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Areas with most smoking-related illness have most exemptions to smoking ban

This article first appeared in the St. Louis Beacon, Jan. 27, 2012 - Many establishments that are exempted from St. Louis County's public-smoking ban are in areas with the highest incidences of smoking-related illnesses, according to an analysis by Tobacco-Free St. Louis. It also argues that the exemptions could undo the health benefits of the Clean Air Act and that they are unfair to the majority of county establishments that have banned smoking.

According to the group, 56 of the exempted establishments are in north county. Another 41 are in south county, 29 are in west county and the remaining 20 are in the mid-county region, including the smoke-free communities of Clayton, Brentwood and Kirkwood.

Dr. Stuart Slavin, a member of Tobacco-Free St. Louis, stressed that the group isn't arguing that illnesses related to smoking would vanish without the exemptions.

"But what's striking to me is that if you look at illnesses that may be smoking related, whether it is heart attacks or hospitalization for chronic lung diseases, you will find significantly greater risks and rates in north county," Slavin said.

He also said that many residents of north county may lack adequate access to health care and "can least afford to suffer from these problems."

He added, "We aren't saying this is the cause of health disparity. But it certainly is one that's contributing, and it's easy to fix. It simply requires an act of the County Council, and these exemptions would disappear."

No council members were available to comment on the analysis, which shows that the 56 exemptions are in districts represented by Democrats Hazel Erby of University City, Kathleen Kelly of Overland, and Council Chair Michael O'Mara of Florissant. Kelly and O'Mara have raised questions over the years about the ban.

To Get an Exemption

The law allows smoking in drinking establishments with a valid liquor license that have applied for and met the qualifications for exemption.

St. Louis County Ordinance 605.030 defines the term as follows:

Any business with a valid license issued by the St. Louis County Department of Revenue (pursuant to Chapter 801, Title VIII SLCRO 1974 as amended, "Alcoholic Beverages") to sell intoxicating liquor by the drink or to sell beer and light wine by the drink whose on-site sales of food for consumption on the premises comprises no more than 25% of gross sales of food and both alcoholic and non-alcoholic beverages on an annual basis

--St. Louis County Department of Revenue

In any case, Slavin says ending the exemptions would level the playing field by "making all the casinos, bars and restaurants smoke-free so that everybody is playing by the same rules."

In addition, he says, the Clean Air Act would do much to protect residents in St. Louis and St. Louis County while the exemptions undermine the benefits.

"These exemptions allow people who work in these bars and casinos to continue to be exposed to what we know is a dangerous substance: second-hand smoke. We feel that that should not be allowed to continue," Slavin says.

Appearing with Slavin at a press conference to discuss the group's analysis were Rance Thomas, president of North County Churches United for Racial Harmony and Justice; Buffy McKinney of the American Heart Association; and Derek Deaver, owner of Three Kings Public House, the site of the press conference.

Those who support a right to smoke continue to say that bans ignore individual freedom and should be modified to account for filtration and other systems they say can address health issues.

Missouri's Low Cigarette Tax

The group's opposition follows the American Lung Association's criticism of Missouri's smoking-related policies. The group gave the state grades of F for its low cigarette taxes, weak smoke-free laws, and relatively low local spending on tobacco cessation and tobacco prevention.

The Lung Association criticized Missouri's cigarette tax of 17 cents a pack, the nation's lowest. Another critic of that tax is Linda Lair, director of clinical education at the University of Missouri-Columbia's school of health professions.

"If we could increase the tax rates (for tobacco), we could generate money for education and prevention as well as smoking cessation programs," Lair says. The Lung Association's report says the state spends less than $60,000 a year on tobacco cessation and prevention in spite of the $4.7 billion in economic costs due to smoking every year.

State spending is low, but others are funding anti-smoking campaigns. The Missouri Foundation for Health funds projects across the state, and some regions are receiving federal dollars. An example is the roughly $6 million going to the Communities Putting Prevention to Work in St. Louis County, funded by the Centers for Disease Control and Prevention.

Patricia Washington, media coordinator of the county's program, noted that some of the smoking cessation projects are in the three districts mentioned by Tobacco Free St. Louis "because of the higher smoking rates."

She says Communities Putting Prevention to Work's projects included:

  • Policy changes to discourage tobacco use in schools, countywide, and particularly among students, faculty and others in Ferguson-Florissant, Hazelwood, Riverview Gardens, Jennings and Pattonville school districts.
  • Free smoking cessation programs, which might normally cost $300 a person, in companies in north county and south county.
  • Sharing information and resources to help people understand the risk of tobacco use and to prevent youth from using tobacco.
  • Working with local retailers in high risk school districts and neighborhoods to focus more attention on tobacco use among the young. The campaign is being taken to retailers situated within 1,000 feet of schools in high-risk districts in north county and south county.

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.