BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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                                 THIRD READING


          Bill No:  AB 574
          Author:   Hill (D), et al
          Amended:  7/9/09 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  6-3, 6/17/09
          AYES:  Alquist, DeSaulnier, Leno, Maldonado, Pavley, Wolk
          NOES:  Strickland, Aanestad, Cox
          NO VOTE RECORDED:  Cedillo, Negrete McLeod

           SENATE APPROPRIATIONS COMMITTEE  :  7-5, 6/29/09
          AYES:  Kehoe, Corbett, Leno, Oropeza, Price, Wolk, Yee
          NOES:  Cox, Denham, Runner, Walters, Wyland
          NO VOTE RECORDED:  Hancock

           ASSEMBLY FLOOR  :  46-25, 5/18/09 - See last page for vote


           SUBJECT  :    Health facilities:  smoking

           SOURCE  :     Breathe California
                      California Tobacco Control Alliance


           DIGEST  :    This bill prohibits smoking in all areas of  
          acute care hospitals, including the general hospital  
          campus, buildings, parking areas, plazas, and sidewalks.  

           Senate Floor Amendments  of 7/9/09 add coauthors and make  
          one technical change.

           ANALYSIS  :    Existing law:
                                                           CONTINUED





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          1.Prohibits smoking inside a public building, or in an  
            outdoor area within 20 feet of a main exit, entrance, or  
            operable window of a public building, which is defined as  
            a building owned and occupied by the state or a local  
            government.

          2.Requires California employers to provide a safe and  
            healthful workplace under the Occupational Safety and  
            Health Act of 1973.

          3.Prohibits employers from knowingly or intentionally  
            permitting any person from engaging in the smoking of  
            tobacco products in all enclosed places of employment, as  
            defined, with specified exceptions. 

          This bill:

          1.Prohibits smoking in all areas of acute care hospitals,  
            including the general hospital campus, buildings, parking  
            areas, plazas, and sidewalks.  

          2.Excludes from the smoking prohibition, public  
            thoroughfares and sidewalks adjacent to the general acute  
            care hospital but not owned by the hospital.

          3.Requires a general acute care hospital to post signs  
            stating that smoking is prohibited on the entire hospital  
            campus, at building entrances and in other conspicuous  
            locations. 

          4.Requires a general acute care hospital to advise new  
            employees of this policy during orientation and inform  
            current employees at least 60 days prior to  
            implementation. 

          5.Permits a city, county, or city and county to adopt and  
            enforce additional smoking and tobacco control  
            ordinances, regulations, or policies that are no less  
            stringent than applicable standards in this bill.

          6.Excludes from the requirements of this bill property  
            owned or leased by the hospital that is distinct from,  
            and not part of, the principal medical campus and that is  







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            used for purposes other than health care. 

          7.Establishes a patient-specific exemption to the bill's  
            smoking prohibition if authorized in writing by a  
            treating physician for patients whose treatment will be  
            substantially impaired by the denial of the use of  
            tobacco.

           Background
           
          Under current law, more than 70 California hospitals  
          currently have voluntarily prohibited smoking throughout  
          their campuses.  Approximately 1,250 hospitals nationwide  
          have smoke-free campuses and most also provide tobacco  
          cessation support services to both employees and patients.   
          Many of these hospitals report that they took this step  
          because smoking was contrary to hospitals' mission of  
          treating the ill and promoting public health.  Research  
          published in the Journal of the American Medical  
          Association has found that the quit rate among medical  
          staff at hospitals with no smoking policies was higher than  
          at other hospitals.  Numerous studies have shown that  
          smoke-free public places are associated with 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  
          second-hand 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. 

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions                2009-10     2010-11     
           2011-12   Fund  
          Tobacco tax                                  unknown,  







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          potentially thousands of dollars             General/
            revenue loss                                          
          depending on the number of people that quit             
          Special
                         smoking as a result of this policy

           SUPPORT  :   (Verified  7/10/09)

          Breathe California (co-source) 
          California Tobacco Control Alliance (co-source) 
          American Lung Association
          Breathe California of Los Angeles County
          Breathe California of Sacramento-Emigrant Trails
          California Hospital Association
          California Medical Association
          Coalition of Lavender Americans on Smoking and Health
          Public Health Law and Policy
          Regional Asthma Management and Prevention
          San Francisco Asthma Task Force
          San Mateo County Tobacco Education Coalition
          Sierra Vista Medical Center
          Sutter Medical Center, Sacramento
          Watts Healthcare Corporation


           ARGUMENTS IN SUPPORT  :    Supporters argue that this bill  
          will help smokers quit while also reducing exposure to  
          second-hand smoke.  They point out that many hospitals in  
          California have already taken this step and have had no  
          problems with enforcement and compliance.  Supporters point  
          out the dangers from second-hand smoke and also note that  
          for individuals who suffer from asthma symptoms, exposure  
          to tobacco smoke on hospital campuses can trigger asthma  
          attacks at the very location that patients are seeking  
          treatment and care.



           ASSEMBLY FLOOR  :
          AYES:  Ammiano, Arambula, Beall, Block, Blumenfield,  
            Brownley, Buchanan, Caballero, Charles Calderon, Carter,  
            Chesbro, Coto, Davis, De La Torre, De Leon, Evans, Feuer,  
            Fong, Fuentes, Furutani, Galgiani, Hall, Hayashi,  
            Hernandez, Hill, Huffman, Jones, Krekorian, Lieu, Bonnie  







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            Lowenthal, Ma, Mendoza, Nava, John A. Perez, V. Manuel  
            Perez, Portantino, Ruskin, Salas, Skinner, Solorio,  
            Swanson, Torlakson, Torres, Torrico, Yamada, Bass
          NOES:  Adams, Anderson, Bill Berryhill, Tom Berryhill,  
            Conway, DeVore, Duvall, Fuller, Gaines, Garrick, Gilmore,  
            Hagman, Harkey, Huber, Jeffries, Knight, Logue, Miller,  
            Nestande, Niello, Nielsen, Silva, Smyth, Audra  
            Strickland, Tran
          NO VOTE RECORDED:  Blakeslee, Cook, Emmerson, Eng,  
            Fletcher, Monning, Price, Saldana, Villines


          CTW:nl  7/10/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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