Tobacco, texting, trans fats all subject to new state laws

States increasingly are restricting certain activities seen as unhealthy.

By Christine S. Moyer — Posted Jan. 25, 2010

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State capitols across the nation are in growing agreement about the need to legislate against threats to public health, including texting, trans fats and tanning beds.

And tobacco -- even on Tobacco Road.

At midnight Jan. 2, a smoking ban went into effect in North Carolina that affects nearly all restaurants and bars, as well as convenience stores, hotel common areas and private/for-profit clubs, according to the state's department of health and human services. There are limited exceptions for cigar bars and nonprofit private clubs. North Carolina boasted the nation's greatest number of tobacco fields in 2007, according to the U.S. Dept. of Agriculture, and tobacco fueled the growth of the state for hundreds of years.

"Historically it has been a long road. It's a major win for proponents of public health and those who are trying to reduce tobacco usage," said Mike Edwards, spokesman for the North Carolina Medical Society.

This bill passing in a state at the center of the tobacco industry was like the planets aligning, joked Chris Hoke, chief of the Office of Regulatory and Legal Affairs for the North Carolina Division of Public Health.

Hoke attributed the bill's passage to the relationship the health department and a coalition of other tobacco prevention advocates formed with the state's restaurant industry, and to the support of the legislation's lead sponsor, House Majority Leader Hugh Holliman, a lung cancer survivor.

As of Jan. 12, the state had received 171 complaints against specific restaurants and bars, including reports on the lack of no-smoking signs, ashtrays still in place and smoking still being allowed, according to the department of health and human services. About 27,000 businesses were affected by the new law. The AMA has longstanding policy advocating banning smoking in indoor public places.

Meanwhile in Michigan, a statewide ban on smoking in public places -- excluding certain casinos, cigar bars and tobacco retailers -- is set to take effect in May. But on Jan. 1, all cigarettes sold in Michigan were required to have a paper band that extinguishes them if left unattended, under a law passed to reduce the risk of fires.

On Jan. 1, Illinois joined 18 states and the District of Columbia in banning texting behind the wheel. The new law also prohibits checking e-mail, surfing the Web and updating social media on any "electronic communication device" while driving.

Legislation banning texting behind the wheel was among the more than 200 public health safety bills the American Medical Association's Advocacy Resource Center tracked during 2009. A year after calling for a ban on driving while texting, the AMA's House of Delegates adopted policy at its 2009 Interim Meeting saying any use of handheld devices while driving should be against the law.

In Texas, adolescents were greeted New Year's Day by tightened restrictions on tanning salons. A new law prohibits people younger than 16½ from using a tanning device. The regulation also requires guardians of teens age 16½ to 18 to give written consent, indicating they understand the advisory statement on tanning issued by the state's medical board and agree that the minor will use protective eyewear while in the tanning bed.

"We think there is an increased risk of cancers with tanning beds, especially skin cancers. They're a huge public risk," said William Fleming III, MD, a Houston neurologist and president of the Texas Medical Assn., which supported the legislation.

Texas joins at least 31 other states in regulating use of tanning facilities by minors, according to the National Conference of State Legislatures.

The AMA in 2006 developed model state legislation that would prohibit the sale of tanning parlor ultraviolet rays to those younger than 18, except as prescribed by a physician.

The International Agency for Research on Cancer, a subsidiary of the World Health Organization, in 2006 issued a report recommending policymakers consider enacting measures to prohibit minors and discourage young adults from using indoor tanning facilities to protect the general population from additional risk for melanoma.

In California, the state's medical association lent support to more than a dozen public health and health care related bills in 2009. Among them was the Donda West Law, implemented Jan. 1 and named after singer Kanye West's mother, who died a day after cosmetic surgery in November 2007. The bill requires patients to have a physical examination within 30 days before an elective cosmetic surgery procedure.

Eating in California restaurants also became healthier in the new year, thanks to novel statewide legislation banning the use of oil, shortening or margarine containing specified trans fats. In 2011, the ban will expand to any food containing artificial trans fat. The law, which took effect Jan. 1, was approved in 2008, allowing restaurants time to implement the mandate.

Similar measures have been enacted by several local governments, including New York City, which in 2006 became the nation's first city to ban trans fats. The law mandated the city's restaurants eliminate artificial trans fats from all their foods by July 2008.

The AMA in 2008 developed policy supporting state and federal legislation that would ban the use of artificial trans fats by restaurants and bakeries.

Minnesota banned in-state manufacturers from selling cups and bottles intended for children age 3 or younger and containing bisphenol A. The sales restrictions, which went into effect Jan. 1, will extend to retailers Jan. 1, 2011.

The Food and Drug Administration on Jan. 15 said it has "some concern about the potential effects of bisphenol A on the brain, behavior, and prostate gland in fetuses, infants and young children."

The FDA is conducting studies to clarify the risks of bisphenol A and is facilitating development of alternatives to the chemical for the linings of infant formula cans. The agency also supports efforts to reduce or minimize levels in other food can linings.

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Newly enacted laws

Public health legislation on a variety of issues was enacted by states, including:

California: Banned the use of oil, shortening or margarine containing specified trans fats, starting Jan. 1.

Minnesota: Banned in-state manufacturers from selling cups and bottles that are intended for children age 3 or younger and contain the chemical bisphenol A, after Jan. 1.

Montana: Required insurance companies to provide coverage for autism spectrum disorders, starting Jan. 1.

North Carolina: Banned smoking in nearly all restaurants and bars, convenience stores, hotel common areas, and private/for-profit clubs, starting Jan. 2.

Texas: Prohibited youths younger than 16½ from using a tanning bed. Required parental consent for adolescents ages 16½ to 18 using a tanning bed, starting Jan. 1.

Sources: National Conference of State Legislatures, state public health departments and medical associations

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