BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 574
                                                                  Page  1

          Date of Hearing:   May 6, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                     AB 574 (Hill) - As Amended:  April 23, 2009 

          Policy Committee:                              Health Vote:13-4

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill prohibits smoking in all areas of acute care  
          hospitals, including the general hospital campus, buildings,  
          parking areas, plazas, and sidewalks. Establishes a  
          patient-specific exemption to the smoking prohibition  
          established by this bill if authorized by a treating physician. 

           FISCAL EFFECT  

          No direct fiscal impact to the California Department of Public  
          Health (DPH) to continue oversight of health and safety in  
          California hospitals. 

           COMMENTS  

           1)Rationale  . This bill is co-sponsored by the California Tobacco  
            Control Alliance and Breathe California to create more  
            "teachable moments" on hospital campuses for patients and  
            their families. According to the author and sponsors, an acute  
            health episode, especially one related to smoking, creates a  
            heightened awareness and concern about the impact of tobacco  
            on one's health. In addition, the sponsors highlight recent  
            research on smoke-free work environments and the impact on  
            smoking cessation and reduced heart attacks. 

           2)Background  . Under current law, more than 70 California  
            hospitals currently have voluntarily prohibited smoking  
            throughout their campuses.  Many hospitals nationally have  
            smoke-free campuses and most also provide tobacco cessation  
            support services to both employees and patients.  

          Numerous studies have shown that smoke-free public places are  








                                                                  AB 574
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            associated with sizable, rapid reductions in hospital  
            admissions for heart attacks. However, many of these studies  
            looked at only a year of data after the implementation of  
            smoke-free laws. More recent research, released in 2008,  
            addressed a three-year study in Colorado and showed a  
            sustained reduction in heart attack hospitalizations after a  
            smoke-free law took effect. Smoke-free laws reduce cardiac  
            hospitalizations by reducing secondhand smoke exposure among  
            non-smokers and reducing smoking. The larger contribution to  
            improved health has been shown to be the reduction in second  
            hand smoke. 

           3)Concerns  . The California Hospital Association recently removed  
            opposition to this bill when the amendment to allow specified  
            patients to smoke was adopted. 

           4)Related Legislation  . AB 3010 (Blakeslee), Chapter 505,  
            Statutes of 2008 authorizes the Director of the Department of  
            Mental Health (DMH) to prohibit the possession or use of  
            tobacco products on the grounds of state mental hospitals  
            under specified conditions. 


           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081