Clean Indoor Air Policies Research Articles

News and Notes

News and Notes

Tobacco coverage in print media: the use of timing and themes by tobacco control supporters and opposition before a failed tobacco tax initiative

ObjectiveTobacco control policies gained ground nationwide in 2006, with voters in nine states approving legislation to strengthen clean indoor air policies and increase tobacco excise taxes. Despite having the second...

The Utility of Anger in Promoting Clean Indoor Air Policies

This investigation examined antecedents associated with support for clean indoor air policies. Participants (N = 550) living in a Midwestern county (population = 62,223) were randomly sampled. Results suggest that beliefs in the health risks associated with secondhand smoke are positively associated with favorable attitudes toward clean indoor air policies, whereas trait reactance is negatively associated with these attitudes. Findings also indicate that risks and trait reactance are indirectly associated with support for clean indoor air policies, mediated through anger arousal toward exposure to secondhand smoke. In addition, regression analyses revealed that health risks, trait reactance, and smoking status explained a significant amount of variance regarding anger toward exposure to secondhand smoke, but only health risks and smoking status accounted for a significant amount of variance toward clean indoor air attitudes. Finally, the Smoking Status × Health Risks interaction was supported for anger toward exposure to secondhand smoke and favorable attitudes toward clean indoor air policies. Our findings suggest the incorporation of anger appeals when promoting clean indoor air policies.

Examining Antecedents of Clean Indoor Air Policy Support: Implications for Campaigns Promoting Clean Indoor Air

This investigation sought to examine the association between knowledge of the risks associated with environmental tobacco smoke and voter support for clean indoor air policies. In doing so, 2 antecedents were employed to enhance understanding of this relationship: attitudes and subjective norms. In addition, differences between nonsmokers and smokers were assessed across the aforementioned variables. The study sampled participants (N = 550) living in the Appalachian foothills as a means of conducting formative research prior to developing messages promoting clean indoor air policies. The study controlled for tobacco usage, age, biological sex, and income. Results revealed that awareness of risk is a good predictor of attitudes and social norms, and in return, attitudes and social norms are good predictors of support for clean indoor air policies. In addition, results reveal that nonsmokers maintain a significantly stronger belief in the dangers associated with environmental tobacco smoke, as well as more favorable attitudes, subjective norms, and support for clean indoor air policies when compared with smokers. These findings are discussed with a focus on message design strategies for practitioners and academics with interests in promoting clean indoor air policies.

Youth Participation in a Community Campaign to Pass a Clean Indoor Air Ordinance

Because of the harmful effects of secondhand smoke, communities are organizing to pass clean indoor air policies. With youth being considered one of the most vulnerable populations to this health hazard, it can be strategic to campaigns and beneficial to the youth's development to involve them in efforts to control this toxin. However, youth participation in health campaigns is limited because of barriers inherent in these initiatives. This article presents lessons learned from a qualitative case study on the youth involvement in a successful local clean indoor air campaign. Through the analysis of semistructured interviews with the adult members of the campaign, group interviews and questionnaire completion by the youth members of the campaign, and additional insight made possible by participant observation, recommendations are provided to engage and sustain youth involvement in local public health initiatives.

Does the Type of CIA Policy Significantly Affect Bar and Restaurant Employment in Minnesota Cities?

Clean indoor air (CIA) policies that include free-standing bars and restaurants have been adopted by communities to protect employees in all workplaces from exposure to environmental tobacco smoke, most notably employees working in restaurants and free-standing bars. However, due to the perception of negative economic effects on alcohol-licensed hospitality businesses, partial CIA policies (those that provide an exemption for free-standing bars) have been proposed as a means to reduce the risk of economic effects of comprehensive CIA policies applied to all worksites. Bar and restaurant employment per capita were used to determine if partial CIA policies produced differential economic effects compared to comprehensive CIA policies. Ten cities in the state of Minnesota were studied from 2003-2006. Economic data were drawn from monthly employment in bars and restaurants, and a pooled time-series was completed to evaluate three types of local CIA policies: Comprehensive, partial, or none beyond the state law. Communities with a comprehensive CIA policy had a decrease of 9 employees per 10,000 residents compared with communities with partial CIA policies (p = 0.10). Communities with any type of CIA policy (partial or comprehensive) had an increase of 3 employees per 10,000 residents compared to communities without any CIA policies (p = 0.36). There were no significant differential economic effects by CIA policy type in Minnesota cities. These findings support the adoption of comprehensive CIA policies to provide all employees protection from environmental tobacco smoke exposure.

The relationship between local clean indoor air policies and smoking behaviours in Minnesota youth

Background:While clean indoor air (CIA) policies are intended to reduce exposure to second-hand smoke in the workplace, restrictions in public workplaces have the potential to discourage youth smoking. There is...

The Economic Impact of Clean Indoor Air Laws

Clean indoor air laws are easily implemented, are well accepted by the public, reduce nonsmoker exposure to secondhand smoke, and contribute to a reduction in overall cigarette consumption. There are currently thousands of clean indoor air laws throughout the Unites States, and the majority of Americans live in areas where smoking is completely prohibited in workplaces, restaurants, or bars. The vast majority of scientific evidence indicates that there is no negative economic impact of clean indoor air policies, with many studies finding that there may be some positive effects on local businesses. This is despite the fact that tobacco industry-sponsored research has attempted to create fears to the contrary. Further progress in the diffusion of clean indoor air laws will depend on the continued documentation of the economic impact of clean indoor air laws, particularly within the hospitality industry. This article reviews the spread of clean indoor air laws, the effect on public health, and the scientific evidence of the economic impact of implementation of clean indoor air laws.

Association between respiratory tract diseases and secondhand smoke exposure among never smoking flight attendants: a cross-sectional survey.

BackgroundLittle is known about long-term adverse health consequences experienced by flight attendants exposed to secondhand smoke (SHS) during the time smoking was allowed on airplanes. We undertook this study to evaluate the association between accumulated flight time in smoky airplane cabins and respiratory tract diseases in a cohort of never smoking flight attendants.MethodsWe conducted a mailed survey in a cohort of flight attendants. Of 15,000 mailed questionnaires, 2053 (14%) were completed and returned. We excluded respondents with a personal history of smoking (n = 748) and non smokers with a history of respiratory tract diseases before the age of 18 years (n = 298). The remaining 1007 respondents form the study sample.ResultsThe overall study sample was predominantly white (86%) and female (89%), with a mean age of 54 years. Overall, 69.7% of the respondents were diagnosed with at least one respiratory tract disease. Among these respondents, 43.4% reported a diagnosis of sinusitis, 40.3% allergies, 30.8% bronchitis, 23.2% middle ear infections, 13.6% asthma, 13.4% hay fever, 12.5% pneumonia, and 2.0% chronic obstructive pulmonary disease. More hours in a smoky cabin were observed to be significantly associated with sinusitis (OR = 1.21; p = 0.024), middle ear infections (OR = 1.30; p = 0.006), and asthma (OR = 1.26; p = 0.042).ConclusionWe observed a significant association between hours of smoky cabin exposure and self-reported reported sinusitis, middle ear infections, and asthma. Our findings suggest a dose-response between duration of SHS exposure and diseases of the respiratory tract. Our findings add additional evidence to the growing body of knowledge supporting the need for widespread implementation of clean indoor air policies to decrease the risk of adverse health consequences experienced by never smokers exposed to SHS.

Engaging Youth for Positive Change: A Critical Analysis of Case Studies on Local Action

This paper discusses the experiences and outcomes associated with Engaging Youth for Positive Change (EYPC), a youth civic engagement program developed to address clean indoor air policy, piloted in four Illinois communities. Youth involvement in public policy offers a potentially powerful tool for empowering youth to affect change, especially when youth representatives are involved as partners in identifying needs, conducting research, and making decisions. The EYPC program seeks to 1) facilitate a critical consciousness about factors at multiple levels that contribute to local problems; 2) facilitate a high level of understanding about power and politics; 3) make youth participants more effective in their efforts to advocate for a clean indoor air policy; and 4) teach youth participants how to collect and analyze data to further support their arguments when speaking to government officials and community members. The paper discusses the difficulty of reconciling a desire for deeper youth engagement with adult-directed civic education and policy goals, addresses youth experiences with the program, and discusses preliminary program outcomes and lessons learned.

Philip Morris’s Project Sunrise: weakening tobacco control by working with it

Objective: To analyse the implications of Philip Morris USA’s (PM’s) overtures toward tobacco control and other public health organisations, 1995–2006. Data sources: Internal PM documents made available through multi-state US...

Tobacco industry consumer research on socially acceptable cigarettes

Objective: To describe tobacco industry consumer research to inform the development of more “socially acceptable” cigarette products since the 1970s. Methods: Analysis of previously secret tobacco industry documents. Results: 28...

Strength of clean indoor air laws and smoking related outcomes in the USA

Objectives: Environmental tobacco smoke (ETS) is often encountered in the workplace. There have been efforts to apply and enforce state laws limiting workplace smoking. There has been little study of...

The Nuts and Bolts of the Passage of a Clean Indoor Air Ordinance in Toledo, Ohio

In many communities across the country various clean indoor air policies (smoking bans) are being put into effect. Implementation occurs in various ways, making each policy unique regarding its components, the processes involved in getting it passed, and the timetable in which it happens. The following article outlines one city's quest for a clean indoor air policy.

From “Taxed” Health to Excise Tax: Ethical Accountability and the Fight for Comprehensive Tobacco Control Programson the National and State Levels

Government needs to take an ethical stand on the issue of tobacco control, thereby falling in line with the public administrators, public health advocates, and other public servants who support the passage of excise tax legislation and local ordinances that go beyond state preemption clean indoor air policy. That the excise tax will generate medical and economic benefits is unquestionable. In a similar vein, stronger local smoking bans to reduce levels of environmental tobacco smoke (ETS) will undoubtedly carry significant import for healthier work and leisure environments. What remains dubious is the degree to which the public can count on government support of anti-tobacco initiatives. A theory of administrative accountability is a significant part of assessing an issue that has ethical as well as medical and economic ramifications. This paper outlines the historical and current challenges facing public servants as they wager public health for regional economy.

Addressing the chronic disease burden with tobacco control programs.

SUMMARYThe benefits of tobacco use prevention and controlinterventions for population health, in terms of dis-ability-adjusted life years, can be estimated throughthe effect of reduced tobacco use on the incidence ofchronic disease, particularly cardiovascular disease,respiratory disease, and cancer. 3 The interventions dis-cussed here have a larger effect on population healthin regions with a high prevalence of tobacco use (e.g.,Central and Eastern Europe, South Asia, Western Pa-cific, and parts of the Americas). To achieve acceler-ated and sustained improvements in population health,a mix of interventions (such as taxation, comprehen-sive bans on advertising, and information dissemina-tion activities) are cost-effective in most countries.The greatest tobacco-related improvements in popu-lation health have been the result of efforts to increasetobacco taxation, develop clean indoor air policies,introduce comprehensive bans on advertising, and edu-cate the public through campaigns. Each componentis greatly enhanced when implemented in conjunc-tion with others. Integrated tobacco control programsrequire a sound surveillance system for monitoringand evaluation while developing infrastructure to sus-tain them. As the tobacco epidemic freely crosses in-ternational borders, strong partnerships within thecountry and across international organizations arenecessary to support global tobacco control. Such com-prehensive programs effectively reduce the prevalenceof tobacco use. With reduced tobacco use—the lead-ing risk factor associated with the greatest burden ofchronic disease—follows reduced incidence of cardio-vascular disease, stroke, and other chronic diseases.The CDC is dedicated to promoting tobacco controlstrategies with the expectation of averting many deathsattributable to tobacco use worldwide.REFERENCES

Preemption in public health: the dynamics of clean indoor air laws.

Preemption is a powerful strategy used by special interest groups to undermine strong, local public health standards. Currently, 20 states in the U.S. have preemption ordinances in place related to clean indoor air initiatives. These preemption laws are the direct result of an ongoing and aggressive campaign of tobacco companies to thwart clean indoor air initiatives, which ultimately, according to tobacco industry internal documents, cause significant reductions in their annual revenues. Clean indoor air policies have arisen from a greater understanding of the documented health risks associated with exposure to secondhand smoke and action by local government (city councils, county commissions, and boards of health) to protect the public from these hazards. The efforts of the tobacco industry undermine local authority and seek to shift policy action to the state and federal levels, where the industry has greater political influence.

Boards of Health as venues for clean indoor air policy making.

This study sought to determine the tobacco industry's strategies for opposing health board actions and to identify elements necessary for public health to prevail. Newspaper articles, personal interviews, and tobacco industry documents released through litigation were reviewed. Twenty-five instances in which the tobacco industry opposed health board regulations were identified. It was shown that the tobacco industry uses 3 strategies against health boards: "accommodation" (tobacco industry public relations campaigns to accommodate smokers in public places), legislative intervention, and litigation. These strategies are often executed with the help of tobacco industry front groups or allies in the hospitality industry. Although many tobacco control advocates believe that passing health board regulations is easier than the legislative route, this is generally not the case. The industry will often attempt to involve the legislature in fighting the regulations, forcing advocates to fight a battle on 2 fronts. It is important for health boards to verify their authority over smoking restrictions and refrain from considering non-health factors (including industry claims of adverse economic impacts) so as to withstand court challenges.

State-Specific Prevalence of Current Cigarette Smoking Among Adults, and Policies and Attitudes About Secondhand Smoke—United States, 2000

Tobacco use, particularly cigarette smoking, is the leading preventable cause of death in the United States, but the health consequences extend beyond smokers to nonsmokers involuntarily exposed to environmental tobacco smoke or secondhand smoke (SHS). Each year, an estimated 3,000 lung cancer deaths and 62,000 deaths from coronary heart disease in adult nonsmokers are attributed to SHS. Among children, SHS causes sudden infant death syndrome, low birthweight, chronic middle ear infections, and respiratory illnesses (e.g., asthma, bronchitis, and pneumonia). Two national health objectives for 2010 are to reduce cigarette smoking among adults to 12% (objective 27-1) and the proportion of nonsmokers exposed to environmental tobacco smoke to 45% (objective 27-10). To characterize state-specific prevalence of cigarette smoking among adults, exposure to SHS at home, smoke-free workplace policies, and attitudes toward smoke-free policies by state, CDC analyzed data from the 2000 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis and indicates that in 2000, state-specific adult smoking prevalence ranged from 12.9%-30.5%, and high levels of public support exist, even among smokers, for smoke-free policies in many settings. States should implement comprehensive programs to reduce tobacco use and adopt clean indoor air policies to reduce involuntary exposure to SHS.

Environmental and Policy Interventions to Control Tobacco Use and Prevent Cardiovascular Disease

Despite its declining prevalence during the past few decades, tobacco use remains one of the most significant public health issues of the 1990s. Environmental and policy interventions are among the most cost-effective approaches to control tobacco use and prevent cardiovascular diseases. In this article, the authors review and offer to state and local health departments and other public health partners a summary of recommended policy and environmental interventions that have either reduced or show potential to reduce tobacco use. Priority recommendations include clean indoor air policies, restrictions on tobacco advertising and promotion, policies limiting youth access to tobacco, comprehensive school health programs, and excise taxes and other economic incentives. Many of these recommendations should be integrated with other health promotion interventions to also improve nutrition and physical activity. The authors also highlight several successful interventions and strategies used to establish policies at the state and local levels.