The landscape of smokefree indoor air laws in the United States is a complex patchwork of state, local, and tribal regulations designed to protect public health from the dangers of secondhand smoke. While significant progress has been made, the current status reveals both widespread protections and critical gaps. As of June 30, 2024, 28 states, the District of Columbia, and several U.S. territories have enacted comprehensive 100% smokefree indoor air laws that cover bars, restaurants, and all worksites, both government and private. This includes Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington, and Wisconsin. Additionally, American Samoa, the Marshall Islands, Puerto Rico, and the U.S. Virgin Islands have achieved similar comprehensive coverage.
Despite these advances, 22 states, along with Guam, Northern Mariana Islands, and Palau, do not yet have comprehensive smokefree indoor air laws covering all bars, restaurants, and worksites. In these areas, protections can vary significantly. For instance, while some states prohibit smoking in government worksites, they may not extend the same prohibition to private worksites. Idaho, Mississippi, North Carolina, and Oklahoma are examples of states that have smokefree laws for government worksites but not for private ones.
The public health rationale for these laws is well-established. Scientific evidence, highlighted by the Centers for Disease Control and Prevention (CDC), demonstrates that smokefree policies are effective at reducing health risks to nonsmokers from secondhand smoke exposure. Furthermore, comprehensive statewide smokefree laws are recognized as effective, high-impact strategies for helping individuals quit smoking and reducing tobacco consumption. Communities that have enacted such laws have seen up to a 17% reduction in hospital heart attack admissions. Smokefree laws and policies also enjoy a high level of public support and compliance, with studies indicating they do not negatively affect sales or employment in the hospitality industry. As of the data available, 61.1% of the total U.S. population is covered by 100% smokefree indoor air policies in bars, restaurants, and worksites.
The regulatory environment is also evolving to address emerging products. The U.S. Surgeon General's report released in December 2016 concluded that e-cigarette aerosol is not harmless and can contain nicotine and other harmful chemicals. In response, 19 states and the District of Columbia have added electronic cigarettes to their comprehensive smokefree laws. The trend of including e-cigarettes is reflected in local policies as well. For example, Northwest Missouri State University's latest policy iteration, effective at the start of the month, fully covers all tobacco products, including non-combustibles, electronic smoking devices (ESDs), and hookahs.
For consumers, travelers, and workers seeking smokefree environments, resources are available to navigate this patchwork of laws. The American Nonsmokers' Rights (ANR) Foundation provides extensive lists and maps, including a Smokefree Casino & Gaming Property Directory that replaces a previous list of smokefree gambling facilities. This interactive directory can be sorted by state, Tribe, and company and includes a map for each state. The ANR Foundation also maintains the only national database of smokefree and tobacco-free college campus policies. Other resources include maps and lists detailing the percent of population covered by 100% smokefree laws, statewide laws requiring smokefree gambling venues, and state and local 100% smokefree hotel and motel guest room laws.
However, the infrastructure supporting this critical public health surveillance is under threat. The elimination of the CDC Office on Smoking and Health has resulted in a loss of decades of scientific experience and institutional knowledge. Access to timely commercial tobacco policy surveillance data is now significantly compromised, making the fight against tobacco-related disease harder. Federal budget cuts have led to a stop-work order against the CDC contract that supports the ANR Foundation's work, jeopardizing state contracts to advance smokefree protections. As a result, the ANR Foundation may need to curtail some of its services, potentially reducing the number of lists and maps it updates and distributes at no cost each quarter.
The American Lung Association emphasizes that progress toward making all 50 states smokefree has completely stalled over the past 11 years, with zero states approving comprehensive smokefree workplace laws during that period. The association believes all 50 states and the District of Columbia must pass laws prohibiting smoking in all public places and workplaces, including all restaurants, bars, and casinos. Until this goal is achieved, people in 22 states remain unprotected from secondhand smoke in all public places and workplaces. For individuals, the American Lung Association suggests that people can make their homes and vehicles smokefree, while states are encouraged to work toward making all public places and workplaces smokefree. The responsibility for deciding whether to address this problem through governmental action lies with local and state governments.
Conclusion
The United States has made considerable progress in establishing smokefree indoor air laws, with 28 states and several territories providing comprehensive protections in bars, restaurants, and worksites. However, a significant portion of the population remains unprotected, and the inclusion of e-cigarettes in these laws is an ongoing development. While scientific evidence strongly supports the health benefits and public acceptance of smokefree policies, the data infrastructure needed to track these laws is currently at risk due to funding cuts. Consumers and advocates can utilize resources from organizations like the ANR Foundation and the American Lung Association to understand local regulations and advocate for stronger protections. Ultimately, the goal of comprehensive, nationwide smokefree air remains a critical public health objective that requires continued legislative action at the state and local levels.