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.

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."

Supporters of smoking bans fear letter from Ky. Association of Counties will halt local efforts to pass such measures

An insurer's letter has warned counties that they may face rate increases if they are sued about local ordinances, including those against smoking. According to a legal consultant to the Kentucky Center for Smoke-free Policy, the letter from the Kentucky Association of Counties "does not square with laws and a Supreme Court decision under which local governments have authority to bar smoking in public buildings," Bill Estep reports for the Lexington Herald-Leader.

In February, the McCreary County Fiscal Court voted 4-1 on first reading for an ordinance to ban smoking in public buildings. After KACo sent the governing body a letter warning them of higher premiums, the ordinance died on second reading, Judge-Executive Doug Stephens said. "Stephens said that some residents objected to the law after the first vote but that the notice from KACo was certainly a factor in the decision to drop the issue," Estep writes.

The letter may also discourage other counties and cities from passing ordinances to protect people from exposure to secondhand smoke, said Ellen Hahn, a professor of nursing at the University of Kentucky and head of the Center for Smoke-free Policy.

However, Denny Nunnelley, KACo's executive director and chief executive officer, said the association didn't intend to discourage counties from passing such laws, Estep reports: "Nunnelley said . . . KACo officials thought it made sense to send a reminder that lawsuits challenging ordinances could result in higher insurance costs."

The letter, which addressed smoking in public places, same-sex marriage, right-to-work laws and minimum wage, was sent to all 113 counties for which the organization provides coverage.

One issue with the letter is that the state constitution, state law and a state Supreme Court case all clearly state that counties have the authority to pass and enforce smoke-free laws, said Judy Owens, a lawyer and consultant for the smoke-free policy center. (Read more)

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.

McCreary County smoking ban fails; story on hearing offers a picture of the strong feelings, pro and con, that the idea evokes

The McCreary County Fiscal Court was unable to move forward with a vote on a smoking-ban ordinance because it lacked a motion for a second reading, Janie Slaven reports for the McCreary County Record.

The ordinance was first presented to the court by Champions/UNITE for a Drug-Free McCreary County in November, but did not get its first reading until February, on a 4-1 vote. But after a public meeting on March 12 and in the presence of a "packed courtroom," County Judge-Executive Doug Stephens asked for a motion for a second reading, but didn't get one.

Approximately 20 people attended the one-hour public hearing, held two hours prior to the regularly scheduled meeting, Slaven reports.

One citizen against the ordinance vowed to "campaign against everyone who votes for this." Other opponents said that "smokers can't be blamed for every cancer occurrence." While others were concerned that there would be no end to the government's involvement, alluding to the day when caffeine might be banned because of health risk, Slaven writes.

A store owner, Rick Wilson, said that "while he respects Champions' mission, he believes the issue of smoking in businesses should be left to the business owners themselves," expressing great concern that the ordinance also included private spaces within a business, like offices and company vehicles. Other business owners agreed with him, even while recognizing the health hazards of second-hand smoke, Slaven reports.

Advocates of the ordinance also voiced their opinions. One Champions member presented the cost burden of smoking and second-hand smoke, saying the "health effects of second-hand smoke cost $10 billion per year."

The Lake Cumberland District Health Department’s Tracy Aaron noted that nearly 40 percent of people in the county smoke and asked the fiscal court to consider the ordinance a public-health issue affecting not only non-smoking customers but also employees. “People have to work, and it’s hard to find jobs,” she said. Upon this suggestion, citizen Albert Coffey urged her to return to her home county, Slaven reports.

Several citizens offered different solutions to an ordinance including increased community education and also a suggestion to put it on the ballot. State law does not allow that.

"For now, on both the county and state level, the issue is dead," Slaven writes, referring to a statewide smoking ban that passed the Democrat-controlled state House but was placed in an unfavorable committee in the Senate.

Slaven also reports that the McCreary County Board of Education is expected to consider adopting a tobacco-free policy at its March 24 meeting and notes that the school district already has an indoor smoke-free policy.

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.

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.

Study shows tailored advocacy for local smoking bans in rural Kentucky gets results

Local smoking bans are only possible if the community is ready for this change, Ellen Hahn, director of the Kentucky Center for Smoke-free Policy, writes in a report of a five-year study she conducted in rural Kentucky.

Readiness for change can be developed in rural communities that participate in smoke-free policy initiatives tailored to their community, Hahn writes in The Journal of Rural Health. The study evaluated six stages of readiness to determine if a community was ready to support smoke-free policy, and then tailored interventions based on how ready the community was.

The study was conducted in 37 rural Kentucky counties that were randomly selected from those without smoking ordinances or regulations. Nineteen of the communities received policy-intervention strategies, tailored to their readiness, from a trained community adviser. The remaining 18 were used for comparison. Data were collected annually and policy outcomes were tracked over five years.

Nearly one-third of the counties that were the target of interventions adopted smoking bans covering restaurants, bars, and all workplaces, while none of the comparison counties did.

Rural, tobacco-growing areas were chosen because they are "disproportionately affected by tobacco use, secondhand smoke, and weak tobacco control policies," Hahn writes in the study, "A Controlled Community-Based Trial to Promote Smoke-Free Policy in Rural Communities."

Health-board smoking bans that Supreme Court struck down are still being obeyed: 'Everybody loves it,' advocate says

By Melissa Patrick
Kentucky Health News

Three counties in Kentucky with unenforceable smoking bans continue to be smoke-free by the people’s choice.

Clark, Madison and Woodford counties have smoking bans that can’t be enforced because they are regulations of county health boards, which the Kentucky Supreme Court ruled in June do not have the power to ban smoking in public places. But officials in each county reported that most of the establishments in these counties continue to be smoke-free by choice.

“We are finding, in general, public spaces and restaurants are still complying with regulations as if it is still enforceable,” said Christie Green, public-information officer for the Madison County Health Department. “It seems as if the general public prefers this.”

In Versailles, the city council “hadn’t heard from one single tax-payer who is opposed to it,” recently resigned city council member Sonny Jones said in an interview before his resignation.

Scott Lockard, director of public health in Clark County, said likewise. “The community has remained smoke free. The public has demanded this, ” he said, and as far as he was aware “No businesses have gone backward in this.”

That doesn’t surprise Ellen Hahn, director for the Kentucky Center for Smoke-Free Policy and the state’s leading smoking-ban advocate. “When communities go smoke free, everybody loves it,” she said.

The anti-smoking regulations can’t be enforced, advocates said. “If enforced, a lawsuit might result,” Lockard said. “We have no active enforcement right now in Clark County.”

The court ruled in a case from Bullitt County, where a local judge had blocked enforcement.

Each of the other counties is handling the issue somewhat differently.

Woodford County, out of “respect for the cities” of Midway and Versailles, will let them determine whether they want to reinstate their previously enacted smoking bans before the county fiscal court makes a decision for the unincorporated area of the county, County Attorney Alan George said, “because the bulk of the affected business is in the city.”

Midway passed a new anti-smoking ordinance Aug. 18 and Versailles plans to hold its first reading on one Sept. 2.

Madison County plans second reading and passage of its smoking ordinance for Sept. 9. Berea is scheduled to do likewise Sept. 2.

Clark County has “no forward actions” or “no ordinance drafted” at this time, Lockard said. Asked if officials are waiting on the Nov. 4 election to move forward, he said that “no one had come out and said the election will play a role,” but he noted that the Winchester mayor and the county judge-executive have opponents.

The Supreme Court ruling was a great disappointment to smoke-free advocates. Betsy Janes, coordinator for Smoke Free Kentucky, said several health boards had been ready to implement smoke-free regulations, but were waiting on the Supreme Court. These plans obviously have had to change.

“It was a major blow, but the good thing is that it is very clear who has the authority to do this now,” Janes said. “Fifty-five percent of Kentuckians want to be smoke free. We are losing 1000 Kentuckians a year to second hand smoke,” based on research that has determined its effects.

While Hahn said the decision was a “step backwards for Kentucky,” she also said her center is “busier than ever” working with fiscal courts to create smoke-free laws on the local level. She said there are 35 city or county ordinances in effect, covering 31 percent of Kentuckians.

The Kentucky Chamber of Commerce supports statewide smoking ban, which has never come to a vote in either chamber of the legislature.

“Twenty-four other states have statewide smoke-free laws and we want to not be the last to join them,” said Ashli Watts, the chamber’s public-affairs manager.

While Clark County is not pursuing a smoke-free ordinance now, the health department is actively educating the public about the benefits of such laws and plans to be a strong advocate to get something passed, Lockard said.

“We are finding overwhelming positive response to smoke-free,” he said. “The Board of Health and health department will work in any way possible to get a law on the books.”

Lockard also voiced his hope that school boards will pass smoke-free policies in schools, which he said should be attainable because no legislation is needed.

“There are 174 school districts in Kentucky and less than 40 of them have smoke-free policies on their campuses,” Lockard said. “If we could have all schools smoke-free, that would have a major impact on our communities.”

Lockard reflected on what Tom Frieden, director of the federal Centers for Disease Control and Prevention, said in his recent visit to Kentucky, that the most important changes Kentuckians need to make to improve their health are to stop smoking, decrease secondhand smoke exposure, and to exercise.

Owensboro commissioners drop pre-existing bars from draft of smoking-ban ordinance

The Owensboro City Commission compromised to gain the support of all five members to vote for a smoking ban, which will come up for a vote on Sept. 2, Steve Vied reports for the Owensboro Messenger-Inquirer.

The original draft of the ordinance eliminated smoking in all public places in the city, and was favored narrowly. The compromise allows smoking to continue in establishments that are already in operation and don't allow entry to anyone under 18, thus exempting bars, as a county ordinance does.

"New bars that open after the ordinance goes into effect, whether they allow customers under 18 or not, will not be permitted to have smoking," Mayor Ron Payne said.

"Thank you so much," said Ashley Oberst, an employee of Rocky's Bar and Grill at Ninth and Crittenden streets. "It means more than you know."

"I'm not here to make choices for adults," Commissioner Jeff Sanford said, but if smoking "is around kids, I can't support it."

Payne told the audience at a meeting, "First and foremost, this commission wants to act in unison. We did not want a split vote. No. 2, we have listened to you. You made some good points that we have considered. We all have wrestled with this. This is a toughie. I have three younger brothers, all gone, two from lung cancer."

The new version also deleted regulation of electronic cigarettes. (Read more; this article is behind a paywall)

'This kind of sloppy defiance reeks of a Podunk attitude,' Hopkinsville paper says after fair doesn't enforce smoking ban

It's been a while since we read an editorial as clear, blunt and well-taken as the one the Kentucky New Era ran about the flouting of Hopkinsville's smoking ban at the Western Kentucky State Fair, so here it is, in its entirety:

The Hopkinsville ordinance that bans smoking at most indoor public places is not enforced at the Western Kentucky State Fairgrounds convention center. That became clear last week during the fair. Despite assurances from the fair board’s leadership that smoking ban violations would be addressed, at least a few people continued to smoke cigarettes throughout fair week inside the convention center.

This is a shame on so many counts.

First, it makes a joke of the smoking ban that is intended to ensure the city’s indoor public places are healthier for everyone, especially for children and for adults who don’t smoke and don’t want to be exposed to secondhand smoke. If the fair board cannot get in line with a smoking ordinance 18 months after it went into effect, why should any store, office or restaurant in the city that’s opposed to the ban go along with it?

Second, by refusing to enforce the ban, the fair board is ignoring the fact that hundreds of people who do not smoke and do not want to be exposed to secondhand smoke will now see the convention center as one of the most undesirable places in the city. It seems to say something about the fair board’s opinion of the building. Is it that negative?

Third, the smoking violations put the fair board in conflict with the no-smoking signs the board itself must have authorized for the building’s front and rear doors. What was the purpose of the signs? It looks like window dressing to anyone who passes the threshold and then finds someone smoking in the middle of the building in the middle of the day.

Fourth, the smoking violations put the fair board in conflict with city government. The convention center and the fairgrounds are inside city limits. The smoking ban applies to the convention center. The building is not an island or a special place set off to itself.

During fair week, the convention center is one of the most public places in the city. Thousands of people, including children, pass through the building for pageants, talent shows and gardening and home goods competitions.

The fair board ought to play by the rules and respect the process that resulted in Hopkinsville City Council’s approval of the smoking ban.

If the fair board won’t obey the ordinance, city officials need to enforce the ban. If they don’t, they will risk having more people behave as if the law does not apply to them.

This kind of sloppy defiance reeks of a Podunk attitude.

That’s not the reputation Hopkinsville wants or deserves.