Tobacco use continues to be the leading preventable cause of disease and premature death in the U.S. As such, there are many targeted efforts at the local, state and federal levels to not only educate consumers about the health risks related to tobacco use, but ban its use in public places. The new Million HeartsTM initiative, in which the ACC is a partner, lists smoking cessation as key element in reducing one million heart attacks and strokes over the next five years. Just this last week the ACC and its CardioSmartTM National Care Initiative took part in the American Cancer Society’s Great American Smokeout campaign.

At the state level, great strides have been made to enact smoke-free legislation. In fact, in my home state of Mississippi we are making headway in reaching our goal of passing a statewide smoke-free law. The Mississippi State Department of Health is undertaking a major project funded by the Centers for Disease Control and Prevention called “Smoke-Free Air Mississippi.” As a board member of the State Board of Health, I had the privilege a few weeks ago of working with the health department and State Health Officer, Dr. Mary Currier, in presenting information on the success of this project. Even though the state as a whole is not yet smoke-free, most of the major Mississippi communities are smoke-free. In fact, 80 percent of Mississippi adults and more than 50 percent of Mississippi smoking adults favor a law prohibiting smoking in most public places.

I personally like some of the slogans from the campaign: "Every child deserves to breathe smoke-free air;" "Breathing smoke is not on any job description;" "Breathing is not optional—smoking is.” Communities with casinos have been hard nuts to crack, and the restaurant industry was initially a main opponent to the project, but once several prominent restaurateurs invoked no smoking rules in their restaurants, they actually saw their business improve. This was especially true for family-focused restaurants. Now many restaurants are strong supporters of ordinances in their community, as well as the goal of a statewide smoke-free law.

Do smoke-free laws improve health? Surely they do, and the data are impressive.  A study from Mississippi State University involving three hospitals, including my own, showed that during the 900 to 1,000 days following implementation of the smoke-free ordinance, there was a 27 percent reduction in one community and a 14 percent reduction in another in heart attack admissions. To me this is incredible information since it even shows the short-term effects of active and passive smoking.

Currently, there are twenty-nine states, DC, Puerto Rico and the U.S. Virgin Islands, plus numerous cities and counties that have enacted smoke-free laws. The National Conference of State Legislatures, of which the ACC is a Foundation Member, has compiled a map (current to November 2010) of states that have indoor smoke-free laws. This is a key issue that the ACC State Advocacy team follows, and they will continue to work with ACC members and stakeholders to pass laws that support smoke-free environments.

I congratulate all of the states and communities that have enacted smoke-free laws, and I have hope that one day it will become the law of the land!

As the recent Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease recommend, “[e]very tobacco user should be advised at every visit to quit.” The single most important thing that clinicians can do is to encourage patients to stop smoking. CardioSmart has several useful resources available online for patients looking to quit, and is supporting the National Cancer Institute’s SmokefreeTXT program, geared toward teens and young adult smokers.