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 Page 2 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