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NEW JERSEY'S CLEAN INDOOR AIR LAWS A PROMISE, BUT LITTLE PROTECTION A Report of the Commission on Smoking OR Health A aETTfR STATE OF NEALTli ~ ~ ~ W ~ ~ 25 May 1989 CA 7renton. New Jersey W GD

Members, Commission on Smoking OR Health '0 Mrs. Thomas Kean. Honorary Chairperson lohn Slade. M.D.. Chairperson Carol Scott. Vice Chairperson Carlton Anderson Regina Carlson John Craig Iolanda Gagliotti Richard Gardiner Shirley Greene, M.Ed. Norman Hymowitz, Ph.D. Daniel Jordan Maureen Lopes Richard Lloyd David Rataiack. M.P.H. Lee Reichman. M.D. Carolyn Turner. R.N. Richard Van Hassel Richard Watson, M.D. Elizabeth Wilson. R N.. Ed D. Medical Society of New Jersey New Jersey School Boards Association The Prudential Insurance Company New Jersey Group Against Smoking Pollution American- Association of Retired Persons New Jersey Congress of Parents and Teachers New Jersey Department of Treasury New Jersey Interagency Council on Smoking OR Health American Heart Association New Jersey Health Officers Association New Jersey Business and Industry Association Blue Cross & Blue Shield of New Jersey New Jersey Chapter of the Society for Public Health Education University of Medicine and Dentistry of New Jersey New Jersey Department of Education New Jersey Hospital Association Johnson & Johnson N6-w Jersey State Nurses Association For copies of this report please contact. New Jersey Departrnent of Health. Smoking and Tobacco Use Control Program EN 360 Trenton. New Jersey 08625 609-588-7470 c

EXECUTtVE SUMMAR e The Commission on Smoking OR Health was•appointed by the Department of Health in 1985 to advise it on strategies to deal with the problems created by tobacco, use in New lersey. The Commission has identified three major areas for action: U. Preventing tobacco use in children. 2. Protecting nonsmokers from involuntary smoking 3. Encouraging and enabling smokers to quit. This report deals with the second of these areas, protecting nonsmokers. (ln November..1,987 the Commission issued its first report, Preveiiling Tobacco Dependence in New Jersey Ckildren.l. FINDINGS 1. Knowledge about tobacco smoke pollution has advanced greatly•since 198.1 and t985;when the existing New Jersey laws were enacted: 2. Tobacco smoke pollution is a cause of disease. including lung cancer and heart disease. in nonsmokers. Involuntary smoking is especially hazardous for children. In the United States as many as 46.000 people dieannually from tobacco smoke pollution. The death toil'in New )ersey may be as high as 1,400 per year. 3. Separation of smoking and nonsmoking areas does not eliminate the hazards if the areas share a common ventilation system. 4. New Jersey's current laws are grossly inadequate and extraordinarily ambiguous. Tihey do not protect the public health, 5. The public feels betrayed by this lack of protection. The laws created expectations. but did not fulfill them. 6. Resources for implementation of the laws within, the Department of Health, are almost nonexistent. 7. Within the constraihts of its resources. the Department of Health has displayed a commitment and: leadership in protecting the rights of all New Jersey citizens to breathe clean air. RECOMMENDATIONS Current laws should be amended. new laws shoulld be passed, and non-legislative changes should be made by governmental- bodies to ensure the following: 1. Places where children are present, health care facilities. educational institutions, and government facilities and functions should be entirely smokefree. 2. Most privately owned places where people must go - workpla.:es, restaurants, stores - should be smokefree in- all areas people must use. but owners may provide enclosed, separately ventilated smoking-permitted areas. 3. If casinos. bars and nightclubs permit smoking, signs warning of tobacco smoke pollution hazards should be required 4. The Department of Health should set standards for maximum levels of, tobacco smoke pollution which are alaovred to pass between residential units in apartment houses arad other multiple-unit residences. 5. The Department•of Health,should award grants and: contracts for pubiic health related services only to recipients with smokefree premises. 6. The legislature should appropriate funding for implementation of clean indoor air laws and for an Office on Smoking OR Health within the Department of Health 1

BACKGRO4JND The Commission on Smoking OR Health- of the New lersey State Department of Health helkf a public forum on New Jersey's clean indoorair lhws f,Nov. 28..1988, Hughes (ustice Complex. Trenton I. The Commission heard a full day's comments on the existing laws and on the health hazards of tobacco smoke pollution. Oral testimony was presented. by more than 25 individuals. including Dr. Coye. the State Commissioner of Nealth..organizational. representatiues, scientists. physicians. teachers. businesspeople and members of the general public. More than 50 letters were received from people unable to attend the hearing. The forum constitutes part of the Health Department s investigation fora report to the legislature on the effectiveness of the laws. The Department has also commissioned scientific studies of the laws; the preliminary results of those studies were presented at the hearing. Additionally, Department staff have compiled a report on requests for information and on complaints received about the laws. and that information was presented at the hearing. FINDINGS 1. The Existing Laws "In my prepared text 1 was going to say the present legislation has served as an excelle nt start..l5ut, frankly. it is extraordinarily weak and ineffectave:' said' Molly Joel Coye. M D.. M.P H. The State Commissioner of Health was the first speaker. but throughout the day other presenters were. unanimously, in agreement with her that the existing laws are: . • inadequate • ambiguous • unimplemented • and unenforced. Regina Carlson. Executive Director of the New Jersey Group Against Smoking Pollution IGASPI. testified that GASP receives as many as 1.000 complaints per year about problems with the existing laws. Carison reported thatcitizens complained most often about the workplace and restaurant laws. but added that recently schools and nursing homes are also the sublect of a growing number of complaints. Patti Van Metre, speaking on behalf of the Respiratory Health Association. Pararnus. reported that their organization gets many complaints, most of them focusing on the workplaceand restaurant laws. Similar reports were offered by the American Lung Association of New Jersey and the American Cancer Society, New Jersey Division. One of'the last speakers of the day. Scott Goldman. of Livingston, was direct and dramatic: "So• what is this businessperson"s opinion of the present state of laws in New Jersey on clean indoorair? Horrible. Awful. Abysmal: Shameful. In New Jersey. forall practical purposes, there are no meaningful protections from the smoke of others:' Despairing about the restaurant law, he said. "_ .. you don't have to do a damn thing if you post a sign that says you didn't. If this isto be our policy toward public health, then I propose this sign: This restaurantdoes notwash itsdishes. and our employees do not wash their hand's. as provided by law." Mr. Goldman thereby articulated a recurring refrain. that citizens believed the passage of the laws promised them protection, so they were doubly disap- pointed by the lack of protection. A number of organizational representatives and'individuals described how nonsmoking citizens feel ignored..insulted: even disenfranchised. by lack of protection Janet Neufeld. a school nurse from southern New Jersey. said. ".. the tyranny of the minority is at work when as few as five people control the literal,aomosptiere and hold hostage a building with-more than 600 adults and children. ' i~ Alice Baranik. Vernon Tbwnship. described how secondhand smoke makes her a second-class ~ citizen: "I am not a free person. I have difficulty going to shopping malls and have to'hold my breath' ~ a great deal of the time. btany umes 1 cannot go into a restroom because people are smoking or have ~ beensmoking,'"WiiliamClark..DirectorofRespiratoryCare BayonneHospital speaking on behalf ofi the New Ilersey Society of the American Association for Respiratory Care. explained. " over 68 ~ million people suffered from chronic respiratory problems and 181 million people suffered from ~ acute respiratory problems . Is the t!egislature condoning the disenfranchising of people who yQ suffer from respiratory ailments by allowing the smoker to dictate where a person can eat. work, or~ ~i enjoy leisure activities?" hMore specific find ings about ihd ividual laws. with-representative citizen comments. are included in the Recommendations sectioml 2

it. Tobacco Smoke Poi ion "The number of cancer deaths from passive smoking is estimated:to-be 100 times as large as It}ie number of d'eaths froml all the other hazardous pollutants we now-regulate " Thus hmes Repace made clear the magnitude of tobacco smoke pollution and: the inconsistency in our society's response to this pollutant. compared to other toxic substances in the air. Mr. Repace is a physicist in the Indoor Air Program of ttie Environmental Protection Agency and has studied tobacco smoke pollution since 11976 He and fiiscoileague. Alfred Lowrey. are internationally recognized:as leading researchers in the field Mr. Repace and other witnesses described the hazards of tobacco smoke pollution. The Commission also• had access to the 1986 Surgeon General's Report. The Health Consequrnces of Involuntary Sntoking. and the 1986 report of the National Academy of Sciences, Environntentaf'Tobacco Smoke. Neither report had been published when the existing laws were passed. Therefore. in the words of Palma E. Formica, M.D., President of the Medical Society of New )ersey, in her letter to the Commission, "The present laws were written, and passed at a time when the data were less persuasive than they are today that tobacco smoke is a serious pollution problem." Based on worldwide scientific evidence. it is established that tobacco smoke pollution isa cause of disease, including lung cancer, in healthy nonsmokers. Simple separation of smoking from nonsmoking areas does not eliminate these hazards, so long as those areas share the same ventilation system. Indeed. Mr. Repace testified that ventilation rates would have to be increased 250 times to eliminate the risk. This, of course, is technologicaily•infeasible and would turn,indoorr spaces into wind'tunnels. Tobacco smoke pollution is a particular risk for children because they inhale two to three times more pollutant per pound of body weight than adults. Tobacco smoke contains 4.000-chemicais. 50 of them known carcinogens. Recent evidence links tobacco smoke to heart disease in-nonsmokers. Tobacco smoke is also synergistic with other pollutants. Smoking also results in 1.500 fire fatalities and 3.400 persons injured in fires in the United States each year. In New Jersey it can be estimated that 45 people a year will die in smoking-related fires. and that more than tU0 people will be injured in fires caused by smoking. Risk analyses place the total death toll among American nonsmokers from tobacco smoke pollution at 16.000 per year. New )ersey's share of this toll would be approximately 1.400 people. In addition to internationally recognized scientists. New Jersey physicians and health leaders, the other experts who testifie6about the health effects of secondhand smoke were ordinary citizens. Employees. teachers. dining patrons. and other New Jersey citizens described being made uncomfoRable. ill. or unsafe at work, in schools. in restaurants. and in other public places in New )ersey. Gloria Liberstein. Paramus. was quite clear: "It causes me to gag and inflames my sinuses: " G loria and Alfred Gary. Bordentown, wrote. "As senior citizens. we are particularly prone to upper respiratory iilness, which makes us more uncomfortable being around smoke at anytime Surely, with the growingg population in our age bracket, some consideration should be shown for our health :" Chilldren. too, understood the problem. School' nurse Janet NI'ufefd quoted fourth-grade student Brian Warner: "People can get sick from smoke and you could make other people sick also." In another school. wrote Deborah-Hubes of Oldwick. a teacher insisting on a"right to smoke" smokes in a workroom where volatile chemicals are stored. Marc Liebeskind. Bayonne, wrote. "I have to work for a living I d'on,t see why I am less entitled:to clean airand must be forced to breathe someone's cigarette smoke because I1work foran employer who has less than 50 employees. ... my mucus membranes and eyes become inflamed. causing dryness in the nasal passages which can then result'sn bleeding, excessive phl'egm production and causes me to become very tired. Additionaily. I hate the smell and resent having to wash, and dry-clean my clothes and ta ke an extra shower because of the lingeri ng cigarette smoke I also resent having to function at an impaired level because the legislation does not go far enough- 4,%oman where hwork is a nonsmokerand is pregnant She is concerned about the effect the smoke will ha~e on her babv She recentl~ ti%entt to her doctor .~ho after e\am,niny her, asked her if she smoked because her throat was infiamed: The inflammation came from the smoke in the office ...' Severall speakers commented on the inconsistency of pollution controll in New )ersey Linda Benjamin. a health educator in Middlesex County, asked. "is it fair that people who do not'smoke are exposed to chemical5. indoors. that we have outlawed outdoors?" liudith Shelton. a high school ;,.

counselor, described the .,urous efforts her schooli system. is m.. .ig to eliminate asbestos exposure and! wondered why herdistrict did so little to protect her from tobacco smoke pollution, Teri Manes. speaking on behalf of the New lersey Society of Public Health, Educators. explained that health education theory encourages social change as a way to eliminate hea Itfi problems •'If we do not strengthen our llegislationl .e we are polluting our children's air and their minds. as well." Additional effects of tobacco smoke pollution in New Jersey are unemployment and d•ecreased business. Mrs. Baranik is a registered nurse and a licensed real estate agent, but she testified she doesn't know where she can work in New Jersey and be safe. Other citizens gave similar reports. Of course, our state (as well as individualicitizensf suffers financially•when willing people cannot work. Numerous people testified bhey avoid New Jersey restaurants because of smoke. Richard Gardner. M.D.. of Cresskill, declared the restaurant law-a " 100 percent farce;' especially compared:to laws in other states. James Katz, Ph.D., Morristown. wrote. "... I would be spending over 51,500 annually in North Jersey restaurants if there were ones with good nonsmoking areas available. As it is. I'm forced to drive to New York City..which does require nonsmokingi areas, and spend my money there." lane Blackman. of Bridgewater, wrote, "Many people like myself... find ourselves forced to go out to•eat mostweekends in NewYork City, which, itappears,cares moreaboutthe health of itscitizens:' Scott Goldman said."When I go out to eat. I take my business associates, my guests. and my family to New York because there, unlike New Jersey, we can dine in separate. comfortable. smoke-free restaurant seating." 41 CONCLUSIONS The existing laws do notguaranteeclean indoorair in New Jersey. New lerseycitizens are suffering discomfort and•disease from involuntary smoking while evidence continues to accumulhte on•the magnitude of the health hazard. Many citizens feel confused and even cynical, and believe that there has been an insulting lack of concern for theirwetlbeing, and are disappointed thata promise made to them•has been broken. RECOMMENDATIONS Recommendations are made for amendments to existing laws, for new laws, and for non-legislative changes by government bodies. The recommendations rest on three premises: First, there should be. in the words of Dr. Coye. "zero tolerance for secondhand smoke" incertain public places. Places where children are present, educational institutions, and health care facilities should be entirely smokefree. Smokefree means there is no smoking or tobacco smoke pollution. Other places where there should be zero tolerance are government facilities and functions. Unpolluted air should be the standard in government facilities because government must maintain a high level of citizen protection and a high level of accessibility to citizens. Testifying before the Commission. Dr. Lawrence Meinert of the Health Department. said "... a completely smokefree environment is the only type of acceptable environment that protects the health, welfare and comfort...." Furthermore, it is inappropriate to use public money to enable addictive behavior. Second. privately owned public places where citizens must go fworkplaces. retail stores. restaurantsl should be smokefree in all areas people must use, but proprietors should be free to create smoking areas if they wish, provided that pollution from smoke does not enter the common ventilation system. Third. certain public places, such as casinos. bars, nightclubs, should be encouraged to provide clean indoor air, not required to do so by law This exception is made for two reasons. Nonsmokers need not frequent these public places. (An exception. of course. is nonsmoking employees ) Furthermore. there is a social reality that sites for gambling and alcohol consumption also-have a high incidence of smoking. Increased ventilation is recommended for, these sites. to reduce the health hazards and to promote user comfort. However, with great sociaf'change taking place about smoking, certainly there will come a time when this exception will no lbnger be acceptable. For the present,•signs warning of the tobacco smoke pollution hazard's should be posted in such places. a-

f. Amendments to exist...g laws (. Funding is needed if these laws are to be effective. There is a need for public ed'ucation on the lhws, for training for agencies and individuatk with enforcement responsibillties. and (orthe treatment of nicotine dependence. Health Department staff reported they are responsible for 145.000 locations. including 30;000 restaurants., but have zero budget. The Commassion recommends the Assembly fund an Office on SmokingOR Health in the New Jersey Department of Health. im ? 2. Most of the laws contain a preamble which has several inaccuracies. The preamble posits a "eight" to smoke although neither the Constitution, norcase law; nor legislation supports such a right. The preamble declares the state has no policy to deny anyone the right to smoke. but. clearly, the State does wish to stop children from smoking. Finally, the preamble states that tobacco smoke is asubstantial, health hazard to a'"smalf segment" of the nonsmoking public. when current data indicate that it is toxic to all. All these inaccuracies could be eliminated with thisversion of the preamble:'"The Legislature finds and declares that in addition to the deleterious effects upon smokers, tobacco smoke is a substantial health hazard to the nonsmoking majority. Therefore..:' 3. Combining all the existing laws into one clean indoor air code is recommended. This would be simpler and would create uniform control of the hazardous substance. with little variation by site. This is how the State usually controls pollution problems. for instance, sewage. 4. The private workplaces law, P.L 1985. C. 184 A. Smoking should be eliminated from all work areas and common areas which employees must use. Steve Rome. who works at Educational Testing Services,.d'escribed how he is exposed to tobacco smoke pollution atwork, even though,his employer is in compliance with the law. ln fact, Janice Marshall. of the Department of Health,, reported'that an employer can be in compliance with the iaw merely by designating any area nonsmoking. even the end' of a halfway or one bathroom. B. Smoking-permitted areas need not be provided. If they are, they should be outdoors or in separately ventilated indoor areas. C. All private employers in New lersey should be covered by the law. Alice Leavy. of Towaco. was one of a number of people who work in such uncovered sites and wrote. asking for help. Testifying before the Commission, Dr. Eugene Lewitt. UMDN}. who studied the law's implementation forthe Departrnent. estimated that one-third to one-half of all employees in New Jersey work for employers of fewer than 50 people, and so are not protected,by the law. D. The law must say "establish and implement" nonsmoking policies. instead of merely "establish: " E. There should be protection against retaliation for employees who seek enforcement of this law, as there is in thecase of other occupational health protections. Tobacco smoke pollution in the worksite is a hazardous working condition. F. The immunity from employee lawsuits given to employers should be eliminated. G. Enforcement should be through citation by state or local health departments f enalties should be fines in local-court. As with other public health nuisances. the fine should be S25-$200 per violation, per day, with higher penalties for repeated offenses. 5. Restaurants..PL 11985 C. 185. The bitterest, citizen complaints were evoked by the restaurant law and restaurant industry noncompliance. THis is not surprising. Dr Lewitt reported that bb o of surveyed resoaurants have of not complied with the minimum standard of the law, posting signs, and more than 86%f surveyed fail to provide nonsmoking dining areas In response to Dr. Lewitt's report. Dr. Lee Reichman. Commission rnember..said. "... I think that's horrendous and appalling "' -5-

A number of corre ndents agreed with Dr. Reichman . and taur;e Legnante of Monroeville. wrote. "Please DO,NOT let the tobacco/restaurant industry take liberties with our lives. We live in an era where tobacco and second-hand smoke have been prot•clt harmful." Alan E. Kligerman. President of Lactaid. Inc. in Pleasantville, wrote. "A restaurant operator has no more right to serve up noxious air than he; she has to serve up polluted water or food'" Dr Katz, of, Morristown: noted an• inconsistency in state policy: "Although it is at, times inconvenient for restaurant owners. we do require that their kitchens and premises be sanitary. We even pay inspectors to go around and check up on them. Why? To protect the health of tffe public But for some reason the same rationale is not applied in terms of harmful fumes in restaurants that are generated-by smokers." Several writers suggested a stronger Il3w would "get the restaurants off the hook" with,the state's assuming the authority for the decision. And Doris Woolf..of Pine Brook, describing a meal ruined by smoke. reported. "The waitress confided that she, too, hated the exposure, but she was forced to breathe the befouled air or leave her job!" A. Nonsmoking should:be the law in restaurants except that smoking-permitted areas would be allowed if they were physically separate and on separate ventilation systems. B. The person in charge oEthe restaurant must be required to tell a person who is smoking in a nonsmoking area to stop smoking. C. There should' be better enforcement and' a stronger penalty. Enforcement could be incorporated into Chapter 12•of the State Sanitary Code. D. The preemption.of stronger Ibcal laws should be eliminated: 6. Educational Institutions. P.L 1481. C. 320 Citizens who cited problems in schools included students, teachers. staff. ad'ministrators. board members, and. parents. The primary concern was tobacco smoke pollution and how it harmed students and teachers. A graphic example came from the Bridgewater- Raritan school district. Enid Bloch. Ph.D., member of the Board of Education, told this story: ".. - a teacher had been demonstrating levels of carbon monoxide in-the lungs. Breathing into the machine, the teacher showed the class that his own level was zero, because he was 'a nonsmoker and an avid joggec' He asked.a secretary. who was a smoker, to take the test also: andher readingwas 15 to 18 on the meter. The teacher attempted to repeat the experiment in his third-period class, telling the class,' Now you'll see the perfect lungs of a jogger, a track coach-and a nonsmoker' But to his great embarrassment. his own readingd now stood at 6 or 7. What had happened is that.this teacher had: spent the second period of the school day in the teachers' lounge:' Concern about compromised educational goals was expressed by Linda Benjamin: "Would we allow cocaine lounges in schools?" Her concern was shared by school nurse (anet Neufeld: Mrs. Neufeld asked. "Hbw can the school nurse, teacher or other adult truthful ly a nswer the chi ld who asks:'Vdhy is my teacher telling me it's bad for my health and yet it's okay foryou to smoke?':' Donald Merachnik. Ph.D... Superintendent. Union County Regional High School District. and Enid Bloch. Bridgewater-Raritan School District, testified' how ambiguity in the current law has forced their school boards.. which want to create smokefree schools, to defend their actions before the Public Employment Relations Commission. Both school distnctsare currently unable to implement their new policies_ A. All educational institutions, from preschools through professional educational institutions, should be smokefree in, all educational and administrative facilities. B. Residentiallfacilities in educational institutions where the stud'ents are adults may establish smoking-permitted areas. so long as the tobacco smoke does not-enter the common ventila- tion s«tem Note: Some educational institutions are extending their nonsmoking policy to includ'e the out- doors. The Commission endorses that decision for~ educational reasons and for consistency 6-

'M. 7. Health Care Facilities a. - Offices. PL 199 1. C. 319. A. Allisites should be h00% srnokefree!' B. Nursing homes should be included. Nursing homes that are primary health care factlities should be entirely smokefree. Nursing homes that are matnly residential facilities rather than health care facilities may establish smoking-permitted areas, so long as the tobacco smoke does not enter the common ventilation system. C. c-entists, chiropractors and psvchotherapists should!be inciud`ed in the law 8. Government Buildings. P.L 1985, C. 381 loan Gelber. a deputy attorney general. working for the State Department of~ Law and Public Safety. Professional Boards Section in Newark, wrote to the Commission, including copies of her correspondence attempting to have herworkplace free of the health hazards and discomforts of tobacco smoke po llution. Many other state and lbcal government faci lities are not in com pliance with the law. A. All' government facilities, local and state. and all government functions held in non- government sites should be entirely nonsmoking. One exception could be ailowed: government-owned residential facilities where the residents are all adults could create smoking-permitted areas for the resident if the tobacco smoke pollution is confined to• those areas. Nbte: Government institutions are often reqffired to meethigherstandards than other segments of society. but given fewer resources to meet those standards. Toprevent this problem..the Commission recommends funding to help government entities create smokefree conditions. This funding should includ'e resources to treat nicotine dependence in affected employee groups. 9. Retail food stores. P.L 1985. C. 186 Beatrice Chambers, of Summit, wrote in dismay about smoking in the Welsh Farms store where she shops "because my husband likes Welsh Farms milk and that store has the freshest tnilk:' She would-iike to have the law applied to small stores, especially since, in the convenience store she uses, sandwiches are also prepared. A. All stores, regardless of size, should be nonsmoking in all areas, except that management may-create a private. separately ventilated, smoking-permitted area for employees. B. Management must be required to tell customers who smoke in violation of the Itaw to stop smoking. C. Enforcement could be incorporated into Chapter 12 of the State Sanitary Code. 10. Indoor Public Places, P.L 1985, C. 318 A. In all structurally enclosed areas generally accessible to the publ ic. the authority in contro l of the public place shall designateas nonsmokingall areas which people must use to conduct business or participate in the activities of the place. B. Smoking-permitted areas may becreated, but only•if the areas are separately venti lated and not areas people must use to participate in the intended- purposes of the public place. C. Specifically named public places shall inclltde department stores. all other retail stores except tobacco stores, malls, banks, savings and loan institutions. churches, synagogues, other places of religious assembly, retail optical outlets. gymnasiums. and ltiundromats The current exceptions and inclusions shall be retalned. Current efforts to create smokefree health,care facilities often incorporate a lim,ted etcepuon,whrch permits smokrng b% npatrents und'er certa n circumstances Generallv. such e.ceptions require the concurrence ot medical and nursing personnel and may only be considered in certain s tuatrons for instance in the case ohconfused or terminally i1/ patients The CommrsSron acknouledges the appropriateness of these limited exceptrons in some hospitals at tfi s time In pramce the etception to policy is rarely m.oked:and s functionally nearlv equivalent to the facility s be ng smokefree Rsvchratnc inpatient facilities and inpattent chemical dependencv treatment umts hate been relhu.e{, reluctant :o became smokefree There are no data whrch rndtcate thamhese factl,ttes should be e.empted Gom smokefree oohc+es and there is a grov.,ng number o6e\amnies of psychtatnc and drug treatment facd tres wHich,have suocesslutlh be nme smokeiree .7.

I1. Areas Unprotected by Existing Laws I. All' indoor educational, recreational. and; custodial facilities where children are present. including day care centers. licensed after-schooll facilities.. nursery school. YMCAs. YWCAs. YMHAs. teen centers, places of extracurricular instruction Idance schools. sports schoolsl; and: Police Athletic Leagues. shallibe entirely smokefree. 2. HoLeis and motels shall designate all their common areas, for example lobbies. hallkvays. e«.. as nonsmoking. except for dining areas, which shallibe subject to the restaurant law, and bars and casinos, which should be separately-ventilated and'have warning signs posted. Hotels and motels must set aside a number of guest rooms as nonsmoking, in quantity sufficient to meet the demand. lMore than three-quarters of, the population do not smoke.) Ventilation systems should:be adjusted to keep tobacco smoke pollution from nonsmoking areas. 3. Control of tobacco smoke pollution in apartment houses, condominiums. and other multiplle- unit residences shall, be under the jurisdiction of local health departments. The State Departmentof Health shall set standards for maximum.levels of particulates. carbon monoxide and other components of tobacco smoke pollution: including detectable odor, which shall be allowed to enter one unit from another unit. 4. Any indoor area where smoking is allowed' except for homes and private clubs must post warning signs reading "Warning - Hazardous Area - Tobacco Smoke Pollution:' IIE. Non-legislative Recommendations 1:. Federal institutions and interstate authorities in New lersey. particularly the Port Authority.. shall be asked to adhere to the standards established in New /ersey law. 2. The New lersey Department of Health should award• grants and contracts for public health related services only to recipients with smokefree premises. s.