FOR RELEASE: March 25, 2002
CONTACT: Dick Gunn
Governor’s Task Force on Tobacco and Youth Releases
Finding on Smoke-Free Environments
Last Friday, the Governor’s Task Force on Tobacco and Youth released its findings and recommendations on rules adopted March 14 by the State Board of Health that would eliminate secondhand smoke in most public places and workplaces.
In total, the Task Force released 38 “findings” and respectfully urged Governor Keating to “approve the Board of Health rules regarding secondhand smoke as adopted, thereby ensuring an historic opportunity for the entire State Legislature to fully consider the rules.” The Task Force also respectfully urged the Oklahoma Legislature to not disallow the rules “unless simultaneously voting to enact state law that would ensure Oklahomans the same level of protection as the rules would provide.”
Today, the Board of Health will forward the rules to Governor Keating and the Oklahoma Legislature for their dual consideration. To become effective, the governor must approve the rules within 45 calendar days. The legislature has up to 30 legislative days to disapprove the rules by a majority vote of both the House of Representatives and the State Senate. If approved by the governor and not disapproved by the legislature, the rules would become effective on July 1, 2002.
The 25-member Task Force was created by Governor Keating in 1995 and includes representatives of the American Cancer Society, American Heart Association, American Lung Association, State PTA, Oklahoma Dental Association, Oklahoma Municipal League, Oklahoma Osteopathic Association, Oklahoma State Medical Association, at-large members, and several state agencies.
The following is the full set of the findings and recommendations as adopted by the Task Force on Friday.
The Oklahoma Governor’s Task Force on Tobacco and Youth
Eleventh Report on Findings and Recommendations
March 22, 2002
“Board of Health Rules to Protect Oklahomans from Exposure to Secondhand Smoke Inside Public Places”
- The Oklahoma State Board of Health has declared tobacco use as our state’s number one health problem. Oklahoma has the ninth highest percentage of smoking-caused deaths in the nation.
- Tobacco use is a major cause of heart disease, cancer, stroke and chronic obstructive pulmonary disease (COPD), killing an estimated 6,000 Oklahomans each year, or an average of 16 each day—more than alcohol, car accidents, AIDS, violent crime, heroin, cocaine and crack combined.
- Tobacco use also causes an increased risk of low-birth-weight deliveries, miscarriage, stillbirth, pre-term delivery, and sudden infant death syndrome (SIDS).
- Oklahomans who smoke consume more cigarettes than much of the nation. The cigarette consumption rate in Oklahoma is 109 packs per person per year compared to a national rate of 85 packs per person per year. In only five states do people smoke more than we do.
- Most Oklahoma smokers don’t want to smoke. Among Oklahoma smokers, three out of four adults and one-half of youths report they want to completely stop smoking.
- Seventy-six percent of all adult smokers in Oklahoma became regular smokers as teenagers. Oklahoma youth continue to be plagued by tobacco products at rates considerably higher than the nation-at-large. Twenty-one percent of Oklahoma middle school students and 42 percent of Oklahoma high school students use some form of tobacco products as compared to current national rates of 13 percent for middle school students and 35 percent for high school students.
- The estimated costs of tobacco use in Oklahoma exceed $1 billion annually, or a per capita average of about $300. The publicly funded portion for Medicaid alone is estimated at over $80 million per year. In addition to treating the chronic disease caused by tobacco, other costs include increased rates of employee absenteeism and lost productivity.
- Secondhand tobacco smoke is a complex mixture of more than 4,000 chemicals including at least 250 harmful substances including mutagens, carcinogens, eye and respiratory irritants, systemic toxicants, and reproductive and developmental toxicants. The irritants and systemic poisons include ammonia, acrolein, carbon monoxide, formaldehyde, hydrogen cyanide, nicotine, nitrogen oxides, phenol, and sulfur dioxide. More than 40 compounds in secondhand smoke are classified as known or suspected human carcinogens, including benzene, hydrazine, vinyl chloride, aromatic amines, arsenic, cadmium, chromium, and nickel.
- Sidestream smoke from the tip of the cigarette is created at lower temperatures than mainstream smoke inhaled through the cigarette and can include greater concentrations of some toxic substances that are reduced at the higher temperatures reached in active puffing. Consequently, secondhand smoke typically is even more toxic than the smoke inhaled by a smoker directly from a cigarette.
- For every eight smokers who die from smoking, one nonsmoker dies from exposure to secondhand smoke. An estimated 750 people die prematurely each year in Oklahoma from exposure to secondhand smoke. The deaths are primarily from cancer, heart disease and breathing disorders.
- Secondhand smoke places extra stress on the heart and affects the body’s ability to take in and use oxygen. A study of 32,000 nurses over several years showed that regular exposure to secondhand smoke at work increased the risk of coronary heart disease by 91 percent. Occasional exposure to secondhand smoke increased the risk by 58 percent, compared to those who avoided secondhand smoke exposure.
- Secondhand smoke kills more Americans through heart disease than from any other disease. Multiple studies confirm this finding, with estimates of the toll in this country ranging from 35,000 to 62,000 deaths per year from heart disease caused by secondhand smoke. Secondhand smoke exposure substantially increases the risk of stroke.
- In 2000, the National Toxicology Program through a stringent interdepartmental scientific review process listed secondhand tobacco smoke as a known human carcinogen in its periodic report required by Congress. Secondhand smoke is estimated to cause 3,000 lung cancer deaths in nonsmokers each year. Secondhand smoke also causes nasal sinus cancer. There is no safe level of exposure to class A (known human) carcinogens.
- Secondhand smoke causes many more cases of cancer than all the federally regulated environmental carcinogens combined (asbestos, benzene, etc.).
- Thousands of Oklahomans suffer from airway obstructive diseases, including 180,000 with asthma. These people may have immediate reactions to secondhand smoke exposure, some serious enough to require emergency medical treatment. In addition to asthma, these conditions include chronic bronchitis and emphysema.
- Tobacco smoke causes immediate effects in many people such as eye and nasal irritation, headache, sore throat, dizziness, nausea, cough, and respiratory problems.
- At least 300,000 to 400,000 workers in Oklahoma are currently subject to worksite exposure to secondhand smoke.
- Children are especially susceptible to secondhand smoke exposure. Their lungs are still developing, and they breathe more per pound of body weight than adults do. Secondhand smoke can lead to a buildup of fluid and infections in the middle ear, the most common cause of children being hospitalized for an operation. Every year, up to 4,500 Oklahoma children less than 18 months old get bronchitis or pneumonia from breathing secondhand smoke. Up to 225 of these cases require hospitalization and several result in death.
- Asthmatic children are especially at risk, and secondhand smoke is a risk factor for new cases of asthma in children. It also increases the frequency and severity of episodes of asthma, adversely impacting up to 15,000 Oklahoma children yearly.
- Secondhand smoke has been identified as a cause of low birth weight and of sudden infant death syndrome (SIDS). A World Health Organization panel concluded in 1999 that maternal smoking causes one-third to one-half of SIDS cases.
- Teenaged workers are the least likely to be protected by smokefree workplace policies because young workers are heavily concentrated in the food service industry where protections are generally less than those afforded white collar workers. As compared to other workers, food service workers working in restaurants where smoking is allowed have an 88 percent higher risk for lung cancer.
- For several reasons, clean indoor air policies are an effective strategy for youth tobacco prevention. Clean indoor air policies result in fewer adults modeling smoking behavior. When messages on smokers’ health and nonsmokers’ rights are addressed to smokers of all ages, youth are less likely to feel singled out and therefore are less likely to rebel against prevention messages.
- A 1999 poll revealed 89 percent of Oklahoma adults believed secondhand smoke was harmful. Seventy-five percent said secondhand smoke bothers them. And 86 percent, including three out of four smokers, agreed with the statement “nonsmokers shouldn’t have to put up with the annoyance and health hazards of cigarette smoke at work or in other public places.”
- The fine print of a Philip Morris publication promoting its Accommodation Program gives the tobacco company legal protection against potential liability claims for knowingly exposing nonsmokers to dangerous secondhand smoke: “Editor’s Note: ...The Accommodation Program does not purport to address health effects attributed to smoking.”
- Internal tobacco industry documents, recently made public through state tobacco lawsuits, indicate that the tobacco companies promote “accommodation” of smokers to protect against resulting losses in cigarette sales. One example is a 1992 Philip Morris interoffice memorandum that states: “Total prohibition of smoking in the workplace strongly affects industry volume. Smokers facing these restrictions consume 11-15% less than average and quit at a rate that is 84% higher than average. ...Clearly, it is most important for PM to continue to support accommodation for smokers in the workplace....”. Another Philip Morris document from 1993 estimates the financial losses if smoke-free policies were enacted: “Financial impact of smoking bans will be tremendous – three to five fewer cigarettes per day will reduce annual manufacturer profits a billion dollars plus per year.”
- A 1988 tobacco industry memorandum describes how “vast sums of money” were spent paying researchers to “stimulate controversy” regarding the science of secondhand smoke. The memo summarized Philip Morris program to recruit scientists “who have no previous record on the primary issues” to conduct research “which apparently would then be ‘filtered’ by lawyers to eliminate areas of sensitivity.”
- In 1975, the Oklahoma Legislature declared secondhand tobacco smoke “a public nuisance and dangerous to public health” in elevators, indoor theaters, libraries, art galleries, museums, indoor roller skating rinks and buses by enacting 21 O.S. §1247. Secondhand tobacco smoke cannot be dangerous in some indoor areas and not dangerous in others.
- On October 1, 2001, a coalition of state agencies including the State Department of Health, the Department of Mental Health and Substance Abuse Services, the Health Care Authority, and the Alcoholic Beverage Laws Enforcement (ABLE) Commission, joined together with state public health organizations including the American Cancer Society, the American Heart Association, the American Lung Association, the State Medical Association and many others to call for a multifaceted strategy to lessen the impact of tobacco use on our society, and to improve the overall state of health.
- On March 14, 2002, the Oklahoma State Board of Health promulgated rules to protect the public from toxic and hazardous substances that can cause disease by adopting rules to eliminate exposure to secondhand smoke in most public places and workplaces.
- Established science since passage of the Oklahoma Smoking in Public Places Act and its amendments have made it abundantly clear that secondhand smoke is a toxic substance to humans of all ages, causing cancer, heart disease and other life threatening illnesses in those exposed, and is thus a toxin for which exposure must be limited to the lowest possible levels.
- The Board’s actions continue a responsibility that began 112 years ago with the first Territorial Board of Health, which was authorized to “…make and enforce any and all needful rules and regulations for the prevention and cure of diseases…” The purpose of the rules is to help protect the public from the recognized hazards of secondhand smoke.
- The rules as adopted would provide a uniform standard to protect persons inside the workplace and in public places from secondhand smoke. They would apply to enclosed indoor spaces inside buildings, not outdoor areas. To help ensure that persons can enter the building without having to pass though smoke, smoking would not be allowed within 15 feet of the main entrance.
- Prior to adopting the rules, the Board reviewed scientific research that documented those places in which smoking occurs cannot have a true smoke-free area because of inadequacies within standard building ventilation systems.
- The Board of Health has stated that the rules are not meant to penalize smokers, but to reduce nonsmokers’ exposure to secondhand smoke. The Board has also recognized that most smokers want to quit smoking, and the state health department has formally requested that the first monies distributed from the Tobacco Settlement Trust Fund be used to support proven cessation programs.
- The 1987 “Oklahoma Smoking In Public Places Act” does not provide adequate protections from the recognized health effects of secondhand smoke and currently includes a provision endorsed and promoted by the tobacco industry that entirely prohibits local governments in Oklahoma from enacting any related ordinance that is stronger than state law.
- Communities across the nation, including many communities in states adjacent to Oklahoma, have taken the lead in developing, enacting and enforcing effective measures to reduce non-smokers’ exposure to secondhand smoke. Local officials are closer to their constituents and tend to be more interested in the voters’ views than in the rhetoric of tobacco industry lobbyists. Local level ordinances have at least two additional inherent benefits. First, as a local government considers proposed tobacco control measures, citizens within the community reach a level of awareness and understanding of the issues which they would have been unlikely to have gained without direct participation in or observation of the process of developing the policy. Furthermore, if the community does decide to adopt the proposed ordinance, they are more likely to feel a sense of “ownership” or loyalty to the provisions within the ordinance.
- Repeated attempts by public health organizations over many years to repeal the preemptive language in state tobacco law and/or to advance legislation that would protect all nonsmokers in Oklahoma from the hazards of secondhand smoke in public places and workplaces have been unsuccessful. Such legislation has rarely been allowed a committee vote in the House of Representatives.
- Under the Oklahoma Administrative Procedures Act, the rules will be sent to the Oklahoma Legislature and Governor Keating for consideration within 10 days of adoption. To become effective, the Governor must approve the rules within 45 calendar days of the date they are received. The Governor may choose to approve certain sections of the rules and to disapprove other sections. The State Legislature has 30 legislative days to disapprove the rules by a majority vote of both the State House of Representatives and the State Senate if they find that the rules are “not consistent with legislative intent.” If approved by the Governor and also not disapproved by the Legislature, the rules would become effective on July 1, 2002 unless successfully challenged in court.
To reduce the recognized health hazards of secondhand smoke inside public places and workplaces among adults and children in Oklahoma, to improve smoking cessation rates among smokers who are trying to quit, and to help reduce tobacco use among youth, the Governor’s Task Force on Tobacco and Youth respectfully urges Governor Keating to approve the Board of Health rules regarding secondhand smoke as adopted, thereby ensuring an historic opportunity for the entire State Legislature to fully consider the rules. The Task Force further respectfully urges all members of the State Legislature to not vote to disallow the rules unless simultaneously voting to enact state law that would ensure Oklahomans the same level of protection as the rules would provide.