No Smoking in the Country? Getting Smokefree Laws in Rural America Sherry L. Tomasky, MA American Cancer Society Syracuse, NY

Background  A proliferation of Clean Indoor Air laws in larger cities in New York caused us to look at differences in how legislation happens in urban vs. rural areas. Three key differences in rural advocacy How we got the law done Ways we are still fighting the battle

Three Notable Differences  Conservative political views  Sparse population/distant media markets  Impact of economic arguments Bar and tavern industry complains Financial impact of smoking on healthcare costs

Political Views  More local laws in the state were passed by Republican held counties vs. Democratic (9 out of 12)  State Conservative Party opposed bill and actively fights it Freedom and rights Economic harm Big Brother

Media Markets  The major media markets are located in the larger upstate cities  Smaller counties – newspapers are most local and relevant news available  Proximity to the small papers can be an advantage or disadvantage Little things make big news in small towns

This article is about a man who sent a letter to some folks about scheduling a meeting! Front page, top of fold!

November 30, 2003 Smoking ban kills local tavern Law hurts business, forces Cam-Nel Restaurant to close, owner and patrons say. By Mike McAndrew Staff writer A wake will be held today for one of Mattydale's oldest taverns.

Economic Arguments  The Hospitality Industry… Puts up sympathetic faces with local recognition Has many more active advocates than we do Bullies the business people who want to champion the law

What Matters? Money  Economic impact on bars and restaurants  Economic impact on the healthcare system Medicaid Dollars Property Taxes

Costs of Smoking  Connecting Medicaid costs to Smoking made an impact in some small towns, because county budgets were being stressed by Medicaid costs.  Formulas are available from the CDC: Explanation of the estimate that 16% of all Medicaid expenditures are smoking-related, as well as the explanation of estimate of $351 per capita are attributable to smoking related illnesses can be found at:

Strategies for Rural Advocacay  Took advantage of “let the state do it”.  Asked county legislators to call their state reps when the state bill gained steam.  Sent action alerts to our 2,500 grassroots advocates via mail and .  Generated over 200 communications to lawmakers through our website (cancer.org).

Media Advocacy  Lots of media coverage for local campaigns  Utilized op-eds and letters as much as possible  Harder to get earned feature stories Use major studies as springboards Conduct your own research (surveys, air monitoring Paid ads

Still fighting….  Constant media coverage of bars’ plight  Dramatic stories “I’ll be on the unemployment line with my two kids at Christmas”  Confusion over provisions of the law herbal cigarettes waivers

What you can do  Empower your local elected officials as advocates for state legislation  Use smoking costs as tools to educate  Find spokespeople that have strong connection to local media