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GDP vs. GPI view of Smoking

Genuine Progress Index for Atlantic Canada Indice de progrès véritable - Atlantique The Cost of Tobacco in Newfoundland and Labrador and The Economics of Tobacco Control and Smoke-Free Places St. John’s, 1-2 April, 2003. GDP vs. GPI view of Smoking.

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GDP vs. GPI view of Smoking

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  1. Genuine Progress Index for Atlantic CanadaIndice de progrès véritable - AtlantiqueThe Cost of Tobacco in Newfoundland and Labrador andThe Economics of Tobacco Control and Smoke-Free PlacesSt. John’s, 1-2 April, 2003

  2. GDP vs. GPI view of Smoking The GDP “view” - all spending, including tobacco, makes economy grow, contributes to “prosperity” • Cigarette sales = $141 million, 1% of GDP, 2001 • $millions for medical costs, hospitals, doctors, drugs for smoking related illness • Nicotine quitting and replacement costs • In GPI, smoking =cost, not gain, to economy

  3. Newfoundland Smoking Rates, 2001 26% of Newfoundlanders smoke (CTUMS) Labrador = 36% men, 30% women 22% of 15-19 year olds smoke At today’s smoking rates: Of the children and teenagers alive in NL today, 9,000 will die from smoking in middle age and 9,000 more will die prematurely later in life

  4. Percent of Population Who Smoke(1985 and 2001)- Current smokers as % of population age 15 and over

  5. Change in Smoking Rates 1985-2001

  6. Daily Smokers -as % of PopulationAged 12 and over, by Health Districts, 2000/01

  7. % Who Never Smoked 2000/01 age 12 and up

  8. Teen Smoking (15-19) 22% in 2001 (down from 28% 2000)

  9. Teen Smoking rates by Gender age 15-19, 1996 vs. 2001

  10. Smoking Rates by Stress LevelCanada, 18+ age

  11. Smoking Rates Related to Education & Unemployment. E.g. Economic Zone, 2001

  12. The Cost of Smoking in Newfoundland & Labrador • Illness and early death to smokers • Medical care costs • Losses in productivity • Costs to employers

  13. Costs of Smoking in NL • 1,000 premature deaths / year • $79 million direct health care costs • $139 million productivity losses • 113,080 smokers smoke 687 million cigs /year at cost of $141 million

  14. Annual Extra Cost of Employing Smokers

  15. Exposure to 2nd-hand smoke in NL • 35% of Newfoundland men and 30% of women are exposed to second-hand smoke on most days. • Labrador = 39% and 34% • NS 1995 = 24% exposed to 2nd-hand smoke at work; 1/3 of children exposed to 2nd-hand smoke at home

  16. Exposure to second-hand smoke, Nfld health regions

  17. Smoking Rates, Exposure to Second-hand Smoke, and Sensitivity to Cigarette Smoke

  18. Proven Health Effects of Second-Hand Smoke • Second-hand smoke causes heart disease, lung cancer, nasal sinus cancer and respiratory ailments in adults. • ETS causes sudden infant death syndrome, fetal growth impairment, bronchitis, pneumonia, middle ear disease and asthma exacerbation in infants and children.

  19. Health Hazards of Second-Hand Smoke Recognized by: • World Health Organization (1986 and 1999), • U.S. National Academy of Sciences/National Research Council (1986), • Australian National Health and Medical Research Council (1987), • U.K. Department of Health and Social Security (1988), • U.S. Environmental Protection Agency (EPA) (1992), • U.S. Public Health Service (1986), • U.S. National Institute for Occupational Safety and Health (1991), • American College of Occupational & Environmental Medicine (2000), • California Environmental Protection Agency (1997), • The Australian National Health and Medical Research Council (1997), • United Kingdom Scientific Committee on Tobacco and Health (1998) • U.S. National Toxicology Program (9th Annual Report on Carcinogens, 2000)

  20. Recent Research Also Shows: • ETS has been linked to cervical and breast cancer, stroke, and miscarriages in adults; and to asthma induction, decreased lung function, cystic fibrosis, and cognition and behaviour problems in children

  21. Restaurant, Bar, Casino Workers Most at Risk • In restaurants, second-hand smoke levels are 2x as high as in other workplaces without smoke bans.In bars and casinos = 3-6 times as high. • Excess mortality for workers in smoking lounges, bars, restaurants, casinos, bowling alleys is 15-26 times higher than OSHA’s “significant risk” level. • “Establishment of smoke-free bars and taverns was associated with a rapid improvement of respiratory health….”Eisner, 1998

  22. Food workers exposed to toxins and carcinogens • Food service workers have a 50% higher rate of lung cancer than the general population. • Second-hand smoke is the leading cause of workplace death in Canada • Occupational hazards not accepted in other industries

  23. Costs of Second-hand smoke in Newfoundland & Labrador • Second-hand smoke kills an estimated 112 Newfoundlanders /yr, (78 from heart disease, 34 from cancers). • Second-hand smoke costs province $12 million a year in health costs + $34 million in productivity losses

  24. Costs of Second-Hand Smoke, Newfoundland & Labrador • Deaths 112 • Potential years of life lost 1,624 • Hospitalizations 784 • Hospital Days 8,400

  25. Direct Health Care Costs- ETS($ millions, Newfoundland and Labrador) • Hospitals $8.8 • Ambulance Services $0.2 • Physician fees $0.9 • Prescription Drugs $1.8 • Other health care costs $0.2 • Total Direct Health Care Costs: $11.9

  26. Indirect Costs ETS, Newfoundland and Labrador • Productivity loss (sickness) $0.4 million • Productivity loss (mortality) (6% discount rate) $33.7 million • Total Cost to Economy: $46 million Sources: Costs based on Canadian Centre for Substance Abuse, The Costs of Substance Abuse in Canada, Colman, The Cost of Tobacco in Nova Scotia, pages 15-20, and mortality rates in Glantz and Parmley, (1995), and Steenland, (1992).

  27. Do “Non-Smoking” Areas Provide Protection from ETS? • “Simple separation of smokers and non-smokers within the same air space ... does not eliminate exposure of non-smokers to environmental tobacco smoke.” U.S. Surgeon-General, National Research Council • “The ‘non-smoking’ (casino) tables... did not measurably decrease employee exposure to ETS.”U.S. National Institute for Occupational Safety and Health • “Simple separation of smoking and non-smoking indoor workers fails to prevent involuntary exposure to ETS.”American College of Occupational and Environmental Medicine (2000)

  28. “Courtesy of Choice” Hotel Association of Canada • “Courtesy of Choice makes it possible for smokers and non-smokers to live in harmony. It is a program of self-regulation that uses scientific air-flow analysis to guarantee that non-smoking areas are truly smoke-free....(It) involves effective ventilation and filtration systems to ensure that smoke and other contaminants in the air are removed.” • The Canadian Tobacco Manufacturer’s Council gave the Hotel Association of Canada $3.2 million to implement its “Courtesy of Choice” program.

  29. Does Ventilation Protect from Second-hand Smoke? “Accommodation of tobacco smoke in the workplace, the solution proposed by the tobacco industry, was found to have no basis in science or public health protection.... The ventilation system capable of removing tobacco smoke from the air does not exist…. ASHRAE no longer provides ventilation standards for air with tobacco smoke in it, only for air in smoke-free buildings....Ventilation provides no solution to the problem of exposure to second-hand tobacco smoke.” Ontario Tobacco Research Unit, University of Toronto (2001)

  30. Would restaurants build ventilated smoking areas? A random survey of 401 Quebec restaurants found that most would not construct ventilated smoking areas, even if they were effective, for financial and technical reasons.Cremieux and Oulette, 2001

  31. Therefore: • “A limited policy offers no advantage over no policy at all…. (T)he only way to protect nonsmokers’ health is with a smoke-free work site.”Borland, JAMA • U.S. Surgeon-General recommends: “100 percent smoke-free environments in all public areas and workplaces, including all restaurants and bars.”

  32. Expert Conclusions • “All involuntary exposure to tobacco smoke is harmful and should be eliminated.”Ontario Tobacco Research Unit, University of Toronto (2001) • “Smoking bans remain the only viable control measure to ensure that workers and patrons of the hospitality industry are protected from exposure to the toxic wastes from tobacco combustion.”Repace (2000)

  33. Smoke-Free Workplaces Save Lives and Money • Smoke-free workplaces cut cigarette consumption among smokers by 20%+. • Smoke-free workplaces can save: 220 lives a year in Nfld, $25 million in avoided health costs, and $65 million in avoided productivity loss (+ $28 mill - cig costs) - Savings begun!

  34. And savings to employers: • It costs Canadian employers $2,446 (2001$) more to employ a smoker vs. a non-smoker. Conference Board of Canada • Smoke-free workplaces can save Nfld employers $22 mill/yr in avoided absenteeism & smoking areas costs, and lower insurance premiums. • “Strong economic incentives exist for rapid adoption of smoke-free workplaces.” American College of Occupational and Environmental Medicine

  35. Occupational Health & Safety Laws“require employers to provide a safe working environment” - Heather Crowe • “Employees...should have the right to refuse to work in environments with high levels of ETS…. Canadian OHS legislation that could apply indirectly to ETS include the regulation of substances found in tobacco smoke (possibly through the national Workplace Hazardous Materials Information System.”Health Canada • Smoke-free workplaces avoid potential litigation based on unhealthy workplaces (e.g. Ontario)

  36. Nova Scotia’s 1996 Occupational Health and Safety Act (ch. 7), sect 13 (1) • requires every employer to “ensure the health and safety of persons at or near the workplace” and to ensure “that employees are not exposed to health or safety hazards.” • Employers shall “render harmless all gases, vapours, dust or other impurities that are likely to endanger the health or safety of any person therein.”

  37. Are Smoke Bans Bad for Business? • Without exception, every objective study using actual sales data finds that smoke-free legislation has no adverse impact on restaurant, bar, hotel and tourism receipts.(California, Colorado, Massachusetts, New York, Arizona, Texas, Utah, Vermont, North Carolina, and BC) • Two of the 16 studies found an initial decline in receipts in the first 1-2 months following enactment, but no overall or aggregate decline in the longer term. • Several studies find smoke-free legislation is good for business as non-smokers eat and drink out more often.

  38. The Researchers Conclude: • “Legislators and government officials can enact health and safety regulations to protect patrons and employees in restaurants and bars from the toxins in secondhand tobacco smoke without fear of adverse economic consequences.... these data further discredit tobacco industry claims that smoke-free bar laws are bad for the bar business. Quite the contrary, these laws appear to be good for business.”Glantz1997 and 2000 (California)

  39. Conclusions from the 16 Studies • “All models indicate that smoke-free restaurant restrictions increased restaurant receipts in towns adopting smoke-free policies, by 5 to 9 percent.”Pope & Bartosch, 1997 (Mass.) • “Other cities can enact similar laws, which protect restaurant patrons and food service workers from tobacco smoke, without concerns that restaurants will lose business.”Sciacca & Ratcliffe (Az)

  40. More Conclusions: • “Smoke-free restaurant ordinances did not hurt, and may have helped, international tourism”From tourism/hotel sales in 6 U.S. States • “The statistical results strongly confirm that there are no long-term impacts from restrictive smoking regulations.”CRD, BC, 2000

  41. “Nine months after tough anti-smoking legislation was imposed in B.C.’s capital, business remains steady and liquor sales are up….”Victoria, B.C. 1999 • “In one study after another, covering multiple states within the US, analysts have found no adverse effect of smoking restrictions, including complete bans, on local restaurants’ business. Indeed, several of the studies have found a tendency for smoking restrictions to increase business. Similar findings derive from analysis of the effects of smoking restrictions on bars ...(and) tourism.”Warner, 2000

  42. Smoke Bans May Increase Sales “Our results indicate that these nonsmokers are more than making up the revenues lost from inconvenienced diners who smoke.... At the very least restaurateurs should make business decisions based on data, not opinion.Ultimately, smoke-free legislation is likely to have a positive impact on restaurant-industry revenues. Our advice to other cities and municipalities is to consider similar legislation. The restaurant industry collectively may experience higher revenues through smoke-free legislation.”Cornell Hotel and Restaurant Administration Quarterly, 1996

  43. Restaurateur Fears Unfounded A survey of Arizona restaurateurs before smoke-free legislation found 44% concerned that customers would be upset. Afterwards, the same restaurateurs reported that most customer reactions were positive. Only 15% found negative reactions. 88% said the law was positive or neutral for staff, and 94% said it was easy to enforce. Sciacca 1996

  44. The tobacco industry resists smoke-free legislation by: • Denying the overwhelming scientific evidence on the health hazards of ETS • Working through third parties, esp. restaurant, bar and hotel associations by spreading fears (never empirically substantiated) that legislation will harm their business. • Watering down and delaying legislation; shifting the focus of debate from public health to market choice; and arguing that ventilation can remove ETS despite scientific evidence to the contrary.

  45. In Tobacco Industry’s Own Words: • “The immediate implication (of smoking bans) for our business is clear: If our consumers have fewer opportunities to enjoy our products, they will use them less frequently and the result will be an adverse impact on our bottom line”(Philip Morris) • “Ourobjective is to contain and refine the environmental smoke issue in order to decrease the pressure for safety measures….”(Tobacco Institute)

  46. Using “third party sources” to gain credibility: “…We try to keep Philip Morris out of the media on issues like taxation, smoking bans, and marketing restrictions. Instead we try to provide the media with statements in support of our positions from third party sources, which carry more credibility than our company and have no apparent vested interest….” (Philip Morris)

  47. ..keep focus off public health “We try to change the focus on the issues. Cigarette tax become(s) an issue of fairness and effective tax policy. Cigarette marketing is an issue of freedom of commercial speech. Environmental tobacco smoke becomes an issue of accommodation. Cigarette-related fires become an issue of prudent fire safety programs. And so on.”(Philip Morris) “Portray the debate as one between the anti-tobacco lobby and the smoker, instead of ‘pro-health public citizens versus the tobacco industry.” (Philip Morris)

  48. What Enables Smoke-Free Legislation to Succeed? • Legislators must be well aware of the facts and evidence and also of tobacco industry strategies to prevent smoke bans. • An in-depth analysis of the politics of tobacco control in California also concluded:“The outcome of proposed local tobacco control legislation appears to depend on how seriously the health advocates mobilize in support of the local legislation. When the health community makes a serious commitment of time and resources, it wins. When it fails to make such a commitment, the tobacco industry prevails.”Samuels & Glantz, 1991

  49. Tourism and Hospitality Industries Can Protect their Employees and their Business • Smoke bans are popular (about 75%), and protect hospitality industry employees who are most at risk from ETS. • More than 90% of visitors to Atlantic Can. are from other parts of Canada and the US, where smoke-free legislation is common.

  50. Taking the High Road • The California Restaurant Association fully supported the smoke-free workplace law that applies to all restaurants, bars and gaming places. • “Why not take the high road and promote NS as a healthy, trend-setting, visionary, smoke-free environment – a marketing opportunity for the new century and new generation of visitors?”Response to a TIANS survey on smoke-free legislation

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