Clearing the air: Ballwin businesses adapt to indoor smoking ban
St. Louis Post-Dispatch Suburban Journals
By Mary Shapiro   July 13, 2010

On a recent Friday afternoon at Bones French Quarter Bar and Grill in Ballwin, customers Jim Nunn and pal Steve Schilson of Chesterfield were relaxing, without the wreath of smoke that would have surrounded them in the past.

"Twenty years ago, when I first started coming here, everybody would be smoking in here," smoker Nunn said. "It doesn't really bother me that you can't anymore. The food and drink are good."

Schilson, a former smoker who quit after coming home from his service in Vietnam, approves of Ballwin's indoor smoking ban in public places.

"If it was the way it was 20 years ago, I wouldn't come here," Schilson said.

Ballwin outlawed indoor smoking in January 2006, making it the first city in St. Louis County to enact a ban. Ballwin's action came not long after a ban was approved in Arnold in Jefferson County.

Similar laws for Kirkwood and Clayton kicked in this year, and St. Louis County's and St. Louis city's bans will take effect in January.

Smoking bans in Ballwin and Arnold were vigorously opposed by bar owners and individuals. Since then, eating and drinking establishment owners, and many individuals, seem to have adjusted to the law.

Brian Armstrong, the owner of Bones, 14766 Manchester Road, had feared he'd lose customers to businesses in neighboring communities that didn't have bans. In response to the ban, he built an outdoor patio and revamped his business.

"We went from a hole-in-the-wall tavern to putting in new TVs and different types of game tables," Armstrong said. "I've changed staff and the menu, and we're now catering to a different generation, rather than just smokers. People like the new things, and it worked out."

He's 35, and admits most people his age and younger don't smoke inside most places.

"Since the law passed, I feel we have a younger overall crowd, though customers range in age," he said. "Without blowing it out of proportion, business is better, but that's not because of a smoking ban, but to us making improvements, thinking outside the box."

Candicci's Restaurant and Bar opened about a year ago at 100 Holloway Road. It's the fourth restaurant in that space since the Ballwin smoking ban took effect.

Owner Bob Candice moved the restaurant there from Clayton, knowing about the ban from the start. Like Bones, Candicci's has a big patio outside to accommodate smokers.

"People coming anywhere in Ballwin already knew they couldn't smoke," Candice said. "There are less and less smokers in West County. Despite our patio, many of our smokers still go out to the parking lot, because nonsmokers on the patio will give them dirty looks."

Candice is looking forward to the countywide ban next year and "a level playing field."

"While I've heard some restaurants here didn't make it after the ban, they go out of business for a lot of reasons," he said. "I've been in business since 1980, and our success is based on a lot of factors, like good food, good service and a friendly atmosphere."

Charles Gatton, a former alderman who spearheaded the smoking ban legislation in Ballwin, said fallout from the ban was a factor in ending his political career in Ballwin. But he bounced back and he became a consultant for cities like Kirkwood, which wanted to outlaw indoor smoking.

"I had people coming in from all over the area to campaign against me," he said. "But Ballwin wound up being a trend setter."

Gatton believes some of restaurants and bars went out of business because of the later recession, competition from businesses opening in Chesterfield Valley or other firms' remodeling and upgrades to attract customers.

Some were in financial trouble and losing money before the law, Gatton said.

"The restaurant business is very competitive," he said. "Ballwin had had a gradual and small revenue slide for a few years before this ban was even talked about. But hospitality sales tax revenues went up in Ballwin in 2009."

Tom Aiken, Ballwin's city planner/assistant city administrator, agreed.

"The most dire predictions of the effects of the ban were probably overblown, with most concerns being exaggerated," Aiken said.

About a year after the ban became effective, Ballwin traced all its restaurants' revenues, based on their business license renewal applications, going back five years for a historic perspective.

"We found a mixed bag," Aiken said. "Some showed declines, some showed increases, but it was all within the individual restaurant revenue variability we saw over the previous five years. The ban didn't appear to have any dramatically identifiable impact on revenue."

http://suburbanjournals.stltoday.com/articles/2010/07/13/west/special_feature/0714wc-balsmoke0.txt
 
 

On Thursday, July 1, all restaurants, bars and public places in the City of Clayton will be 100% smoke-free.  In addition, the entire campuses (inside and out) of Washington University and Fontbonne University will also go smoke-free on July 1. 

Below is more detailed information on the Clayton law from the City's website:

Effective July 1, 2010, Clayton will be smoke free. Last summer the city amended the 1988 ordinance that limited smoking in certain public areas.  The health of Clayton residents, the visitors who patronize Clayton businesses and the employees who work in the community was the motivation behind adopting the new smoking ban ordinance. Under the new ordinance, smoking will be prohibited in all enclosed public places with the following exceptions:

•    Private residences

•    Private clubs of non-profit organizations that do not allow the general public and do not allow “membership” upon payment of a nominal fee

•    Private or semi-private rooms in nursing homes and long-term care facilities

•    Retail establishments where more than 70 percent of sales includes tobacco and tobacco-related products

•    No more than 20 percent of Clayton hotel rooms

•    Outdoor public dining areas

•    Cigar bars in operation prior to the enactment of the ordinance.

Violation of the smoking ban is punishable by a fine of not more than $1,000 or incarceration of 90 days or less.

If you have questions or need additional information, call Clayton's Economic Developer Gary Carter at 314.290.8467.

St. Charles County smoking ban election unlikely until 2011
By Mark Schlinkmann
St. Louis Post-Dispatch

The St. Charles County Council is unlikely to schedule an election on a countywide ban on smoking in enclosed public places until April 2011 at the earliest.

Councilwoman Cheryl Hibbeler, who has been urging the council to put the issue on the ballot this November, acknowledged Friday that probably won’t happen – based on her discussions  so far with other council members.

 Unless there’s a change of heart among her colleagues before the Aug. 24 deadline for putting issues on the November ballot, Hibbeler said, she’ll switch gears and “will very aggressively pursue it for the April election.”

Hibbeler, an O’Fallon Democrat,  is the only one of the seven council members who say now they’d support a November vote.

However, three of her colleagues support putting a smoking ban before voters sometime in 2011 -  Republicans Terry Hollander of St. Charles and Nancy Matheny of Weldon Spring and Democrat Jerry Daugherty of Portage des Sioux. That would be enough council votes to get the issue on the ballot, assuming they could agree on what to include in it.

That’s also assuming that those supporters up for election themselves in November will be returned to office.  Hollander and Matheny are running unopposed but Hibbeler will have an opponent. Also opposed in November will be Republican John White of St. Charles County, who is undecided on whether to have a smoking ban election.

Agreement on what to include in a smoking ban proposition may not be a cinch. For example, Daugherty wants no exemptions in the bill - either for places that serve mainly food or for the Ameristar Casino.  Hibbeler has suggested exempting the casino, fearing that Ameristar would finance an ad campaign against a ban.

 Two other council members, Republicans Joe Brazil of Defiance and Paul Wynn of O’Fallon, oppose smoking bans as an unwarranted government intrusion on business owners’ rights and oppose an election on the idea as well.

 White says if the council decides to schedule an election on smoking, he’d prefer next year instead of November.

 Hibbeler and leaders of an anti-smoking coalition had hoped St. Charles County could have a ban in place to go into effect in January, when smoking bans already are set to become law in St. Louis and across St. Louis County. Both the city and St. Louis County laws exempt casinos and taverns with relatively small amounts of food sales.

But other council members say it makes sense to hold off a decision in St. Charles County to see the initial effects of the St. Louis and St. Louis County bans and of a city prohibition set to go in effect Oct. 1 in Lake Saint Louis.

Kirkwood and Ballwin are now the only cities in St. Louis County with comprehensive bans; Clayton joins them next month.

Program targets pregnant smokers

By Michele Munz, ST. LOUIS POST-DISPATCH
Thursday, Jun. 03 2010

When a pregnant patient reveals she smokes, Dr. Roxane Rampersad tells her the  long list of risks:

— Decreasing her baby's oxygen supply.

— Increasing her chances of having a premature or low birth weight baby.

— Increasing the chances of her placenta sheering off her uterus.

— Her baby could be stillborn.

But too often, short doctor visits are not enough to end the dangerous addiction.

"We don't have a lot of help," said Rampersad, who works at Barnes-Jewish Hospital's clinic for high-risk pregnancies. "We do this sort of on our own. We always ask about smoking, discuss why it's important to quit, but we don't have a lot of options for them."

In Missouri, 25 percent of adults smoke — the third highest in the United States, according to a comparison released in April by the Centers for Disease Control and Prevention. The state's smoking rate among pregnant women — 18 percent — is also among the worst. The rate soars even higher among the disadvantaged: 31 percent of pregnant women on Medicaid, the state and federal health care program for the poor, smoke.

That's why the Missouri March of Dimes has made providing Medicaid coverage for tobacco cessation programs its newest focus after working to improve newborn screening tests.

"About 18 months ago, we've shifted our focus to smoking cessation because of Missouri's horrible track record," director Debbie Kersting said. "As far as the problem of premature babies, if there's a silver bullet, it would be to stop smoking."

A smoking cessation program can take many forms, from self-help booklets to weekly support group sessions. The more intense the therapy, the greater chance of long-term success. Therapy along with the consistent use of nicotine replacements such as patches, gums and nasal sprays or other FDA-approved medications can double a person's chances of quitting, research shows, though they should be seen as a last resort among pregnant women.

The budget passed by the Missouri Legislature last month includes using $3 million to pay for smoking cessation programs for those on Medicaid, which would trigger another $5.2 million in federal funds. But it could still get the ax. Democratic Gov. Jay Nixon must make $350 million in cuts before signing the already lean budget, which takes effect July 1.

The total of $8.2 million in cessation funds would help 14,200 smokers quit through a mix of behavior therapy and medications depending on the individual needs, according to the Missouri Department of Social Services. Teens and pregnant women — which alone total about 11,400 — would get priority.

'LET'S BE SMART'
The provision's sponsor, Sen. Kurt Schaefer, R-Columbia, said the expenditure is a start in reducing Medicaid costs. State figures show Missouri spends about $512 million in Medicaid funds each year to treat smoking-related illnesses.

"When it comes to Medicaid, we have to pay for that no matter what," Schaefer said. "For those Medicaid dollars we have to spend, let's be smart about it."

Tobacco use is the single leading preventable cause of disease, disability and death, according to the CDC. The list of complications is long with having a premature or low birth weight baby. Children born to mothers who smoke during pregnancy are also at increased risk for asthma, colic and obesity. Maternal smoking has been linked to sudden infant death syndrome.

According to federal estimates, smoking-attributable newborn health care costs for Medicaid total $738 per pregnant smoker.

The solution is clear, according to a state-by-sate comparison released recently by the CDC. The report found that states which banned smoking in public spaces, enacted high cigarette taxes, placed restrictions on cigarette advertising and publicly funded cessation programs made great strides in reducing smoking rates.

Missouri is one of only six states that doesn't cover tobacco cessation programs for people on Medicaid. It lacks statewide smoke-free laws in workplaces, restaurants or bars; and its 17-cent tax per cigarette pack is the lowest in the country. In overall funding for tobacco control, the state ranks 49th.

States that invest heavily have seen cigarette sales drop more than twice as much as the nation as a whole, the CDC has found. As spending increased, smoking prevalence declined faster. California, which has had a comprehensive tobacco-control program in place the longest, has seen lung cancer rates decline four times faster than those in the national average. The state saved $86 billion in tobacco-related health care costs between 1989 and 2004.

In Illinois, 21 percent of adults smoke and 11 percent of women smoke during pregnancy. The state two years ago banned smoking in public places, has a 98-cent cigarette excise tax and provides medicaid coverage for nicotine replacements and medications but not counseling.

HARD TO QUIT
Medicaid recipient Janee Staples, 24, of St. Louis, was smoking about 10 cigarettes a day before she became pregnant. She had to quit her job at a nursing home, she said, because of the heavy lifting involved. Now 16 weeks into her pregnancy, she said she's gone over two weeks without a cigarette but is struggling. Her boyfriend smokes and stress is a trigger.

Staples receives prenatal care at People's Health Centers on Delmar Boulevard, where she also participates in monthly parenting classes. She wishes something similar was offered to help her with her addiction.

"There's parenting classes but no classes to help you stop smoking cigarettes," Staples said. "They just tell you it's not good, but your mom can tell you that. People can tell you that until they are blue in the face, but that doesn't mean it's going to help you stop."

Dr. Abbe Sudvarg is a family doctor at Family Care Health Centers, which serves primarily Medicaid patients at their two locations in St. Louis. Sudvarg said the pregnant women she sees are highly motivated to quit and are often successful with just the counseling they get from nurses during their prenatal appointments.

"But then they come in for their postpartum visit, and they are smoking," Sudvarg said. "They never stopped wanting it ... their only motivation was in terms of unborn child. It didn't have to do with themselves and their own well-being."

Assistance would greatly increase quit rates, research shows. Of daily smokers who try to quit unaided, 90 to 95 percent will relapse, according to U.S. Public Health Service clinical practice guidelines.

For now, Rampersad said she just tells her patients at the Barnes-Jewish clinic to set a reasonable quit date, avoid people who smoke and reduce stress.

"It would be really nice if the government takes this as something really important and set aside funding," she said. "We could take that money and have resources for this parent. It obviously affects health care dollars ... and it's so modifiable."

Editorial: Missouri’s race to the bottom on tobacco
The Kansas City Star
May 8, 2010

Missouri is well on its way to becoming the most tobacco-friendly state in the nation. It is an unsavory and embarrassing distinction.

Beyond putting people in early graves every year, the state’s shameful love affair with tobacco drives up medical bills for thousands upon thousands of residents.

Check out some disturbing facts:

Missouri soon could have the nation’s lowest cigarette tax.

That’s a clear invitation for people young and old to buy something that will harm them.

The state’s cigarette tax is a paltry 17 cents a pack, ahead only of South Carolina’s 7-cent rate. Last week, though, South Carolina legislators approved raising their state’s tax to 57 cents.

They reached that decision for the same excellent reasons lawmakers in other states have opted to raise tobacco taxes in recent years. Higher taxes can prevent tens of thousands of residents from starting or continuing to smoke. And they can create millions of dollars a year for state health care programs and smoking cessation efforts.

While South Carolina Gov. Mark Sanford has threatened a veto of the higher tax, lawmakers tired of dealing with the issue say they can override it. Missouri then would have the lowest cigarette tax by a long shot; the next is 30 cents a pack in Virginia.

The Kansas tax is at 79 cents and — regrettably — appears ready to be stuck there, despite good-faith attempts by Gov. Mark Parkinson and others to boost it toward the national average of $1.41.

At the very least, Missouri should raise its tax to the Kansas rate.

Puffing away on cigarettes is a way of life for 25 percent of Missourians.

This rate is the third highest among states and the District of Columbia, according to a new report from the federal Centers for Disease Control and Prevention.

More smokers, of course, means more deaths from lung cancer and other well-known health problems connected with tobacco use. Missouri has the ninth highest rate of smoking-related deaths per 100,000 people.

Missouri doesn’t have a comprehensive smoke-free law.

That puts Missouri in the small minority of fewer than 10 states that don’t have some form of the law, which protects people from smoke in workplaces such as offices, restaurants and bars.

Also, the CDC report found that Missouri ranked next-to-worst in the nation for workplace exposure to smoke.

The Missouri General Assembly has handled the smoke-free issue in a disgraceful manner. It refused for years to seriously debate the matter even as more states outlawed the habit in workplaces.

One bill introduced this year got a little more attention but is not likely to become law.

The Kansas Legislature, which for many years had also stayed on the sidelines, finally endorsed a smoke-free law this year with strong support from Parkinson. It goes into effect July 1 in all workplaces, restaurants and bars (casinos are exempted).

Missouri should approve a similar law.

There’s more bad news from the CDC report.

Missouri’s funding for tobacco control programs was third lowest in the nation.

The state had the 13th highest rate of teenage smoking. And Missouri is irresponsibly lax in not licensing retailers that sell tobacco products, something that Kansas and 36 other states do.

Unfortunately, Missouri is racing to the bottom when it comes to smoking, with cigarette manufacturers and vendors cheering it on.

The losers are smokers and the taxpayers who foot the bill for many medical expenses.