Smoking at State Health Department Campuses – 5/17/05

Q:

a) What are the policies at your state health departments (that house the CDC Comprehensive State Based Tobacco Control Programs) regarding smoking/tobacco use? Is yours a completely smoke-free campus, does it have entrance restrictions, is it 100% smoke-free indoors, etc? How is this handled at satellite offices (i.e. county health departments) and/or agency leased building with outside occupants?

b) We are aware of the data from James Repace's study "Banning Outdoor Smoking is Scientifically Justifiable", but need to know what is the basis for designating entrance restrictions at the specific distances of 50-ft, 25-ft, or 20-ft? We want to promote 50-ft restrictions and want to collect any science supporting this distance.

A:

a)

1. Alabama: The building that houses the Tobacco Control Program is smoke free. There are designated smoking areas outside, but there is no specified distance from the door. County health departments are encouraged to be smoke free, but the decision is left to local ordinances and the preference of the Area or County Administrator. Most are smoke free.
    
2. Arizona: our Department of Health Services located in Phoenix is 100% tobacco-free, including the campus. This went into effect October 1, 2004. We have signs posted in English and Spanish notifying our customers that it is a tobacco-free campus. The central parking garage is also tobacco-free. We have many visitors each day to our Vital Records and they are not allowed to use tobacco either while on campus. Those who must smoke have to cross the street or stand out on the sidewalks.
   
   Our satellite offices do not have the same requirement of 100% tobacco-free campus presently, but we expect to expand that in the near future. I do not know what the entrance restrictions are for those locations, but I would guess it's 50 ft from the entrance. They are not allowed to smoke in the building, and have designated smoking areas.
    
3. California: Governor Pete Wilson issued an Executive Order in 1993 that banned smoking in state-owned buildings and leased space and within 15 feet of doorways and ground level air intake structures. The statewide law went into effect in 1995 that prohibited smoking in indoor worksites. In 2004, another state law was passed that prohibits smoking within 20 feet of government building doorways.
    
4. Connecticut: state laws mandate that all state and municiple buildings, owned or leased are to be 100% smoke free. However there are no regulations regarding the distance from an entrnace that smoking can occur.
    
5. Florida: Smoking is not allowed in any state building. There are designated smoking areas outside of most state buildings. Any employee who violates this policy is guilty of a non-criminal violation, punishable by disciplinary action, up to and including dismissal, and/or a fine.
   The campus is not smokefree; however, we do have entrance restrictions.
   
   It is 100% smoke-free indoors - the Florida Clean Indoor Air Act (FCIAA) prohibits smoking in all enclosed indoor workplaces. All Department of Health employees are made aware of policy. Should someone violate the law, it should be reported to the program office responsible for enforcement of the FCIAA.
    
6. Indiana: According to the ISDH New Employee Orientation Manual, the office building is smoke free. However, the building owner has provided an employee smoking lounge in the lower level. Employees, customers, and visitors are not to block the entrance. When taking breaks outside, employees should not stand under the canopy covering the entry to the building. No smoking is permitted anywhere in the off site buildings that house Medical Science and Weights & Measures. Both locations have landlord provided smoking areas outside.
    
7. Michigan: Executive Order 1992-3 issued by then Governor John Engler requires smoke-free policies for all facilities owned, leased and operated by the Executive branch of government. This includes the state health department as well as all government facilities excluding the state capital. The Executive Order prohibits the use of tobacco products (including spit tobacco) in all regulated facilities.
   
   This policy covers indoor areas of regulated facilities. The Order requires Department Heads and Administrators to designate a reasonable distance away from buildings in which smoking can be allowed. This distance varies based on the location of each building. The majority of state buildings have a 25 foot restriction. The Department of Corrections have a designation of 100 to 500 feet. If the facility is owned by the state, all leasing occupants are required to follow the policy. Due to accreditation standards, Michigan's local health Departments and satellite offices are smoke-free.
    
8. Missouri: the state clean indoor air law of 1992 states in Section 191.767. 4. RSMo: "A designated smoking area where state employees may smoke during the work day shall be provided by each state executive department and institution of higher education, provided such area can be adequately ventilated at minimum cost, within the physical confines of each facility." The Missouri Dept of Health tried an enclosed smoking lounge with a vent directly to the outside, it was quickly evident that very strong smoke odors were noticeable upon entering the building. The Dept then issued a no-smoking policy for its buildings since such area could not be adequately ventilated at minimum cost.
   
   Smokers then congregated at entrances, which caused complaints from nonsmoking employees and visitors. The policy was amended to move the smokers away from entrances. At our current main campus, smokers are very visible to the public as they sit at picnic tables in various areas of the parking lot and as they walk around the campus on breaks. This sends an incongruent message to visitors that the Health Dept doesn't practice what it preaches about tobacco use.
   
   Almost two years ago, our program has requested the policy be amended further to consider a tobacco free campus as first choice; or to move the smoking areas out of the public eye as a second choice. A couple of reminders have been sent. There's been no official reply. An unofficial reply was that Section 191.767.4 cited earlier prevents the Health Dept from having a tobacco-free campus policy. Our response is that this law applies only to indoor areas and has no jurisdiction for outdoor areas of state facilities. We now have a new Dept Director and we shall again approach the subject in the near future.
   
   Agencies that we contract with [e.g. county health depts] are required to have tobacco-free indoor areas, but not campuses.
    
9. Nebraska: Here is a copy of Nebraska statute that covers state buildings including the Nebraska Health and Human Services System offices:

   (4) Smoking is prohibited in all vehicles owned or leased by the state and in all buildings, and the area within ten feet of any entrance of such buildings, which are owned, leased, or occupied by the state except as provided in subsections (5), (6), and (7) of this section.
   
   (5) The following buildings or areas within buildings in which persons reside or lodge may be exempt from this section: (a) Nebraska veterans homes established pursuant to section 80-315; (b) private residences; (c) facilities and institutions under the control of the Department of Health and Human Services; and (d) overnight lodging facilities and buildings managed by the Game and Parks Commission, but no more than twenty-five percent of the overnight lodging facilities at each park location shall permit smoking.
   
   (6) Designated smoking areas not to exceed fifty percent of the space used by the public may be established in state-owned buildings at the Nebraska State Fairgrounds that possess a Class C, I, or M license for the sale of alcoholic liquor for consumption on the premises under the Nebraska Liquor Control Act.
   
   (7) Smoking may be permitted in no more than forty percent of the residential housing rooms or units owned or leased on each campus under the control of the Board of Regents of the University of Nebraska or the Board of Trustees of the Nebraska State Colleges.

10. New Jersey: There is no smoking in any health department building. This was implemented about 15 years ago by a very progressive Commissioner, Molly Coye. This has remained in effect to this day.
    
    There was the issue of smokers right by the entrance to the Health an Agriculture building. Recent Commissioners have reenforced the policy that smoking can only be at the sides and back of the building where there are no entrances and thus no need for people to walk through the clouds of smoke. The entire campus has not been declared smoke-free.
    
    Prior governor Florio required that all State departments to have smoke-free buildings in 1992 and this has been done. It has worked well, aside from discussions of whether a garage was part of the building and smoking in the residential sections of prisons. Over time these have resolved in favor of smoke-free including prison residential areas. No campuses are required to be smoke-free.
     
11. Nevada: All state buildings are 100% smoke-free, but there are no entrance restrictions specific to the building where my office is located. We keep moving the ashtray, but that doesn't stop smokers from hovering near the door. When they are asked to move away from the door they do so, but that has been difficult to monitor since there is no policy to back it up.
     
12. Ohio: Currently, smoking is prohibited in all state-owed or leased buildings. At the state health department, we also do not allow smoking in doorways, but since our doors open onto the sidewalks, the only area we have control over is the 2 foot alcove in front of each door. There is a parking garage attached to one of our buildings and smoking is allowed there since it is more or less open to the outside. Smoke does get into the building from the doors leading to the garage. I understand the the Department of Administrative Services, which administers our building is looking into this, but it is still a problem.
     
13. Oklahoma: the Oklahoma State Department of Health has had a NO TOBACCO USE policy for all of our approximately 104 campuses since January 1, 2002. This includes all grounds of our facilities. Not just smoking. Not just inside. Not just within a certain distance of entrances. It also applies to our vehicles. And to private vehicles on Health Department property.
    
    Our rationale for the outdoor restrictions was based primarily on this agency's commitment to set a good example for communities throughout this state in our comprehensive campaign to reduce the effects of our state's number one public health problem, rather than justifying it on any specific set of scientific observations or conclusions regarding secondhand smoke exposure as we had done previously for prohibiting smoking indoors.
    
    Prior to the Health Department taking this bold step, few others had done so in Oklahoma. Since then, other places---including many of our Oklahoma hospitals---have voluntarily made their entire campuses 100% tobacco-free zones.
    
    In 2002 our State Board or Health promulgated rules establishing smokefree zones outside entrances---including the entire walkways to the main entrances---of hospitals, nursing homes, residential care facilities and assisted living centers.
    
    Four months after the Oklahoma State Department of Health's new policy, in April 2002 the state legislature voted to make all state owned or operated buildings smokefree effective July 1 of that year! This included all space within 25ft.of any entrance, exit or air intake. (There was an allowance for just one smoking room per building. But no public business can be performed in it, and it must be fully enclosed, separately ventilated and under negative air pressure.)
    
    One year later, when the legislature extended the ban to nearly all Oklahoma workplaces effective September 1, 2003, the 25-ft. rule was also applied to all county and city owned or operated facilities. However, the smokefree entrance was not required for most of the newly covered private workplaces. However, restaurants, which were given 30 months (until March 1, 2006, just 288 days from now) to comply, must establish a 15-ft smokefree zone outside all public entrances when the law becomes effective for them.
    
    Our agency's policy has been a great success. You can learn more about Oklahoma's laws at our web site www.breatheeasyok.com.
     
14. Oregon: The Oregon Department of Administrative Services owns and operates most state buildings (including the building that houses state public health). They allow agencies to set their own policies for outdoor smoking . For the public health building, the rule is no smoking within 25 feet of building entrances.
     
15. Rhode Island: All buildings 100% smokefree and smoke cannot migrate back into the building. (Rules and regulations recommend 50 feet but it is only a recommendation, added at the insistence of many callers.) All public buildings and workplaces smokefree.
    
    Health Dept. Policy: No smoking within 25 feet of building. Smoking picnic tables in the 25 feet area and beyond.
     
16. Texas: Texas Department of State Health Services just issued a new policy clarifying and strengthening restrictions. DSHS property will be tobacco free. Property not controlled by DSHS may still have designated tobacco use areas. Staff will not be permitted to use tobacco in any other location, including building entrances, parking lots, or other sites now used for smoking. A second difference is that locations of such designated tobacco-use areas "will comply with all applicable laws and will not be visible from main public entrances." Third, the policy prohibits employees and persons working or living on DSHS property from using tobacco products on non-state property contiguous to DSHS property, such as the sidewalk or street adjacent to DSHS buildings. Finally, the policy prohibits the use of tobacco products by DSHS employees while in the performance of their official duties in the presence of a client or a patient in the care of DSHS.
     
17. Tennessee: Smoking policy states “Smoking is permitted inside a building only in a designated area unless prohibited by law. The law governing smoking in indoor facilities providing children’s services is Public Law 103-227, the Pro-Children Act of 1994. The law requires that smoking not be permitted in any portion of an indoor facility used routinely for the delivery of services to children if the services are funded directly or indirectly with federal dollars. Thus, smoking is prohibited in any local health departments and in regional offices in which clinic services are delivered. Also, smoking is prohibited in the Laboratory Services Building due to potential interference of laboratory testing.
    
    Smoking is not permitted within the area of the office building doorways. Smoking is permitted on state grounds provided it occurs beyond 50 feet of the building entrances or in the external “designated smoking areas”. Employees who choose to smoke within the permitted areas must do so on regularly scheduled breaks and meal periods. Rule 1120-6-08 of the rules of the Tennessee Department of Personnel, provides that “appointing authorities may allow employees two 15 minute paid rest breaks during each workday”. These breaks should not be divided into smaller segments of time to allow for multiple breaks.”
     
18. Washington: Smoking is banned in all Washington State buildings and vehicles per Governor's Executive Order 88-06 (1988). This includes all facilities owned, operated, and/or leased by the state and therefore applies to all satellite offices/locations. Smoking is banned in all office work environments in Washington. In addition state Department of Health requires smokers be 25 feet away from all entrances of DOH buildings.
     
19. West Virginia: Code of State Rules 64-73-9.5 : "The board (of health) shall establish a policy prohibiting smoking or the use of smokeless tobacco in the local health department." Click here for entire position statement.

b)

1. Americans for Nonsmokers Rights: there really is no basis for specific distance numbers. Our model ordinance states 10-25 feet, but that's arbitrary. The key is to find the number that works best for a particular community, without going overboard. Example: Las Cruces, New Mexico had a smokefree ordinance on the ballot. They lost solely because they had a 50-foot distance provision, which in Las Cruces would have meant that smokers had to smoke in the street. The important thing is that people are protected walking in and out, and from smoke entering through windows.
    
2. Campaign for Tobacco Free Kid: I'm unaware of any science on this specific topic. I think it's borne from people who have achieved success in indoor environments and now that all the smokers are outside, don't want to walk through all the smoke outside to get inside - I don't think it's more scientific than that. And in many locations where this is an issue, we often have not fought it vigorously since I think we have often concluded that it makes us look too extreme (we got the smoke out from indoors and now you're going to force people literally into the street). I've never heard of a 50 foot boundary and would imagine that would put people literally on the other side of the street from their own building.
    
3. California: Twenty feet was the selected distance for the outdoor law from discussions with experts who felt that this is a safe enough distance to protect non-smokers.
    
4. Florida: The supporting elements could possibly be found through a number of resources such as American Cancer Society, Centers of Disease Control, National Cancer Institute, etc. We cannot provide scientific evidence on entryway smoking and square footage. The square footage away from an entryway is at the discretion of the person in charge.
    
5. Michigan: The designated foot rule was implemented to remove smoking from entrances, windows and ventilation systems. While the foot rule may work in some instances, in other it can be a problem. For example, a designated foot rule of 50' may place individuals on the property of another business or in the middle of a busy street. With the exception of health facilities, I would suggest designated outside areas that are located a distance away from entrances, windows and ventilation systems. Designated outside areas are easy to enforce because you simply tell individuals where smoking is allowed.
    
6. Washington: The 25 foot distance was chosen for our buildings to ensure that smoking would not occur under any overhang or recessed area that might trap smoke and allow it into the building.

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