BILL ANALYSIS                                                                                                                                                                                                    �



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          ASSEMBLY THIRD READING
          AB 1278 (Hill)
          As Amended January 4, 2012
          Majority vote 

           HEALTH              12-5        APPROPRIATIONS      12-5        
           
           ----------------------------------------------------------------- 
          |Ayes:|Monning, Ammiano, Atkins, |Ayes:|Fuentes, Blumenfield,     |
          |     |Bonilla, Eng, Gordon,     |     |Bradford, Charles         |
          |     |Hayashi,                  |     |Calderon, Campos,         |
          |     |Bonnie Lowenthal,         |     |Chesbro, Gatto, Hall,     |
          |     |Mitchell, Pan,            |     |Hill, Ammiano, Mitchell,  |
          |     |V. Manuel P�rez, Williams |     |Solorio                   |
          |     |                          |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Logue, Garrick, Mansoor,  |Nays:|Harkey, Donnelly,         |
          |     |Silva, Smyth              |     |Nielsen, Norby, Wagner    |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Extends the current ban on tobacco use in workplaces, 
          including hospitals, to include the entire hospital campus.  
          Specifically,  this bill  :  

          1)Prohibits, on and after March 1, 2013, smoking in all areas of 
            a general acute care hospital and throughout the entire 
            hospital campus, including, but not limited to, buildings, 
            parking areas, plazas, vehicles, underground passages, and 
            sidewalks, unless there is a government-mandated exception.

          2)Exempts public thoroughfares and sidewalks adjacent to the 
            general acute care hospital, but not owned by the hospital, 
            and specified property owned or leased by the hospital that is 
            used for non-health care-related purposes from the prohibition 
            in 1) above.

          3)Permits smoking on a hospital campus by a patient with the 
            written approval of the treating physician. 

          4)Requires a general acute care hospital to post conspicuous 
            signs of the no smoking policy at building entrances and other 
            locations and to inform new and current employees of the 
            policy.  








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          5)Allows a general acute care hospital to provide interested 
            patients, visitors, and staff with information on, or refer 
            them to, smoking cessation services.

          6)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 the 
            applicable standards in this bill.

          7)Declares the intent of this bill to encourage and assist 
            smokers to quit tobacco use and to reduce the associated risks 
            of tobacco smoke to hospital patients, staff, and visitors.

           EXISTING LAW  :  

          1)Prohibits smoking in an enclosed space at a place of 
            employment including lobbies, waiting areas, elevators, 
            stairwells, and restrooms that are a structural part of the 
            building.

          2)Exempts specified areas of workplaces from the smoking ban 
            including:  a specified percentage of hotel and motel rooms; 
            parts of hotel lobbies; warehouses; patient smoking areas in 
            long-term care facilities; small businesses; and, certain 
            employee break rooms.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee:

          1)Negligible state fiscal impact to the Department of Public 
            Health to continue oversight of hospital licensure.

          2)To the extent that this more comprehensive smoking ban on 
            hospital campuses reduces the number of cigarettes purchased 
            by hospital employees, visitors, and patients, there could be 
            a minor reduction in revenues to various state tobacco tax 
            funds. 

           COMMENTS :  The author states that while smoking is generally 
          prohibited in patient areas, waiting rooms, and visiting rooms 
          of health facilities, there are still many areas within a 
          hospital campus where smoking is permitted.  The author asserts 
          that exposure to second-hand smoke should be eliminated to the 








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          extent possible for staff, visitors, and patients, in 
          particular, while they are recovering and/or seeking medical 
          treatment.  Furthermore, the author maintains that 
          hospitalization for treatment of an acute health problem, 
          specifically an illness related to tobacco use, forces smokers 
          to confront the consequences of their addiction and, frequently, 
          to make a commitment to stop.  The author argues that smoke free 
          hospital campuses motivate patients, visitors, and employees to 
          quit tobacco use in a supportive environment that is prepared to 
          provide cessation assistance to smokers.

          According to research published in 2009 in the British Medical 
          Journal Tobacco Control, more than half of accredited hospitals 
          in the U.S. have instituted completely smoke-free medical 
          campuses.  Many of these hospitals report that they took this 
          step because smoking was contrary to their mission of treating 
          the ill and promoting public health.  Research published in the 
          January 2010 Journal of Hospital Medicine that evaluated the 
          impact of a smoke-free medical campus policy at an acute care 
          facility in New York found that the employee smoking rate fell 
          from 14% in the year preceding the ban to 9% in the year after 
          the ban was implemented.  Similarly, an article in the September 
          2010 American Journal of Health Promotion reported that the quit 
          rate among medical staff at smoke-free hospitals was higher than 
          at other hospitals and 60% of those employees who reported quit 
          attempts or not smoking indicated that a tobacco-free hospital 
          policy was influential in their efforts.  Smoke-free laws have 
          been shown to reduce cardiac hospitalizations by decreasing 
          second-hand smoke exposure among non-smokers and reducing 
          smoking. The larger contribution to improved health has been the 
          reduction in second-hand smoke. 

          The sponsor of this bill, Breathe California, states that 
          hospitals that have established smoke-free campuses have taken 
          an important step in advancing public health and report almost 
          no problems with compliance or enforcement of their 
          restrictions, with minimal cost.  The California Hospital 
          Association notes in support that, on a daily basis, California 
          hospitals see the negative effects smoking can have on the 
          health of their patients and the increased costs it can have on 
          the health system.


           Analysis Prepared by  :    Cassie Royce / HEALTH / (916) 319-2097 








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