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Smoke-free Air Law Had No Economic Effect On Off-Track Betting Facility

In State News on March 23, 2011 at 7:27 am

BLOOMINGTON, Ind. — An Indiana University study found that a smoke-free air law implemented in an Indiana community did not hurt business at the off-track betting facility in that community. The findings, the researchers said, suggest there is “no economic reason for policymakers to exclude OTB facilities from smoke-free legislation.”

Indiana legislators are currently debating a statewide smoke-free air law. Exceptions could include casinos and other gaming venues. Jon Macy, assistant professor in IU’s School of Health, Physical Education and Recreation and lead author of the study, said past research has shown that smoke-free laws do not negatively affect businesses, but the findings concerning gambling facilities have been mixed.

“Prior research has very clearly demonstrated that laws prohibiting smoking in public places and workplaces have no negative economic consequences in multiple industries,” Macy said. “Our study is one of the first to find that this holds true for gaming facilities as well.”

The study, published online on Tuesday by the journal Tobacco Control, compared per capita “handle,” or the amount gamblers spent per number of people living in the county, for three Indiana OTBs from 2002 to 2009. The OTBs were located in Fort Wayne, which in 2007 implemented a smoke-free air law in all workplaces, including gambling facilities, and in Indianapolis and Merrillville, where smoking is permitted at the facilities.

The study found that the per capita handle in all three facilities declined at a similar rate during this period, with unemployment rates proving to be a significant predictor of the per capita handle. As unemployment rates increased, per capita handle decreased. There was no change in the trend in per capita handle after the Fort Wayne location went smoke-free or in the two control locations that continued to allow smoking.

“Given the well-established negative health consequences of secondhand smoke exposure, strong policies should be enacted to protect workers and patrons at gaming facilities from exposure to secondhand smoke,” the authors wrote in their study, ‘The impact of a local smoke-free law on wagering at an off-track betting facility in Indiana.’ “These strong public health policies can be implemented without fear of negative economic consequences.”

Co-author of the study was Ericka L. Hernandez, Department of Statistics in IU’s College of Arts and Sciences.
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The article is available online at http://tobaccocontrol.bmj.com/content/early/2011/03/19/tc.2010.041913.full.

Indiana Tobacco Prevention & Cessation Celebrates Milestones

In Local News, State News on February 23, 2011 at 3:27 pm

This op-ed by Sandy Gleim was published in the Herald Argus:

After 10 years working on the local and state levels, Indiana Tobacco Prevention & Cessation is celebrating impressive milestones that positively impact Hoosier health.

  • Smoking rates for high school youth have dropped by 42 percent, resulting in 49,000 fewer youth smokers.
  • Adult smoking decreased from 27 to 23 percent. This historic low rate means there are 207,000 fewer smokers in Indiana.
  • Per capita cigarette consumption has declined by 40 percent.
  • More than 2,000 community organizations statewide – including in LaPorte County – are working to help reduce tobacco use.
  • Many more Hoosiers are protected from the dangers of secondhand smoke, within 30 smoke-free communities.
  • The Indiana Tobacco Quitline at 1-800-QUITNOW has served more than 60,000 residents since it was launched in 2006.
  • 70 percent of Indiana’s schools have a tobacco-free campus, an increase from 28 percent.

That is much good work to applaud! But the flip side is there are still more than one million smokers in our state, translating to 9,700 deaths each year. An additional 194,000 Hoosiers live with serious tobacco-related illness. The tobacco use burden to the Indiana economy is estimated at $7.7 billion annually, and the state spends a whopping $487 million each year on Medicaid payments caused by tobacco use. The bottom line is that many Hoosiers continue to smoke, ultimately costing the state and taxpayers in increased health care costs.

Balancing all these facts, it’s apparent while much has been achieved in Indiana, we still have major work ahead to improve our health status.

Enacting smoke-free policy is not only an effective measure in leading persons to give up smoking, but public health advocates support 100% comprehensive legislation to protect the rights of all workers to breathe healthy air. Once again, our legislature is considering a statewide smoke-free policy. The House bill contains numerous exemptions to public places, including bars. Now the Senate has the chance to debate the issue and hopefully to strengthen the stance.

As these discussions progress, from an economic as well as a health angle, it benefits Indiana to support comprehensive smoke-free policy and the continued prevention and cessation work of the state tobacco agency.

Exemptions Make Proposed Smoking Ban Useless

In Local News, State News on January 28, 2011 at 8:47 am

The Washington Times-Herald published an article Jan. 25 titled “House exempts bars from proposed smoking ban.” Our state legislators have so watered down the proposed law with exemptions that it’s practically useless at this point.

Indiana needs a smoke-free workplace law that covers all workers, including those in the hospitality industry, because all workers deserve a safe and healthy work place, no matter where they work.

Many employees in the restaurant, bar, and casino industry have limited employment options, especially in this economic environment. They should not have to choose between their health and earning a living for their families. Secondhand smoke kills thousands of nonsmokers every year, especially people working in restaurants, bars, and casinos.

Numerous polls show a majority of Hoosiers support a smoke-free law that covers all workplaces. Bars and casinos in other states with smoking bans have not been financially harmed because of the law. Instead, those states are seeing drops in heart attacks and other diseases related to secondhand smoke exposure.

It all boils down to this – secondhand smoke is a worker safety issue, the same as any other workplace safety hazard. I like how Dave Crooks put it in his recent blog: “It’s time to ban smoking in ALL public places in Indiana. We have nothing to fear but cleaner air and a more attractive state for all.”

I urge you to contact your legislators today and ask them to support a smoke-free law for everyone.

Indiana’s Faith Leaders Call For Legislature To Approve Tobacco Prevention & Cessation Funding, Statewide Comprehensive Smoke-Free Workplace Law

In State News on January 25, 2011 at 12:29 pm
Yesterday in Indianapolis, leaders of Indiana’s major faiths and denominations called upon the members of the Indiana General Assembly to commit to reducing the serious burden tobacco smoke takes on both the primary user and also those who are exposed to secondhand tobacco smoke. Leaders from a diverse array of faith denominations issued this call to action at Christ Church Cathedral on Monument Circle in Indianapolis at an event hosted by the Hoosier Faith and Health Coalition.
Reverend Dan Gangler of the United Methodist Church said, “The clear and present danger caused to Hoosiers by tobacco products, plus the costs to the state incurred because of disease and death caused by tobacco products and secondhand smoke demand that our state’s policymakers show true commitment to addressing the toll of tobacco by providing meaningful funding to Indiana Tobacco Prevention & Cessation Agency and by adopting a comprehensive smokefree workplace law.
“Hoosier Faith & Health Coalition members are proud to partner with ITPC in its community- based campaign to reduce tobacco use. Our faith leaders and health leaders in communities across Indiana have a great resource in ITPC’s state office staff and the community partners across the state. Hoosiers need the experienced, dedicated staff of ITPC and the independent, expert guidance provided by ITPC’s Executive Board in order to continue the decade of progress Indiana has witnessed in reducing youth and adult smoking rates and consumption,” Gangler said.
Research shows that reducing tobacco use is one of the most effective ways to protect our state’s health and prevent deadly and costly diseases such as cancer and heart attacks by preventing kids from starting and helping adults quit.
The Hoosier Faith and Health Coalition event celebrated 10 years of service to Hoosiers by the Indiana Tobacco Prevention and Cessation Agency. During this last decade of service, ITPC has led Hoosiers to major successes in tobacco prevention, such as:
  • Successfully reducing adult smoking to an historic low of 23.1%. Consequently today there are 208,000 fewer smokers in Indiana than there were just 10 years ago;
  • Reducing annual per capita cigarette consumption of Hoosiers by 40%; and 
  • Reducing the high school smoking rate by 42%, resulting in 49,000 fewer youth smokers.
In spite of this success, there still is a tremendous amount yet to do to help Hoosiers quit smoking, prevent young people from starting to smoke, eliminating exposure to secondhand smoke and reducing disparities caused by tobacco. At the same time while ITPC has been efficiently and effectively doing its work to combat the significant health and financial toll caused by tobacco and providing Hoosiers with a positive return on their investment by reducing tobacco-related costs for the state, businesses and individuals, the tobacco industry continues to spend hundreds of millions of dollars more than Indiana dedicates to tobacco control efforts. For example, tobacco companies spent $426 million to market their products in Indiana in 2006 alone, according to the most recent Federal Trade Commission report that tracks these expenditures, outspending tobacco prevention funding by a scale of 46 to one.
Kevin O’Flaherty of the Campaign for Tobacco-Free Kids said, “We ask the Indiana General Assembly stand up for healthy Hoosiers and against disease, death and $2 billion per year in costs due to smoking and $390 million per year in costs due to secondhand smoke. Investing in ITPC is a smart investment, especially in such hard economic times, because it’s an expenditure that is shown to provide a positive return on investment. We ask Indiana’s leaders to not turn back the clock on our decade of progress but to commit to continue these important programs and the valuable work of ITPC.”

How Long Will We Hold Out?

In State News on January 19, 2011 at 12:36 pm

Opinion piece by Richard Feldman that was published recently in the Indianapolis Star.

The Indiana General Assembly again is considering a comprehensive smoke-free statute that would prohibit smoking in enclosed public places including worksites, restaurants and bars. The legislature has previously lacked the courage to overcome the powerful political influence of the tobacco industry. Hoosiers also fervently value personal liberties and resent intrusive governmental control of business. These attitudes, although understandable, are applied excessively regarding this issue.

Individual freedoms are not absolute; they are balanced by the greater public good, and they end when one’s actions injure another. Smokers do hurt those around them. Nonsmokers cannot always deliberately avoid environmental tobacco smoke. It is ubiquitous. Although the enactment of smoke-free laws has reduced the risk, studies demonstrate that Americans greatly underestimate their exposure to secondhand smoke. Commonly, people who believe that they are not exposed to smoking have significant blood levels of tobacco-smoke metabolites.

Also, workers may be trapped in smoke-filled environments. Jobs are not easily found and many workers have no alternatives. For example, I had a patient with severe asthma. She was a cocktail waitress in a smoky work environment that triggered her asthma. I advised her that she should find another job. Surprised, she looked at me and said, “Dr. Feldman, working in bars is what I do. It’s all I know. If I found another job, it would be in another smoky bar.”

Consider these additional facts as ample rationale for a smoke-free statute:

No legitimate study has ever found a negative economic effect of a smoke-free law on restaurants, bars, convention business or the hospitality industry. These include studies conducted in Bloomington and Fort Wayne. My goodness, the pubs in Ireland went smoke-free and they’re doing fine.

Environmental tobacco smoke annually kills 1,300 people in Indiana, 53,000 in the United States (including 6,200 children), and 600,000 worldwide. It is America’s third leading cause of premature death.

Secondhand smoke causes lung cancer and at least 15 other cancers in nonsmokers chronically exposed. Tobacco smoke is America’s number one airborne carcinogen.

Secondhand smoke significantly increases the risk of chronic obstructive lung disease and asthma in nonsmokers and various respiratory infections, including pneumonia, in children.

Environmental tobacco smoke increases the risk of heart disease in nonsmokers by up to 60 percent and stroke by 50 to 80 percent.

Before the era of smoke-free laws, restaurant and bar workers had up to four times the risk of lung cancer and more than twice the risk of heart disease as compared to other workers.

Numerous studies have demonstrated hospital admissions for acute heart attack have been reduced between 14 and 42 percent in the months after smoke-free laws take effect; in one study, hospital admissions for childhood asthma were reduced by 16 percent.

Pregnant women exposed to secondhand smoke have twice the risk of having a low-birth weight baby, which is associated with 40 percent of neonatal deaths. These women also have higher rates of miscarriage, premature birth and other obstetrical complications.

Secondhand smoke considerably increases direct and indirect costs to businesses and is responsible for $390 million in health-related costs yearly in Indiana.

Nearly two-thirds of likely Hoosier voters support comprehensive smoke-free laws that include restaurants and bars. That would be a landslide victory in any election.

As the Indiana legislature debated this issue last year, South Dakota became the 29th state to enact a comprehensive smoke-free statute. Minnesota, Wisconsin, Michigan, Ohio and Illinois all have good smoke-free laws.

Although there may be more momentum this year, its enactment remains an uphill battle. Will Indiana or Kentucky be the last state in the country to enact a comprehensive smoke-free statute? Tough call.

Feldman, M.D., is director of medical education and family medicine residency at St. Francis Hospitals and Health Centers and is a former state health commissioner. Contact him at richard.feldman@ssfhs.org.

Indiana Needs A Comprehensive Smoke-Free Workplace Law

In State News on January 17, 2011 at 10:29 am

On Wednesday, the House Public Health Committee held a hearing on HB 1018, the Indiana Comrehensive Indoor Clean Air Act, which would require all Indiana workplaces, including restaurants and bars, to go smoke-free.

The bill, however, contains exemptions for casinos. Radio show host Dave Crooks wrote a great blog about the issue here: http://wamwamfm.com/dcs/.

We feel all workers deserve to breathe clean air. No one should have to choose between their health and a paycheck. You can support smoke-free workplace by contacting your representative and patronizing only smoke-free businesses.

Indiana Ranks 28th in Protecting Kids from Tobacco

In State News on November 30, 2010 at 9:16 am

Indiana ranks 28th in the nation in funding programs to prevent kids from smoking and help smokers quit, according to a national report released today by a coalition of public health organizations.

Indiana currently spends $9.2 million a year on tobacco prevention and cessation programs, which is 11.7 percent of the $78.8 million recommended by the U.S. Centers for Disease Control and Prevention (CDC). Other key findings for Indiana include:

  • Indiana in the past three years has cut funding for its tobacco prevention program by 43 percent (from $16.2 million to $9.2 million), and funding is now at the lowest level since the program was launched 10 years ago
  • Indiana this year will collect $599 million from the 1998 tobacco settlement and tobacco taxes, but will spend just 1.5 percent of it on tobacco prevention programs.
  • The tobacco companies spend $426.2 million a year to market their products in Indiana. This is 46 times what the state spends on tobacco prevention.

The annual report on states’ funding of tobacco prevention programs, titled “A Broken Promise to Our Children: The 1998 State Tobacco Settlement 12 Years Later,” was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association and the Robert Wood Johnson Foundation.

The Indiana Tobacco Prevention and Cessation program has contributed to significant declines in tobacco use. Between 2000 and 2008, smoking declined by 42 percent among Indiana high school students. However, that progress is at risk because of the budget cuts. Indiana is also falling short in implementing other proven measures to reduce tobacco use. The state lacks a statewide smoke-free law that applies to all workplaces, restaurants and bars, and the state cigarette tax of 99.5 cents per pack ranks 31st in the nation and is below the national average of $1.45 per pack.

“Indiana’s progress against tobacco is at risk unless state leaders step up the fight by increasing funding for tobacco prevention and implementing other proven measures, including a comprehensive, statewide smoke-free law,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. “Despite the state’s progress, tobacco still takes a huge toll in health, lives and health care dollars in Indiana. Even in these difficult budget times, tobacco prevention is a smart investment for Indiana that saves lives and saves money by reducing health care costs.”

In Indiana, 23.5 percent of high school students smoke, and 9,900 more kids become regular smokers every year. Each year, tobacco claims 9,700 lives and costs the state $2.1 billion in health care bills.

Nationally, the report finds that most states are failing to adequately fund programs to prevent kids from smoking and help smokers quit. Altogether, the states have cut funding for these programs to the lowest level since 1999, when they first started receiving tobacco settlement payments. Key national findings of the report include:

  • The states this year will collect $25.3 billion from the tobacco settlement and tobacco taxes, but will spend just two percent of it – $517.9 million – on tobacco prevention programs.
  • States have cut funding for tobacco prevention programs by nine percent ($51.4 million) in the past year and by 28 percent ($199.3 million) in the past three years.
  • Only two states – Alaska and North Dakota – currently fund tobacco prevention programs at the CDC-recommended level.

The report warns that the nation’s progress in reducing smoking is at risk unless states increase funding for programs to prevent kids from smoking and help smokers quit. The United States has significantly reduced smoking among both youth and adults, but 20.6 percent of adults and 19.5 percent of high school students still smoke.

Tobacco use is the leading preventable cause of death in the U.S., killing more than 400,000 people and costing $96 billion in health care bills each year.

More information, including the full report and state-specific information, can be obtained at www.tobaccofreekids.org/reports/settlements.

Most Hoosier Voters Would Vote For Candidates Who Favor Statewide Smoke-Free Law

In State News on October 19, 2010 at 1:11 pm

Below is a press release issued today by the American Cancer Society Cancer Action Network. For a complementary opinion piece, check out this Indy Star column.

Legislators have opportunity to align with constituents

Indianapolis, IN – Oct. 18, 2010 – A majority of Hoosier voters are more likely to vote for a state candidate who favors a statewide smokefree air law, according to the latest statewide poll conducted for the American Cancer Society Cancer Action Network (ACS CAN). When asked, 53 percent of Hoosiers polled said they are “much more likely” or “somewhat more likely” to vote for a candidate who supports smokefree air legislation.

“Clearly, Hoosiers continue to support clean indoor air and their willingness to take this issue to the ballot box only confirms how eager they are for their elected officials to take the appropriate action,” said Amanda Estridge, Indiana state government relations manager for the American Cancer Society Cancer Action Network. “There is no valid argument that can refute the numerous public opinion, health and economic studies that show the state would be better off all around with a comprehensive smokefree air law.”

The poll, completed by Bellwether Research & Consulting, polled Hoosiers statewide, all of whom are self-described likely voters this November.

Other significant findings of the statewide poll include:

1. Smoke-free air will not hurt Hoosier businesses. Ninety-two percent of those polled stated that they would be more likely or just as likely to visit establishments that will go smokefree under a statewide law. Sixty-six percent of those polled say their impression of restaurants and other establishments would improve if they convert to smokefree.

2. Employees should be protected from second-hand smoke. Over half of voters (54 percent) say secondhand smoke is a serious health hazard, while only five percent say it poses no hazard at all. Eighty-one percent of those polled believe that all employees have the right to breathe smokefree air at work, including in bars and casinos.

3. Restaurants, bars, and other establishments will be healthier if smokefree. Eighty-seven percent of those polled agree smokefree air will be healthier, while only 11 percent disagree.

Rep. Charlie Brown (D-Gary) and Rep. Eric Turner (R-Marion) are expected to introduce bi-partisan legislation banning smoking in all public places in Indiana. 

“A smokefree Indiana is long overdue,” said Brown. “We have an opportunity to make a profound difference in health of our state, for individuals as well as businesses that will benefit from a comprehensive smokefree law. We’ve seen our neighboring states go smokefree and do it successfully – Indiana has no excuse.”

“Smokefree air is not a Democrat or Republican issue,” said Turner. “It’s about ensuring everyone has the right to breathe smokefree air, no matter who they are or where they work. I encourage my colleagues in the General Assembly to do the right thing and make Indiana smokefree.”

Each year, more than 1,200 Indiana adult nonsmokers die from exposure to secondhand smoke. Food service workers are 50 percent more likely to develop lung cancer, largely because of exposure to secondhand smoke on the job. In terms of economic impact, secondhand smoke costs the state of Indiana more than $390 million each year, or $62 per taxpayer.

“Once again, a survey is showing that the people of Indiana want smokefree air,” said Danielle Patterson, chair of the Indiana Campaign for Smokefree Air. “It’s time for lawmakers to listen to their constituents, which they were elected to do, and support statewide smokefree legislation.”

The Bellwether Research poll was conducted October 7-10, and has a margin of error of + or – four percent. Interviews were conducted via landline and cellular telephones.

ACS CAN is the nonprofit, nonpartisan advocacy affiliate organization of the American Cancer Society, dedicated to eliminating cancer as a major health problem. ACS CAN works to encourage lawmakers, candidates and government officials to support laws and policies that will make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer. For more information, visit www.acscan.org.

Financial Toll of Smoking

In State News on October 4, 2010 at 10:30 am

Check out this article from Sunday’s Indianapolis Star: Financial Toll of Smoking Explored.

Smoking costs not just the smoker, but business, taxpayers, and our state as a whole. This is just one of many reasons that Indiana needs to continue allocating tobacco settlment dollars to the work of Indiana Tobacco Prevention and Cessation Agency, which provides cessation services to all Indiana residents through the Indiana Tobacco Quitline (1-800-QUIT-NOW).

This year, Indiana received $135 million from the Tobacco Master Settlement Agreement, and just $10 million was appropriated to ITPC for tobacco prevention work in our state. Research shows that tobacco control is a good investment for states; the more they spend on tobacco control, the lower the smoking rate, and the less they spend on tobacco-related healthcare costs. For more information about Indiana’s tobacco control programs, check out ITPC’s annual report.

New Study Finds That Smoking Costs Indiana $7.7 billion Annually

In State News on September 15, 2010 at 12:02 pm

 Here is a news release from the American Lung Association about recently-released study data.

New Study Finds That Smoking Costs Indiana $7.7 billion Annually

For every pack of cigerettes purchased at $5.13 it costs Indiana $15.90.

INDIANAPOLIS, IN — A new study released today by the American Lung Association, and conducted by researchers at Penn State University, finds that helping smokers quit not only saves lives but also offers favorable economic benefits to states.  The study, titled Smoking Cessation: the Economic Benefits, provides a nationwide cost-benefit analysis that compares the costs to society of smoking with the economic benefits of states providing cessation (quit-smoking) coverage.  The study comes at an important time, as important cessation benefit provisions are being implemented at the federal and state levels as a result of healthcare reform legislation.

Each year, tobacco use kills 9,700 people in Indiana, and this new study identifies significant and staggering costs directly attributable to death and disease caused by smoking.  For example, the study finds that smoking results in costs to the Indiana economy of more than $7.7 billion. This includes workplace productivity losses of $2 billion, costs of premature death at $3 billion, and direct medical expenditures of $2.6 billion.

The study also calculates the combined medical and premature death costs and workplace productivity losses per pack of cigarettes.  In Indiana, the retail pack of cigarettes is $5.13.  The costs and workplace productivity losses nationwide equal $15.90.

Smoking is the number one preventable cause of illness and death in Indiana and surveys show that 80 percent of tobacco users want to quit.  Quitting can often take several attempts before a smoker is successful.  Using evidence-based treatments increases smokers’ chances of quitting – but many smokers don’t have access to or don’t know about what kind of treatments are available to them.

“Given this demand, the ALA is redoubling its efforts to work closely with state leaders, health care organizations, educational institutions, and other partners in developing policies and programs to help smokers quit.” Says Bill Stephan, Chairman of the Board for The American Lung Association in Indiana.

In addition to identifying the staggering costs of smoking to the U.S. economy, this new study now provides state governments with compelling economic reasons to help smokers quit.  For example, the study finds that if Indiana were to invest in comprehensive smoking cessation benefits, each would receive, on average, a 19 percent return on investment.  In other words, for every dollar spent on helping smokers quit, states will see on average a return of $1.19. 

“The results of this study are staggering.  Smoking imposes a heavy financial burden on Indiana and in this time of economic crisis, we can no longer afford to supplement this dangerous habit. As a state we need to do better to help our citizens quit smoking,” State Representative Peggy Welch.  Welch is a member of the House Ways and Means Committee and the State Budget Committee.  She is also a practicing cancer nurse at Bloomington Hospital.

About the Study

Researchers at Penn State University with expertise in health economics and administration performed this cost-benefit analysis using government and other published data.  The analysis compares the costs of providing smoking cessation treatments (including price of medications and counseling and lost tax revenue) to the savings possible if smokers quit (including savings in health care expenditures, premature death costs, and productivity losses).

Funding for the study was provided through an unrestricted research grant from Pfizer Inc.

About the American Lung Association
Now in its second century, the American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease. With your generous support, the American Lung Association is “Fighting for Air” through research, education and advocacy. For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA (1-800-586-4872) or visit www.LungUSA.org.