HomeMy WebLinkAboutCOM 0013.299 2002-2004 1. 1\
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July 2z, 2003 •03 JUL 22 A~110 'i 6
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COUNTY iF HAWAII
At the last hearing I was asked by Councilmember Aazon Chung to provide evidence of
my assertions concerning smoking cessation in San Luis Obispo, California several years
ago. I have provided him with a number of sources of information, and have copied some
pertinent pages for your review. These aze specific to the restaurant business and come
from the guide "Smoking and Restaurants: a Guide for Policy Makers."
Ed Fess, MD, MBA
935 1825 x140
fens@hirad.com
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CHAPTER 8
ARGUMENTS AGAINST 100% SMOKE-FREE RESTAURANT ORDINANCES
There are essentially four arguments against smoke-free restaurant ordinances which
are consistently raised by the opponents of these ordinances. This chapter analyzes each
of these arguments.
I. Let restaurant owners decide whether to go smoke-free or not. Customers will then
have a choice of whether to eat at a smoke-free restaurant. The market is working.
Let the marketplace decide.
There are 9 reasons why this argument is invalid:
1. The market has created a society where 145 people a day die from breathing other
people's smoke, and where involuntary smoking is the number one environmental
cause of cancer (Chapter 1).
2 The market has resulted in restaurant employees having exposure to environmental
tobacco smoke which is 3-5 times higher than typical workplace exposure and 12-20
times higher than domestic ETS exposure (Chapter 2).
3. The market has resulted in restaurant air having a genotoxicity 10-100 times that
of urban air (Chapter 2).
4. The market has forced restaurant employees to be the group most heavily exposed
to ETS (Chapter 2).
5. The market has allowed restaurant owners to expose their employees Eo high levels
of carcinogens (Chapter 2).
6. The market has forced many restaurant employees to inhale the benzo(a)pyrene
equivalent of actively smoking 1'fi to 2 packs of cigarettes per day (Chapter 2).
7. The market has resulted in waiters and waitresses having almost twice the risk of
lung cancer due to involuntary ETS exposure (Chapter 3).
8. Studies of the market approach have demonstrated that only about 10% of
restaurant owners will choose to protect the public and their employees from ETS,
despite intensive educational campaigns (Chapter 6).
9. Unlike restaurant patrons, employees have no choice in the matter. Their exposure
to the carcinogens in ETS is truly involuntary.
37
II. Let the state pass a restaurant smoking law, not local government.
There are 4 reasons why this argument is invalid:
1. There have been several attempts to pass a statewide restaurant smoking law in
California, but the tobacco industry has successfully defeated every attempt.
2. The tobacco industry has contributed over $1.6 million to California state legislators
since 1975, including $255,150 to Assembly Speaker WiI[ie Brown.' This makes it
virtually impossible to pass a statewide restaurant smoking law.
3. The failure of the state to protect its citizens from the hazards of E15 is a poor
excuse for local government to fail to do so. Local governments have an obtigation
to protect the public health, and it is their proper role and responsibility to
intervene where the state has left jurisdiction to them. Local governments, then,
must formulate policy on restaurant smoking precisely because of the state's failwe
to do so.
4. By failin to take action, local governments are actually establishing a policy of
allowing the exposure of its citizens and employees to high levels of carcinogens
to be unregulated. Inaction amounts to action that will ensure that the near
doubling of lung cancer risk in restaurant employees due to ETS exposure will
continue.
III. Smoke-free ordinances will hurt restaurant business.
There are 2 reasons why this argument is invalid:
1. There is no valid evidence that smoke-free ordinances decrease restaurant sales. All
of the evidence that has been used to convince policy-makers of an adverse
economic impact has been- based on evaluation approaches which are
methodologically flawed, and invalid. This type of evidence has misled policy-
makers, convincing them that asmoke-free ordinance caused a decease in
restaurant sales when no such effect occurred (Chapter 5).
2. There is valid evidence, based on a rigorous econometric analysis, that smoke-free
ordinances do not decrease restaurant sales. The only valid evaluation approach
revealed that there was no significant economic impact of 100% smoke-free
restaurant ordinances in Bellflower, Lodi, San Luis Obispo and Beverly Hills
(Chapter 5).
38
IV. As a reasonable compromise to protect the health of nonsmokers, legislators
should increase the size of mandated nonsmoking sections, rather than ban
smoking completely.
There is 1 simple reason why this argument is invalid:
Segregation of smokers and nonsmokers is not effective in protecting the nonsmoker
from EI'S:
a. After one hour of air mixing, there is little difference between smoking and
nonsmoking sections (Chapter 6).
b. Numerous studies have shown that there is very little reduction in air
concentrations of tobacrn smoke rnnstituents in nonsmoking areas of restawants
(Chapter 6).
- c. The- creation of a smoking section may actually increase ETS exposwe in the
nonsmoking location nearest the designated smoking, area (Chapter 6).
d. Separation of smokers and nonsmokers does not reduce average concentrations of
tobaccro smoke. Thus, it does not reduce the risk of adverse health effects for
restaurant employees (Chapter 6).
e. Increases in the size of nonsmoking sections do not significantly reduce restaurant
patrons' exposure to ETS, and do not reduce employees' exposwe to ET'S at all.
Increasing the size of nonsmoking areas is not a compromise measure, because it does
not reduce exposure to ETS, and therefore protects no one. Policy-makers who are truly
interested in protecting public health must eliminate restaurant E'I'S exposure rnmpletely.
The appropriate area of compromise is the time frame for phasing-in the 100%
restriction.
CONCLUSION
The 4 major arguments against 100% smoke-free ordinances are flawed. The benefits
of protecting restaurant patrons and employees from the health~haurds of involuntary
smoking by eliminating exposure to ETS in restaurants far outweigh any possible rnsts.
39
FACT SHEET #1 (page 1 0(2)
HEALTH EFFECTS AND PUBLIC HEALTH IMPACT OF PASSIVE SMOKING
¦ Passive smoking in the United States causes 53,000 deaths per year: 37,000 from heart disease, 4,000 frog
lung cancer, and 12,000 from other cancers.
ANNUAL DEATHS FROM PASSIVE SMOKING
Heart Disease
(69.8%)
n,oao
.Lung Cancer
(7.5%)
iz,ooo
Olher Cancers
(22.6%)
. r. III ~
¦ Passive smoking is the third leading cause of preventable death, behind only active smoking and alcoh
It causes more deaths than AIDS, motor vehicle accidents, drugs, or homidde.
PREVENTABLE CAUSES OF DEATH
000
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Smoking Alcohol PASSIVE Mobr AIDS Nom1e1M° ONga
SMOKING AV° cN ~
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FACT SHEET #1 (page 1 of 2)
¦ Passive smoking is the #1 cause of environmental cancer. It causes more cancer deaths than all other
regulated carcinogens combined.
CANCER DEATHS:
PASSIVE SMOKING vs. ALL REGULATED CARCINOGENS
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From: Smokin¢ and Restaurants: A Guide for Policy-Makers
Michael Siegel, M.D., M.P.H.
UC Berkeley Preventive Methane Residency Program
September, 1992
FACT SHEET #2
ENVIRONMENTAL TOBACCO SMOKE EXPOSURE IN RESTAURANTS
¦ Exposure to environmental tobacco smoke in restaurants is 3-5 times higher than typical workplace
exposure, and &20 times higher than domestic exposure (living with a smoker).
RELATIVE ETS EXPOSURE:
RESTAURANTS vs. WORKPLACES vs. DOMESTIC
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RESTAURANTS Workplaces` ~ Oomestie
¦ The most heavily exposed restaurant workers inhale as much benzo(a)pyrene (a carcinogen) as active
smokers of 1 1/2 to 2 packs of cigarettes per day.
¦ Restaurant air causes mutations and chromosome changes at a rate 10-100 times higher than urban
outdoor and indoor air.
¦ Restaurant air causes mutations in genes at a rate 5-10 times higher than industrial workplace air.
GENE MUTATIONS CAUSED BY
RESTAURANT vs. INDUSTRIAL AIR
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¦ Restaurant employees are the occupational group most heavily exposed to ETS and most likely to~suffer
adverse health effects due to this exposure.
From: Smokin¢ and Restaurants: A Guide for Policy-Makers
Midiael Siegel, M.D., M.P.H.
UC Berkeley Preventive Medidne Residency Program
September, 1992
FACT SHEET #3
HEALTH EFFECTS OF ETS EXPOSURE IN RESTAURANTS
¦ In California, waitresses have the hi¢hest death rate of anv female occupational group. They have a s
times higher rate of death from lung cancer and a 2 1/2 times higher rate of death from heart disease
CALIFORNIA RELATIVE DEATH RATES:
WAITRESSES vs. OTHER WOMEN
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OVERALL LUNG CANCER HEART DISEASE
¦ Waiters and waitresses have a 50-90% higher risk of dying from lung cancer because of exposure t
tobacco smoke in restaurants. Involuntary exposure to tobacco smoke at work makes restaurant worker
1 ]/2 to 2 times more likely to die from lung cancer.
RISK OF LUNG CANCER DEATH IN WAITEAS AND WAITRESSES
DUE TO ETS EXPOSURE IN RESTAURANTS
2
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WAITERS AND WARRESSES Population
From_ Smokin¢ and Restaurants: A Guide for Policv-Makers
Michael Siegel, M.D., M.P.H.
UC Berkeley Preventive Medicine Residency Program
September, 1992
FACT SHEET #4
SMOKING IN RESTAURANTS: THE LEGAL SITUATION
¦ Restaurant employers are required toprovide a smoke-free work environment for employees. If they
to do so, employees may:
? Collect workers' compensation benefits for injury due to tobacco smoke exposure.
?-Sue the employer for damages due to failure to protect from the hazards of environmental toba
smoke, if the injury is not within the scope of cvorkers' compensation.
? Quit working for fear of health damage from environmental tobacco smoke, and col
unemployment compensation benefits.
¦ Claims in each of these three areas have been made by employees affected by ETS at work, upheld
the courts, and have resulted in numerous large awards or settlements:
? In California, a waiter won an $85,000 settlement after suffering a heart attack caused by involun+
exposure to tobacco smoke in the restaurant.
? In Washington, an employee won a $27,000 settlement after developing chronic lung disease f~
years of exposure to passive smoke in the workplace.
? In Wisconsin, an employee won $23,400 in workers' compensation for permanent disability caL
by exposure to secondhand smoke.
? In California, an employee won $17,500 in workers' compensation for headaches caused
workplace tobacco smoke exposure.
From: Smokin¢ and Restaurants: A Cuide for Policy-Makers
Michael Siegel, M.D., M.P.H.
UC Berkeley Preventive Medidne Residency Program
September, 1992
F.-1CT SHEET #6
ANALYSIS OF POSSIBLE REGULATORY APPROACHES
~ p legislated 100% smoke-free restaurant policy is the only effective way to protect restaurant employees
dnd patrons from the hazards of second-hand smoke:
• A voluntary restaurant approach is ineffective because most restaurant owners will not voluntarly
prohibit smoking and because even if many do, employees will not be adequately protected.
Restaurant workers cannot easily choose to work only at smoke-free restaurants.
• Nonsmoking sections are not effective in protecting patrons or employees. Peak concentrations of
tobacco constituents are only modestl~~ decreased in remote locations and actually increased in
locations closest to the smoking area. Average concentrations are exactly the same, as are t':e
adverse health effects for employees.
RELATIVE NICOTINE CONCENTRATIONS BEFORE AND AFTER
DESIGNATING A SMOKING AREA
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Many city councils have required nonsmoking sections in an effort to protect the public health.
Unfortunately, the scientific evidence suggests that increasing the size of nonsmoking sections will not
inQease protection for nonsmokers, because it will not significantly reduce restaurant patrons' exposure
to ETS, and will not reduce employees' exposure at all.
Local governments that truly wish to protect restaurant employees and the public from the hazards
of restaurant ETS exposure have no effective approach available, other than to legislate a 100% smoke-
free policy.
From: Smoking and Restaurants: A Cuide for Policy-Makers
Michael Siegel, M.p., M.P.H.
UC Berkeley Preventive Medicine Residency Program
September, 1992