workplace
Publication Date: 02/02/2011
The Problem:
Tobacco use is a source of chronic and fatal illnesses for users and persons with secondary exposure. In the United States, cigarette smoking contributes to one in five deaths and costs more than $193 billion annually in lost productivity and healthcare expenditures. CDC: Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004. Nearly 25 percent of annual deaths related to cardiovascular disease in the United States can be attributed to smoking and cigarette smokers are 2 to 3 times more likely to die from cardiovascular disease than non-smokers. CDC: The Health Consequences of Smoking. Complete Report. 2004
The Law:
Smoking bans and restrictions prohibit smoking in specified areas. These restrictions aim to eliminate or reduce exposure to secondhand smoke. Smoking bans and restrictions are found in state and local laws as well as regulations governing workplace safety. For examples of state smoking bans, see ARS 36-601.01 (Arizona), Utah Health Code § 26.83.3 (Utah), VT Health Code § 1742 (Vermont), and RI Health & Safety Code § 23-20.10-3 (Rhode Island).
The Evidence:
Meyers et al. performed a systematic review and meta-analysis of 11 studies that assessed the impact of public smoking bans (including workplaces) on the incidence of acute myocardial infarction (AMI) on the general population. Meyers et al. Cardiovascular effect of bans on smoking in public places: A systematic review and meta-analysis. J Am Coll Cardiol, 2009; 54:1249-1255. Studies were drawn from the United States, Canada, Italy, and Scotland. The authors used a random effects meta-analysis to control for differences in study population size and duration of observations. The meta-analysis found that public smoking bans reduce the risk of AMI by 17 percent, and this risk continues to decrease each year after ban implementation. Meyers et al. suggest that the duration of the post-ban effect may be explained by greater compliance to bans, decreased prevalence of smoking, improved air quality, and reduced environmental exposure to tobacco.
The Bottom Line:
According to a peer-reviewed systematic review and meta-analysis, substantial evidence suggests that public smoking bans effectively reduce the risk of acute myocardial infarction.
Regulatory agencies established to protect the public all face a fundamental challenge: there are many more firms to inspect than there are government personnel to inspect them. For example, more than 50,000 Americans die each year from health and safety hazards at work, but the U.S. Occupational Safety and Health Administration (OSHA) can only visit about 1 percent of the nation's potentially dangerous workplaces each year. Improving OSHA's and other agencies' techniques for selecting workplaces for inspection could help prevent numerous unnecessary injuries and fatalities. A multidisciplinary team of experts in science, law, and statistics from the University of Pennsylvania will use cutting edge analytical techniques to develop and test alternative strategies for deploying regulatory inspection resources based on risk levels and on financial and other characteristics of individual companies.
Grant Number: 68398
Funding Date: Mon, 11/15/2010
Researching Institution: University of Pennsylvania
Researcher: Adam Finkel, M.P.P., Sc.D.; Cary Coglianese, Ph.D., M.P.P.,J.D.,A.B.
Publication Date: 12/07/2009
The Problem:
Tobacco use is a source of chronic and fatal illnesses for users and persons with secondary exposure. In the United States, cigarette smoking contributes to one in five deaths and costs more than $193 billion in annual lost productivity and healthcare expenditures. CDC: Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004.
The Law:
Smoking bans and restrictions prohibit smoking in specified areas. These restrictions aim to eliminate or reduce exposure to second hand smoke. Smoking bans and restrictions are found in state and local laws as well as regulations governing workplace safety. For examples of state smoking regulations, see ARS 36-601.01 (Arizona), Utah Health Code § 26.83.3 (Utah), VT Health Code § 1742 (Vermont), and RI Health & Safety Code § 23-20.10-3 (Rhode Island).
The Evidence:
In a systematic review, a Community Guide expert panel reviewed 10 studies that assessed the effectiveness of smoking bans and restrictions as means of reducing exposure to secondhand smoke in workplaces. Hopkins DP et al. Reviews of Evidence Regarding Interventions to Reduce Tobacco Use and Exposure to Environmental Tobacco Smoke. Am J Prev Med 2001; 20(2S). Some of the underlying studies measured the impact of specific smoking restriction laws; others measured the impact of policies initiated and enforced by private entities. The reviewers identified reductions in self-reported exposure or actual nicotine vapor in 9 of the 10 studies. Reductions in vapor measures ranged from 44 percent to 97 percent.
The Bottom Line:
In the judgment of a Community Guide expert panel, there is strong evidence supporting smoking bans and restrictions as effective public health interventions aimed at decreasing exposure to secondhand smoke.
Additional Information:
An interactive map from the Robert Wood Johnson Foundation gives policy-makers and advocates a nationwide picture of continuing state efforts on key tobacco control policies.
Additional Resources: Smoke-free Laws by State
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Public Health Law Research is a national program of the Robert Wood Johnson Foundation. It is housed at the Temple University Beasley School of Law.