Smokefree workplaces: No delays, no exemptions

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Smokefree workplacesNo delays, no exemptions

• The importance of total indoor smoke bans for
  worker and public health
• September 2006

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Outline

• Public health
• Worker health
• Gambler health
• OHS laws
• Ventilation/separation
• Economic arguments
• Big Tobaccos role
• Discrimination
• Impact on smoking rates
• Public support
• Expert support
• International trend
• Summary clear benefits

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1. Serious health harm

• Secondhand smoke (SHS) causes serious and
  potentially fatal health harm. See list of
  proven harms in US Surgeon General report, 2006
• It kills at least 224 Australians a year.
• Conservative estimate, Collins Lapsley (2003)
  Nat Drug Strategy.
• Heart attacks Many studies.
• World Heart Fed says SHS increases coronary death
  risk by 20-70.
• Just 5 yrs exposure can increase heart risk by
  15
• Panagiotakos (2003), Uni of Athens.
• Immediate impact 60 drop in heart attacks in
  Helena, Montana
• 6 months after start of smokefree workplace law
  trial
• Sargent et al (2003), presentation to Am Coll
  of Cardiology.
• Cancer Many studies and many cancers, not just
  lung/throat.
• SHS causes cancer in non-smokers, even in typical
  daily doses WHO, International Agency for
  Research on Cancer (2002) world review US
  Surgeon General 2006.
• Lung cancer risk rises by as much as 32 with
  passive exposure
• Brennan (2003), recent French study in
  International Journal of Cancer.

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Serious health harm (2)

• Respiratory harm Many studies.
• SHS causes emphysema in social/workplace
  settings Carnevali et al (2003) Am J
  Physiology.
• Both cumulative recent exposure ups risk of
  adult-onset asthma Maritta (2003), new Finnish
  study in American Journal of Public Health.
• Other harm Many studies most recent link SHS
  with increased risk of
• Meningococcal disease in young pub-goers
• Osteoporosis bone fractures in all ages
• Female fertility loss
• Male sex drive loss
• Development of diabetes 2
• Harm to pregnant women
• See the evidence at www.ashaust.org.au/SF03/heal
  th.htm

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2. Harm to workers

• SHS is especially and immediately harmful to
  hospitality workers.
• International
• Many studies cited in UK report A Killer on the
  Loose
• Repace (2003), ASH UK at www.ash.org.uk/html/work
  place/pdfs/killer.pdf.
• e.g. Health of bartenders improved measurably
  after introduction of smoke bans Eisner et al
  (1998), California
• Australia
• Workers in smoky venues suffer wheezing,
  coughing, sore eyes and more Woodward (2002)
  Cancer Council Vic.
• 54 of LHMU Vic workers exposed, 34 daily, 79
  worried
• Cameron et al (2003), ANZ J Public Health
• Sharp v Port Kembla RSL Club (2001) NSW Supreme
  Court awarded 466,000 damages to non-smoking
  bar worker who developed throat cancer from
  working in a smoky club and hotel.

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3. Harm to gamblers

• SHS in gambling venues is harmful to gamblers
  health and financial security.
• Smokefree venues would improve gamblers health
• Gamblers smoking rates higher than general
  community gamblers nicotine intake rises when
  gambling Relationships Australia (2002),
  report to SA Independent Gambling Authority
• Smokefree venues would reduce problem gamblers
  hardship
• Pokie players who smoke are significantly more
  likely to get into financial hardship Shepherd
  (2003), Nat Inst of Econ Industry Research
• Smoking reinforces trance-inducing gambling
  rituals
• Smoke bans would help gamblers reconsider their
  gambling Harper (2003)
• Smoking associated with severity of problem
  gambling
• Daily smokers gamble more and have less control
  Petry (2002)
• This is why gambling treatment and referral
  services throughout NSW (surveyed 2003)
  unanimously supported smokefree venues as part
  of a responsible gaming policy.

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4. Undermining OHS laws

• Occupational health and safety laws are meant to
  protect workers from unnecessary exposure to
  toxic chemicals.
• Toxic chemicals
• Tobacco smoke contains hundreds of known toxic
  compounds, including at least 60 known
  carcinogens.
• Chemicals such as 2-naphthylamine and
  4-aminodiphenyl are individually banned in other
  (non-hospitality) workplaces as Class A
  carcinogens.
• Hospitality workers are forced to work among
  these chemicals every day/night.
• Turning a blind eye to this encourages employers
  to repudiate their legal responsibility to
  provide a safe workplace.
• NOHSC Guidance Note
• The National Occupational Health and Safety
  Councils Guidance Note on the Elimination of
  environmental Tobacco Smoke in the Workplace
  NOHSC3019(2003) makes it clear that SHS in
  workplaces is contrary to existing OHS laws and
  that governments and businesses should seek its
  elimination as soon as possible.

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5. Ventilation and separation

• All credible research evidence says measures
  based on ventilation, extraction or separate
  areas are ineffective.
• World Only smoke bans can protect workers and
  patrons
• Smoking Bans remain the only viable control
  measure to ensure that (hospitality) workers and
  patrons are protected from exposure to the toxic
  wastes from tobacco consumption. World Health
  Organisation
• Europe Ventilation is ineffective against
  passive smoke
• Efforts to reduce it by increasing ventilation
  offer little or no measurable improvement.   Joint
  Research Centre of the European Union (2003)
• Australia Toxic danger remains in partly smoky
  Australian venues
• - Dangerous levels of toxic smoke remain in "no
  smoking" areas of pubs/clubs. Cenko and
  Pisaniello (2002) Adelaide University
• - Ventilation and separation do not effectively 
  protect against harmful SHS, says
  soon-to-be-published NSW pubs/clubs study.
  Stewart et al (2003) NSW Health Dept
•    

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• The Pee Pool

Peeing
No peeing The effect of partial
solutions separate areas currently floating
around in several states
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6. The economic debateinternational

• Public and workplace health should remain the
  paramount consideration - ahead of revenue
  arguments.
• But opponents of bans, notably Aust Hotels Assoc,
  have waged a fierce campaign to scare
  proprietors, workers MPs with wild predictions
  of ruin.These claims are not supported by
  objective research. In fact
• Worldwide studies Smoke bans do no harm to
  hospitality businessGoing smokefree does not
  hurt hospitality trade, says international review
  of 106 studies on economic impact of bans says
  all credible studies point to no harm, some to
  positive benefit. Scollo et al (2003) Tobacco
  Control VCTC
• New York California, US Business booms after
  bans In the quarter after introduction of total
  indoor bans in New York City, despite dire
  warnings, hospitality trade boomed alcohol
  sales, hotel accommodation up 10,000 new jobs.
  US government, ind. surveys California reports
  similar positive results.

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6. Economic debate Australia

• SA Smoke bans did no harm to restaurants Study
  of impact on dining trade shows fears of economic
  harm were unjustified. Wakefield et al (2002)
  ANZ J Public Health
• WA 3 x more would be attracted than deterred
  Survey showed those attracted to venues by smoke
  bans would outnumber those deterred by 31. WA
  Healthway (2003) survey
• National Small impact mostly on problem
  gamblersBased on Vic and other figures,
  authoritative report forecast 10 negative impact
  of total smoke ban on NSW gaming machine revenue
  in year 1, then 4 and 5 in years 2 3. But the
  report called attention to the strong association
  between smoking and problem gambling (see earlier
  slide HARM TO GAMBLERS). ABN-AMRO (Jan. 2004)
  Industry under pressure

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6. Economic debate overlooked factors

• Potential new custom Only 21 of the community
  smoke. Many currently do not go to licensed
  venues because of the smoke. This is a large
  untapped vein of new custom which would more than
  replace the few smokers deterred (see WA study
  above).
• Pub club patrons are not an aberrant species !
• Surveys showing public support have been
  discounted by tobacco industry supporters on the
  basis that licensed venue patrons are (unlike the
  general community), mostly smokers. This is not
  supported by objective evidence. In fact Smoking
  rates among licensed venue patrons are only
  slightly higher than among the general community.
  Tzelepis (2001, unpub. data) Semmonds (2003)
  Newcastle hotels survey
• Where venues will save
• As well as attracting new custom, smokefree
  venues will save in legal and fire insurance
  costs, air conditioning operation and cleaning.
  The healthier environment will also reduce staff
  absences and turnover and improve employee
  relations. These factors have not been mentioned
  by tobacco allies in discussing economic impact.

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7. Big Tobaccos role

• The tobacco industry has operated behind the
  scenes to frustrate clean-air workplaces.
• Worldwide Proprietors misled on economics,
  ventilation
• Tobacco industry documents show they have worked
  through hospitality associations (including the
  AHA in Australia) to scare proprietors with the
  myth of lost profits and lead them into
  expensive and ineffective ventilation-based
  options. Dearlove et al (2002), Tobacco
  Control
• Australia Healthy consultancy used to stall
  smoke bans
• Indoor air quality consultancy Healthy Buildings
  International (HBI), partly tobacco-established
  and funded, has pushed ventilation options
• and fed confidential public submissions to
  Philip Morris.
• Chapman Penman (2003), Sydney Uni School of
  Public Health (unpub.)

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8. Discrimination

• Smoky venues discriminate against up to 2 million
  Australians with smoke-affected disabilities
  including
• Heart disease (more than half a million)
• Respiratory conditions
• Diabetes.
• not to mention pregnant women!
• So smoky venues contravene the Commonwealth
  Disability Discrimination Act and several
  state/territory laws
• The NSW Anti-Discrimination Board ruled
  (Meeuwissen case 1997) to the effect that a smoky
  room is as much of a barrier to a person with
  asthma as are steps to a person in a wheelchair.
• Do smokefree venues discriminate against
  smokers?
• No. No-one is suggesting banning smokers
  only requiring them to smoke where their smoking
  does not harm others. This is another tobacco
  industry-inspired furphy.

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9. Impact on smoking rates

• Research establishes that indoor smoke bans in
  hospitality venues help cut smoking rates
  especially among youth.
• California, US
• Dept of Health Services report (2003)
• Smoking rates down 27 in 12 years
• Partly attributed to smokefree workplace laws.
• Glantz (2003) review of several studies
• 29 overall reduction in consumption.
• Australia (youth)
• Trotter (2003), Centre for Behavioural Research
  in Cancer, Vic
• Social smoking in bars makes it hard for youth to
  quit
• Smokefree venues would improve health of young
  people.

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10. Strong public support

• Australians overwhelmingly and increasingly
  support total smoke bans in workplaces including
  licensed venues. Objective evidence includes
• National
• Stollznow research (2005)
• - 65 say bans are too slow
• - 64 say mostly-enclosed smopking rooms are
  unacceptable.
• National Household Drug Survey (2001) - of
  27,000 Australians. - 81.1 support for banning
  smoking in the workplace - 60.8 backing for
  smoke-free pubs and clubs.
• Tzelepis/Walsh (2003), Cancer Council NSW -
  national review of polls.
• - Support for total bans in hospitality venues
  up almost 20 in past decade
• - All recent surveys show clear majority
  support
• - Total bans "overdue" and governments have no
  excuses for further delay.
• NSW Tzelepis/Walsh (2003), Cancer Council NSW -
  later NSW-only study.
• - 67 public support for total bans in yes/no
  question
• - 63 support for total bans among pub/club
  patrons.
• SA Unpublished survey (2003) - reported in
  Adelaide Advertiser 20/10/03, p.8.
• - 72 support for immediate total indoor ban in
  hotels and gaming rooms

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11. Expert support

• Speedy and total indoor smoke bans in all
  workplaces, including licensed venues, are
  strongly supported by
• The SmokeFree Australia coalition
• - Leading health groups The AMA, Cancer
  Council, Heart Foundation, Asthma and Allergy
  Research Institute, Action on Smoking and Health,
  Australian Council on Smoking and Health,
  Non-Smokers Movement.
• - Trade union groups The ACTU and hospitality
  unions Liquor, Hospitality and Miscellaneous
  Workers Union Media, Entertainment and Arts
  Alliance Musicians Union.
• The National Occupational Health and Safety
  Commission
• Congress of Occupational Safety and Health
  Association Presidents

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12. International trend

• The growing international trend is for total
  indoor smoke bans to protect occupational and
  public health.
• New Zealand
• All licensed venues indoor-smokefree from
  end-2004.
• Republic of Ireland
• All venues indoor-smokefree from March 2004.
• Norway
• All venues indoor-smokefree from early 2004.
• Sweden
• All venues indoor-smokefree from mid-2005.
• North America
• Several USA states and Canadian provinces have
  legislated for speedy total bans more on the
  way.
• UK
• Scotland already has venues indoor-smokefree
  all of UK by mid-2007.

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13. Conclusions

• Rapid implementation of TOTAL indoor smoke bans
  in all workplaces, including pubs and clubs,
  will
• Improve public health - reduce SHS harm and cut
  smoking rates, especially among youth
• Improve worker health - reduce dangerous
  high-level SHS exposure
• Benefit business improve employee health,
  reduce costs including legal actions, and attract
  new custom currently deterred by smoke
• Remove legal anomalies - in OHS and
  discrimination laws and
• Meet with strong community approval - especially
  among youth, also among licensed venue patrons
  and among smokers.
• Save lives, health and money !

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More information

• SmokeFree Australia
• coalition for safe, clean workplaces
• Phone Stafford Sanders, media co-ordinator
• [phone] staffords_at_ashaust.org.au
• Website www.ashaust.org.au/SF03
• (more contacts on Partners page)