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Published on December 7, 2007

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Smokefree workplaces: No delays, no exemptions :  Smokefree workplaces: No delays, no exemptions The importance of total indoor smoke bans for worker and public health September 2006 Outline:  Outline Public health Worker health Gambler health OH&S laws Ventilation/separation Economic arguments Big Tobacco’s role Discrimination Impact on smoking rates Public support Expert support International trend Summary: clear benefits 1. Serious health harm:  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. Serious health harm (2):  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/SF’03/health.htm 2. Harm to workers:  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/workplace/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. 3. Harm to gamblers:  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. 4. Undermining OH&S laws:  4. Undermining OH&S 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 Council’s Guidance Note on the Elimination of environmental Tobacco Smoke in the Workplace [NOHSC:3019(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. 5. Ventilation and separation:  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     Slide9:  The “Pee Pool” Peeing No peeing The effect of partial solutions & separate areas – currently floating around in several states 6. The economic debate: international:  6. The economic debate: international 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 business Going 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. 6. Economic debate: Australia:  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 3:1. WA Healthway (2003) survey National: Small impact – mostly on problem gamblers Based 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 6. Economic debate: overlooked factors:  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. 7. Big Tobacco’s role:  7. Big Tobacco’s 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.) 8. Discrimination:  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. 9. Impact on smoking rates:  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. 10. Strong public support:  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; - 27% want March 2005 deadline; less than 1% want longer deadline; - Almost 95% support for immediate ban among 18-24 year olds. 11. Expert support:  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 12. International trend:  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. 13. Conclusions:  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 ! More information:  More information SmokeFree Australia coalition for safe, clean workplaces Phone: Stafford Sanders, media co-ordinator (02) 9334-1823 staffords@ashaust.org.au Website: www.ashaust.org.au/SF’03 (more contacts on Partners page)

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