CLEAN INDOOR AIR ORDINANCES

Clean indoor air ordinances came about as a result of two landmark reports published in 1986: the National Research Council of the National Academy of Sciences report entitled Environmental Tobacco Smoke: Measuring Exposures and Assessing Health Effects, and the U.S. Surgeon General's Report entitled The Health Consequences of Involuntary Smoking. These reports, along with other authoritative scientific studies, described the health risks to nonsmokers of breathing tobacco smoke in various settings. The terms used to describe the tobacco smoke being breathed by the nonsmoker became known as involuntary, passive, secondhand, or environmental tobacco smoke (ETS). The 1986 Surgeon General's Report reached three important conclusions: (1) ETS causes disease, including lung cancer in healthy nonsmokers; (2) children of smoking parents have an increased frequency of respiratory infections, slower development of lung function, and are more likely to have middle-ear disease; and (3) the simple separation of smokers and nonsmokers within the same space does not reduce the exposure of the nonsmoker to ETS. In 1992, the Environmental Protection Agency (EPA) designated ETS as a Class A carcinogen, which placed tobacco smoke in the same category as asbestos, benzene, and radon. People may be affected most by ETS where they work, in public places (restaurants, shopping centers, public transportation, schools), and in the home.

The mechanisms used to create clean indoor air policies can be seen by looking at federal, state, and local legislation, and at private sector policy development. The legal foundation for regulating public smoking is based mainly on protecting the health of workers. Courts have ruled that employers must provide nonsmoking employees protection from the proven health hazards of ETS. In 1977, Berkeley, California, became the first community to pass local legislation that limited smoking in public places. By 1998, public smoking was restricted or banned in 820 localities in the United States. The most notable federal regulation was passed in 1988, and required domestic airline flights under two hours in length to be smoke free. In 1990, smoking was banned on longer flights. In 1997, President Bill Clinton signed an executive order establishing a smoke-free environment for federal employees and all members of the public visiting federally owned facilities. By December 1999, laws regulating smoking to some degree had been established in forty-five states and the District of Columbia. Utah, California, and Vermont completely prohibit smoking in restaurants.

The agencies most often responsible for enforcement of clean air ordinances are health departments. Clean air regulations or policies can also be implemented by private companies or organizations. Exemplifying nongovernment regulatory action is the adoption of an accrediting standard that prohibits smoking in hospital buildings. Among private companies, a survey by the Centers for Disease Control and Prevention (CDC) in 1995 found that 87 percent of worksites with fifty or more employees had a smoking policy. The impact of clean indoor air ordinances can be evaluated by the change in attitudes towards restrictions, the effects of restrictions on nonsmokers' exposure to ETS, and the effects of restrictions on smoking behaviors. Surveys among U.S. smokers show that between 82 and 100 percent support restrictions in public places. The effectiveness in reducing nonsmokers' exposure to ETS has been demonstrated by the reduction of nicotine levels in nonsmokers. Numerous studies have also shown that restrictions on smoking have reduced the number of smokers and reduced the number of cigarettes smoked among those who have not quit.

Jon Jenney

(see also: Air Quality Index; Ambient Air Quality [Air Pollution]; Clean Air Act; Environmental Tobacco Smoke; Lung Cancer; Tobacco Control )

Bibliography

American Cancer Society (1999). Cancer Facts and Figures. Atlanta, GA: Author.

Environmental Protection Agency (1992). Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. Washington, DC: EPA, Office of Research and Development, Office of Air and Radiation.

U.S Department of Health and Human Services (1986). The Health Consequences of Involuntary Smoking: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

—— (2000). Reducing Tobacco Use: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.