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.

UK quickens drumbeat of tobacco-free policy through report line

The University of Kentucky promotes compliance and enforcement of its tobacco-free policy through a community report line, among many other measures.  Although the report line was established last spring, its mention in recent campus communications suggests a hightened emphasis on compliance measures. 

The line to report violations of the smoking ban engages the community in developing an environment in which compliance is expected, said Dr. Ellen Hahn, a nursing professor and co-chair of UK's Tobacco-free Taskforce and director of its Kentucky Center for Smoke-free Policy.

"Since these policies are self-enforcing, we need a mechanism by which everyone on campus can easily report violations," Hahn said. "Most people do not feel comfortable approaching a violator, so this is a way to encourage everyone to be involved in promoting compliance." She said the report line was a suggested "best practice" from other campuses with similar policies.

Implementation of the policy, the ultimate goal of the policy is to promote a healthy place to live, work and learn, has been a success, Hahn said: The air is healthier, and exposure to secondhand smoke has decreased. Also, since the policy was established in the fall of 2009, there has been a four-fold increase in the use of nicotine replacement to quit using tobacco, and UK has many low- or no-cost options to help students and employees do so.

Click here to report a violation of the tobacco-free policy, here for a tobacco-free brochure.