“The bars in California have been raped and stripped of what they do well, and that’s hospitality” “Boycott California!” “This thing is scary to us … It could go national” National Licensed Beverage Association, April 29, 1998 “California bars are experiencing an average sales decline of 26.2%” “first definitive proof that the bar smoking ban has had severe negative impacts” “This is conclusive evidence that the California smoking ban is an experiment that has failed” The American Beverage Institute, April 29, 1998

Countering Industry-Initiated Economic Arguments History of Tobacco Control in California The Wheels Are Turning Labor Code Implementation Fiscal Impact (The Science) What “The Science” Means –Tourism –Businesses –Employment The Future

Effects Causally Associated with ETS Exposure Low Birth Weight SIDS Respiratory Infections in Children Asthma: Induction and Exacerbation Eye and Nasal Irritation Ear Infections in Children Cancer: Lung and Nasal Sinus Heart Disease Morbidity & Mortality Source: Health Effects of Exposure to ETS, California EPA, September 1997

Estimated Annual Morbidity & Mortality in Non-Smokers from ETS Exposure in California 147, ,820 Illnesses & Hospitalizations 4, ,945 Deaths Source: Health Effects of Exposure to ETS, California EPA, September 1997

The Law Regulates smoking by employees and patrons in most “enclosed” workplaces in California. Adopted as part of the Labor Code to protect workers from involuntary exposure to ETS. Both business owners and patrons may be issued a citation. Is enforced at the lowest jurisdictional level. Does not apply to owner operated establishments or Native American (sovereign) lands among other exemptions.

Primary “On-Sale” Alcohol License Types Type 40: On-Sale Beer (Beer Bar) - 1,510 Type 41: On-Sale Beer and Wine Eating Place (Pizza Place) - 20,113 Type 42: On-Sale Beer and Wine Public Premises (Beer and Wine Bar) - 1,202 Type 47: On-Sale General Eating Place (Full-Service Restaurant) - 10,966 Type 48: On-Sale General Public Premises (Stand-Alone Bar) - 3,261 These numbers are from June 30, 2000 and these five types constitute 94-96% of all On-Sale licenses in California annually

Smoke-free Workplace Timeline Highlights June, 1994: Assembly Bill 13 Signed by Governor and becomes Labor Code Section ; November 1994: Proposition 188 (Philip Morris Initiative) defeated (71% to 29%) guaranteeing LC stays in place; January 1, 1995: Nearly all enclosed workplaces go smoke-free; 1996: AB 3037 passes postponing Bar/Gaming Club implementation by one year; January 1, 1998: All bars, gaming clubs and bingo halls go smoke-free: #1 Media Story in the Country!

Smoking in Bars & Compliance 75% of California Bar Patrons DON’T SMOKE IN BARS (1997) 86% of Bar Patrons REPORT COMPLIANCE WITH THE LAW (2000) July 1997 and October 2000 studies conducted by the Field Poll Corporation for the California Department of Health Services, Tobacco Control Section.

Study Populations July 1997 Field Poll –Total Respondents: 1,023 –Bar Patrons in the Last Twelve Months: 686 (67%) –Smokers: 215 (21%) –Non Smokers: 808 (79%) March 1998 Field Poll –Total Respondents 1,001 –100% Patronized Bars in the Last Twelve Months –Smokers: 255 (25%) –Non Smokers: 745 (75%) August 1998 Field Poll Total Respondents 1, % Patronized Bars in the Last Twelve Months Smokers: 255 (25%) Non Smokers: 765 (75%) October 2000 Field Poll Total Respondents 1, % Patronized Bars in the Last Twelve Months Smokers: 255 (25%) Non Smokers: 765 (75%)

USA SNAPSHOTS ® A look at statistics that shape the nation Smoke gets in their hair More than half of Americans say they regularly avoid places to keep from smelling of cigarette smoke afterward. Places they avoid: Bars/lounges Nightclubs Homes of smokers Restaurants Private parties Source: NFO Research for Banish By Anne R. Carey and Suzy Parker, USA TODAY 70% 59% 48% 33%

Bar Patrons Support Smoke-Free Bars A Survey of California Bar Patrons: July 97, August 98 & October 2000 July 1997, August 1998 & October 2000 studies conducted by the Field Poll Corporation for the California Department of Health Services, Tobacco Control Section.

Bar Patrons More Likely to Visit Smoke-Free Bars 56.4% “more likely” to visit bars Now that smoking is prohibited in bars, are you more likely, …, to visit them? 1.6% No opinion 10.6% “less likely” to visit bars October 2000 study conducted by the Field Poll Corporation for the California Department of Health Services, Tobacco Control Section. 31.4% “no difference” on visits to bars

Bar Patrons More Likely to Visit Smoke-Free Bars Now that smoking is prohibited in bars, are you more likely, …, to visit them? August 98 & October 2000 studies conducted by the Field Poll Corporation for the California Department of Health Services, Tobacco Control Section. Percent

Patron Approval for Smoke-free Bars FIELD POLL February 1998, August 1998 & October Approval for Smoke-free Bars Increases March 1998, August 1998 & October 2000 studies conducted by the Field Poll Corporation for the California Department of Health Services, Tobacco Control Section

Quality Literature on Smoke-Free Bars and Restaurants Data for towns with smoke-free restaurant laws –Massachusetts (Bartosch and Pope, 1999) –New York City (Hyland et al., 1999) Data for towns with smoke-free restaurant and bar laws –California and Colorado (Glantz and Smith, 1994, 1997)

Quality Literature on Smoke-Free Bars and Restaurants Aggregate sales data for state restaurant and bar laws –California (Glantz, 2000) Taxable sales and tourism –3 States and 6 cities (Glantz and Charlesworth, 1999)

Poor Quality Literature on Smoke- Free Bars and Restaurants Supported by Tobacco Industry Survey of bar owners on predicted impacts or anecdotal information Bizarre time periods or inappropriate control groups for comparison Non-peer reviewed

Data From California Board of Equalization (BOE) from Q1 of 1990 to Q4 of 2000 Categorized as follows: –Eating and drinking establishments that serve all types of liquor (about 25% stand- alone bars) –Eating and drinking establishments that serve beer and wine –Eating and drinking establishments that serve no alcoholic beverages

Eating establishment’s taxable annual sales in California by liquor license type, Billion Dollars Smoke-free Restaurants Smoke-free Bars Source: California State Board of Equalization. Prepared by: California Department of Health Services, Tobacco Control Section, November 2001.

Methodology Examine bar sales divided by all retail sales –Tries to account for underlying economic trends and inflation Examine bar sales divided by all eating and drinking sales –Change in proportion

Methodology Variables considered for modeling –Quarter, Time –Change in intercept and slope for smoke- free restaurants –Change in intercept and slope for smoke- free bar law –Autoregressive error terms “Proc Autoreg” in SAS V8

Percentage of quarterly bar revenues as a total of all retail revenues, Percentage Source: California State Board of Equalization. Prepared by: California Department of Health Services, Tobacco Control Section, November 2001 Smoke-free restaurant law Smoke-free bar law

Bar/Retail Results No change in intercept and slope after implementation of smoke-free bar law Change in intercept and slope after implementation of smoke-free restaurant law

Percentage of quarterly bar revenues as a total of all eating and drinking revenues, Percentage Source: California State Board of Equalization. Prepared by: California Department of Health Services, Tobacco Control Section, November Smoke-free restaurant law Smoke-free bar law

Percentage of quarterly bar revenues as a total of all eating and drinking revenues, Percentage Source: California State Board of Equalization. Prepared by: California Department of Health Services, Tobacco Control Section, November Smoke-free restaurant law Smoke-free bar law

Bar/All E&D Results Change in intercept and slope after implementation of smoke-free bar law Change in intercept and slope after implementation of smoke-free restaurant law

Conclusions Slowing in decrease of bar/retail sales associated with the smoke-free restaurant law –Due to only 25% of “bars” being stand alone bars, the law could have increased sales at the 75% bar/restaurant combinations No negative change in “bar” sales for either smoke-free law

Conclusions The decrease in bar/all E&D sales has reversed and is now increasing –A portion of it can be explained by the smoke-free restaurant and the smoke-free bar law Limitations –Retail sales are changing at a rate different than bar sales  possible change in consumption  change in demographics –25% of “bars” are stand alone bars

Conclusions Bar patrons - spending more time in bars Smokers prefer smoke-free bars and restaurants Because of large scale of data, length of time and sound methodology, use to contradict anecdotal data from TI and front groups

Tourism in California California Travel Spending and Related Impacts: Source: California Trade and Commerce Agency, Division of Tourism, October, 2001 “Total Payroll” definition changed in 1999 to include sole proprietors such as owners of Bed & Breakfasts and their family members instead of just the hired staff of such establishments. Destination Spending includes spending on accommodations, eating and drinking, groceries, ground transportation, recreation and retail sales. Total spending also includes air transportation and travel arrangement services. Billions of Dollars

Tourism and Employment California Travel Spending and Related Impacts: Source: California Trade and Commerce Agency, Division of Tourism, October, 2001

Number of Eating and Drinking Establishments in California by Major License Type: * Data reflects mid-year count of establishments. * Data missing for 1995 due to computer failure and loss of data. Source: State of California, Alcohol Beverage Control (5/00) Year Smoke-free Restaurants Smoke-free Bars Establishments

Number of Individuals Employed in Eating and Drinking Places in California: Annual Average Labor Force Source: State of California, Employment Development Department, Labor Force Statistics (4/01) Year Number of Employees Smoke-free Restaurants Smoke-free Bars Increase of 19.5% in 9 years as compared to a 13.5% increase for all employment statewide over the same period.

Smoke-free Restaurants Smoke-free Bars Taxable Sales per Eating and Drinking Establishment Serving All Alcohol in California: for Second Quarter Only* Data reflects mid-year count of establishments (end of the second quarter). * Data missing for 1995 due to computer failure and loss of data at Alcohol Beverage Control. Source: State of California, Alcohol Beverage Control & Board of Equalization (5/00) Dollars Year Increase of 30% in 7 years!

Smoke-free Restaurants Smoke-free Bars Taxable Sales per Eating and Drinking Establishment Serving Beer &/or Wine Only in California: for Second Quarter Only* Data reflects mid-year count of establishments (end of the second quarter. * Data missing for 1995 due to computer failure and loss of data at Alcohol Beverage Control. Source: State of California, Alcohol Beverage Control & Board of Equalization (5/00) Dollars Year Increase of 38.3% in 7 years!

Smoke-free Restaurants Smoke-free Bars Avg. Per-Capita Taxable Sales per Eating and Drinking Establishment Serving Alcohol vs. Eating and Drinking Group as a Whole in California: for Second Quarter Only* Source: State of California, Board of Equalization (12/01) Dollars Year Since 1995, per-capita sales for all eating and drinking increased by 27% and establishments serving both food and alcohol increased by 25%.

Keys to Success Collaborate: You CAN’T do it alone. Prepare and Educate: This won’t happen overnight. Develop and Maintain a Solid Support Base: You can match their numbers, but this will be a time-intensive task. Advertise: Make your issue known. Do it early and often.

Educate Opinion Leaders: Educate key officials to become your advocates. Gather Your Facts: Who will be impacted and how and why is this important to your target population. Involve the Target: Survey the target audience to find out what they need and what will be most effective in reaching them - Give them what they need!. Understand Diversity: Prepare culturally appropriate messages and delivery avenues. Keys to Success

Uniformity in Implementation: Investigate or design, promote and implement a modifiable, but uniform implementation plan. Consistency in Enforcement: Know who is enforcing the law and what message will promote “buy- in.” If any law is not enforced, it will not be respected.

Keys to Success Never Forget the Past : Learn form your mistakes Keep Your Eye on the Next Step : Where will your current strategy take you next?

Next Steps Smoke-free Nursing Homes:88.7% Support Smoke-free Playgrounds:88.1% Support Smoke-free Hospital Grounds:86.5% Support Smoke-free Hotel Lobbies:85.6% Support Smoke-free Apartment Common Areas:82.5% Support Smoke-free Outdoor Entertainment Venues:82.5% Support Field Research Corp - January Survey of 1812 California Adults

Paul Hunting, MPH California Department of Health Services Tobacco Control Section P.O. Box , MS 555 Sacramento, CA (916) For more information... David Cowling, Ph.D. California Department of Health Services Tobacco Control Section P.O. Box , MS 555 Sacramento, CA (916) Tim Filler Americans’ for Non-Smoker Rights 2530 San Pablo Avenue Suite J Berkeley, CA (510)