Public smoking bans have helped smokers to quit, improved health and cut health-related costs. Although about half the states have enacted bans over determined opposition by big-tobacco lobbyists, the effort to enact statewide bans has slowed. Groups such as the American Cancer Society have increasingly turned their smoking ban initiatives to individual cities, where the bans have found a much warmer reception.
As of July 1, some 13,689 municipalities in 32 states have smoke-free laws, and 28 states and Washington, D.C., have laws that require workplaces, restaurants or bars to be smoke-free, according to the American Nonsmokers' Rights Foundation. Within the United States, 65.1 percent of the population lives in an area that is covered by a smoke-free law.
The move to restrict smoking in places where others have to breathe in secondhand smoke is almost two decades old, and it's been a state-by-state battle, or even town-by-town battle all the way, anti-smoking groups say.
"I can't think of any places where smoking bans have been a slam-dunk to implement," said Cathy Callaway at the American Cancer Society.
Coalitions of smokers, such as the National Smokers' Alliance and groups within the Center for Individual Freedom, have banded together to support smokers' rights. These groups are sometimes backed by lobbyists, and they've been remarkably effective at getting their message out despite the clear dangers of tobacco use.
"I don't think the government should tell us where we can or cannot smoke," said Scott Smith, 32, who has worked with individuals from the National Smokers' Alliance to try to promote smoking in restaurants of New York. "And it's even more ridiculous for the policymakers to make these no smoking laws apply to a state. Secondhand smoke can easily be decreased if restaurants would make their smoke-free sections better ventilated."
But the U.S. Surgeon General maintains that there is no risk-free level of exposure to secondhand smoke. "Only 100 percent smoke-free indoor spaces fully protect nonsmokers from exposure to secondhand smoke," according to the agency.
Efforts to implement smoking laws began in the 1980s, but the first smoking ban that covered all restaurants and bars dates back to Aug. 3, 1990, in San Luis Obispo, Calif.
If a strong smoke-free law was present in all public places, according to the surgeon general, the nation would see "1.3 million smokers quitting, 950 million fewer cigarette packs being smoked, 1,540 myocardial infarctions and 360 strokes being averted, and $49 million in direct medical cost savings being realized all within one year."
But getting the laws passed remains a challenge, even though the benefits are so obvious and immediate.
"We've found that the best practice is to start at the community level," the ACS's Callaway said. "You have a smaller population, a smaller elected body to educate and a lot of grass-roots power. It helps the general public to work through the process and understand what a smoke-free law is."
Most states with smoke-free laws began with citywide initiatives. For example, New York City passed its smoking ban in March 2003 and secured a statewide ban in June of the same year. The positive effects on public health increase with time, according to Stanton Glantz, a cardiology professor at the University of San Francisco who is credited with top research advances by the American Heart Association.