The most c=monly employd my for mu~ ectivity is done
with various strains of &l~~~~ e whole irmdta 8%
well as CSC from four types of bh - fauad ;O be mutageaic in
S. typhrimurium TA1533 (Basrur et d 1~8).  -      gmo)reWarr
also found to be mutagenic in a w hy- wLLB -
directly on the bacterial plates (w et d 193~. b etudies lend
support to the extensive assays performed a a w eehaMiah
that tobacco smoke has significant mutagepic *w

Several of the studies with Csc fm em haW besu
aimed at comparing the effects of &ous tobaocas, w -
strains, and various systems selected far m w lost
of the mutagenic activity was m &tb & bagic fnrtion a
CSC (DeMarini 1983). For the CSC! from w e mpta
genie activity was primarily detected with &e m T- and
TA98, thus indicating the presence of &e u - tJped
mutagens. Except for studies on the e&&s af m
cigarettes, metabolic activation was required t.4) demoaastra&e m*
genie activity for most of the CZC studied.

Several short-term tests have been performed in s
systems. A solution of the gas phase of e mm
dissolved in a phosphate buffer induced reciprocal u&c& e
nation in Swcharcmzpc?s ~e~~isiae D3 snd petite mm io m
i&ate of strain D3 (Izard et al. 1980). Whole mainetwam c&are&e
smoke induced mitotic gene conversion, reverse mu&&m, and
reciprocal mitotic recombination in strain M ofS. cenx&& @air&a
1982).
Transformation of mammalian cells was also induced in several
cell systems using the CSC from mainstream  .
&g&t&i 1968; Inui and Takayama 1971; Rhim auE?m
&n&ct et al. 1975; Takayama et al. 1978; Ridal and ti
1980). Transplacental exposure t0 n CSC was WJorted b
trasfom Syrian hamster foeti cells (Raamuseen et ~ ml).
Transforming activity was reported in the acidic and basic fra&~~
                                                    I
as well as the neutral fractions of C&L S~dies on v of
csc have shown that the basic fraction and some of the a&c&
fractions are the most active in Cd tran%formation (Bened& ~4 d
1975). The neutral fraction OfCSCwaS*~ported~~*DNA
repair h normal human lymphocytes (Gadin et al- 197% Transfer
mation of mammalian cells with SS or m has not been repOti

Summary of Carcinogenicity

At present, the scientific literature offers some information on the
physicochernical nature of the sidestream smoke from tobacco
products and of environmental tobacco smoke. Chemical analytical
studies have already demonstrated that SS and FYI'S contain a wfde
spectrum of carcinogens such as polynuclear aromatic hydrocarbons,

261


volatile and tobacco-specific N-nitrosamines, and polonium-210. To
date, only one study has demonstrated the carcinogenic activity of
the particulate matter of sidestream smoke and a few isolated
reports have dealt with the genotoxicity of SS and EX'S. Therefore,
bioassay studies with the mainstream smoke and the environmental
tobacco smoke of cigarettes are needed. Although the resulting
bioassay data will derive from tests of concentrations of environmen-
tal smoke that do not realistically occur in the human setting, these
results will provide information about the relative carcinogenic
potential of sidestream smoke in comparison with the mainstream
smoke of the same cigarettes. In a comprehensive analytical
approach, data should be generated to systematically determine the
concentrations of toxic and tumorigenic agents in the ETS samples
and to simultaneously measure the uptake of tobacco-specific agents
by the body fluids of nonsmokers exposed to ETS.

Conclusions

1. The main effects of the irritants present in EZS occur in the
conjunctiva of the eyes and the mucous membranes of the nose,
throat, and lower respiratory tract. These irritant effects are a
frequent cause of complaints about poor air quality due to
environmental tobacco smoke.

2. Active cigarette smoking is associated with prominent changes
in the number, type, and function of respiratory epithelial and
inflammatory cells; the potential for environmental tobacco
smoke exposure to produce similar changes should be investi-
gated.

3. Animal models have demonstrated the carcinogencity of ciga-
rette smoke, and the limited data that exist suggest that more
carcinogenic activity per milligram of cigarette smoke concen-
trate may be contained in sidestream smoke than in main-
stream cigarette smoke.

252


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260


CHAPTER 6

POLICIES RESTRICTING
SMOKING IN PUBLIC PLACES
  AND THE WORKPLACE


CONTENTS

Introduction

Current Status of Restrictions on Smoking in Public
Places

Legislative Approaches
  Federal Legislation
  State, Legislation
  Local Legislation
Regulatory Approaches
Smoking Regulation in Specific Public Places
  Public Transportation
   Retail Stores
   Restaurants

Hotels and Motels
Schools
Health Care Facilities

Current Status of Smoking Regulations in the Workplace
  Smoking Policies
  Prevalence of Smoking Policies
  Reasons for Adopting Smoking Policies
  Barriers to Adopting Smoking Policies
  Types of Smoking Policies
    The "Individual Solution" Approach
     Environmental Alterations
    Restrictions on Employee Smoking
    Banning Smoking at the. Workplace
    Preferential Hiring of Nonsmokers
Implementation of Smoking Policies

Impact of Policies Restricting Smoking in Public Places
and in the Workplace
Potential Impacts of Smoking Policies
    Policy Implementation and Approval
    Direct Effects: Air Quality and Smoking Behav-
       ior
    Indirect Effects: Knowledge, Attitudes, Social
     Norms, and Smoking Behatior
Methodologic Considerations in Policy Evaluation


Study Design

  Assessing the Effects of Smoking Policies
Review of Current Eviderice on Impact
  Workplace Smoking Policies
  Policy Implementation
  Air Quality
  Policy Approval
  Smoking Behavior
  Attitudes About Smoking
  Management Issues
  Legislation Restricting Smoking in Public Places
  Policy Implementation and Enforcement
  Policy Approval
  Attitudes tid Social Norms
  Smoking Behavior

Recommendations for Future Research

Conclusions

Appendix: `I'he Comprehensiveness Index of State Laws

References

264


Introduction

Since the 197% the accumulating evidence on the health risks of
involuntary smoking has been accompanied by a wave of social
action regulating tobacco smoking in public places. hntiatives in the
public sector and in the private sector have aimed at protecting
individuals from exposure tc side&ream smoke by regulating the
circumstances in which smoking is permitted. Smoking h public
places has been regulated ~rhmily by government action at the
local level and at the Federal level. Legislation has been the most
common vehicle at the local and State level; agency regulations have
predominated in the Federal Government. There has been relatively
little judicial action to restrict smoking in public places; most cases
have focused on nonsmoking employees' right to a smokefree
workplace (Feldman et al. 1978; Eriksen, in press; Walsh and Gordon
1986). Private sector initiatives have gained momentum in the 1980s.
Businesses in a ,wide variety of industries have adopted smoking
policies to protect employee health. Other private initiatives include
no-smoking sections in restaurants, no-smoking rooms in hotels and
motels, and smoking restrictions in hospitals.
Though this trend was fueled by growing evidence about the
health effects of involuntary smoking, it also reflects the changing
public attitudes about smoking since 1964, when public attention
was focused on the health hazards of cigarette smoking by the
Report of the Advisory Committee to the Surgeon General (US PEIS
1964). The acceptability and desirability of tobacco smoking in public
places has fallen dramatically over time, as reflected in public
opinion surveys. A majority now support the right of nonsmokers to
breathe smoke-free air and favor policies that ensure that right
(ALA 198!jb; Hanauer et al. 1986; BNA 1966; US DHEW 1969).
This chapter addresses the scope and impact of these diverse
pohcies. It begins with a review of the current status of policies
restficting smoking. Issues specific to smoking regulation in trans-
portation vehicles and motels, restaurants, stores, schools, health
care facilities, and the workplace are addressed. The effects of
smoking policies on air quality, attitudes, and smoking behavior are
considered.

Current Status of Restrictions on Smoking in Public Places

Smoking regulations in public places represent a mix of public and
private actions. A public place may be defined as any enclosed area
in which the public is permitted or to which the public is invited.
Smoking restrictions are generally limited to indoor enclosed spaces
(Hanauer et al. 1986). This broad definition of a public place
encompasses a diverse group of facilities that differ in the degree to
which smoking is restricted, the ease of introducing new regulations,


and the methods by which new smoking restrictions have been
proposed and adopted.

Smoking in Federal, State, and local government facilities has
been addressed by legislative and regulatory action. These facilities
include government offices, public schools and libraries, and publicly
owned transport&ion, health care, cultural, and sports facilities. In
public facili&s under private ownership, smoking restrictions are a
mixture of government-sponsored regulation and private initiative.
These facilities include retail stores, restaurants and bars, hotels and
motels, and privately owned transportation, health care, cultural,
and sports facilities.
The extent and ac&ptability of smoking restrictions in public
places is influenced by (1) whether ownership is public or private; (2)
the historical acceptance of smoking in the facility; (3) the degree to
which nonsmokers are exposed to involuntary smoking, determined
by the facility's size, degree of ventilation, and ease of separating
smokers and nonsmokers; and (4) the degree of inconvenience that
smoking restrictions pose to smokers. Smoking restrictions are still
most widespread and least controversial in facilities where smoking
has traditionally been prohibited by fire codes, such as theaters or
libraries, or where smoking is negatively associated with the activity
taking play, such as gyms or health care facilities (Feldman et al.
1978). Small crowded areas with poor ventilation, such as elevators
and public transit vehicles, are also frequently regulated. On the
other hand, the strong association of smoking with eating and
drinking contributes to the controversial nature of smoking re&ic-
Cons in restaurants and bars.

Legislative Approaches
Fe&r-d Legislation

Congress has enacted no Federal legislation restricting smoking in
public places, although bills have been introduced in Congress
several times since 1973 (Feldman et al. 1978).

State Legislation

Most legislation restricting smoking has been enacted at the State
level. Although legislation regulating smoking for health reasons is
largely a phenomenon of the past decade, cigarette smoking has been
the subject of restrictive legislation for nearly a century. Early
legislation had two different rationales. The first, a relatively
noncontroversial rationale, was the protection of the public from fire
or other safety hazards, largely in the workplace (Warner 1981b).
The second, more controversial motivation for early legislative
action was a moral crusade against cigarettes similar in tone and
coincident with the moral crusade against alcohol that emerged at


the tux-n ofthe century Wlow 1981; Nobel 1978). INS goal w~ a total
ban On Cigarettes, which were blamed for social e* and physical
% based 1arge~Y on unfounded claims. By 1887, three States (North
Dakota, Iowa, and Te==ee) had completely banned the de and
use of cig=ett-. At the peak of the movement, cigarettes were
b-cd h a dozen Stat.e~ RJuhing and Markle 1974; sobe 1978).
Most were in the Midwest where cigarette consumption was low and
a~~ticigarette feeling high. The movement lost momentum when
enforcing the regulations proved controversial. AS part of the strong
reaction to alcohol prohibition, ah State laws banmng smoking were
repealed by 1927.
During the 196Os, as the health risks of smoking became widely
`recogn&d, public POLICY on smoking began tc focus on encow
the smoker to quit. However, the few existing State laws regulating
smoking in public places were old and limited in scope. Even newly
enacted laws-in Delaware (1960) and in Michigan (1967, 1968&
restricted smoking in limited areas: public buses and trolleys,
elevators, and retail food establishments (VS DHHS 1985b). Protec-
ting the health or comfort of nonsmokers was not cited as a rationale
of these laws. As Of 1970,~tatuteS restricting smoking were in force
in 14 states (US DHHS 1985b).
In the early 19709, a new wave of smoking legislation emerged. It
covered smoking in a larger number of places and extended for the
first time to privately owned facilities. The language became more
restrictive, moving from permitting a no-smoking section to requir-
ing one and making nonsmoking the principal or assumed condition.
me language also changed to make it clear that the specific intent
was the safety and comfort of nonsmokers.
me pace of new legislation increased in the mid-1970s. Between
1976 and 1974, 9 laws were enacted in 8 States, between 1975 and
1979, 29 new laws were passed and 15 additional States adopted
smoking regulations. Minnesota passed its landmark Clean Indoor
fi Act in 1975 "to protect the public health, comfort, and
environment by prohibiting smoking in public places and at public
meet-s except in designated smoking areas" (M~IUESO~~ Stthte~
Annual 1985). It covered restaurants, private worksites, and a large
number of public places, and soon became the model for other State
legislation. Within the next 5 years, Utah, Montana, and Nebraska
enacted similar comprehensive legislation (US DHHS 1985b). The
language of statutes passed by 11 States during the 1970s made it
clear that the specific purpose was to protect nonsmokers from
involuntary smoking (US DHHS 198523). Model legislation and
advice about the successful enactment of State laws can be found in
several sources (Hanauer et al. 1986; Feldman et al. 1978; Walsh and
Gordon 1986).


1
f  30-
.s
e
$  25-
5
f
z20
b
P  15 -
2

1960 1964   1970            1975            1880            1885

                      Year

FIGURE l.-Prevalence and restrictiveness of State laws

     regulating smoking in public places, 19604986
NOTE See appendix for definitions of mtrictivenem of laws.
S4WRCE: ASH (1SW; OTA (1986); Tri-Agency Tobacco Free Project MSSk US DHHS WS6b).

The rate of enactment of State legislation increased throughout
the seventies (Figure 1, Table 1). The pace of new legislation
continues in the 1980s with 23 new laws enacted by 16 States
between 1980 and 1985 (Table 1). As of 1986, 41 States and the
District of Columbia have enacted laws regulating smoking in at
least one public place (Figure 1). Eighty percent of the U.S.
population currently resides in States with some smoking restric-
tion, compared with 8 percent in 1971 Warner 1981b). Most of the
nine States with no smoking legislation are concentrated in the
southeast United States and include three of the six major tobacco-
producing States (North Carolina, Virginia, and Tennessee) (Figure
a.

Current State legislation varies in comprehensiveness and lan-
guage. The number of public places in which smoking is regulated by
State law ranges from 1 (Delaware, Mississippi, and South Carolina
regulate smoking on public transportation only) to 16 (Minnesota
and Florida) (US DHHS 198513, Tri-Agency Tobacco Free Project

268


1986). State laws most often restrict smoking in public transporta-
tion (35 States), hospitals (33 States), elevator (31 States), indoor
cultural or recreational facilities (29 States), schools (27 Stat.@,
public meeting rooms (21 States), and libraries (19 States) (Table 2).
Other public places specifically mentioned in State smoking legisla-
tion are public restrooms and waiting rooms, jury rooms, polling
places, prisons, hallways, stairwells, and stables. Most laws restriqt
smoking in these places to designated areas, thereby making
nonsmoking the norm; in a few States smoking is banned entirely in
these places. For example, smoking on pqblic transportation is
banned entirely in four States (Florida, Georgia, Massachusetts, and
W&&t& ad one (Washington) bans smoking in theaters,
m-e-, au&t()dm, and indoor sports arenas. Smoking restric-

                                          269


m Nominal
0 No-ns

FIGURE 2.-Geographic variability of State laws regulating
      smoking in public places, 1996

tions extend to restaurants and retail stores, which are largely
privately owned, in 18 States.

Smoking at the workplace is restricted for public sector employees
in 22 States and for private sector employees in 9 States. The
provisions of worksite smoking legislation vary widely, making
direct comparisons of their comprehensiveness difficult.
Currently enacted workplace smoking laws contain provisions to
(1) require a written policy (5 States); (2) limit smoking to designated
areas (8 States); (3) require the posting of signs (10 States); and (4)
give preference to nonsmokers in resolving conflicts over the
designation of a work area (2 States) (OTA 1986). Public or private
worksites are included in the definition of public places in some
States where worksites are subject to the general provisions for
public places. Other States have written separate guidelines for the
worksite, which are usually more stringent. Laws in four States
apply only to State and local government employees; restrictions
apply to the private worksite in an additional nine States.

270


state            AL AK AZ AR     CA     CO (;T DE DC FL GA HI ID   IL IN IA KS KY
                             1971.76         1973                            1925
Year(s) legislation         1975   1973   1977   1960.61    1977   1974             1963             1975
   enacted        -   1964   1981   1963    1962    1985'   1963   1960   1979   1965   1975   1976   1965   -      1978   1975   1972

PUBLIC PLACES WHERE SMOKING IS PROHIBITED (EXCEPT IN DESIGNATED AREAS)
Public transportation       x x    (X)'     X3.4     X     X8 x     X     x3.5 X'         X           X     X     X
Elevators              X' x                 X     X'         X     x1 X' x     X           X     X
Indoor recreational or
cultural facilities'         x x           X      X                    X          X     X           X     X
Retail stores            (X)'             (X)' x     X          X     X              X
Restaurants             X'               X0     X     X'O             X'             X
Schools                X     X     X      X      X     X          X     X              X
Health care facilities
Hospitals              X     X     X      X      X     X         x x          X     X           X     X
Nursing homes          X                X      X     X          X     X              X           X     X
Public meeting rooms       X                X           X          X     X          X     X           X     X
Libraries               X     X                                     X                         X     X
Restrmns              X' x                 X     X              X
Waiting rooms           X     X                 X     X               X                          X
Other               p.27 xn                                     X262-7.30

WORKSITE SMOKING RESTRICITONS "
Public worksites          D"               B      D' B          B    B,D I11       B' B           D
Private worksites          A                            B             BD

IMPLEMENTATION PROVISIONS
Nonsmokers prevail
in disputes             X
No discrimination
against nonsmokers

    ENFORCEMENT
    Penalties for violations      X     X     X      X           X     X     X     X     X     X     X           X     x x
    Smoking              Xm   pa x23.     XS          xm X" x= X21' x23. X"   X2&i          x- 2P x-
Y    Failure to post signs       X@h                                    XUh
c
    Overall State law
     restrictiveness:"      0    3     2     1      3       3     4     1     2     4     1     2     3    0   0    2     2     1


ii   TABLE 2.-Cantinued

St&           LAME MDMAMIMN   IbiB MO MT NE NV NH NJ Nbf   NY NC ND OH
                  1954        1924 1967                                 1955       1921
Year@) legislation         1961,63   1957   1947 1966   1971                     1911        1979       1975           1961
  enacted              1965    1975   1975   1976   1975   1942 -   1979   1979   1976   1961 1965 16%   1976 -   1977 lsec

PUBLIC PLACES WHERE SMOKING I8 PROHIBITED (EXCEPT IN DEslGNATBD AREAS)
Public transportation          X      X    X' 00' x x        X    x x x x x x       x x
ElW&XI                     X    X' x x           x x x x x x            x x
Indoor recreational or
cultural facilities*                      X         X           x x x x x x x       x x
Retail stores              X         cm' x x            x x         X    X
Restaurants                             X    X"           x x             X"   X"           X
Schools                                       X           x x x x x x            x x
Health care facilities
Hospitals               X     x x x x            x x x x x x            x x
Nursing homea            X     x x x x           x x x x x x            x x
Public meeting rooms                            X           x x x x x x            x x
Libra+                          X         X                x x         x x x       X
Rentmoms           x                     X                 X                              x x
waiting rooms             X                    X                 x x x                       X    X
Other                  X'"         X"        Xmm              X"        X"            X"

WORKSITE SMOKING RE!i%`RICl'IONS"
Public worksites           BP                   D"           D "   D"        D'O   B,C" B$F           C     C
Private worksites          4D                  Dl7.21           D"   D17P A"       B,C "       Aal

IMPLEMENTATION PROVISIONS
Nonsmokers prevail
in disputes                                    X                                     X
No discrimination
against nonsmokers          X

ENFURCEMENT


state              OK     OR     PA I.. SC SD TN TX UT VT VA WA WV WI WY
                    1973.76    1927                                            1913               w
Year(s) legislation             1977    1947   1976                     1976                1919               N CC)
   enacted          1975    1961     1977   1977   1937   1974   -   1975   1979   1692   -   1963   1965   1964   -       51 wo)

PUBLIC PLACES WHER?- SMOKING IS PROHIBITED (EXCEPT IN DESIGNATED AREAS)
Public transportation     X                X    (x)* x        X
Elevators            X      X          X         X        X
Indoor recreational or
cultural facilities0      X      X      x x         X        X
Retail stores                 X      X    X
Restaurants                 X          X
Schools                    X           X          X        X
Health care facilities
Hospitals                  X      X    X          X        X
Nursing homes               X      X    X                  X
Public meeting rooms            X
Libraries             X                 X         X        X
Restrooms
Waiting rooms               X
Other                          XS"   X"

X
X
X
X

X'
XL

X'
X'
X
X'

X
X
X'
X
X
X
X"

X     X
     X

     X
     X
     X
X     X

X
X

X

36 (66.6)
31 (60.8)

29 (59.6)
16 (35.3)
16 (35.3)
n (52.9)

33 (64.7)
29 (56.9)
21 (41.2)
19 (37.2)
11 (21.6)
16 (31.4)
12 (23.5)

WORKSITE SMOKING RESTRICI'IONS"
Public worksites               D
Private worksites

D"            D          D"           22 (43.1)
D17.22   A"       D    A"                9 (17.6)

IMPLEMENTATION PROVISIONS
Nonsmokers prevail
in disputes
No discrimination
against nonsmokers

X                                  4 (7.6)

X                                  2 (3.9)

ENFORCEMENT
Penalties for violations    X      X      X    X          X        X     X     X        x x     X            40 (78.4)
Smoking            XW     XWb    X2" x=        X2.%       X2" x=   X23.       XZJ'   psa    X=          39 (76.5)
Failure to post signs            X2&         XW                                       pe                9 (17.6)

Overall State law
restrictivenewzS        2      3      2     3     1     2    0    2     4     1    0    4     1     3    0


Y  TABLE 2.-C!ontinued (Footnotes)

' Executive order.
`School buses only.
a Including school buses.
`California stipulates that at least 50 percent of all passenger seats must be in nonsmoking areas on trains, airplanes. and street railroad cam departing from the State.
`Smoking never permitted in this area.

`Indoor recreational and cultural facilities: museums, auditoriums, theaters, and sports arenas.
`Grocery storea only.
' Beatauranta seating 50 or more persons must have a no-smoking section.
eBestauranta seating 50 or more persons must have e no+moking eection if the restaurant ia in a publicly owned building.
`OBestauranta seating 15 or more persons must have a nwmoking section.
" Restaurants must designate at least 30 percent of their mata aa a no+moking area.
" Reatauranta are encouraged to establish noamoking areas.
`I Ftentauranta must designate at least 50 percent of their seats 88 a no.emoking area.
"Kkleted).

I' No place other than a bar may be designated B smoking area in its entirety.
`* Worksite (only 8, C. and D munt aa having a worksite policy in maculation of totals): A - Employer must post a sign prohibiting smoking at the work&q B - Employer mu& have a (wit&n)

smoking policy; C - Employer must have policy that provides a nonsmoking area; D - No smoking except in designated .wcas.
" Employer must post signs designating smoking and nwmoking arena.
`*Employer mu& vt signs in smoking area.%
`*Employer must post either smoking or nwemoking sign& depending upon their policy.
`"Employer must post Ggna in no-smoking areas.

" State doea not restrict smoking in factories. warehouses. and similar placea of work not usually frequented by the general public.
" Prohibita smoking in any mill or factory in which a no-emoking sign is pasted.
"Pereons who smoke in a prohibited area are subject to a tine or a penalty. Maximum fina or penalties, where applicable, are listed below: a = $5; b = $10, c = 1%; d = $& e = $100, f =
$loO/day; g = $200; h = *urn; i = $5CO; j = $50 or up to 10 days in jail or both; k = $60 or SO daya imprisonment; 1 = civil action; m = minor misdemeanor; n = petty mi&mwnor; o =
misdemefmor; p = petty offense.

" Persona who are required to and fail to pcet smoking and/or no+moking sigma are subjected b a penalty. Maximum finea. where applicable. are listed in footnote 23.
I6 Restrictivenea key: 0 = None, no statewide restrictions; 1 = Nominal, State ragul&en smoking in one to three public placm, excluding restaurants and private vorknita; 2 = B&c, State
regulatea smoking in four or more public places, excluding restaurants and private workaita; 3 = Moderate. State regulatea smoking in restaurants but not private workaitcs; 1 = ENnaive.
State regulates smoking in private work&es.
*`Jury moms.
" Halb and stain.
`*stables.
"Polling plaan.

*`Prisons, at ptin offL%& diiretion.


The least restrictive workplace laws simply empower the employer
to restrict smoking in factories by posting signs. These statutes were
enacted in the early 1900s. The weakest recent laws simply require
an employer to issue a written smoking policy and to post signs.
More restrictive laws require that employers designate no-smoking
areas at work, implying that smoking is the norm. The most
comprehensive laws prohibit smoking except in designated areas,
making nonsmoking the norm. Seven States (Florida, Maine, Minne-
sota, Montana, Nebraska, Utah, and Washington) have this type of
law. In several States, some worksites or some parts of a worksite
(usually private offices) are exempted from the regulations. To
prevent employers from complying with the letter but not the intent
of the law, some States prohibit a workplace from being designated
as entirely smoking.
State laws vary in their provisions for implementation and
enforcement. In most States, the State health department is
responsible for policy enforcement. Nearly all (39 of 42) States with
laws provide penalties for smokers who violate restrictions; the
maximum penalty is $500. In two States violators can be jailed.
Employers or others who fail to designate smoking areas can be fined
in nine States.
The comprehensiveness of State laws, as defined by the number
and nature of places where smoking is restricted or prohibited, has
increased since 1970. In 1981, Warner (1981b) classified State laws
according to their comprehensiveness (restrictiveness) and docu-
mented an increase in the average restrictiveness from 1971 to 1978.
An updated and modified index of the comprehensiveness of State
laws (described in the appendix) demonstrates that the phenomenon
reported by Warner has continued into the mid-eighties. The
comprehensiveness of newly enacted laws increased markedly dur-
ing the mid-seventies, and the average restrictiveness of State laws
in effect has increased more than twofold between 1972 and 1985
(Table 1, Figure 3). As shown in Figure 1 and Table 1, the increase in
comprehensiveness of State laws occurred in two ways. The average
comprehensiveness of first laws in additional States increased, and
existing State smoking laws were replaced with more comprehensive
legislation.
Warner also documented that both the prevalence and comprehen-
siveness of State laws enacted through 1978 varied by geographic
region (Warner 1982). This has not changed (Table 3, Figure 2). Over
90 percent of the States in the Northeast and West have enacted at
least one law regulating smoking, as have three-fourths of the North
Central States. Southern States have fewer laws than other regions,
and the laws they have are less comprehensive than laws in other
regions. The six major tobacco-producing States, all located in the
South, have less restrictive laws than do the other six Southern