Reducing Outdoor ETS Exposure: A Policy Analysis

Each year, approximately 49,000 non-smokers are killed due to environmental tobacco smoke (ETS). Because even brief exposure to ETS is harmful to health, the Centers for Disease Control and Prevention has identified reducing ETS exposure as a priority in the winnable battle against tobacco use. Remarkable progress has been made through implementing indoor clean air policies throughout the nation; however, exposure in public outdoor facilities is a significant factor that is often overlooked, leaving a considerable number of non-smokers exposed. Outdoor smoking restrictions in many states are currently left to the discretion of facilities, cities, and counties, leading to inconsistent policies or a lack of policy altogether. To address this need, a policy analysis, including a stakeholder analysis, was completed. Initial reviews of outdoor policies across the nation resulted in four best practice policies that were thoroughly analyzed against five implementation criteria: Ease of Enforcement, Cost of Implementation, Level of Community Support, Overall Feasibility of Implementation, and Potential to Reduce ETS Exposure. Two policies are recommended for implementation at the statewide level as a result of this analysis—creating a smoke-free radius around building entrances and/or creating smoke-free bleacher sections in sporting venues. Both options are of equal importance, but the feasibility of implementation will vary by state needs, current smoking restrictions, and readiness for change. Based on results of this analysis, each state should assess its individual needs and priorities and implement one or both of these options at the statewide level.