The Texas Legislature is again, for the fifth session in a row, considering a statewide ban on smoking in public places. One of the important concerns is whether this is yet another example of government intrusion. It is not, and Texans will be healthier if a statewide ban passes.
It’s been more than 50 years since the first surgeon general’s report on tobacco and health. Yet, tobacco use, primarily from cigarette smoking, is still the leading preventable cause of death in the United States.
Why is this? Are we not talking about the dangers of smoking anymore? You could ask almost anyone if it’s a good thing to smoke cigarettes, and they will say no. (I even asked my 6-year-old son, and he said no.)
Unfortunately, knowledge of the potential harmfulness of cigarette smoking is not enough. Although the prevalence of cigarette smoking has declined dramatically during the past 20 years, the latest data show there were still at least 56 million Americans who were current cigarette smokers in 2013. The prevalence of smoking was highest among adults aged 21-34; about 1 in 3 had smoked a cigarette at least once in the past month.
More than 15 years ago, an expert in public health law established a series of criteria that should be met in order to consider public health regulation. If at any point the answer is no, there should be pause for debate.
Does the behavior demonstrate a significant risk? Absolutely. We have decades of studies supporting the link between cigarette smoking and negative health outcomes.
Is the regulation effective? Yes. Most of this information has focused on the impact of secondhand smoke. Studies have shown that when a ban is enacted, exposure to secondhand smoke decreases.
In addition to decreasing the likelihood of nonsmokers being exposed to toxic cigarette smoke, my research has shown that comprehensive indoor smoking bans also decrease the overall prevalence of cigarette smoking. In other words, these bans may help smokers decrease their personal health risk as well.
Are there reasonable economic costs of the regulation compared with the benefits? This is an important concern for Texas. But do smoking bans reduce patronage? A study done in Austin in 2007 showed that revenue stayed stable after the passage of the city’s smoking ban, and the same was shown in El Paso. After Wisconsin passed its statewide indoor smoking ban, bars and restaurants actually showed an increase in revenue.
On the flip side, we know that cigarette smoking costs the state of Texas billions of dollars a year in health care costs and worker productivity losses.
Given that nearly two-thirds of states are now considered “smoke-free” states, we should be concerned that less than 45 percent of our state’s population is protected by smoke-free legislation compared with the national average of 80 percent.
Are there reasonable personal burdens due to the regulation compared with benefits? This is where the discussion should be focused. Is it reasonable to ask an individual to refrain from smoking in a public location such as a bar, restaurant or music venue given the known risks of smoking to both that individual and the people in close proximity? Is it reasonable to ask business owners to take the risk of supporting a ban when it’s unknown whether revenue will increase or decrease? Is it reasonable to inconvenience an individual now by asking that person to refrain from smoking, knowing that the personal gain in the long term will be positive?
Simply put, I would answer yes. It is critical in this discussion that we listen to all opinions, but keep the debate focused on the balance between personal burdens and benefits. The research clearly supports that comprehensive indoor smoking bans are an important public health measure that is best for our communities. Texas should adopt a statewide ban, and policymakers would be wise to support it.
Jessica Duncan Cance is an assistant professor of health behavior and health education in the College of Education at The University of Texas at Austin.
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Smoke-free legislation needs to pass in Texas says @utexascoe prof in new op-ed. https://t.co/25xLGRxs5y. #smokefree
— Texas Perspectives (@TexPerspectives) April 23, 2015