2007 johns hopkins bloomberg school of public health section b case study: new york state

2007 Johns Hopkins Bloomberg School of Public Health

Section BSection B

Case Study: New York State

2 2007 Johns Hopkins Bloomberg School of Public Health

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).


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?


Measuring Air Quality

Cigarettes, cigars, and pipes are major emitters of respirable suspended particles less than 2.5 microns (PM2.5) in diameter that are easily inhaled deep into the lungs

TSI SidePak AM510 personal aerosol monitor (weight: 1 pound)

Image source: TSI Incorporated. (2007).


Measuring Air Quality: www.tobaccofreeair.org


Images source: Hyland, A.



Measuring Air Quality: China

Image source: Hyland, A.



Measuring Air Quality: Greece



Measuring Air Quality: Romania

Romanian colleague carrying the TSI SidePak (in shoulder bag) before setting out to collect data


Image sources: (left to right): St. Petersburg Times. (May 23, 2004);Corning Leader. (May 21, 2004); Tacoma News Tribune. (May 21, 2004).

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 source: Chicago Sun-Times. (October 25, 2005.)




Image source: USA Today. (October 18, 2005).


U.S. EPA Air Quality Index

Air QualityPM2.5

(µg/m3)Health Advisory

Good ≤15 None

Moderate 16–40Unusually sensitive people should consider reducing prolonged or heavy exertion

Unhealthy for sensitive groups

41–65People with heart or lung disease, older adults, and children should reduce prolonged or heavy exertion

Unhealthy 66–150

People with heart or lung disease, older adults, and children should avoid prolonged or heavy exertion; everyone else should reduce prolonged or heavy exertion

Very Unhealthy

151–250People with heart or lung disease, older adults, and children should avoid all physical activity outdoors; everyone else should avoid prolonged or heavy exertion

Hazardous ≥251

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


Worst Forest Fire in Colorado History: June 8, 2002


Hayman Fire: Colorado

Image source: The American Society for Photogrammetry and Remote Sensing. (2002).

Denver


Image source: Colorado Department of Public Health. (2002).


Visibility in Denver: one day before Hayman Fire


Image source: Colorado Department of Public Health. (2002).


Visibility in Denver: one day after Hayman Fire

Worst PM2.5: 4.3 µg/m3 (24 hour maximum) or 200µg/m3 (hourly maximum)


Indoor Air Quality Improvement

Source: adapted by CTLT from The U.S. Center For Disease Control MMWR. (2005).


Average Level of PM2.5

Source: adapted by CTLT from Hyland, A. Original Data. Unpublished.


Average Fine Particle Air Pollution by Region

Source: adapted by CTLT from Hyland, A. Original Data. Unpublished.


Reduced Nicotine Exposure Biomarkers

Source: adapted by CTLT from Farrelly, M., et al. (2005).


Decreased Reported Symptoms of SHS Exposure




Evaluation questions Does SHS exposure decrease and health improve? Do people comply with the rules? Does the hospitality economy suffer? Unintended consequences


Smoke more at home?


Support for the Clean Indoor Air Act in New York State

Source: adapted by CTLT from New York State Department of Health. (2004).


Reported Smoking in Various Locations






Smoke more at home?


Predictions of Economic Doom

Source: Staten Island Advance. (1995).

Eateries say ban on smoking is killing themBy CRAIG SCHNEIDERADVANCE 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


Likelihood of Patronizing Bars Following CIAA



Likelihood of Patronizing Restaurants following CIAA



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).


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.


Liquor Licenses Granted: New York

Source: adapted by CTLT from the New York State Department of Health. (2004).





Smoke more at home?


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 smoke-free law took effect


Relative Risk for Quitting

Source: adapted by CTLT from Bauer, et al. (2005).


Smoking Cessation Indicators: NRT Sales

Source: adapted by CTLT from Metzger, et al. (2005).


Smoking Cessation Indicators: Quitline Calls


New York State (NYS) Clean Indoor Air Act (CIAA)

Image source: The Rural Three for Tobacco-Free Communities. (2003).

2007 johns hopkins bloomberg school of public health section b case study: new york state

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