Advocates hope push in rural areas will help pass statewide smoking ban, at least in the state House

By Justin Richter

University of Kentucky College of Communication and Information

Kentucky has had a love affair with both growing and smoking tobacco, but supporters of a statewide smoking ban believe that smoke should not be shared with people who don’t smoke.

Rep. Susan Westrom

For the fourth straight year, Democratic State Rep. Susan Westrom of Lexington is filing a bill for a smoking ban in workplaces and enclosed public places. She and her allies are focusing increased attention in the state’s rural areas, where smoking is more prevalent.

This summer Westrom visited several towns, from Owensboro to tiny Sandy Hook, to talk with fellow legislators and their constituents about the bill. “We want to be able to access legislators in the rural areas, meet them on their own turf,” showing them their constituents care about secondhand smoke, Westrom said.

A third of the adults in Eastern Kentucky smoke, and almost a third of those in Western Kentucky do, according to the Behavioral Risk Factor Surveillance System, an ongoing telephone survey by the federal Centers for Disease Control and Prevention.

"We're going to need a lot more legislative support, and we're pretty much doing that one legislator at a time," Smoke-Free Kentucky Coordinator Betsy James said at last month's meeting of Kentucky Voices for Health, an association of health lobbying groups. "This is sort of a rural-urban issue, so we do need help out in the counties."

Advocates are hoping to build on the passage of smoking bans in 28 Kentucky cities and 10 counties.  “We’ve got 38 different locations that have smoke-free ordinances and we want to meet the standard we have in Louisville and Lexington,” Westrom said in an interview. 

Louisville and Lexington were two of the first cities to ban smoking in enclosed public places.  Each had exemptions, including bars and clubs, but by 2008 both went to comprehensive bans, unlike some other jurisdictions in the state that have large exceptions.

The Hopkins County Board of Health, for example, passed a regulation in 2009 that permits individuals from smoking in workplaces but has large exceptions that allow individuals to smoke in private clubs, privately rented restaurants, as well as hotel and motel rooms that are rented.

Westrom is working with Dr. Ellen Hahn, director of the Tobacco Policy Research Program at the University of Kentucky College of Nursing, who has led the efforts to pass local smoke-free measures.  After working for years on local bans, she is now working on both local and state fronts. 

Work towards smoke-free public enclosed places has gained ground steadily since Hahn started 10 years ago, but most of the state remains unaffected by any smoking ordinances or regulations.

According to a booklet prepared by the College of Nursing and the state Cabinet for Health and Family Services, “70 percent of Kentuckians are regularly exposed to secondhand smoke in the workplaces and public places.”

Smoking is more common in Kentucky than any other state, with 28.3 percent of adults smoking, compared to 19 percent nationwide according to the CDC. Kentucky Youth Advocates recently released a study done that revealed Kentucky has one of the highest rates of smoking during pregnancy in the nation. 

Westrom and Hahn have been working together since 2011, when Westrom first filed a state-wide smoking ban bill. The first bill did not get out of the House Health and Welfare Committee, but the next two bills did. 

Last year, her bill was then sent to the Judiciary Committee, a sign that it was being taken a bit more seriously, because that panel was more skeptical of it and raised issues that if resolved could help the bill pass.

In 2013 the bill was not given a vote on the House floor, presumably because it did not have enough votes to pass.  Westrom is anticipating getting past the House floor and into the Senate this year. “I think we’re really close in the Senate,” she said, noting that almost every Senate district has at least one smoke-free community.

The Kentucky Chamber of Commerce has supported Westrom’s bill since it was introduced three years ago.  “Over 90 percent of respondents expressed support for a smoke-free law in Kentucky in a recent Chamber survey,” said Ashli Watts, the business lobby’s public-affairs manager.

The chamber is advocating a smoke-free workplace largely because of lost worker productivity due to illnesses causes or worsened by smoking. Research by The Ohio State University's College of Public Health found that every U.S. smoker is costing his /her company an extra $6,000 per year.

Democratic Gov. Steve Beshear said he will continue to support a statewide smoking ban, and that it would be a help to business.  House Speaker Greg Stumbo, D-Prestonsburg, said he hopes the House will pass the bill.

Stumbo spoke at a panel discussion held by the Kentucky Hospital Association with Senate President Robert Stivers, R-Manchester.  Stivers said individual businesses should be able to allow smoking, but said that he would not impose his view on the rest of the Senate.

Indoor air study is background for smoking-ban discussion in Elliott; statewide ban sponsor is optimistic about a vote

As the debate over a statewide smoking ban persists, a study shows evidence of harmful air quality levels from second-hand smoke in places where smoking is allowed in Elliot and Lawrence counties. The researcher, the sponsor of a statewide smoking-ban bill and a skeptical legislative leader talked about the issue this month at a meeting of the Elliott County Chamber of Commerce.

The study, funded by the Kentucky Cancer Consortium, found indoor air pollution that slightly exceeded the Environmental Protection Agency's national ambient air quality standard for outdoor air, reports Kenneth Hart of The Independent in Ashland. There is no EPA standard for indoor air,

The study also found that air pollution levels averaged higher in Elliott and Lawrence counties than in Georgetown and Lexington, where laws banning smoking in building have been implemented, Hart writes.

Carol Riker

The study was conducted by trained health department researchers in 11 public venues in the two counties, neither of which have laws prohibiting smoking, from July 2012 to January 2013, Carol Riker, a University of Kentucky nursing professor who reported on the study to the Elliott County chamber.

Smoking was observed in five of the 11 venues tested. Riker said one had a level that was more than double the national outdoor air standard. She said the study pointed to a need for anti-smoking ordinances in the two counties, especially to protect the health of workers in these smoke-filled environments, reports Hart.

According to the Kentucky Center for Smoke-Free Policy at UK, that 38 Kentucky communities have adopted any sort of smoke-free law, and 22 have passed comprehensive ordinances banning smoking in all workplaces and public places.

State Rep. Susan Westrom

The chamber also heard from state Rep. Susan Westrom, D-Lexington, longtime sponsor of a statewide smoking ban. "She was cautiously optimistic that 2014 will be the year the matter finally comes up for a vote in the General Assembly after twice failing to do so," Hart reports. "Westrom said she believed a statewide law was needed to provide some consistency in anti-smoking regulations and because cities and counties have generally been slow to adopt such laws on their own."

House Democratic Floor Leader Rocky Adkins, an Elliott County native, said such decisions should be made locally. "But Adkins — who told the chamber he spent many hours working in tobacco fields and barns as a younger man, but had never taken so much as a drag off a cigarette his entire life — said he was keeping an open mind on the idea a statewide smoke-free law and would consider changing his stance if his constituents indicated they were in favor of it," Hart reports.

10 years ago, Lexington's smoking ban started creating a healthier city and a movement among others in Kentucky

A decade ago, Lexington took a bold step by enacted the state's first public smoking ban, in a city that once proudly touted its status as the "World's largest burley tobacco market." As smoke-free supporters and Lexington residents celebrate the ordinance's 10th anniversary Monday, a recent editorial in the Lexington Herald-Leader highlights the dramatic benefits that have followed this historic step.

After the smoking ban took effect in April 2004, the city had 22 percent fewer emergency room visits for asthma in the next 32 months, and the Fayette County smoking rate has dropped from 26 percent to 17.5 percent, the editorial notes. These positive changes have yielded health-care savings of $21 million a year, says the University of Kentucky's Tobacco Policy Research Program.

"There is nothing quite as cost effective as smoke-free policies," the editorial quotes Ellen Hahn, a UK nursing professor and director of the Kentucky Center for Smoke-Free Policy, as saying. "We predict a 32 percent decline in smoking rates if Kentucky were to go smoke-free. That would save billions in health care costs and reduce premature death and suffering from the chronic diseases that plague Kentucky."

The editorial also says Lexington led the way for Louisville and 20 other municipalities to protect citizens from secondhand smoke; a third of the state's population now lives in a smoke-free environment, and many of the initial fears about a smoking ban are now extinguished.

Kentuckians feared economic harm, the shunning of Lexington restaurants and bars and suffering tourism or downtown attraction, but the opposite predictions came true, says the editorial. The scene in downtown Lexington is "far richer than 10 years ago... It once was an article of faith that tobacco would always be king in Kentucky, yet tobacco declined and agriculture has thrived."

U.S. adult smoking rate dips to 18 percent; when state rates come out, will Kentucky still have the country's highest?

CDC chart; confidence interval (or error margin) means that
 95 percent of the time, the result for the entire U.S. population
would be within the range indicated at the tops of the bars.

The smoking rate for U.S. adults dropped to 18 percent last year, continuing a steady decline since 2009, when it was 20.6 percent, says an early release report of the 2012 National Health Interview Survey by the federal Centers for Disease Control and Prevention.

While state numbers will be released later, Kentucky's 2011 smoking rate was 29 percent, higher than any other state, says the CDC's Tobacco Control State Highlights 2012 report. (For county-by-county figures, click here.) State leaders and other observers have cited the high rate as the largest single reason for the state's health problems.

A recent editorial in the Kentucky New Era of Hopkinsville, a tobacco town that recently enacted a smoking ban, says this about the state's smoking statistics: "Medical expenses related to smoking are $1.5 billion annually and smoking is the cause of approximately 7,800 deaths each year."

The editorial says the state's tobacco use hurts its economy and quality of life. In addition to health-care costs, smoking-caused productivity losses in Kentucky total $2.3 billion a year. These amounts do not include health costs caused by exposure to secondhand smoke or other tobacco use, and does not include the money spent to purchase cigarettes.

"At the very least, Kentucky’s political, health and business leaders should know the rates of smoking and what it costs the state in medical care and diminished earning potential," says the editorial.

Dr. Stephanie Mayfield, commissioner for Kentucky's Department of Public Health, recently told a legislative committee that a typical smoker in the state spent $2,237 last year on cigarettes, says the editorial. And, despite Kentucky’s continuous efforts to discourage youth smoking, about 6,100 minors begin smoking each year, reports The Associated Press.

Overall, the U.S. survey found smoking rates were lower among adults ages 65 and over (8.9 percent) than among those ages 45 to 64 (19.5 percent) and those ages 18 to 44 (20.3 percent). Additionally, the percentage of current smokers was higher for men (20.4 percent) than for women (15.8 percent). The report doesn't include smoking rates for children. Click here to read about all CDC early-release measures.

Williamsburg in line to pass smoking ban next month

An ordinance imposing a smoking ban in Williamsburg is ready for a City Council vote. The council listened Monday to the first reading of the ordinance, required before a vote, which could follow the second reading, planned for Feb. 11. If approved, the ban would take effect immediately, reports Mark White of the Corbin-Whitley News Journal.

The new ordinance says “Smoking shall be prohibited in all enclosed areas within all enclosed buildings open to the public and within places of employment,” reports John Ross of The Times-Tribune of Corbin. “Enclosed buildings” includes libraries, bars, bingo houses, child- and adult-care facilities, public and private educational facilities, gaming facilities, restaurants, pool halls, lobby areas and hallways in all multi-residential buildings, such as apartments and condominiums, and hotels and motels, Ross reports. In December 2011, the Corbin City Commission implemented a ban that prohibits smoking in similar locations and within 25 feet of main entrances and exits.

Ross's account of the meeting included no negative comments. Mayor Roddy Harrison said, “I know both sides of the issue — but our job is to protect everybody.” Harrison said he found extensive research to back up the negative effects of secondhand cigarette smoke while researching the ordinance.

3 in 5 Kentucky adults favor a statewide smoking ban, according to an independent poll that may have oversampled smokers

By Al Cross
Kentucky Health News

Kentuckians now favor a statewide smoking ban by a margin of 3 to 2, according to the latest Kentucky Health Issues Poll conducted last fall for the Foundation for a Healthy Kentucky. Interestingly, 38 percent of the Kentucky adults polled said they were smokers, much more than the 29 percent found by a year-long federal survey. Among those identified as smokers, 37 percent favored such a law, while it was favored by 68 percent of former smokers and 75 percent of those who said they had never smoked.

Overall, 59 percent of those polled said they supported a state law that would prohibit smoking in most public places, including workplaces, public buildings, offices, restaurants and bars, while 38 percent said they opposed it and 4 percent said they had no opinion. The figures showed a 5-point shift toward support since the last poll, in 2011. The gain was among smokers and former smokers.

Support for the law was higher among registered voters than non-voters, perhaps a consideration for legislators considering the proposal. Among voters, 62 percent favored it while 36 percent opposed it. Only 50 percent of nonvoters supported it. Support was slightly higher among Republicans (64 percent) than among Democrats (59 percent; only 44 percent of independents, who comprise about 7 percent of Kentucky voters, said they supported it. The poll also found that support for the law increases as age and income increase.

As for the apparent oversampling of smokers, pollster Eric Rademacher said self-reporting of such habits is known to vary according to time, and the differences in his poll and the federal survey "are likely due to the different time frames in which they were conducted and the different methodology employed by each study." He added, "For example, a person who regularly smokes might openly disclose that information at one point in the year. However, at another point in the year, that same person might be directly exposed to news or advertising that paints smoking in a negative light from a societal perspective. Hearing that information could make the person more reluctant to discuss their smoking behavior with researchers soon after they have seen or heard it.”

Rademacher is co-director of the Institute for Policy Research at the University of Cincinnati, which did the poll for the foundation and the Health Foundation of Greater Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone from Sept. 20 to Oct. 14. This included 1,360 landline interviews and 320 interviews with cell phone users. In 19 of 20 cases, each statewide figure will be accurate to plus or minus 2.5 percentage points. Smaller samples, such as those of smokers and non-smokers, have larger margins of error. There are other sources of variation inherent in public opinion studies, such as non-response, question wording, or context effects that can introduce error or bias. For a copy of the poll's full questionnaire and guidance to interviewers, click here. For more information, go to www.healthy-ky.org
or www.healthfoundation.org/kentucky-health-issues-poll.

The Foundation for a Healthy Kentucky noted the health implications that a smoke-free law would address: "Secondhand smoke poses serious health risks. Smoke-free environments are the only way to fully protect nonsmokers from these hazards. To reduce these risks, many Kentucky communities have adopted smoke-free policies. On Jan. 1, 2013, Hopkinsville became the 22nd municipality in Kentucky to implement a comprehensive smoke-free ordinance or regulation," bringing to 34 percent the share of Kentuckians who live in jurisdictions covered by comprehensive smoke-free ordinances or health-department regulations. For a list of the communities and percentages, and those with bans that are less than comprehensive, from the Kentucky Center for Smoke-Free Policy, click here.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

U.S. teens' cigarette use drops to a new low, but use of alcohol goes up a bit and more 12th graders are smoking marijuana

Teenagers' cigarette smoking dropped to a record low this year but alcohol use rose slightly after seven years of decline, according to a survey of 45,000 eighth-, 10th- and 12th- graders for the National Institute of Drug Abuse.

The survey also found that the use of illicit drugs dropped slightly among eighth-graders but rose slightly among 12th-graders. Among them, 36.4 percent reported using marijuana in the past year, up from 34.8 percent in 2010, and the share who saw great risk in smoking marijuana occasionally dropped significantly, to 20.6 percent, from 24.5 percent in 2010.

Among all three age groups, only 10.6 percent said they had smoked cigarettes in the past 30 days, down from 11.7 percent in 2010. The University of Michigan researchers who did the survey said the decline was significant, and may have been driven by a big increase in the federal tobacco tax in 2009.

"A 1-percentage-point decline may not sound like a lot, but it represents about a 9 percent reduction in a single year in the number of teens currently smoking," principal researcher Lloyd Johnston said in a news release. Among eighth-graders, the decline was about 20 percent. For other results of the survey, click here; for a PDF version, here. For the full survey report, go here.

"Teen attitudes toward smoking also continued to become more negative. For example, 80 percent of teens said they preferred to date nonsmokers in 2012," Steve Gorman reports for Reuters. "But anti-tobacco advocates said their battle to stamp out teen smoking was far from over, noting that 17 percent of high school seniors still graduate as smokers." And the figure is higher in many rural areas.

Kentucky ranks at or near the top in youth smoking. In 2010, the last year for which state figures are available, 16 percent of Kentucky children aged 12 to 17 (a slightly younger group than the one above) reported smoking a cigarette in the past month. The national rate for that age group was 10 percent, according to the Centers for Disease Control and Prevention.

Study: Raising cigarette taxes does curb even heavy smoking

The more you raise cigarette taxes, the less people smoke. That presumption was confirmed this week in a study by the Washington University School of Medicine in St. Louis. This has some resonance in Kentucky, where just last week the state’s Blue Ribbon Commission on Tax Reform told Gov. Beshear the state should raise taxes on tobacco, to $1 per pack from 60 cents. Other forms of tobacco would get a corresponding tax hike, reports Beth Musgrave of the Lexington Herald-Leader. The changes would raise an estimated $120 million in revenue and, if the research is right, cut down on long-term health care costs.

The researchers are the most adamant about the last point. “Most clinicians and researchers thought these very heavy smokers would be the most resistant to price increases,” says study author Patricia A. Cavazos-Rehg, PhD. “But our study points out that, in fact, change can occur. And that’s very good news.” In fact, in states where taxes on tobacco products rose by at least 35 percent, heavy smokers -- who averaged 40 cigarettes a day or more -- lowered their daily smoking by 14 cigarettes, on average.  In real numbers, the price for a pack of cigarettes increased from an average of $3.96 in 2001 to $4.41 in 2004. (Read more)

In Kentucky last year, almost 30 percent of residents said they were smokers, the highest in the nation. The state also has the highest rates of diabetes and lung cancer, reports Jim Malewitz of Stateline News. Kentucky’s cigarette tax is also among the country's lowest.

Teen smoking in Kentucky declined more than it did in nation from 2002 to 2010, but state remained in top 10

Like most states, Kentucky showed a drop in reported cigarette smoking among 12- to 17-year-olds from 2002 to 2010, according to a report by the Substance Abuse and Mental Health Services Administration.

Nationwide, teenagers' reported "current use" of cigarettes dropped from 12.6 percent to 8.7 percent. In Kentucky, that decline was even more significant, plummeting from 17.6 percent in 2002 to 11 percent in 2010. The 2002 rate was third in the nation; the latest one is sixth. The surveys defined "current use" as smoking in the past month. (Click on map for larger version)

Strangely, the data showed that during the same period, teens' perception of risk from cigarette smoking remained unchanged in Kentucky and most other states. Tobacco use is the leading cause of premature and preventable death in the United States. (Read more) To read the full report, go here.

Cigarette companies balking at Justice Dept's request for "confessional" advertising that they say goes too far

Calling them "forced public confessions," America's largest tobacco companies are asking a federal judge to reject the government's proposed corrective statements for cigarette advertising. Fred Frommer reports for the Associated Press that the Justice Department has responded by saying that such statements need to be strong enough to protect people from future false declarations made by cigarette makers. The statements that the tobacco industry views as "going too far" include admissions that the companies lied about the dangers of smoking, the addictiveness of nicotine, the lack of health benefits for "low-tar" and "light" cigarettes and the negative effect of second-hand smoke. U.S. District Judge Gladys Kessler, who is hearing the case, has already said "she wants the industry to pay for corrective statements in various types of ads," writes Frommer. (Associated Press photo)

Judge Kessler ruled in 2006 that America's largest cigarette makers had systematically concealed the dangers of smoking for decades and that, as assurance that the crime was not repeated, such statements as a requirement in tobacco advertising would be appropriate. An example of an advertising statement under consideration, as suggested by the Justice Dept.: "For decades, we denied that we controlled the level of nicotine delivered in cigarettes. Here's the truth: Cigarettes are a finely tuned nicotine delivery device designed to addict people." At Monday’s hearing, Kessler said she doesn’t have to take the government’s proposed statements word-for-word, and will come up with “modifications.” (Read more)

Study estimates that secondhand smoke kills 42,000 Americans a year, and 900 of those are babies

More bad news for smokers and those who love them: A report out this week in the American Journal of Public Health says secondhand smoke is accountable for 42,000 deaths of non-smokers each year in the U.S., including nearly 900 infants. Kentucky likely has more than its share of those deaths because the percentage of Kentuckians who smoke is the nation's highest.

The study at the University of California, San Francisco notes that those annual deaths represent nearly 600,000 years of potential life lost and $6.6 billion in lost productivity, amounting to $158,000 per death.

The study by Wendy Max a professor of health economics at the UCSF School of Nursing, involved the first use of a biomarker to gauge the physical and economic impacts of cigarette smoke, and revealed that secondhand smoke exposure disproportionately affects African Americans, especially their infants. 

Smoke Free Kentucky Coalition's multi-city tour launches push for statewide smoking ban in 2013 legislature

Backers of an effort to ban smoking in all public places in Kentucky took their message on the road this week in hopes of getting legislation passed in the 2013 General Assembly. The Smoke Free Kentucky Coalition swept through the state's largest cities to gather support for a final punch to be delivered at the annual Fancy Farm Picnic in Graves County on Saturday. Beth Musgrave of the Lexington Herald-Leader reports that one of the week's first stops was at the Kentucky Chamber of Commerce, a longtime supporter of the statewide smoking ban. "We know that a majority of Kentuckians support a smoke-free Kentucky," said Amy Barkley, chairwoman of the coalition. (KRT graphic)

Rep. Susan Westrom, D-Lexington, has sponsored a statewide smoking ban for several years. During the 2012 legislative session, the House Health and Welfare Committee passed the measure, but the full House did not vote on it. Westrom told the Herald-Leader that said she did not aggressively pursue the matter during the 2012 session because all 100 members of the House are up for re-election in November. "But we've had several members who have said that they will be co-sponsors" next year, she said.

Musgrave notes that even Westrom is unsure how the the Republican-led Senate will vote. Senate President David Williams has said he supports the idea of a statewide smoking ban, while opponents of the proposal have said it represents an overreach of government power. "There are personal property rights that are being trampled," Rep. Ben Waide, R-Madisonville, said when he voted against a statewide smoking ban in March.

Graphic warning labels help smokers remember tobacco health risks, study finds

Study participants looked at these two images while
researchers assessed how effectively they were viewed.
Graphic by Penn Medicine.

Graphic warning labels on cigarette packages can help smokers remember the message and the health risks associated with smoking, a study has found.

Researchers asked 200 smokers to look at either a text-only label advertisement — which is similar to warnings that have been on cigarette packages since 1985 — or a graphic warning label showing a hospitalized patient on a ventilator along with a written warning — which has been proposed by the U.S. Food and Drug Administration.

Researchers used eye-tracking technology to measure how the advertisement was looked at and for how long, reports research-reporting service Newswise. Then participants were asked to rewrite the message they'd seen to show how well they remembered it.

Results showed 50 percent of participants who saw the text-only ad remembered the warning label, while 83 percent of those who saw the graphic image warning remembered what they'd seen.

"In addition to showing the value of adding a graphic warning label, this research also provides insight into how the warning labels may be effective, which may serve to create more effective warning labels in the future," said Andrew A. Strasser, associate professor at the University of Pennsylvania, where the study was conducted. "We're hopeful that once the graphic warning labels are implemented, we will be able to make great strides in helping people to be better informed about their risks, and to convince them to quit smoking."

The 2009 Family Smoking Prevention and Tobacco Control Act mandated the FDA to require graphic warning labels on cigarettes packaging starting in September 2012. The mandate has since been held up in court. (Read more)

Floyd County woman is Kentucky's smoke-free advocate of year

For her work spreading the word about second-hand smoke and founding the coalition that ultimately helped Prestonsburg pass a smoke-free ordinance in 2009, Floyd County's Jean V. Rosenberg was named 2012 advocate of the year at the annual Smoke-Free Policy Conference hosted by the University of Kentucky's Kentucky Center for Smoke-Free Policy. She stands with center Director Dr. Ellen Hahn, left, and Dr. Melissa Walton-Shirley, right, the Glasgow cardiologist who won in 2011.

Rosenberg started her work in 2005 when she began working for the Floyd County Health Department as a program specialist to increase awareness about the dangers of second-hand smoke, reports Ann Blackford reports in a university press release. During that time, she founded the Breathe Easy Floyd County Coalition, which educated people about second-hand smoke and supported local smoke-free initiatives.

On Nov. 1, 2009, the City of Prestonsburg implemented a 100 percent smoke-free ordinance in all workplaces and enclosed public places, with Rosenberg at the helm to propel the effort forward. (Read more)

Mayor will propose smoking ban in Hopkinsville, largest Kentucky city without one

The largest Kentucky city that has not banned smoking in public places may change that.

Hopkinsville Mayor Dan Kemp's proposal "fundamentally resembles Lexington's ban," reports Nick Tabor for the Kentucky New Era. The law would apply to bars and restaurants but not private clubs; retail tobacco stores and tobacco warehouses; and rented rooms in hotels, hospitals and nursing homes. "The best thing would be to have no exemptions," Kemp said, adding that he recognizes the need for compromise. 

An online survey by the Christian County Health Department two years ago indicated strong support for a ban. A recent, scientific survey of 500 Kentuckians shows 59 percent support a statewide ban, the American Cancer Society found. Kemp said he has "received a mostly positive response from local businesses," Tabor reports.

As for a smoking ban imposing on a person's right to light up, Kemp said, "I just think it's such an overriding health concern that that trumps the individual rights argument." Kemp hopes the council will vote on the proposal June 5. If they ratify it, the ban could take effect July 1. (Read more)

Number of teens and young adults who smoke, use smokeless tobacco is on the rise

A "shocking" number of American teenagers smoke cigarettes and/or use smokeless tobacco, the first U.S. surgeon general's report on youth tobacco since 1994 has found. (Photo by Karen Bleier, AFP/Getty Images)

"The numbers are really shocking," Surgeon General Regina Benjamin said, noting the data show 1 in 4 high school seniors and 1 in 3 young adults under age 26 smoke. "It's a problem we have to solve."

Though there was dramatic progress in reducing youth smoking rates from 1997 to 2003, the 899-page report shows the decline has flattened. "Smokeless tobacco is up among white high school-age boys, and cigar smoking appears to be rising among black high school girls," reports David Brown for The Washington Post.

Data from the 2010 Kentucky Youth Tobacco Survey show that almost 25 percent of the state's high-school students are smokers. Although the prevalence of smoking among youth has declined in the past few years, the smoking prevalence among teenagers and young adults is higher than among other adult populations.

"Two people start smoking for every one who dies from the habit each year," Benjamin said. "Almost 90 percent of those 'replacement smokers' first try tobacco before they are 18."

The findings showed smoking can damage lung function at a very young age. One study of "nearly 700 children from East Boston found that those who started to smoke at age 15 exhaled 8 percent less air in one second — a key measure of lung function — than non-smoking teenagers. The growth of lung capacity stopped a year earlier in smokers — at 17 in girls and 19 in boys — than in non-smokers," Brown reports.

Another study showed how smoking affects the cardiovascular system. Researchers looked at autopsy results of white men ages 25 to 34 who were killed either by trauma or homicide. Smokers were two times as likely to have advanced damage of the abdominal aorta as non-smokers. "They also had somewhat greater damage to the blood vessel most often implicated in acute heart attacks," Brown reports.

Danny McGoldrick of the Campaign for Tobacco-Free Kids told USA Today's Wendy Koch tobacco marketing "is a big cause of the problem." He pointed to his organization's report revealing the tobacco industry's relationship with convenience stores to blatantly advertise and display tobacco products.

The industry's success in fighting increases in tobacco-related taxes is considered to be another factor. But industry officials like Ken Garcia of Altria Group, parent company of Philip Morris USA, said "there's already quite a (tax) burden on adult smokers." (Read more)

Replacing cigarettes with smokeless tobacco reduces disease risk, says U of L prof who's received tobacco-industry funding

Smokers can greatly reduce their risk of disease if they replace their cigarettes with spit-free smokeless tobacco or electronic cigarettes, University of Louisville professor Brad Rodu, right, said in a presentation at the annual meeting of the American Association for the Advancement of Science last week. It's the same message residents of Owensboro heard in an advertising campaign with which Rodu was involved late last year, one partly funded with grants from the tobacco industry.

"Quit or die: That's been the brutal message delivered to 45 million American smokers, and it has helped contribute to 443,000 deaths per year," Rodu said in a U of L press release. "The truth, however, is that total nicotine and tobacco abstinence is unattainable and unnecessary for many smokers."

Rodu's 20 years of research has reportedly shown that e-cigs and smokeless tobacco are relatively safe alternatives for smokers who can't or are unwilling to quit nicotine. "Nicotine is addictive, but it is not the cause of any smoking-related disease," he said. "Like caffeine, nicotine can be used safely by consumers."

Research has shown smokeless products are 98 percent safer than cigarettes, the press release states. A 2002 study in the United Kingdom found smokeless tobacco to be up to 1,000 times less hazardous than smoking.

As for whether smokeless tobacco can contribute to mouth cancer, Rodu said the risk "is extremely low." "The annual mortality rate among long-term dry snuff users is 12 deaths per 100,000 and the rate among users of more popular snus, moist snuff and chewing tobacco is much lower. For perspective, the death rate among automobile users is 11 per 100,000 according to the 2009 report from the National Highway Traffic Safety Administration. Compare those to the rate among smokers: more than 600 deaths per 100,000 per year." (Read more)

The Oral Cancer Foundation's website says about 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year and cause about 8,000 deaths. The foundation does not support the contention that smokeless tobacco is "safe." "Promoted by some as a safer alternative to smoking, it has in actuality not proven to be any safer to those who use it when referring to oral cancers," the website reads. "Campaigns to promote the safety of smokeless are being initiated, but it is clear that while it may reduce lung cancers, it has a negative effect on the rates of oral cancers."

Judge continues to block graphic images on cigarette packs

Getting graphic labels on cigarette packages continues to be an uphill battle for the Obama administration, as a skeptical judge sided with cigarette makers who say "they can't be forced to spread the government's anti-smoking advocacy with 'massive shocking, gruesome warnings' on products they legally sell," reports The Associated Press.

U.S. District Judge Richard Leon of Washington, D.C., has already decided that the cigarette makers will probably succeed in their lawsuit, because he has ordered the government to not enforce the requirement that the labels appear on cigarette packages next year.

The labels, approved by the Food and Drug Administration, "included color images of a man exhaling cigarette smoke through a tracheotomy hole in his throat; a plume of cigarette smoke enveloping an infant receiving a mother's kiss; a pair of diseased lungs next to a pair of healthy lungs; a diseased mouth afflicted with what appears to be cancerous lesions; a man breathing into an oxygen mask," among others, AP reports.

Leon has indicated he thinks the labels go overboard in their efforts to convey the dangers of cigarettes. He has ruled they are too large; they were intended to cover the top half of packs. "It sounds like they are headed to a place," he said Wednesday, "where you have to watch a 10-minute video before you can even buy a pack of cigarettes." (Read more)

FDA finds more than 1,000 retailers selling tobacco products to minors, several in Kentucky

More than 1,200 retailers, including CVS, Walgreens and Rite Aid, were issued warning letters by the Food and Drug Administration this year for illegally selling cigarettes to minors. FDA inspectors conducted 27,500 undercover checks by sending children under 18 into stores to buy cigarettes. These checks resulted in hundreds of letters being sent to retailers. Many of the warnings were sent to stores in rural areas where a recent U.S. Department of Health and Human Services report found youth are more likely to use tobacco products.

Alina Selyukh reports for Reuters that under the Tobacco Control Act of 2009, the FDA was given broad authority over tobacco manufacture and sales. One of the provisions of the act "allows the agency to contract with states to inspect spots where youths could buy cigarettes or chewable tobacco." Under the law, store workers are required to check identification of anyone looking younger than 27. Selyukh writes: "FDA officials said they are on a mission to begin battling the stubbornly high U.S. smoking rates by keeping tobacco out of underage hands in the first place."

The agency posted the warning letters on its website last week along with a searchable database of all checks it conducted. The letters allow retailers to correct their infractions without fines, but repeat offenders could face fines or loss of ability to sell tobacco products of any kind. To see if retailers in your state, community or city were issued a warning letter, search the FDA database of compliance checks.

Light up at school? Face a $150 fine in Jessamine County

If students at the two Jessamine County high schools are found with cigarettes or any kind of tobacco product while on campus, they can face a fine up to $150.

East Jessamine High started issuing tickets a few years ago, and West Jessamine joined the effort last month, reports Jim Warren of the Lexington Herald-Leader. Since it was implemented, the number of students caught with the contraband items has gone down at East, with 120 incidents in 2009-09 and 149 in 2009-10. "Last year, we only had 39," Principal Janet Granada said. "Once the word spreads that there's a fine involved, it seems to lessen smoking greatly."

The idea came from Billy King, a school resource officer at East Jessamine High. "We recognized we had a problem with minors using tobacco," he said. "I felt that it would prevent them from bringing tobacco to school if they knew they could get a fine. But I also knew that they probably didn't think it would happen. Police generally don't cite juveniles for tobacco possession, even though the law has been on the books forever."

King posted signs around the school warning students of the possibility of a fine. A few weeks later, he started handing out tickets. "The word got around pretty quickly," he said. School resource officers write up the citations, which are referred to juvenile court. Fines are paid to the court, so the schools have no financial incentive to issue the citations.

Though many school districts in Kentucky have adopted tobacco-free policies on their campuses, Lisa Gross, spokeswoman for the Kentucky Department of Education said this is the first she's heard of students being given a fine. (Read more)