The adoption of local ordinances regulating the use or sale of
tobacco represents an extraordinary social trend in the United
States. Although such laws were virtually unheard of just a decade
ago, hundreds of cities and counties across this country have taken
aggressive action to control smoking in public settings as well as
making it more difficult for minors to obtain tobacco. Major Local
Tobacco Control Ordinances in the United States provides clear
documentation of the extent to which local com munities are
enacting legislation to restrict or severely curtail tobacco use.
The monograph also represents a social barometer regarding the
seriousness with which communities view the smoking problem and the
range of remedial actions taken to reduce tobacco use through
socially responsible public policies. These ordinances are not
based on social whim, however, but are based on decades of
scientific research, which has increasingly documented the health
consequences of tobacco for users and non-users alike. Since the
early 1960's, medical science has left no doubt about the deadly
nature of tobacco use, especially the practice of cigarette
smoking. The scientific data base establishing a causal connection
between smoking and increased death rates from various cancers,
cardiovascular diseases, chronic obstructive lung diseases, fetal
distress, and other chronic and debilitating conditions is truly
staggering. Between 1960 and 1990, more than 60,000 scientific
citations appeared in the worldwide literature linking cigarettes
and other forms of tobacco use to these adverse health outcomes.
Smoking is a health hazard in its own right, but smoking
potentiates the risks of several environmental and occupational
carcinogens. More than 400,000 premature deaths annually occur in
the United States directly attributed to the effects of cigarette
smoking. Of course, we should recall that even smokeless tobacco is
a health hazard. Such high levels of death and disability affect us
all, however, whether we smoke or not. In a comprehensive study
conducted by the Congress' Office of Technology Assessment in 1985,
it was estimated that cigarette smoking alone cost this Nation
upwards of $95 billion annually. Given the spiraling increase in
costs for both acute and long-term health care over just the last
few years, such costs would be substantially greater in 1993
dollars. As a Nation, we simply cannot afford to pay for the health
care costs associated with smoking. Major Local Tobacco Control
Ordinances in the United States should also provide a tangible
boost for local tobacco control policy development. It contains a
comprehensive review of local and State tobacco control
legislation, trends in tobacco control ordinances, and model laws
for reducing both nonsmokers' exposure to ETS and youth access to
tobacco products. It is, in short, a call to action to all who wish
to improve the health of our Nation through reasonable and prudent
public health policies that reduce tobacco addiction among our
young and protect nonsmokers from the documented hazards of
environmental tobacco smoke. Nevertheless, true prevention of
smoking-related illnesses must depend on individual responsibility
and action. Each of us as individuals must do our part.
General
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