It may surprise you to learn that there are no nationwide federal government bans on smoking in the US. Legislation and enforcement of smoking laws are left up to the states. Even some cities and local governments are empowered to pass their own laws. However, there are a few federal regulations that pertain to indoor smoking. For example, in April 1988, the US Department of Transportation banned smoking on all US commercial airline passenger flights [1]. Also, the federal government banned smoking inside all spaces that are owned, rented, or leased by the Executive Branch in August 1997 [2]. Most recently, the US Department of Housing and Urban Development enacted a law that bans smoking in all public housing facilities as of July 31, 2018 [3], [4].

Progressive California Shows the Way

On January 1, 1995, California (gotta love them) was the first US state to enact a statewide ban on smoking in the workplace and restaurants, but it effectively banned smoking in all indoor (‘enclosed’) public places [5]. Bars, taverns, casinos, and gaming clubs were phased in by 1998. Some exemptions are allowed including specified hotel guest rooms, tobacco shops, certain warehouse facilities and employee break rooms. However, many jurisdictions closed exemptions by enacting their own local ordinances. Also, effective January 1, 2008, it’s against the law to smoke in a moving vehicle in California while in the presence of a minor under 18 years of age [6]. In 2006, Calabasas, CA passed what is believed to be the strictest smoking ban in the US---banned in all indoor and outdoor public areas except for a few scattered designated areas around town [7], [8]. One exception, you can smoke in your own car as long as the windows are closed.

Power to the States

Smoking laws vary widely in US states. Thirteen states don’t ban smoking at all in workplaces or restaurants and leave it up to municipalities to enact the laws. In some places, the decision to ban smoking is left to individual businesses. Oklahoma, Tennessee, and Virginia are the three US states with the fewest legislated smoking bans [9]. This is because state laws prohibit local governments from passing laws that are stricter than the state laws. Kind of oppressive if you ask me.

Better late than never, the most recent state smoking ban was in 2018. Alaska’s ban was enacted on July 18, 2018 and will go into effect on October 1, 2018 [10].

Statistics Tell the Story of Regulations

The American Nonsmoker’s Rights Foundation maintains a list of current statistics on smoking laws in the US [11]. Here are some of the highlights:

• 4,964 US municipalities have laws that restrict smoking.
• 751 cities and counties restrict e-cigarette use in 100% smoke-free venues.
• 2,212 colleges and universities have campuses that are 100% smoke-free.
• 1,790 colleges and universities prohibit the use of e-cigarettes.
• 81.8% of the US population is covered by 100% smoke-free laws in non-hospitality workplaces, restaurants, and/or bars.
• 21 states, Puerto Rico, and the US Virgin Islands have laws that require state-regulated gambling to be 100% smoke-free.

Science Shows the Regulation is Worth It

There is no shortage of scientific studies showing that smoking bans improve the health of people [12]–[20]. A 2014 study published in The Lancet examined the results of 11 studies that looked at the impact of smoke-free legislation on the health of babies before and after they’re born [20]. Five of the studies covered local smoking bans in North America and six were from national bans in European countries. Altogether, the studies covered 2.5 million births and 247,168 asthma attacks. The results showed that smoke-free legislation was associated with fewer premature births and fewer visits by children to the hospital for asthma attacks.

Studies done in Helena, Montana in 2004 [13] and New York State in 2007 [15] showed public smoking bans reduced hospital admissions for myocardial infarctions (heart attacks). In the Helena study, hospital admissions for heart attacks decreased from 40 to 24 in the same 6-month span before and after the smoking law went into effect. The New York State study counted 3,813 fewer hospital admissions for heart attacks than would have been expected for the 10 years of data they studied. A 2007 study done in Bowling Green, Ohio used hospital data to study the effect of an indoor smoking ban on coronary artery disease [16].  They found a 39% reduction in coronary artery disease after the ban had been in effect for just 1 year and a 47% reduction after 3 years.

Bartenders and others who work in restaurants and hospitality industries were often subjected to second-hand smoke before smoking bans went into effect. A 1998 study published in JAMA looked at the respiratory health of 53 bartenders before and after a ban on smoking in all bars and taverns in California went into effect [17]. The researchers found, “Establishment of smoke-free bars and taverns was associated with a rapid improvement of respiratory health.” Compared to before the smoking ban, 59% of the bartenders no longer had respiratory symptoms (wheezing, coughing, etc.) and 78% no longer had sensory symptoms like a runny nose, scratchy throat, and irritated eyes. Another JAMA study looked at 77 bar workers before and after a 2006 smoking ban in Scotland [18]. The study found that after the ban the employees had less inflammation in their bodies, considerable improvement in their breathing, and decreased respiratory symptoms. Asthmatic bar workers had improved quality of life and reduced airway inflammation.

Government Regulations Work Sometimes – Be Glad!

We all feel burdened, bogged down, and strangled by government regulations sometimes, whether it’s at the city, state, or federal level. Things can get out of hand quickly if we don’t keep an eye on what’s happening and hold our representatives accountable for wasting our tax money, favoring their private interests, and enacting more regulations just because they can. However, public smoking bans are an example of regulations that have more long-term benefits than drawbacks. Sometimes the system does work.

References

[1] “14 CFR Part 252 - SMOKING ABOARD AIRCRAFT,” Cornell Law School / Legal Information Institute. [Online]. Available: https://www.law.cornell.edu/cfr/text/14/part-252. [Accessed: 28-Aug-2018].

[2] “Executive Order 13058—Protecting Federal Employees and the Public From Exposure to Tobacco Smoke in the Federal Workplace,” Government Publishing Office, 09-Aug-1997. [Online]. Available: https://www.gpo.gov/fdsys/pkg/WCPD-1997-08-18/pdf/WCPD-1997-08-18-Pg1224.pdf. [Accessed: 28-Aug-2018].

[3] “Smoke-Free Policy: Preparing for Your Smoke-Free Home,” US Department of Housing and Urban Development, 2018. [Online]. Available: https://www.hud.gov/sites/documents/5_SMOKEFREE_FS_PREPHOME.PDF. [Accessed: 25-Aug-2018].

[4] “SmokeFree 1 | HUD.gov / U.S. Department of Housing and Urban Development (HUD),” US Department of Housing and Urban Development. [Online]. Available: https://www.hud.gov/program_offices/healthy_homes/smokefree. [Accessed: 28-Aug-2018].

[5] “ETS Exposure in the Home,” California Air Resources Board, 2017. [Online]. Available: https://www.arb.ca.gov/toxics/ets/laws_ets.htm. [Accessed: 28-Aug-2018].

[6] “Bill Text - AB-1569 Smoking in vehicles with minor passengers.,” California Legislative Information. [Online]. Available: http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=200320040AB1569. [Accessed: 28-Aug-2018].

[7] “Chapter 8.12 - SECOND-HAND SMOKE CONTROL* | Code of Ordinances | City of Calabasas, CA | Municode Library.” [Online]. Available: https://library.municode.com/ca/city_of_calabasas/codes/code_of_ordinances?nodeId=TIT8HESA_CH8.12SENDSMCO. [Accessed: 28-Aug-2018].

[8] J. M. Broder, “Smoking Ban Takes Effect, Indoors and Out,” The New York Times, 19-Mar-2006.

[9] “List of smoking bans in the United States,” Wikipedia. 12-Aug-2018.

[10] “Alaska Smoking Law,” The Great State of Alaska, 2018. [Online]. Available: https://dec.alaska.gov/eh/fss/smoking. [Accessed: 28-Aug-2018].

[11] “Overview List - How many smokefree laws?,” American Nonsmokers Rights Foundation. [Online]. Available: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6015a2.htm. [Accessed: 25-Aug-2018].

[12] P. Shafer, “Impact of US smoke-free air laws on restaurants and bars by employer size: a panel study,” BMJ Open, vol. 7, no. 11, Nov. 2017.

[13] R. P. Sargent, R. M. Shepard, and S. A. Glantz, “Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study,” BMJ, vol. 328, no. 7446, pp. 977–980, Apr. 2004.

[14] C. M. Fichtenberg and S. A. Glantz, “Effect of smoke-free workplaces on smoking behaviour: systematic review,” BMJ, vol. 325, no. 7357, p. 188, Jul. 2002.

[15] H. R. Juster et al., “Declines in Hospital Admissions for Acute Myocardial Infarction in New York State After Implementation of a Comprehensive Smoking Ban,” Am J Public Health, vol. 97, no. 11, pp. 2035–2039, Nov. 2007.

[16] S. A. Khuder, S. Milz, T. Jordan, J. Price, K. Silverstri, and P. Butler, “The impact of a smoking ban on hospital admissions for coronary heart disease,” Preventive Medicine, vol. 45, no. 1, pp. 3–8, Jul. 2007.

[17] M. D. Eisner, A. K. Smith, and P. D. Blanc, “Bartenders’ Respiratory Health After Establishment of Smoke-Free Bars and Taverns,” JAMA, vol. 280, no. 22, pp. 1909–1914, Dec. 1998.

[18] D. Menzies et al., “Respiratory Symptoms, Pulmonary Function, and Markers of Inflammation Among Bar Workers Before and After a Legislative Ban on Smoking in Public Places,” JAMA, vol. 296, no. 14, pp. 1742–1748, Oct. 2006.

[19] J. Repace, “Respirable Particles and Carcinogens in the Air of Delaware Hospitality Venues Before and After a Smoking Ban,” Journal of Occupational and Environmental Medicine, vol. 46, no. 9, p. 887, Sep. 2004.

[20] J. V. Been, U. B. Nurmatov, B. Cox, T. S. Nawrot, C. P. van Schayck, and A. Sheikh, “Effect of smoke-free legislation on perinatal and child health: a systematic review and meta-analysis,” The Lancet, vol. 383, no. 9928, pp. 1549–1560, May 2014.

[21] J. Horowitz, “Opinion: Smoking ban must be enforced to protect disabled students – Vassar Political Review.” .