<div>Tobacco (nicotine) is a physically addictive drug. Once addicted, "choice" becomes a problematic concept. And many people become addicted while underage, encouraged to continue their addiction in bars, where cigarettes are often shared between customers. </div>
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<div>The fact tobacco is physically addictive is absent from the comments of many opposing the smoking ordinance, as are the facts regarding the magnitude of the damage. Comparisons to other harmful behaviors are drawn (fatty food, etc.), suggesting that a slippery slope of regulation will lead to government control over too many aspects of life, but many of these behaviors do not involve a drug addiction. Of course alcohol has dramatic negative impacts. But workers in bars are not forced to drink the drinks the customers order, as they breathe the smoke of the customers. </div>
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<div>I find it incredible that the health of workers exposed to an addictive drug when they breathe in the workplace is approached so callously. They can work elsewhere, it's announced with smug authority, as if in this economy workers have the luxury of choosing whatever job suits their fancy, rather than an urgency to take whatever work they can find. If it was cocaine or heroin or methamphetamine that workers were exposed to, the attitude might be different. </div>
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<div>Profits from exposing workers to addictive drugs in the workplace should be protected based on free market, free choice, adult responsibility? If this is the logic, where are the protests against laws imposed on those selling cocaine, heroin or methamphetamine, et. al., to consenting adults, which can result in long prison sentences? Let the free market decide! Why stand in the way of profits and the free choice of adults? </div>
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<div>If those opposing the smoking ordinance were consistent in their outrage against limits on the free market, their ideology might have more intellectual credibility. Instead, the libertarianism proposed is inconsistent and conformist. Or perhaps those opposed to the smoking ordinance will now protest that bars do not allow legal cocaine, heroin or methamphetamine use? Think of the profits to be made! And remember, tobacco prematurely kills more people than those three drugs combined...</div>
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<div>If attempts were made to criminalize tobacco like cannabis is, resulting in prison sentences, home invasions, for sale or use, I would oppose this vehemently. But an ordinance regulating smoking in bars does not stop any adult from legally using tobacco products in settings where they do not expose workers.</div>
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<div>If worker freedom of choice was a valid argument to justify the exposure of workers to tobacco smoke in bars, than OSHA could be mostly eliminated. After all, if workers exposed to hazards monitored or banned by OSHA don't want to work with those risks, they can work elsewhere, as long as signs posted in the workplace inform them of the risks. A "Big Brother" government bureaucracy gone. </div>
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<div><a href="http://www.cdc.gov/NCCDPHP/publications/aag/osh.htm">http://www.cdc.gov/NCCDPHP/publications/aag/osh.htm</a></div>
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<h2>The Burden of Tobacco Use</h2>
<p>Tobacco use is the single most preventable cause of disease, disability, and death in the United States. Each year, an estimated 443,000 people die prematurely from smoking or exposure to secondhand smoke, and another 8.6 million have a serious illness caused by smoking. For every person who dies from smoking, 20 more people suffer from at least one serious tobacco-related illness. Despite these risks, approximately 43.4 million U.S. adults smoke cigarettes. Smokeless tobacco, cigars, and pipes also have deadly consequences, including lung, larynx, esophageal, and oral cancers.</p>
<p>The harmful effects of smoking do not end with the smoker. More than 126 million nonsmoking Americans, including children and adults, are regularly exposed to secondhand smoke. Even brief exposure can be dangerous because nonsmokers inhale many of the same carcinogens and toxins in cigarette smoke as smokers. Secondhand smoke exposure causes serious disease and death, including heart disease and lung cancer in nonsmoking adults and sudden infant death syndrome, acute respiratory infections, ear problems, and more frequent and severe asthma attacks in children. Each year, primarily because of exposure to secondhand smoke, an estimated 3,000 nonsmoking Americans die of lung cancer, more than 46,000 (range: 22,700–69,600) die of heart disease, and about 150,000–300,000 children younger than 18 months have lower respiratory tract infections.</p>
<p>Coupled with this enormous health toll is the significant economic burden of tobacco use—more than $96 billion per year in medical expenditures and another $97 billion per year resulting from lost productivity.</p>
<p align="center"><a name="1"><img height="457" alt="Chart showing about 443,000 U.S. deaths attributable each year to cigarette smoking. Text description below." src="http://www.cdc.gov/NCCDPHP/publications/aag/images/2009/tobacco2.gif" width="425" border="0"></a></p>
<p class="psmall" align="center">[A <a href="http://www.cdc.gov/NCCDPHP/publications/aag/osh_text.htm#1"><font color="#003366">text description of this graph</font></a> is also available.]</p>
<h2>The Tobacco Use Epidemic Can Be Stopped</h2>
<p>A 2007 Institute of Medicine (IOM) report presented a blueprint for action to “reduce smoking so substantially that it is no longer a public health problem for our nation.” The two-pronged strategy for achieving this goal includes not only strengthening and fully implementing currently proven tobacco control measures, but also changing the regulatory landscape to permit policy innovations. Foremost among the IOM recommendations is that each state should fund a comprehensive tobacco control program at the level recommended by CDC in <i>Best Practices for Comprehensive Tobacco Control Programs–2007</i>.</p>
<p>Evidence-based, statewide tobacco control programs that are comprehensive, sustained, and accountable have been shown to reduce smoking rates, tobacco-related deaths, and diseases caused by smoking. A comprehensive program is a coordinated effort to establish smoke-free policies and social norms, to promote and assist tobacco users to quit, and to prevent initiation of tobacco use. This approach combines educational, clinical, regulatory, economic, and social strategies.</p>
<p>Research has documented the effectiveness of laws and policies to protect the public from secondhand smoke exposure, promote cessation, and prevent initiation when they are applied in a comprehensive way. For example, states can increase the unit price of tobacco products; implement smoking bans through policies, regulations, and laws; provide insurance coverage of tobacco use treatment; and limit minors’ access to tobacco products.</p>
<p>If the nation is to achieve the objectives outlined in <i>Healthy People 2010</i>, comprehensive, evidence-based approaches for preventing smoking initiation and increasing cessation need to be fully implemented.</p>
<h1>CDC's Response</h1>
<p>CDC is the lead federal agency for tobacco control. CDC’s Office on Smoking and Health (OSH) provides national leadership for a comprehensive, broad-based approach to reducing tobacco use. A variety of government agencies, professional and voluntary organizations, and academic institutions have joined together to advance this approach, which involves the following activities:</p>
<ul>
<li>Preventing young people from starting to smoke.<br>
<li>Eliminating exposure to secondhand smoke.<br>
<li>Promoting quitting among young people and adults.<br>
<li>Identifying and eliminating tobacco-related health disparities. </li></li></li></li></ul>
<p>Essential elements of this approach include state-based, community-based, and health system-based interventions; cessation services; counter marketing; policy development and implementation; surveillance; and evaluation. These activities target groups who are at highest risk for tobacco-related health problems.</p>
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<p>Vision2020 Post: Ted Moffett</p></div>