nection between saving lives and saving money, focusing on the return on invest- ment the state achieves by putting mon- ey in public health,” she said. One initiative TMA supported during the 2011 session and will advocate again this session costs nothing up front and would improve health and save the state money in the long run. TMA backed House Bill 670 by Rep. Myra Crownover (R-Denton) and Senate Bill 355 by Sen. Rodney Ellis (D-Houston) to prohibit smoking in workplaces. The smoking ban ended up as an amendment to an- other bill, but opponents blocked the legislation when it reached the Senate, and it failed to pass during the regular session. The legislation staged a come- back during the special session, but the newest incarnation, Senate Bill 28 and House Bill 46, didn’t survive. The American Lung Association gave
Texas an “F” in tobacco prevention and control spending in its report titled State of Tobacco Control 2012. According to the report, in fiscal year 2012, Texas spent $5.45 million on tobacco control programs. The Centers for Disease Con- trol and Prevention (CDC) recommends Texas invest $266 million in tobacco control programs, but the state spends only 4.6 percent of the recommendation. (See “Tobacco’s Toll on Texas,” at right.) Comprehensive smoke-free workplace
ordinances now cover 36 Texas cities. Twenty-nine states are smoke-free. In a 2011 Baselice & Associates Inc. survey, 70 percent of Texans supported prohibit- ing indoor smoking, including in restau- rants and bars. Dr. Patt says the TPHC-sponsored University of Health event gave her a platform to educate legislative staff on the benefits of a comprehensive smoke- free indoor workplace policy. “The natural consequence of this pol-
icy would be improved health among Texans, improved productivity, and de- creases in health care spending,” she said.
A DSHS analysis of smoking ordi- nances in El Paso County and Travis County — areas with populations of at least 50,000 that have the most restric- tive smoking ordinances passed since 2005 — reveals reductions in potentially
preventable hospitalizations (PPHs) from 2005 to 2009. According to the DSHS Center for
Program Coordination, during the five- year period, El Paso County adult resi- dents experienced a reduction in the chronic obstructive pulmonary disease PPH rate that was 50 percent less than the state rate. Residents’ congestive heart failure PPH rate fell to 22 percent less than the state rate, while the bacte- rial pneumonia PPH rate was 16 percent less than the state rate. From 2005 to 2009, Travis County
adult residents’ asthma PPH rate was 22 percent less than the state rate. The chronic obstructive pulmonary disease PPH rate was 56 percent less than the state rate, while the congestive heart failure PPH rate was 43 percent less than the state rate. Residents’ bacterial pneu- monia PPH rate was 47 percent less than the state rate. Dr. Patt adds that it’s “important for legislators to understand the positive economic impact from strong smoke-free
laws. Time and again, restaurants and bars have shown stable and sometimes even increased revenue when smoke- free policy is enacted.”
In fact, a DSHS 2000 analysis of sales tax data from 1987 to 1999 in four smoke-free Texas cities — Austin, Arling- ton, Plano, and Wichita Falls — found smoke-free policies don’t affect restau- rant revenue or the sale of alcoholic bev- erages in bars. Dr. Patt explains that by not having a
comprehensive smoke-free indoor work- place policy at the state level, many em- ployees continue to be exposed to unac- ceptable levels of carcinogens and toxins on the job each day. Opponents of such a law commonly cite infringement on the personal liberty of the smoker as an ar- gument against passage. “By not limiting toxic exposure to Tex- as workers, absence of a comprehensive smoke-free policy is an infringement of their civil liberty. No one should have to choose between a paycheck and their health,” Dr. Patt said.
Tobacco’s toll on Texas
• Economic costs due to smoking: $13,044,600,000 • Adult smoking rate: 15.8 percent • High school smoking rate: 21.2 percent • Middle school smoking rate: 5.7 percent • Smoking-attributable deaths: 24,570 • Smoking-attributable lung cancer deaths: 7,770 • Smoking-attributable respiratory disease deaths: 6,324
Source: American Lung Association State of Tobacco Control 2012
February 2013 TEXAS MEDICINE 29
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