New bill aims to restore local decisions on smoking policies

TML Communications Specialist

A new bill aims to restore more local control over smoking policies to better protect the health of local citizens just as a new report gave the Tennessee Legislature low marks for efforts to prevent tobacco use and encourage tobacco cessation among citizens.

Known as the Local Option Bill, HB 2327 was introduced by House State Government Committee Chairman Bob Ramsey, R-Maryville, with the companion SB 2525 introduced by Sen. Bill Ketron, R-Murfreesboro. The bill seeks to repeal the tobacco preemption clause from Tennessee law and insert the local option. The bill designates local government exemptions to state tobacco products preemption law and allows local governments to regulate smoking in those areas.
“As written today, state law is ignoring the will of the people in local communities who desire smoke-free air,” Ramsey said. “The air we breathe is a public safety matter — no one should be forced to walk around in a cloud of poison. Telling a community ‘you have control over your smoking-related policy’ is simply the right thing to do.”

Under the bill, cities could not be less restrictive to smoking than currently permitted by state law. The bill has the support of the American Heart Association as well as Tobacco Free Kids, the American Cancer Society Cancer Action Network, Americans for Nonsmokers Rights and the American Lung Association. Officials hope the bill will also help educate Tennesseans about the health issues caused by secondhand smoke.

As currently written, the Tennessee Code Annotated 39-17-1803 prohibits smoking “in all enclosed public places” and lists 19 examples. However, TCA 39-17-1804 does allow smoking in “non-enclosed areas of public places” and 10 exempted enclosed areas.

These include age-restricted venues including retail tobacco stores; premises involved in manufacturing, importing, wholesaling, storing, or dealing tobacco; private businesses with three or fewer employees; nursing homes for residents only; private clubs; private homes or residences not used for child care; private vehicles not being used for child care transportation; and commercial vehicles with a single occupant. Hotels and motels can also designate 25 percent of their rooms as smoking so long as they follow certain guidelines.

Christian Marks, chairperson of the American Heart Association’s Tennessee State Advocacy Committee said numerous studies show smoke-free laws do not hurt restaurant and bar patronage, employment, sales or profits. In fact, the laws have been found to either have no effect at all on business activity, or they even produce slightly positive trends.

“It is 2018, yet so many Tennesseans are not given an option to breathe clean air,” Marks said. “The choice is to limit the places they visit or risk being exposed to secondhand smoke.”

Alex Carmack, a spokesperson with the American Heart Association, said the bill both benefits Tennesseans healthwise and restores local control to governments.

“This bill will give cities the ability to act on reducing secondhand smoke exposure, should they wish to do so,” he said. “But if a city is not interested in taking on secondhand smoke, this bill would allow that option. It also gives certain cities the opportunity to set themselves apart in the tourism-and-event marketplace. A city could advertise that they have smoke-free parks, public spaces, restaurants, bars, and hotels guaranteed as an incentive to attract conferences and events in a way they could not before.”

Carmack said the bill would allow Tennesseans more freedom of choice.
“This gives consumers the option to choose a smoke-free environment for their events and stay, or they could choose a city that does not have those same smoke-free guarantees; this could be particularly beneficial for the smaller cities in Tennessee that are often overlooked by these events and people in favor of our larger cities,” Carmack said. “Also, current Tennessee law requires most, but not all, workplaces to be smoke-free. Having the exceptions leaves many employees and customers open to exposure to dangerous second-hand smoke, and some cities would like to address the issue.”

However, the state legislature has historically voted against bills aimed at curbing second-hand smoke and regulating tobacco access.
A similar bill sponsored by Sen. Jon Lundberg, R-Bristol, last year to allow municipalities more leeway in regulating smoking policies in public places like parks was deferred to summer study by the Senate Commerce and Labor Committee.

Carmack said some lawmakers cited infringing on personal freedoms as why they didn’t support the bill.
“Just about all lawmakers agree we need to get people to stop smoking, and they want to do so in a way that does not violate a person’s personal liberty or stigmatize or ostracize the smoker but instead encourages them to quit,” he said. “[Ramsey’s] bill does not violate personal liberties, which is one of the many reasons we think this is a bill a lot of lawmakers can get behind. It gives local governments the ability to protect non-smokers’ rights to breath smoke-free air.”
Tennessee has earned lower than average grades on its tobacco policies from the American Lung Association’s 2018 State of Tobacco Control Reports. While the state has taken some significant steps to reduce tobacco use, the study said that the state hasn’t done enough to curb preventable tobacco-related disease and deaths.

The state’s highest grade was a “C” for smoke-free workplace laws, but it earned an “F” grade for state funding of tobacco prevention programs, level of tobacco taxes, coverage and access to tobacco cessation programs, and the minimum age for sale of tobacco products.

Carmack said Tennessee is currently ranked 43 out of 50 in terms of health among the states, is the 44th in cardiovascular deaths, 44th in cancer deaths, 43rd in premature deaths and 48th in diabetes. The state also has the third highest number of smokers per capita in the nation.

“First and foremost, lawmakers should support this bill because we have to start addressing our health as a state,” he said. “In Tennessee, we spend $2.67 billion on health care costs on smoking related illnesses, $823.6 million of which comes directly from the taxpayers through TennCare. This bill offers a conservative approach to addressing this issue by just allowing local governments to prohibit smoking in public places reducing exposure to secondhand smoke. This bill will prolong lives, improve our health, save taxpayer dollars, and provide cities the opportunities to attract businesses and events that might have otherwise gone to another state or a bigger city in our state.”

American Lung Association in Tennessee’s Director of Advocacy Heather Wehrheim has called on Tennessee policymakers to act on repealing preemption related to smoke free public places and making sure all cessation treatments are covered under Medicaid and private insurance without barriers.

“Nationwide, smoking rates have continued to decline to historically low levels, yet tobacco use remains the nation’s leading cause of preventable death and disease killing over 480,000 Americans each year,” Wehrheim said. “Tobacco use is a serious addiction, and the fact that 26.8 percent of Tennessee residents are current smokers highlights how much work remains to be done in our communities to prevent and reduce tobacco use.”

Those who smoke are also putting non-smokers at risk. According to the Centers for Disease Control and Prevention (CDC), more than 41,200 adult non-smokers die every year in the United States from heart disease and lung cancer caused by exposure to secondhand smoke. It is also a known cause for low birth-weight births, chronic lung ailments as well as other health problems.

According to the Campaign for Tobacco Free Kids, annual healthcare costs in Tennessee directly caused by smoking total $2.67 billion. Medicaid costs caused by smoking total $823.6 million annually. And smoking-related productivity loss totals $3.59 billion annually — this does not include secondhand smoke.
While smoking cessation rates are improving nationwide, Tennessee lags behind other states. The current smoking rate in Tennessee — 22.1 percent of adults use cigarettes — gives it the eighth highest rate of smoking prevalence in the nation.

“We lose 30 precious people a day in Tennessee to tobacco use, and beyond these tragic early deaths, it costs our state billions of dollars each year in lost productivity and health care costs,” Dr. John Dreyzehner, Tennessee Department of Health commissioner, said in a statement. “The impacts of tobacco and nicotine addiction in Tennessee go beyond the damage done to the health, quality of life and incomes of people using these products, most of whom got addicted as youth.”