The Effects of Freedom to Breathe
On October 1, 2007, the Freedom to Breathe Act took effect, making Minnesota the 17th state with a comprehensive indoor smoking ban. This July, Wisconsin became the 26th. Another 12 states have less far-reaching bans in place.
What lessons can Wisconsin take from Minnesota's experience with a ban?
In 2008, the Minnesota Department of Health released the Youth Tobacco Survey, the latest report on this issue. It shows "a continued decrease in the percentage of high school and middle school kids who were smoking," according to Pete Rode with the department's Health Statistics Research staff. It's a continuation of a trend that started in 2000, but that doesn't mean the ban itself had no effect. Rode says that the DoH's Tobacco Prevention and Control agency had much more funding early in the decade, ending around 2003 and 2004. Yet the decline continued. "The ban could well have had an impact here," Rode says.
Furthermore, the indoor smoking ban could be a factor in the continued declining exposure to second-hand smoke. "It was a pretty sharp drop this time," Rode says. From 2005 to 2008, high school students saw a drop from 64.8 percent to 55.4 percent in those exposed to second-hand smoke in an enclosed room, car, or workplace setting within the past seven days, while middle school students dropped from about 50 percent to 40 percent over the same period.
The department has yet to release adult smoking statistics following the ban, but expects the Adult Tobacco Survey to be out near the end of the year.
The University of Minnesota Cancer Center released another helpful study this year looking at changes since the ban to bar and restaurant employees' health. The study concluded that "the comprehensive smoking ban has had a significant impact in reducing exposure and uptake of carcinogens and nicotine in hospitality workers."
Jeanne Weigum of the Association for Nonsmokers-Minnesota (ANSR) wishes more studies of the ban's effects were available. In particular, she points to research in other states on hospital admissions for cardiac incidents, but says such studies are difficult to replicate for the whole state of Minnesota, where it's common for residents in many communities to visit out-of-state hospitals. But she says, "There has been substantial research that when a comprehensive smoking ban goes into effect, hospital admissions for cardiac incidents-heart attack or similar-go down... There's no reason to believe it isn't happening in St. Paul."
Weigum also says, "We know fewer workers should be having asthma attacks... but there's no Minnesota research in that area."
The relevant health numbers in Minnesota since the ban are trending positive, but what about the most common reason for opposition to the act: Its impact on businesses?
Weigum refers to the often-cited statistic that 400 bars and restaurants closed in the Metro Area as a direct result from local smoking bans as inaccurate. "No one knows where it came from," she says. ANSR followed up on a number of bars publicly claiming that they closed down directly because of smoking bans and found that some closed before bans even took effect, one closed because the owner faced a sexual harassment lawsuit, one hadn't paid its dram shop insurance in months, and the City of St. Paul closed another down because it didn't have a liquor license. She says that many used the bans as an excuse when the real problems lay elsewhere.
A number of reports from ClearWay Minnesota support ANSR's investigative conclusions. One study, "Effects of Clean Indoor Air Laws on Bar and Restaurant Revenue in Minnesota Cities," concluded, "Findings from this study suggest that clean indoor air ordinances, whether comprehensive or partial, had no adverse effects on total bar and restaurant revenue in communities in Minnesota and may be associated with slightly higher revenue." Three other ClearWay studies examined employment numbers and reached similar conclusions, with no apparent impact on employment in either rural or urban parts of the state.
If the ban's alleged adverse effects on businesses haven't materialized, does that mean there have been no negative effects associated with the ban? Minnesota's experience does point to one.
Dr. Ed Ehlinger, Director and Chief Health Officer of Boynton Health Service at the University of Minnesota, has been tracking smoking rates on college campuses since 1995. He notes that while college student smoking rates declined from 2000 to 2007, rates since then "are still way too high and seemingly stable." Ehlinger worries that the Freedom to Breathe Act's passage has led to complacency regarding smoking and that the state is focusing resources elsewhere. "I think the Freedom to Breathe Act has caused us, as a society, to take our 'eye off the ball' and allowed the tobacco industry to get back in the young adult game," he says. "There was a downside to it that many didn't pay attention to. We really need to re-ramp-up our efforts to eliminate tobacco use among college students."
On a more positive note, for Twin Cities campuses with smoke-free policies in place, smoking rates are lower than on all other campuses, according to Ehlinger. He hopes that the Freedom to Breathe Act will make it easier for more campuses to implement such policies.
Overall, Minnesota's experience with an indoor smoking ban should provide useful information to Wisconsin, while also offering some caution not normally associated with the ban. While smoking bans might lead to lower smoking rates among youth and better health for hospitality workers, and appear to have no ill effects on business revenue or employment, Wisconsin should be wary not to treat the ban as an excuse for future inaction. Minnesota, too, would be wise to learn this lesson.