falling behind on smokefree protections
only 4.6% of Georgians are protected by a 100% smokefree workplace, restaurant, and bar law
• 61% of Americans enjoy comprehensive smokefree protections in all public places and workplaces, including restaurants and bars. In contrast, in Georgia only 4.6% of the population is protected by this type of smokefree law. 
• 204,000 Georgians currently under the age of 18 are projected to die of tobacco-related disease. 
• Smoking costs $3.18 billion in annual health care costs and an estimated $3.17 billion in lost productivity. 
• Georgia is 1 of 10 “Most Challenged” states based on the United Health Foundation’s “America’s Health Rankings Annual Report,” ranking 39th out of 50. 
• Closing smokefree gaps would reduce exposure to the hazards of secondhand smoke and increase health equity by providing healthy smokefree indoor air to all individuals.
Georgia adopted a law that prohibits smoking in some enclosed public places and workplaces that went into effect July 1, 2005. Smoking is allowed in restaurants and bars that do not admit or employ people under 18. With a population of 9,737,146, only 4.6% of the population is protected by one of the 6 local 100% smokefree workplace, restaurant, and bar laws, leaving 95.4% of the population unprotected.
State law does not preempt local governments from adopting smokefree air laws. Preemption refers to situations in which a law passed by a higher level of government takes precedence over a law passed by a lower one. In such cases, preemptive state laws set a ceiling, rather than a floor, and do not allow local authorities to enact strong local laws.
Almost Everyone is Exposed to Secondhand Smoke in Georgia
current landscape of smokefree Protections
Smaller cities have led the way in Georgia; and 6 localities have adopted a smokefree workplace, restaurant, and bar law; however, this leaves the majority of Georgians, particularly those living in larger metropolitan areas, exposed to secondhand smoke. The City of Atlanta is considered the "Capital of the South" and has been the focus of smokefree efforts over the past few years. Previous efforts have been abandoned due to a lack of political will, particularly from the Mayor’s office, which created an enormous barrier for the coalition. In 2016, the Smokefree Atlanta coalition regrouped and started a renewed effort. The November 2017 elections and smokefree successes in southern states such as Louisiana and Texas presented a new opportunity to revisit the issue and opened new possibilities for a successful smokefree campaign.
When Atlanta implements its 100% smokefree workplace, restaurant, and bar law in January 2020, the percent of Georgia’s population protected from exposure to secondhand smoke would increase from 4.6% to 9.0%. Notably, the percentage of African Americans protected will increase from 7.7% to 15.2%, more than doubling the protection of African Americans in the state.
Who is Left Behind?
Nearly every citizen in Georgia is still exposed to secondhand smoke in workplaces, restaurants, and bars. Since the state passed its partial smokefree law in 2005, only five cities and one county have adopted a 100% smokefree law to close the gaps and protect all workers from secondhand smoke exposure. The cities of Augusta, Buena Vista, Morrow, Pooler, Savannah and Chatham County have passed stronger laws during that time, accounting for 4.6% of the Georgia population. Augusta's law was adopted on July 1, 2019, and will go into effect January 2, 2020.
While many establishments have adopted voluntary smokefree policies, those trends favor the metro regions throughout the state. Rural populations disproportionately represent Georgia’s most disparate public health outcomes. Access to care continues to be a challenge as communities are losing resources and capacity to provide adequate services, including closures of rural health centers and the reduction of the number of medical professionals in the region. The absence of healthy, smokefree workplaces for every worker doubles down on the social determinants of health for Georgia’s most marginalized residents. Georgia Smokefree Air Act of 2005 gives a smokescreen of protections for the state’s workforce. Blue collar and hospitality industry employees often suffer in silence, working in the forgotten establishments exempted by the state’s partial protections.
poor health outcomes and high costs
Tobacco use is the leading preventable cause of death in the United States. More than 480,000 people die from smoking or exposure to secondhand smoke each year. 
In Georgia, the smoking rate among adults is 17.5% and 12.8% for high school students, compared to national rates of 14% and 8%, respectively. Tobacco exacts a high toll in Georgia: 11,690 Georgians die each year of tobacco-related illness, and annual health care costs in the state directly caused by tobacco use are $3.18 billion. 
Secondhand smoke exposure causes heart disease, stroke, and lung cancer among adults, as well as respiratory disease, ear infections, sudden infant death syndrome, more severe and frequent asthma attacks, and slowed lung growth in children. [3,6]
Beyond secondhand smoke exposure, nonsmokers exposed to thirdhand smoke in a casino are at an ever higher risk than those in a thirdhand smoke-polluted home.  Further, hospitality workers and children are susceptible to thirdhand smoke exposure, as the particles cling to hair, clothing and cars. Young children are particularly vulnerable, because they can ingest tobacco residue by putting their hands in their mouths after touching contaminated surfaces. 
Smokefree laws help to reduce adult smoking prevalence and prevent youth and young adult smoking initiation. [3,6]
Entertainers, bar staff, and hospitality employees are exposed to secondhand smoke in most venues throughout Georgia
New Potential Challenge:
Secondhand Marijuana Smoke
In April 2019, the Georgia legislature approved a bill to allow in-state cultivation of cannabis and the sale of the low-THC oil. Secondhand marijuana smoke and vapor is a health hazard for nonsmokers. Just like secondhand tobacco smoke, marijuana smoke is a potent source of PM 2.5 fine particulate matter. Marijuana secondhand smoke impacts cardiovascular function; it contains thousands of chemicals and at least 33 carcinogens.
Public health advocates are fighting
for health equity
Health equity requires an investment of time and money.
Change doesn’t happen overnight, and partners must be committed to building relationships, identifying needs, and investing in activities and resources that will close the gaps. Collaborative efforts in Georgia have a track record of including and mobilizing community-based partners who represent those individuals left unprotected by the current state law. Indeed, these community-based partners are key to achieving success. Funds for tobacco prevention, education, training, and cessation resources are necessary to better address disparities in smoking and exposure to secondhand smoke. The cost of prevention would be significantly less than the $3.18 billion currently being spent to address annual tobacco-use related health care costs in Georgia, thus representing a savings to the state.
The People of Georgia Deserve to Work, Play, and Live in Smokefree Air
Strategies to Close Gaps & Increase Health Equity
Focus On Smokefree Policy & Laws
Let Local Lead The Way
Beware of Marijuana Industry Opposition
Invest in the future
Focus on smokefree policies: Competing issues can distract and delay work on smokefree policies. Smokefree laws have immediate and long-term health and economic benefits, and they are worth the investment of time and effort to protect everyone from exposure to a known human carcinogen.  Strengthening the statewide smokefree law will require highly organized, concentrated efforts to build decision maker support and create a sense of urgency to act to make all workplaces smokefree.
Let local lead the way: Since Georgia municipalities have the authority to adopt local laws, communities should focus on local laws covering all workplaces, including bars and gambling facilities.
Electronic cigarettes (e-cigarettes), marijuana, and hookah should be included in smokefree laws: Smokefree laws should also prohibit the use of e-cigarettes, marijuana, and hookah to prevent secondhand smoke exposure to the toxins, carcinogens, fine particles, and volatile organic compounds that have been found to compromise respiratory and cardiovascular health. [9,10]
Thwart preemptive efforts: With the recent success of local laws in neighboring states like Louisiana, Mississippi, and Texas, the tobacco industry and its allies are eager to block the wave of momentum from spreading to Georgia. Public health advocates can expect to see more aggressive attempts by the opposition to promote preemptive legislation in the Capitol. Preemptive laws typically contain a few very weak provisions and prevent further progress at the local level where stronger laws are more likely to pass. Thwarting preemptive efforts will require vigilance from the public health community and its allies in order to preserve the landscape for local smokefree policy progress.
Beware of opposition from cannabis/marijuana proponents: The Georgia legislature legalized the sale of the low-THC oil in 2019. States that legalize medical marijuana typically go on to legalize recreational, adult use marijuana after a few years. Marijuana smoke is also a form of indoor air pollution and a hazard to nonsmokers’ health. In order for indoor workplaces and public spaces to truly be safe and healthy environments, tobacco and marijuana smoke, along with secondhand e-cigarette aerosol/vapor should be prohibited.
Invest in the future by increasing funding and resources: In order to address the gaps in smokefree coverage and build momentum across the state, a great deal of effort and financial resources will be needed to explain the ongoing disparities in smokefree protections and the benefits of 100% smokefree environments, as well as to counter misinformation about the ability of ventilation systems to protect people from secondhand smoke exposure.
Strengthen power of partnerships: Many local coalitions are supported by resources provided by the Georgia State Health Department. Emphasizing the importance of smokefree policy change to partnerships built with organizations and affiliates across the state will continue to build power for strengthening the statewide smokefree law.
The American Nonsmokers’ Rights Foundation is dedicated to improving community health and increasing health equity by ensuring that everyone is protected by a 100% smokefree law. We provide training, technical assistance, and tobacco policy surveillance data for civic engagement to improve community health.
Sources of data:
1. “U.S. Environmental Protection Agency, Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders,” EPA/600/6-90/006F, December 1992.
2. American Nonsmokers’ Rights Foundation. (2019). U.S. Tobacco Control Laws Database. Berkeley, CA.
3. US Department of Health and Human Services. The health consequences of smoking: 50 years of progress. A report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, CDC; 2014.
4. Centers for Disease Control and Prevention. (n.d.). State Highlights: Georgia [from State Tobacco Activities Tracking and Evaluation System].
5. United Health Foundation. (2018). America’s Health Rankings Annual Report.
6. US Department of Health and Human Services. Preventing tobacco use among youth and young adults. A report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, CDC; 2012.
7. Matt, Dr. Georg (2018). Smoking Bans May Not Rid Casinos of Smoke. US News and World Report.
8. Matt, G E, Quintana PJ E, Hovell MF et. al. (2004). Households contaminated by environmental tobacco smoke: sources of infant exposures. British Medical Journal: Tobacco Control.
9. Grana, R; Benowitz, N; Glantz, S. “Background Paper on E-cigarettes,” Center for Tobacco Control Research and Education, University of California, San Francisco and WHO Collaborating Center on Tobacco Control. December 2013.
10. Williams, M.; Villarreal, A.; Bozhilov, K.; Lin, S.; Talbot, P., “Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol,” PLoS ONE 8(3): e57987, March 20, 2013.
Huang, J., King, B.A., Babb, S.D., Xu, X., Hallett, C., Hopkins, M. (2015). Socio-demographic disparities in local smoke-free law coverage in 10 states. American Journal of Public Health, 105(9), 1806–1813.
Tynan, M.A., Baker Holmes, C., Promoff, G., Hallett, C., Hopkins, M., & Frick, B. (2016). State and local comprehensive smoke-free laws for worksites, restaurants, and bars — United States, 2015. Morbidity and Mortality Weekly Report, 65(24), 623-626.
American Gaming Association. (September 2018). State of the States: The AGA Survey of the Casino Industry.
[n.a.], "Tobacco industry interference with tobacco control," Geneva: World Health Organization (WHO), 2008.
NCI Monograph 17: Evaluating ASSIST – A Blueprint for Understanding State-level Tobacco Control Evaluation of American Stop Smoking Intervention Study for Cancer Prevention Chapter 8, Evaluating Tobacco Industry Tactics as a Counterforce to ASSIST (October 2006).