HCR 76 Smoke-Free LA Jeanie Donovan jeanie@labudget.org - PowerPoint PPT Presentation

HCR 76 – Smoke-Free LA Jeanie Donovan jeanie@labudget.org 225.614.9126 www.labudget.org

Louisiana has high smoking rates Percentage of population that smokes 25% 22.8% 20% 15.5% 15% 12.3% 10% 7.6% 5% 0% Louisiana United States Adults Teenagers Source: Center for Disease Control, Adult (2016) and Youth Risk Behavior (2017) Surveys.

Smoking and secondhand smoke kill thousands each year Deaths from cancer in Average annual deaths in Louisiana, 2014 Louisiana, 2005-09 Smoking -related, Smoking- 7,210 related, 3,044 Non- Non- smoking smoking related, related, 6,306 14,365 Source: State-Level Cancer Mortality Attributable to Source: Center for Disease Control, Cigarette Smoking in the United States, JAMA State Tobacco Activities and Evaluation Intern Med. 2016;176(12):1792-1798. (STATE) System, 2005-2009 Published online October 24, 2016.

Secondhand smoke causes cancer and heart disease • Secondhand smoke causes 7,333 annual deaths from lung cancer nationwide. 1 • Secondhand smoke causes 33,951 annual deaths from heart disease nationwide. 1 • Even relatively brief exposure to secondhand smoke can cause heart disease and heart attacks. 2 Sources: 1. U.S. Department of Health and Human Services. The Health Consequences of Smoking — 50 Years of Progress. A Report of the Surgeon General. Atlanta: U.S., 2014 2. Institute of Medicine. 2010. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington, DC. The National Academies Press.

Secondhand smoke harms non-smoking hospitality workers and patrons • Casino workers are exposed to hazardous levels of toxic secondhand smoke at work and tobacco-specific carcinogens increased in the body through a worker’s shift. 1 • Secondhand smoke kills 6 in every 10,000 non-smoking casino workers' in Pennsylvania annually. 2 • Good ventilation does not mitigate effects of secondhand smoke. One study found with sophisticated ventilation system, metabolized nicotine increased by 456% and carcinogens increased by 112% after four hours of exposure. 3 “ The only means of effectively eliminating health risks associated with • indoor exposure is to ban smoking activities.” - American Society of Heating, Refrigerating, and Air Conditioning Engineers’ 4 1. National Institute for Occupational Health and Safety. Environmental and Biological Assessment of Environmental Tobacco Smoke Among Casino Dealers. May 2009 2. James L. Repace . “Secondhand Smoke in Pennsylvania Casinos: A Study of Nonsmokers’ Exposure, Does, and Risk.” Am J Public Health. 2009 Aug; 99(8): 1478 – 1485. 3. Anderson, K. et al, “Metabolites of Tobacco - Specific Lung Carcinogen in Nonsmoking Casino Patron,” Cancer Epidemiology, Bioma rkers & Prevention, 12:1544-1546, December 2003. 4. ASHRAE Position Document on Environmental Tobacco Smoke. June 19, 2016. https://www.ashrae.org/File%20Library/About/Position%20Documents/ASHRAE_PD_Environmental_Tobacco_Smoke_2016.pdf

Smoke-free laws reduce exposure to secondhand smoke Local example: 1 National data: 2 • Fine particle air pollution fell by Nonsmokers with measureable levels of 96 percent in New Orleans bars cotinine (nicotine-enzyme) that had previously allowed 100% smoking two months after 90% 87.9% smoke-free ordinance 80% 70% • Fine particle air pollution 60% virtually eliminated (99% 50% reduction) in Harrah’s two 40.1% 40% months after smoke-free 30% 25.4% 20% ordinance 10% 0% 1988-1991 2007-2008 2011-2012 Sources: 1. New Orleans, Louisiana. Indoor Air Quality Monitoring Study . Roswell Park Cancer Institute. August 2015. 2. Centers for Disease Control and Prevention. Vital Signs: Nonsmokers’ Exposure to Secondhand Smoke — United States.

Smoking-related illness costs the state millions • • As estimated 12 percent of Total smoking-related health care costs in Louisiana equal $1.9 state Medicaid expenditures in billion. 3 Louisiana are attributable to smoking. 1 12 percent of state’s share of • 2016-2017 Medicaid expenditures is $348 million. 2 Sources: 1. Armour et al. “State - Level Medicaid Expenditures Attributable to Smoking,” Preventing Chronic Disease, Vol 6: No. 3, July 2009. 2. Louisiana Department of Health. Medicaid Annual Report, 2016-17. 3. Center for Disease Control and Prevention. State Tobacco Activities Tracking and Evaluation (STATE) System. 2009.

Hospitality workers are likely to be eligible for Medicaid expansion Number Annual of Medicaid eligibility thresholds Occupation Median Wage Mean Wage workers Max Modified Bartender $8.84 $19,260 8,950 Adjusted Gross Household Size Income Bartender helper $8.95 $19,080 5,980 Food server, non- 1 $16,753 restaurant $8.99 $19,990 3,720 2 $22,715 Gaming dealer $9.07 $22,100 3,220 3 $28,676 Gaming service worker $10.33 $25,610 740 4 $34,638 Gaming change provider and cashier $10.38 $22,910 1,080 Gaming and sports books, writers and runner $9.38 $19,520 60 Total “floor” workers employed in Louisiana bars and casinos: 20,530 Source: U.S. Department of Labor, Bureau of Labor Statistics, May 2017 State Occupational Employment and Wage Estimates, Louisiana

Smoke-free laws reduce smoking prevalence • In 2010, a systematic review of research by the Task Force on Community Preventive Services found: • Smoke-free laws are associated with median 6.4% increase in cessation of tobacco use • Smoke-free laws and policies are associated with a median 3.4% decrease in tobacco use prevalence. Source: Hopkins DP, Razi S, Leeks KD, Priva Kalra G, Chattopadhyay SK, Soler RE, et al. Task Force on Community Preventive Services. Smoke-Free Policies to Reduce Tobacco Use: A Systematic Review. American Journal of Preventive Medicine 2010;38(2 Suppl):S275 – 89

Smoke-free laws could save lives and state funds Reduced prevalence Reduced Clean air in and Statewide of smoking-related prevalence of around all of smoke-free law related illness and smoking among Louisiana’s prohibits death in hospitality general hospitality smoking in bars workers population venues and casinos Reduction in state Reduction in & Medicaid overall health expenditures on care expenditures smoking-related for smoking- illnesses related illnesses

Contact Info • Jeanie@labudget.org • 225-614-9126