laws banning smoking in all indoor, private-sector workplaces, restaurants and bars.
Twenty-six states and the District of Columbia had the laws in 2015, compared to none in the year 2000. But just two states – North Dakota and California – have passed comprehensive smoke-free laws over the last six years, suggesting that adoption of such laws has stalled.
Among the 24 states without comprehensive smoke-free laws, five (Florida, Indiana, Louisiana, Nevada, and North Carolina) prohibit smoking in two of the three venues, while six states (Kentucky, Mississippi, South Carolina, Texas, West Virginia, and Wyoming) have no statewide smoking restrictions at all.
The report was published June 23 in the CDC’s weekly Morbidity and Mortality Weekly Report.
“Ten years ago, the Surgeon General concluded there is no risk-free level of secondhand smoke exposure,” CDC Director Tom Frieden, MD, MPH, noted in a written press statement. “We’ve made great progress in protecting many Americans from secondhand smoke exposure, but millions of Americans, especially those living in southeastern states, are still unprotected from this completely preventable health hazard.”
Government health officials estimate that secondhand smoke contributes to 41,000 deaths among nonsmoking adults and 400 death in infants each year in the United States.
CDC considers a smoke-free law to be comprehensive if smoking is prohibited in all indoor workplaces, bars and restaurants. Many states without comprehensive laws do have laws prohibiting smoking in some, but not all, of these venues and others have even less stringent bans, restricting smoking to designated areas or to separately ventilated areas.
Data on state smoke-free restrictions were obtained from the CDC’s State Tobacco Activities Tracking and Evaluation (STATE) System database, and the report updated data on statewide smoke-free laws from 2010 to 2015.
California adopted a statewide smoke-free law in May of this year, and the law went into effect earlier this month, bringing the total number of states with the laws to 27 plus the District of Columbia.
“With this change in California’s smoke-free status, it is estimated that the proportion of the U.S. population protected by a comprehensive state or local law increased from 49.6% in December 2015 to nearly 60% in June 2016,” wrote Michael Tynan of the CDC’s Office of Smoking and Health, and colleagues.
The report highlighted a lack of progress in reducing secondhand smoke exposure among casino workers. Casinos have often been excluded from statewide smoking bans.
A CDC-led health hazard evaluation at three Las Vegas casinos showed evidence of carcinogen exposure from secondhand smoke among workers.
The CDC is also calling for the wider inclusion of electronic cigarettes in comprehensive smoke-free laws. Roughly 350 localities and seven states (California, Delaware, Hawaii, New Jersey, North Dakota, Oregon and Utah) currently include electronic nicotine delivery systems (ENDS) in their comprehensive smoke-free bans.
“It is important for ENDS to be included in state and local smoke-free laws because indoor use of ENDS can expose nonusers to aerosolized nicotine and other harmful constituents, complicate smoke-free enforcement and impact the social acceptability of tobacco use,” the report noted.