Ky. Center for Smoke-free Policy seeks nominations by March 15 for smoke-free advocates to be honored at next conference

The Kentucky Center for Smoke-free Policy is accepting nominations for local smoke-free advocates who deserve to be recognized for their dedication to improving smoke-free policy and secondhand smoke education in Kentucky. Self-nominations are welcome. 

The winners will be honored at the 2024 Kentucky Tobacco Control Conference, to be held April 23-24. One of the advocates will be awarded the Dr. David B. Stevens Smoke-free Advocate of the Year Award. 

Nominations are due March 15. The nomination form requires a minimum of 500 characters to describe the advocate’s smoke-free work. Also, please remember that the Advocate of the Year Award is intended for individuals and that nominations of groups or organizations will not be considered. 

Submit nominations here: https://uky.az1.qualtrics.com/jfe/form/SV_2osikEukP52JfWS

Ky. Center for Smoke-free Policy recognizes communities, groups and individuals who work to create smoke-free communities

Lori Fulton Brookbank is Smoke-free Advocate of the Year. Image from the Smoke-free Tomorrow Facebook page

The Kentucky Center for Smoke-free Policy honored communities, groups and individuals from across the state who are making progress in creating healthier, smoke-free communities. The awards were presented Nov. 10 at a virtual award ceremony. 

“Kentucky has had an amazing year as we now have 38 communities with comprehensive smoke-free workplace laws, covering 36.2 percent of Kentuckians," said University of Kentucky nursing professor Ellen Hahn, director of the Kentucky Center for Smoke-free Policy. "We have experienced extraordinary momentum and leadership by local elected officials and advocates for smoke-free and tobacco-free protections even during the pandemic. These community heroes are making Kentucky a better place to breathe.” 

This year’s awards include:

The Smoke-free Indoor Air Excellence Award recipients were the cities of Hazard, Perryville, and Hodgenville as well as Perry County (which includes Hazard) for their leadership and collaborative efforts in promoting the health of their citizens by enacting comprehensive smoke-free workplace ordinances.

The Smoke-free Excellence in E-Cigarette Policy Award recipients were the cities of Corbin, Campbellsville, and Williamsburg for their leadership and collaborative efforts in promoting the health of their citizens by strengthening their comprehensive smoke-free ordinance to include e-cigarettes.

The Smoke-free Endeavor in E-cigarette Policy Award recipients were Franklin County, its seat of Frankfort and the City of Hopkinsville for their leadership and collaborative efforts in promoting the health of their citizens by adding e-cigarettes to their partial smoke-free ordinance.

The Lee T. Todd Jr. Smoke-free Hero Award  recipients were Hayley Leach and Sierrah Miley, UK Tobacco-Free Take Action Ambassadors, for their commitment to smoke- and tobacco-free environments in the face of adversity.

The Timothy W. Mullett, MD, Lung Cancer Prevention Award went to Angela Criswell of the Lung Cancer Alliance, and Lindi Campbell of Breath of Hope KY, for their devotion and passion for preventing lung cancer through education, advocacy, or policy change. 

The Lifetime Achievement in Tobacco Control Award recipient was Mary Singler, retired health -promotion manager with the Northern Kentucky District Health Department, for her exceptional career devoted to leadership in tobacco control.

The Tobacco-free Campus Award recipient was Western Kentucky University for its leadership and collaboration in promoting a healthy campus environment by implementing a 100% tobacco-free campus policy.

The Smoke-free Youth Advocate Award recipient was the Mason County High School Family, Career and Community Leaders of America chapter for excellence in promoting secondhand smoke education and smoke-free policy.

The David B. Stevens, MD, Smoke-free Advocate of the Year recipient was Lori Fulton Brookbank, with the Smoke-free Partnership of Mason County, for her excellence in promoting secondhand smoke education and smoke-free policy. 

The other two nominees for the Smoke-free Advocate of the Year award were Shirley Daulton of the Lake Cumberland District Health Department, and Jennifer Osborne of the Lincoln Trail District Health Department.

Ky. River District Health Department director named a Ky. health policy champion for helping pass Perry County's smoke-free law

Scott Lockard

The Foundation for a Healthy Kentucky has named Public Health Director Scott Lockard of the Kentucky River District Health Department its latest Healthy Kentucky Policy Champion for leading the team that helped Perry County enact a smoke-free workplace ordinance.

Perry is the first county in Eastern Kentucky to go smoke-free, and one of only six that have a comprehensive law that includes all workplaces and enclosed public places.

"Scott and his team showed patience, persistence and a determination to do the legwork to get the right policy passed in Perry County," Fran Feltner, director of the Hazard-based University of Kentucky Center for Excellence in Rural Health, said in a foundation news release. "This law will greatly reduce the exposure to secondhand smoke for all residents of the county, and may also reduce the smoking rates."

The Perry County Fiscal Court passed the ordinance June 18 and it went into effect immediately. It bans smoking and use of e-cigarettes in all indoor and outdoor workplaces, and indoor public places.

The health department worked closely with Shannon Smith, state director of government relations for the American Heart Association, to educate the community and Fiscal Court members about the health benefits of the ordinance, the release says.

"With the help, guidance and support of Scott and his team, especially Sherrie Stidham, we were successful in building the powerful partnerships needed to pass this ordinance, which is backed by many health organizations and citizen advocates," Smith said.

Following passage of the ordinance, the county seat of Hazard strengthened its smoke-free policy to mirror the countywide law.

Lockard and the health department, along with other winners of the award, are now eligible for the Gil Friedell Health Policy Champion award, which comes with a $5,000 grant from the foundation to a Kentucky-based nonprofit of the winner's choice. The winner will be announced at the foundation's annual health policy forum Sept. 23 in Lexington.

Perry County becomes the 35th Kentucky community with a comprehensive anti-smoking ordinance; Hazard keeps partial ban

The Perry County Fiscal Court unanimously passed a comprehensive smoke-free ordinance on June 18, becoming the 35th community in Kentucky to do so.

The law, which took effect immediately, bans smoking, including the use of electronic cigarettes, in all places of employment and public buildings. It also prohibits smoking within 15 feet of any public door, window or ventilation system, as well as any public outdoor seating and recreational areas.

Perry County (Wikipedia map)

The county seat of Hazard will continue to operate its own smoke-free ordinance, which was implemented in 2016. The county ordinance "does not affect property within the City of Hazard," Katie Kelley of the Hazard Herald reports. The city's ban is considered only partial because it doesn't include all workplaces, says the Kentucky Center for Smoke-Free Policy.

The county ordinance will be enforced by the county Code Enforcement Board, with a possible fine  for violators of up to $50. Fines have also been set for business owners and employers who fail to comply with the ordinance. Business owners and employers are required to post "no smoking" signs.

At 28 percent, smokers are more prevalent in Perry County than the rest of the state, where that rate is 25%, but Emily Bennett with Hazard's WYMT-TV reports that most there are pleased with the ban.

Local diners at Frances' Diner, a restaurant that used to allow smoking, told Bennett that they are now able to eat without worrying about their health.

Matthew Combs, who works in Hazard, told her that he suffered from allergies and asthma and that being able to eat in a smoke-free environment is "wonderful."

One local health official pointed out the dangers of secondhand smoke, especially for employers who are exposed to it all day.

 "If it's a smoking venue, it is the equivalent to them having a pack a day habit themselves for a non-smoker having to work in a smoking environment where that is allowed," Scott Lockard, the public health director for the Kentucky River Regional Health Department, told Bennett.

Another told Bennett that such policies eventually create a "new norm."

Sherrie Stidham, a health educator, told Bennett, "We're wanting to set a new norm. We don't want children to get used to seeing everybody in these places and smoking and think it's an okay thing to do."

Smoke-free advocates say the policy can be more palatable if part of a wellness campaign; also say to include smokers at the table

By Melissa Patrick
Kentucky Health News

If you're trying to win passage of smoke-free policies in communities that have been resistant to such efforts, you should focus on the broad issue of improving the health of those communities. That's what one told more than 250 attendees at a conference, saying that efforts to make a community healthier naturally lends itself to policies that minimize exposure to second-hand smoke.

Onjewel Smith of the Southern States Regional Project of
the American Nonsmokers' Rights Foundation discussed
smoke-free campaigns in rural communities at the 2019
Kentucky Tobacco Conference. (Photo by Melissa Patrick)

Onjewel Smith, who works for the American Nonsmokers' Rights Foundation Southern States Regional Project, offered examples of how rural communities in Mississippi and Louisiana have successfully passed smoke-free laws by focusing on "healthy community initiatives." She told the group that these strategies have worked because advocates have framed smoke-free in a way that matters to these communities.

"It's about getting people to think about wellness and not necessarily smoke-free," she said. Later adding, "I don't care what the motivation is. I really don't. At the end of the day we want these policies in place. We want people protected. "

She also reminded the group that getting folks ready for a smoke-free policy requires a whole lot of community engagement to bring awareness to the issue. "We can't ask for change until people understand there is a problem," she said.

As of April 1, 35.5% of Kentuckians are protected by smoke-free laws covering all indoor workplaces and public places.

The 2019 Kentucky Tobacco Conference "Envisioning a Smoke-Free Future" was held April 16 and 17 in Lexington. It was hosted by the Kentucky Center for Smoke-Free Policy, the Kentucky Department for Public Health, the University of Kentucky College of Nursing and the Kentucky Tobacco Prevention and Cessation Program.

Another recurring theme at the conference was to make sure people who would be most affected by a smoke-free policy are included at the table. Speakers at a harm-reduction summit shared a similar message last week, stressing the importance of partnering with drug users to make syringe exchanges truly successful.

For example, the speakers said African Americans, people from the LGBTQ community, people in addiction and recovery, and people from low socioeconomic status, all need to be involved in policy making. These groups were mentioned because they tend to use tobacco products at high rates, largely because they have been targeted by the tobacco industry.

Vivian Lasley-Bibbs, acting director of the Office of Health
Equity at the state Department for Public Health, engaged
with the advocates at the conference. (Photo by Melissa Patrick)

Vivian Lasley-Bibbs, acting director of the Office of Health Equity at the state health department, talked about the importance of looking at tobacco policies from the lens of health equity, which she said requires us to think about how a policy, decision or practice is unfair to one group or another.

She asked, "How many times have you worked around an issue or gone into a community and sat around the table where those who are impacted aren't there?"

Dr. Valerie Yerger, an associate professor of health policy at the University of California, San Franscisco, had a similar message as she spoke about the tobacco issue: "Look around; if you are dealing with an issue that affects marginalized people, make sure that they are there and let them participate. And think in terms of how you can make the work very, very relative to them."

Another hot topic at the conference was use of electronic cigarettes among teenagers, which has increased nearly 80 percent in the last year among high-school students.

Mindy Ickes, an associate professor at UK and the director of several programs that promote tobacco-free college campuses, told the group that Kentucky data shows that e-cigarette use is as high as 75% among students in some Kentucky high schools.

Jelaine Harlow, a Lake Cumberland District Health Department health educator who works with youth in Casey and Adair counties, said they have largely focused on e-cigarette education with teachers and youth this year, adding that they have even had to deal with a first-grader on the school bus with a Juul, which is the most popular e-cigarette device among teens.

"Juuling has consumed us," she said. "Our kids are using them and they are using them tremendously, it's unbelievable."

Awards were also given for work in several categories, including:

The city of Williamstown was one of six Kentucky cities to be
recognized for success in enacting a smoke-free workplace
ordinance. Mayor Rick Skinner (far left) was also the recipient
of the Smoke-free Advocate of the Year award. (UK photo) 

The city of Elizabethtown received the Smoke-free Excellence in E-Cigarette Policy Award for expanding its smoke-free ordinance to include e-cigarettes.

The Lee T. Todd Jr. Smoke-free Hero Award recipient was Liz Burrows, health educator for Oldham County Health Department, for her commitment to smoke and tobacco free environments in the face of adversity.

The Timothy W. Mullett M.D. Lung Cancer Prevention Award recipient was Ashley Gibson, research coordinator for St. Claire Healthcare in Morehead, for her devotion and passion for preventing lung cancer through education, advocacy and policy change.

David Nunery received the Brian Early Mattone Esq. Legal Counsel Smoke-free Support award for outstanding smoke-free legal service.

The Smoke-free Youth Advocate Award recipient was Monroe County CARES Youth Prevention Ambassadors for excellence in promoting secondhand smoke education and smoke-free policy.

The Smoke-free Indoor Air Excellence Award recipients were the cities of La Grange, Martin, Murray, Paducah, Stanford and Williamstown, and Hardin and Oldham counties.

The recipient of the David B. Stevens M.D. Smoke-free Advocate of the Year, for promoting the secondhand smoke education and smoke free policy, was Rick Skinner, mayor of Williamstown.

Gubernatorial candidate Adam Edelen endorses statewide smoking ban and raising cigarette tax to national average

By Melissa Patrick
Kentucky Health News

Adam Edelen, a Democratic candidate for governor, has endorsed a statewide ban on smoking in indoor workplaces and an increase in the state cigarette tax to the national average of $1.72 per pack as part of his agenda to "modernize and reform" Kentucky.

Adam Edelen

"I am not a nanny-state candidate. I believe that if you want to smoke, you should be able to," the former state auditor said in a Feb. 5 press call. "But I also believe that those who choose not to smoke -- those who choose to protect their health in the workplace or the health of their children -- have a right to a law that protects them in the pursuit of clean air."

Edelen, one of three major Democrats in the May 21 primary, said his smoke-free law would ban tobacco products, including electronic cigarettes, from all indoor workplaces with three or more employees, but would exempt facilities that specialize in tobacco products.

About 35 percent of Kentuckians live in cities or counties that have adopted such laws. Nationwide, 28 states and the District of Columbia have passed them. Such a law is supported by 66 percent of Kentucky adults, according to the latest Kentucky Health Issues Poll.

The state House passed a statewide smoking ban in 2015, but its takeover by Republicans after the election of a Republican governor has dimmed the prospects for such a law. Gov. Matt Bevin, who is running for re-election, has said this is a matter for local governments, not the state.

That is also the view of the new chair of the House health committee. Rep. Kim Moser, a Northern Kentucky Republican, recently told Kentucky Health News that while she personally wouldn't mind a statewide smoking ban, and is an advocate for smoke-free policies, especially when it comes to smoking around children, she too thinks this should be a local decision.

Edelen also called for raising the cigarette tax by 62 cents to get it to the national average of $1.72 per pack. He said some of the revenue would be used to help Kentuckians stop smoking, or on aggressive efforts to discourage them from smoking. The poll found that 23 percent of Kentucky adults are smokers.

The General Assembly increased the cigarette tax by 50 cents to $1.10 per pack in the last legislative session. That was the largest increase in the state's history.

Edelen pointed out that Kentucky only invests $2.6 million on its smoking and prevention efforts while paying nearly $2 billion a year on tobacco-related illnesses. "That is a wrong-headed approach," he said.

Edelen said that cigarette manufacturers have "far too much influence with our legislators," and that he is prepared to go up against them to pass his anti-smoking agenda. He noted that he had pledged not to accepting money from political action committees of lobbying groups and other interests.

"I think the legislature's reluctance to embrace a more modern approach to dealing with our public health concerns in Kentucky is largely because of a dependence on PAC money and the strength of lobbyist who represent these special interests," he said.

Edelen said he is a former smoker and the son of a Meade County tobacco farmer, but his role as a parent cemented for him the importance of passing laws to would improve the state's health and economy.

"This isn't just about public health, this is about what kind of state we live in," he said. "Do we believe our people in every walk of life has the right to clean air? I certainly believe that we do and will be leading from the front on this issue."

House Minority Leader Rocky Adkins, who will be running against Edelen in the May 21 primary, said in an e-mail, "I have favored a statewide smoking ban in the past, but we need to look at comprehensive tax reform that doesn't overly burden our working families."

Attorney General Andy Beshear, the other major candidate in the Democratic primary, did not respond to a request for comment.

Most Ky. adults for statewide smoking ban and raising legal age to buy tobacco to 21, but movement on either issue is unlikely soon

A majority of Kentucky adults continue to support a comprehensive statewide smoke-free law and favor raising the legal age to buy tobacco products from 18 to 21 years, according to the latest Kentucky Health Issues Poll.

The telephone survey, taken Aug. 26 through Oct. 21, found that 66 percent of Kentucky adults support a comprehensive statewide smoke-free law, down from 71 percent in the last two polls, but generally about the same since 2013. The poll's margin of error is plus or minus 2.5 percentage points for each number.

The poll found about the same support as last year, 56 percent, for raising the legal age to buy tobacco products in Kentucky to 21.

"Neither proposal is the subject of a bill in the 2019 legislative session, but it's important for policymakers to recognize both that these laws work, and that the public strongly supports them," said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsors the poll.

This year, bills have already been introduced in the House and Senate to prohibit the use of tobacco products, including the highly popular electronic cigarettes, on school properties. The latest poll on this topic shows that 87 percent of Kentucky adults would support such a law.

The Kentucky Health Issues Poll found that a statewide smoking ban still has strong bipartisan backing, but since the 2016 poll was taken support has dropped among Republicans, to 62 percent from 72 percent, and among independents, to 55 percent from 68 percent.

Kentuckians who say they have never smoked continue to voice the greatest support for a statewide smoking ban, at 75 percent, followed by former smokers, at 67 percent. And nearly half of current smokers, 46 percent, favor such a law.

A statewide smoke-free law would prohibit smoking in public places, including workplaces, public buildings, offices, restaurants and bars throughout Kentucky. About 35 percent of Kentuckians live in cities or counties that have adopted such laws. Nationwide, 28 states and the District of Columbia have passed statewide smoke-free laws.

The state House passed a statewide smoking ban in 2015, but its takeover by Republicans after the election of a Republican governor has dimmed prospects for such a law. Gov. Matt Bevin has said it is a matter for local governments, not the state.

As with support for a smoke-free law, the percentage of Kentucky adults who favor raising the minimum legal age to purchase tobacco in Kentucky to 21 has held steady for the past three years, with six in 10 Kentucky adults in favor of making this change.

Such a law is often referred to as a "Tobacco 21" law. According to the Campaign for Tobacco-Free Kids, six states and at least 430 cities and counties have adopted such a policy.

According to a 2015 Institute of Medicine report, a Tobacco 21 law would reduce the smoking rate by about 12 percent and smoking-related deaths by 10 percent over the long term. The report adds that among teens ages 15 to 17, such a law would decrease initiation of tobacco use 25 percent, says the release.

"Kids today are the primary feeder market for the nicotine-addicted tobacco customers of tomorrow," Chandler said. "Most youth who experiment with tobacco products start at about age 13 or 14, and they often get their tobacco products from older teens. Between the ages of 18 and 21 is when youthful experimentation turns into adult addiction. Tobacco 21 laws reduce both experimentation and addiction at a time when young brains are vulnerable to irreparable damage from nicotine."

The poll is funded by the foundation and Interact for Health, a Cincinnati-area foundation. It surveyed a random sample of 1,569 adults via landlines and cell-phones.

Williamstown is first city in Northern Kentucky to implement comprehensive workplace and public-place smoking ban

On Jan. 1, the Grant County seat of Williamstown became the first place in Northern Kentucky to implement a comprehensive ban with smoking ban. Kenton County has significant exemptions, meaning it does not have a comprehensive smoke-free policy.

The ordinance, which passed in September, bans smoking, including the use of electronic cigarettes, in all buildings and places of employment, as well as in public outdoor patios. The new law allows for an exception for private clubs, unless it is being used for a function where the general public is invited.

Parks in the city of Williamstown have been tobacco-free since July 2017.

The new law also requires smokers to be 25 feet away from all entrances and windows that open and ventilation systems.

The Northern Kentucky Health Department will be responsible for enforcing the law and investigating any complaints.

"We congratulate the Williamstown City Council in taking this important step to improve the health of the community,” department Health Director Lynne Saddler said in a news release.

Williamstown is the 33rd city in Kentucky to implement a comprehensive smoke-free law, according to the news release.

On Oct. 1, 35 percent of Kentuckians were covered by comprehensive smoking bans for indoor
workplaces and public places. Williamstown's took effect Jan. 1. (Kentucky Center for Smoke-Free Policy)

If Ky. teenagers' use of e-cigarettes continues at its current pace, look for a new generation of adult smokers, conference is told

By Melissa Patrick
Kentucky Health News

Kentucky teachers have plenty to keep up with in the schools, which can cause an issue like teenagers' vaping of electronic cigarettes to get lost in the shuffle, but health advocates warn that if we don't get in front of this uptick in e-cigarette use, a new generation of adult smokers is on the horizon -- along with all of the health issues that come with it.

Eric Kennedy of the Kentucky School
Boards Association ( Foundation for a
Healthy Kentucky photo )

At a Dec. 10 Coalition for a Smoke-Free Tomorrow conference in Louisville, Eric Kennedy, chief lobbyist for the Kentucky School Boards Association, said KSBA offers districts a model policy for 100 percent smoke-free schools that includes e-cigarettes, and encourages them to adopt it. However, despite the e-cig epidemic in schools, it hasn't offered any specific guidance on the topic of e-cigs or Juul, a wildly popular e-cig that looks like an oversize USB drive and comes in popular flavors.

"I think there is a lot coming at classroom teachers on this and every issue, and it's not as streamlined as it needs to be, and that is a big part of what the coalition is working on," he said. "We're almost at a level of being overwhelmed, if not already beyond that point. . . . It's unfortunate that it's easy for an issue like this to get lost in the shuffle of the massive amounts of information coming at classroom teachers and superintendents and everyone else in the district. So I think that's something that we will keep working on, but that's always going to be part of the problem."

Many new school board members will take office in January.

Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky and chair of the coalition, told the conference, "The enormity of this . . . surge is a recent phenomenon, so I don't think anybody has realized just how dire this issue is and how quickly it has become so."

Some may question the use of the word "dire," but teen use of e-cigarettes has become so prevalent that the U.S. Food and Drug Administration has called it an epidemic. Federal research shows that high-school students who reported being current e-cig users increased 78 percent between 2017 and 2018, exceeding 3 million. The same report showed use by middle schoolers increased 48 percent.

In Kentucky, about the same number of high-school students smoke cigarettes as use e-cigs, 14 percent. But health advocates at the conference warned that e-cig use is likely much higher among the state's youth because the survey was taken before the introduction of Juul and Juul-like products.

To get a more current understanding of what is going on in Kentucky, the foundation and Kentucky Youth Advocates conducted focus-group discussions in October with 35 Kentucky teens in Campbell, Clay, Jefferson, McCracken and Monroe counties about their knowledge, perception and usage of e-cigarettes in their schools.

"The kids asserted educators and parents were clueless about their use," said Terry Brooks, executive director of KYA. "And checking with parents and educators, they confirmed they were clueless. So, we've got a real adult/kid knowledge gap."

Catie Kelly, senior at Martha Layne Collins
High School, talked about e-cig use by teens.
(Foundation for a Healthy Kentucky photo)

Catie Kelly, a senior at  Shelby County's Martha Layne Collins High School, who was not part of the focus groups, told conference attendees that the flavors were the main reason kids are using e-cigarettes, and that most kids don't realize they are harmful or have nicotine in them. In fact, a Juul can have as much nicotine as a pack of cigarettes.

"It is so easy to use in school because it's so small and is really easy to hide. Most of my friends, they'll just put their head down and put it under their sleeve and then blow the smoke into their sweatshirt," she said. "People you wouldn't think would use a Juul would use a Juul." The device has 75 percent of the e-cigarette market.

Chandler offered four policy suggestions toward decreasing e-cigarette use among teens, including making sure e-cigs are included in all local ordinances and school policies; an excise tax parallel to regular cigarettes; the prohibition of flavors in e-cigs; and allowing cities and counties to enact stricter tobacco control policies than at the state level.

Asked why a statewide smoke-free school law wasn't listed as a policy priority on the news release, Chandler said it had inadvertently been left off. "One hundred percent smoke-free schools is what we intend to do," he said. "This whole boom of e-cigarette use I think has made this tobacco-free schools issue much more important and timely right now."

As of July, 72 of the state's 173 school districts (42 percent) have 100 percent smoke-free schools, covering 57 percent of the state's students. However, many of these districts still need to update their policy to meet new standards for e-cigarettes.

Rep. Kim Moser, R-Taylor Mill, said she also thought the surge in e-cigarette use among Kentucky's youth could spur the passage of a statewide tobacco-free school bill this year. Moser is the new chair of the House Health and Family Services committee and said she plans to file a bill for such a law.

But Sen. Ralph Alvarado, R-Winchester, new chair of the Senate Health and Welfare committee, said he wasn't so sure the epidemic would change things. "It's not a guarantee, but I'm hoping that with the new leadership in the House this coming year that this will loosen the tobacco policy up a little bit," he said.

Alvarado's tobacco-free school bill passed the Senate in 2017 but died in the House. Two such bills were introduced in the last session, but were not called up in the legislature's education committees.

Alvarado, a physician, said he will file the legislation again, but added that no matter how much science and data he has presented in the past to show the harms of smoking, it hasn't outweighed the philosophical argument for many that the government shouldn't be telling people what to do.

The KSBA's Kennedy said parental support for such policies to include e-cigs is vital, because many parents still "don't think they are a big deal" and often ask that their child not be reprimanded for using them. He said the problem is so rampant that it's not possible to suspend all student violators.

He said, "It's almost in some ways too late to get out in front of it, but of course that can't stop us from trying to do everything that we possibly can."

Other points from the conference:

• 80 percent of children are exposed to e-cigarette advertising.
• 85 percent of youth who use e-cigs report using flavored varieties.
• 40 percent of 18- to 24-year-olds who vape report never smoking a regular cigarette.
• One-third of youth who have ever used e-cigs report also using marijuana.
• Nine out of 10 adult smokers started smoking before they turned 18.
• 99 percent of e-cigs have nicotine; the rest are typically found in vape shops.
• The adolescent brain is "uniquely vulnerable" to nicotine addiction, meaning youth become addicted more quickly and smaller amounts of nicotine can create addiction.
• Nationwide, nearly 3 percent of adults use e-cigarettes and 21 percent of youth do; adult e-cig use in Kentucky is higher, 5.9 percent; 24.6 percent of Kentucky adults smoke.
• Research has not proven that e-cigs help smokers quit smoking.
• Research shows that kids who use e-cigs are more likely to smoke.
• E-cigs create secondhand aerosols with potentially harmful ingredients, including volatile organic compounds, ultrafine particles, heavy metals and potential cancer-causing agents.

Smoke-Free Coalition will lobby for state law to ban tobacco products and e-cigs from all school property and activities

By Melissa Patrick
Kentucky Health News

Concerned that historic declines in youth tobacco use will be undermined by the "exploding popularity" of Juul and other e-cigarettes, Kentucky's Coalition for a Smoke-Free Tomorrow says it will lobby for a law making all schools in the state 100 percent tobacco-free in the upcoming year.

Photo by The Sentinel-Echo, London, Ky. 

"We're suddenly seeing epidemic levels of kids vaping e-cigarettes, and we've got to get a handle on it before we totally reverse the gains we've made in the last couple of decades in reducing youth tobacco use," Ben Chandler, chair of the coalition, said in a news release.

The latest Kentucky Health Issues Poll  found 87 percent of Kentucky adults would support such a law, and polls since 2013 have found strong support for the policy, but there has been little legislative progress toward it, and fewer than half of local school boards have acted. School-board seats are on the ballot in all districts this fall.

"It's a good time to ask school board candidates what they think about such a policy, and if they would support it or not," said Al Cross, director of the Institute for Rural Journalism and Community Issues, which publishes Kentucky Health News.

Legislative bills to require all school properties and school events to be tobacco-free have gained little to no traction. Two were introduced in the last session, but were not called up in the legislature's education committees. The Senate passed one in 2017, but the House didn't take it up.

The coalition says it will promote a comprehensive policy that "prohibits the use of all tobacco products, including e-cigarettes and vapor products, by staff, students and visitors at all times inside board-owned buildings or vehicles, on school property, and during school-sponsored field trips, sports events and other activities."

It also wants the law to provide adequate funding for signage and other tools to implement the policy, make penalties for violation appropriate and not prevent students from learning, and allow local bodies to enact stronger policies than the state policy.

Fewer than half of Kentucky's school districts have enacted such policies. As of July, 72 of the 173 districts had adopted 100 percent tobacco-free school policies, covering 734 schools and 57 percent of the state's students. Federal law only prohibits smoking inside schools that receive federal funding.

"A statewide tobacco-free schools law would expand a powerful tool already used by 734 schools in the state to all Kentucky public schools, in order to reduce youth exposure and peer pressure to tobacco products and create an atmosphere where tobacco use is not the norm," the coalition said.

Coalition for a Smoke-Free Tomorrow chart

Kentucky's high school students smoke at a much higher rate than the national average, 14.3 percent compared to 8.8 percent. Almost as many, 14.1 percent, use e-cigarettes, a bit above the 13.2 percent nationally, according to the 2017 Youth Risk Behavior Survey.

The e-cigarette figures are probably higher now, health experts have warned, because Juul sales have surged since the survey -- so much that it's prompted the U.S. Food and Drug Administration to crack down on them and other vaping-product companies over their teen marketing strategies.

Juuls and their cheaper knock-offs are especially popular among teens because they are small and look like an oversize USB drive, making them easy to hide from parents and teachers. They also offer flavors that are appealing to youth, and pack a powerful nicotine punch.

Murray Mayor Jack Rose named a Healthy Ky. Policy Champion; among winners eligible for top award to be made Sept. 24

The Foundation for a Healthy Kentucky has named Murray Mayor Jack Rose a Healthy Kentucky Policy Champion for his work to improve local health by successfully pushing for a smoke-free ordinance in the city. It takes effect in October.

"Mayor Rose was the primary impetus behind adoption of a comprehensive smoke-free law in Murray, one of only two such laws in the western third of the state," Dona Rains, director of community outreach at Baptist Health Paducah and a member of the foundation's board of directors, said in the news release. Rains nominated Rose for the award.

Foundation President and CEO Ben Chandler said, "He is an ideal recipient of this award because he did his homework to put forth an ordinance based firmly in science, rounded up the necessary community and city council support, and got it passed without a lot of delay. Murray will see great health and economic benefits from his leadership on this issue."

Rose was elected mayor in 2014. He previously served as Murray State University's faculty regent, was dean of its College of Education in 1998-2003 and was Calloway County school superintendent for 21 years. He has been chairman of the Murray-Calloway County Hospital; president of the board of the Kentucky YMCA Youth Association; and president of the Southern Association of Colleges and Schools, an accreditation organization.

Earlier the same week, the foundation named as champions Paducah Mayor Brandi Harless, for her leadership in enacting a stronger city smoking ban, and Dr. Van Breeding of Whitesburg, for leadership in fighting the substance-use crisis in Eastern Kentucky. Earlier winners were Paducah cardiologist Pat Withrow, 19 Casey County High School students, Lexington Legends owner Andy Shea and Lexington Mayor Jim Gray, all of whom took steps against use of tobacco, a main cause of Kentucky's health problems.

The winners are eligible for the Healthy Kentucky Policy Champion of the Year award, which comes with a $5,000 grant from the foundation to a Kentucky-based nonprofit of the winner's choice. The winner of that award will be announced on Sept. 24 at the foundation's Howard L. Bost Memorial Health Policy Forum in Lexington.

Nominations for the Healthy Kentucky Policy Champion Award are accepted at any time. A nomination must also be supported by a member of the foundation's board or Community Advisory Council; details are on the foundation's website.

Paducah Mayor Brandi Harless and Dr. Van S. Breeding of Whitesburg are named Healthy Kentucky Policy Champions

The Foundation for a Healthy Kentucky has named two new Healthy Kentucky Policy Champions: Paducah Mayor Brandi Harless for her leadership in enacting a stronger city smoking ban, and Dr. Van Breeding of Whitesburg for leadership in fighting the substance-use crisis in Eastern Kentucky.

Before being elected mayor in 2016, Harless worked with several community organizations to strengthen Paducah's existing smoke-free laws to include vaping of e-cigarettes, according to Michael Muscarella, executive director of ambulatory services at Baptist Health Paducah, who nominated her for the award.
"She was instrumental in helping us communicate our message to the city council and the public to gain support. Our coalitions could not have done this without Mayor Harless' wisdom and keen sense of timing," Muscarella wrote.

Harless is also the CEO and co-founder of PreventScripts, a company that promotes automated preventive medicine, through daily tracking, to help people maintain healthy habits.

"A strong leader like Mayor Harless can bring committed organizations together to transform community health," said Ben Chandler, president and CEO of the foundation. "She understands the importance of collaboration and her guiding influence with local health coalitions and agencies was key in focusing their efforts and transitioning Paducah to a comprehensive smoke-free community."

Dona Rains, director of community outreach at Baptist Health Paducah and a member of the foundation's board of directors, also endorsed Harless for the award, noting her efforts to improve the region's health and education. Rains highlighted Harless' work to develop the Purchase Area Health Connections nonprofit, which the release says has been awarded $1 million in grants, used in part for programs to decrease hospital readmission in high-risk patients.

"She is a prime example of Paducah pride: returning home to put her advance public health education and knowledge to work for the betterment of her fellow citizens," Rains said. Harless has a B.S. from Vanderbilt University and a master's in public health from Boston University, according to the news release.

Since moving to Paducah in 2009, Harless has served as a grant writer and development manager for Heartland CARES and executive director at St. Nicholas Family Free Clinic. She has also served on the boards of Child Watch, Paducah Day Nursery, and Project AIDS Orphan. She was a co-facilitator of the United Way's Impact Poverty Task Force "Getting Ahead" program. She was the president of the Paducah Rotary Club's Rotaract in 2013 and most recently graduated from the Delta Regional Authority Leadership institute and Leadership Kentucky.

Frances J. Feltner, director of the University of Kentucky Center of Excellence in Rural Health, nominated Breeding for the Policy Champion award in part for spearheading the creation of Help End Addiction For Life this year.

"HEAL is a nonprofit consortium of federal, state and local agencies, both public and private, that have combined resources to work on addiction prevention, education, treatment and recovery," says a separate news release.

HEAL has helped establish a syringe-exchange program at the Letcher County Health Department, and a partnership with Addiction Recover Care connects addicts to peer-support specialists. Since its inception, the program has provided services for 130 patients in the region, the release says.

"Dr. Breeding cares deeply about the well-being of people as is evident in his work as a physician and with the community," said Feltner, who is also a member of the foundation's Community Advisory Council. HEAL "is already making an impact. Health care agencies are coordinating efforts, more treatment is available, and overdoses are down."

Chandler said, "This is the kind of progress that can be made when committed organizations come together, share resources and collaborate to solve a community problem. Dr. Breeding's leadership in launching and energizing HEAL is exactly what the Healthy Kentucky Policy Champion Award was created to recognize and promote. He is making a difference in Letcher County and he is an example to his colleagues throughout the state."

Breeding is also known for supporting nutrition programs to combat diabetes and his efforts to increase screenings for colon cancer. He is director of clinical affairs at Mountain Comprehensive Health Corp. and is affiliated with the Whitesburg ARH Hospital; he is a native of Letcher County and graduate of the University of Kentucky College of Medicine.

Breeding and Harless are now eligible for the Healthy Kentucky Policy Champion of the Year award, which comes with a $5,000 grant from the foundation to a Kentucky-based nonprofit of the winner's choice. The winner of that award will be announced Sept. 24 at the foundation's Howard L. Bost Memorial Health Policy Forum in Lexington.

Nominations for the Healthy Kentucky Policy Champion Award are accepted at any time. A nomination must also be supported by a member of the foundation's board or Community Advisory Council; details are on the foundation's website.

Murray City Council passes a smoking ban on 8-2 vote, but the mayor, who pledged to pass it, says it could still be 'tweaked'

Murray City Council members voted 8-2 on June 14 to prohibit smoking in all public places and places of employment within the city limits, but John Wright reports for the Murray Ledger & Times that it may not be a "done deal." After about an hour of debate, Mayor Jack Rose suggested that the council pass the ban, but leave the issue open. (Wright's story is behind a paywall.)

Sperling's Best Places map

“I think we need to go ahead and pass it tonight, then come back and tweak it if need be,” Rose said. “I’m interested in listening if someone has an idea to make this the best situation we can find. If we see that there’s an element of difficulty with it, then we can look at it later.”

The ordinance, which is set to take effect in September, prohibits the smoking of cigarettes, as well as electronic cigarettes and vapor devices, in parking lots and areas within 15 feet of entrances, windows and ventilation systems. In restaurants and bars there must be a 15-foot buffer between outdoor seating and serving areas, and the rules also apply for numerous outdoor areas, Taylor Inman reports for WKMS-FM.

"Heartfelt congratulations to Mayor Jack Rose," Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, said in a news release. "He committed to getting it done before he retired. And, by gosh, he has done that! Even better, the ordinance that he was able to shepherd through to passage follows all the guidelines for truly making a difference in the health of those who live, play and work in Murray."

Local restaurant owners voiced opposition to the ban. Ron Gladden, owner of the Big Apple Cafe, one of only six restaurants in Murray that still permits smoking, told the council that smokers often outnumber non-smokers in his restaurant, and non-smokers had 62 non-smoking restaurants in the area to choose from.

“The citizens of Murray and Calloway [County] essentially vote every day on where they want to eat," Gladden said, adding that at the Big Apple, "the vote" is pretty clear. “I don’t believe it is the city council’s right to make decisions on smoking. It should be the business owners and the citizens of Murray, Kentucky," he said.

Robin Floyd, a longtime radiologist at the local hospital and also the owner of Tap 216, a restaurant that allows smoking, acknowledged that smoking is unhealthy, but said he thought restaurants that had created ways to separate the smokers from the non-smokers should be allowed to "opt-out" of the ordinance.

Supporters of the ordinance also spoke out. Local hospital CEO Jerry Penner said he had worked to strengthen smoke-free rules at the facility over the past two years, and though he recognized how hard these rules are for smokers, he said, "I think we have to err or the side of health here."

Penner also pointed out that far Western Kentucky, including Murray, ranks first in the state for lung cancer cases and deaths from it. “I’m tired of burying people," he said.

Rose, citing studies proving the danger of secondhand smoke, said the ordinance is needed to improve health in the city, Kentucky's 20th largest. “Let’s just say they get all kinds of secondhand smoke and are lucky and don’t get cancer or some other kind of disease because of that,” Rose said. They’re still more comfortable, so we’re making a comfort level.” Here is a video report from Paducah's WPSD-TV.

Oldham County adds e-cigarettes to smoking ban, partly at the behest of students, and drops exemptions, including break rooms

Oldham County has expanded its anti-smoking ordinance that it passed in 2006, the second jurisdiction to do so this month.

The Oldham County Fiscal Court voted 7 to 1 on April 17 to add electronic cigarettes to the ban and to remove exemptions that had left some workers unprotected from second-hand smoke, Kentucky Youth Advocates reports. On April 10, Paducah expanded its ban to electronic cigarettes and private places of employment.

The county's new ordinance removed exemptions to independently ventilated rooms in hospitals, hospice or nursing homes, facilities operated by private organizations, designated hotel and motel rooms, retail tobacco stores and designated indoor smoking areas.

The change was prompted partly by Youth Linking Oldham County, "a new collective of high-schoolers advocating for healthier lifestyles and a shift in social norms," Oldham Era Editor Amanda Manning reported in March, when the ordinance had first reading. "They said that the JUUL, a vaping device that looks similar to a flash drive, is popular among students."

Smoke-shop manager Cathleen McCarthy demonstrates the

JUUL device. (Photo by Suzanne Kreiter, The Boston Globe)

“It’s becoming a really big thing in our high school,” student Ava Schumacher said. “They were originally made to get people to stop smoking, but kids our age find them appealing because they come in different flavors.”

"The new ordinance also removes an exemption that allowed for smoking breakrooms in the workplace," Manning reports. Liz Burrows, health educator at the Oldham County Health Department, told the Fiscal Court, “We know based on science that those break rooms are not effective.”

The statewide Coalition for a Smoke-Free Tomorrow praised the Fiscal Court, health department and advocates who led the effort for the stronger protections.

"Strengthening this law -- by removing exemptions that left some workers unprotected and by including e-cigarettes -- recognizes that everyone has the right to breathe clean air," the coalition said in a statement. "Doing so recognizes that comprehensive smoke-free workplace ordinances improve health, and save health care dollars.And it recognizes that no one should have to choose between their lives, and their livelihood.

"Including e-cigarettes among the tobacco products that must be taken outside will keep the air in indoor public spaces and enclosed workplaces free of the toxic aerosol and pollution emitted by these devices. Oldham County is one of 21 Kentucky jurisdictions that has protected workers from these emissions, which can cause lung cancer and contribute to heart disease."

Oldham County is the fifth county in the state to pass a comprehensive smoke-free ordinance, the Oldham Era reports.

The coalition comprises more than 155 groups who support efforts to decrease smoking in the state. Kentucky's smoking rate is second only to West Virginia's, and tobacco is the broadest cause of Kentucky's most serious health problems.

71% of Kentucky adults continue to support smoking ban

Seventy-one percent of Kentucky adults support a comprehensive statewide smoke-free law, the same percentage as the last time the Kentucky Health Issues Poll asked the question, in 2016. Opposition to a smoking ban rose to 27 percent from 25 percent, a change that was within the poll's error margin of plus or minus 2.4 percentage points for each number.

The poll, taken Oct. 24 to Dec. 2, found that a statewide ban still has strong bipartisan support, with 79 percent of Democrats and 68 percent of Republicans saying they favored it. Support among Democrats rose by 3 percentage points from the previous poll, but dropped by 10 points among independents, to 62 percent from 72 percent.

Most adults in every region of the state favor a statewide smoke-free law. Support increased in the Louisville area to 80 percent in the most recent poll, from 74 percent in 2016 and support dropped in the Lexington area to 74 percent, from 82 percent in 2016. Those changes are within the larger error margins for subsamples. Other regions showed even less change.

Kentuckians who say they have never smoked continue to voice the greatest support for a statewide smoking ban, at 83 percent; 74 percent of former smokers favor it. Even among smokers, 44 percent say they favor such a law.

The annual poll, which is co-sponsored by the Foundation for a Healthy Kentucky and Cincinnati foundation Interact for Health, found that nearly a third of Kentucky adults said they were exposed to secondhand smoke at their workplace in the week before they were surveyed.

In a news release about the poll, Ben Chandler, president and CEO of the foundation, listed a few of the many dangers of secondhand smoke, including cancer, heart disease and stroke and called on Kentuckians to pass a comprehensive workplace smoke-free law.

"The single most effective thing we can do to improve Kentucky's health is to reduce our smoking rates," Chandler said. "And one of the most successful tools for doing that is to enact smoke-free laws, which also protect nonsmokers from tobacco smoke."

Chandler is also the chairman of the newly formed Coalition for a Smoke-free Tomorrow which has over 140 members. One of the immediate efforts of the coalition is to help counties pass local smoke-free laws, with a statewide ban part of a longer-term goal.

The Kentucky Center for Smoke-free Policy reports that only 33 percent of Kentuckians are protected from exposure to secondhand smoke by local smoke-free ordinances. Nationally, 27 states and the District of Columbia have enacted smoke-free laws, says the release. Almost 25 percent of Kentucky adults are smokers.

The state House passed a statewide smoking ban in 2015, but it was not called up for a vote in the Senate. Republican Gov. Matt Bevin, who took office in December 2015, has said this should be a local decision so it's not likely such a bill will pass while he is in office.

Marijuana, tobacco and opioids will get different types of debate than in previous legislative sessions, lawmakers indicate

Legislators will debate what to do with drugs of several types when the General Assembly opens in Frankfort Tuesday, Jan. 2. And the debates may be different than in past sessions, if the discussion on the Dec. 18 "Kentucky Tonight" on KET is indicative.

The four lawmakers, including the two health committee chairs, indicated that the use of marijuana will be debated more openly than before, and even for recreational purposes, and that more action will be taken against the opioid epidemic.

"I think we’re gonna see a little bit of everything introduced," said Louisville Republican Julie Raque Adams, chair of the Senate Health and Welfare Committee. "I think we’re gonna see a recreational bill," in addition to legislation for medical marijuana.

"A lot of people across the state of Kentucky have told me they’re tired of talk" and want to see some votes on the issue, Adams said. "We’re gonna see a lot of testimony."

When host Renee Shaw asked if efforts to legalize marijuana would have trouble because some see it as gateway drug, or if there might be less resistance because it is seen as less harmful than opioids, Democratic Rep. Chris Harris of Pike County indicated the latter.

"I think the time is coming in Kentucky for medical marijuana," he said, adding that he has an "open mind" on the issue.

L-R: Reps. Angie Hatton, Chris Harris, Addia Wuchner; host Renee Shaw; Sen. Julie Raque Adams

Rep. Angie Hatton, D-Whitesburg, said "My constituents want to talk about it more than almost any other issue," and it offers the possibility of tax revenue. "We have to talk about it."

Rep. Addia Wuchner, R-Florence, chair of the House Health and Human Services Committee, was skeptical of medical marijuana. A registered nurse and former hospital administrator, she said more research is needed.

Harris said, "There is some track record in other states," and added, "It could help a certain group of people."

Wuchner said legislators are trying for a comprehensive approach to the opioid epidemic, and Adams said they need to discuss a holistic approach with alternative approaches to drugs as the first option for pain relief.

Adams said Kentuckians should expect to see some criminal-justice reforms aimed at steering violators into recovery rather than putting them behind bars. "The trend lines for incarceration are all going in the wrong direction," she said. "We have to be creative about this opioid problem."

Adams said she will introduce a bill to keep the state from pre-empting local smoking ordinances, which are now a focus of anti-smoking advocates because Republican Gov. Matt Bevin opposes a statewide smoking ban. The bill would ban any state limits on local smoking laws.

Adams, who favors a statewide ban, said proposals for it prompted calls for local control, and "We listened. This is a creative way for us to say, 'Hey, start doing it.'" She noted that a Senate-passed bill to ban tobacco at all Kentucky schools got nowhere in the House.

Hatton said tobacco control "needs to be local decision" because it is "a personal freedom issue for a lot of people." Harris agreed, saying smoking bans should be "a step-by-step process. We need to walk before we can run."

Two decades of data show Kentucky communities with strong smoke-free laws have 8 percent fewer cases of lung cancer

By Melissa Patrick
Kentucky Health News

Kentucky communities with strong laws against smoking in workplaces have fewer cases of lung cancer, according to a University of Kentucky study that says it's the first to show such findings.

Researchers found that residents of counties with comprehensive smoke-free laws, including those with city-only smoking bans, were 8 percent less likely to be diagnosed with lung cancer than those living in communities without smoke-free laws.

There was no difference in lung-cancer rates between places that don't have smoking bans and those that have moderate or weak laws. The study considered laws to be comprehensive if they covered all workplaces, including restaurants and bars; moderate if they covered indoor public places, but not all workplaces; and weak if they allowed for major exemptions.

The researchers say the findings could encourage more localities to pass smoking bans. Only a third of Kentuckians are covered by such ordinances.

"Local government can play a critical role in preventing lung cancer," Ellen Hahn, the lead author of the study, said in a UK news release. "Elected officials can ensure that all workers and the public are protected from secondhand smoke by passing strong smoke-free laws with few or no exceptions."

Hahn is a UK nursing professor and director of the Bridging Research Efforts and Advocacy Toward Healthy Environments initiative at UK.

The BREATHE researchers looked at 20 years of lung-cancer data for more than 80,000 Kentuckians 50 and older. (Few Kentuckians under 50 have lung cancer.) The state has more cases of lung cancer than any other state, and its death rate from the disease is 50 percent higher than the national average. And not surprisingly, at 25 percent, Kentucky leads the nation in adult smoking.

Jim Waters, president and CEO of the Bluegrass Institute for Public Policy Solutions, a libertarian, free-market think tank, said that while lower rates of lung cancer are "wonderful," correlation does not equal causation and therefore public policy should not be built around it. "You can't attribute deaths directly to a single cause such as smoking," he said, "since many factors usually are involved: hereditary issues, poor diet, lack of exercise and education."

Hahn said the study did take other causes of lung cancer into account. "We used a sound, well-known statistical method to consider the other factors that may have affected new cases of lung cancer, in addition to smoke-free laws," she said. "Even after taking sex, age, smoking rate, and income into account, comprehensive smoke-free laws were associated with fewer new cases of lung cancer."

Hahn said factors that protect Kentuckians from lung cancer were being female, being younger, and living in a county with a lower smoking rate or higher median household income in the county.

Waters said his institute supports education efforts to encourage people not to smoke "without the punitive action of denying individuals the right to participate in a legal practice on private property. . . . Where does that end? We don't believe such reasoning will end with anti-smoking policies."

Hahn replied, "Research shows that simply educating the public not to smoke does not work to lower smoking rates or to reduce disease from tobacco smoke exposure. Smoke-free laws are known to reduce disease," heart attacks and hospital visits for emphysema and asthma, as BREATHE summarizes. "Just as we have laws to prohibit drunk driving (alcohol is legal), smoke-free laws prohibit smoking (legal) indoors where the second-hand smoke can harm workers and the public."

Ben Chandler, CEO of the Foundation for a Healthy Kentucky and chair of the recently launched Coalition for a Smoke-Free Tomorrow, called on Kentuckians to use this research to pass more smoke-free laws.

"We know that the Kentucky communities with smoke-free laws covering every workplace and public building are protecting the freedom of their residents and visitors to breath air untainted by dangerous secondhand smoke," Chandler said. "We know that a secondary benefit of these laws is that they help reduce smoking. But here's solid evidence from more than 20 years of data showing a significant decline in lung cancer."

The latest Kentucky Health Issues Poll on the issue found that 71 percent supported a statewide law to ban smoking in public places and the workplace. The state House passed such a ban in 2014, when it was controlled by Democrats, but the bill died in the Republican-controlled Senate, and Republican Gov. Matt Bevin, who took office in 2015, says smoking bans should be a local issue.

The study was published in Cancer, a journal of the American Cancer Society. An editorial in the journal said the "unique and important" study "has shared an incredibly valuable insight into the impact of smoke-free ordinances on lung cancer mortality" and emphasizes "the need for statewide, not municipal, enforcement for maximum efficacy."

Advocate says keys to passing a local smoking ban are a plan, mobilized citizens, young people and perhaps a dose of luck

Wayne Meriwether at the workshop (Photo by Melissa Patrick)

By Al Cross
Kentucky Health News

MADISONVILLE, Ky. – Two big keys to winning passage of a smoke-free ordinance are a systematic plan and mobilization of citizens, a hospital administrator who has persuaded two towns in his county to enact indoor-smoking bans told Western Kentucky journalists Friday.

It also helped that high-school students were involved and that one of them prompted the county judge-executive at the time to make a controversial remark, Wayne Meriwether, CEO of Twin Lakes Regional Medical Center in Leitchfield, said at "Covering Health: A News Workshop" in Madisonville.

Meriwether said Judge-Executive Gary Logsdon "went berserk" and drew Louisville news coverage that reached Grayson County. He said city officials in Leitchfield and Clarkson "didn't want to be seen as being like the elected county officials" on Fiscal Court, which rejected the ordinance.

Meriwether said he had hoped Logsdon, the recipient of a double lung transplant, would be the "elected-official champion" of the ordinance, but when it came before Fiscal Court, defenders of individual and private-property rights carried the day and a magistrate's motion for an ordinance didn't even get a second.

When a high-school student asked Logsdon, "If it’s not the role of government to protect people, then what is the role of government?" Logsdon replied, "I’m not black and I’m not Obama, and I’m not passing, making you do anything."

Logsdon apologized a few days later, and resigned several months later. But he inadvertently paved the way for passage of an ordinance in the county seat of Leitchfield, population 6,700, Meriwether said.

The Population Health Committee had already taken a poll that showed 82 percent of the people in the "very conservative" county favored a smoking ban, and had prepared booklets for each community showing the potential benefits. So it was ready to mount a campaign to persuade the Leitchfield City Council – where two or three of the six members are smokers, Meriwether said.

"I guarantee they received a lot more calls in favor of a smoking ordinance than against it," he said. The vote on the council was 5 to 1.

"This was amazing, that we could do that," Meriwether said. He said the involvement of Grayson County High School students helped, because "It's harder to say no" to them.

The task was more difficult in the smaller town of Clarkson, pop. 875, where the city commission vote was 3-2. Meriwether said one commissioner told him, "I can't support this. I might make somebody mad. I need this job."

"Those are the kinds of issues that you face in small, rural Kentucky," said Meriwether, who moved to Leitchfield from Henderson five years ago.

Meriwether said the most common objection he hears is "It's my right to smoke." He said he replied, "You have a right to smoke, but you don't have the right to impose your right on someone else when it affects their health."

He shares credit with the hospital's Population Health Committee, which includes the school superintendent, a plant manager, a business owner, the health department director, an extension agent and the tourism director, "A good cross-section of people who care about the community."

The committee decided to tackle smoking, Meriwether said, because "We didn't want to do another 'How much weight can you lose over the next six weeks?' We wanted to do something with a long-term effect."

Besides smoking, the committee's targets are obesity, lack of physical activity and awareness of health issues. He said it is working on a community garden and a permanent location for the local farmers' market.

But there is still work to do on smoking. Meriwether said he is working on an ordinance in Caneyville, pop. 600, and may go back to Fiscal Court because appointed Judge-Executive Kevin Henderson, former police chief in Leitchfield, is more favorable to it than Logsdon was.

"We may wound up with a countywide smoking ordinance yet," he said. "If it can be done in Leitchfield and Clarkson, it ought to be done anywhere in the state of Kentucky."

Newly launched Coalition for a Smoke-Free Tomorrow has quickly grown to more than 100 members and partners

The Coalition for a Smoke-Free Tomorrow has signed on more than a dozen additional organizations since it launched two weeks ago, bringing its number of supporters to over 100 members and partners.

"Every day, more organizations join our campaign because they see the fundamental link between our state's dismal health and our high tobacco use, and they know we have to build a new generation of nonsmokers," Ben Chandler, chair of the coalition and CEO of the Foundation for a Healthy Kentucky, which staffs the coalition, said in a news release.

Supporters of the new campaign to reduce smoking and secondhand smoke exposure in Kentucky range from major employers like Toyota Motor Manufacturing and UPS to faith-based groups and local health departments. Click here for a complete list of supporters.

The coalition has set three goals: raising the state's cigarette tax by $1 or more per pack, with parallel increases in taxes on other tobacco products; helping counties and cities enact comprehensive smoking bans; and educating the public and health-care providers about a new law that requires health insurers to provide barrier-free coverage for all federally approved tobacco-cessation medications and programs.

The release notes that raising the cigarette tax by $1 a pack would keep 23,200 youth from becoming adults who smoke. Almost 17 percent of Kentucky's high-school students are smokers; the national average is 8 percent.

"Kentucky is one of the cheapest places in the nation to purchase tobacco products, and that's a big reason why our youth smoking rate is more than twice the national average," Chandler said.

The coalition says cigarette taxes need to be raised by $1 or more per pack because anything less could be absorbed by the tobacco companies through temporary price cuts, coupons or other promotional discounting. "Smaller increases do not produce the significant health benefits or health care cost savings," says the release.

Leaders of companies and organizations who would like to join the coalition can do so on the website.

'Tobacco Nation' report cites Kentucky as example of challenges facing those who want to change public policies on tobacco

Kentucky, which has the nation's highest smoking rate, is of 12 contiguous states where smoking rates are higher than "not only the national average, but that of many of the most tobacco-dependent countries in the world," says a report published by Truth Initiative, a nonprofit organization created by the 1998 agreement among states and cigarette manufacturers.

The report, "Tobacco Nation," cites Kentucky as an example of "the challenge of changing policies" relating to tobacco. It notes that the state has "no broad restrictions exist to prevent smoking in public places and workplaces," and "A statewide smoking ban to prohibit tobacco use on school properties and at school events has yet to be enacted. Moreover, the tax rate hasn’t changed since 2009."

It adds, "In Missouri, the circumstances are even more bleak; the state has the lowest cigarette excise tax per pack in the nation ($0.17) and the rate hasn’t changed in 24 years. One factor clearly suppressing the adoption of tobacco control policies in Tobacco Nation is opposition by Big Tobacco."

Ben Chandler, President and CEO of the Foundation for a Healthy Kentucky, said the report "paints a stark picture of the health benefits policymakers can achieve by enacting stronger laws proven to protect the public from secondhand smoke and reduce smoking rates. The good news is that we know what works to reduce tobacco-related disease and illness. The bad news is that Kentucky leads the other 11 'Tobacco Nation' states in smoking, cancer and COPD. But with stronger laws and ordinances -- including higher state tobacco taxes and local smoke-free ordinances covering indoor workplaces -- Kentucky can lead regional health improvements."