AGENDA ITEM #6A
November 27,2012
Introduction
MEMORANDUM
November 21,2012
TO:
FROM:
SUBJECT:
County Council
Amanda Mihill, Legislative
Attorney~
Introduction:
Bill 33-12, Health and Sanitation
Smoking
County Property
Bill 33-12, Health and Sanitation - Smoking - County Property, sponsored by Councilmembers
Floreen, Navarro, Rice, Riemer, Leventhal, EIrich, and Andrews, is scheduled to be introduced
on November 27,2012. A public hearing is tentatively scheduled for January 15 at 7:30 p.m.
Bill 33-12 would prohibit smoking on property owned or leased by the County. The ban would
exclude County rights-of-way. Materials from the chief sponsor, Councilmember Floreen begin
on©4.
This packet contains:
Bill 33-12
Legislative Request Report
Sponsor materials
Circle #
1
3
4
F:\LA W\BILLS\ 1233 Health· Smoking. County Property\lntro Memo,Doc
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Bill No.
33-12
Concerning: Health and Sanitation ­
Smoking - County Property
Revised:
10/17/2012
Draft No. _1_
Introduced:
November 27,2012
Expires:
May 27,2014
Enacted: _ _ _ _ _ _ _ _ __
Executive: _ _ _ _ _ _ _ __
Effective: _ _ _ _ _ _ _ _ __
Sunset Date: _--::-:-:------:::--_ _ __
Ch. _ _, Laws of Mont. Co. _ __
COUNTY COUNCIL
FOR MONTGOMERY COUNTY, MARYLAND
By: Councilmembers Floreen, Navarro, Rice, Riemer, Leventhal, EIrich, and Andrews
AN
ACT to:
(1)
(2)
prohibit smoking on property owned or leased by the County; and
generally amend County law on smoking.
By amending
Montgomery County Code
Chapter 24, Health and Sanitation
Section 24-9
Boldface
Underlining
[Single boldface brackets]
QQuble underlining
[[Double boldface brackets]]
* * *
Heading or defined term.
Added to existing law by original bill.
Deletedfrom existing law by original bill.
Added by amendment.
Deletedfrom existing law or the bill by amendment.
Existing law unaffected by bill.
The County Council for Montgomery County, Maryland approves the following Act:
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Bill
No. 33-12
1
Sec. 1. Section 24-9 is amended as follows
24-9. Smoking in public places.
-
2
3
4
5
6
7
*
(b)
III
*
*
Smoking prohibited in certain public places. A person must not smoke
or on any:
*
(9)
*
*
Restroom, except a restroom in a private residence; [or]
8
9
10
11
(10) Enclosed auditorium, concert or lecture
hall[.]~
or
Ql} property that is owned or leased
.Qy
the County, except
~
County
right-of-way.
*
Approved:
*
*
12
13
Roger Berliner, President, County Council
Date
14
Approved:
15
Isiah Leggett, County Executive
Date
16
17
This is a correct copy oJCouncil action.
Linda M. Lauer, Clerk of the Council
Date
(J)
f:llaw\bills\1233 health - smoking county property\bill1.doc
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LEGISLATIVE REQUEST REPORT
Bill 33-12
Health and Sanitation Smoking County Property
DESCRIPTION:
PROBLEM:
Bill 33-12 would prohibit smoking on property owned or leased by
the County, excluding County rights-of-way.
Smoking is knmvn to cause cancer and other illnesses. The Centers
for Disease Control state that there is no risk-free level of exposure to
secondhand smoke.
To reduce employees' and visitors' exposure to secondhand smoke.
Health and Human Services
To be requested.
To be requested.
To be requested.
To be researched.
Amanda Mihill, 240-777-7815
To be researched.
GOALS AND
OBJECTIVES:
COORDINATION:
FISCAL IMPACT:
ECONOMIC
IMPACT:
EVALUATION:
EXPERIENCE
ELSEWHERE:
SOURCE OF
INFORMATION:
APPLICATION
WITHIN
MUNICIPALITIES:
PENALTIES:
Class C
f:\law\bills\1233 health - smoking - county property\legislative request repor
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Montgomery
County Council
From the Office ofCouncilmember Nancy Floreen
November 13,2012
CONTACT: Jed Millard 240-777-7959
N
E
W
S
Councilmember Floreen Will Introduce Bill
to Ban Smoking on Montgomery Property
On
Thursda~
Nov.
1~
in Rockville/ She Will Host Event
With American Cancer Society to Mark
3;1h
Great American
Smokeout and Offer Details on the Legislation
ROCKVILLE, Md., November 13, 20l2-Montgomery County Councilmember Nancy
Floreen at 11 :30 a.m. on Thursday, Nov. 15, will hold a news conference in Rockville to
give details on a bill she
will
introduce that would ban smoking on property owned or
leased by Montgomery County. The ban would include all County properties except
R
E
L
E
A
public rights of way.
The bill, which is scheduled for introduction on Nov 27, is co-sponsored by Council
Vice President Nancy Navarro and Councilmembers Craig Rice, Hans Riemer, George
Leventhal and Marc EIrich. A public hearing on the bill is tentatively scheduled for Jan.
15.
The news event will be held in the Third Floor Hearing Room of the Council Office
Building, which is located at 100 Maryland Ave. in Rockville. Representatives of the
American Cancer Society will be present as the event coincides with the organization's
37
th
Great American Smokeout. The Smokeout is an annual event that urges smokers to
give up their smoking habits.
"I have unfortunately spent a lot of time over the past year with people who have
cancer," said Councilmember Floreen, a survivor of breast cancer. "I want to do
everything I can to help prevent this awful disease in all of its forms, and this is a good
place to start."
S
E
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2
In Montgomery County, one in 12 adults smoke cigarettes. Nationally, tobacco use is
responsible for one in five deaths, and an annual toll of 443,000 deaths. Smoking
accounts for at least 30 percent of all cancer deaths and is associated with increased risk
for 15 types of cancer. Tobacco use remains the single, largest preventable cause of
disease and premature death in the U.
s.
"The Great American Smokeout is about helping people quit, and we know that passing
this bill is critical to helping people in Montgomery County do just that," said Bonita
Pennino, Government Relations Director for the American Cancer Society's Cancer
Action Network. "In addition we know that strong smoke-free laws mean fewer smokers
and reduced health care costs."
####
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Montgomery County
Tobacco Use by
Adults:-
2000-2010
Maryland Department of Health and Mental Hygiene
Tobacco Use Prevention and Cessation Program
'c.
-,-~
CURRENT USE OF TOBACCO PRODUCTS!
Current Adult (Age
18
and Older) Use of Tobacco Products
Proportion
(%),
Confidence Interval (CI), and Estimated Number of Adults
TOBACCO PRODUCTS
Prevalence
(%),
CI, and Number Adults
I
i
2000
Baseline Data
DATA NOT AVAILABLE
FOR
2000
I
2002
DATA NOT AVAILABLE
FOR
2002
2006
DATA NOT AVAILABLE
FOR
2006
2008
2010
Any Tobacco Product
(All Adult Populations)
DATA NOT AVAILABLE DATA NOT AVAILABLE
FOR
2008
FOR
2010
Any Tobacco Product
(Adult Minority. Populations)
DATA NOT AVAILABLE . DATA NOT AVAILABLE
FOR
2000
FOR
2002
DATA NOT AVAILABLE
FOR
2006
DATA NOT AVAILABLE DATA NOT AVAILABLE
FOR
2008
FOR
2010
Cigarette
13.2%±3.1%
82,261
15.8%±4.1%
110,320
9.3% ±2.4%
70,439
8.0%±2.8%
55,297
8.0%±2.6%
55,245
Cigar
DATA NOT AVAILABLE
FOR
2000
DATA NOT AVAILABLE
FOR
2002
DATA NOT AVAILABLE
FOR
2006
DATA NOT AVAILABLE DATA NOT AVAILABLE
FOR
2008
FOR
2010
Smokeless Tobacco
1.1% ± 0.9%
6,928
DATA NOT AVAILABLE
FOR
2002
DATA NOT AVAILABLE
FOR
2006
I
DATA NOT AVAILABLE
FOR
2008
I
1.1% ± 0.7%
7,281
INITIATION OF TOBACCO USE
IN
PAST YEAR
Current Adult (Age
18
and Older) Use of Tobacco Products
Proportion
(%),
Confidence Interval (Cn, and Estimated Number of Adults
i f
INITIATION"
.
,"
.
.
Prevalence
(%),
CI, and Number Adults
~
2
2000
Baseline Data
NOT AVAILABLE­
TOO FEW INITIATING
RESPONDENTS
2002
NOT AVAILABLE­
TOO FEW INITIATING
RESPONDENTS
2006
NOT AVAILABLE­
I
TOO FEW INITIATING
RESPONDENTS
2008
2010
Adult Population
I
NOT AVAILABLE­
DATA NOT AVAILABLE
TOO FEW INITIATING I
FOR
2010
RESPONDENTS
CESSATION OF TOBACCO USE
IN
PAST YEAR
Current Adult (Age
18
and Older) Use ofTobacco Products
Proportion
(%),
Confidence Interval (CI), and Estimated Number of Adults
3
CESSATION
Prevalence
(%),
CI, and Number Adults
2000
Baseline Data
25.2% ± 13.0%
8,174
I
2002
31.5%
±
17.3%
11,947
I
2006
35.2% ± 16.5%
10,928
2008
34.3% ± 13.6%
12,073
2010
DATA NOT AVAILABLE
FOR
2010
Adult Population
1 SOlirte: Behavioral Risk Factor SurveiUance Survey, 2000, 2002.
2006~
2008. and 2010. The Behavioral Risk Factor Surveillance Survey coUett.s data on use of cigarettes and smokeless tobacco only. It does not collect
data on use of cigars or any other tobacco product,
Thus~
estimates of these behav;ors are lInavailab'e for 2000, 2002, 2006, Z008, and 2010, Estimates for use of smokeless tobacco are available for 2000 and 2010 ontv.
2 Souree: MaryJand Adult Tobaceo
Survey~
2000. 2002. 2006, and 2008.
3 Source: Maryland Adult Tobacco Survey, 2000, 2002. 2006, and
20OS.
• Estimates of prevalence are stated as a percentage
(%)
of the total relevant population.
• Confidence Intervals
(±¥o)
appear immediately following prevalence estimates.
• Statistically significant change between survey years is underlined, between 2000 and 2010 preceded by an asterisk
'*'.
APPENDIX B - ADULT PREVALENCE, INITIATION,
&
CESSATION
Page
120
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CURRENT CIGARETTE SMOKING ­
POPULATIONS
Prevalence
(%)
and Number Adults
Pregnant Women
4
100%
of Birth Certificates
I
!
i
Proportion
(%)
of Selected Populations and Number for Pregnant Women from
I
2000
Baseline Data
I
2001
I
2002
I
2003
7.7%
7,759
1.3%
171
2004
7.4%
7,508
1.0%
142
2005
6.9%
7,001
0.9%
120
2006
6.8%
7,267
2007
i
2008
6.6%
7,113
I
2009
6.1%
6,593
Maryland Statewide!
.
Montgomery County
I
9.2%
8,842
2.5%
327
8.7%
8,361
2.0%
269
!
8.0%
7,879
1.3%
168
6.6%
7,152
0.7%
0.5%
95
• 68
I
0.6%
I
0.6%
80
76
ADULT HOUSEHOLDS WITH MINOR CHILDREN
s
Current Adult (Age
18
and Older), Proportion
(%),
Confidence Interval (CI), and Estimated Number of Adults
POPULATIONS
Prevalence
('Yo)
and Number Adults
2000
Baseline Data
2002
19.4%.± 4.7%
52,278
2006'
20.8% ±4.5%
59,233
2008
14.0%±3.4%
43,342
2010
DATA NOT
AVAILABLE FOR
2010
Proportion
with Adult Smokers
19.9%±4.4%
51,360
I
MOST IMPORTANT REASON FOR WANTING TO QUIT SMOKING CIGARETTES, 2008
6
(Top 3 Reported as 'Most Important Reason'
by
Former Smokers and Smokers Trying to Quit)
I
'.,.
;"~"
I
,,".,
.~,
.'.'_T·
r','_
.;,"'"
,.
I~·'
..
-~.
-'".1;.... ''';'-';';;;'"
",;;"~,,,,,,,,,,,,~,,,";;i
,.;;.".•
. ,;<,,/3:
",,,.;c::;,j,:
:
-",;';'
-
..
'~-
.
,"
_
..
,-.~.
.
"~ ;.:);::'~··d'
,
.'
,,:I
Health
Ha~r
~sofSmoking,
6%
.
...
!II
::lE
-c
c
!II
.
"
..
I
I
"
"-
~'--
.
,;.
,"'-"'.
•"',•
.
~<f'~
.
;.-",:.j"J,,>,
'),."
.••...
",.;,
.
..
,;,.
..
·'C
I
.....
,
-,
-"
'1
Health Pre blemsfrom
Smokir E,17.2%
.
'.'
.~.~,,' 011';'~
-
..
"
I
;
'
.",,,,"
.~;.
.. Jlset
Ex
mple for Children,
13.2%
I
0%
5%
I
10%
15%
20%
25%
30%
35%
'~'p''''
>
...
CI
E
I
....
c
0
!Ill
0
Health
D •• _
from
Smoking, 16.7%
::lE
~
0%
5%
2002~
~"t"'.mpl'
.
10%
pr Children,
11.
~%
lS%
20%
25%
30%
35°
4 Source: Vitat Statistics
. S Source; Maryland Adult Tobacco
Su~ey,
2000, 200.2:,
6 Source: Maryland Adult TobaccQ SUf\ley, 2000,
Z006~
and 2;008.
2006, and 2008.
Page 121
APPENDIX B - ADULT PREVALENCE, INITIATION,
&
CESSATION
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Montgomery County
Tobacco Use by Youth: 20.00-2010
Maryland Department of Health and Mental Hygiene
---­
Tobacco Use Prevention and Cessation Program
CURRENT USE OF TOBACCO PRODUCTS
Underage
«18)
Public Middle and High School Youth (Combined)
Proportion
(%)
and Estimated Number of Youth
TOBACCO PRODUCTS
Prevalence
2000
Baseline Data
16.6%±4.1%
10,604
15.9%±3.4%
4,507
12.1%±3.4%
7,455
6.6%±1.8%
4,107
2.9%±0.7%
1,853
5.0%±1.6%
3,087
3.4%±0-8%
2,113
2.9%±L1%
1,836
(%),
CI, and Number Youth
2002
14.9%±2.7%
10,561
15.0%±2.4%
5,755
9.5%±2.1%
6,474
6.1%± 1.3%
4,152
3.7%±0-8%
2,545
4.6%±0.9%
3,177
3.1%±0.8%
2,109
2.S%±0.8%
2006
14.3%±1.7%
10,519
14.5%± 1.8%
6,058
9.0% ±1.3%
6,414
6.2% ±i.0%
4,423
5.0%±0.9%
3,640
5.2%±0.8%
3,801
5.S%±0.9%
4,219
3.3%±0.7%
2,364
I
2008
11.5%±1.4%
8,348
11.7%±1.6%
4,823
6.9%±0.8%
4,971
7.7%±1.0%
5,529
4.6%±0.9%
3,246
3.0%±0.5%
2,136
2.5%±0.6%
1
2010
13.1%±2.3%
9,599
14.5%±2.3%
6,730
*7.1% ±l.5%
5,182
7.1%±1.5%
5,153
PIPE SPECIFIC DATA
NOT AVAILABLE FOR
Any Tobacco Product
(All Youth Populations)
Any Tobacco Product
(Minority Youth)
Cigarette
Cigar
Pipe {tobacco }
'.
2010
BIOI SPECIFIC DATA
NOT AVAILABLE FOR
Bidi
Kretek
Smokeless Tobacco
,
2010
KRETEK SPECIFIC DATA
NOT AVAILABLE FOR
2010
2.6%±0.6%
1,849
2.2%±0.6%
I
1,870
I
1,563
INITIATION OF TOBACCO USE IN PAST YEAR
Underage
«18)
Public Middle and High School Youth Combined, Proportion (%) and Estimated Number of Youth
INITIATION
Prevalence
I
(%),
CI, and Number Youth
2000
Baseline Data
15.S%±H%
10,100
14.9%±2.7%
4,232
,
:
200S
I
2002
13.4%±2.8%
9,546
12.4% ±2.5%
4,785
!
2006
13.1%±1.7%
9,640
11.S%±1.6%
4,906
2010
lS.0%±2.5%
11,066
16.3%±2.4%
7,581
All Youth
Minority Youth
11.7%±1.3%
8,497
10.6%±1.1%
4,355
CESSATION OF TOBACCO USE IN PAST YEAR
Underage
«18)
Publk Middle and High School Youth Combined, Proportion
(%)
and Estimated Number of Youth
.'
CESSATION .
. 1 < ,
Prevalence
(%),
CI, and Number Youth
2000
Baseline Data
36.9%±6.9%
1,955
I
I
I
2002
43.7%±3.5%
2,046
49.4%±5.3%
1,218
I
2006
4S.0%±6.2%
1,577
47.9%±B%
995
200S
39.4% ±5.6%
1,481
41.6% ±6.1%
1,010
I
2010
*50.S% ± 6.4%
1,881
52.3%
±
6_2%
1,452
All Youth
Minority Youth
I
46.7% ±12.1%
987
• Estimates of prevalence are stated as a percentage
(%)
of the total relevant population.
• Confidence Intervals
(±%)
appear Immediately followmg prevalence estimates.
• Statistically significant change from the previous survey year are underlined; change between 2000 and 2010 preceded
by
an asterisk '.'.
APPENDLX' A-YOUTH PREVALENCE" INlTIATION"
&
CESSATION
Page
6S
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CURRENT CIGARETTE SMOKING - School Type, Gender
&
Minorities
Underage «18) Public Middle and High School Youth
Proportion (%) and Estimated Number of Youth
YOUTH POPULATIO,NS
Prevalence (%), CI, and Number Youth
2000
Baseline Data
2002
3.1%± 1.0%
981
2.3% ±0.9%
346
4.0%±1.8%
635
3.9%±1.2%
685
14.9%±2.0%
5,494
14.1%±2.5%
2,583
1S.4%±1.9%
2,836
14.0%±1.9%
2,683
2006
3.0%±1.2%
916
2.1%±1.3%
320
3.6%± 1.8%
556
3.3%±1.5%
553
13.4%±1.5%
5,498
12.8%±2.0%
2,573
14.0%±1.9%
2,899
12.9%±1.7%
3,006
2008
1.3%±0.7%
408
1.0%±0.7%
146
1.7%±1.1%
262
1.8%±0.9%
316
11.1%±1.3%
4,563
8.9%±1.3%
1,823
13.1%±2.0%
2,700
11.2% ±l.3% .
2,543
2010
2.7%±1.2%
816
2.3%±1.6%
362
3.1% ±1.5%
4S4
3.7%±1.7%
706
*10.4% ±1.5%
4,366
*8.2% ±1.7% .
1,798
*12.7% ±1.9%
2,568
*11.1% ±1.3%
2,927
Middle School (MS)
MS Females
MSMaies
MS Minorities
High School (HS)
HS Females
HS Males
HS Minorities
3.7%±1.S%
1,065
3.3%±2.1%
450
3.8%±2.5%
SS8
4.4%±1.7%
566
19.4%±2.5%
6,389
19.6% ±4.4%
3,217
18.8% ±3.9%
3,101
is.4%±2.9%
2,222
Montgomery County - Current Cigarette Smoking
(Underage Middle
&
High School Youth,
by
Grade)
50%~--------~
2002
~2006 ~2008 ~2010-Maryland"v"'vf-
_ _ _ _---'
~----------------------~
40%+--------------------------------------~
30%+---------------------------------~~~--~
20%+----------------------~ ----~-------~~~;_-~
10%+-----------~,·~~~---~
~
____6_t_h_G_r_ad_e_ ____7_t_h_G_ra_d_e_____8_t_h_G_r_ad_e_ ____9_t_h_G_r_ad_e_ ____
l_O_th_G_r_a_d_e____
l_1_th_G_f_Q_d_e____
1_2_th_G_r_a_d_e__
~~
Page-69
APPENDIX A-YOUTH PREVALENCE, INITIATION,
&
CESSATION
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Evolution of Montgomery County smoking laws
1977 Prohibited smoking in elevators, retail stores where more than 8 persons
work at any time, public areas of health care facilities, public schools,
County government facilities, and theaters. Exceptions: private enclosed
offices, when facilities are closed to the public, central areas of malls,
barbershops, and beauty shops (Bill 26-76, effective 5-5-77)
1979 Required patient rooms in hospitals to be nonsmoking unless otherwise
requested by all occupants. (Bill 53-79, effective 3-12-80)
1981 Required employers to "consider the needs of nonsmoking employees and
... accommodate their need to the extent possible." (Bill 53-81, effective
11-15-82)
1986 Prohibited smoking in rail transit stations and most County government
workplaces. Exceptions to the workplace prohibition: designated smoking
areas, private enclosed offices. (Bi1127-85, effective 4-28-86)
1987 Required all restaurants with at least 50 seats to have a no-smoking area
covering at least 50% of the total seating area' (Bill 1-87, effective 7-10­
87)
1988 Prohibited smoking in public areas of offices, retail stores, banks,
factories, and other private businesses. Exceptions: mom & pop stores
(where no more than 2 persons work at any time), private ftmctions not
open to the public. Also prohibited smoking in public restrooms and
auditoriums. (Bill 27-87, effective 6-9-88)
1990 Prohibited smoking in shared workplaces, and required employers to post
notices and inform employees. Exceptions: mom
&
pop businesses, other
businesses when all employees sharing the workplace consent. (Bill 51­
89, effective 5-24-90)
1992 Prohibited sale of tobacco products from vending machines, except in
private clubs. (Bill 5-91, 64-91, effective 5-1-92) County law declared
invalid by Circuit Court 4-19-93; Court of Appeals declared similar laws
from cities of Bowie and Takoma Park preempted by state law later in
1993.
1994 Prohibited smoking in
all
County government workplaces, with no
designated smoking areas. (Bill 42-93, effective 5-2-94)
1998 Prohibited a person in the business of selling or distributing tobacco
products for commercial purposes to distribute any tobacco product,
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cigarette rolling paper, or tobacco product coupons
tb
a minor (Bill 13-98;
also adopted as Board of Health regulation(Council Resolution 13-1410))
1999
Conformed County law to state workplace smoking regulations by
dropping references to workplaces in County law, thus focusing County
law on public places (Bill 3-99, effective 6-29-99)
Prohibited smoking in all restaurants (Council Resolution 14-70, adopting
Board of Health regulation), Regulation declared invalid because of
improper adoption by Maryland Court of Appeals 5-2-03
Required retail sellers to display or store tobacco products in a place that is
not accessible to buyers without the intervention of the seller (Bill 23-00,
effective February 19,2001)
Prohibited smoking in all restaurants except certain private clubs with
liquor licenses (Bill 15-03, effective October 9, 2003)
Prohibited smoking in indoor common areas of multi-family residential
units and playgrounds (Council Resolution 17-210, adopting Board of
Health regulation, effective August 12,2011)
1999
2000
2003
2011
F:\LAw\TOPICS\Smoking\History Of Smoking Laws Updated.DOC
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Tobacco Use - Fact Sheet
American Cancer Society Great American Smokeout® 2012
• Tobacco use remains the single largest preventable cause of disease and premature
death in the United States. i
• For every person who dies from a smoking-related disease, 20 more people suffer with
at least one serious illness from smoking. ii
• In the US, tobacco use is responsible for nearly 1 in 5 deaths, or about 443,000
premature deaths each year.
1
• On average, smokers die 13 to 14 years earlier than nonsmokers,iii
• The risk of developing lung cancer is about 23 times higher in male smokers and 13
times higher in female smokers, compared to lifelong nonsmokers,i
• Tobacco use increases the risk of myeloid leukemia and cancers of the lung, mouth,
.nasal cavities, larynx, throat, esophagus, stomach, colorectum, liver, pancreas, kidney,
.
bladder, uterine cervix, and ovaries.
i
• Tobacco use accounts for at least 30% of all cancer deaths and 80% of lung cancer
deaths,i
• Thousands of young people begin smoking every day.iv
o Each day, more than 3,800 people younger than 18 smoke their first cigarette.
o
Each day, about 1,000 people younger than 18 begin smoking on a daily basis.
• Cigars contain many ofthe same carcinogens that are found in cigarettes. Cigar
smoking increases the risk of cancers of the lung, mouth, throat, larynx, esophagus, and'
probably the pancreas. i
• Sales of little cigars increased by 240% from 1993 to 2007.
i
• Smokeless tobacco products are a major source of cancer-causing nitrosamines
(chemical compounds) and a known cause of human cancer. They increase the risk of
developing cancer of the mouth and throat, esophagus, and pancreas.
i
• Sales of smokeless tobacco products are growing at a more rapid pace than cigarettes.
While sales of cigarettes declined by 42% between 1990 and 2006, per capita sales of
smokeless products in the US nearly doubled.
i
Global Tobacco Use
In 2011, tobacco use killed almost 6 million people, with 80% of these deaths occurring
in low- and middle-income countries,i and current trends show that tobacco use will
v
cause more than 8 million deaths annually by 2039.
• 43 trillion cigarettes have been smoked in the last decade. vi
 PDF to HTML - Convert PDF files to HTML files
• Smoking rates are increasing among women, particularly young women, in many
countries. Women and children account for 75% of the deaths caused by secondhand
smoke. vi
Costs
and
Expenditures
• Cigarette smoking costs the United States more than
$19~
billion (i.e., $97 billion in lost
productivity plus $96 billion in health care expenditures).
VII
• Secondhand smoke costs United States more than $10 billion (i.e., health care
expenditures, morbidity, and mortality).viii
.
• The tobacco industry receives annual profits of almost $6,000 per death caused by
tobacco.
vi
Smoking Cessation
• People who quit, at any age, live longer than people who continue to smoke. i
• Smokers who quit before age 50 cut their risk of dying in the next 15 years in half,
compared to those who continue to smoke. i
• Large disparities in smoking prevalence and cessation continue to exist. Smokers with
an undergraduate or graduate degree are more likely to quit than those with less formal
education.i
• Many adult smokers want to quit smoking.
o Approximately 69% of smokers want to quit completely.
o Approximately 52% of smokers attempted to quit in 2010.
ix
Secondhand Smoke
• Secondhand smoke contains more than 7,000 chemicals, at least 69 of which cause
cancer.i
• Each year, about 3,400 nonsmoking adults die of lung cancer as a result of breathing
secondhand smoke.
i
• Secondhand smoke may cause coughing, wheezing, chest tightness, and reduced lung
function in adult nonsmokers.
i
1
American
Cancer Society.
Cancer Facts
&
Figures 2012.
Atlanta: American Cancer Society; 2012.
II
Centers for Disease Control and Prevention. Cigarette Smoking-Attributable Morbidity-United States, 2000. Morbidity and
Mortality Weeldy Report 2003 ;52(35):842-4 [accessed 2012 Jun 7]).
iii
Centers for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years ofPotential Life Lost, and
Productivity Losses-United States,
1995-1999.
Morbidity and Mortality Weekly Report 2002;51 (14):300-3 [accessed 2012 lun
7].
Substance Abuse and Mental Health AdministratioIl. Results from the 2010 National Survey on Drug Use and
/.0l
Health: National Findings Rockville
(MO):
Office of Applied Studies [accessed 2012 Jun 7].
IV
lQJ
 PDF to HTML - Convert PDF files to HTML files
v
World Health Organization. \VHO Report on the Global Tobacco Epidemic, 2009. Geneva: World Health Organization, 2008
[accessed 2012 Jun 7].
vi
Eriksen M, Mackay
J,
Ross
H.
The Tobacco Atlas. Fourth Ed. Atlanta, GA: American Cancer Society; New York, NY: World
Lung Foundation; 2012. Also available at www.TobaccoAtlas.org.
vii
Centers for Disease Control and Prevention. Smoking-Attributable Mortality, Years of Potentia! Life Lost, and Productivity
Losses-United States, 2000-2004. Morbidity and Mortality Weekly Report 2008;57(45):1226-8 [accessed 2012 lun
7].
viii
Behan DF, Eriksen MP, Lin Y. Economic Effects of Environmental Tobacco Smoke Report @Schaumburg, IL: Society of
Actuaries; 2005 [accessed 2012 Jun 7].
ix
Centers for Disease Control and Prevention. Quitting Smoking Among Adults-United States,
2001-20
IO.
Morbidity and Mortality Weekly Report [serial online]
2011 ;60(44):1513-19
[accessed
2012
Jun 7].
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CDC
-
Fact Sheet - Health Effects of Secondhand Smoke - Smoking "".
http://www,cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_" ..
Centers for Disease Control and Prevention
. CDC 24/7: Saving Lives. Proteciing
Peopt0.™
Health Effects of Secondhand Smoke
Overview
(#overview)
Secondhand Smoke Causes Heart Disease
(#heart)
Secondhand Smoke Causes Lung Cancer
(#lung)
Secondhand Smoke Causes SIDS
(#sicls)
Secondhand Smoke and Children
(#children)
References
(#ref)
For Further Information
C#info)
-
Overview
Secondhand smoke is the combination of smoke from the burning end of a cigarette and the
smoke breathed out by smokers. Secondhand smoke contains more than 7000 chemicals.
Hundreds are toxic and about 70 can cause cancer. 1
,2
There is no risk-free level of exposure to secondhand smoke.
Secondhand smoke
causes numerous health problems in infants and children, including severe asthma attacks,
respiratory infections, ear infections, and sudden infant death syndrome (SIDS).l Some of the
health conditions caused by secondhand smoke in adults include heart disease and lung cancer.1
Secondhand Smoke Causes Heart Disease
Exposure to secondhand smoke has immediate adverse effects on the
cardiovascular system and can cause coronary heart disease.
1
,3
• Secondhand smoke causes an estimated 46,000 premature deaths from heart disease each
year in the United States among nonsmokers.4
• Nonsmokers who are exposed to secondhand smoke at home or at work increase their risk of
developing heart disease by 25-30%.1
@
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""1."'''''7
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DC - Fact Sheet - Health Effects of Secondhand Smoke - Smoking ...
http://www. cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_... ,
Breathing secondhand smoke can have immediate adverse effects on your blood
and blood vessels, increasing the risk of having a heart
attac~.1,2
• Breathing secondhand smoke interferes ,,\lith the normal functioning of the heart, blood, and
vascular systems in ways that increase the risk of having a heart attack.
• Even brief secondhand smoke exposure can damage the lining of blood vessels and cause
your blood platelets to become stickier. These changes can cause a deadly heart attack.
People who already have heart disease are at especially high risk of suffering
adverse effects from breathing secondhand smoke and should take special
precautions to avoid even brief exposures.1
Secondhand Smoke Causes Lung Cancer
Secondhand smoke causes lung cancer in adults who themselves have never
smoked. 1
• Nonsmokers who are exposed to secondhand smoke at home or at work increase their risk of
developing lung cancer by
20-30%.1
.
• Secondhand smoke causes an estimated
3,400
lung cancer deaths among U.S. nonsmokers
each year.
4,5
Nonsmokers who are exposed to secondhand smoke are inhaling many ofthe same
cancer-causing substances and poisons as smokers. 1,2
• Secondhand smoke contains about 70 cancer-causing chemicals.
• Even brief secondhand smoke exposure can damage cells in ways that set the cancer process
in motion.
• As
vvith active smoking, the longer the duration and the higher the level of exposure to
secondhand smoke, the greater the risk of developing lung cancer.
.
..
Secondhand Smoke Causes SIDS
SIDS is the sudden, unexplained, unexpected death of an infant in the first year of
life. SIDS is the leading cause of death in otherwise healthy infants.6 Secondhand
smoke increases the risk for SIDS.l
• Smoking by women during pregnancy increases the risk for SIDS.7
• Infants who are exposed to secondhand smoke after birth are also at greater risk for SIDS'b
• Chemicals in secondhand smoke appear to affect the brain in ways that interfere vvith its
regulation of infants breathing.
1
• Infants who die from SIDS have higher concentrations of nicotine in their lungs and higher
c!!V
f
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11/14/20123:37
PM
 PDF to HTML - Convert PDF files to HTML files
CDC - Fact Sheet - Health Effects of Secondhand Smoke - Smoking ...
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_...
levels of cotinine (a biological marker for secondhand smoke exposure) than infants who die
from other causes.
1
Parents can help protect their babies from SIDS by taking the following three
actions:
8
• Do not smoke when pregnant.
• Do not smoke in the home or around the baby.
• Put the baby down to sleep on its back.
Secondhand Smoke and Children
Secondhand smoke can cause serious health problems in children.
9
• Studies show that older children whose parents smoke get sick more often. Their lungs grow
less than 9hildren who do not breathe secondhand smoke, and they get more bronchitis and
pneumoma.
• Wheezing and coughing are more common in children who breathe secondhand smoke ..
• Secondhand smoke can trigger an asthma attack in a child. Children with asthma who are
around secondhand smoke have more severe and frequent asthma attacks. A severe asthma
attack can put a child's life in danger.
• Children whose parents smoke around them get more ear infections. They also have fluid in
their ears more often and have more operations to put in ear tubes for drainage.
Parents can help protect their children from secondhand smoke by taking the
following actions:
9
• Do not allow anyone to smoke near your child.
• Do not smoke or allow others to smoke in your home or car. Opening a window does not
protect your children from smoke.
• Use a smoke-free day care center.
• Do not take your child to restaurants or other indoor public places that allow smoking.
• Teach children to stay away from secondhand smoke.
References
1.
u.s.
Department of Health and Human Services.
The Health Consequences of
Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General
Utobacco/data statistics/sgr/sgr 2oo6/index.htm).
Atlanta: U.S. Department of Health
and Human Services, Centers for Disease Control and Prevention, Coordinating Center for
Health Promotion, National Center for Chronic Disease Prevention and Health Promotion,
fil\
Office on Smoking and Health,
2006
[accessed
2011
Mar
11].
2.
U.S. Department of Health and Human Services.
A Report of the Surgeon General:
How Tobacco Smoke Causes Disease: What
It
Means to You
Utobacco
Idata statisticslsgrl201olconsumer booldet/index.html.
Atlanta: U.S. Department of
v
 PDF to HTML - Convert PDF files to HTML files
DC - Fact Sheet - Health Effects of Secondhand Smoke - Smoking ...
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_ ... :
Health and Human Services, Centers for Disease Control and Prevention, National Center
for Chronic Disease Prevention and Health Promotio,n, Office on Smoking and Health,
2010
[accessed
2011
Mar
11].
3. Institute
of Medicine.
Secondhand Smoke Exposure and Cardiovascular Effects:
Making Sense of the Evidence (http://www.iom.edu/''''/media/Files/Report%2oFiles
/2oo9/Secondhand-Smoke-Exposure-and-Cardiovascular-Effects-Making-Sel e­
~l: 4-"'~ 1:7u:.1~~~~/Secondhand%2oSmoke%2o%2oReport%2oBriefOA)203.Pdt)
@
(PDF-707-47 KB).
Washington: National Academy of Sciences, Institute of Medicine,
2009
[accessed
2011
Mar
11].
4. Centers for Disease Control and Prevention.
Smoking-Attributable Mortality, Years
of Potential Life Lost, and Productivity Losses-United States,
2000-2004
(http:Uwww.cdc.gov/mmwrfpre"iew/mmwrhtml/mm5745a3.html .
Morbidity and
Mortality Weekly Report
2008;S7(4S):1226-8
[accessed
2011
Mar
11].
S.
American Cancer Society.
Cancer Facts and Figures
2009
(http:/[www.c--- ---- ---­
1~~'1/groups/content'@nho'documents'document'500809webpdf.pdf)@.
(PDF-l·7
MB)
Atlanta: American Cancer Society,
2009
[cited
2011
Mar
11].
6.
American Academy of Pediatrics, Task Force on Sudden Infant Death Syndrome.
The
Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding
Shifts; Controversies Regarding the Sleeping Environment; and New Variables
to Consider in Reducing Risk.
Pediatrics
200S;116(S):124S-SS
[cited
2011
Mar
11].
7. U.S. Department of Health and Human Services.
The Health Consequences of
Smoking: A Report of the Surgeon General ([tobacco/data statistics
/sgr/sgr 2oo4/index.html.
Atlanta: U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention, National Center for Chronic Disease
Prevention and Health Promotion, Office on Smoking and Health,
2004
[accessed
2011
Mar
11].
'.
8.
National Institutes of Health.
Safe Sleep for Your Baby: Ten Ways to Reduce the
Risk of Sudden Infant Death Syndrome (SIDS) (http:Uwww.nichd.nih.gov
'publications/pubs/safe sleep gen.cfml@.
Rockville (MD): National Institutes of
Health, National Institute of Child Health and Human Development,
2003
[accessed
2011
Mar
11].
9.
U.S. Department of Health and Human Services.
The Health Consequences of
Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General:
Secondhand Smoke: What
It
Means To You. (http
'I
~eneral.gov
/library/secondhandsmoke/secondhandsmoke.pdf)
@.
(PDF-ll.0S
MB)
Atlanta: U.S.
Department of Health and Human Services, Centers for Disease Control and Prevention,
National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking
and Health,
2006
[accessed
2011
Mar
11].
For Further Information
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E-mail: tobaccoinfo@cdc.gov
Cmailto:tobaccoinfo@cdc.gov)
1-80o-CDC-INFO
Media Inquiries: Contact CDC's Office on Smoking and Health press line at
770-488-S493.
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