As evidence of tobacco’s harmful effects has accumulated, smoking bans have been instituted in the U.S., first in specific indoor venues, such as restaurants, and more recently in outdoor areas such as parks and beaches and on the campuses of hospitals and schools.
In Maine, smoking bans have followed the national trend. Beginning with indoor bans, smoke-free ordinances have progressed to some outdoor areas.
Maine State Parks and historical sites were made smoke free in May 2009. This includes beaches, playgrounds, snack bars, picnic shelters, business facilities and any enclosed public place or public restroom. Several Maine municipalities have followed suit with similar ordinances on smoke-free beaches or 100 percent smoke-free parks. In 2011 the South Portland City Council passed an ordinance prohibiting all tobacco use in town parks and beaches.
This action followed an extraordinary piece of activism by members of the South Portland High School Interact Club. Members of this service group, which is the youth affiliate of Rotary International, organized fellow students to accompany them to city-owned Willard Beach. There they collected more than 1,000 cigarette butts from the sand in an hour and presented their collection to the city council with a request that the city beaches be made smoke free. City council members, perhaps thinking about the fact that their children and grandchildren play in the sand at Willard Beach, unanimously agreed.
When asked by one of this article’s co-authors why the Interact Club had chosen this issue from the many worthwhile causes they could have pursued, one group member replied “because it’s a no-brainer.” This suggests that attitudes toward tobacco use are changing, at least among some youth, and that smoking is no longer considered normative as it was in the past.
In Maine, several hospitals, including Mercy Hospital in Portland and Franklin Memorial Hospital in Farmington, have smoke-free campus rules. As is the case in several areas of preventive health, Franklin Memorial Hospital was a leader in becoming the first smoke-free hospital in the state. As early as 1985, the hospital instituted a policy prohibiting smoking among hospital visitors and employees. The explicit motivation for the hospital to take these actions was health promotion. Franklin Memorial Hospital has an extensive community health program, and program leaders felt the hospital could maintain its moral authority in health-related lifestyle issues only if it led by example.
In 2006 Kennebec Valley Community College in Fairfield became the first Maine institution of higher learning to adopt a 100 percent tobacco-free policy. The University of Maine followed suit in 2011, as did the University of Maine at Farmington in 2012. Colby College in Waterville and the University of Maine at Augusta have announced that they will be tobacco-free in 2013.
Efforts to restrict tobacco use at the University of Southern Maine began in 1999 when the USM Tobacco Policy Committee spearheaded efforts that led to restrictions on indoor smoking, first in residence halls and then campuswide. By 2009, however, it was clear that existing policy did not separate smokers from nonsmokers, and the committee turned its efforts toward instituting a smoke-free policy at USM. To gain grass-roots support, the committee met with the senates representing multiple USM constituencies to advocate for campuswide smoke-free policy. This support was forthcoming in 2011, but only after the committee developed a strategic plan, which involved incremental steps for implementing the smoke-free policy.
While the risks of indoor exposure to secondhand smoke are well documented, the dangers of outdoor tobacco smoke exposure are just beginning to be studied. Although the available evidence suggests that outdoor tobacco smoke may also be dangerous, more work on this point is needed to quantify the harm.
The Maine experience with smoke-free regulations suggests the following lessons:
1. Recognizing and being in step with historical trends are important to the success of efforts to limit tobacco use. Both Franklin Memorial Hospital and USM spent many years implementing incremental smoking restrictions that were politically acceptable at that time before becoming totally smoke free. The successful efforts to make Willard Beach smoke free occurred at a time when other municipalities around the country were considering similar regulations.
2. Dedicated activists are indispensable to efforts limiting tobacco use.
3. Having a well-thought-out and well-developed plan is vital to the success of smoke-free efforts. Activists should seek to establish such a plan, and administrators who will ultimately be responsible for defining and implementing such a policy should demand this sort of preparation.
4. Some push-back is inevitable. Thus, ultimately, both a grass-roots effort by activists and bold decision making by the institution’s administration (who must be willing to expend some political capital) were required to make large institutions, such as USM and Franklin Memorial Hospital, smoke free.
5. The announcement of smoke-free regulations is not the end of the matter. Not everyone at any institution, never mind in any city, agrees with making outdoor areas smoke free, and some members of any community are addicted to nicotine. Successful implementation of smoke-free regulations requires education and the provision of smoking-cessation tools to those who need them.
Suzanne Roy has been health-promotion manager of the Employee Wellness Program of the University of Southern Maine since 2001. Sarah Mayberry serves as program director for the Breathe Easy Coalition of Maine. David E. Harris is a professor at the University of Southern Maine School of Nursing. A longer version of this article appeared in Maine Policy Review, published by the University of Maine’s Margaret Chase Smith Policy Center, and can be found at digitalcommons.library.umaine.edu/mpr.