10 YEARS AFTER THE CLEAN INDOOR AIR ACT:INDOOR PUBLIC PLACES PROTECTED FROM TOXIC SECONDHAND SMOKE

"Smoking or non-smoking?"

Restaurants and other public indoor places no longer need to ask that question, since the Nov. 27, 2002 implementation of Delaware's Clean Indoor Air Act (CIAA). Ten years later, the law remains untouched, respected by health-conscious Delawareans and visitors, and inspirational to some local governments and out-of-state jurisdictions.

Delaware was the second state, after California, to pass a law against smoking in indoor workplaces and public places. Sen. David McBride and Sen. Patricia Blevins, along with Representative Deborah Hudson and many others, sponsored Senate Bill 99, which amended Title 16 of the Delaware Code relating to the Clean Indoor Air Act. Former Governor Ruth Ann Minner signed SB 99 on May 31, 2002, and it became effective six months later. The law banned indoor smoking at workplaces, healthcare facilities, public and non-public schools, restaurants, bars, libraries, museums, theaters, auditoriums, casinos, and 75 percent of hotel rooms.

"The Clean Indoor Air Act reduces our exposure to secondhand smoke, discourages the social acceptance of tobacco, and leads to less tobacco-related disease and deaths," said Lt. Governor Matt Denn. "I hope that more and more Delawareans will recognize the dangers of smoking and make a real effort to quit."

"Improving the quality of life for Delaware's citizens by promoting healthy people in healthy communities is one of our Department's core missions," said Rita Landgraf, secretary of the Department of Health and Social Services. "The public indoor smoking ban has led to many positive health benefits. Today, we have fewer people smoking, fewer children and adults taking up smoking, and, most importantly, many lives being extended and saved. A national study, released just last month, found that in the 33 states and territories with smoke-free laws there was a significant reduction in hospitalizations for heart attacks and strokes."

"It was an honor for me to work on the Clean Indoor Air Act campaign in 2002," said Deb Brown, president and CEO of the American Lung Association of the Mid-Atlantic. "Ten years ago, dealing with tobacco smoke was just part of the cost of working in the service industry here in Delaware. Restaurant servers would go home after their shifts with burning eyes, coughing and reeking of cigarette smoke. And then there were those of us relegated to the non-smoking sections of our favorite restaurants, dealing with endless whiffs of secondhand smoke. Thankfully, a group of public health advocates teamed up with concerned citizens and lawmakers to improve workplace health for all Delawareans. Common sense won out and Delaware stepped into a leadership role in the nationwide battle for clean indoor air."

Babies whose mothers were around secondhand smoke during pregnancy are more likely to have lower birth weights, and children who breathe secondhand smoke are more likely to have lung problems, ear infections and severe asthma. Smoking costs the state of Delaware more than $1 billion annually, according to the 2011 Plan for a Tobacco-free Delaware issued by the IMPACT Delaware Tobacco Prevention Coalition.

"The Clean Indoor Air Act was a groundbreaking step toward reducing Delawareans' exposure to smoking," said Congressman Carney, a member of the Delaware Cancer Consortium. "We know that some of the most deadly chronic diseases, including cancer and heart disease, are directly related to smoking and being around those who smoke. The smoking ban helps Delawareans lead healthier lifestyles, and ensures that they can go to work, or visit a restaurant, theatre, or museum without putting their health at risk. I'm proud to have played a part in passing the Clean Indoor Air Act and pleased to live in and represent a state that values the health of its residents enough to enact such legislation."

"Our goal was to promote healthy indoor environments where Delawareans would not be exposed to secondhand smoke and its cancer-causing agents, tar and toxins," said Dr. Karyl Rattay, DPH director. "Breathing secondhand smoke or smoking causes heart disease and increases the risk of cancers of the lung, bladder and pancreas. Heart disease and lung cancer are leading causes of death among Americans."

The CIAA law is credited with helping smoking levels among Delaware's youth fall to all-time lows, according to the Department of Education's Youth Risk Behavior Survey. Among Delaware high school students who regularly smoked at least 20 days in the past month, the smoking rate decreased by 57 percent between 1999 (17.7 percent) and 2011 (7.6 percent). Among students who smoked one or more days in the past month, the smoking rate decreased by 43 percent, from 32.2 percent in 1999 to 18.3 percent in 2011.

Cigarette smoking among Delaware adults also declined, from 23.2 percent in 2000 to 21.7 percent in 2011, according to the Delaware Division of Public Health's Behavioral Risk Factor Survey. However, in the period 2004-2008, the adult cigarette smoking rate was as low as 17.8 percent in 2008.

For Delaware residents 18 years and older who want to quit smoking or stop using smokeless tobacco, DPH offers a free counseling phone service called the Delaware Quitline. Tobacco users can call the Delaware Quitline toll-free at 1-866-409-1858 and speak with English or Spanish-speaking counselors who teach how to beat tobacco cravings. Smokers younger than 18 years can contact the American Lung Association for the Not on Tobacco Use (NOT) program.

The CIAA allows cities and towns to adopt more restrictive indoor no-smoking policies, though ordinances to date have concerned outdoor smoking. In 2011, eight municipalities - Delaware City, Bethany Beach, Dover, Georgetown, Milton, New Castle, Seaford and Smyrna - received AARA grants to establish smoke-free zones. Bethany Beach adopted a smoking ban on its boardwalk and much of its beach in 2008. Lewes Beach and the Rehoboth Boardwalk also became smoke-free.

Since Delaware Health and Social Services declared its state-run facility campuses smoke-free in 2007, all hospitals in Delaware now have smoke-free campuses. Delaware Technical and Community College's campuses became the first smoke-free college campuses in the state. Wilmington University campuses statewide went smoke free on Oct. 29, 2012. Earlier this year in his State of the State address, Gov. Jack Markell announced that all state agency campuses would be smoke free as well.

Complaints about indoor smoking violations should be placed to DPH at this toll-free number: 1-800-297-5926. If a smoking violation is found, DPH assesses an administrative penalty ranging from $100 to $1,000, depending on the frequency of violations.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.