Monthly Archives: June 2011

2011-06-17 P-D: “7 area SSM hospitals will no longer hire smokers”

Ernie Wolf, recent photo from Facebook page

Not mentioned anywhere in this story, but deserving to be for historical reasons, is Ernest “Ernie” Wolf, who operated Skytop Sunroofs Ltd in St. Louis for twenty years until 1992.
         He was a pioneer in only hiring nonsmoking employees well before it became accepted practice.
         He found that his nonsmoking employees were more productive, they didn’t take as much sick leave, and had lower healthcare and life insurance coverage costs than smokers.
         Ernie Wolf and the union ended up agreeing to only add nonsmokers to the workforce, the same policy as SSM Healthcare is about to implement.

Following is a comment I submitted earlier to the St. Louis Post-Dispatch comments page following the SSM hospital story, which is arousing a lively debate among readers:

Martin Pion said on: June 17, 2011, 11:31 am
This is a contentious issue.
Missouri GASP doesn’t take a position on it, but speaking personally, if I were to hire an employee to work in my home office they would have to be a nonsmoker. I wouldn’t be prepared to allow them smoking breaks outside and wonder where they’re throwing their cigarette butts for me to pick up after them. Plus, they would still be smelling of tobacco smoke when they came back inside my house. And finally, even when smoking outside, I would be concerned about the smoke wafting in my direction if I were to go outside myself.
Yes, I can certainly understand smokers feeling unfairly targeted by an employer’s policy of only hiring nonsmokers, but one could argue that it’s another incentive for smokers to quit.

Related Stories
         Big tobacco prevails in St. Louis lawsuit by hospitals
         From 2004: SSM Health Care outlaws smoking on its properties

11/16/04: SSM Healthcare is instituting a policy Thursday that will prohibit smoking on their property. Sonya Johnson of Portageville, Mo. takes a break for a cigarette outside Cardinal Glennon Hospital Tuesday. Her daughter Bailey, 4 mos., is being treated there for an undiagnosed infection.
File photo by Karen Elshout

Sonya Johnson was quoted in the photo caption as saying: “I think it sucks that the hospital is going to force us to go elsewhere to smoke, ” she said. “This isn’t the safest neighborhood. Aren’t we stressed out enough?

7 area SSM hospitals will no longer hire smokers

BY BLYTHE BERNHARD 314-340-8129 | Posted: Friday, June 17, 2011 12:15 am | Comments (115 as of June 17, 2011, 9:39 am; 237 as of June 17, 2011, 3:05 pm)

Smokers need not apply at SSM Health Care hospitals, which will start a tobacco-free hiring policy next month.
         Job applicants at the seven SSM hospitals in the St. Louis area will be asked whether they have used tobacco in the last six months. Anyone who answers yes will be eliminated from the hiring process.
“As an organization that provides health care, we want to encourage our employees to take better care of themselves and set good examples for our patients,” said SSM spokesman Chris Sutton.
         Cost-cutting is a side benefit of the new policy, Sutton said, because “healthier employees does mean lower health care costs.”
Text STLTODAY to 21321 to download the free Post-Dispatch news app.
         Each smoker costs a company an additional $3,400 annually in health care costs and lost productivity, according to the federal Centers for Disease Control and Prevention.
         Current SSM employees will not be bound by the policy when they’re off-duty. All SSM facilities have been tobacco-free since 2004.
         Thursday evening, beyond the parking garage on the east side of St. Mary’s Health Center in Richmond Heights, a half dozen hospital employees were lighting up on a city sidewalk. Word of the new policy came as a shock.
         “They wouldn’t hire you because you’re a smoker?” said Angela Mueller, who said she has been working at the hospital just over a month. “That’s not right.”
         The new policy will apply only to SSM hospitals in Missouri, where about 25 percent of adult residents smoke. About 6,000 companies nationwide have stopped hiring smokers, according to the New Jersey nonprofit National Workrights Institute. Missouri law supports the practice for certain employers, including health care providers.
         SSM officials said they will lobby for similar legislation in Illinois, Wisconsin and Oklahoma, where they also operate hospitals.
         Workers’ rights groups argue that the shift to a smoke-free workforce could lead to similar crackdowns on health behaviors like drinking alcohol and eating fast food. Others have warned that the policies punish lower-paid employees like janitors and cafeteria workers who are addicted to nicotine.
         “If enough of these companies adopt these policies and it really becomes difficult for smokers to find jobs, there are going to be consequences,” said Michael Siegel, a professor at Boston University School of Public Health. “Unemployment is also bad for health.”
The trend started 20 years ago when companies like Union Pacific, Turner Broadcasting and Alaska Airlines adopted smoke-free hiring policies.
         Since then, more than half the states have passed laws that prohibit discrimination against smokers.
         But courts in some of those states have upheld the hiring bans when challenged.
Health care providers have led a more recent trend away from employing smokers. The Cleveland Clinic stopped hiring smokers in 2007. Hospitals in Florida, Georgia, Massachusetts, Ohio, Pennsylvania, Tennessee and Texas have recently made the move.
         Staring this year, St. Francis Medical Center in Cape Girardeau, Mo., only hires nonsmokers.
“We felt it was unfair for employees who maintained healthy lifestyles to have to subsidize those who do not,” Steven Bjelich, the hospital’s chief executive. “Essentially that’s what happens.”
         Most smoke-free policies are enforced with the honor system. Truman Medical Centers in Kansas City investigates accusations of tobacco use and has fired employees who violate the smoke-free policy.
         BJC HealthCare, the largest hospital system in St. Louis, has no plans to implement a tobacco-free hiring policy. The company provides discounts on health insurance to nonsmokers and offers incentives to employees to quit smoking.
West County EMS and Fire Protection District has mandated since 2010 that all employees abstain from smoking or chewing tobacco. The firefighters union unanimously approved the policy.
         There have been few challenges to employee smoking bans.
         In the 1980s, a firefighter in Oklahoma City sued after being fired for smoking during a lunch break.
         The court eventually ruled that anti-smoking policies are reasonable to protect employees’ health.

Marlon A. Walker of the Post-Dispatch and The New York Times contributed to this report.

2011-06-15 P-D: “Ehlmann blocks smoking ban from going to voters in St. Charles County”

St. Charles County Executive, Steve Ehlmann, appears to be taking a principled position in his veto message of this bill, arguing that it isn’t acceptable to allow exemptions for casinos, for example, if it is genuinely a health measure to protect employees. He added:

If tobacco smoke is harmful, there is no reason to exempt cigar bars, while regulating bars that allow cigarette smoking.

In a rational world free from pressures from special interests, government policy should work this way, but certainly when it comes to secondhand smoke, it hasn’t for most of the past twenty five years I’ve been actively involved in this issue. That is why MoGASP supported the successful Proposition N on the November 2009 ballot, which ushered in the sweeping smoke-free air ordinances in St. Louis City and County despite their exemptions, the most objectionable being casino gaming floors and small bars.

The voluntary health agencies – American Heart, Lung and Cancer – did not support Prop N, having earlier echoed County Executive Ehlmann’s position: that casino and small bar exemptions were unacceptable. This all or nothing approach would be laudable if it offered a realistic way forward on this contentious issue. Unfortunately, it’s typically obstructive.

If County Executive Steve Ehlmann is truly interested in protecting the public health, as his veto message implies, he will need to demonstrate it by working with St. Louis County and City on their efforts to forge a comprehensive regional approach to the issue of secondhand smoke pollution, which includes St. Charles County.

For the record, below is reproduced a letter published in yesterday’s St. Louis Post-Dispatch from Kay Young, wife of laryngeal cancer survivor Don Young, who live in St. Charles and are both very active on this issue. It’s evident that County Executive Ehlmann had already made up his mind before this was published.

Let voters decide

Posted: Wednesday, June 15, 2011 10:15 am

Kay Young celebrating success of smoke-free O'Fallon vote in April, 2011

The St. Charles County Council passed a bill that will allow voters to decide if they want the county to be smoke-free. The bill has been sent to County Executive Steve Ehlmann, who will decide whether or not county residents get the opportunity to vote on this important health issue.
         For over three decades, I’ve called St. Charles County home. Due to health issues, my husband and I cannot go anywhere smoking is allowed, severely limiting our choices of entertainment and dining in our own community.
Secondhand smoke is a real danger. And, sure, smokers have a right to smoke, but not in ways that harm other people. So why must I and others have to endanger our health because of someone else’s choice? Every St. Charles County resident and employee has the right to breathe smoke-free indoor air.
         If our county were smoke-free, it would mean that myself and others would have the freedom to patronize any establishment, the choice to go anywhere without the forced consequences to our health. After all, five minutes outside isn’t a lot to ask to keep toxic smoke out of other people’s lungs.
         I hope County Executive Ehlmann will allow residents the opportunity to make their voice heard and place the county-wide, comprehensive smoke-free ordinance on the ballot for a vote of the people.

Kay Young, St. Charles

Related Stories
         O’Fallon, Mo., smoking ban starts Thursday
         St. Charles County Council passes bill for vote on smoking ban
         Survey shows St. Charles County supports indoor smoking ban

Related Documents
         Ehlmann’s veto letter June 15, 2011

Ehlmann blocks smoking ban from going to voters in St. Charles County

BY MARK SCHLINKMANN • > 636-255-7203 | Posted: Wednesday, June 15, 2011 12:16 am | Comments (47 as of June 15, 2011, 9:31 pm)

Friday June 10, 2011--Jason Fletcher, left, and his mother Pat Edwards, owner of P&R Lounge in O'Fallon, Missouri enjoy a smoke and a beer together as they relax at Edwards' bar on Friday. Edwards fears the recently passed smoking ban in O'Fallon will hurt small bars like hers.
Click to enlarge. Photo: David Carson, Post-Dispatch

ST. CHARLES COUNTY • A countywide smoking ban is in doubt after County Executive Steve Ehlmann on Tuesday blocked a ballot referendum, saying it had too many exemptions, including for the Ameristar Casino.

Steve Ehlmann, St. Charles County Executive and former state senator

         If the purpose of the smoking ban is to protect the health of employees, there is no rational reason to exclude casino floor workers,” Ehlmann said in his veto message. “If tobacco smoke is harmful, there is no reason to exempt cigar bars, while regulating bars that allow cigarette smoking.”
         The bill’s sponsor, County Councilman Joe Cronin, R-St. Paul, said it was unlikely that he could muster the required five votes on the seven-person council to override the veto. He said he would rather not take that “adversarial” approach anyway. The council passed the bill, 4-2, with one opponent absent, on May 31. It would have set up a ballot referendum in November 2012.
         Cronin said he instead would try to craft a new version that could get the support of both the executive and a council majority.
         However, he said that would be difficult because some who voted for the vetoed measure were adamant about exempting Ameristar in St. Charles. They worry that some of the casino’s jobs could be in jeopardy if smoking is banned there while smoking is allowed at the competing Harrah’s gambling facility across the Missouri River in Maryland Heights. St. Louis County’s current smoking ban exempts casinos.
         “I got a feeling that maybe the petition form might be the best way,” Cronin said, referring to the possibility that an anti-smoking coalition might gather signatures to put a smoking ban on the ballot.
         Late last year, coalition members did just that in O’Fallon, St. Charles County’s largest city. Voters there in April overwhelmingly approved a ban. The O’Fallon measure takes effect Thursday. The only other part of the county with a ban is Lake Saint Louis, where one started last October.
         Councilman Jerry Daugherty, D-Portage des Sioux — who supports a smoking ban election but voted against the measure because of his opposition to the casino exemption — said he agreed with Ehlmann that the measure wasn’t fair to small business owners.
         “I basically think it’s a dead issue” on the council, he said.
         However, two supporters of the bill who had wanted the casino exemption, Republicans Terry Hollander of St. Charles and John White of St. Charles County, said there was at least a chance something could be worked out.
         “The big question is St. Louis County,” White said, referring to efforts on the St. Louis County Council to repeal exemptions for casinos. Progress on that front could get him to support banning smoking at Ameristar, he said.
         In St. Louis County, Council Chairman Steve Stenger and County Executive Charlie A. Dooley, both Democrats, say they want a smoking ban without exemptions. Stenger met last month with three St. Charles County Council members to discuss trying to work out a common approach across the region.
         Stacy Reliford, an American Cancer Society official active in the anti-smoking coalition, confirmed that a countywide petition drive in St. Charles County was a possibility but emphasized that no decision had been made.
         “November 2012 is still a long ways away,” she said.
         Reliford said that although it was unfortunate that the veto apparently would keep the council plan off the ballot, it was promising “that everybody’s talking about ways to strengthen it than ways to weaken it.”
         Ehlmann, a Republican, said he was willing to discuss revisions. Asked if he’d support a no-exemption measure, he said, “I’m open to that and a lot of things.”
         Ehlmann’s decision was applauded by Bill Hannegan, a dogged opponent of smoking bans across the metro area, and Council Chairman Joe Brazil, R-Defiance, who also objects to governmental restrictions on business owners’ rights.
         “He did the right thing,” Hannegan said. “He said the casino exemption had no rational basis.”
         Ehlmann said in his veto message that government shouldn’t pick “winners and losers” in establishing regulations. He said the bill would have led to casinos’ and cigar bars’ winning “at the expense of the nonprofit organizations and small businesses that compete against them for the entertainment dollars of individuals who smoke.” He also objected to a provision allowing hotels and motels to set aside 20 percent of their rooms for smokers.
         The countywide proposal would have covered both unincorporated areas and cities. Unlike current bans in St. Louis and across St. Louis County, the St. Charles County proposal wouldn’t have exempted bars in which food service is a small portion of their business. City bans in O’Fallon, Lake Saint Louis, Clayton, Brentwood, Creve Coeur, Kirkwood and Ballwin also do not have exemptions for bars.
         The veto Tuesday was only the second issued by Ehlmann since he became executive in 2007. Ehlmann, a historian and former circuit judge, began his veto letter by quoting from President Andrew Jackson’s 19th-century veto of a bill to recharter a national bank.
         Jackson objected to a law he said gave “artificial distinctions … to make the rich richer and the potent more powerful.”

2011-06-09 “For Better or For Worse” comic strip

When you read today’s “For Better or For Worse” comic strip the first three panels convince you that Ellen Patterson’s brother is finally feeling the ill-effects of his smoking, but the punch-line suggests otherwise.

For Better or For Worse, by Lynn Johnston
Please click to enlarge

The brother’s shortness of breath etc. could still be related to his smoking though.

On her web page accompanying the strip, Lynn Johnston wrote:

My brothers’ smoking was always a bone of contention. He was still puffing when I did this strip and I was still trying to get him to stop. I don’t think he ever blew up the kiddie pool, but he did play the trumpet professionally and I wondered how his lungs held out!

2011-06-01 P-D: “Smoking ban has hookah bars in haze”

Who would have thought that hookahs would move in to fill the void left by smoke-free bars? I can’t imagine this device, which appears to deliver tobacco smoke to the user’s lungs, will be materially safer than a cigarette. The article notes:

According to the U.S. Centers for Disease Control and Prevention, hookah smoke delivers the addictive drug nicotine and is at least as toxic as cigarette smoke. Hookah smokers are at risk for the same kinds of diseases caused by cigarette smoking, including cancers and decreased fertility. The charcoal used to heat tobacco produces high levels of carbon monoxide, metals and cancer-causing chemicals.

The St. Louis Post-Dispatch article included a detailed illustration explaining the workings of a hookah which I also found on-line at

Hookah - Click to enlarge

The following is a brief explanation of how the hookah works:

Inhaling via the mouthpiece draws air in through tobacco and charcoal in the bowl on top of the pipe, where the tobacco is burned, producing tobacco smoke. The smoke passes down into the water-filled jar in the base, before exiting to the tube at the top of the jar connected to a hose and mouthpiece.

At the bottom of the Post-Dispatch illustration of the hookah these additional health risks were noted:

* More smoke – Person inhales more smoke over a longer time compared to cigarette smoking
* Exposure – Increased carbon dioxide and nicotine exposure may contribute to heart disease and cancer.

Smoking ban has hookah bars in haze

BY MICHELE MUNZ • > 314-340-8263 | Posted: Wednesday, June 1, 2011 8:46 am | Comments (64 as of June 2, 2011, 6:16 am)

May 24, 2011---Ali Abdulrazzak blows out a puff of smoke at Ranoush Nights, a new venue in the Delmar Loop. Ranoush Nights offers hookah but has no alcohol or food in order to comply with a smoking ban. Abdulrazzak works at the hookah lounge.
Photo: Emily Rasinski

Since a smoking ban went into effect in St. Louis and St. Louis County at the beginning of this year, numerous hookah lounges and cafés have found various ways to continue lighting up, resulting in a confusing mix of services that some — even hookah lounge owners — say is unfair.
         The Middle Eastern restaurant Ranoush, located in the Delmar Loop, spun off into a separate business a few blocks east and into St. Louis, selling only hookah, soft drinks and coffee.
         At Al Waha on South Grand, the owner moved hookah smoking to the patio.
         Nara Café downtown closed its doors to those younger than 21 to allow hookah smoking inside.
         Other restaurants limited their hours or food sales so they could sell hookah inside to customers, including those under 21.
         “Are you a restaurant? Are you a bar? Or are you a hookah lounge? What are you? That’s what’s hurting me,” said Ranoush owner Aboud Alhamid, who said confusion has resulted in an uneven playing field. He took a strict interpretation of the ban and opened Ranoush Nights three months ago with no food or alcohol service so as not to lose the 18- to 21-year-old hookah smoker and those who want to smoke inside.
         Some hookah café owners argue for exceptions or even the creation of a special hookah license, saying that hookah smoking is a unique service — a deep-rooted Middle Eastern tradition tied to socializing, relaxing and meditating that dates to the 16th century.
         “It’s ethnic. It’s different,” says Riyad Alwadi, owner of Al Waha. “It’s not like smoking cigarettes.”
         Hookah is a water pipe used to hold tobacco soaked in flavorings such as apple, coconut, cherry and mint. Charcoal is used to burn the tobacco, and users inhale the water-cooled smoke through a hose.
         According to the U.S. Centers for Disease Control and Prevention, hookah smoke delivers the addictive drug nicotine and is at least as toxic as cigarette smoke. Hookah smokers are at risk for the same kinds of diseases caused by cigarette smoking, including cancers and decreased fertility. The charcoal used to heat tobacco produces high levels of carbon monoxide, metals and cancer-causing chemicals.
         Hookah smoking is also communal; each person uses his or her own replaceable and disposable hose tip. One hookah session costs about $12 for the group and lasts 45 minutes to an hour.
         Arguments over whether hookah lounges (as well as a downtown cigar bar) are considered a restaurant, bar or retail tobacco store have led Pam Walker, the director of the St. Louis Department of Health, to refer the issue to the city’s legal counsel for interpretation.
         “These hookah bars and cigar bars are a new phenomenon, and there’s a question over where they fall,” Walker said. “As you can see it’s kind of complex, and I need a lawyer to figure it out.”
         An exemption in the law was meant to be applied narrowly — to bars serving patrons 21 and older with food sales less than 25 percent of total food and alcohol sales. The city also requires that serving areas be less than 2,000 square feet.
         “It was meant for these tiny little places with just a microwave in the back … the corner bar that’s been there forever,” Walker said. “But people are trying to drive a train through it.”
         Retail tobacco stores earning more than half their revenue from tobacco and tobacco products are also exempt under the ordinance.
         The St. Louis County Department of Health has taken a stance that businesses “where they only hookah” are not regulated in any way as a restaurant or a retail store, said Gerrin Butler, the food and environmental program manager. These business do not sell food or alcohol. “The ones that decided just to open up a hookah bar, we don’t regulate them,” Butler said. “We recognize that that’s an establishment that doesn’t meet any of those clear definitions.”
         Because many states and cities have enacted smoking bans, hookah lounges have been growing in popularity in the U.S., especially around college campuses.
         Double Apple Café and Hookah Lounge opened in February near St. Louis University, and Café Nura opened six months ago near Webster University.
         The Ninth Street Hookah Lounge opened more than a year ago in the college town of Columbia, Mo., and Jinn Lounge opened about two months ago in Kirksville, Mo., home of Truman State University. Hookah lounges in the Central West End and Delmar Loop are popular spots for Washington University students.
         Double Apple co-owner Keren Arismendi said her partner Tareq Khoury used to own a hookah lounge near Lindenwood University in St. Charles. “It was a very busy area, and this area is the same,” Arismendi said. “They are all college kids, and they all love hookah.”
         Arismendi and Khoury got their business permit before the start of the ban. They had planned to open at 11 a.m. with a full menu but learned that would force their hookah services outside. Instead, they limited their menu and don’t open until 4 p.m. They also serve alcohol and allow minors, she said.


         Health officials fear that ways around smoking bans — as well as outright exemptions for hookah lounges — reinforce the belief that hookah is less harmful than cigarettes. The misconception combined with hookah’s increasing popularity represents a growing public health issue, they say.
         “The popularity of hookah smoking among young adults is quite alarming given the potential for negative health effects,” said Wake Forest University assistant professor Erin Sutfin, the lead researcher on a study published in April about hookah use among college students. “Unfortunately, many young adults are misinformed about the safety of hookah smoking, and some mistakenly believe it is safer than cigarette smoking.”
         Little research has been done on hookah use by young adults. But Sutfin surveyed nearly 3,800 students from eight North Carolina colleges and universities about their drug habits and knowledge.          The research found that 40.3 percent reported having smoked tobacco from a hookah, and 17.3 percent said they actively used hookahs. The hookah smokers were most likely to live within 10 miles of a hookah venue and believe that smoking from a hookah is less harmful than smoking a cigarette.
         A 2008 Internet-based survey of nearly 750 college freshmen found that 20 percent had smoked hookah in the past 30 days. Small studies in Florida and California show that significant numbers of high schoolers have smoked hookah. The findings have researchers pointing to the need to address the legality of hookah lounges.
         “State smoke-free bans need to include hookahs in their policies,” Sutfin said. “Several states with strong smoke-free policies have exemptions for hookahs. Hookah cafés create the perception that this is a safe activity. It is not.”
         Users interviewed at various hookah lounges, however, say they smoke hookah in moderation and don’t feel like it’s addictive. “It’s not a gateway to anything. I don’t want to smoke cigarettes,” said Carlos Restrepo, 21, a junior at Webster University. He says he enjoys the relaxed atmosphere and the social aspect of hookah smoking, especially with his younger friends.
         Hookah café owners said they were unsure how the law was going to be effective when it was being debated, and they continue to struggle to get straight answers on how to be in compliance.
         Rimla Javed, owner of the Café Nura in Webster Groves, sells a few pastries and sandwiches, but mainly coffee along with her hookah. She said she has been told by health department officials that she has to have a liquor license in order to sell hookah inside “because only bars can be exempt from the smoking ordinance.”
         But she’s willing to do that, “even though she does not want to sell alcohol” and because hookah is her niche, she said. “My biggest competition is Starbucks, and I can’t compete with Starbucks.”
         Unless the law is changed, hookah smoking will disappear from St. Louis in five years.
         The city ordinance ends all exemptions in 2016, but the county does not have such a sunset clause.