Not all smoke-free laws are created equal. Effective, or comprehensive, smoke-free laws protect all workers from secondhand smoke and aerosol from electronic smoking devices by covering all indoor workplaces and buildings open to the public, and all tobacco products that pollute the air. This means no exceptions—all workers and patrons are asked to step outside away from entryways, windows, and vents when they want to smoke, ensuring that indoor air remains clean. These laws ensure that no one is left out. Comprehensive smoke-free laws covering everyone and all tobacco products that pollute the air are the only ones that have been shown to be effective at significantly improving public health.

Partial smoke-free laws fall short of being effective by failing to protect all workers. These laws make exceptions that take away smoke-free protections from certain businesses or communities, leaving workers and patrons exposed to deadly air pollution from secondhand smoke or aerosol from electronic smoking devices. Secondhand smoke is a well-known air pollutant, containing 69 toxins known to cause cancer and emitting tiny particles known to cause heart and lung disease. Electronic smoking devices are considered a tobacco product by the FDA and they are known to pollute the air with toxic aerosol. While the long-term effects of exposure to electronic cigarette aerosol are not yet known, research shows negative short-term health effects. E-cigarettes emit lung and eye irritants such as propylene glycol, carcinogens such as formaldehyde and ?-nicotyrine, toxins such as metal and silicate particles, and addictive nicotine.

Effective smoke-free laws are comparable to a vaccine for heart disease and cancer—when given at the right ‘dose,’ they are effective at preventing fatal diseases and improving public health. People with emphysema who live in Kentucky communities with an effective smoke-free law are 22% less likely to go to the hospital than those living in communities with partial or no smoke-free laws. Additionally, people living in communities with comprehensive smoke-free laws are less likely to be hospitalized for heart attacks, compared to people living in communities with partial smoke-free laws. In turn, fewer sick people needing healthcare and missing work means lower healthcare costs and higher worker productivity, improving the Kentucky economy. It is important to note the difference in health effects between communities with effective smoke-free laws and those with partial laws. Passing a partial law is like taking a lower dose of a medicine than is recommended: you can say you took the medicine, but your health may not improve.

Some may want to compromise, saying a partial law is better than no smoke-free law at all. However, data show that partial smoke-free laws fail to protect the public health. For example, after a partial smoke-free law that exempted certain places was enacted in Georgia, the number of restaurants and bars that allowed smoking nearly doubled, putting more workers in danger than before the law was passed. Sometimes it is argued that a partial smoke-free law is a starting point, and that if the public responds well, the law can be strengthened later. However, research shows that once smoke-free laws are passed, they tend to ‘stick.’ Partial laws are rarely strengthened, making it critical that policymakers pass an effective law with no exceptions the first time.

No worker should have to choose between their health and a paycheck. An eight hour shift in a business where other people are smoking exposes workers to the same amount of toxins and carcinogens they would get from smoking a pack of cigarettes. Workers employed in places that allow smoking are subjected to the same health effects of being a pack a day smoker, even if they do not smoke themselves. Nearly 1,000 non-smoking Kentuckians suffer and die prematurely every year from exposure to secondhand smoke. Effective, comprehensive smoke-free laws could prevent these needless deaths. Comprehensive smoke-free laws that cover everyone regardless of where they work and that cover all tobacco products including electronic smoking devices that pollute the air are the only laws that will save lives and money for Kentucky taxpayers.

For more information about smoke-free legislation, go to www.kcsp.uky.edu or email us at kcsp00@lsv.uky.edu.

Ellen Hahn, PhD, RN, FAAN, Professor and Director, Kentucky Center for Smoke-free Policy (KCSP), University of Kentucky College of Nursing; Holly Brown, MS, Research Assistant, KCSP