We’re Number Seven:
The Public Places and
Workplace Safety Act of 2004 prohibits smoking in
workplaces and public places in
Policy Initiation
After the Surgeon General
declared secondhand smoke a Group A carcinogen which kills 200 Rhode Islanders
annually,
Public Health Agency Roles
During the years leading up
to passage of the act, Rhode Island Department of Health (HEALTH) provided
annual $300,000 multi-media campaigns--radio, television, billboard and
print--to educate policy makers and the public about the health effects of
exposure to ETS. The Director of Health,
Dr. Patricia A. Nolan, provided key leadership on this issue. She advocated with consecutive Governors,
testified at hearings, sent information to leaders in the General Assembly,
appeared on numerous television and radio programs, and was relentless in her
advocacy. In 2002, the media coordinator
conducted weekly conference calls with major partners to keep the momentum
going and coordinate action. In 2004,
the Program Manager of the Tobacco Control Program served ex-officio on the
Steering Committee of the Campaign for a Health RI (CHRI), our advocacy
coalition, until individuals from Ocean State Action and the voluntaries began
to conduct secret negotiations with a key member of the legislature to
introduce the bill for that year. The
partners insisted that the other advocates not be told about the negotiations,
which included making compromises before the bill was ever submitted. A bill was presented to the legislator with
exceptions that included small private clubs that can serve the public, half of
hotel rooms, smoking bars, retail tobacco stores, and two gaming
facilities. The bill also preempted
local control. The Program Manager
resigned in protest after consulting with key decision-makers at HEALTH. It was HEALTH’s
position that advocates are never insiders, that their
activity should always be conducted in the broad light of day, and that
preemption is never acceptable. HEALTH
continued its media campaign.
Major Partners
For
years, the key players who testified for this policy were the Lung Association,
the Heart Association and the Cancer Society.
After the tobacco settlement, the Cancer Society in
Official Support
In addition to Dr. Nolan, the
legislative Liaison and Communications Director for HEALTH were actively
involved in this effort. CHRI reached
out to the House Majority Leader to work on the bill. This was delicate, since Representative Betsy
Dennigan who had introduced the legislation the
previous 6 years, was having a conflict with the majority leader, but
Representative Dennigan was very clear that the law
the important thing, not whose name appeared on. Senator Susan Sosnowski
introduced the bill in the Senate and the Chair of the Senate Health and Human
Services Committee helped shepherd it through committee and the full
Senate.
Results from the Policy
The
following are outcomes from the law:
·
Enforcement
Outcomes: People are complying with the
law. Complaints have dropped from 77 in
March of 2005 to 11 in January 2006.
·
Air Quality
Outcomes:
·
Health
Outcomes: The big news is that
preliminary data from the Behavioral Risk Factor Surveillance Survey of adult
smoking has shown a slight but significant drop from 21.3% in 2004 to 19.8% in
2005. As we look more closely at the
data by month, we will be able to better determine the impact of the law. We are also looking at hospital discharge
data for incidence of heart attacks before and after March 1. If the same pattern as seen in
Opposition
Until this year, opposition to the law was
sufficiently intense to cause it not to be passed. This past session when it finally did pass,
there was still plenty of opposition.
1. Opposition from the tobacco industry was
never able to be identified as direct industry activity, but the addition of
language preempting local control is a favorite tobacco industry tactic, and
even advocates saying that preemption was a non-starter in talks did not keep
it from being added to the bill. Also,
language that has appeared in other states describing “smoking bars” wound up
in the legislation and could not be negotiated out.
2. Opposition from bars and restaurants was also
strong although for the first time, the Hospitality Association, formerly a
front group for the industry, actually talked about supporting the
legislation.
3. Opposition also came from legislators,
including the Chairman of the House Labor Committee who would not let the bill
out of committee without delaying implementation for 35 Class C bars (that
don’t prepare food) and all private clubs.
This resulted in a lawsuit filed on behalf of Class B bars that were not
included in the delay that Superior Court agreed with and those bars and
private clubs were forced to prohibit smoking.
This was actually helpful to us because there was so much controversy
about the different kinds of bars, no one was focusing
on attacking the law itself.
4. Opposition came from the 2 gaming establishments
in
Lessons Learned
The following were the most
important lessons learned in this initiative:
·
Policy change
requires persistence and time. Over a
dozen years of education and seven of intense advocacy after the first
submission of legislation.
·
It also takes
money. Community advocates do come out
of the air, and funded projects prepare the ground through years of education
and media advocacy activity that changes public attitudes.
·
Policy change is
very different from program implementation.
It requires community mapping and organizing skills, advocacy skills,
understanding and working with legislative and political systems. Some health staff prefer
conducting programs, and are even uncomfortable with advocacy.
·
Players must
include everyone from state government to grassroots activists. What one cannot do,
another can.
·
Working with
multiple partners is harder than it seems.
Communication and a point person to tend relationships are crucial.
·
When conflict
cannot be avoided, relationships must be repaired.
·
Sometimes
unintended, potentially ominous consequences can save the day.
Submitted By
Betty Harvey, Program
Manager, RI Tobacco Control Program
RI Department of Health
1 Capitol Hill – Room 408
(401) 222-3293
(401) 222-4415 FAX
Additional Information/Documentation
See document titled
« Thirteen Years in the Making »