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During Tobacco-Free Awareness Week, community leaders came together to draw attention to a significant problem for St. Louis County - exemptions to the 2011 Clean Air Act. While most St. Louis County business owners support keeping establishments smoke-free, the exemptions allowed under the law have drawn sharp criticism from restaurant and hospitality businesses because it create an uneven playing field. Now, thanks to a new analysis conducted by Tobacco-Free St. Louis, the exemptions are under fire from community leaders, as well. The analysis revealed a large number of exemptions in communities where there is already a high incidence of heart attacks and respiratory diseases. "The rate of exemptions is higher in the districts where health disparities are highest - making a bad health situation worse," said Stuart Slavin, M.D., physician and member of Tobacco-Free St. Louis.

"The Clean Air Act was a positive and necessary first step to creating a less toxic environment for St. Louisans. But we're failing those who need it most." North St. Louis County, defined as County Council Districts 1, 2, and 4, has nearly 40 exemptions - higher rate than other parts of the county. According to the Saint Louis County 2011 Community Health Needs Assessment, residents of North County were more likely to have poor health, less access to healthcare, and lower wages. To make matters worse, a large number of North County residents are also uninsured. Also high is South St. Louis County's Council District 6 with 30 exemptions, many of which are located in pockets where health disparities also occur. "Where people are most vulnerable in our community is where they are most likely to be exposed to secondhand smoke and poisonous air," said Rance Thomas, president of North County Churches Uniting for Racial Harmony and Justice.

"These exemptions were put in place to accommodate certain businesses, but that shouldn't come at the expense of public well-being." Many St. Louis County business owners argue that the exemptions actually hurt area businesses. In 2011, 145 locations across the county received exemptions. Exemptions were granted to casinos and bars that generate the majority of their income from the sale of alcohol instead of food. "I was in favor of the Clean Air Act," said Derek Deaver, owner of Three Kings Public House in University City. "Like most people in St. Louis, I actually prefer restaurants smoke-free. But to have some establishments playing by one set of rules and others by a different set of rules has created confusion, and an unlevel playing field.

The exemptions have to go." Among the most impacted are employees of the exempted locations. St. Louis-area resident and employee of American Heart Association, Buffy McKinney lost her nonsmoking mother to lung cancer after she worked for years in a Las Vegas casino where smoking was allowed. "It's more than unfair that thousands of area bar and casino workers are still exposed to toxic chemicals at work. It's immoral," McKinney said. "In this economy, good jobs are hard to come by. My mom had a good job, but it left her with no choice than to breathe in the smoke-filled air around her - and that took her life." Leaders said it is up to citizens to ask their friends, neighbors and relatives to encourage their St. Louis County Council members to remove the exemptions.

Secondhand smoke won't bother Housing Authority of the City of Freeport residents anymore. All HACF property and units are proposed to become smoke-free, effective June 1. Smokers will be required not to smoke in their apartments or the buildings and to be at least 15 feet from HACF entrances. HACF's board of directors unanimously approved the smoke-free policy in November to be added in the proposed modifications to the Lease, HACF Executive Director Larry Williams said. Survey responses and encouragement from the U.S. Department of Housing and Urban Development (HUD) prompted the move. HUD issued a July 2009 directive, urging housing authorities to adopt a smoke-free policy, citing a 2006 U.S. Surgeon General report. Secondhand smoke, according to the report, kills 50,000 non-smokers in the United States annually. In 2005, there were 32 housing authorities with smoking bans in effect.

It's estimated, by the end of 2011, there were 285—or 9 percent of housing authorities—with smoking bans, according to the Smoke-Free Environments Law Project director, who was quoted in a Dec. 17, 2011 New York Times story. Of the 1 in 4 HACF households that responded, 35 percent of all respondents championed a "strong need" for a smoke-free policy. An additional 23 percent of those responding felt there was a "strong need" for some type of policy, while 14 percent believed no new policy was necessary. With that said, more than 40 percent of respondents supported adding the policy to HACF's lease agreement. Surveys were mailed to all residents on July 13. HACF held resident meetings June 6 through 8, in order to educate residents about and encourage them to fill out the surveys, and again last week, to discuss the proposed policy.

A new state report found that sales in bars that serve food declined in the first year of Michigan's smoking ban, but doesn't shed light on whether more people are smoking and drinking at home, state Department of Treasury officials said. The department's report, issued in December, was based on sales-tax revenue and actual sales in bars, restaurants, nightclubs and hotel dining rooms, and is not intended to be a full barometer of whether the ban is hampering businesses. The ban was signed into law by former Gov. Jennifer Granholm in December 2009, and took effect May 1, 2010. Liquor sales inside establishments dipped 3.2 percent the year following the ban, but increased by the same percentage outside places of business, according to the report. Meanwhile, cigarette sales declined 6.4 percent, compared to a 3.9 percent decline the year before the ban took effect.

The report attributed the corresponding decline in liquor sales in establishments to patrons who once liked to drink and smoke simultaneously. In other words, people likely spent less time and money at bars because they couldn't smoke inside, the report says. "It seems likely that the smoking ban reduced the opportunity for cigarette smoking and, as a result, reduced taxable cigarette sales," the report says. Club Keno and Pull Tab sales declined 13.6 percent in the year after the ban took effect, compared to a 0.7 percent decline in Club game sales the year before the ban took effect. It's too early to know if money that would otherwise have been spent on liquor, cigarettes and lottery games in bars was instead spent in stores where those items can be purchased, said Terry Stanton, state Department of Treasury spokesman. The state is unable to determine if there was simply a shift in sales tax collection of where the items were purchased, as opposed to a net lost in tax revenue, Stanton added. "We do not have the information necessary to infer where the money that would have been spent on those items absent the ban was actually spent," Stanton said. Only bars with that serve food showed declining beverage, cigarette and state lottery ticket sales in the first year of the ban based on sales tax figures, the report says.

The report says bars that serve liquor and food produced 2.76 percent less sales tax revenue and bars that serve beer and wine only with food produced 3.71 percent less sales tax revenue in the ban's first year. The other reported categories, including hotels, night clubs and restaurants, reported sales tax collection increases in the ban's first year. About half of all sales tax collections from eating and drinking establishment tax revenue come from family restaurants, which showed a 4.15 percent increase in tax revenue in the ban's first year. "The ban doesn't appear to have affected restaurants in a material way," Stanton said. Hotel dining rooms saw a 10.13 percent increase in tax revenue during that time. Those figures could suggest that the smoking ban not only didn't deter business to family restaurants and hotel dining rooms, but also brought back customers who previously avoided those establishments where smoking was once allowed. Statewide sales tax collections from eating and drinking establishments were up 2.64 percent in the first year of the smoking ban, compared to a decrease of 1.33 percent the year before.

Those positive figures indicate the smoking ban isn't hindering business where smoking was once allowed, said Amanda Bosherz, spokeswoman for the American Cancer Society. Bosherz cited a study that says there was a 93 percent reduction in the amount of dangerous-particulate matter in 77 tested Michigan restaurants that once allowed smoking. The Michigan Department of Community Health study, released in October, says that 85 percent of those establishments registered poor to dangerous air quality prior to the ban's passage. The clear air is also proving to be a big plus for business, as seen in the treasury report, she added. "We definitely think that that has helped the increase because more people can breathe freely in these establishments," Bosherz said. While there are vocal opponents to the ban, "a majority of Michiganders have been in support of it as well and are enjoying it," she added. The mostly positive year-to-year figures may be more directly related to an uptick in the state economy during the one-year period, during which Michiganders may have had more expendable income, however, Stanton said. Statewide tax collections in the first year of the ban were up 6.39 percent, however, which suggests Michiganders were buying more things that year.

The report notes a study done in more stable economic times will produce more reliable results. Exceptions to the ban are granted in the law for casinos, cigar bars, tobacco specialty stores, home offices and motor vehicles. While smoking is allowed on casino gaming floors, it is banned in bars and restaurants within casinos. The law doesn't apply to American Indian-run casinos. Smoking is banned in outdoor areas if food and drink are served there. Private clubs, such as American Legion halls that require dues, were not exempted from the ban.