1. Background Results Conclusions / Policy Implications SHS causes approximately 38,000 deaths among nonsmokers in the U.S. each year (1,2) Workplace smoking bans reduce exposure to SHS (3) 1.9 million workers are employed at U.S. airports (4) 1.9 million passengers per day visit U.S. airports (4) 93.4% have signs to communicate policy Large-hub airports were likeliest to use PA announcements (84.6%) Smoke-free airports were more likely to designate outdoor smoking areas than non- smoke-free airports Smoke-free airports were more likely to require people to move a minimum distance away from entrances when smoking Large-hub airports carry about 70% of all commercial passengers, meaning that most travelers and airport workers are still not protected from secondhand smoke Travelers and airport employees are also at risk for being exposed to secondhand smoke when entering, leaving, or working inside and outside of airport buildings Since 2002, additional states have adopted policies requiring workplaces to be smoke-free, meaning that additional airports are now smoke-free Still, more action is needed to ensure that travelers and airport employees are not exposed to secondhand smoke Tobacco Industry Influence References General strategy: Focus on accommodation (i.e. promote the adoption of airport smoking lounges) at high-profile, large-hub airports; publicize “successes” 1993 TI doc – “Financial Support for Airport Smoking Areas” –Industry hitting a “brick wall” in accommodation efforts; most airports wanting to ban smoking at this point. Efforts to advocate through Healthy Buildings International were subsequently successful in, e.g., Denver (fig. 1). 1994 PM doc – Proposed budget for “reasonable alternatives” –Allocates over $4 million to fight smoke-free policies, including $275,000 to encourage U.S. and Asian airport managers to accommodate smokers 1997 PM doc – “Airport Accommodation Issues: From the terminal to the tarmac” –Reviews key players in airport smoking policy—trade associations, airline clubs, government officials –Surveyed top 50 airports, of which 34% were smoke-free at that time –Notes 57% of smoking policies were developed by government (local or state) –32% of surveyed airports provide smoking lounges –Industry goal: Persuade airports that allowing smoking is like providing other amenities (shopping, dining, etc.) 2000 PM doc – “Trends in Airports” –Notes “malling of terminal” trend –Asserts accommodation is becoming more prevalent Methods Variations in Designated Areas Acknowledgments Cynthia Mack, Henry Ford Health System, assisted with data collection Sharon Glasgow, Federal Aviation Administration, provided information on passengers, employees and technical terms WKY Pan, Johns Hopkins University Bloomberg School of Public Health, assisted with data analysis Corinne Husten, Terry Pechacek, and Ann Malarcher, Centers for Disease Control and Prevention’s Office on Smoking and Health, assisted in the preparation of a manuscript for publication in Morbidity and Mortality Weekly Report Funding for this project was provided by the Flight Attendant Medical Research Institute Telephone survey of primary commercial service airports Census of all large-, medium-, and small-hub airports and a simple random sample of nonhub airports Information collected: –locations (if any) where smoking is allowed –whether smoking areas enclosed/separately ventilated –whether smoking is prohibited within a specified distance from entrances –how the policy is communicated (i.e., written policy, signs, PA announcements) Smoke-free airports were defined as prohibiting smoking by anyone, anywhere, and at any time inside the airport Response rate: 98.0% (all 31 large-hub, 34 of 35 medium-hub, 69 of 71 small-hub, and 63of 64 nonhub) Figure 1. Smoking lounge at Denver Airport, 2002. 1) CDC. Annual smoking-attributable mortality, years of potential life lost, and economic costs— United States, 1995-1999. MMWR 2002;51:300-3. 2) National Cancer Institute. Health effects of exposure to environmental tobacco smoke: the report of the California Environmental Protection Agency. Smoking and tobacco control monograph no. 10. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 1999. NIH pub. no. 99-4645. 3) CDC. Strategies for reducing exposure to environmental tobacco smoke, increasing tobacco-use cessation, and reducing initiation in communities and health-care systems: a report of recommendations of the Task Force on Community Preventive Services. MMWR 2000;49(No. RR-12). 4) Airports Council International. The economic impact of U.S. airports 2002. Washington, DC: Airports Council International; 2003. Accessed April 22,2005 at http://www.aci-na.org/docs/us_econ_impact.pdfhttp://www.aci-na.org/docs/us_econ_impact.pdf. Survey of Airport Smoking Policies: United States, 2002 Holm AL 1, Pevzner ES 2, Davis RM 1 1) Henry Ford Health System; 2) University of North Carolina – Chapel Hill Figure 2. Smoking lounge at Cincinnati Airport, 2003.