NC Med J May/June 2005, Volume 66, Number 3
Background: Exposure to job-related secondhand smoke represents a significant, but entirely preventable occupational health risk to
non-smoking workers. This article examines trends in smoke-free workplace policies in North Carolina. We also examine whether workers
comply with such policies.
Methods: Data from the Census Bureau’s Current Population Survey were analyzed from 1992 through 2002. Trends for North
Carolina workers are compared with workers nationally, and trends are presented by age, race, gender, and type of worker.
Results: North Carolina ranks 35th in the proportion of its workforce reporting a smoke-free place of employment. The proportion of
workers reporting such a policy doubled between 1992 and 2002. Females were more likely to report a smoke-free work environment (72.0%,
CI +/-2.6) than males (61.2%, CI +/-4.6%). Blue-collar (55.6%, CI +/-5.5) and service workers (61.2%, CI +/-8.4), especially males,
were less likely to report a smoke-free worksite than white-collar workers (73.4%, CI +/-2.6). Compliance with a smoke-free policy does not
appear to be an issue, only 3.2% of workers statewide reported someone had violated their company’s nonsmoking policy.
Conclusion: While some progress has been made in North Carolina to protect workers from secondhand smoke, significant disparities
exist. Smoke-free policies can make a significant difference in reducing exposure to airborne toxins and their associated diseases, and these
protective public health policies have not been shown to reduce business revenues. Much has been done to assure the health and safety of
workers through public health policy. However, opportunities to protect North Carolina workers from the health effects of secondhand
smoke are limited by a preemptive state law.
Key Words: Secondhand smoke, environmental tobacco smoke, occupational status, public health policy, CPS, NCI.
series of authoritative reports have conclusively demonstrated
that exposure to secondhand smoke is a significant health
threat to non-smokers, increasing the risk for lung cancer, coronary
artery disease, asthma and other lung diseases, and Sudden Infant
Death Syndrome.1-5New evidence indicates there are health risks
for even a brief exposure to secondhand smoke for individuals with
preexisting heart disease. In Helena, Montana, a comprehensive
local ordinance that banned smoking in all indoor public places,
including worksites, was associated with a 40% decline in hospital
admissions for acute myocardial infarction during the six months
the ordinance was in effect, only to rebound after the ordinance
was suspended following a legal challenge.6The Helena study
prompted the Centers for Disease Control and Prevention to
review the literature and to issue a commentary on the public
health risks of secondhand smoke, stating, “All patients at risk
of coronary heart disease or with known coronary artery disease
should be advised to avoid all indoor environments that permit
Protecting Workers from Secondhand Smoke
in North Carolina
Marcus Plescia,MD,MPH,Sally Herndon Malek,MPH,Donald R.Shopland,Christy M.Anderson,and
Marcus Plescia, MD, MPH, is Chief of the Chronic Disease and Injury section in the Division of Public Health, North Carolina
Department of Health and Human Services.He can be reached at email@example.com or 1915 Mail Service Center,Raleigh,NC
Sally Herndon Malek,MPH,is the head of the Tobacco Prevention and Control Branch in the Division of Public Health,North Carolina
Department of Health and Human Services.She can be reached at firstname.lastname@example.org or 1932 Mail Service Center,Raleigh,NC
Donald R.Shopland,is retired from the United State Public Health Service,Ringgold,GA.
Christy M.Anderson,BS,works with the University of California at San Diego,San Diego,CA.
David M.Burns,MD,works with the University of California at San Diego,San Diego,CA.
NC Med J May/June 2005, Volume 66, Number 3
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