Tobacco Documents Online

cy . I I _,% Report f The Mayor's Cominittee On Smoking And Health july 1, 198,6 Appendices JOSEPI-I, A..CALIFAiVQ7, Jlr'.. Chairman. VICTO'R' BOTiVICI<. CHARLES HUGH' ES STEPHEN JOSEPH, wt'.D. ALAIR TOWNSEND'

LIST OF APPEMICFS A. New York City Smoking PoTlution t:ontro]: Act of 1986 - Original Draft Legislation B. New York City Snoking, Pollution Control Act of 1986 - Revised Text C. Mayor Koch"s letter to Joseph A. CaIifano, Jr., 3/24/86 D. Letter to Concernet! New Yorkers, 4/18/86 E. List of witnesses at Mayor's CeAnnittee on Snoking andi Health,Hear'~ing, May 19,, 1986 F. Behavioral Risk Study on Smoking in New York Ctty, 5/86: G. Proposed General Service Administrati~on Re; ,lations on Stnokingi in Federal workplaces H. Depaz-tment of Army Directive on Smoking in II.S. Army Facilities, 4/17/86

APP= T.{ a. A LOCAL LAW' - n'RAB'T To amend t71e administrative code of the ci ty of' New York in relation to the control of pollution from smoking. Be it enacted by the City Counci'1 as, follows: Section 1. Chapter twenty-two of the administrative code of City of'. New y'ork ia hereby amended1by adding a new Title F' as followa: Section F22-1.0 Title Thi'.e Title shall be known as the Sbnoking Pollution Control Law Sect~ionF~2~~2'-2'~.~©~Find~inas and Pu~apome~ The City Council does hereby find thats Numerous studiese have found that tobacco smoke i's a ma jor. contributor toAndoor air pollutiont andd th e Reliabler studies have shown that breathing second-hand' smoke is a signiftcimt bealth hazard for several population grouQs, including elderly peoAsp individuals vith cardiovascular disease, and individuals with impaired respiratory function, including asthmatics and those with obstructive airway diseaser and ~fb~ V II Health hazards inducscli by breathing'seQond-hand smoke include M~ Xlung cancer, resp.iratory inlfection, decreased exercise tol:erance, ~ ~ ~

LOCAL LA.W' PAGE' ( 2'J DRAF'T - MARCH 20, 19'g5' increased respiratory infection, bronchoconstriction, and bronchospasm; and Nonsmokers who suffer allergies, respiratory diseases and other ill effects of breathing secondhand smoke may experience a loss of job productiv!ity or may be forced to take periodic sick leave because of such adverse reactions; and Numerous studiies have shown that a ma joai~ty of both nonsmokers and' smokers desire to have restrictions on smoking in: public places and places of employments and' Smoking is a potential cause of fires, and cigarette and ci'gar burn& and' ash stains on merchandise and'd fi'ztures causing losses to businesses< Accordingly, the City Council finds and; declares that the purposes o~~f~ thi's~ larr~ ars~ (1)' to~ protect the public heaSth~, an~d~~ wel fare by~ pr~ol'iibi~ting s~noking~~ i'n public place~s~ ex~cept~ in des~ignate~d smoking areasr, and, by rcgtl-lating saoking in places of employment: and: ('2 )' to strike a re8ronab.Iic; balance between the needs of per sons and to recognize that, wheYe these needs. confli'ct, the need, to, breathe~smoke.-free air shall havre priority. Section F2'2'-3,A Definitions The fiollowing, words and phrases, whenever used in this, Ti tle, shall

LOCAL LAW PAGE (3) '. D'R'AF'P~ - MAR'~CH~ 2~~a1, 198~~6~~ be constrLed~ as defined in this section: (I~ "£ar" means an area which is devoted to the serving of alcoholic beverages.for, consumption by guests on th& premi!ses~ and in which the serving of food' is only incidential to the consumption of such beverag,ea. Although, a restaurant may contain a bar, the term "bar" shall not include the restaurant dining area. ('2), "Buainess" means any sole proprietorship, partnership,, j'pint venture, corporation or other business entity formed for profit-making purposes, including retail establishments where goodwor services are sold as well as profesaional corporatiens and other entities where legal!,medical, dental. engineering, architectural or other professional, services are delivered'. (3')~ "Department" meanw the New. York City Department of Health. (4), "Dining Area." means any enclosed area containing a; councLar or tables upon which meals are served. ( 5) "rmployee' means any person who is esp:;oymd by any, employer in consideration for direct or indirect monctary wagea or profit, and any person who volunteers his or hor services for a non«-profi'.t entity.

LCCAL LAW ~ PAGE (41)~ DRAFT - MARCH 2'0, 1786 C6a' "E~mployer"'means any person, partnership, corporation, including the City of New York, or non-profit entity, who employs the services of one or more individual persons., ( 7) "Enclosed Area" means all space between a floor and ceiling, which i& enclosed on all sides by solid, walls or windows (exclusive of door or, passage ways) whi'ch extend from the floor to the ceiling, including alli space therein screenedby partitions which do not extend, to the ceiling or are not solid, "offlice landscaping" or similar structures. ('8)I "Motion, Picture Theatre" means any theater, engaged in the business of, exhibiting motion pictures. (9), "Non-Profit Entity' means anX corporation., unincorporalted association or other entity created for charitable,, philanthropic, educational,, character bwlildling, political.~ social oir other similar purposes, the net proceeds from the operatfonsLot ahiZh are committed to the promotion of the ob jects or purposws° of ths org,antsation. and not to private financi!a3 gain- A publAs agency is not a"non-profi't entity" within this meaning of this section:. (10), "Place offtploysent" means any enclosed area undorthe control of a public or private employer which employees normally

LACAt. LAW PAtiGE' ( 51) ' DRAFT' - MARCH 20, 1986 fr~e~q,ue~~alt, during th~~e~ cours~e~~ o~~f' employment, including, but' no~t. IimItedl tol, work areas, employee lounges and restrooms, conference and class rooms, employee cafeterias and riallwaye. a. A private residence is not a"place oflemployment" unl'es'~sit~ i& used as a child' care or hea~lth, care facility. . The dining area of' a restaurant is aot a"p];ace of employment. " (11) "~Pub~~1i!c~ Place"' means any enclosed~ area to~ which ~ the publi~~c~ i's invited or' in which the public i's permitted, including but not~ lim~i~ted~~ to~i.~ banks, educational facilities, h~~ealth~ fa~ci~l~i~ties~,, malls, publictra~nsporta~t~i~=faciliti~es, re~ce~pt~ion areas, restaurants, retail food producti'on andmarketingestablishments, retail service establishments, retail stores, theatres and waiting roi A private residence is. not a "'pub'lic place." (12) "Ratauaant" mesac any coffro shop, calfeteria, l'uncMeonetteRtavern.coc:;Csil loung..,,saadotkch~ s~tana, sodafountaiaa paivato and public xchcol cafstera'a or, eating establishment, and any other eating establi'shsent, organisation, . CZ club, including v:tQrans." club,, bo&'rdinghouse, or guesthous., UT which gives or' oflfern for smla food to, the public,, guestsi,' ~, .".~. m My

LO CA L LAW PAGE (6) DRAFT - MARCH 20, 1986. patronr or employees as well as kitchen&in which food' is prepared on the premises for sezaing elsewhere, including~ catering facilities except that, the term, "'restaurant" shall not include & cock~tail lounge~ or~ tavr~ern, or~ pa~rt~~ th~~ereo~~f~ rvhich~ is a "bar" as defined inisection F22L3. 0(1)1. (13') "Retail Tobacco Store` means a retail store utilized! ,pri~mairi~ly~ for, the sa~le~, o~fl tobacco~~ products and accessories and in which the sale of other products is merely incidental. (14) "ServiceLine"'means any indoor line at which one (1) or more persons are waiting for or receivi:ng service of' any kind, whether or not such service involves the eachange of' money. (15) "Smoking," means inhaling, exhaling, burning or carrying any lighted cigar, cigarette, pipe, wee4, plant or any other form of Tighted object or dawic+s meant to be inhaled!. ('16) "Sposts• Arena' means sports pavi'lions. gymnasiums, healt,hh spas,, bozinaf arenas, swimming polls~, roller and ice rink,s, bowling a1l'sys and other similar places where seabcss of the. general public assemble either to engage in physical, e:ercise., participate in athletic coapetition or witness sports events.. Cn' Seetion F22-~4~~.~0~ Avol~icat~io~n~ of~ ''itle to~ C~itY-Own~ed~ Facilities ,i OD All enclosed facilities owned by the City of New York shall be ~', . N

LACAL LAWPAGE ( 7:) DRAFT' - MARCH' 20', 19'86 subject to the provisions of thi's Title. Sectibn,F22-5.0 Prohibition of' Smokingiin Public Places Smoking shall, be prohibited in all enclosed public places within the City of New York, including, but not limited to:, the followiing places, and with the following ea¢captionsx (1) Elevators (2) Buses, tamicabs, andr other means of' public transit and ti:ket, boarding, and waiting areas of public transit depots;; provided'., however, that this prohibition does not prevent (a). the establishment of separate wai'ting areas for smokers and nonsmokers of' equal silse, or (b) the establishment of a maxi'mumm oflfifty percent (50t) of'a given waiting room as a smoking area, if adequato ventilati'on subject to the approval of the Department is provided so as tolavoi'd smoke or other similar pollutants resultingm fros smoking in the non-smoking area,. (1 3), Restroossr_. Gb V ~ ~ ('4) Service lines. m ".a m. W (5) Retail stores, except areas in said storee not open to the public and all areas within retail tobaccolstores.

LO CAL LAW PAGE ( 8) DRA:FT - MARCH 20,, 1966 ( 6)~ All area~~s~ a~vailable~ to~~ a~nd~ cu~stom~~ari1!~y~ u~se~d~ by ~ th~e~ qene~r~all public in all busi'nesses and non-profit entities patronized by the public, including~but not limited to, attorneys' offices and other offi'cea, banks, hotels and motelw. (',7~~)~ Res~taurants~~ prov~ided,, however, that, th~is~ pr~~oh,ib~ilti~on do~e~s not prevent (a)~~ the designation of~ a contiguous ar~e~a, within a~~ restaurant that contains a maximum of fifty percent (S0$) of the seating capacity of the restaurant as a smoking area if adequate ventilation subject to the approval of the Department is provided so~ a~s~~ toavo~~id~ s~m~oke~ or other s~imi!l~a~r po~Tlu~ta~n~ts~ reaulting from smoking in the non-smoking area or (b) the providing of separate rooms for smokers andi nonsmokers so longg as the rooms designated for smoking do not contain more than fi fty percent (SG1) of' the seatingicapacity of' the restaurant . (8) Public a~r~ea& ~ of aquariums, galleries, libr~mr~ies;and museums ~ when operr trr ths, publicr provided, however, that this prohibit3owdtreek-Mt-pravcntthc d.oignation ofl a. separate roomm for smoki'ng in suc?': arcEr.. (Z (9) Any building sky not op.n to! th. k. which is primarily used, ~ .y f~or~, or~ desi~gned~ for~ th.~ primary purpase of ezh~~i!b~~iti'~n~g any ~ ~~ motion picture, stag., drama, lecture, musical recital or other ~

IA C'AL LAW' PAGE ( 9 ) DRAFT - MARCH' 20,, 19'66 similar performance, except when smoking is part of a stage production; provided, however, that thi'~s prohibition does not pr'event the designation of a contiguous area containing a maximum, of fifty percent ('50=) of'any area commonly called aa l;obbyas a smok,ing area. (10) Sports arenas and convention halls, which are not open to the sky, except in designated smoking areas, which designated area shall not exceed 50= of seating capacity if adequate ventilation subject to the approval of the Department is. provided solas to avoid smoke or other similar poll'utants resulting from smokingiin the non-smoking area. (11)' Every room, chamber, place of' meeting or public aasembly,, includ'i'ng school buildings under the control: of any board,. council u commissfion, cozmdttee, including joint committees, or agencies of the City, or any political subdivision ofl the State duri'ng such timeias a public meeting is in prograss. (,12)Waiti'mg rooms„ hallr+ayys, wards and, semiprivate rooFac of health facilities, including, but not limited to, ho€pi'tslw, clinics., physical therapyfacilitiesr doctors' officea, and d'enti'~sts~~'~~ officesi.. Ih~ b+ed'~ space ~ areas of~ hea~l~thl fa~cilit~i~es~ used~ for two, or more patients. smoking shall, be prohibited' unless all patients within tt.e room are smokers and request in kriting upurk

LOCAL LAW' PAGE (' 10' ). DRAFT - MARCH 20, 1986' th~e~~ health ca~r~e~ facil~i'ty,~~'& admiss~i~on form~~ to~ be placed in, a~ r~com~~ where smoking is permitted'. 8ection_F2'2-b.0~ Requlation of Slnokina i'n Places of EmwSoyatent. A~. It shall be the responsibility of employers to provide smokefree areas for nonsmoking employees within existing, facilities to the: maxi!mum extent possible. . Within 90, days of' the effective date of' this Title, eacbemployer having an enclosed place of employment located within the city shall adopt, implement, make known and maintain: written smoking policy which shal1 contain, at a minimum the following requ!irements: 1. Any employes in a place of emplo!yment shall have the ri gh!t to designate his or her work area as a nonsnoking area and too post the same with an appropriate sign or signs, to~ be provided' by the employer. if, due w the proximity of smokers, size of th,e wor7c area, poor ventilation or othar, factors, suchh des ignatiossi does not reduc& the, ef facts~ of smoke, the employer shall make:additiona2 accomsodation by reassilgning the employee to a! di fferent- work a=sa,, ex1panding thr sise of' the~ work area sublj.ct to the prohibition against smoking or isplementing other measurem reasonably designed to~minimise or eliminate the QD C!t M ef'fects of' ssmke on thc~ employee. ZIA,. OD fb 05

LOCAL LAW PAGE (11) DRAFT - MARCH' 20',, 1966 2'. Prohibition of smoking in aud'itoriums, classrooms, con'ference and: meeting rooms, elevators, hallways, medi~cal facili!ties and restrooms. 3. Provi'sion and maintenance of separate and'contiguous nonsmoking areas of not less than fi fty percent ( 503 )~ of the seating capacity and floor space in cafeterias, lunchrooma and employee loung,es if adequate ventilation subject to the apprbva1 of the Department is, provided so: as to avoid smoke or other Aimilar pollutants,resuyting from smokfng, in the non-amoltingg area or provision and maintenance oflseparate.and equal sized cafeterias, lunchrooms and employee loung,es for smokers and n ons mio~k ers . 4., In any dispute arising under the~ seoki'ng policy, the heal!thh concerns of the:nonsaoker shall be given precedence.. C., 'i'he smoking policy shall be cromaunicated to all employees wi.thinf threet (~3) w.eks of i'ts adoption. D. All employers shall supply a written copy of the smoking policy upon request to artp .uisting or prospective employee. m. E., A copy o:fl the smoking policy shall be provided! to the ~' mD tj Sealth~ Departaent or any other Ci'tyagency uponr'equest . ~

LO CAL LAW PAGE (12) DRAFT - MARCH 20, 1986 Section F22-7.0 Where,Smoking Not Regulated No.twithstanding any other procrisi'on of this Title to the contrary, the following areas shall not be subject to the amoking,res.tri~ctiorns of this Title: 1. Bars.. 2. Private residences, except when used, as a child care or health, care facility. 3. Rotel and'motel rooms rented to guests. C Retail tobacco stores. 5., R'estaurants, hotel and' motel conference or meeting rooms andd public and private,assenbly rooms while these places are being used for privata functions. 6. A priaateenclose4 office workplace occupied exclusively-by ssoikera-,, evear though such an of f i ce workplace may be v:is i ted be, MI nonsmok ers.. .612b GD t.J OD Section P22-9.0 Posting of Sians A. "Smokiing' or "No 9aoking" signw. whiichever are appr-cpri'ate, with letters~ of not less than one inch t'~1"~y in hei!gqh~t~ or

L0 CeAL LAW PAGE (13)~ DRAFT - Ni'ARCH 20, 1986 thle international "'No Smoking" symbol (consisting of a pictorial representation ofl a burning cigarette enclosed in a red circle with! a red! bar across it)l shall be clearly, sufficiently and' conspicuously posted'in every building or other place where smoking isl regulated by this Title, by the owner, operator, manager or other person having control ofsuchbu~ildingorother place. Bl. Ev!ery theatre owner, manager or operator shall conspicuously post signs.in the lobby! stating that smoking isl proh,ibited, wi;thin the! theal or auditorium,and in the case of motion pi'cture theatera, such, informati'on shall bee shown upon the screen for at least five (5) seconds priorr to the showing of each feature motion picture.. C. Every restaurant shall have posted at every entrance a conspicuous sign: clearly, stating,that a nonsmoking section is available, and every paVon shall be asked as to his or her preference. Section! F22T-9.0i Enforcement A. Enforesaont of this Title shall be impiemented "by th,e Department. In addition to employees of the Department, police officers and employees of the D+spartment of Buildi'ngs, Department of Consumer Affmirs, Department of Ehvironsentsl Protection., Fire Department, and Department

LO'CAL LAW PAGE (14) DRAFT' - MARCH 20'. 19,86 of' Sanitation may enforce the provis ions of this Ti tle. B. ' Any citiaen who desires to register a complaint under this T~i~t1~e~~ may~~ do; so with th~e~ Department. C. The Fi~re~ D+epartmen~t~~ o~~r~~ th~e:, Heal th~ Department shall r,equ~ir~e,. while an establishment is undergoing otherwise mandated' inspections, a "self-certification" from the owner, manager, operator or other, person having control of'such establishment that all requirements of this Title have beend complied with. . Any owner, manager, operator or employee of'any establishment regulated by this Title shall inform personns violating this Title of' the appropriate provisions thereof. Section P22-10.0 Violations and' Penalties A. It shall be unlawful for any person who owns, manages, opeaates or otherwise controls the use of any preaises subj'eet" ty regulation under this Title to fail to comply wit2a anTot' its provisi'on.z. ThG oc.ner, manager or operator of' a restaurant shall notbQ dc®eed in violation of' Section P212'-81.010 i f the host or, hoctsco of the restaurant fails to ask the seating pr.ference of patrons, but shall be deemed in violation thereof' if' the reataurant has no stated' Policl+" requiring that patrons be asked thsir prsference.

Z,0'C'AL LA:W' PAGE' (115) DRAFT - MARCH 20, 1986 B. It shall be unlawful for any person toismoke iniany area . where smoki'ng isl prohibited by the provisions of this Ti t1e . C. Any person who violates any provia ion of' this Ti t1e shall be guil:ty,~ o1 a~ civil v~~iola~tio~~n, which~, shal~l~ b~e, adjudicated before the Administrasi've Tribunal of the Department.. Violations shall be punishable byx 1. A fine not exceeding two: hundred'~ dollars ('$2'00) for a first. -iioTationi. 2. A fine not exceeding four hundred dollars ($40'0), for a second violation o!' this Title within one ('1) year. 1., A fine not exceeding one thousand, dollars (41000) for each, additional violation of this Title within one (1) year. Section P2Z-1L.Q Nonretaliation. No person. or e=ptoyer shall discharg.~,refuse to hire or in any manner, retaliate against any eaployee . or applicant for enployaaent because such employeee or applicant exercises any rights afforded by thils Title. Section P22-12.0' PIa i v e r

' LOCAL LAW PAGE (16). DRAFT - MARCH 24,, 198'6 The.Depar*ment shall have the authority to grant a waiver from a specific prov!ision of this Title, in a particular case, subject to~ appropriatec~onditions~,where such, wai!veris:n harmony with the general purpose and intent of this Title. Section F22-13.0'Public £ducation The Department shall engage i'n a continuing program to explain and clarify the purposes of this Title to citizens affected by it, and .k to guide owners, operators and manager& in their compliance with it. Section F2'.2'-14.Q Governaental Acencv Cooveration, The Department shall annually request other governmental and'educationali agencies hav:ing faci'.Tities withi'n: the City ofl New! York to establish local operating procedures in cooperation and' compliance with this Title. Section F22-15.©0 other Apnli'cable Laws Nothing in thiw Ti'tle shall not be construed t* permit smokingwhe re it is othert.izs restricted bylaw, or shall be construed to! preclwde an owner, oprratorr, nanager, or other person having contsol of any establishment- frosr prohibit3ng, smoking in such establishment or portion.thereof. Grj .y ~ ~ Section F22'-16'.41 Severabillity Ca Tf'any provision, clauGe, sentenco or paragraph ot'thia Titl'e or the.

IA.GAL~ LAW PAG€ (17) DRAFT - MAEtC'Fi' 20', 1986 application thereof to any person or circumstances shall be held invalid, suchi invalidity shall not affect the other provisions of thisiTitSe which can be give.x effect without the invaTidi prov!ision or appli'cation, and: to this end the provisions of' thi'~s Title~ are declared, tobe severable. Section 2'. This Title shall be effective ninety (~90'): days from and after the . date of i'ts~ adopt~i~on,~ a~nd, ~ shall b~e~ rev~iewed w~i th~i'~n one~ year o~fi ts~, ef'fective date. 1181 K

ME M O R' AND U'. M I N. S U' P P O R T LEGISLATYVE' The Smoking,Pollution Control Act of 1986 REFERENCE TITLE' AN ' ACT' to amend the administrative code of the city of',Nsw York in relation to the control of pollution from smoking. SLAMMARY OF This act will (1)' protect the public health and PROVISION'S' welfare by prohibiting smoking in public places except in designated smoking area~s, and by regulating smoking in places of employment; and(2), strike aa rea~sonable balance between the needs of persons who smoke and the need of nonsmokers to breathe smoke-free air, and to recognize that, where these needs conflict, the need to breathe smoke-free air shall have priority. Specifically, the act prohibits smoking in all enclosed! public places within the City of'New York, including elevators:, buses, taxicabs and other means of public transit, retail stores, and all public areas, at a71l businesses and non-profit organizations. Restaurants and enclosed sports arenas and convention halls may have up to 50'$ of, seating capacity designated as a, smoking, area .4f adequate ventilation is provided. Theaters may designate up to 50% of lobby space for smoking.. ASso,, all empSoyers are required to implement and maintain a written smoking policy which acknowledges and protects the ri!ght of any employee to smoke-free air. Any employee may designate his or her work area as a, nonsmoking area. E~nployers must take stepss such as reassigning employees to a different work area or improving ventilation in order to minimize or eliminate:the effects of smoke on employees. in any dispute, the:health concerns of the nonsmokers will be:given precedence:. The act does not regulate: srnoking in bars, private residences,, hotel and motel rooms, retail tobacco stores,, or, offices occupied exclusively by smokers. Enforcement of the ordinance will be implemented by the New York City Department of Realth, Anyone found guilty of violating this, act can be fined up to: $200 for a first offense, up: to $400 for a second'violation within one year, and up to~$1,000 for each additional violation within one year. A waiver from specific provisions of the act may be granted, if such a waiver, is not contrary to.the.rights of nonsmokers. The act allows any owner or operator of a facility to designate all or any portion of'the facility as anonsmoking area. . ~

REASONS FOR The most direct positive effect of such alTaw SUPPORT would be tolencourage smoking cessation; and reduce the amount of passive smoking., The effects of smoking on the incidence of cancer, heart disease, and other illness is well-established. Besides the immediate discomfort and annoyance associated with exposure to secondhand smoke, epid'emiologica~l studies indicate there is a possible relationship between passive smoking and disease. Reliable studies have shown that breathing second-handl smoke is aa significant healthl hazard for several population groups, including elderly people, individuals with cardiovascular disease, and individuals with,impaired respiratory function, including, asthmatics and those with obstructive airway disease. Respiratory problems, decreased exercise tolerance, d!ecreasedd respiratory function, bronchoconstriction, and bronchospasm halve been related'to long term exposure to secondhand smoke. Nonsmokers who suffer fromiallergies and respiratory disea~ses may have their conditions aggravated by secondhand smoke and, as aa result, experience a loss of job: productivity or be forced to takee periodic sick leave because of such adverse reactions. It is clear that a! reduction in, or overall elimination of',, secondhand smoke will benefit many employers through an increase in productivity on the part of' their nonsmoking employees. while this regulation is not d'esigned to directly influence smokers to, quit, it does,afford employers the chance to provide their non-smoki:ng employees &more comfortable, less distracting, smoke-free workplace, as well as put pressure on smokers to quit. Smoking!is a potential cause of fires, and cigarette andcigar burns and ash stains onimerchand!ise and fixtures cause losses to businesses. Experience:from other municipalities and counties.also indicates an additional benefxt derived from,nonsmoking ordinances in the form of alsubstantial increase in the number of people actively seeking informationlon, or enrolling in, smoking cessation, programs. As smoking becomes less socially acceptable, (restrictive ordinances have!the effect of focusing attention on the distastefui aspects of tobaccolconsumption) more and more people will actively attempt quitting. In California, the state with the longest and most extensive experience with nonsmoking regulations, state law regulates smoking inisupermarkets, health faciTities, public meetings and certain parts of publically-owned, buildings. S'eventy-two cities: and counties have significant nonsmoker protection laws supplementing the existing state law. At least 42% of the population of California lives in a place where a, smoking policy is required of private employers., And, new ordinances are being enacted at the rate of several a month.

3'. Among California cities~and counties, at least:. 0 59 regulate smoking in priva~te workplaces 0 61 require nonsmoking sections in restaurants 0 51 restrict smoking in retail stores Over-two thirds of those California ordinances covering smoking,inn the: workplace allow employees to designate their own, area as nonsmoking and give ultimate preference to the rights of nonsmokers.. The experience of other cities indicates that the cost of implementing and maintaining a restrictive non-smoking ordinance is unexpectedly low relative toithe benefits . Ih~June,1983, San, Francisco received national attention when: theBoard!of Supervisors passed!legislation regulating smokingiinithe, workplace., As with the New york City Smoking Pollution Control A~ct,, it requires that employers make known and maintaiina written, smoking policy. If an acceptable compromise cannot be reached between smokers and nonsmokers, smoking is to be prohibited entirely. Also, as with, New York's proposed, law, the ordinance provides for penalties if employers do not comply withithe legislation. W~ithin a short time a groupisupported almost entirely by tobacco company contributions collected enough signatures to bring the ordinance before the voters in the form of a proposition. This g,roup!subsequently spent 1.2 million dollars campaigning, against the ordinance. It claimed that it would be expensive!to administer and would divert attenti'on from other important activities of the health department. In addition,, opponents contended that government intrusion into an arealthat should be a private matter between individuals wouTd cause increased antagonism and would'incite litigation involving employers, employees, and the city. It has become clear that the law is not the leviathan originally envisaged by its opponents. One:year after enactment: o.there had been a total of 1241 complaints related to enforcement in the workplace.., 0 only one~citation had been issued'.: o there were no legal actions either by the city or against the city because of the ordinance. o there had been.no new employees hired for the programr one Oepartment of Health inspector handles all complaints an a, part time basis CZ) o.no additional funds were requested or needed UT to enforce the:law ~, .O~ ~ :.a CD 0~

In San Diego, a city ordinance: regulating smoking in indoor public places has been in effect since January, 1975. Like the proposed New York City law, the ord!inace now covers virtually all retail sales and service establishments, cultural institutions, public conveyances, health care facilities, food marketing esttablishrnents and restaurannts and', it requires the posting, of' ad'visory signs soo the public will be aware where smoking is permitted and' where it is not. San Diego's experience has shown that a high percentage of smokers will comply voluntarily to reasonable regulations and prominentt signingi. Except as allast resort, that city!"s efforts have focused'on promoting public awareness and seeking voluntary compliance and cooperation, rather than prosecuting violation!s. A survey of' San Diego' s business community by the ci',ty' s administration, including comments from the Restaurant Association, uncovered no indication that the restrictive. ordinance,or the,a~dministrationof' it, works an unreasonablehardship on business in San Diego. T.heMinnesfltaiCleanIndoorA~ir Actwasenactedin:19175toprotect the public health by prohibiting smoking inipublic places exceptt in designate ismoking areas. A public place wad specifically definedto include a place of work. In general„ there has been broad acceptance of this law among employers. The Minnesota Department of'Health has been receiving an average of about 137 complaints per year from nonsmoking employees involving alleged workplace violations. Virtually all of these complaints have beenn resolved satisfactorily' through correspondence and discussions between State Department of Health personnel, the employer, and the employee. According toistate officials there have been no, lawsuits involving workplace violations. Also, there have been no grievance proceedings which have arisen under labor contracts because of the application of the lawto the workplace. All in all,, the Minnesota law has resulted in significant progress in protectiing nonsmokers fromiambi:ent tobacco smoke at the workplace, without an undue hardship on employers and smoking, employees. This has been achieved with minimum governmental intervention and at no additional public tax cost. knd, a recent survey indicated this law is approved by 92% of Minnesota residents (smokers and nonsmokers). As these examples indicate, it is possible for ordinances protecting the rights of nonsmokers to be implemented with modest enforcement monies or personnel added in response Those counties and municipalities which have been implementing these ordinances in alcost-effectiv!e spent the greatest amount of time andenergy w.ith, to the law. successful in manner have on media coverage. C!t GD ~. 4t~ ~

il 5. Specifically, The Smoking Pollution~ Control Act of 1986 is an appropriate ordinance for The City of New York in that it respects the! needsof' nonsmokers while, at thesamee time, recognizing the economic realities faced'by employers and businessmen such as restaurant owners. while the act disallows smoking in all enclosed public places, there are provisions for establishment of smoking~areas, in restaurants and places ofemployment., Also included are guidelines for recognizing the needs of'smokers and nonsmokers within the framework of'reasonabTe cost to employers and businesses. Up to now, New York City has relied on public education and voluntary action to promote the right of nonsmokers to breathe smoke free air. These efforts~, while helping many people to quit, did not ensure this right. For example, last summer the New York City Department of Health offered to publish and distribute the names of' those restaurants~ which voluntarily set aside 25% of their seating capacity as nonsmoking area. 0'f the 15,0'00~ resttaurants who were contacted by mail, only 4'05' restaurants responded positively. It should be noted'that a U'.S. Government poll has shown that a majority (170'$), of Americans desire tolhave restrictions on smoking in public places and places of employment. It is clear the time, has come for New York City to stand up for nonsmokers inia more assertive andiproactive manner., As you know, less than 3'0% of adult New York City residents smoke. By reinforcing the growing sense that smoking is a socially unacceptable activity carried out by a relatively small group, this initiative can be, in a sense, a self-fulfilling prophecy.

APPE:ZLy BI A LO C.?.I. LAW To amend the administrative code of the city of New York, in relation to the control of' poliiltion from smoking; Be it enacted by the CitY' CouneiP as foll©ws :~ Section 1. Declaration of' legislative findings and intent. The council' hereby finds and! declares that: Numerous studies have found that tobacco smoke is a major contributor to indoor air pollution;, and Reliable studies have shown that breathing' second-hand smoke is & significant heaith hazard for several population grrmups,, inc!liding the eiderl{y people, iindividuaLs with cardiovascular disease, and individuals with impaired respiratory function, including asthmaucs and those with obstructive airway disease; and Health hazards induced by breathing, second-handi smoke: include lung, cancer, respiratory infection, decreased exercise tolerance,, increased respiratory infection, bronchoconstriction, and bronchospasm; and N'onsmokars who suffer from allergies, respiratot^y diseases and other ill' effects of' breathing seuondhand, smoke may experience a loss of job: productiv'ity or may, be forced to take periodic sick leave because of such~adverse reactions; and Numerous studies have: shown that a majprity of both nonsmokers and smokers desire that there be restrictions on smoking in public places and places, of' employment; and Smoking is a potentiai cause of fires, and cigarette and cigar, burns and ash stains on merchandise and, f'ixtures, causing losses to businesses. Accordingly, the council finds and deciares thnt the purposea of this law are (1) to protect the public heaith, and welfare by prohibiting siuoi¢ing in public places except in areas dQsignated for smokiiig and by regula¢ing smoking in places, of employment; and (2) 8'SV^18aTJ!.,7

toi strike a reasonable balance, between persons who smoke and t.hee right of nonsmokers to breat'he smoke-free air,, and to recogni¢e ::hat,, where needs conflict, the need to breathe smoke-free air shall have priority'. !2'. Title seventeen of the administrative code of the city of New York is amended by adding, a new chapter five to read as follows:, CHt1PTER FIVE Sb1OKING BOT.LUTIONi CONTROL fi1'7-501 Short title. This chapter shall be known and mav be cited as' the "Smcir•W-:~ Pollution, Control Law". 917-51D2 Definitions. As used in, this chante'r, the followinQ' terms shall have the foll'owinsz'meaninzs: a. "Bar" means an area which is devoted to the servinK of alcoholic beverazes for consumption b_v Auests, an the premises and in which the serving of foodi is only inddentaI to the consumption of' such me.eraQes. A.lthouLrh a restaurant may' contain a bar, the~ term "bar" shall riot include the dininst area of'the restaurant. b. "Business" means any sole prolDrietorshiD, Qrtnership, ioint vonture, corpora+i;on or ot;;er business entity formed for profit-rnalansr purposes, inciudinic ret;ail est'abliyhments where goods or servzces are soid'as well as orofessional' corporations' and, other entities where '.egal, medieal, dental,, enRineerinQ, arc'r.itecturnl or other arofessional services are Drovided. c., "Cbmmissioner" means the commissioner of the New York city deflartment of health. d. "Dapartment" means the New Y'orK (ntv: departasent of health. a.., ")'ini~ast_ attia,• 7feins.[cl. orenwntalrun ;, a~ cou'nter'or tables uuon,which,foad is served.. -2-

f. "Etnployee" means any person who is empioyed' b)7' any employer in consid'eration for direct or indirect monetary waqes or orofit, and anV person, who volunteers his or her services for a non-profit entity. ir. "EmploVer"' means any person, partnership, corporation,, includin¢ the city of' New York and agencies thereof, includin¢ the board of education, or non-profit entitv, which emplovs one or more persons. h. "Ehclosed areW' means alll sDace between, a floor and' ceilln¢, which, is enclosed on, all sides bu solid waiLg or windows (exclusive of door, stairway or passage ways) which extend from the floor to the ceilin¢. i. "'.Vtiotion picture theater" means a motion picture theater required to, be licensed by the department of consumer affairs pursuant to section 20-203 of the code. j. "Non-orofit, entity"' means any corporation,, uninicoryoratQd association or other entity created for charitable, pliilsnthropic, edhicat'ionai'„ character buildinsr; political,social or otherr similar purposes, tt<s net nroceeds from che operations af' which are cammftted to the prommtion, of the objects er vurposes of the qraani¢at¢ons and not to nriyate financisil qain. A public agency is not a"non-orofit, entzty" withia this meanine of' this subdivisiom.. k. "place of' empiovmQr.t" means any Rrea inder the controi' of an employer which employees normallY freguent durin¢ the course of emp{oyments inciwd.inQ, but not: lim.ited to, wmrit areas, empiovee, lounges and • restrooms, eneif^_:-enc-' tnii _:a_=s .?o,)ms, --tireterres andi tialiways, but not' includin;T an area where -3'.-

persons are detained therein for Denal, or correctional! purposes., .a private residence is ror. & "place of empioyment" within the meaning of this subdivision unless a chilti, care, or health care facility is operated therein or unless it is a common, area of a multiple dwellinQ which contains ten or more d+wellin¢ units. The dininq area, of a restaurant is not a"rlace of emplovtaent" within, the meanin¢ of this subdiwision. 1., "Private function" means wedldi.n¢s, aartaes. testrimonial dinners and other simidar functions inn which the seatinZ arran¢ements are under the controll of, the art$nizer or sponsor of the function and' npt' the, tnerson who, owns,, manwps,,, operates or otherwise controls the use of the place in which the function is held. m. "Public place" means any area to which, the public is invited or permitted, incl'udinQ„ but r.ot limited to, banks, edlsrstional facilities, health care: facilfties, mails, property owned, occupied or operated by the GitF of' Yb.v York or ap azency thereof, public transportation fae^lities, reception areas, restaurants„ retail service establishments, retail stores, theatres and waitinSL' troms. A grltate, residence is not a"public ^lace" withia the mcanine of this subditisi,on, except for the common areas of a multiple dwellinq wttich centai,ns_ten or rnnx+e; dwelli:nst tln.its. n. "Rpstaurant" means any' coffee shop, cafeteria,: luncheonette, tavern, cocktail lounqe, sandwich stand, soda fountain, and' any other eatin¢, establishment, orzanization, club, fraternal orQanization, boardinlChonsQ, or 0ueethouse, which g2ves or offers for sale frod to the oublic, -,u4sts or oatror.a, vr,hPther fond ~ c;stomar~ consumed on or off the wremisew but not an -4 r

estabiishment the Drimary ournose of whirh :s lo serve food to emplovees of a common emploVer or tp students of a common educational institution., o6"Ret'ail tobacco store" means a retail store in which the primary activity is the sale of tobacco, tobacco prodtrcts and' accessories and in which the: sale of other prodtilcts is' merelF' incidental. p."Seryice. ;.ine" CSeansaqueue:, line or other' formation, ofl nersons, whether seated or st.andlng, in which one or more uersons are waitinq f,or, providing or receivinZ,, service of any icind', whether or not such' service involves an exchanZe of consideration. 4i. "Smokine' means' itihalin¢, exhal{nZ,, burnin2Z or carr7inz ' anP' lfghted cigar, cizarette', pipe, or any form of liiLhted! obiect or device whichh contains tobacco, r. "Snorts arenas"' means swrts paviiions, vva+nmsiums,, health spas, boxinQ' arenas,, swimmin¢ nools, roiler and ice: skatinkr rinks,, bowiintr allpys and other similar places where membQrs of the 2eneral public assemble either, to enctasLe in phvslcsl exercise, particinate in athletic compotition or witness snorts or similar events., 31!7-903 Prohibitign of smoldng in nublic places. a. fmnkin2 is Drnhibited in a11 enclosed arefv: within puhlic Dlaces, during the times in which the' Dublic is in:itedi or oermitted, inciudinQ, hut not limited to, enclised! areeu, within the f~llowlS public places: , (1) Public transaortation facilities, includinZ, but: not limitedi to, ticket, boarding. , and waiting areas of nublie t'ranslt, depots; prov'ided, however, that this section shail not nrohibit smokinQ in; one, or moro contiguous waitinQ areas, desi¢nated' for smolanQ so lonyZ' as such areas do, -5-

not constitute more than fifty t•;ercent of' 'de, ctaii waiting area in the vublic transit deoon, suchi percEnta¢e shall be determined in accordance: with rules and re¢ulations tDromul'qated by the commissioner. (2) Restrooms., (3) Retail' stores and retail' service establishments other than retail tobacco storesi and areas. in restaurants designated for smokihQ nu:rsuant, to paraqraph five of this subdivision. ('4)1 A1D areas in w,hich, the aublic is invited~ or permitted in, any business or non-proiit entit7 includinQ, but not limirted to._ legal, medicall and dental offices. and other offices, banks, hotels and motels. (5)' Restauraats;, provided, however„ that *.his section, shall not orohibit smokinZ in a, contir.icus area within a restaurant designated for smoicin~* which contains no more than fifty percent af' the seatin¢ eapacity of' the restaurant, and further provided that smakinst' is not prohibited in any part' of a restaurant which is a, bar.. (5), Acuariums, zaileries, libraries and museums. (7) 1Kotion picture theaters and buildings primariTV used for, or desiqned fer the prinarv purpoae of cxhibitinjZ an*I sta¢e, drama, ?ecture., musical' trcit-l or vher strruizr cer%,±r^~ancr, excnpt, when smokinQ is t7art of' a: 9tag,- production; vrovided, however, that this section shall not prohibit smokinst in a conticvous area desi¢nated for smoking containing no more than fifty percent, of any area commonly' called a lobbv,, such nercents¢e shn1T be determined in accordance with rules and razulations nromulqated by *.he commissioner. -8-

(8'), Convention halls and sports, arenas • provided„ however„ that this section shall not prohibit' smokin¢ in a contiguous area designated for stnohinZ containinZ no more than fiftv' percent of any area commonlV: called a Ibbby' such percentage shsll be determined in accordance withh rules and re¢ulhtions promulZatedi bk the commissioner. (9Y Places of ineetfn2 or public assemblV durir.q such time as a, meetintt ooen, to: the nublic is being conducted, but not inciudin¢ meetings conductedi in private residences,, unless the meeting is conductedi in a common area of a multdple dwellYnz which, contains ten or more dkvellinZ units.. (10) Health care facilities includin¢, but not ]tmi'ted to, hospitals, clinics, phzJsical therapu facilitfes, convalescent homes, homes for the aged; proa'ided!, however, that this section shalU not prohibit, smokih¢ in areas desi¢nated for staoldnpC in restaurants and dininQ areas and in offices which are not ordinnriiv used: for care and treatment of' patients as IbnQ as (:4!) prior written~ approval is received from the fire commissioner pursuant to section 27-4276 of' the code and (B) smoking iit, such restaurants and dinin$ areas is not' otherwise prohibited nursuant to naragrann five of this subdivision 3nd smoisjnZ in offices wtii:ch, are, not ordinaM~y u_ed_ for care an6 treatment of, patients is not otherwise: prohibitPd pursuant to section 17-504. In addition this section shail not nrohibit smoltin¢ in natienr ~ kbun¢es desi¢nated for smoking, pmvided fhat, ~ (A): prior written anproval is received from the xb fire commissioner nursuant to section 27=4276 of ~ the code and (B) such tounQes shall not: CA ' -7-

constitute more than fiftv oercent of the totai loun¢e space available. (11i) All pre-primara, primary, and secondarv schools providinQ instruction for studpnts 3t, or below the tsveifth-Ztsde level; proaidpdl„ however,, that this section, shall not prohibit, smoking in , areas desi¢nated for smoldnq, in, employee dininqZ areas, lbunrres, or administrative aff'.ces, so lon$ as~ (A) prior written aDproval is received from, the fire commissioner. and' (B) smoking in such areas is not, otherwise prohibited pursuant `o secuon. 1i7=504. (12) A11' schools other ttian those covered in para¢rsph eleven of t'his~ subdivision, incltrdinst,, buil not limited to, communitV: coLle$es, techrticai trainin establishmenss, stecia:ltq schools, r_ollesses and universities; orovided,, however, that' this section, shall'i not prohibit smokin$ in: A Areas desiznated for smoki.ng in employee iunchzrooms, cafeterias, and lbllnEes, Dursuan2i topraraQZaph three of subdivision b of' section 1,7=5Q4, provided thatt prior, written approval is received from the £imevmmissioner. (3) Areas desienated for snoi¢1nq' ip student dinin¢ areas or !ounaes which shall constitute not less than fifty percent of' the seat,irrA ca acity or floor s ce , whiehever is streater; of' such, student dinin~ areas or lounRes, provided that, prior written approoal is recrived from the fire commissioner. (13) Elevatars -8-

b., SmokinZ is~ prohibited in the followinq •rerucies: durinz tunes in which the public is invited or perttntted!: (1) Ruses, and other vehicles of pubiic transport. (2) Ta~dcabs, required to be !icensed' by the tac:i~ and dmousine: commission: pursuant to section 19-504 of the code. ('3)~ Limousines, required ta be licensed by the taxi and limousine commission pursuant to section 19-504 of the code. (4) Wheeict'aair , accessible vans, reguired to be licensed 5w the tsaci and limousine commission, nursuant to section 19-504 of the code. c. Smoking is nrohibited on, any service Line, or oortioni thereof, in an enclosed area within a Dublic, nlace dur.n¢, the times in which the z7ublic is invited' or permitted, notwitlistandinq the fact that the service une, or portion thereof, notwithstanding the fact ttat, thee service line, or portion thereof, is in an area otherwise: desiqnatedd for smoicia¢ oursuant to subd:ivision a of this section. This subdivision shall not be construed to vrohibit, smokin$ in anv area where smokir.t is not orohibited pursuant to section 17'-505. !'17'-504 ReQwation, of smoking in places of employment. a. It shall be the responsibilitV of' employers to provide smoke fnee~ areas for emDloyees workeing within enciosed are" in nlaces n8 employment to the maximum extent possible. b. Within ninety davs after the effective date of this chapter, every employer h4vinz emplovees working wittiin enclosed areas in places of emploument' shall adotDt„ iiaDlement,maite known and maintain a written itaokinZ poiicv which, shalli rnntain at a rninimum the fullbwin¢ reguirements:, (1) ', Any emniovee in a clace of empioyment shall have~ the riqnt to ciesi,gnate his or her work area as a nonsmokin.g area, and t'oi post' suchi designation with, an: apOropriate 7iQn orr si1[Tls., t'o, be provided byr the employer. If, due to the nroximitv of persons smoianst; size of the work area„ poor ventilation or other factors:, such, desiQast:ioni does not reducs; the effects of smoke, thee emnloyer sha11 ma4te additionai reasonable accommodation bv ^eassi¢ninq ±'he emplovee tai 3 different work, area, expandinQ the size of the, wnrk, area -9-

subiect to the prohibition a¢ainst smokinz or, imnlemenL^ng other measures reasonablK designed to minim;Ze or eitimi^.ate, the effects of smoke on the emrlovee., LU Prohibition of smokinq, in auditoriums.,, class rooms, conference and meetinq rooms, elevators, hallwavs, emplbyee medicall facilities and' restrooms. (3) Provision and! maintenance of contiguous areas or entire rooms in which smolang is prohibited, which, snall constitutee not less than fift?d' nereent of *.he seating caDacitv or floar space, whichever is Zreater,, of empiovee lunc^scorns., cafeterias and' loun¢es. (4) Provision for a procedure to resolve disputes arisinZ under the smoking nolicy; in which the heaith concerns of the empicuee desirin¢ a smoke free area shall be 2:iven nriority over any other emolovee's desire to smoke. ~(5) Any enclosed area occunied exciusivelv by emDiovees who each reguest', or do not obiect,, that the enclosed area be desi¢nated for smoking, sha11 be so desiRnated and smokin¢ shall not be restricted therein, even t'hou¢h such enclosed area mayy be visited bv other nersons whether or not emplovees of ' the employer. ~L Protection •if' employees or applicants for QmDiovment who exercise„ or attempt, to exercise, any right Zranted' under the written smokin¢ policy pursuant to this subd'1?ision, from advarse nersonnel, action taken in retaliation f'or such exercise or attemat to exercise„ ipcludjnZ dismissai, demotion, suspqnsian. disc',plihary actuun, neiZative nerfor.:.ance ev,uuat'.oe, any actian_ resultin¢ in loss of staff, camnensation or ')ther benefit, failure to' hire, fa.ilure_ to app4ipt, failure to oromote, or any transfer or assiLmment or failure to transfer or assizn aQainst the wishes of the affected empioyee', and a procedure too provide for the adequate redresS'of any such adverse persannel action taken in retaiistioni c. T?he smoking pgLic:,- shaall, be disseminated to a11 employees within three weeks of, its adootion and to new emeibyees whena hired. -10-

d. Aii empiovers shall sut:nlv a wt^.tten copy of the smokinZ polic•r upon request to anV'emplovee or orospective emvlovee. e. A conv of the smoking nolicy shail, be nrovidedo to the, departmenti, the deDartment of' buildin¢s, the department of consumer affairs, the deDartment of' environmentai tDroteetion, the fire department or the department of sanitation unon reguest',. f. This section shalli not be construed to nermit smokin¢ in anv enclosed area in which, smoicinZ is prahibited, nursuant to secton 17-a03. 3'S7-5A5 Where smoking is not reguiated. N'otwithstandin¢ any provision of' this charter to the contrary. the following areas shall not be subiect, to the smokinQ restt^ctons of this chapter: a. Bars, including anw bar within a restaurant. b.. Private residences, excent' when a child csre or heaith~ care facility is operated therein; orovided however that, a cottimon area of a multiple d'wellinq which contains ten or more units sha11 be subiect to smold.ttg restr!ctions when itt is a place of employment or aPublic Dla.ce. c. Hotel and moteL rooms occunied by, or avaiiabl+e forr occuflancv by, guests. d. Retail tobacco stores. e. Enclosed areas in rest,aurants, hotel and motel cpnference or meetinst rooms and public and orivate assembEy ronms' during the tiiae these onclosedi areas~ or rooms places are used exclusiv.eitir f.'ir cri:<:zte functions.. f. Restaurants containing enclosed, areas with a*otali capaci3y of less than for2y customers, whether seated or standing. The commissioner shall oromudZate rules and resavdations by which, the person who owns, mana¢es, operates or otherwise controls: any such: restaurant shali ~ certif7' to the department the csDacit'7 nf aa ?nclosed ac =ss. ~ .~ ~. -11-

c l17-508' Posting of signs. a. Except' as may otherwise be nrovided bv rules and regulations promulizated by the commissioner„ "5mokin¢"' or "Vo Smoki¢te'' si¢ns, whichever are aDprooriate„ with letters of not less than one inch in hei¢ht or the international "Smoking" or "No SmolQ,n¢" sYmbols, whichever are appropriate, of' a size and style to be determined by the commissioner, shall be cleariv postedi in consnicuous spots, such that t!hev will be clearl~z and easiTy noticed, at, all maior entrances to,, and at freovenr intervals within, each enclosed nrea where smoitin2 is etohibitedt pursuant to sections 17-503 and 17-504„ or zermitted nursuant to sections 17-"a03, 17-50;i1 and 1'7-5,05' bv the owner,, ooerator, manaraer or other person havin¢ control of such enclosed area.. b. Every theater, owner, manaster or oDerator she11! post signs in, conspicuous places in the lobby' clee.rly' statinZ that smolang , is prohibited within the theater or, auditorium, and in the case of motion picture theaters, such information sha11 be shown uuon the screen for at, least five seconds arior to the showing of' each, feature motion picture. e. Every restaurant, other tham restaurants in which smoking is not' revU9ated pursuant to subdlvision e of section 1i7-505, shall have posted' at ever4 entrance a conspicuous siQn clearlv stating that a nonsmokinq _ section is available. When an employee responsible for seating atzsnQements is on duty, each oatroa, prior to bein;C seated, shall be asked his or her preference re¢ardin¢ seat location in a smaking or nonsmokinq secton. 91'7-507 Enforcement. The department, shall, enforce the: provisions of this chapter. [n, addition to emnloyees of' the deyetrtment', --mplovees of the: department of buildinzs, department of consumer affairs, department of, environmental protection, fire deaarcment, and department of sanitation shall have the oower to enforce thee prowis'eons of this chapter. ~ b. Any ' person *+ho desires to rec'ister a, ^aarpiaint under t'his, V wj chapter may do so with the denartment. ",A ~ © a. -12-

c. d. The owner, man.a¢er, operator or other nerson having , con:rol of a public, place or place of employment, or nortion thereor.'. shs11 infarr-,, or shall designate an~ agent who: shall be responsible for informi'nQ,, anF' person smoldng in an ene:osed' area ih, violation of this chapter that: such person is in violation, of t'his~ chapter and': sublect~ to the ci'vil penalties orovided in, section 17-508I. The department shsll seek t'o obtain voluntary compliance with this chapter by means of nublicitv and education oroaram, and the issuance of' warninzs', where arnronmate. l17.-508 V'iolations, and cenaities. a. b. It shall, be unlswful for any person who owns, TtanaZes,, operates or otherwise controls the use of aremises, in which, smoii3ncr is orohibited~ pursuant to: section 17'-503, or the designated aQent thereof, to fail to compiy with anv 'iiaitation on the size of' an area desiQnated for smol¢inQ nursuanr to subdivision a of section, 117-503, to fail to nost the sig*ts regu:red' by section 17-506, or to fail t'o make a, zood faith effort, to comply w'ith subdivision c, of, section 17r507~. In act_'~ons brouQht for violetions' of this subdivision, it shall be an affirmsti^e defense that durinQ the i*elevant time oetnod, actual control of tbe premises w1r not exercised b:,T the resnondent't nr a person •inder the control of the respondent, but: rathier'by a lessee, subtessee or any other person, provided that after receiv-ing ' the notice of violati'on, the respondent notifies the dqpartment pramntiv' that 2is or she has not exercised actual contr-A , durir;¢ the relevant time neriod. It shall be unlawful for a.n, emplbuer whose place off empioyment is subiect to regulation under sectzon 1',7'-544. *.o fa;il to~ comply with: the provisions of that section, includin2 the adoption, imDlement'auon„ makinst known, and maintenance of a written.n smokiniLZ wlicy which, conforms to the requlremenssof~s subitivision b nf sectYbm 17-504!, or to fail! to :aake a, Zood faith, effort to comnPV with subdivision c of sect':on 17-i'07. 'n actonss brouqht fcr v olgt!ons of this subdirrision, :t sltiail be an -:,3'~

affirmative defense that the emDiover has made good faith! ~rfarts to ihsure that employees compiY with the nrovisions af such written smokina policv. c. It shall be unlawful for any: person who awns, mana¢es or operates a restaurant in which smokin¢ is restricted' to designated areas pursuant to DaraZraph five of' subdivision a afi' section 17-503 to fail to make aood fa'rth efforts to insure thatt emnloVees resuansible for seatin¢ arrangements substan:.islly compiy wi.th~ the requirements of subdivision c of section 17-506. d. It shall be unlawful for any' cersom to smoke ih an:- area where, smolang is nrohibited under section, 1'7=a03. e. EverF aerson who violates subdiRrisions a, b, c or d oc.' oh:s subdivision shall for a first violation thereof be liable for a ciT1 penaity af' not more than two hundred dol.lars; for a second violation, both of which, were committed withi¢s, a aeriod of tweive months, such, person shall, be lcable for a civil nenaltv of nott more, than four hundred dol:arst for ai third or subsecuent: violation, all of which were committed within a period of tweivee months, such, person shali be liable for amvii oenaltv of' nat more than'one~thousand dollars. f. A oroceedinrd to recover ana cival t>enaltryr authorized pursuant to the nrovisions of 9ubdiaision e rrf this section shall be -~_ commenced by the ser4-ice of a notic4 of' viola:tion which shail be returnable to the administrative tribunali estabLished bv the board of' health. The board of' health's adknuulstrative tribunal. 5hall, have the po.rer to impose the civi.l, penalties orescz-bed bw suhdfviaion e of this sec.tion. ~ Whenever a notice of violatian of subdivision a, b or r_ '.s servedd by a person with power to enforce the nravisions of this cl+.anter pursuant to subdivision a of section 17-507 such notice shall include an order which: requires their respondent to correct the conditioni constitutinQ the violation: and, to file a certifi¢ation with the department tliat' t'he condition has been corrected. Such order sha11, require that the condition be correctedi •wirhin thirty ' days fmm the date that thw order is issued and .''.at certification of the correction of the conaition shall" be fled -14r

with the denartment in a~ manner and fiorm and wtthin such further, period of time asshall bees~tablished'bvrule~ orre¢u~lhtion ofthe, deoartment. h. It the administrative tribunal established tiv, the board of health, finds, upon 2ood cause shown, that the resDOndentt cannot correct the: violation, sbecified in, subdivision ¢ of this section:, it may oostvone the period f'or compliance with such order upon such, terms and conditions and for such period of t]me as shall be appropt^.ate under the circumstances. i,. For violations of subdivisions a, b: or c of' this section wF1ch ar-- subject to nenalties for a first' violation as set forth in subdivision e of this section, if' the respondent commdes with, the: order issued nursuant, to subdivision: cX of this section •rntN.ine the time set forth in such subdivision there shall be no~ civil penalty for such first, violation.. Such violation mav however serve as a predicate for ourposes of the multiple, violstion schedule set forth in subdivision e of this section. L In any uroreediniZ : before the, administrative tribunal estigbiished bvr the board of health, if the tribunal finds that the departmentt or other a¢ency issuing the notice of violation has failed `o prove the violation charged it shall notify the departmer.t or ottaer agency issuinst, the notice of violet;on tind i'r~e uruer, reguiztin~t the respondent', to correct the condition constituting violation shall' be deemed to be revoked.. 1g~ The penaltiesi provided bv this seetion shal.l, be irt additon t'oo anY othet+ penaltV imposed bV any other provision of law or rept.tlation, thereunder. S1T-5q8 `Maiver., a. The department, in conjunction, with the offiae of economic development', may 0-ant, a walver fromi the appiicaaon of a specific grovisiomof this chapter;, pravided that prior to the 5Manting of any such waiver, the applicant for waiver shall clearly estabtish that axaDliance wtth, a specmfic orovisionn of this. c.hapter would! c.ause, the aDplicant undue financ2ali hardship or that other factors exist which .+nuld render strict, compliance unreasonable. -I5'-

b. Every: waiver Zranted stiall be subiect' to such conditions or restrictions as may be necessary in~ order to m+rr,r„ize thee adverse effects of, such waiver upon oersons subiect to an involuntary exposure to second-hand smoke, and to insure thart such waiver is in harmony with, the zeneral purpose and intent of this chapter. c. Waivers ¢rantQd pursuant to this subdivision shall be vaiid for a period of no more than twenty-four months and . av ~ae renewedd u"pon application to the department and, the office of ecnnomic develbpment. Applicationsforrenewall shail hereviewed in t!:e?ame manner as providedifor auplicauons for waiver. l17-Bi0 Public education. The department shall enqaze in a, continuing nroqram to e.r;,lain and clarify the provisions and Durposes of this chaoter, and shall provide assistsnce, to those nersons who seek to comuly. lS7-511i Governmental agency cooneradon. The der_aartment shall seek to encourao state and'i federai~ governmental' and educational aqencies havinst' f!aciiities, within the ctv of New York not subiect to the provisions of this chapter to estaolishh local averatin¢ procedures which, substantiallv conform to the requirements of this chnpter. l37,-512. Other atrniiCabie lawa~ and private smoking pailu!don corytrolL , a_ NothinZ in this local law shall be construed to: oermiti smoking where it is otherwise prohibited by '.aw., b. *IothinQ in this chanter shall be construed to oreclude an owtser, operator, managMF gr other, person havin¢. ca'ntrol; of aAy establishment, from orohibitinR smoking in such establishmen2 to a Zreater extent tharl is nrovided by this chapter. l17-513 Regalations. The commissioner shail pramuleate such rules and reQulati'ons ass may be necessary for the purpose of implemenrin$ the provisions off this~chapter~ l3., N'ot lrter than twelve months atter thQ effective datr of this local law, the department shall submit a report to the mayor and the council concerning the admihistration, of' this !ocal inw.. -16-

34. If any provision of this local Law or the application thereof is held invatid, the remautder of' this local Ihw and the applicationn thereof to other persons or circumstances shall not: be affected by such holding, and sha11 remain in full force and' effect. 45. This local law shall take ef'fect ninety' days after its enactment. Actions necessary to prepare for the implementation off this local lgw may be taken prior to its effective date..

PP -F- DIL•r C THE CIT1r' OF NEw YORK OFFICE, OF TH E P49AYOR NEVW' YO'RK,, NI.Y: 10007 March 24', 1986 Mr. Joseph A. Caiif'ano, Jr. Dewey, Ballantine, Bushby,. PaJlmer andl Wood 140 Broadway New York., New York 10'005 Dear Joe: I appreciate your wi'Ilingness to serve as Chairman of the Mayor's Committee on Smoking,and Health. As you know, the other memtisrs of the Committee are Stephen Joseph,, MD, Health CommilssIoner; Victor Botni'ck, Health Services Administrator; A4air Townsend, Deputy Mayor for Financ&and Economic D'evefopment;:, and Charles Hughes, President, Local 372, Boardlof'Education Emp Iloyees, AFSCME., My charge to the.committee I's to review the draft smoking polUution control law I made public at my, press conference oniMarch 2'1'st and soll'cit comments from interested New Yorkers on the issue« When you haweistud'i'ed!these comments and'held whatever hearl'ings you consider necessary to g,[ve New Yorkers a chance to be heard, I woul'd Ilike you tolprepare recommendations regarding the proposals you consIder appropriate tolgiveiNew,York the best smokingipollution controU law fnithe.nation« P1!ease report to me nolIater than J'ul'y 1'st, and sooner if possiblie. Tihank you. Edward I ~ iCoch M I A Y 0~R'

/ tiPPEI%DTi:{ D THE CIT1T' OF NEW YORK MA'YOH'&COM'M'ITTEE ON S~M'OK~~ING~AM'D~HEALTHI 125WO'.RTH' STREET ~~ NEW'Y'ORX,~ NEW,YORIK~ 10013 (21^) 566~-3850, JOSEPH A. CALIFANIO', Jh. Chairman UUCTOR BOTNiCK'. CHARLES HUGHES STEPHEN JOSEPHI M.O. AI,AiR'TOYNNSENO Dear Concerned'New Yorker:. Apr i' I 18'„ 1986 On March 21!, 1986, Mayor Edward li. Koch rei eased a draft of' a proposed b i'I I to provi.de for smoke-free space In enciosed!spaces in New York City. A't the, same tiime, the Mayor established this Committee on Smoki'ng, and Health. The Mayor has chargedl us w i th so l iic iit i ng comments on the enc Ilosed draft I aw. from all iinterested New Yorkers. We are particu'Iarly Interested inicomments about how to i~mprove the proposed law, how to appJy it In the workplace, and how to make fit enforceable without undue regulation. Please submit your comments by May 20',, 1986. I f you be i ong, to aimembers h i p organ iizat i on, I hope you wi!II share these materials with your fel'low members and encourage them to submit their views. I'ni add it i on to wr iitten comments, the Comm ittee w i i' I ho l d'. a pub l i'c hear i nglon May 19,, 1986, in the Board of Estimate Chamber i'n C i'ty Ha l I. The Co+mm ittee w'i'II receive testi'mony from national experts and from New York groups, businesses and i'ndivildual's. Obviously,, it would not be possible for everyone to appear„ but fifl you are interested, please ca'I) the Committee ofifi'ce at (212) 5G6-385D. Writtemicomments should be addressed to: Joseph A'. Cali'fano, Jr., Chairman NI'ayor"s Comm i'ttee on Smoking, i'ng, and Hea l th 125lWorth Street - Room 519 New' York, NewiYork 1'001'3 Twenty-eiight states and'lhundreds of' cities and towns have successfully Implemented Iaws~providing for smoke-free space. With your support,, New York C'i'ty can have the best smoki!ng polduti'on control law in the nation. Enclosures

- APP=L{ E MAYQR'S'COMMTTTEE GN SMOKING AND HEALTH LIST OF S?PEAKERS' Hearing of~ May~ 19'~,~ 1986~~. Board of Estimate Chamber City Hall, Cilty of' New York C'., EVerett Koop, M.D., Surgeon General of, the United States William G. Cahan, M.D., Chairman People for Smoke Free Indoors Julius B. Richmond, M.D., Director Harvard University D'ivisionlof Health Policy, Research and Education Paul Screvane, Chairman Comm~itt~e~e~f~oir~ Common Co~urte~sy Stephen Scheidt, M1.D. Professor of Clinical Medicine New York H~ospital-Cornell Medical! Center New York City Coalition, on Smoking o~r Health, Harold P. Freeman,, M.D._ D'i~rector of Surgery: Harlem Hospital Amer i can Cancer S'oc i:ety Edith Ewenistein General Director New York Lung Association Nancy BaTter, Ph.D. Associate Professor of Bilology Georgetown University Sbrell L. Schwartz, Ph.D. Professor of Pharmacology Georgetown University Lawrence G'arfinkel, Vice President Epidemiology and Statistics American Cancer Society G'ray Robertson, President ACVA Atlantic, Inc. Alfred1H. Lowrey,, Ph.D. Research Chemist

David Schottenfeld, M.D. Professor andChief of Epidemioiogy Memorial Sloan-Kettering Cancer Center New York Academy of Medicine Stanton GTan~tz, Ph.D. Associate Professor of Medicine University of California,, San Francisco Robert H. Niebling, M.D., Deputy Commissloner of Health Nassau County Department of Health! Sister Mary MadonnalAshton Commissioner of Heallthl Minnesota Department of He~~a,~l t~h~~ James Hargrove Con~suitant, Past President National Black Police Association George W. Cooper„ Vice President Niew!York Chamber of Commerce and Industry Fred Gi. Sampson, President New York State Restaurant Assoclaition. Ellen Hart-Sturm, Owner Ellen's Restaurant Albert A. Fbrmicola President and Chief Executive Officer Hotel Association of New York Cilty, Inc., Patricia Broadhag,en, Manager Governmental Rela~t ionsNew!York State Food Merchants Association Bruce Logan, President East Manhattan Chamber of Commerce James M. Savairesse, President,. Savaresse and Assoc~iates Representative, New York State AFL-CIO Marvin M'., Kristein, Associate Professor of Econemics and. Community and Preventive Medicine State University of New Y'orrk at Stony Brook. Denis J. O!'Leary, M.D., New! Y'~o~rk Life~ I~nsurance~Comp~~any

Stephen Ciccone Program Associate The Business Council of New Y'ork State Regina Carlson., President New Jersey Gasp, Inc.. J. Pena Ve1ez U'.nited Neighborhood Improvement Organizaticn (UNICO) John Banzhaf', III Executive Director and Ch,ilef Counsel Action on Stnoking~ a~nd~ Health, (~ASH~)~ Claire Mili'man, vice Presi~dent GASP of New York. John Ji. Albanese, Jr.„ President New York City Bowling Proprietors S~~ta~nely~ E. M~iche~ls~~ Member New York City Council Don Ramos New York State Minority Trade Rhoda Lyman White Lung Association Roy: Hasitick, President. Carribean-American Chamber of and Industry . Rita Sleven nssociation Convention Commerce Bob~ Crogh~an,, Ch&i rper~so~n. Organization of Staff Analysts. Joanne Biancamano George Torres. Sargeant at Arms, Bronx Vietna7niWar Veterans Carolyn Brown Carolyn"s Non-smokers Club 3

i AET, EIIDLY' F NEW YORK CITY: SMOlCING-ATTRIBUTABLE MORTALITY, MORBIDITY AND ECONOMIC COSTS Prepared' by: James M. Shul tz „ M. S. Mi'nnesots Department of Health Minneapol is,, Minnesota May, 1986

1.40 INTRODUCTION 1.1!0' SMOK'.I'NGrA'TTRIBUTiABL.E MORTALITY . Csya~;at.`_2 smckiny' is the chief, sinqle pre•.entable 'cause of death in the l'Jni tzd States. A seri es of Surgzon GeneraL '_. Repcrts on smoking and health has implicated cigarette' smo4::ing as a principal cause of death of 'S0.0c.i0Americ_n- each year. This fiy,ure rep:re=_ents the sum of e=_timate= c:f smok:irng7athributab:le mortality from heart disease--1,0,000 deaths (USDHHS, 1980, cancErs of murl ti p1'e sites--1'0, 0-~i deaths (USDHHS, 19SC), and chromic obstructive lung dis_ase--50,,ri00 decths !'tJSDHHG„ 1984') . Recent e:stimates have pL acad' •annaial nati onal deaths f rom smok: i ng at 314,000 (Dffi'.c.e of Technology Assessment, 1985a) and 270.000 (F:ice. Hodqson„ Sinsheimer„ and Ecrowner, 1985). respectively. 1.20 HEALTH ECONOMICS AND EP'IDEMI!OLOI6Y' The ca'Tculation of "costs of iilness" has been reFined a'nd' aystemat:ced during the last two decadles. This endeavor. drterm'ininq'the costs of all diseases in the aggregate. dzterminlnq, the-costs of major categories of diseases (canccrs, h,Part disease), andl determi'ning costs of d'isease_ by primary cost sources (hospitals'~ phy_ician fees, nur_in,- home co4tsJ has app.ropriateTy residedl a~ithin the purviie"-~f heel th ecQnomi cs'. F'r-imaril y wi'thi'n the last decade, several attempts ha•.e bwen made to translate the health toll from cigarette =_mckinq :nt_o economic cost estimates. Calcul ation of the cost:s o:f _m.o!•.ing requires brid'qi'ng across the disciplines or health economics and epidemiolog;.°. This merger of ev:pertise is necessary to define causal 1inb.ages brtwc:en =_moi!ing and multiple diseases, and-t` provide quantitative estimctG= of theproportions of disease cases attributable to smohi;ng.. 1.30 COMPUTER' SOFTWA'RE FOR MORTALITY, MORBIDITY, ANIDi ECONOMIC COST CALCULAT IDNS 5af:ni.ny the dliaease impact of smoking for the group under study can be f'aci 1 i tated b•: appl yi ng state-of-thc--art p.aN,aqyd for ease of use byy heal th prorassionais:. Computer spreadsheets used for New Citv 3.'c'.t l±t. l•1'n' s hd.y been dE:`+'t`31 opFed at the ML (?1'nE?si7t,a De,''Jor t,iT.-r" t ,,,4 ' I-;eal th Qhu1. tc , 198341 whTcfi compute sToPi ny-spec i f. c 85648422

disease i,:Tp;_tLt, incRsl_Fe.' reca11i;1 u'Fijat,ad b`.~` Rice and colleaaucs CF:xce„ Hc:;dy :on', Sir7sheimer, rind Bro:,,rer, ±JST,. 2'. 00-.NEW YORK CITY: SMOKING-ATTRIBUTABLE MORTALITY CiT`ulation of smo4:inq-attributable mortality requires nP definiti!on cf the set of diaqnoses causally linledto .ci.garettz smoking,,, i_) an estimate of the relati .e r:>!-: ronr siTloke.rs coillpared to nonsmokers for e~c;h d'idglnosis, ard ' !7; inf ormwa't ion on smick ; nq' prevaT emce rates. Lorrent smokers are at increased risk for muLtiple dices=_=, primari ly from three dliaynostic cateqories: neoplasms„ respiratory d.iseases, and', cardiovascuolar di=_ea=_es. Fcrmer s„:okars are al so at el evated ri sk compared to never smoE er-, for a period of time po=_t-cessation. That time period varies by di:agma5is and by level of lifetime tob'acco smoE>:e. enwosure. Data from several 1arge prospective epidemiologic studias whi'ch e;ramirrined' the impact of smoking on multipl'ee d'iseasz outcomes permit estimation of relative ri=_l.s for both current and former smokers for approa: i matel y Cfi d'iagno=_es. c^.1CQ THE DIAGNOSIS SET The drzA3nasrs set u'sedl f'or New York Ci ty caLcul ations 1 s identicc,l to that used by Rice, Hodgson, Sinsheimer, cnd' Browner ('1955) .- Earl i er stud i es have i ncl ud'ed addii t i on all smoE:inng-r'elated'~ diaqncases (Rice and Hodqson, 19S7; MD'H. T%4) . The diagnosi=_ set used. by F;i'ce and colleaqucs r_s generally distinquished by robust relative risk estimate-, typ.ically derived from"inulti'ple prospective stad'ies. The folTowinq, diagnoses are inc1!udzdl in"the campuntations: ICD-9 C d no Di is o e 1*1l ;i-<~1C ag s F'espiratory tuber'c'uI'osi s. 1 4 Ci -14!9 Cancers of the L i p, oral cavi ty, phar,;n~: 1 !~%'? Cancer of' the esnphayus 151 Cancer of the stomach 157 C.nnc'er of the pancreas m' 161 Cancer of the 1ar vn:: tJT Cancer s of the-1 unq, trache a, bronc_nus ~, 1 J'( / Cancer of' the uterine cervl:: ~ ~9N9, Cancer of the kidney W' Ah .' ~'. Qa~ .:

C Hypertc+is ion _ tsche:n'ic heart disea5e C'ardiac arrest Carabro.rescular d'ise~~se AtfieroslIerosi s Aortic aneurysm 4?~u-4W 7' F'neumoni a; i nf Z uen: a 4?1-4!aC Chronic bronchitis, emph>/se,ra 4!95 Chronic ai'rways ob=tructi'on~ 5 71 1-C'4 Ul cers The e::'clusion of' liver cirrhosis (appearing in e:~rlier7 iss r'e-asonabl!a because of' the strong, covar'iation ,f and aicoha1l c(Jr'i5UiTlptYon. Other dliagniJses, T1asV iTe'rlt, inclusioni in f'utur'e calculations. Peripheral vascular disease (ICD-9 Code: 44.C) appears to have a stronq 1l1nG: to smoking (USDHHS, 190-') but reZati~xe r'is4:: estimates are generally: 1'ack:ingi. Attributabl'e risks have rerFntly been estimated for per'i'natal and early childhood' cnnditions l i nE: ed to maternal smoG~i ng (Mc Iintosh, 198'4 ). Di aynosEs to consider for inclusion are: short gestation andilow birth weight (ICD~9 C,3(Je: 7-,:r), respir'story di's'tresss s•;zndrcme ('I1CD-9 Code: 76?) , re=_p i ratory cond'i t'i ons of the ne~jt,orn Code: 7'70), and suddP-n infant death svndrome ~'IC'C-'= Code: 792.!:}) . Cor7,.ersel;:, hypertension iis i~ncPuded by Rice end coPlea,;-;es . bPcause of modest relative risks in several major stuid:es. Hbwever, the 1acE:: of consi'Stant e-vidence for a cau=_ai relationship between smok:i'na and hypertension was noted in the 19S'_• Surgeon Gereral "s Report (USDHHS, 19s') . That report did concede a'possiblv causal relationship between s,nol,: ing arrdi ear ly stroke (pri or to ape, -55) . The R;'i d'a, et al'. , methodbloy,y includes all ages in calcuIlaticns o+ sm'oking-attri!butabl'e' czrebrova=_cuTar diseases. Finallyr„ chronic airways obstruction (ICD-9' Code: 496 + :•,a-- incliuded' i'n addition to emphysema and' chroni_c bronchi:ti=. In Minnesata„ and presumably elsewhere, when a patient presents with chronic obstruct.ive Zung disease (CDLZ% symptoms, the physician may attempt' a d'iff'erential diagnosis to classiify the patient as havingchronlic bronchlitils or emph•fsema.. Very of ten, the case i s not easi l'y cl assi f' i ed into one of these categories and' is classified instead a=_ r_hron tc airways obstruction. W 2.20 ' RELATT VE R I SI` EST IMA'TES C11 . . ~

!r ~`r e'ach' dl 7g r, 0-s 1' =_ 1'n th P_ =a1cu, la tl~7ns't rZla '-_ 1•ia' irl SI estimates are a,Iailablr fr-om major lenigitUdinal epldem.e-' 1ogilc StUdl'es and' these estimates are th'cr-7l.(yhl : in a series of four Surgeon General's Reports !UEDHE'uJ, 13'',; USDHHS, 199C': USrJHHS, 199''; USDI-IHS, 19°4) . 1'ni previ'cus wor:. iF:it_e and Hcdgson, 198__;, MDH, 1984) relative ris4:s u(sea were d1:3',,:,G or T1ed1.3n vdil.leS from' si_lmmar/ tables app',.?_arI!'iq ' ..:. report?s cf ttie Surg,eoni General. In the Upolat.ed wC;i-:: •_ F'ice. Hodyi>>n,i Sinsheimer, and Browrner t t Mr; , rr: l4+ ,.';~ risks for each diagnosis are .actlny: 'i Accardingto the meth:~t ~ ;,;_,_ . L car, • ( epu.,r t , ~,~. L.~_1'ijl L: '~. ~1a7~_. 1..~~~'~~}' «ai~l lIlc?. :. i..~, -. ~ _.~. ~~ fi _. 1~-... -..`~.rc-' -.' . _,. ~ Jht la'iJ~ ......, .~ + ~ .~~.1_.. T:i:: ,'Lri:a 'L :3e1-;rl-'r --l:e?c ~ ". _ ~ - . . . .' ,.,': P ., ._., •"..' , _ _~: . ^.I ....j• C:r~ ! ~.1 ~-a!"t. F-'h.`, :Sli~=1..a~1"i'- =f~.~~a.t_~~'i., 1:-Pj "t_-Llt::, 1jr; t.Cd' ..i : r,rm r:S4Cs f,.;r- fT JL a"j-:I1,J5i:S we;r~?' f,7r c_,-.eIlh. ,:al ~ _- ~ EW `i~t7F.'F' C 1 T'' . 1 `~94 ": EW 4 tb -..-3':~~.i .,h ~ r 2:, JC?:At'h,s yimony nan s ni_74 er-s J.i..'7 t, t.,. _aIm-yaars of observation in stuld~r i person-years for smokers in StUid•.. i person-years -for nonsmo4::ers in studyi 2.30 SMOKING PR'EVALENCE' RATES. Smoking, preva'lence rates usedl in the spreadsheet calculations are 1984 New York: Cit, , rates based an projection of' large sample data to the entire popu:ation r=t New York City. These numeric and' percentage zstimat=s or cc:crrent, former, and ne•:•er 3mo4:ers were calculated b•,• ,:ip:d'emiol'ogists at the New York City Diepartment of Hralth. ' - ' T,b.a~ _.'H. SMQF ING F EE .'ALENCE F:MTES "1A LF_8: a''-_4 2 5 -_4' 7 5 -4 4 45 -6 4 ~~+ ~',

;:,JF:FEVT . 6 5 '. 7'1.5~.. 'O W=,. ii.'S7.: 21.15. FORMER . e.67 -O. 08 :. 21. 17 26.71 40.75 NEVER 5;'.68 42.22 34.00~~4'. 1C 78. W _ ' . , ^i ~ '. . T ~ ^ _. .. .... ~ ~. ~~ ~ ~ : ' FEMC,LES _ - ~4 - 4 . .J J~`t '7" ~v; ~ '7..J''t 6W . CUF:F'EhiT 26.62% =3.'u?;'. _. 16;. Em.27% 1 a'.W: FORMER 12494 11,51 M I6.54 1b.?6 22. 4' NEVER 60. 44l 54. 8C' 50. 20 51. -7 6'.7"' . 2. 4'O ATTR I BUTABG.E R ISY< CA4.CULAT IDN The critical cal!cuTation in this spreadlsheet is the smokiny- attributable fr.,cticn of deaths from each smoking-related dia.gnosis. The attributab1'e ri5l: calculation manipulatcs the data elzmenf s di scussedl above; for each di agnosi s in the diag;nosis set, the gender-specific smo~~!;ing-attri5atable risl:: i s calicuTated from currant, former„ and never smcker prevaLence rates and from current and' former smcG er rei''ati fe risl;s according Wthe following formula: CpO +p 1( RR 1) + Q 4RR'_')7- I Httributab1!e F:i sk = ---------------- ----- Cpca' + p1 (F:R1) + pZ'CRR2) 7 where: p!'i: - percent of never smokers in group under stud-i p l: percent of' current smok ers i n group under =_tud'/ p2': '- per-cent of former smokers in group under st+_id, RR2: • weiyhted relative risk for former smokers* . RF'1: weighted relative risk for current .smckerst * rel ative to never smoE! er=_ 2'.60 DA'TA SUMMARY Tab l e r^..6r+: ANNUAL SMOFr.:I'NG-ATTFi I L+<UTF',BLE "1OFi'TAL I,T`+ roEW YORY CITY . m AGE GF:GUF' MALES FEMALES FOTN' SEYEJ ~ ~ 20-a- 7294 1954 112 4 3

ZO:-'44 48` 177 :5' 45-64 ., 897 l.=u5--' .-. • 3.' 1 4~J.•.,7~ 2.50 SUMMAFeY OF METHODS i+rom g:nder-spec't f lc siToki,ngprt-"6val,enice rat,r=5 f(or =orr -'o" and former =_mokers ('for al L ages _0-and over, for a,;e 0- - 6F, and far aqes 6C-and over) and gendcr-spar_i f u<< mor ta1 t`. data for C0' d'iagnoses, es.timates of s!moGrinq"attrtbutabl _ rort a1 i t.y wern computed for mal es, fema'1 ts, and both :,emAr= 7E b: i ndli •, i dua'1 ddagross s, by d i agnost i c cat:egory, and f or the t,_t,aii dii,,,gnov:s sYt. The numbersof deaths are presente.d tn ?y'e b'.racE, ets: : 0-441„ 4'5-54, 6C-74, of these bracr:e'ts, a'ges 2~~:> and over., 75 andi over 3.00: NEWYORkC CI?Y: Sf9OK'IN6-ATTR'IBUTABLE . YEARS OF'POTEN'TIAL LIFE'LOST (YPLL) 3.10 METHOD'OLOCiY' AND SOFTWARE OPERATI'ON'. tssi~_~e's inuolved in the cal'cul ation of _nok:.nq-autributa'b1e mortality are' g,ermane to the .:a'1zur: xtion' of years of potential 1'ife lost. hi._..-i7t .. .Ji.i se~nC.e Wll-1w 1995s. I,1~9~O..cJb~.J'~. Havi^g d!ef'ined the diagnos'is set of diseases cauu_aI1v 1tnl=t to sanoking, and ha4ing inserted the two comp'on?n* .:ar:;tlps of the attributable ris1: formula--smoF:_ing p,~reval:ence, rat__ and gender and d i seaye-spe'c &ic, wce,i ghted'. rel at i4n r i=', est'imates--smoking-attributablr mortality ha'= been cal''culated4 Cigaret te smok i ng i s tCnown to ca!_~Ja' nr~m :r _:=e mortali ty i n the sense that nonsmoker=_ are 1 ess L:. Wel , t.= dl e f'rom certal n s+To4: i ng-rCl at'zd diseases and ntilnsilrihet' _. "; .:; do succumb to thes= di ag'noses yeneral l y d'i e at amor-_ e-. .;d r-;nced age than th'ra.~i r coun terp<art s who amoke. Hawe', re1ative ris1:; data' bu a:aa isy only a•.nailable for a.mal 11 na,nber <<f :dia'ynose_. Estima:ti'on of e:;cas=_ smoking-- ,ttl.rt ib~':;t.abte mcrtaliity by age of' death has been perfvr,ra.-' f'c,r r_;rrcer-= c_~f sa:era'1' s'ites (Coll and F'etW. 1TE'Li', for Lsclhow.c heart disasse !^1DH, 1184), and for botlh cacaer _ :' lJ,(',`~ ,1f RtL~O ar,~d~ n~a'.l.l.r.~.6ig'l-Dn^3 1~1?35i, d~:.di, rYG1t, osr3 nCl.o.- :p<-VIc y.c re::at7..C' "l si> data (a?;.Sept fur- t'wio, alE rang•_-

C a.hy.a 1 i ed~d t..i7 i.si=.h~aiG~1, -., h~ _ .. - _. : . _.- _ _:c3~, . 0. - sd annd 6J+I 1 . 4~~1 t..^.=. yasis for the skra..d _nart „+.h„-drL<_qw, the' wcr'k of h-hE=_. ~LinVestity.ytCr'a c_.n i.,•? _. ..:_yd to undc?'"ast1,^=t^a YPLL,. .`.c l iimif:,lng a'ssu!amF't ionl-1!S t;'+at, for each SiT,(DkLny-;^'e,.I at=6 d!lngnos'17, tirlre smWE:ing-,3tF_r.:,b'ut•3bl,e fr'.y,i=tlon r7f ijeatfis.[ s dii=_tri'biited_ in e;:act prapm_rtion to the di stribution cf al i~ d.=_ .,th.s Fr- ..m that cause. Th iazverrtuates a consar : at i._ e,;timnaa' of Y'PLL •based on the' prc_iumption of a di ..prroN'mr}i ]nate amount of earU':' death from"s,nokTngi. rates for r_urr?nt and f,orrner smoE:ar-, and aye and yendo.- - sFeci f l c mortaL i t}; data fcr thE' dl agnes:. s set--chE: -:=r'?a1sheet s[7ft.Wctr-n interlial'1'y' ca1L:l.llatrr_'s siTlokinqattribatable mc,rta;:ity f'or males and females' bl rndi . Z_r_.1. di3".1'UzI','s.. Re5.1.(jc?nt .. l,nthiespr-andshe.e'tn are tC1b.l,es .. ot' ,<ptcted years of' iifa remainin'y for males and f'erri;les b. 5- y••,.r age', •jroUp. F'.r each d2'aLqnosl s, tCr' e'aCh' c-year a'yc groufa, the software multipli'es the number of deaths in thw aNl t b;. the :exprzcted years of I i f'e rem,,i niny for that age Jf d'e.'ath, and mul tipl i es thi s product, in turn, by the smo4: ing- afi.t.ributable risk for the d'iagno=_is. YPLL estimates are aqgregated into four age brracke}':.; 20-44, 45-641„ 6C-74, 70 .A rrd1 o•:.er. These age br<_,chet.s are summed to pro~ide the estimate of totall smoking-attiributable YF'LL for- each Using f'Jew Yurk City data--gender-specific smuki'ng pre•:a di.aynosi's. The spreadsheet provi des gender-speci f i r_ `rF'LL e'sti mate _.~or thQse age brackets by individual diagnosis nndl 5-> diay zstic crateg¢,ry. and' dlspllys total smcF:lng-attribUtable YPLL. Fur: -ha_rmore', these data ?.re al3o pr,-sen'ted tor bcrhisr ez- combinrd.. Additronai't f, all data-is computed' baaedl on twoo e`_s w'f nati'onal ye-zr=.-o'f-e>:p'ected-life-remaini'ng data MCH.:, 10''34'1 re'siid'ent in the spreadsheet: all races cr_anbi'ned and' whites. 3.20 DATA' SUMMA'RY ''ab~1 e 1~~.CAz ANNUAL SMDKI NG-H~TMI SUTM~LE~. 1"EraRS' QF' F'OTE"1TINL LIFE LOST (`rPLL)' F:ELAT I VE TO EXPECTED YEAF:S OF LIFE FE"'?!5L;;!_: New `!'crG:. Cvty (IifE' e;:p:ectancy for all r,___: AGE C;FOUF f1A LES FEt1ALES ' RQTH '_ E'! E' ; _ 9`* 111_5C b:4o5 ' 1,'=71-" _>,: ~ -4 4 1,_~r_,._ , . 4.a--'a.1 J1P/4 ~. - i 7?~. ~.~. _.'t~J'4 ` CV7 14M.,

4.00 NEWYORK CITh':' SMOKIh1IGr-ATTR'IHU'TAEtLE DIRECT HEALTH CARE COSTS 4.1C1 DIRECT COSTS' :rjl~u}: ing-<ittv i',:;Lttablt-~ direi_t c7sts ira ~r,u]_`._., __ ?,... th,e , ,?:.1.o^'',, d'.i.3g inus .1.° anld t:rC?a ,t'i71en1"_ ~f S7ic.r! ;i y-..:..._ _-_.. ~1~:da~=~l ~llll iT?GLi=a1 condltlloris., r'1,11'e:•_'_ l ~D`:>It._= inedi~.= al c=.'i'e^-per'sonai'; l1e;.~1,tj-i, :` lln .1~_lr~I'ry sUch c17st t=t='nt.e?rz _irs hGSpltct.lTze,tlGn,, SlLtr~c~tL=~i}' L1in'Tc-=i1 care?, nttr'siny' hiome cc7re, home health c-;r_., ser:ic~~ ro+ prlmarv ph, sic.ilans and': jpecial ist:s, servic;~~ of non- p'hysici•an h,,al1th practitioner-s, and medl =atiorr co=_ts., ,?Lrrect costs al'.sn inctt_tde the "St_spport" costs o+ proaram a.d;ni^isrration, resear'ch, public he'aTth acti:rtie~, and maaiir_al f,~tt_i l ities constrt_iction costs, a...riie;- =_''_tdi:es ap!plked the "mortali'ty ,_'cmparlson" tA3f:1hi:db1'oM3'f lL!:Ce dn'tr' jL.t`lwelt.'.er, 1977; F';1't=e and Hr;d4,s''._„-. which as=_umed that the proportion u+ attr iL-1_ttab ae ;ncrt•a'1 it f fur 1' aryz dise;,se grrurp.=_ ,~.- a arc::•;y tor esti.matiny the proportron of smaL. Ln~ ~it;~ rlbi_t} - afl'i r3' t~:~~t.'~,. i i re rCi=trnt.) y ~_Lpt~r ~ded' m~?t!z ;i;ci ~,~'. =r ~'1~i:~; an d' CJ11?,agU.ts s :19SJ)' applLa~ dlrect' me_is1jrc_ :at di~f~?r er~tia'1 medical care t_ttili-ation by cur;^'ant ard ._,n•.~Eers relative to never smokers. ' MeCica1 uti1l~~,ti.cn h, a~nc4. in•a st?:tt!rs was obtairred from speci al anal .se= o+ t1~Lii.~n~.T Heal'th Int'er•~iew Si_tre^a erf data. The met`Icd ent,lla =.tzps, (1) Di fferences be+:wken smol ;Ar=_ and ne•,-er smc~ ar ; 1 n capita rates of' ut'11 ilzation of hospital carF and ph ;s; -, services were e::amined b•.: age and gender cateq,-~r-le,s ,:nd tested f'mr stati=_ti'caI =_ignir'icance. (~? Attributable risk., a me'asure of the ma;:irnal pr,,G~r'.i ~r uf hospiital utllization and physiJciani servrt_es attrlb..t~:a:_ tG S,nol: tnL] waa t_al cu1 ated . The Treva1 ence r,_te usatd w.: =_ `.t,et ccinfi';.nCct proportion of c;urr'ent and former smc~.et"S •.-• jJ_i~?ntl'a,l si71~_4rc~c-~ of Ova)rrst,lifla't,lon). Pela'tl,:?, r:Sl s 0-4tCJ the attr:bU.table rls:E> farmula were srrrO~:er' C=ne_-' =mcE,er ratios f,3r hospital' da•j+= and ph'y_ici,an ;) =rc,E iny-<;ttrihUtable hospital diiz•.= __ acd r'~•~~. UR1_At~-?~i]. +'~-Dr t•ha~* d L S:Ca~S??' rQ ur~l.:-5~ c'F 7- ~C,7~p L 85648429

.CcU'1at.=rrV ~.~ in~v 1,~:.~ p att.ribt:rta'ble sr.•I- :~<a: tstfs f,zr tha condi t l o rs ~.b`r aye ; g vrr.cG?r- -.± (4? (tii3es, 17-64 ~e'ar=- '•UFre' =oiT14TY-?s ~cdtr't'ta s:lng 1e Crc f:- r s; =ttnc ; w;t'hi a.ail:;ble t--, ealth rr.ar~ _ast dat; vt l.3kJie ' fL,r z gr?,s 6-4 r and under at3,=c_' OL- a ~Q (c E-tima+lit:~n rf s;noG:i'n~-attriU+_ttabl'e dir-pct herlth •-ara crs`= wr.•s acc-lt-lpltshed' using the following cor,.~ent-Lon: -'p:t '.<Kl L',t} L e--r1,i r, i_frS:l ny hojne,, and other Fri-, teSls 1 arl-3 L =er•~ice cc_it_ u4rre estimated Usi'lllig the attributable' rls. L.~r It:,_;pital ph:;sician ser.icas an'd' drt_ty _osts w_-r : Asti.,natr-d tht_' attribL.itablre risl:: for physician .1s.ti-i. Thi = procr.li,rw repre-ents an irnportant upqrade o-f =,,noG in-3- at'tri~utat,l'e LQ'I method~.5'1oy,1, the shi.' ft from trcrtal ityr to inurbid'i t,t rnea>.ures ~f ;d''irot_t ;.osts'. Hhwe,rer, use of t:torbid'it•/ comparisoni5 is not aComplete solutlon. Exce=_s l;~rb:c~lty in :--_in;:;G ers is not as well, doCLlmentedb'y age, gender, arrdl dl aqncai s code as e ccess mortal i ty. Data on use' 134"::t_Ltt7=1t1'~pnf mr?d1 =-31 ser_..iliCes 1s partl'CLIl':c;r1'V sP:4?1-ch'J. ruurthermori:?, thP logic of cost estimation a=_=_umes that, for a,;i ,e;-i degr~2e af i l ln?_•s, smol!:er , and nons;-~ :.it ct7iTlp?ra't:e ra'tes. Thl's ass!!lTiptLC.- 1=, m . + vU;-h.,+=^'t ed'' ',.- . ~loyt., artd Sch,W-?'i yzt•~r'' 3 ( 1'3Q.) stLtd , u+ 51C:F:ltiy, =^_'n.rci,- -t li=t C5 and Utlllzat'lon' pat'iFr'1E _tr,11 F:uis:- r-F'erm'ar~ntheallth p1<,n picpcllatiun. ~;r• . ra ~-,ad, --r-- e-rs; r.:f ~To-= hospital d~; = 1, ?r:/~J person-.•ear u =,-iri'..iyT :; t(:. n7 n•=in0 V ?r=- ',1r- =s f,h'a 'n ?,'•.pect'ed:l and' ;o4.1'tac;tl,-?nt -_t:.ilL-ation' drd n';-,t difiar between current and neoer S . Sm-;F.er swere .ess l il: el to see~ preventl.,e' ;-ai error in the appl'ica'ticin of prevalence-bas _c-, 1-1., I ,rc-:t`,'cds to lifestyl!e beha~iors such as cigarztte :ric:ude i'1l imprecisiLn in a'ttribi-~'table r1sE! e=_tim~te=. t'~`,`' i~ncompl'ete data on dlfferential mcrbidity for smoVers and n,onsmokers, (3) inc~mnl~_te d'atc on p~;tt.ern= ot util'iaation by smotring statL.ts, (4!" the gross agyr'egatlc~n n- econQlmilc dc3ta NJhich pcj,71 s ci'..,:Sts f:-3r l:ar.~ra i_at?y:or'ies _• d'i sease rather than f or i rrd i' .1 d~taI d'l seaJe=_ . (1S ~ erri-or : n the under'1ying tot.aL L0[1 astimates, and' (,3) error lnt, U; es-trapol'a'tilny from national data: to the yroup undler- St.i-ol :;. (z 4.20 METHODOLOGY AND SOFTWARE OPER'AT I'ONI N' ~. dlt . vuPP: _ed for' r9ewi _,_ -,. ~ L'-....11 .3~L'.:- Jr-i ~ ~i~T •]L "r...='L..*_ Fn.R~~A.y r~n, cc;/"~-- L:7~B t--:1 ~r~ L'1"1~-2 ~ t_~r`2 ~-. :...=r-. r ~ .;C

, _HUsp i ta? care 1!~q' -/)). ?[)(. F`hiys lLlan s sE-r'J1't_eS Nursi'ng home care DrUgs and drug satndrles -,2, ,,.;,:-) ,f v: ; Other professronaT services . . 4 .,t,;,:_„ .:., _ - 5.041 MEWYO'RK CITY: SMOKING-ATTRIBUTABLE INDIRECT MORTALITY COSTS a .. of sRIcG: 1 ng-re: :att:d ' u; .=c'. _== .it1C, Tie:~. 1:-:3:. cr'I-f~ I-!osGl ta 1 zuntd ofl rJr'rI ,.i Total personal he:-:l th $ 14, 1 L , 1. ~. . _ - - No_,,ita2 care . ..C/~,=~~i~l..i~:,n,s '~ s~er'w~~'1C~C.s ..' Cv u= , n q h o ', n a r, a r e 1 . ~ ~-} , 41' - DrU,QS and drug sundrl e= 01th2r prtcfes,ianaL servi _e5 ,t.. ~'.' . , The s+7+'twar'e dlstrit*!ute- these he;ltrr t_arre ctjsts 1'ni ac;_ordancr wlth the distrihution o+' 1990 U.S. n=.tllon_.,' ('7NCtllt,h' t_<=tre' Lost:s l 'ln, esC.P:m'cttlng th'e' f9^?;~tTOri Qt' t_ost nE 'P :L.i=T1L, t=1rCLl'La t::,Y"jt, ~snd ra s p7.lyd:to 1^`J fjls e c.s't3~:a r,`.iE i:'.]iilizlll l1 _F7 .:7~:~ts tt7r thi'"Sr~ d 'l,sre'ase '= arr mU l t: p '1 i ed t'y' tl'ie f'or hr~spltall care and fc~r yr, ;~~ciart •.l Sl ts CF:ice, Wodyazon, Sinshaiimer„ and Br•owner, 1^3~i ta.., appro~rimate the smo4:ing-attributat'Ie fra,Ztlon cf hE?--+l tlh 4.30 DATA SUMMFIRY' z~._r~: Sh1JF'INL~'-~:TTF:ISUTA'ELE D'IF:ECT HEi;L•T.H' C'rF'E N.3w 'iorEr (:it'•,'„ 193'' dol''larc '3I"iGF:: I NG -A TTIF: I BUTr";ELE D I F:ELT COS T;: F'1=r ~'Jn:ni (iie3i'th c'ctre', e:;penvitt_trtes: 5.~ 1~0 INDIRECT MOR'~TAL ITY' COSTS ,rtortaTlt": ci~~ts are the estlmated cost. ,ot , 6~i:..: ?r(:( P)~"~Ji~~L.,~='r,1 •1~1.t~ f ra ~~!UL. t,l.r(y f'rO1T1 G~ri?tn~a~t.l:!.r~? ~'".`l .. l.

to =!moE:imq-r'claledl ,:rd inju.r. Frar lndl .:cu -aia _'ie prematurel /, ,li' t~.-ut~ar-r' -=arr arP t Ur teir_ed .fle hLamelni cd'pl't cil this 1'C3'ii S' i7} incoifle T c J-ttzmated as the pre_;tant uf' future' aarn'i'ng';s. Tha inW'i rAct mor_taili tu c,.st est ilnO.'tes are' cCup,l ed'' to the ~`L;n'ate7 of sm0'.'.Lnn~-attrlbt t.:b1e' mort'all't'y for' the 3r,-:;:_Ip U s•r- stltd,, ec:r ea!=h ,dtagnn_is, smrol.:lng-attrlbU±ab'1e' ra:=ts' are' Ct7inputed as the sum Ct' th-3 Q'f the Pressnt vSl ue af fUture earn i,' ny=_ c'str ~r t ~ i,r,: •.kye and gendar i time= the nUmber of smo,4: ;n:g '-'at+':_r:ti_Etz't _m dle,:, ths fu-~r- each h;, ayra and gender categcrv- -r C~ Lr[• ~~n r•i~. 'rr .~. Cr~~C I~r.T' t.l;~,L_LiE t:, ~F FlJ~TUF:E E';;F.N~I7 G,f~ j:-E• 1 nD_, . ~P'1G~ = t~' tJ'r, ted' :t ate s, 1.98?=i: Di scc~~~m't F:ate = 4'<, .Hge Ma1es F:emales. ------------------------------------------------------------ _i-1 ~ 415',?93 ~' -7 1-4 4-'8 . 24I_ : 4 _'. ~l ~ : ~ ~ 479, 294 -79', '7 1 c~~7 5'~'9, _f 413', 1E 19 5T5', 3'55 443, 342 ~Ci~-~'4 6r_?4, 1'4 ', ~'E`= C~ 4 ~9~'~' 4 13 , 7i:~- ~I~-~F1~~ _ ~ . . . , J0~ ~~, JJ.i',. . 49_,0 8'I 4j-441 4 1 ". 77.E 717c[i . `-", 45-44 =25, 967 ~lv„3±lJ J4 2~5,464 1'67,i_'14 ==-=9 14u. 1 l~a 1! I 1.~41_ 60-54 44'S ~? , -8'_ 5"S - 6 9 7o-74 12, 666, `,:i. 75-79 6 , 1(:i3 9O-94 - ,,~~(:) 2 4,'4.: VJ `* 914 i'. 1~' 3L:,Urc?: Ri ce, Hodqson , and k:.opstPi n, 1936 H+uture strea'mi uf =arn'inys i''s callcUlated as the SLIm Gf i~. hi_iitUrC _.'nnl'1'c.,l E''3'r'i~Lt1~5 prlior to re.tlr"•?ment„ assuinln'y, a 3~t~raL~lr? ~rirti'~1 ~i Ln and an rnfl!atl`.n ratE. Th~= present ~a1'uz' of f'uture earnl•-:'qs is Lr _n,~La i:7:13u v fashi.:)n, but each term t s dll =_, ~;nt~.~,

if ter funr Haal th 'I"t',-o" r at.= -i l~~e. Hi,d~-. _ ~; •--,rt , ttn.i F t.::1 -. 1q°E! forr I,Sc"i, T•ab'1e =. ti,'; disNla,,= t'he'prt_=_errr 'aloe .- .-4a t~he a>/er~ a :lj,,e~ atin'Y!iilC~, li ..~':'' t..J: ?. .~. -: .. _ . --ifiei_+_'3'. The p:rr,:s=;- ts=;-t .;;.I.I:y ,fl tl.l'ti.lrr_: :z,rmtn-gS ersed' tm f'- .. u'. t.hC- Ncit..";1- 3: ft_t'•.ira ?,iirntn~.g= S .-.0 U lnt,ed at 4'., ._ -~rl~~a C f i tyaui-e-s ~~ ~Je.ni-2 ~r~A t~~-= d F''~~; iT, ~~ ~ ~~1 ca~~ a m d 'ro'1 I e a ;,d _!.~es ar P pro -+ ~u J c~=_ ^7r s,- ji•'ari' .nt~r Vall s ~sfiij ~t=Ci]tlnt f 7r ( l.%' 3q ;r?- -zk n'd •r~ p E3!-tf c life a p rcl-an'czAs, (2) patter-n=_ of' earniny,s ,.'-. ~dt.Tfc=rent ~y«=•~, r'i ]:abor force p;,rti_ii3.ati.on (I4,; i,mp,...ted valt_te f.Dr housa'keepiny and :5, +.J:., _' fLlt,:!ir? strezz~m' u•fi G+;?.rnllngs into its Fire=:?nt, worth L.' L'?C :C, ufIt Ic'1':!. ';•i =e andl :t7'.1,1e'C,g'LS'C' S l-ISeC both a. a•::, and .'. 'jl ='=c, ntf.x?' :! n nytlo n:a.L c: jt.lt'=.a-ll.a tl~7ns. The sGftWcira.. -+.1C1!' S,L'C.:tr(q : 1bUt'"tt,l,'? 1'ndl'r'ect tTio:rt a17Jty LGsT-, f c' Ji s-,~clrlt rates. Final est,imate= can be tnflatedl to 1 dkrr' y.e=•r dlr,i 1 ars' t'f =~.nnl,l'~1 irr_' ea='es if1' hm?J.r1''Y r,:,rnpen5ariun iin the bl_i=iness se'_tor. 2Rcau(_e aggregcted mcrtal rty data r=_: Used„ i t i s g'eneral. 1' ;~ ni-.,t pc-srible' to ~jliff'eranti ate lndi•ridu'al smcEkimyr-related death's from othwr. de'ath s with the same cau_=.e-of-dGrth codle. Tilatrar'nr~. wLthln e'ach t_aLtsa-of-death related tn, smcck:ang„ it i1s a'S_uime•d that the distribl:.ltion of' age cf death 1'=_ t'•1ert.i:- _.:1 f;nr- <.ll rieat.h- = and fcr the srnol!:inyr-~'ttriblltc~,; ='r ac++; ,_~i of t:ho5e dcaths. Thi s i s a comservati •re 3 >!_cT~,; ~ l I1n a -si11c)[f 1'iyi, 1'3I StrQn gl'yf' I mQ LL'_.Kt ad ' l n P_~r l d?'=' `. 5. 2,'Cy' SUMMARY OF METHODS t-J' t'!.. C 1't.; ytm 'I'tdt•r-s p 'H-- r_ii= :3tTioV lnq pre•.,;.-s le ncm rHtr -s G•-i5 cS c triOr t al 2i t',+ d!atal f c: r tht: d l a'~no51 ~Jo r = I''._rei into the spreaij'snaet. l+llth this the so:•*k•Jr,, •- .,,'«?r Ca1CU 12:t.?s s'fncS l,ni-i -a }~rllb ..lt~tile' 1T1ortz- 1.1~ .,-ir_ ,nales and' females b•y i'n't u:ict_,a1 iil-Ag nc,=i=n pFsident ,n spreadsheet are tabl:e=_ of the pre=ent vai~!e' of ft_Itu r:a •E'arm T ngs d'1 scOUnt?''t •1 t 4. f-;itnci l? ~ ,aar age grou!P. De'td iS rE-g,3 t,?d' IrfO f0 lr c.~= _,a-44, 45-b4. 65-,4, 7'jI and The'ze aL3e hr sL.!mmed t0 provlde the esti tnG h e of t•Jt al gmo~ t.rndirect' m!Jrtal'it/ fkDr e,:k,_h T~te acftware pro•ri',d'es gender-=_peclflc indirect mortal'it., -.r.. z=+';ma+`e=_- f;-Ir t'ha<-:,~ atga- br.ac4:et., byr indi.id!_Iall :~_~rtcs;.s arrd, b• Wllay',-to=_ti,_ cateL3or•:, amd disa:la~,s 1iot-k1l ;nf t'r-:t,l.lt<,b1«: cros* s. These dA t a ;it ra a 1's:.a Fres;? n se:.ts comb~.nedb r;Ii data are uomN~,ted ior -, di=+-riu;nt r,.,t.es, 4: and .5'.. 5~. -D'' D!A'TA~~ SUMMAR~Y~ 8!i648'433

Table W. =A: ANNUAL SMGF:If!dG-hTTF:IB`UTHBLE - It`JDI=:ECT MOF?TrLIT'e CGSTS' DE:It~~i]!JPUTED ;~T 4". fJeua Yc~r 4!C.'i ty.(19St_i~ d'o11 arr s) :ahE t3Fa7UF' MALES : FEMALE'S Bi0 'Tf1 3: E - !_"= (mi1lions) . (mi11'ic+ns) :mi1'i::- 7,',,+ I ,)C1.() 1'~'L. :3-1'-. _ -4-1 C `2.. 4 5L3. (") 4 • 4 5-~a-4 _-•4'. 5 1~:iC. :) 4' bu.-74 '~. 1 C4. C J~. i + •T1. J. L 7 . ~ New Ycirl: Cit•~ (estl1mated 19°T dv11%,r=: AhE GF:OUF' MhLES FEMALES EtOTw SEXES (~mi'11i~ons~) ~ ('~m~iLlio~n=_)~~ ~ ~ (m:i1~::1!on=), '91 . C C'"(7 . Ci 1'.•! 1 i. i :'T2.9 ~7. C 1 445 1^_. 4 6,5 74 4'C. L 11.4 6.00 NEW' YORk; CI'TY: SMOIk:INS-ATTRIBUTABLE INDIRECT'MORBIDITY' COSTS 6.10 INDIRECT MORBIDITY'COSTS'. Smoking-attri'but•,t;: _LnU;r,_t_t mizrbidit-.• costs ara the .:)f liost income and pr-oductUl.t•;- fcr indl•lidi-taTs whc are d'i sabl'ed by nonf atal or sl owl y f'at.al' smoi> i ny-re L',,,ted iliness, Srnod::ing-attribut'able' prodLacti•.:it;.: TcJJ=_'`= ara k~ t~t! r^gtj aS WdyZS, Sa.i ll' i e,5, dnd Sla47p 1'e,flZJntS f rO,T Fr; om vrcr.:. among cUrrrentl y cmpi o;.-ed aerrsons, Lcny-te-r a; }a'b11,I f_:, cj"t"y5 A;n'dI ~q=PItd1 iz'atl,ort dar s f'Jr s,TG7Grin,y- rn~ attr':.b;.,tabie c'al,.,ses: and the impUted v'alue of F,cr_i_r+eep r . 1 = r +ema l a'~ii l.Un.~L7l a tv l, eep h(-j l_l «e br+ e :) t Tm,:; ~ in~y-indU ced :11'ne=s, I ".r~r _:Oiilp inr~T'-1:i'.l d .:~t,`,. t~=. L.,=-? ' and : ~t i.e t, - : _. =p ll'-'~ r_l' mC;t .hCJlj',i_1Jy+ S1m11'ar to the d ir'e Lt Cr.1 sf' Vy1= t:-

r . ~ pro,_e+d Lir~ ~iT.Cny ` l i^`f F 1 ~~ ti_ h ~. ~_ ci~ 6,;rrP_~ u~; .:... ~J!'" v'~2@ hOC:=E'. r r'nlc'r' J<+ u .,..s2.s '. +Df ri~a1Jr.a ~i H 'E''.?,.~.~~.'?':h ~ i~~nf.e_'_':, r .. n' .=--:?rj f or .3.' :7 .~+". i, ]'n - _., ..- .~ a.. y" al't~ii g'Peh~u~~,cr, ,~. a~^i,~, ._!~'Ct r ...li',.jl , ~ .. , 3. i ~f' _al.,tj.+jr_~-~.L_~a+~' -r_..~.i!•_e , p ;ric4j~~ /irYTTlllriL ll~~rZ 'tr~•-.. . .. ~. r. __. f~b, i=. L i , o the g,rmt_ip, uu- d4=r !-.',:'d' . i . e, PJt.~ ~ ! '.-I+.::>h i?~~. :=:~Ci'4•r"Nar%?I tLnn~".~.'..IT~~~~. ~_. _. S ,i ..r~Ly, .~vUdt,~.h'.Ia ~ Cb'Jb t,..'7:'.?. r ~..~.!. .., -. .. r f~Jh- d7..~ fn,-D C'~,( r'O'.r-:-. >, nc) r!:, : ~j i ~~#i ~ b; ~~ F=i:r,;i ,y,rn I,r Lr p r 3 p t:ucr tc ,!;re=. Ti'i.a pr0Pur ti:7r:3i ...5't,irTl3t•.i 7n Orf' indir^Ct _-;mp•.tt -d e's fo',.i 1,7j ua ;; :,L;;a,~ Lh..t. ',Ch._s1 cmsts .U.`.7.t Dtt ~+ast~ iJ.S'., + Ilndir"~ct ~c =_t~ J.~. i _ ., ~1.av! --+ t: C t,+ .: , 1'tld l ^ =C t tT(D rt 1 ~J 1 t :F.i.i'ttitp2ijir f!=ir ?=e=il 3 jtq ' 3r+~ ^•~F?i 17 _ fs. 2`O SUMMARY OF METHODS Th'e sof t w a re user p r a ': :, d!?- a y ~- -z .r+,J j;rn-` r--CP W _. for direct and ind'1~ -ect •-tur tal.''l t+ ..-I ILies) for tFhe' ,yrnup Wnder =tu+!•, r~,. ~ :'n r;l' b. I d L, }'J G o s f.=- 3 r F t'_:;'" ! Ti 4F;t,'r. d T, i? t h t r! Er. j'i =F +1u_4tf.;;urt '7f 11 ... :. I a ta =- in..:1Gr: n j-:_rt t" , bt. ,~j :'r' -..•7 t' _ _ !~ .rI J=,-r.~ S1n'zf`io'2'i d1?7dBrUwnerf L.CF`C:, ~1 . 6'..'0 DATA SUMMARY `rc_! .."Jl3 =,'7 !; 1 _'tJT~6'L2 85648435

INL'IF:ECT '.,..r 77ST'z AGE GkOUP. .1 2` ?-5 -2 ,tC+ M:,LEw FEMALES .(millians) (miilionsi riCTM •3E x E:=. (;ni 111~n~) NEW YrRF CITY: COMF~3SITE :'M17V I1'aG-ATTF;IBUTAELE CS='= :. The final sprcad="' ec-+_ sLLms dir_ct, indirect mcrtality, and .. ---timat_d indirect inorbidit, costs tc provide an zstimated - :-ilue for tota:l smol:ing-attribttt'able costs for the groUp ~rnder study f,Jr ina,le=_« femal'es., both, se;ces, and fcr itg_~'g,ender-sp=cif'ic subyrcLups. The percentage distribut:on ,~f' tc~t •,1 costs by te pA of cost i s computed. T.3b: _'.+:)Fp' jl_MMAFi'( OF SML^~ I'NG-ATTF;I$UTr16LE COSTS Clew Yor4; Cit•; (198'C dollars) _ L I F:ECT COSTS IhlDIRECT MQF:TAL I T'i'' COiSTS' I'^lDIRECT' MORBI D'I TY COSTS TOTAL COSTS + 542',128,0'52' 781,159,651 327,212,,6I6 1,650,500,319 _ r:i-6 4 350-,,785,285' 728, 3791, 52'1 3115,048,183 1,404,212,989 65+ 181,342,767 52,780,130 12,164,433' 246,287,330 FE!'!'tALES' _ C0+ 435.I068,52'5. 23'0,003,214 155,027,349 820,099,088 =Ct-64 257,932.68'9'. 189,507',575 151,915,661 599„3'55,925 7~* 177',135',83b'.: 40,4951*639' 3',151„68'8 220,,743',16'3 0 ELTH SEXE S C1T' ~ =`'-''+ 977,196',577 1,011,162'.865' 479,693,314 2,468',052,758' ~ ~-J-64 618,,717,974 '4 917,887,09'6: 464,072„73'0 2,000,,677,800 rCy. ~ .L-11'+ 358',,478,603 93,2751,770 15,620,583 467„374,9'S6'

tJ[111[](ll][][][1LJL1LJL1l1lJ11[JIJlJC1lJ[1C1[]C]C~C)I,JLJLJLJLILJLJLILJL1L1lJLJLJL1i1l11111~JI 1lJLJl~t ll /l ~t it ~t [ ] 1 ' . = 1 I [ ] f 1 , f 1 , a, I t l [![][]C]E]E]H[]El(][lE]C]ElE][]Cl[][iC)flElE]HE)I][]f]C][]C]C]flC]C][][lE3{]Cl[]C][][1[][][][][][~E7 Clflflfltit]1.If 11 1 , [iSt9uk1NG-ATTRIBUTABLE COSTS FOP GROUP UNDER 57UDY SUM OF II [] DIRECT AND"'. " ESTIMATED " I1 C9 INDIRECT INDIRECT INDIf~ECI'..,. ESTIMATECI I I [] GENDER/ DIRECT MORTALITY MORTALITY MORBIDITY_ 'e TOTAL 1I C] AGE CATE60_RY COSTS COSTS COSTS COSTS COSTS I1 I (lf][l[][]Clf][][]C][]f]ClC]C]f]CiC]ClC][iClClCI[lf]f][]C][]EICIC][]ff][]C]flClC][]C][]flf](l[][7[lC it.lf][][lfi[]f 11 11 I []PY3LES: ALL AGES - - - $542,128,052 i791 , 159, 651 f 1, 525, 29?, 70:~ Cl ~C][]C]E]C][lf](]C]C][]C)C][]C]C][]C][]C)El[] -- ---- - []MALES: 2¢-64 YEARS ~[] DATA s36©,765,2e5 f?28,379,521 Cl $1,089,164,006 C] C] ENTRY , E] []MALES: 65+ YEARS [] CELLS $181,342,767 $52,780,130 Cl S234,122,697 C] f][]C][]E][]tl[]C)C][][]C7[][)ClC]ElC][7C][7 Cl []FEMHLESq ALL AGES $435,068,525 $230,003,214 $665,071,739 Cl C][)C]C][]C][][)f]E]EHC]ElE]f]f)E]E]C)C3E][] []FEMALES: 2©-61 YEARS Cl OATA $257,932,689 $189,507,575 f] $447,440,264 E] , 11 ENTRY 11 E IFEMALES: 65+ YEARS [] CELLS , $177,135.836 ' f40, 495, 639 E l $217,631,475 Cl E][3E][][JCI~I[)ElC]CICIC][]C]C][lC]ClC)[]C] [l' [ l GOTH SEXES: ALL AGES ,., $977,196,577 t 1, O1 1, 16-c~, 665 'l 1, 966, 359, 442 (I []BOTH SE?SES: 20-64 YEAR S ~f616,717,974 J<917,987,096 >E1,536,6U5,Q74 El : [ )E~tITH SExES: 65+ YEARS 15358,176,603 t93, 275, 77U $151,754,575 f ].. ' - I l 11 Jl JL J[ Jl JL JL Jl JL JL JL JL JE 1[ JL JL JL JL JL ]L JL 1L 1L JL JL JL JL )L JL JL Jl JL JL JL JL JL_ JE ]E ]L Jl J( JL JL JL JL JL ]E )C J[ 1[ ][ It )l 11 1l 1[ ]1 11 11 1 - - []PERI:ENT DISTRIBUTION BY TYPE OF COST_ SUM OF ~~ []FOR GROUP UNDER STUDY DIRECT AND ESTIMATED I t lI INDIRECT INDIRECT INDIRECT A ESTIMATED II Cl GENDER/ DIRECT MORTALITY MORTALITY MORBIDITY_ f~::TElL I 1 - 1' ] AGE CATE6ORY COSTS COSTS COSTS COSTS 1 Il~~l 1 1 I 1 [][]C3Elt]E]E]C)[]ClC][]Clf]C)C)f)C)CICI[lC]C][]ClC]C][][]C]E][]C7[][~CIC][]Cl[)C]fi[lflf][][][)Cl[] [)f][][l[][1[lf 1t 11 I []MALES: ALL AGES .'32. A5G 47. 33? 00. 1 7 i' 19. E13t4 100. E] ' []MALES: 20-64 YEARS 25.69'. 51 . B7'f_ i~7. 56i 22. 44i: 100. O-~t E] _ I 1 []MALES: 65+ YEARS 73. 63~ 21. 43i; 95. 06r [) 4. 94i; 100. (?E~::1 1 [] 1 1 ~ S ' I t [ ]FEMALES: ALL AGES 53.05? 29.05:; 91 . lOr 1t3.90C~ 1~~~~,r(~:.I t E ] 1 1 C]FEMHLES: 20-64 YEARS 43.05X • 31. 62.. 74.65% 1.~0. OrJ:'I 1 f 7 9p _5q;: 1 . 41,: t0o • n~',::t ( 132,~ , 212, 616 .;1 , 65G~, 500, _. 1 `? 1 I II'f 2,=+~i'+ II E315,049,1e5 $1, 404, 21 - 11 ;12,164,433 ;216,2B1,'~30 1 1 II $155,027,349 $820,095l,OE~[i~' l1 f151,915,661 $599,`35a,92a 11 1 1 S3,111,688 J:22Q, 743, 16'S 1 1 ll I t $479, 69'~3' , 314 t2, 466, 052, ; 5E. [ 1 ( i $464,072,730 f2,000,67T,f1UG (1 EI S15,620,583 346?, 3?4 ,~+-i~. I; 1 ----- - - 4MV999

List of Subjects in -I0' CFR Part 271 -Administrative practice and procedure; Confidential business information. Hazardous materials Federai Re(,, Jcer /Vol. 51. No. 99 / Thursday. May C9d6 /_Pr~osed' Rules transportation. H'azardouswaste. Indian lands, I'nt'eraover.imental relations, Penalties, Reporting and recordkeeping, requirements. Water pollution control.. Water supply. • Authority This notice is issued under the authority of sections 2002(a), 3006. and 7004(b)lof the'Sol'id Waste Disposal Act, as amendedi by the Resource Conservation and Recovery,'A,ct~ of'1976. asamendedi 4I21J.S.C. 6912{a)! 6926:an& 6974(b)', and EPA Delegation,8-7: Dated: May 13. 1986. ~ Robert,Springer. Acting Regroncl Adtninistnator: [FR Doc. 88-11'519 Filed'S-21'--8Q: 8:45 am] aILLING CODE656'6-50-N. GENERAL SERVICES' ADMINISTRATION 4'1I CFR Part 101-20 Smoking i3egul3tions AGENCY: General Service Admi'nistration.. ACTiCN: Proposed rule. ^ APBaZIY. G Facili ty Management Di sision. (202-566- 1563).. SUPPLEb1'ENT.SRY' INFORMATION:IThe General Service Administration has determined that this rule is not a major rule for the purpose of E.0:12_91 of' February17; 1981, because it is not' - likely to result in an, annualleff''ecton the economy'of'$100 million or more: a major increase in costs to, consumers or, others; or significantadvE.se effects.. Therefore, a Regulatory Impact Analysis has not been prepared. GSA has'based alliadministr!ative decisions underlying this rule an adequate information, concerning the need for, and the consequence of, this rule: has determined that the potential benefits to society from this rule outweigh the potential costs and has maxim+im the net benefit's: and' has chosen, the aiternative!approach involving the least net cost to society'. List of Subjects in 91' CFR Part' 101-20. Sinoking;, Federal bu'ildings~a~nd facilities. GSA proposes to amend Part:101-201 as f'ollows:. PART 101,20-i40ANAG'EMEtVT OF BUILDihIGsA,VD GROUNDS 1. The authority citation forParti 1ta1-' 20 continues to read as follows: Authority: Sec. 205(0). 63 Stat. 390: 40 U:S.C. 486(c) Subpart 101-20.1-8uilding O'perations, N.faintenance,,Arotect'ion„ and Alt'arations SUMMARY: Th%s regulation provides for revised smoking regulations in buildings controlled by GSA. It has become necessary to regulate smoking in certain areas of Federal buildings because smoke in a confined area may be irritating,aad annoying to non-smokers. In addition, the Office of the Surgeon General has indicated that current scientfic evidence suggests that exposure t'o ambient tobacco smoke can be hazardous to non-smokers and may create a potential hazard toithose suffering from heart and respiratory diseases or allergies. GSA alsa recognizes the right of individuals to smoke in suchibuildings provided suCh action does not'cause:discomfort or unreasonable annoyance to non- smokers or'inf'ringe upon their rights. The intent of this!regulation is to provide a reasonably smoke-free environment for those working and visiting GSA-controlled'buildings. DATif: C'omment's must be received'on or before July 21. 1986. ADDRESSrWritten comments should be sent to the General!Services ' Administration (PMFS), W ashingtoni DC I 20405. FOR FURTHER INFORMATION CONTACT:'. Mr. James A. Marsden. Acting Director. 2. Section 101-20.109-1U'is revised to read as follows: § 101-20.103-1'0 Regulaticn oRsmoking. Regulations for controlling, smoking, in GSA-controlled buildings and facilities are!set forth below. Agencies are encouraged to develop~additional. guidelines for'internal' use for action when violations of these regulations' occur. Nothing in these regulations, preclud'es' an agency from establishing more stringent' guidelines. For purposes of'these regulations, general office space is'defined as'space occupied by personnel performing their daily work functions: this includes, but is not limited torADP'arsas, mall'rooms, fiie: rooms; duplicating areas, court and jury rooms: office space, etc. (a) Smokin8 is prohibited in the following areas, exceptas designated'' pursuant' to paragraph (b)(1) below: (1) General office space. (2) Auditoriums. classrooms, and conference rooms.. (3) Elevators. "No smoking"'signs shall be posted, inelevators, adequate s receptacles shall'be placed outside the entrances. (4) Corridors, lobbies and~restrooms. (5) `Sedicallcare faciiities such as medical clinics and''health units. ('6) llibraries. (7) Hazardous areas: Eac`i agercy shall post and enforce "ho smcf:ing" rules in any l'ocation under its jurisdiction which involves f3ammab':e liquids, flammable gases. or flammable vapors, or in all other locatior.s~where there is a collection of'readily iQnitible; combustible materials. (b) Smoking is permitted in the follo}wing,desionated!"smoliinc areas: (1) Agency heads willlbe responsiblee for establishment of designated "smoking?" areas. in addition too monltdring',a,.^.d eontroil',IIo t~ese area9l Agencies are responsible for enaurir.,g that designated "smoking" areas are identified by appropriate signs.. Agencies in multi'-tenant buildings are eneoura;ed to wark together to ide t'.fy these designated' "'smokir.g;' areas. (2) "Smoking" areas shall be established in cafeterias. including Randoiph-Siieppard vending facili:;es and automatic v.e.n.di_z; areas. These areas shallibe designated as "s.:,o;ir.a" areas by each buildings manager.. in coll'aboration, wit.h the heads of't:;e oceupant' agencies. The areas designated, shalllbe based upon an estimate ef'the number of smeking and non-smoking,patrozs served. This may be adjusted on the basis of local experience. The designated "smoking" areas shail be identified by appropriate sigris. (3) A private office may be declared' a "smcking" area by the agency. (c) Agencies are responsible for providing adequate ash trays or receptacles in the designated "smckir.g"' areas. (d) Suitable, uniform signs reading "No Smoking,Except imDesignated' Areas" shall' be placed on or near entrance doors of buildings subject to these regulations. It should not' be necessary to display a sign in every room of'such buildings. (e)IAn agency'is notrequired' by this regulation tomake any expenditures for' structural changes to accommodate the preferences of non-smoking employees. Datedl April 17, 1988. W.F. Sullivaa, Commissioner. Public Buildings Sern-ice.. [FR IDoc: 8Br-11670 Filed 5-Z1-86: &.45 am( 01LLIN6CCVOE "20:I~-Y

APP&NIDIX H CON=S' 1. 17 April 1986'Secretary of the Azzny Proclamation on the:T!obacco Cessation Program. 2. Army Tobacco Cessation Gaite Plan., 3., Military District of Washington Supplement 1 to Aacny Pegulation 1-8 on &noking. 4. 6 June. 1986,Arnry Policy Directive on Shoking, to be incorporated into AR 1-8.

C U.S. ARMY TOBACCO C ESSATION PROGRAM 'The readiness and weff beingvf Total AF my members 8nd their famiIfes challenge ars to deaf with ffae~~ puobim of' to~bac~~co~~ use: ' JOHN A. iN!ICKHIAM, JR'. JOHN O. MARSH, JR. General, United Statea Army Secretary of the Army Chief' of Staff i UIT Just for the health of it! HODA/'DAiPE-HR'L WASHINGTON, DC 2013110-0300

TOBACCO CESSATION PR:OG RAM 'The, readiness and welt being afi T'otal' Army members and thetr families challenge us to deal with the problem oifi tobacco Gse.' JOHN A. WICKHIAM, JR. JOHfV! O. MARSH, J!R, General, Un,ited States Army Secretary of the Army Chief' olf S'taff' Just for the ihealtlh, vf, itt WASHI HODA/ DiA PE-1'riR'L NGTON, DC 20'3110-©'3001

F DEPARTMENT OF THE ARMiYWA5'HMGTOW. D.C. 20310-0200 17' Ap ri l 1: 9'8 6' pROCLAMAT IDIV' The!read'i'ness and well being of Total Army members and their families challenge us to deal with,the problem of tobacco use. Medical evidence shows overwhelmingly thatthe!use!of tobacco products adversely impacts Onthe health andireadiness ofour force. Tobacco usage impairs such critical military skilLs as, night vision, hand-eye coordination, and! resistance to cold weather injuries. Moreover, it, increases susceptibility to disease. It h.as become a substantial threat to the well-being of our Army, and' we must take immediate steps to eliminate its usage. Every Army member is charged to make this goal a reality. All of us have a clear responsibility in~ making this h.appen,. As part, of the Army Tobacco 'Cessation Action F1'an, we will encourage smokers to quit through a program of' education, information, and'assistance: We will also safeguard the health of smokers. and nonsmoker~s alike by limiting theareas in which, smoking willbepermitte'd. Finally, we will check on all forms of tobacco usage from time to:time to determine progress. in,meeting our goal.We believe thiis campaign is~ absolutely essential to maintain, the health anri.readiness of our Army. Ours is aprofession unique in many respects,, requiring physical fitness and.stamina to get the job done. Each of us must be ready physically to endure the strains of'a crisis. Additionally, caring leader- ship dictates. that we demonstrate a sincere., unambig- uous concermfor the health and safety of those entrusted to our, care. 0 A. WICKHAM, JR. on 0. Marsh, J'r~. 6~~ra1, United S'ta~tes~ Army ~cre~~t~ary~ of the~~ A~~rmy~ ef of Staff