Health Officials Focus on Banning Smoking in Bars, Casinos
By Ryan Schlehuber

As the Eastern Upper Peninsula catches up with a worldwide trend to ban smoking in public places, local health agencies are considering the next step here, to extend a general smoking ban to include bars, restaurants, and casinos.

District health departments across the Upper Peninsula are participating in an internal survey which asks their opinion as to whether restaurants, bars, and casinos should be included in smoking bans, said Melanie MacDowell, a prevention specialist for the Luce, Mackinac, Alger, Schoolcraft (LMAS) Health Department.

"We're gradually working our way to that point," she said. "We didn't want to do it right off the bat, because we wanted to allow businesses, such as bars and restaurants, to have time to adjust to it. Now that they are aware of it, it may come down to that."

Since last October, smoking is prohibited in all public and business facilities in Mackinac County. Exempt from the regulation are restaurants, bars, casinos, tobacco specialty stores, and private residences that are not being used as a state-recognized child care, health care, or adult day care facility.

Smoking outside near doors, windows, and ventilation systems is also prohibited.

To comply with the countywide smoking ban, businesses need to incorporate a written policy, either their own or one from the Health Department, post "No Smoking" signs, and make employees aware of the regulation. The Health Department is available to assist businesses in implementing their policies.

Banning smoking from public places is a health trend that is growing as the dangers of smoke, including second-hand smoke, to a person's health become universally recognized.

In the United States, California was the first state to ban smoking in most bars and casinos in 1998. Today, it has some of the toughest and most extensive anti-smoking legislation in the world, according to Smoke Free USA, a Web site that supports smoke-free areas. New York has enforced a ban in restaurants, bars, and clubs since 2003.

In the United States, half of the 50 states have banned at least some smoking, or contain cities or counties that have, according to the group.

Michigan has been mulling the idea of creating a state-wide smoking ban since 2000. Several counties, including Mackinac and Chippewa, have taken the initiative to pass a smoking ban themselves.

Wayne County has a countywide ban on all public places, said Ms. MacDowell. Like many states, however, Mackinac and Chippewa counties have exempted bars, restaurants, and casinos.

Other places around the world have been tougher on smoking.

Bhutan, a remote Himalayan kingdom, is thought to be the first country to introduce a total ban on tobacco sales. Norway has imposed a national ban on smoking in restaurants, bars, and cafes since 2004.

Places like Montenegro, India, Norway, and Tanzania not only have made efforts to prohibit smoking in public areas, these places have also banned advertising of any tobacco product.

Canada has among the lowest levels of smoking in the world, according to Canadian government statistics. Public health experts in Canada say the decline in smoking has been driven by tough antismoking measures that have been in place for the past few years. In one anti-smoking measure, graphic images of damaged internal organs from smoking are printed on all cigarette packets.

No Complaints Yet About Ban

in Mackinac County

The enforcement of LMAS Health Department's smoking ban is heavily dependent on complaints fielded from citizens, said Ms. MacDowell.

Since Mackinac County's smoke-free work site regulation was implemented October 7, 2006, the health department has received no complaints from business owners or citizens.

"I'm really happy that we haven't received any complaints yet," she said. "At this time, it's just a matter of getting the information out there."

LMAS sent out informational pamphlets to many of the county's businesses, both regulated and not regulated. Ms. MacDowell included non-regulated businesses so that if a business opted to prohibit smoking voluntarily, the pamphlet can be used as a guide to do so.

The pamphlets explain how to implement the smoke-free regulation, such as how to post signs, and point out such measures as moving outdoor ash tray bins away from the building doors and windows.

Some business owners have had questions, ranging from how to implement the policy properly to whether their business falls under the regulation.

There are still some loopholes in the policy, however, as Ms. MacDowell found out after speaking with one caller.

"The strangest call I got was from a business owner who operated a post office, a restaurant, and a bar under one roof," she said, stating that the business did not need to adhere to the smoke-free regulation because the health department recognizes it first as a bar and restaurant, although, she said, the building's owners will prohibit smoking in the post office.

"That was one of the more unique situations you see in the Upper Peninsula," she said.

One caller was a small motel owner who operated the office from his private residence. He was told by LMAS that the office area is considered part of the business, thus that area must be smoke-free.

Hotels and motels can have rooms where people can smoke, however, the occupant cannot smoke outside the door.

If LMAS receives a complaint about a business, Ms. MacDowell said, a notice will be sent to the company and a health department official will follow up with a visit.

If the violation continues or another one is submitted, then the matter would go before Dr. James Terrian, medical director and health regulations enforcement officer for LMAS Health Department, who can determine a fine or punishment.

Smoking Facts - Michigan

Information provided by

Luce, Mackinac, Alger, Schoolcraft Health Department + Adult smoking rate - 21.9 percemt + Women who smoked while pregnant - 13.7 percent Smoking during pregnancy is the foremost preventable cause of illness and death among mothers and infants. Pregnant women who smoke or who are exposed to second-hand smoke are between 1.5 and 3.5 times more likely to have a low birth-weight baby. + Deaths that are directly cause by smoking annually - 14,539 In 2003, there were a total of 86,306 deaths in Michigan; 14,565 (16.9 percent) of those deaths can be linked directly to tobacco use, according to the Michigan Department of Community Health. Additionally, 2,400 Michigan residents die each year from second-hand smoke. + Health care costs directly related to smoking annually - $3.4 billion Direct health care costs include but are not limited to medical expenditures paid for ambulatory, hospital, prescription drugs, nursing homes, and other personal care. + Medicaid smoking-related health care costs annually - $1.1 billion Approximately 32.4 percent of Michigan's smoking-related health care costs are paid by Medicaid. + Potential annual savings to Medicaid if smoking is reduced - $323 million (Potential annual savings to Medicaid if the smoking rate among Michigan adults was reduced by five percent.) + Smoking-caused productivity losses - $3.8 billion Productivity losses include, but are not limited to smoking-caused work absences, smoking breaks, on-the-job performance declines, and early termination of employment caused by smoking-caused disability or illness. + Michigan losses per-pack; costs caused by smoking - $10.44 For each pack of cigarettes sold in Michigan, $5.02 is spend on medical care attributable to smoking, and $5.42 in productivity losses are incurred, for a total of $10.44 per pack. Michigan taxes cigarettes at $2 per pack, with a net loss of $8.44 on each pack of cigarettes sold. + Smoking-related health care costs per capita - $336 Each Michigan resident pays approximately $336 each year to treat smoking-related illnesses. + Taxes paid by Michigan households to state/ federal governments to cover costs related to smoking - $637 per household.