Section B. Case Study: NY State Clean Indoor Air Act (CIAA) Case Study: New York State. Evaluating Smoke-Free Policies: Andrew Hyland, PhD

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1 Section B Case Study: New York State Case Study: NY State Clean Indoor Air Act (CIAA) Effective July 24, 2003 Requires indoor public places including bars and restaurants to be smoke-free Image source: The Rural Three for Tobacco-Free Communities. (2003). 2 1

2 What Happens When Places Go Smoke-Free? Evaluation questions Does SHS exposure decrease and health improve? Do people comply with the rules? Does the hospitality economy suffer? Unintended consequences Are smokers more likely to seek treatment services and stop smoking? Smoke more at home? 3 Measuring Air Quality Cigarettes, cigars, and pipes are major emitters of respirable suspended particles less than 2.5 microns (PM 2.5 ) in diameter that are easily inhaled deep into the lungs TSI SidePak AM510 personal aerosol monitor (weight: 1 pound) Image source: TSI Incorporated. (2007). 4 2

3 Measuring Air Quality: 5 Measuring Air Quality Images source: Hyland, A. 6 3

4 Evaluating Smoke-Free Policies: Andrew Hyland, PhD Measuring Air Quality Images source: Hyland, A. 7 Measuring Air Quality: China Image source: Hyland, A. 8 4

5 Evaluating Smoke-Free Policies: Andrew Hyland, PhD Measuring Air Quality: Greece Image source: Hyland, A. 9 Measuring Air Quality: Romania Romanian colleague carrying the TSI SidePak (in shoulder bag) before setting out to collect data Image source: Hyland, A. 10 5

6 Evaluating Smoke-Free Policies: Andrew Hyland, PhD Measuring Air Quality: Media Coverage Data from air monitoring studies is used to educate the public about the dangers of secondhand smoke in: News articles Editorial support Image sources: (left to right): St. Petersburg Times. (May 23, 2004); Corning Leader. (May 21, 2004); Tacoma News Tribune. (May 21, 2004). 11 Measuring Air Quality: Media Coverage Image source: Chicago Sun-Times. (October 25, 2005.) 12 6

7 Measuring Air Quality: Media Coverage Image source: USA Today. (October 18, 2005). 13 U.S. EPA Air Quality Index Air Quality Good Moderate Unhealthy for sensitive groups Unhealthy Very Unhealthy Hazardous PM 2.5 (µg/m 3 ) None Health Advisory Unusually sensitive people should consider reducing prolonged or heavy exertion People with heart or lung disease, older adults, and children should reduce prolonged or heavy exertion People with heart or lung disease, older adults, and children should avoid prolonged or heavy exertion; everyone else should reduce prolonged or heavy exertion People with heart or lung disease, older adults, and children should avoid all physical activity outdoors; everyone else should avoid prolonged or heavy exertion People with heart or lung disease, older adults, and children should remain indoors and keep activity levels low; everyone else should avoid all physical activity outdoors 14 7

8 Worst Forest Fire in Colorado History: June 8, Hayman Fire: Colorado Denver Image source: The American Society for Photogrammetry and Remote Sensing. (2002). 16 8

9 Evaluating Smoke-Free Policies: Andrew Hyland, PhD Hayman Fire: Colorado Visibility in Denver: one day before Hayman Fire Image source: Colorado Department of Public Health. (2002). 17 Hayman Fire: Colorado Visibility in Denver: one day after Hayman Fire Worst PM2.5: 4.3 µg/m3 (24 hour maximum) or 200µg/m3 (hourly maximum) Image source: Colorado Department of Public Health. (2002). 18 9

10 Indoor Air Quality Improvement Source: adapted by CTLT from The U.S. Center For Disease Control MMWR. (2005). 19 Average Level of PM 2.5 Source: adapted by CTLT from Hyland, A. Original Data. Unpublished

11 Average Fine Particle Air Pollution by Region Source: adapted by CTLT from Hyland, A. Original Data. Unpublished. 21 Reduced Nicotine Exposure Biomarkers Source: adapted by CTLT from Farrelly, M., et al. (2005)

12 Decreased Reported Symptoms of SHS Exposure Source: adapted by CTLT from Farrelly, M., et al. (2005). 23 Decreased Reported Symptoms of SHS Exposure Source: adapted by CTLT from Farrelly, M., et al. (2005)

13 What Happens When Places Go Smoke-Free? Evaluation questions Does SHS exposure decrease and health improve? Do people comply with the rules? Does the hospitality economy suffer? Unintended consequences Are smokers more likely to seek treatment services and stop smoking? Smoke more at home? 25 Support for the Clean Indoor Air Act in New York State Source: adapted by CTLT from New York State Department of Health. (2004)

14 Reported Smoking in Various Locations Source: adapted by CTLT from New York State Department of Health. (2004). 27 What Happens When Places Go Smoke-Free? Evaluation questions Does SHS exposure decrease and health improve? Do people comply with the rules? Does the hospitality economy suffer? Unintended consequences Are smokers more likely to seek treatment services and stop smoking? Smoke more at home? 28 14

15 Predictions of Economic Doom Eateries say ban on smoking is killing them By CRAIG SCHNEIDER ADVANCE STAFF WRITER Many Staten Island restaurants appear to be obeying the new law to extinguish smoking. But some owners are afraid that, instead of cigarettes, their profits are going up in smoke. Business is slipping. People like to come in here and have a cigarette and some coffee. Now they can t. said Suzette Linde, manager at Mike s Place in New Dorpe. Some people are going outside for a smoke. So now we are getting complaints about cigarette butts in the street. Several restaurant owners said they ve seen business fall off 10 percent or more since the ban on butts. And they worry there are more blows to come. Nineteen of 20 Staten Island restaurants visited at random by the Advance yesterday appear to be obeying the city s new anti-smoking ban. Ashtrays are off the tables, no-smoking signs are posted, and waitresses are regularly Source: Staten Island Advance. (1995). 29 Likelihood of Patronizing Bars Following CIAA Source: adapted by CTLT from New York State Department of Health. (2004)

16 Likelihood of Patronizing Restaurants following CIAA Source: adapted by CTLT from New York State Department of Health. (2004). 31 Employment in Hospitality Industry: New York Source: adapted by CTLT from New York State Department of Labor and the U.S. Census Bureau ES-202 Data Set (NAICS 722)

17 Employment in Drinking Places: New York, New Jersey Source: adapted by CTLT from the New York State Department of Labor; New Jersey Department of Labor and Workforce Development; US Census Bureau. 33 Liquor Licenses Granted: New York Source: adapted by CTLT from the New York State Department of Health. (2004)

18 What Happens When Places Go Smoke-Free? Evaluation questions Does SHS exposure decrease and health improve? Do people comply with the rules? Does the hospitality economy suffer? Unintended consequences Are smokers more likely to seek treatment services and stop smoking? Smoke more at home? 35 New York State (NYS) Clean Indoor Air Act (CIAA) Record drop in consumption in New York City Confluence of clean air, tax increase, media campaign, and free nicotine replacement therapy Hard to sort out the independent effect of clean air 11% consumption drop one year after New York City smokefree law took effect 36 18

19 Relative Risk for Quitting Source: adapted by CTLT from Bauer, et al. (2005). 37 Smoking Cessation Indicators: NRT Sales Source: adapted by CTLT from Metzger, et al. (2005)

20 Smoking Cessation Indicators: Quitline Calls 39 New York State (NYS) Clean Indoor Air Act (CIAA) Image source: The Rural Three for Tobacco-Free Communities. (2003)