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Tennesseans will be breathing easier now that lawmakers have joined the national bandwagon to nip smoking in the bud, effective Oct. 1.

Phyllis McNeill, manager of environmental sanitation for the Memphis and Shelby County Health Department, said enforcement in Memphis is going smoothly.

“Because we introduced the act to food service operators and operators of other establishments we regulate well before Oct. 1, they are conforming to the law,” she said. “We’ve investigated a few complaints from the public, but upon investigation found that the operators are legally exempt and are conforming to the law by only allowing in patrons who are 21 or older.”

The Tennessee Non-Smokers Protection Act, signed into law on June 11 by Gov. Phil Bredesen, makes it illegal to smoke in nearly all public places around the state with very few exceptions.

Restaurants, indoor and outdoor sports arenas, retail shops, hotels, motels, all educational facilities both public and private, lobbies, reception areas, child and adult day care facilities, restrooms, healthcare facilities and even common areas in multi-unit residential facilities are now off limits to smokers.

The few exceptions where owners may allow smoking are bars that serve people 21 years of age and older, smoking rooms in hotels and private clubs, and some open areas such as patios, porches or decks.

Employers, including physicians offices, are required to post “No smoking” signs at every entrance. Employees must be notified that there are no exceptions and patrons or customers who are found smoking on the premises must be informed that it is prohibited.

The American Heart Association reports that cigarette smoking accounts for nearly 440,000 of the more than 2.4 million annual deaths, of which more than 135,000 are due to smoking related cardiovascular diseases. Cigarette smokers are two to three times more likely to die from coronary heart disease than nonsmokers.

The Tennessee Department of Health Division of Health Statistics reports that 26 percent of Tennesseans still use tobacco products. Lung cancer was the number one cancer killer in the state in 2005, killing more than 4,000 Tennesseans and accounting for one-third of all cancer deaths that year.

Not only is it costly to lives, annual direct health costs in Tennessee from smoking is $2.16 billion annually. The portion covered by the state Medicaid program totals $680 million. Residents’ state and federal tax burden from smoking-caused government expenditures equaled $614 per household and caused $2.74 billion in productivity losses in Tennessee alone.

Tennessee Commissioner of Health Susan R. Cooper said the law may be the single most significant public health achievement Tennessee will see in our lifetime.

“Tobacco use is taking a significant human and financial toll in our state,” said Cooper. “Tennessee’s poor health indicators and their associated health costs, as well as increased use among our teens, prove the need to reinforce our efforts to prevent tobacco use. The Department of Health supports this law and all efforts to promote prevention and cessation of tobacco use among Tennessee’s citizens.”

Both the Tennessee Department of Health and the Tennessee Department of Labor and Workforce Development have authority to enforce the law.

A first offense by a an employer that fails to comply with the requirements will be subject to a written warning from the Department of Health or the Department of Labor and Workforce Development. A second violation within a 12-month period will subject them to a civil penalty of $100 and a third within the period will result in a $500 penalty.

In an Oct. 1 letter to colleagues, Cooper said:

“In Tennessee, there are more than 1 million adult smokers, many of whom have tried to quit but have failed. Tennessee has the third highest smoking rate in the nation. As a healthcare provider, you know the impact that tobacco has on one’s health. It leads to many diseases such as asthma, emphysema, heart disease, lung cancer, and sudden infant death syndrome. You are one of the most important sources of information for your patients and their families on health issues and risks. Smokers need help to quit, but less than half of smokers who were advised to quit were given tools to assist them. You have the ability to aid your patients in reducing smoking and tobacco use. Today is the day that we should all start with a clean health slate.”

To help patients quit, a two-page reference for tobacco dependence staging, cessation counseling and medications is available on the Quitline site at: http://health.state.tn.us/tobaccoquitline.htm. Select menu item: Resources for Healthcare Professionals, Healthcare Providers Guide. If you are in a specialty practice and do not offer cessation services, please refer your patients to their primary care provider or the local health department for cessation management.




December 2007

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