Despite the flood of state and local laws since the 1990s to ban indoor smoking, millions of Americans still are exposed to secondhand smoke on the job.

As a bulletin last month from the National Institute for Occupational Safety and Health pointed out, 20.4 percent of nonsmoking workers say they encounter secondhand smoke at least once a week. A separate U.S. study determined that 10 percent are exposed to secondhand smoke on the job at least twice a week.

For workers like John W. McDonnell, 47, a bartender at Caesars Palace in Las Vegas, secondhand smoke remains a serious issue. “You get done with your shift, and you’re breathing heavy and your eyes burn and your nose is sore,” he said.

smoky-encountersNIOSH, part of the U.S. Centers for Disease Control and Prevention, called on employers to take steps to protect workers. The advisory agency recommended banning smoking in indoor work spaces, in work vehicles and in areas immediately outside building entrances.

It also called for eliminating exposure in the workplace to e-cigarette vapors – the first time the agency has addressed potential risks of e-cigarettes. Although e-cigarette emissions are thought to be less dangerous than tobacco smoke, they have not yet been thoroughly studied, and they contain such harmful substances as nicotine and formaldehyde.

Over the past half-century, adult smoking has dropped sharply, driven partly by bans on puffing in public. The smoking rate was down to 17.8 percent in 2013, the most recently reported year, versus 42.4 percent in 1965. Yet public health advocates say there is a widespread, but false, assumption that the battle to protect nonsmokers has been won. In fact, tobacco smoke remains one of the most commonly encountered airborne hazards in the American workplace.

“While we’ve made tremendous progress in protecting workers and everyone in the U.S. in general, there remain significant gaps in coverage,” said Clifford E. Douglas, director of the University of Michigan Tobacco Research Network.

The thousands of local and state bans on indoor smoking are a patchwork, and don’t cover all job sites or other public areas. During the Clinton Administration in the 1990s, the Occupational Safety and Health Administration considered a national ban on workplace smoking, but dropped the idea in the face of ferocious opposition by the tobacco industry.

Douglas called the gaps in smoke-free laws around the country “a reflection of the unfair nature of how we’re protecting our citizens.” He said young people, the poor and the less educated “are far more likely to be in those workplaces that don’t protect them against secondhand smoke or, for that matter, e-cigarette exposure.”

Photo of Clifford Douglas

“While we’ve made tremendous progress in protecting workers and everyone in the U.S. in general, there remain significant gaps in coverage.”
– Clifford Douglas, director of the University of Michigan Tobacco Research Network

Federal researchers have found that blue-collar workers are the most likely to be exposed. In the job category including construction, mining and energy drilling, 28.5 percent of workers encountered secondhand smoke at least twice a week. The rate for the next-highest group — installation, maintenance and repair workers — was 21.1 percent.

Dr. David Weissman, director of the division of respiratory disease studies at NIOSH, noted that federal research has shown links between secondhand smoke and cancer, along with cardiovascular disease. “People shouldn’t have to have shorter lives or sicker lives because of what they had to do to earn a living,” Weissman said.

According to the American Nonsmokers’ Rights Foundation, 24 states and the District of Columbia have strict, comprehensive laws prohibiting smoking in restaurants, bars and other workplaces. The group says those state bans, along with local smoke-free laws, cover 49.3 percent of the U.S. population. Many other workers are protected by less sweeping laws. For example, California isn’t considered by the foundation as “smoke-free” because its state law provides exemptions for firms with fewer than six employees as well as to some warehouses. Yet other workers are protected by employer policies restricting smoking.

Still, the smoke-free movement has lost momentum. The last state to embrace a comprehensive ban was North Dakota, where voters in 2012 approved a referendum that expanded smoking restrictions for bars, gambling operations and other workplaces. The North Dakota measure also banned the use of e-cigarettes in public places.

Although local measures continue to be passed, that pace has slowed, too, according to Cynthia Hallett, executive director of the ANR Foundation. Pointing to Oklahoma and Tennessee as prime examples, she said that some states with relatively weak laws preempt localities from passing stricter measures.

Photo of John McDonnell

John W. McDonnell, a bartender at Caesars Palace in Las Vegas.

Hallett blamed the tobacco industry and its allies for thwarting new or more protective state laws. For instance, in Kentucky, where tobacco giant Altria is one of the biggest spenders on lobbying in the state legislature, this year smoke-free legislation failed for the fifth year in a row.

State Rep. Susan Westrom, the Democrat who sponsored the legislation each of the last five years, noted that the tobacco industry prevailed despite widespread support for a ban among the public and groups including the Kentucky Chamber of Commerce.

Representatives of the nation’s three biggest tobacco companies – Altria, Reynolds American and Lorillard – either declined to comment or failed to respond to calls and emails seeking comment for this story.

Casinos, which repeatedly have been sued by workers claiming harm from secondhand smoke, stand out as a major industry that often is exempt from state or local smoke-free laws. Sometimes it’s because of specific legal exemptions and, in other cases, it’s because the casinos are on self-governing Indian reservations. As a result, says a report by a tobacco control group, “Casino employees face higher levels of exposure to secondhand smoke than almost any other profession and, as a result, they more frequently suffer from its devastating health effects.”

McDonnell, the Caesars Palace bartender, said his complaints to his bosses, and his suggestion that the casino add a non-smoking bar to help both smoke-averse customers and employees, have fallen on deaf ears. He contends that bartenders and other casino employees deserve the same protection from unwanted smoke as everyone else. “Anybody who thinks it’s not unhealthy, let them sit in my bar for eight hours and tell me that it’s not negatively affecting them,” McDonnell said.

Gary Thompson, a spokesman for Caesars Entertainment Corp., which owns Caesars Palace, said the company agrees “in concept” with “banning smoking throughout all businesses.”

But it’s not something the company is going to do in practice. “A large percentage of our customers prefer to be in an area where they’re allowed to smoke and have a drink and gamble,” he said, and the best thing for workers who can’t accept it is ‘’to go someplace else.’’

Westrom, the Kentucky lawmaker, said she often encounters the “why not get a job someplace else?” argument in her fight for smoke-free legislation.

“That’s ridiculous,” she said. “In so many areas of our state, there are limited job opportunities. And many people end up working in an entry-level position in a restaurant or a bar just to survive, or to get through college or to feed their kids.”

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