Study outlines historical barriers to tobacco prevention in Kentucky and other tobacco-growing states

A University of Kentucky College of Nursing study published in The Milbank Quarterly has shown that five major tobacco-growing states—Kentucky, North Carolina, Virginia, South Carolina and Tennessee—fall behind the rest of the states in enacting laws to reduce tobacco use.

Tobacco and the diseases it causes affect those five states more than others across the nation, and tobacco is the leading cause of preventable death in the U.S. Those states also have fewer smoke-free laws and lower tobacco taxes, which are two evidence-based policies that help reduce tobacco use, write the authors, Amanda Fallin and Stanton A. Glantz.

The researchers used five case studies chronicling the history of tobacco-control policy "based on public records, key informant interviews, media articles and previously secret internal tobacco industry documents available in the Legacy Tobacco Documents Library," they write.

They found that beginning in the late 1960s, tobacco companies focused on creating a pro-tobacco culture to block tobacco-control policies. However, since 2003, tobacco-growing states have seen passage of more state ad local smoking bans, partly because the alliance between tobacco companies and the tobacco farmers dissolved and hospitality organizations stopped objecting to such bans. National Cancer Institute research projects also built infrastructure that led to tobacco-control coalitions. "Although tobacco production has dramatically fallen in these states, pro-tobacco sentiment still hinders tobacco-control policies in the major tobacco-growing states," the researchers write.

To continue the progress, health advocates need to teach the public as well as policymakers about "the changing reality in the tobacco-growing states, notably the great reduction in the number of tobacco farmers as well as in the volume of tobacco produced," Fallin and Glantz write. Kentucky once had about 50,000 tobacco farmers; today it has about 5,000, and production is dominated by large farmers. The study is behind a paywall; to read its abstract, click here.

Lake Cumberland District Health Department using polls in an effort to get school boards to make campuses tobacco-free

Countywide smoking bans are unlikely to pass anytime soon in most of rural Kentucky, but more county school districts are making their campuses tobacco-free. Now a multi-county health department is trying to get rural school boards to do that, with public-opinion polls showing that county residents overwhelmingly favor the move.

Department logo has been altered to
show Clinton County in yellow.

The Lake Cumberland District Health Department conducted the poll in Clinton County, and said it found that 86.55 percent were in favor and 7.16 percent were opposed. The rest had no opinion.

Making a campus tobacco-free means that members of the public are not free to smoke at school athletic events, so the poll also asked, “Would you like to see our school become tobacco-free at all events?” The results were virtually the same: 85.3 percent answered yes and 8.7 percent answered no, even though one-fourth to one-fifth of the county's residents smoke and it has a long history of raising tobacco.

"The results are perhaps surprising to some, considering the rate of tobacco usage in the county," reports the Clinton County News. The poll of 749 residents has an error margin of plus or minus 3.6 percentage points.

The department also surveyed 100 teachers in the school system and found that 77 percent would "definitely" support making the schools 100 percent tobacco-free.

The health department presented the survey and other findings to the Clinton County Board of Education June 15, but the board took no action. The department noted that a recent survey found that 28 percent of the county's students in eighth through 12th grades had used smokeless tobacco in the previous 30 days. "That level was the highest in the Lake Cumberland District," the Clinton County News reports.

The Casey County Board of Education adopted a smoke-free policy after a poll by the health department showed 70 percent of the county's residents favored it, the Casey County News reported.

Bourbon Co. teen named South's top youth anti-tobacco advocate for his efforts in pushing for county smoking ban

Tyler Boyle (Photo from
Lexington Herald-Leader)

Tyler Boyle, a Bourbon County High School senior and president of Students Making A Change in the Community, was named the South Region Youth Advocate of the Year by the Campaign for Tobacco Free Kids for his efforts to push a smoking ban in Bourbon County, Lashana Harney reports for the Lexington Herald-Leader.

Boyle has been a part of SMACC since it was re-established in 2013. The club is a place for youth voices to be heard on smoking issues, with the ultimate goal of a countywide smoking ban -- but in the meantime, working for a school regulation that would ban electronic cigarettes.

The smoking ban has yet to pass, but the schools have added e-cigarettes to their comprehensive tobacco policy, which banned tobacco products of any kind on school grounds.

Boyle told the Herald-Leader that he applied for the award in hopes of bringing more attention to the anti-tobacco cause in his county, which has a long history of tobacco production and sales.

"I applied for this award because of all of the work that I've done in my home community and state for tobacco control," he told Harney. "I thought that if I could make national attention, maybe, it would make the officials in my community take this issue more seriously."

Boyle said that he was honored to receive the award, which was presented at a gala in Washington, D.C., in mid-May. He plans to attend a symposium sponsored by the Campaign for Tobacco Free Kids in Washington in July and the Philip Morris Cos. international shareholder meeting next May.

Boyle told Harney that sometimes he gets frustrated because change is slow to take place, but the will to keep pushing forward always comes back.

"After attending the award gala, I was revitalized and I'm ready for the next step in tobacco control," he said.

Boyle will attend Vassar College in the fall to study political science with a focus on advocacy work and said he would continue his work with the Campaign for Tobacco Free Kids.

"Tobacco advocacy is something near to my heart," Boyle said. "Vassar is actually going smoke free in July 2015. So, I plan to work hard to implement and support their new policy."

Elementary-school students prompt Middlesboro smoking ban

UPDATE, May 20: The council passed the ban with one member opposing it. Gary Mills said, “I don’t think it’s the government’s right to intrude on businesses owned by individuals. If the public doesn’t like it, they won’t come. . . . This is too intrusive by the government.” Two non-smoking business owners expressed similar sentiments.

The Middlesboro City Council has approved on first reading an ordinance that would ban smoking in public, enclosed spaces. "It remains unclear if the ban would apply to the use of e-cigarettes and vaping products," William Tribell reports for the Middlesboro Daily News.

The ordinance was prompted in part by a March presentation and petition from a group of Middlesboro Elementary School students involved in Destination Imagination, "a volunteer-led, educational nonprofit organization whose purpose is to inspire and equip students to become the next generation of leaders," Tribell writes. "The team was awarded the DaVinci Award for Outstanding Creativity for their efforts and will now compete at the world competition May 20 in Knoxville."

The students drafted the ordinance after researching those in other cities, Tribell reports: "In their presentation to the city council, the team said that 33 percent of Bell County’s population smoke, and they discussed the health effects it has on the community at large."

"The council voted unanimously in favor of the ban ordinance, and it will go up for a second-reading vote at their meeting on May 19," Tribell reports.

Burgin, in heart of Kentucky, is state's 40th school district to go tobacco-free; ban, won by students, applies to vapor products

Burgin Independent Schools, in the heart of Kentucky, will be the latest 100 percent tobacco-free schools in the state, and the first in Mercer County, which has a strong tobacco heritage.

The Burgin Board of Education voted April 8 to ban all tobacco use, including vapor products, on school grounds and during school-related student trips, Robert Moore reports for The Harrodsburg Herald. The policy becomes effective July 1 and includes any building or vehicle owned or operated by the board and applies to any renters of school property.

Burgin will be the 40th Kentucky school district to become fully tobacco-free. Kentucky has 173 public- school districts, with 1,233 public schools, according to the state Department of Education.

The Kentucky 100 percent Tobacco-Free Schools website says, "Studies show that schools with 100 percent tobacco-free school policies for three years of more have 40 percent fewer smokers than those in non-tobacco free school districts." The 2013 Kentucky Youth Risk Behavior Survey found that 18 percent of Kentucky youth smoke, and 47 percent of them have smoked at least once.

"I’m really proud we’re going to be a tobacco free campus," board member Priscilla Harris told the Herald after the meeting. "We want to set a good example." The independently owned weekly newspaper recently did a three-part series on tobacco in the county, including Burgin students' efforts to get tobacco banned.

Kentucky 100 percent Tobacco Free Schools map, with Burgin added

Beshear cites signs toward better health: kids are more active and getting more dental care; adults are getting more screenings

Kentucky Health News

Kentucky is moving toward achieving the broad, ambitious goals for better health that Gov. Steve Beshear laid out when he started the "Kyhealthnow" initiative in February 2014, his office says.

"More Kentuckians have health insurance, are covered by smoke-free policy, can access physical activity resources, seek care for heart disease and cancer prevention, and get dental services" since the initiative began, Beshear said in a press release.

The program builds on federal health reform, which has made Medicaid or private insurance available to hundreds of thousands of Kentuckians, many of whom were previously uninsured and unable to afford health coverage. According to a Gallup Poll released in February, 9.8 percent of Kentucky’s population is uninsured, down from 20.4 percent in 2013.

Kyhealthnow targets seven major health goals to be met by 2019, focusing on increasing health insurance coverage; reducing the smoking rate and tobacco use; lowering the prevalence of obesity; lowering cancer deaths; reducing cardiovascular disease; treating and reducing dental decay; and reducing drug overdoses and mental health issues in Kentucky.

The report said more adults have been screened and identified as having high blood pressure and are able to control their hypertension, and more adults have had their cholesterol checked.

Significantly more children on Medicaid are being seen by dentists, and the number of children enrolled in Medicaid receiving two fluoride dental varnishes per year has increased. The state has given money to five health departments for dental-hygiene programs, and will fund five more this year. "These programs broaden access to hygiene services, such as cleanings, screening and referrals, by providing staff and resources to supply mobile units to deliver care in schools," the release said.

School districts are showing an increase in the amount of time devoted to physical activity, the state reports. The Comprehensive School Physical Activity Program has been implemented at proficient or distinguished levels at all grade levels in 515 of the state's 746 elementary schools, 186 of the 329 middle schools and 109 of the 228 high schools. Also, more schools report they are using body-mass index data to inform school wellness policy.

The state health department is using federal funds to implement physical activity and obesity-prevention curricula in early-childhood care centers. "The goal is to develop healthy habits in children before the age of 5 and prevent obesity," the news release says.

To increase physical activity and deter obesity among older children and adults, the state is establishing “trail towns.” Morehead and Olive Hill were recently certified by the state Office of Adventure Tourism and eight more are expected to be certified this year. The Dawkins Trail, an ongoing rail-to-trail project in Eastern Kentucky, has reached a length of 18 miles.

Diabetes management has improved among adults, and a study of Medicaid patients showed an overall decrease in those with poor diabetes control, the release said. State employees now have easier access to the nationally recognized Diabetes Prevention Program, which helps people who are at risk of developing diabetes reverse the onset of the disease.

Dr. Stephanie Mayfield, the state health commissioner and vice chair of Kyhealthnow, has emphasized the importance of reducing tobacco use to make Kentuckians healthier. Beshear has expanded the ban on tobacco products and e-cigarettes on executive branch properties, making Kentucky one of only five states in the country with such a policy. Smoking bans exist in 24 communities, 37 school districts and 51 college or university campuses.

Kyhealthnow, chaired by Lt. Gov. Crit Luallen, includes people from many areas of state government who develop innovative strategies for addressing the state’s health woes and challenge local governments, businesses, schools, nonprofits and individuals to take meaningful steps toward improving health in their communities, the release said.

Kenton County Schools ban use of tobacco

The Kenton County Board of Education voted unanimously March 2 to approve a smoke-free policy immediately prohibiting the use of tobacco on school property, in board-owned vehicles and on school-related trips.

“We have a responsibility to model healthy behavior for students,” Supt. Terri Cox-Cruey told the Community Press and Recorder. "Jess Dykes, director of public relations and community engagement, said the request for the district to become smoke-free came from Gov. Steve Beshear," reporter Melissa Stewart writes. "The governor has requested all school districts to consider the policy change."

Dykes said Kenton County joins six other Northern Kentucky school districts with a smoking ban: Grant County, Beechwood, Dayton, Carroll County, Gallatin County and Williamstown.

Harrodsburg Herald, a weekly newspaper, does three-part series on tobacco issues in Mercer County and statewide

In a state where more than one of every four adults smoke, tobacco is an issue in every county, but it's rare for weekly newspapers to take a detailed look at the issue. The Harrodsburg Herald did that recently, in a three-part series by Robert Moore.

Moore explored why Mercer County and the state have relatively little money for tobacco prevention, writing, "Kentucky doesn't seem all that interested in fighting tobacco. In 2014 the state will receive $158.7 million in tobacco settlement money and spend only $2.5 million to help smokers quit and prevent kids from starting, according to the Kentucky Center for Smoke-free Policy."

The states' lawsuit against cigarette manufacturers, and the Master Settlement Agreement that followed, was ostensibly to recover their costs for treating illnesses due to smoking. However, most of the money has gone to general purposes, and in Kentucky half the money was dedicated to improving the agricultural economy — but the legislature steered some of that money elsewhere, mainly for rural water lines, Moore noted.

"The largest single use of tobacco funds now is debt service," he wrote. "Every year, $28 million of the MSA payment goes to pay interest on $434,883,200 in outstanding municipal bonds. The bonds financed various construction projects over the last decade—$20 million for construction of the UK Veterinary Diagnostic Center in Lexington and $2 million for renovations to the FFA Leadership Training Center in Hardinsburg, both in 2008."

Another story explored the growing phenomenon of electronic cigarettes, and the other looked at efforts to curb smoking, statewide and locally. Moore looked at lobbying and campaign-finance reports from Altria Group, the leading cigarette manufacturer, and wrote about efforts by the Burgin High School chapter of Teens Against Tobacco Use to have smoking banned on their campus.

In a more recent story, Moore updated the Burgin issue, concluding, "Until something changes in the state legislature, schools like Burgin will be the most important battlegrounds in the fight against tobacco-related deaths."

Opinion: Toward a healthier Kentucky, with a smoke-free law

By the Friedell Committee for Health System Transformation 

It is no secret that Kentucky is among the unhealthiest states in our country. 

Kentucky is No. 7 in cardiovascular deaths, No. 1 in cancer deaths, No. 1 in lung cancer, and No. 13 in asthma prevalence. And Kentucky leads the nation in smoking with 26.5 percent of its adult population.

Even non-smokers are at risk of diseases caused by tobacco. Exposure to secondhand smoke increases the risk of coronary heart disease by 25 to 30 percent among nonsmokers.  It increases the risk of lung cancer in nonsmokers by 20 to 30 percent. 

This means that waitresses and bartenders (most of whom do not smoke) in workplaces that allow smoking risk their lives just to earn a paycheck.  Sadly, 68 percent of Kentuckians are currently exposed to secondhand smoke in public places.  At this rate it is no wonder that Kentuckians suffer serious and deadly consequences.

Fortunately, we have scientific evidence that a smoke-free law will reduce disease rates in areas where such a law is in effect. Communities that pass comprehensive smoke-free workplace laws have experienced a 15 percent drop in emergency-room visits for heart attacks.  ER visits for asthma dropped by 22 percent in Lexington after the smoke-free law was enacted. 

Also, adult smoking rates declined by 32 percent in Lexington, saving $21 million per year in health care costs! While a decrease in smoking rates is not the primary reason for secondhand smoke-free laws, many people express an interest in stopping, and the laws make quitting easier.

Our poor health is a problem that affects us all.  It affects our health-care costs, our community health, and a national perception of us as being an unhealthy place to invest in and live.  That problem can be addressed by smoke-free local ordinances, a state law, and/or local boards of health regulations. 

The Affordable Care Act presents a unique opportunity to look at health differently.  We need to start emphasizing prevention of diseases rather than relying only on treatment.  Smoke-free policy is one effective type of prevention. We know that prevention will save lives and reduce health care costs borne by individuals, private business and the government. 

The Saving Our Appalachian Region effort in Eastern Kentucky reminds us that Kentucky can do better.  Going smoke-free is one way. Imagine a Kentucky where no one is exposed to smoke in the workplace and where fewer people actually smoke.  Lives would be saved, diseases would be prevented, and health care costs would decrease.

Thankfully, most Kentuckians agree. Statewide polls show that 66 percent of likely voters are in favor of a smoke-free law.  This makes sense since most Kentuckians do not smoke.  It is time for the state legislature to implement a policy that will improve our health, save lives and reduce health costs.

The Friedell Committee for Health SystemTransformation is an organization of community leaders across the state that knows that Kentucky is not a healthy state but that working together we can do something about it.

Hope is high for a House floor vote and passage of a statewide smoking ban, but the Senate remains doubtful

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. -- A bill to ban smoking in public places and places of employment is headed to the House floor yet again, and its sponsor says it will finally get a vote. But its chances in the Senate remain doubtful.

Rep. Susan Westrom

"I feel very confident that we will get a floor vote," Rep. Susan Westrom, D-Lexington, five-year sponsor of the legislation, said after Thursday's committee meeting. "I am shooting for next Wednesday."

House Bill 145 passed the Health and Welfare Committee 11-4, with all Democrats and two Republicans on the panel for it and four Republicans opposed.

Westrom said the bill is not a smoking ban, but simply asks smokers to step 15 feet outside to smoke. She said, this is "not a huge sacrifice, but the benefits are so incredible."

The bill also requires those smoking electronic cigarettes and hookahs to step outside, which could cause a "battle," Westrom said.

The legislation got to the House floor last year, but didn't get a vote, and has never gotten out of committee in the Senate. Polling shows a clear majority of Kentuckians support banning smoking in indoor public places, but almost 30 percent of Kentuckians smoke, tops in the nation. The state also is No. 1 in lung cancer and deaths from it.

Two Republican senators, pediatrician Ralph Alvarado of Winchester and lawyer Julie Raque Adams of Louisville, chair of the Senate Health and Welfare Committee, sat with Westrom and Rep. David Watkins, D-Henderson, a retired physician, before the committee.

Alvarado gave an impassioned reading of his op-ed that was in the same day's Lexington Herald-Leader to the committee. "Smoking is killing Kentucky, literally and fiscally," he said.

He said an estimated 950 Kentuckians die every year because of secondhand smoke; exposure to it costs Kentucky more than $128 million every year; children exposed to secondhand smoke suffer from repeated ear infections, bronchitis, pneumonia and asthma; and secondhand smoke is a proven cause of heart disease, cancer and stroke in non-smoking adults.

By passing the bill, "The General Assembly can save more lives with this legislation than I can throughout my entire medical career," Alvarado said. Democratic Gov. Steve Beshear supports it.

Adams, who will be sponsoring the legislation in the Senate, told the committee, "We need to see a vote on the floor. We need to talk to our senators. We need to keep up the advocacy because Kentuckians deserve better."

Senate Republican Floor Leader Leader Damon Thayer told Jack Brammer of the Herald-Leader that there is "not much sentiment" for the bill in the Senate: "Let the free market work this out."

Republican Bob DeWeese, a doctor from Louisville, voted for the bill. He said the title of representative was fleeting, but "I'm a doctor for life."

Newly elected Rep. George Brown Jr., D-Lexington, noted that he voted against the smoking ban in Lexington many years ago. "Since that time, I've had an awakening and I understand that the collective rights of citizens are much more important than those of individuals."

Rep. Robert Benvenuti III, R-Lexington, said "liberty interests have to be balanced" between the rights of smokers to smoke in the workplace versus the rights of others to be healthier.

Newly elected Rep. Phil Moffett, R-Louisville, said "I support it at the local level and that is where is should reside," and asked Westrom why the legislature shouldn't just make tobacco illegal "if it is that devastating."

Westrom suggested Moffett ask the Kentucky Farm Bureau Federation about that. She said in December that Farm Bureau has been the main obstacle to the bill.

About 5,000 farmers in Kentucky grow tobacco, a greatly reduced number from the days of the federal tobacco program, which ended 10 years ago. Farm Bureau spokesman Dan Smaldone said in December that the organization continues to oppose the legislation because it invades the private-property rights of business owners.

Asked why a farm organization cares about that, Smaldone wrote in an email, "KFB's membership supports policy for rural issues that fall outside of the agriculture industry, including educational and economic issues that impact their local communities. The organization has policy on the issue because its membership determined it was important to take a position on it."

As for the local approach, Westrom said after the meeting that too many local communities have not taken the initiative to pass smoking bans.

About one-third of Kentuckians are covered by strong local smoke-free laws, with 24 communities with smoke-free laws that cover all workplaces and enclosed public places, according to the Smoke-Free Kentucky Coalition website.

Westrom, Alvarado and committee Chair Tom Burch, D-Louisville, said they thought the bill would pass the House, but none were sure about the Senate. Westrom noted that Senate President Robert Stivers, R-Manchester, has been vocal against the bill.

"The wonderful thing about Sen. Stivers is that he understands how important the cancer research center is at the University of Kentucky," Westrom said, noting Stivers' call to reopen the 2014-16 state budget to authorize the project: "If we are going to invest that amount of money for a cancer research center, the best thing we can do . . . is make sure the entire state is setting the example of a smoke-free state."

Smoke-Free Kentucky Chair Amy Barkley said, "If the House passes it and puts the ball in their court . . . I'm just going to be optimistic that they will listen to their voters. We know that 66 percent of the voters support a statewide smoke-free law and that crosses all parties and regions of the state." That is the figure in the latest Kentucky Health Issues Poll; a Bluegrass Poll put the figure at 57 percent.

Public opinion will make the difference this year, Westrom said. "Some portions of the state are more that 74 percent approval; 70 percent of the people who used to smoke are in favor of this; and an average of 60 percent of those in rural areas are in favor of smoke-free."

Newport school board's smoking ban, which includes e-cigarettes, would be 38th among 173 Kentucky school districts

The Newport Independent Board of Education passed the first reading of a proposed smoking ban Wednesday, Jan. 28 after adding electronic cigarettes to the ban.

The ban would prohibit smoking on any school campus, including parking lots, cars and the bus garage, and no smoking will be permitted by any groups who rent or meet on any school properties.

The second reading of the ban will be in February and if passed will go into effect July 1, Patricia A. Scheyer reports for The River City News.

"I do expect that it will pass," Superintendent Kelly Middleton told Scheyer. "I haven't had anyone say anything against passing it, and in fact, I have had a couple of comments in favor of it."

If passed, the "Newport school district will be the 38th school district out of Kentucky's 173 districts to become smoke free, joining Beechwood and Dayton Independent schools locally," Scheyer reports.

Weekly paper in Carter County runs voluntary-response survey about statewide smoking ban, finds slim majority in favor

Wikipedia map: Carter County

The Journal-Times, the weekly newspaper in Carter County, is running an online "poll" of reader opinions about the proposed statewide smoking ban and finding a slim majority in favor of it. At 4:20 p.m. Sunday, 52.3 percent of the voluntary respondents said they favored the legislation, while 45.4 percent said they opposed it and 2.3 percent said they didn't care.

Despite those numbers, reporter Leeann Akers writes that the idea "seems to be unpopular in Carter County," based on "overwhelming opinion on social media." She cites the Facebook page of the Carter County Citizens For a Better Way and this post from Brandon Boggs: “If a business wants to prohibit smoking they have that right, however, we have the right to support that business or not depending on our personal preferences.”

Some posters on the page favor the ban. Travis Horton wrote: "I as a nonsmoker think people that smoke in restaurants or in businesses are showing disrespect for people with health issues and other things."

A continuing national survey by the federal Centers for Disease Control has found that between 31 and 46 percent of Carter County residents smoke, with the most likely number being 38 percent, well above the statewide figure of 29 percent in the same survey.

Akers reports that the county's two state legislators, "Sen. Robin Webb and Rep. Jill York, both say they remain undecided on how they will vote if it comes to the floor but both have a history of following their voters." She gives the legislators' email addresses and the telephone number to leave a message for them.

"This is the sort of story that most local newspapers with websites can do," said Al Cross, director of the Institute for Rural Journalism and Community Issues, publisher of Kentucky Health News. "But I suggest that they avoid calling any voluntary-response survey a poll, because that word implies that the results are from a scientific, random sample, and that they remind readers of that in giving the results."

Hopkinsville newspaper says it's time for legislators to capitalize on strong public support for a statewide smoking ban

Noting the results of a poll that show two-thirds of Kentuckians support a statewide ban on smoking in public places, the Kentucky New Era of Hopkinsville said in an editorial, "It is time to capitalize on the public’s support for smoke-free legislation."

The locally owned daily, in a town where tobacco remains influential, said "Kentucky lawmakers — especially those from rural areas where tobacco interests have political influence and where residents value private property rights — have been reluctant to expose themselves to any backlash from opponents of smoke-free laws. Unfortunately, this kind of political calculation ignores the heavy toll of tobacco on Kentucky’s health."

The paper noted that a smoking-ban bill "died in the Senate Judiciary Committee, chaired by Sen. Whitney Westerfield, R-Hopkinsville. Obviously, Senate leaders expected Westerfield to let the bill languish. The appropriate assignment for the bill would have been the Senate Health and Welfare Committee, chaired by a supporter of the legislation. If the bill does land in Westerfield’s committee again, we hope he will ensure the measure advances to a floor vote."

Liberty City Council rescinds smoking ban that had passed with mayor's tie-breaking vote weeks earlier

Liberty city council members voted 5-1 to repeal a city-wide smoking ban in public buildings that was passed narrowly in November. The law was to go into effect Jan. 1, Larry Rowell reports for The Casey County News.

The ban had passed in November when Mayor Steve Sweeney cast the deciding vote because the council was split 2-2. Two council members were absent at the meeting, Rowell reports in a separate article.

A special meeting was called Dec. 17 for first reading of an ordinance to to rescind the ban and a new restaurant tax; both passed on second reading Dec. 22, but Sweeney vetoed the restaurant measure, which passed 4-2. He could not veto the smoking measure because it passed 5-1. Council Member Brian Beeler stood by his original vote for the ban, but Member Andy Lawhorn switched to oppose it.

“I stand by what I voted for,” said Lawhorn, who lost the November election for mayor to Council Member Steven Brown. “We sit here and say that second hand smoke is not harmful. I smoke. If we can actually say it's not harmful to us or other people and 'other people' being the key word, we're in denial. That's just a fact.” But he said he changed his vote because of public opinion.

“I've heard a lot of outpouring conversations from the public that's come to me that was against it. And I feel that maybe I voted my conscience and what I believe kind of before I got any feedback, good quality feedback, from the public on what they wanted,” Lawhorn said.

Several Liberty residents attended the meeting and voiced their opinions about the issue, Rowell reports. One woman whose husband died from complications of smoking said public places should be made safe, and Jelaine Harlow, a health educator from the Lake Cumberland District Health Department, said it's a public health issue, much like keeping sewage out of water supplies.

But County Attorney Tom Weddle, a smoker, objected that the ordinance would not allow him to smoke in his office after hours, when no one else is around. Councilman Doug Johnson, a non-smoker who has made two businesses smoke-free, agreed with Weddle and said to people who don't like secondhand smoke, “You should boycott that place until they yield to no smoking but we should not mandate that to the owner. If we mandate that, we can mandate anything. It’s their personal space, they own it even though it’s open to the public. It is privately owned.”

Studies have found that 65 percent of Kentuckians support banning smoking in indoor public places, but despite this support only 23 Kentucky communities have smoke-free policies that cover all workplaces and enclosed public places, according to the Smoke-Free Kentucky website. This breaks down to 32 percent of Kentuckians covered by strong local smoke-free laws.

Kentucky Hospital Association backs state smoking ban

The Kentucky Hospital Association on Thursday reiterated its support of smoke-free workplaces and public places throughout the state in hopes that 2015 will be the year that legislators pass a statewide ban on smoking in enclosed spaces.

“Kentucky hospitals have treated illnesses like asthma and heart disease as a result of secondhand smoke exposure for too long, only to send patients back out to the very job conditions where they are getting sick," KHA president Michael Rust said. "Secondhand smoke exposure-related illnesses are completely preventable by simply asking smokers to step outside."

Kentucky leads the nation in smoking and lung cancer. The state's lung-cancer death rate is 46 percent higher than the national average, and nearly 1,000 Kentuckians are estimated to die each year from secondhand smoke. And all of these statistics come with a price tag.

"Smoking costs Kentucky $1.92 billion a year in health care costs, $487 million of that in Medicaid costs alone," KHA said in a press release. "It also costs Kentucky $2.3 billion in lost productivity. Secondhand smoke exposure costs Kentucky an estimated $106 million in health care costs each year. Kentucky can no longer afford to shoulder these costs."

Dennis Johnson, KHA board chair and president of Hardin Memorial Health, said "If Kentucky wants to improve our health and attract economic development opportunities, it must make indoor workplaces and public places smoke-free.”

Rust closed the press conference by urging calls to legislators at 1-800-372-7181. "Tell them you support a smoke-free law which would make Kentucky workplaces and public places smoke-free."

Rep. Susan Westrom, D-Lexington, will again be the lead sponsor of the statewide smoking ban bill, according to her office.

As Ky., other states debate smoking bans, Ariz. county considers ban on hiring smokers, penalizing employees who smoke

Smoking bans for public places are still the subject of debate in Kentucky and many other places, but the Arizona county that contains Tucson may take the war on tobacco to a new level, refusing to hire smokers.

The Pima County Board of Supervisors is scheduled to vote Dec. 16 on a proposal that "prevents the county from hiring smokers and slaps a 30 percent health insurance surcharge on employees who do smoke or use other tobacco products," Mariana Dale reports for the Arizona Daily Star. "County health officials predict the new policy could save the county more than $1 million annually on health-care costs as tobacco-users retire and are replaced with healthier workers. . . . Pima County estimates 32 percent or 2,304 of its current employees are tobacco users and they cost the county about $13.4 million each year, according to a memo from the Health Department."

Dr. Michael Siegel, a professor of public health at Boston University and an advocate of smoke-free workplaces, "says a ban on employee tobacco use in their personal life goes too far," Dale reports.

Casey joins Adair and Russell as longtime tobacco counties where schools are going tobacco-free; Clinton defers action

The schools in another longtime tobacco county in Southern Kentucky are going tobacco-free. With only one member in opposition, the Casey County Board of Education recently enacted a tobacco-free school policy beginning with the 2015-16 academic year, Abigail Whitehouse reports for The Casey County News.

Jelaine Harlow, health educator for the Lake Cumberland District Health Department, presented the board with letters from community partners supporting a tobacco-free school policy, and results from surveys that showed 70 percent of school parents in the county school support a tobacco-free school policy, Whitehouse reports.

The surveys included ones given to parents and students across the school district including a ninth-grade student survey, a teacher-opinion survey, and a parent survey. It also included opinion results from attendees at a Casey County basketball game that showed overwhelming support for tobacco-free policy.

Following Harlow’s presentation, Beverly Hoskins, who taught at Casey County High School for 30 years, voiced her support for a tobacco-free campus. She said her father's tobacco crop put her through college, but "has lost the two men she loved the most to smoking, first her father and then her husband," Whitehouse writes.

Board Chairman Ken Coffman first said the issue would be decided later, but member Marilyn Coffey said, “Ken, I believe some of us are ready to vote. I think we’ve had a year to think about this and I’d like to make a motion to pass it and phase it in.” the motion carried, with only Vice Chairman John Cox opposed.  

The school board in Clinton County also heard a similar plea from the same health department, including a report that high-school sophomores' use of smokeless tobacco had increased, but took no action, the Clinton County News reports. The high-school principal noted that many school employees smoke.

The health department noted that school boards in Somerset, Adair County and Russell County had recently enacted tobacco-free policies. Since the end of the federal tobacco program in 2004, tobacco production in the area has sharply and steadily declined, leaving tobacco with little of the political support that once insulated it from government controls.

With school-board elections held this month, and not to be held for another two years, there may be more such votes in the near future.

Kentucky School Boards Association spokesman Brad Hughes said in an e-mail that as of June, 33 of the state's 173 school districts had adopted all-encompassing tobacco-free campus policies; 12 have adopted policies that only affect students and staff, with no restrictions for visitors and groups renting district facilities. Four have adopted tobacco-free policy language with exceptions, such as allowing smoking in personal vehicles or at outdoor events; and four have asked KSBA to draft tobacco-free policy language, but have not yet reported final adoption of those policies. Hughes noted that smoking by underage students is prohibited by law anywhere, including in schools, in buses and anywhere on campus.

Smoking ban upsets some state workers; entrepreneur starts a van to take some off Human Resources campus to smoke

Cigarettes and all other tobacco products, as well as e-cigarettes, are no longer allowed on most state property, both indoors and outside, and some state workers aren't happy about it, Jack Brammer reports for the Lexington Herald-Leader.

"Under the new rules, employees and visitors to executive branch agencies of state government won't be able to light up or chew tobacco in state-owned or state-leased buildings, in state-owned vehicles or on state property — including parking lots, sidewalks and green space under the control of the executive branch of government," Brammer writes, reporting that state workers "are fuming about it."

Human Resources Building, from main highway entrance

About a dozen people smoking outside the state Human Resources Building last week told Brammer they were not happy with the policy. All but one did not want to be identified for "fear of retribution," he reports, but Andrea Schank of Frankfort told him, "It feels like discrimination against smokers." She and the others said there should be a designated smoking area. State Personnel Secretary Tim Longmeyer told Brammer that wouldn't happen. He said state officials understand how addictive smoking is and they "are helping people to stop."

David Smith, president of the Kentucky Association of State Employees, said "state workers who smoke should have a designated area and called the state's ban on smoking in personal cars on state property 'really invasive,'" Brammer writes.

Schank told Brammer that workers in the building will now have to walk about a half-mile to smoke, but that may not be the case if a new enterprise stays in business. Bill Bryant of WKYT-TV reported on KET's "Comment on Kentucky" Friday night that a van is circulating in and around the huge Human Resources campus, giving smokers a ride to places off the campus during work breaks.

State government is the largest employer in Kentucky, and the tobacco-free rule will affect about 33,000 state workers, plus hundreds of thousands of visitors to state offices and properties. Gov. Steve Beshear makes no apologies for the executive order that put this policy in place, justifying his decision with Kentucky's dismal health statistics. Kentucky ranks first in smoking and cancer deaths.

Kentucky is the fifth state to adopt such a policy. The others are Delaware, Oklahoma, Oregon and South Dakota. Details of the policy can be found at https://tobacco-free.ky.gov.

Ky. Rural Health Association backs statewide smoking ban

The Kentucky Rural Health Association is asking Kentuckians to contact their legislators and advocate passage of a statewide smoking ban in the 2015 session of the General Assembly.

KRHA Executive Director Tina McCormick writes, "Smoke-free laws have been unmitigated and popular successes here in Kentucky at the local level and virtually everywhere they have been implemented. Comprehensive laws protect everyone equally, achieve nearly universal compliance, and improve air quality and the health of workers almost immediately." To read McCormick's article, click here.

Lexington is considering whether to add electronic cigarettes to its anti-smoking ordinance

The Lexington-Fayette Urban County Council will discuss whether to expand its smoking ban to include electronic cigarettes, possibly as early as Oct. 7 at the General Government Committee meeting, Beth Musgrave reports for the Lexington Herald-Leader.

Berea, Bardstown, Danville, Glasgow, Manchester and Richmond have banned included e-cigarettes in smoking bans; on Oct. 6 Versailles may do likewise. (The city is replacing a Woodford County Board of Health regulation that was ruled unconstitutional.)

Amy Barkley, chairwoman of the Smoke-Free Kentucky Coalition, told Musgrave that cities and states updating their anti-smoking ordinances to include e-cigarettes is "part of a trend," and "Lexington has always been the leader in smoke-free policy in this state."

But e-cigarettes have changed the terms of smoking-ban debates. Tony Florence, co-owner of 723 Vapor Store in Lexington, which sells e-cigarettes, told Musgrave, "It's ludicrous to try to ban something that is trying to help people kick a horrible habit," Florence said. "The way that I look at it, if you are anti e-cigarette then you are really pro-lung cancer."

Gorton, who is a registered nurse, told Musgrave that she supported an amendment to the smoking ordinance because the Fayette County Board of Health recommended it. Gorton also noted that the state now bans all tobacco products, including e-cigarettes, on most state properties and that Rupp Arena and the attached Lexington Convention Center do likewise.

Supporters of e-cigarette ordinances say the devices are not effective in helping people stop smoking and "not much is known about the effects of electronic cigarettes," Musgrave reports. Barkley also told Musgrave that because e-cigarettes look like real cigarettes it "undermines the enforceability of smoking ordinances."

The Food and Drug Administration does not regulate e-cigarettes. Smoke-free advocates, including Barkley say that "until the FDA regulates e-cigarettes, it's best to include them in smoking bans," Musgrave writes.

But Florence told Musgrave that "the federal government hasn't acted on e-cigarettes for a reason: The research is not conclusive."