1. NCI Smoke-Free Meeting Policy
American Public Health Association November 6, Mary E. O'Connell National Cancer Institute

2. Secondhand Smoke
Secondhand smoke is also know as environmental tobacco smoke (ETS), passive smoking, and involuntary smoking
Formed from exhaled mainstream smoke and side stream smoke
Contains more than 4,000 chemicals, including more than 50 known carcinogens, nicotine and carbon monoxide
There is no risk-free level of exposure to secondhand smoke
Separating smokers from nonsmokers, cleaning the air, and ventilating buildings does not eliminate exposures to secondhand smoke
Nat'l Toxicology Program. Report on Carcinogens. Eleventh Edition. US DHHS, Public Health Service, Nat'l Toxicology Program, 2005.
NCI. Cancer Progress Report Public Health Service, National Institutes of Health, US DHHS, 2004.
International Agency for Research on Cancer. Tobacco Smoke and Involuntary Smoking. Lyon, France: 2002.
US DHHS. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Rockville, MD: US DHHS, CDC, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.

3. Health Effects of Secondhand Smoke Exposure
Secondhand Smoke is a human carcinogen and causes premature death and disease in nonsmokers
Secondhand Smoke causes an estimated 3,000 lung cancer deaths and about 46,000 heart disease deaths each year
Living with a smoker increases a nonsmoker’s chances of developing lung cancer by 20 to 30 percent
In children and pregnant mothers, secondhand smoke exposure is especially harmful:
Decreased fetal growth in pregnancy, and may cause preterm delivery and some childhood cancers
Sudden Infant Death Syndrome (SIDS)
Asthma, ear infections, upper/lower respiratory tract infections
California Environmental Protection Agency, Office of Environmental Health Hazard Assessment. Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant: Part B Health Effects, 2005.
US DHHS. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, 2006.

4. Smoke-free Air Benefits Smokers and Nonsmokers
Reduces nonsmokers’ exposure to Secondhand Smoke
Encourages and facilitates smoking cessation
Educates the public
Changes social norms
May help decrease smoking in the home
Provides economic benefits for many employers
Well accepted by public, both smokers and nonsmokers
Largely self-enforcing

5. NCI Policy Adoption
Healthy People 2010 includes the goal of reducing nonsmokers' exposure to secondhand smoke from 88 percent to 63 percent by 2010
Increasingly, public health and medical organizations are choosing to hold meetings and conferences only in smoke-free jurisdictions
In 2005, C-Change adopted a smoke-free meeting policy, and challenged its member organizations to adopt similar policies
On July 13, 2006, the National Cancer Institute announced the NCI Smoke-free Meeting Policy
US DHHS. Healthy People 2010 Midcourse Review. Washington, DC: U.S. Government Printing Office, December 2006

6. NCI Policy Announcement
NCI recognizes that Secondhand Smoke is an important preventable cause of death from cancer and other illnesses, and that many Americans, both adults and children remain at significant risk from Secondhand Smoke exposure. In order to reduce cancer and other serious health hazards caused by Secondhand Smoke exposure, all meetings and conferences organized and/or sponsored by NCI shall be held in a town, city, county, or state that is smoke-free, unless specific circumstances justify an exception from this policy.
“NCI Announces New Smoke-free Meeting Policy to Address Major Public Health Hazard” Press Release, July 13, 2006.

7. NCI Policy Goal
Exposure to secondhand smoke remains “a serious public health hazard,” and there is no risk-free level of exposure.
Surgeon General Richard Carmona, M.D., upon releasing The Health Consequences of Involuntary Exposure to Tobacco Smoke. June, 2006.
“NCI seeks to recognize the contribution of states, counties, cities and towns that have chosen to protect the public, including employees, from secondhand smoke exposure. We hope this policy will encourage other states and cities to do likewise.”
Robert Croyle, PhD., Director of NCI’s Division of Cancer Control and Population Sciences, NCI Press Release, July 13, 2006.

8. NCI Policy Implementation
Policy became effective January 1, 2007
For purposes of meeting planning, NCI considers a jurisdiction (state, county, city, or town) smokefree if it provides complete or near complete protection from secondhand smoke in enclosed workplaces, including restaurants
Policy applies to meetings/conferences with 20 or more attendees that are organized or sponsored by NCI
The policy does not apply to grantees, including conference grants
NCI sponsored meetings held outside the U.S. are not subject to the policy
Holding a meeting at a smoke-free facility is not sufficient; the facility must be located in a smoke-free jurisdiction

9. Smoke-free Meeting Planning smokefreemeetings.cancer.gov
NCI has developed a website to support meeting planning in smoke-free jurisdictions
Data on smoke-free legislation is collected by Americans for Nonsmokers' Rights (ANR)
The site will feature an interactive tool to help NCI employees and the general public locate smoke-free jurisdictions based on the latest smoking policy information
As of October 2007, twenty-one states, plus the District of Columbia are entirely smokefree
Illinois will become effective 1/2008; Maryland in 2/2008
In addition, there are eighteen states that contain at least one smoke-free jurisdiction
Only eleven states contain no smoke-free jurisdictions
Exceptions to this policy are allowed in specific circumstances such as the need to:
hold a meeting or conference at an NCI designated Cancer Center located in a jurisdiction that is not yet smokefree;
Convene an NCI meeting or conference in coordination with another meeting or conference taking place in a jurisdiction that is not yet smokefree;
the requirements of the Competition in Contracting Act (41 U.S.C. sec. 253).

10. NCI Online Smoke-free Locator Tool Smoke-free States as of October 2007WA NH MT ME ND VT OR MN ID MA SD WI NY WY RI MI CT PA IA NJ NE NV OH UT IL IN DE CA WV CO MD VA KS MO KY NC TN AZ OK
NCI’s Division of Cancer Control and Population Sciences (DCCPS) is finalizing a web interface which features an interactive smoke-free venue locator tool
The tool will help staff find smoke-free venues based on up-to-date smoking policy information for states and local jurisdictions
Much like this map, the web tool presents with a map and users are able to locate smokefree jurisdictions by state, county, city, or town
The web tool will be available for public use in late 2007 AR NM SC
Smokefree
State AL GA MS TX LA
Partial Smokefree
State AK FL
State with inadequate or no Smokefree
Municipalities HI

11. Announcement Coverage Lancet Oncology, September 2006; 7: 707
“Scientists are beginning to practice what they preach. The US National Cancer Institute (NCI) announced in July, 2006 that all its organized or sponsored meetings and conferences will be held in cities and towns that have adopted comprehensive smoke-free policies. The move comes in the wake of a new report from the US Surgeon General, saying that more than 12.6 million Americans are exposed to second-hand smoke. The NCI directive aims to raise public awareness about the importance of protecting adults and children from environmental tobacco smoke.”

12. Announcement Coverage USA Today, July 24, 2006
“The NCI has become the latest of a small but growing number of health organizations pledging to hold meetings only in cities, counties or states with “smoke-free air” laws. The announcement comes at a time of increasing concerns about SHS. The U.S. Surgeon General released a report in June concluding that secondhand smoke, which is thought to kill nearly 50,000 Americans a year, is dangerous at any level and that only smoking bans can protect non-smokers.”

13. Announcement Coverage CBS Eyewitness News at 5:30, Philadelphia, PA, July 14, 2006
“Well, where there is smoke, there will be less business at hotels, restaurants, elsewhere, they could lose big dollars as the National Cancer Institute is promising to avoid all sites that are not completely smoke-free… They’ll be off limits in 13 states, including Pennsylvania.”

14. Announcement Coverage Associated Press, July 13, 2006
“Here’s a new incentive for cities to go smoke-free. The government’s top cancer agency could take away some tourism dollars if they don’t… The decision follows the recent Surgeon General’s report that declared breathing any amount of someone else’s tobacco smoke harmful to nonsmokers, and called for completely smoke-free buildings and public places.”

15. National Institute on Drug Abuse (NIDA) Adopts Smoke-free Meeting Policy
“Most smokers use tobacco regularly because they are addicted to nicotine. Addiction is characterized by compulsive use, even in the face of negative health consequences. Reducing such exposure will not only improve public health but may also facilitate quit attempts by those addicted to tobacco, benefiting their health as well.”
“NIDA hopes that the new meeting policy will raise awareness of the importance of protecting nonsmokers from secondhand smoke exposure, and will encourage communities to adopt nonsmoking regulations for public facilities.”
Dr. Nora Volkow, NIDA Director. “NIDA Announces Smoke-Free Meeting Policy.” Press Release, September 21, 2006.
The Centers for Disease Control and Prevention (CDC) has recently developed a similar policy requiring conferences be held in smoke-free communities

16. Conclusions
Exposure to secondhand smoke is an important, preventable cause of morbidity and mortality in adults and children
There is no risk-free level of exposure
Although momentum towards smokefree jurisdictions is strong and growing, many adults and children remain at risk
Health organizations can play an important exemplar role by adopting policies that recognize the contribution of those jurisdictions that have chosen to protect the public from secondhand smoke
NCI hopes that the new Smoke-free Meeting Policy will encourage jurisdictions that have yet to adopt smoke-free laws to do so