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Regulations to prevent spread of infectious disease at hookah bars – 1/21/11
Q: Rhode Island would like to learn whether other states are using a specific regulatory approach for hookah bars. Research indicates that hookah can be a transmitter of viruses, and an indoor air pollutant that requires specific air filtering device standards:
“Sharing a hookah may increase the risk of transmitting tuberculosis, viruses such as herpes or hepatitis, and other illnesses.” Knishkowy, B., Amitai, Y. Water-Pipe (Narghile) Smoking: An Emerging Health Risk Behavior. Pediatrics. 2005; 116:113–119
At this time, there are 26 hookah bars in Rhode Island, and they are regulated as “smoking bars” in RI general laws. Do any states regulate hookah bars using standards for ventilation systems and indoor air quality, OR with regulations pertaining to the spread of infectious diseases? If so, please provide your state’s regulatory language, words of advice, and any lessons learned.
A:
- California: The California Tobacco Control Program worked with our Infection Disease Branch to try and regulate hookah establishments from an infectious disease view point several years ago, but we were unable to make it work. The reason is that the establishments themselves provide each hookah user their own disposable tip. If members in a group decide to share their tips, that’s up to them. It’s kind of like trying to regulate whether teens can share soda cans or straws.
We’ve been approaching the hookah issue by regulating indoor smoking and outdoor dining smoking. Another approach might be to ban the sale of flavored tobacco products which is permitted under the new FDA law and which Santa Clara County, California just did. Below are links to articles about Santa Clara County’s new tobacco retail licensing law and Escondido banning hookah lounges.
California local contacts who have dealt with hookah issues:
- Nancy Mahannah (Mono County Health Department) —has successfully kept hookah establishments out with an outdoor dining policy
- Debra Kelley - works in San Diego County and had a role in the Escondido policy
- Janie Burkhart (Santa Clara County Health Dept) - role in tobacco retail license ordinance prohibiting flavored tobacco sales
- New Jersey: The New Jersey Smokefree Air Act (2006) and New Jersey Dept of Health Regulations (2007) to help implement the Act do not allow for new smoking lounges. A smoking lounge had to exist as of 12/31/04 and meet certain requirements to continue to allow smoking. If requirements are met, the local health department can issue a waiver. There are very few smoking lounges in New Jersey, due to the Act and Regulations. Read details about the New Jersey requirements to be met to qualify for a smoking lounge waiver here.
The Act/Regulations do allow for a tobacco retail establishment (TRE) to permit smoking, but only to sample an expensive product that will be bought in bulk and used off-premises. However, there can be no sale of food, beverages, etc. for on-site consumption in a TRE. A hookah lounge is not for sampling a product to be used in bulk off-premises, but to be using the smoking materials on premise; therefore under the New Jersey law a hookah lounge does NOT qualify for a TRE waiver. Read more here about the exemption for TRE establishments under the New Jersey law.
The PowerPoint from a presentation at the 2009 APHA conference on whether smoke-free air laws apply to hookah lounges is available here.
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Editor’s Note: the following Help Your Peers archives contain related information about hookah regulations:
Additional resource: Confronting the Emerging Threat of Hookah Bars - Presentation by Michael F. Strande, J.D., University of Maryland School of Law, from the Access 2008 Conference
(includes background on hookah, and legal and regulatory options for regulating hookah bars, including pursuing health code violations)
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