Pittsburgh Smokes (by Jennifer Geiselhart and Bernard Goldstein)

Adult smoking prevalence is greater in the Pittsburgh 7-county region than in most of our comparison areas and we have more difficulty quitting. According to the 2006 US Centers for Disease Control statistics , we are third highest among the fifteen comparison areas in smoking and are close to the bottom in the percent of our smokers who have quit. Among our adults, 22.2% reported that they smoked as compared to a national average of 20.1%. Only Indianapolis, Cincinnati and Detroit recorded higher adult smoking rates. When compared to smoking rates in 2003, the first year for which there are data for all of our comparison areas, our percent decline in smokers among those who smoked is only 3.1% - less than half the US overall percent decline of 8.6%. Only Detroit is lower among the 14 comparison areas.

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Perhaps most notable is that among all 15 regions we have the lowest percentage of adult smokers who reported having never smoked (49.8%). Surprisingly, we are appreciably lower in “never smokers” than our two tobacco alley comparison areas - Charlotte, NC (57.0%) and Richmond, VA (54.5%). Our pervasive culture of smoking makes our area particularly challenging to tobacco prevention and control organizations.

Tobacco control professionals have been particularly active in advocating smoke free workplaces. Of our 14 comparison cities, nine have smoke-free ordinances that extend to restaurants and bars. Six of these (Minneapolis, Boston, Denver, Baltimore, Philadelphia and Cincinnati) are reasonably effective in that there are few if any loopholes. Three others, (Kansas City, Cleveland and Indianapolis) have ordinances whose effectiveness are as yet limited by extensive loopholes or inadequate enforcement. In 2006, Allegheny County passed an ordinance banning smoking in workplaces and most public places that was rule pre-empted during a legal challenge. The pre-emption challenge, upheld by Commonwealth Court leaves our region with no alternative but to wait for the legislature in Harrisburg to enact a statewide law – which is currently under consideration.

Tobacco industry documents, released through anti-tobacco law suits, show the industry’s awareness of the importance to product sales of observing smokers in favorable circumstances. Promotional activities to the film industry, including payments to Hollywood moviemakers for placement of tobacco products, emphasized that cigarette use should only be shown in positive surroundings. Attending restaurants and bars are usually considered to be positive experiences, while observing smokers huddled around the outdoor doorway of a workplace often leads to pity – particularly during our cold rainy winter. Banning smoking in restaurants and bars not only protects workers and patrons from the adverse effects of environmental tobacco smoke, it also counters the positive reinforcement so desired by tobacco marketers.

A future indicators project will examine how well we are doing in preventing youth and adolescent smoking.

Jennifer Geiselhart, JD, MPH
Center for Public Health Practice
Graduate School of Public Health
University of Pittsburgh

Bernard D. Goldstein, MD
Department of Environmental and Occupational Health
Graduate School of Public Health
University of Pittsburgh