Health and Economic Impacts of the Proposed Florida Smokefree for Health Initiative

Florida was an early and important battleground for local nonsmokers’ rights advocates vs. the tobacco industry. In the early 1980s, several cities in Florida passed what were at the time state-of-the art local clean indoor air ordinances. The tobacco industry responded by working through the state restaurant association and others to enact a weak statewide law that overturned these local ordinances and forbade passage of additional laws. While the state voluntary health agencies initially opposed this bill, in the end they supported it and claimed that it represented a reasonable compromise which represented a step forward. In fact, passage of the Florida Clean Indoor Air Act (FCIAA) effectively arrested progress on protecting nonsmokers from secondhand smoke in the state of Florida. As of 1999, Florida was twenty-fourth among the fifty states plus the District of Columbia in percentage of indoor workers protected from passive smoking in the workplace (68%). The Smoke-Free For Health Initiative proposes a constitutional amendment for the state of Florida that would prohibit smoking in the workplace. Specifically, it would prohibit tobacco smoking in enclosed indoor workplaces except in retail tobacco shops, designated smoking guest rooms in public lodging establishments, stand-alone bars, and private residences not used for to provide child care, adult care or health care. The initiative is sponsored by many organizations, including the American Cancer Society, American Lung Association, American Heart Association, Campaign for Tobacco-Free Kids, American Association of Retired Persons, and the Center for Florida’s Children. This analysis evaluates the effects that this strong, comprehensive clean indoor air amendment would have in Florida, assuming that the Legislature enacts appropriate implementing legislation and that the Executive branch makes a good faith effort to enforce the resulting state law. These effects include reductions in smoking behavior, cigarette use, tobacco company revenues, and tobacco-related illnesses. The benefits realized in the first year after implementing the policy include: 1. 1.5 million Floridians would no longer be passive smokers 2. 81,400 Floridians would quit smoking 3. 48.6 million packs of cigarettes would go unsmoked (worth $114 million in pre-tax sales to the tobacco industry) 4. 120 acute myocardial infarctions and 20 strokes would be prevented 5. 50 deaths among the people suffering myocardial infarctions and strokes prevented 6. 300 low birthweight births would be prevented 7. 80 new cases of asthma would be prevented 8. 2 cases of sudden infant death syndrome would be prevented 9. $6.8 million in medical cost savings would be realized during the first year, consisting of $5 million in direct medical cost savings from prevention of cardiovascular disease, $2 million in savings from prevention of low birthweight infants, and $1 million saved from prevention of excess respiratory illnesses in children aged 0-5. Over time, additional health and economic benefits would be realized from the reduction in active and passive smoking. At steady state (assuming no population growth or medical cost inflation), reduction in cancer and emphysema, as well as further reduction in heart disease, would lead to annual savings of: 1. 1820 early deaths prevented, consisting of 1090 from cardiovascular disease, 480 from cancer, and 250 from respiratory disease 2. 300 low birth weight infants 3. Yearly health care savings of $220 million, consisting of savings of $196 million from ex-smokers and at least $24 million dollars from reduced exposure to secondhand smoke The effects in future years would be larger because the population of Florida will continue to grow, and this growth has not been taken into account in these estimates.