BILL ANALYSIS �
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|SENATE RULES COMMITTEE | AB 1278|
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THIRD READING
Bill No: AB 1278
Author: Hill (D), et al.
Amended: 6/20/12 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 6-1, 6/13/12
AYES: Hernandez, Harman, Alquist, DeSaulnier, Rubio, Wolk
NOES: Anderson
NO VOTE RECORDED: Blakeslee, De Le�n
SENATE APPROPRIATIONS COMMITTEE : 5-2, 7/2/12
AYES: Kehoe, Alquist, Lieu, Price, Steinberg
NOES: Walters, Dutton
ASSEMBLY FLOOR : 48-26, 1/30/12 - See last page for vote
SUBJECT : Health facilities: smoking
SOURCE : Breathe California
DIGEST : This bill expands the prohibition on smoking in
general acute care hospitals to include the entire hospital
campus, including plazas, sidewalks and parking areas.
ANALYSIS :
Existing law (Health and Safety Code):
1. Provides for the licensure and regulation of health
facilities by the Department of Public Health (DPH),
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including general acute care hospitals, which are
defined in part as providing 24-hour inpatient care,
including the following basic services: medical,
nursing, surgical, anesthesia, laboratory, radiology,
pharmacy, and dietary services.
2. Prohibits smoking in patient care areas, waiting rooms,
and visiting rooms of a health facility, except those
areas specifically designated as smoking areas, and in
patient rooms where all persons assigned to the room
have requested smoking to be permitted. Specifies that
any person who violates this provision of law is guilty
of an infraction and subject to a fine of not more than
$100.
Existing law (Labor Code):
1.Prohibits an employer from knowingly or intentionally
permitting the smoking of tobacco products in an enclosed
space at a place of employment.
2.Exempts certain places of employment from the prohibition
on smoking tobacco products in an enclosed space,
including the following:
A. Up to 50 percent of the area of a hotel or motel
lobby, depending on the size of the lobby;
B. Meeting and banquet rooms in hotels or motels,
except when food and beverage functions are taking
place or when being used for an exhibit;
C. Retail or wholesale tobacco shops and private
smokers' lounges, as defined;
D. Warehouse facilities, as defined;
E. Medical research or treatment sites, if smoking
is part of the research and treatment;
F. Patient smoking areas in long-term health care
facilities;
G. Break rooms designated for smoking by an
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employer; and
H. Employers with five or fewer employees, subject
to specified requirements.
3. Establishes a $100 fine for the first violation, a $200
fine for the second violation, and a $500 fine for the
third and subsequent violations of the above provisions.
4. Requires enforcement of the smoking prohibition by local
law enforcement agencies. Requires an investigation by
the Division of Occupational Safety and Health in the
case that an employer has been found guilty of three or
more violations.
This bill:
1. Prohibits, beginning 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 from the prohibition on smoking on a hospital
campus.
3. Exempts property owned or leased by a hospital that is
distinct from, and not part of, the principal medical
campus if the property is used for purposes unrelated to
health care.
4. Permits smoking on a hospital campus by a patient if
the treating physician determines that the patient's
treatment will be substantially impaired by the denial
of tobacco, and the physician enters a written order
permitting the use of tobacco by that patient.
5. Requires general acute care hospitals to post signs
stating that smoking is prohibited on the entire
hospital campus at building entrances and in other
conspicuous locations.
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6. Requires new employees of general acute care hospitals
to be advised of the nonsmoking policy during
orientation and requires current employees to be
informed of the policy at least 60 days prior to
implementation.
7. Permits general acute care hospitals to provide
interested patients, visitors, and staff with
information on, or refer them to, smoking cessation
services.
8. 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 provisions of this bill.
9. Exempts violations of this bill from specified
provisions of law establishing penalties for violations
of the laws pertaining to hospitals, including a $100
fine for violating existing provisions of law
prohibiting smoking in certain areas of a hospital, and
misdemeanor penalties of up to a $1,000 fine and up to
one year in jail for other violations of the laws
pertaining to hospitals.
10.States the intent of the Legislature to encourage and
assist smokers to quit tobacco use and to reduce the
associated risks of tobacco and secondhand smoke to
hospital patients, staff, and visitors.
Comment
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 percent in the year preceding the ban to nine percent in
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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 percent 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.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Minor enforcement costs to DPH, which licenses hospitals.
Unknown, potentially offsetting impacts on state tobacco
tax revenue and/or state public health coverage programs.
SUPPORT : (Verified 7/3/12)
Breathe California (source)
American Cancer Society
California Black Health Network
California Hospital Association
California Medical Association
Coalition for a Smoke-Free Long Beach
Coalition for a Tobacco-Free Monterey County
Physicians for Social Responsibility - Los Angels
San Francisco Asthma Task Force
San Luis Obispo County Health Agency
San Mateo County Tobacco Coalition
Santa Clara County Board of Supervisors
Stanford Cancer Center
ARGUMENTS IN SUPPORT : This bill is sponsored by Breathe
California, which states that there are more than 73
smoke-free hospital campuses in California, including all
Kaiser affiliated hospital campuses. According to Breathe
California, hospitalization for treatment of an acute
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health problem, particularly an illness related to tobacco
use, represents for many patients a teachable moment and a
time of heightened motivation to quit smoking. Breathe
California states that research published in the Journal of
the American Medical Association confirms that the quit
ratio is greater for hospital employees in smoke-free
environments than employees in hospitals without smoking
restrictions. The California Hospital Association also
supports this bill, stating that 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. The California Medical Association states
in support that their physicians are strongly supportive of
working toward a smoke-free California.
ASSEMBLY FLOOR : 48-26, 1/30/12
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Beall,
Bill Berryhill, Block, Blumenfield, Bonilla, Bradford,
Brownley, Buchanan, Butler, Charles Calderon, Campos,
Carter, Cedillo, Davis, Dickinson, Eng, Feuer, Fong,
Fuentes, Galgiani, Gatto, Gordon, Hayashi, Roger
Hern�ndez, Hill, Hueso, Huffman, Bonnie Lowenthal, Ma,
Mendoza, Mitchell, Monning, Pan, Perea, Portantino,
Skinner, Solorio, Swanson, Torres, Wieckowski, Williams,
Yamada, John A. P�rez
NOES: Conway, Cook, Donnelly, Fletcher, Beth Gaines,
Garrick, Grove, Hagman, Halderman, Harkey, Huber,
Jeffries, Jones, Knight, Logue, Mansoor, Miller, Morrell,
Nestande, Nielsen, Norby, Olsen, Silva, Smyth, Valadao,
Wagner
NO VOTE RECORDED: Chesbro, Furutani, Gorell, Hall, Lara,
V. Manuel P�rez
CTW:do 7/3/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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