The Smoke-Free Arizona Act
“It’s a Benefit, Not a Ban!”

Annual Report 2012
Arizona Department of Health Services

Janice K. Brewer, Governor
State of Arizona

Will Humble
Director, Arizona Department of Health Services

ARIZONA DEPARTMENT OF HEALTH SERVICES
Bureau of Epidemiology and Disease Control
Office of Inspection and Compliance
Smoke-Free Arizona Program
150 N. 18th Avenue, Suite 130
Phoenix, Arizona 85007-3245
(602) 364-3122

This publication can be made available in alternative format.
Please contact the number listed above.

Permission to quote from or reproduce materials from this publication
is granted when due acknowledgment is made.

“Equal Opportunity/Reasonable Accommodation Employer”

Table of Contents
Annual Report 2012
“It’s a Benefit, Not a Ban”
Executive Summary ___________________________________________________________ 1
1.0

Smoke-Free Arizona Program_____________________________________________ 2
1.1
1.2
1.3
1.3.1
1.3.2
1.4

2.0

Education _____________________________________________________________ 9
2.1
2.2
2.3
2.4
2.5

3.0

Initiating Legal Procedures _________________________________________________________ 25
Achieving Compliance through Legal Proceedings ______________________________________ 25

Protecting Arizonans Health _____________________________________________ 27
6.1
6.2

7.0

Verifying Compliance through Complaint Response and Routine Inspections _________________ 21
Complaint Investigation ___________________________________________________________ 21
Complaint Numbers Stabilize With Increased Compliance throughout Arizona ________________ 22

Enforcement __________________________________________________________ 25
5.1
5.2

6.0

Reaching Out to Public Places and Places of Employment ________________________________ 15
Reaching Out to the Community: Success Stories _______________________________________ 16
Educational Newsletter ____________________________________________________________ 18
Working with Smoke-Free Arizona Partners ___________________________________________ 20

Compliance ___________________________________________________________ 21
4.1
4.2
4.3

5.0

Enhancing the Website: www.smokefreearizona.org ______________________________________ 9
Answering the Information Hotline: 1-877-AZ-STOPS (1-877-297-8677) ____________________ 10
Maintaining the Email Addresses: smokefreearizona, nosmokingarizona _____________________ 12
“No Smoking” Signs ______________________________________________________________ 13
Advisory Visits __________________________________________________________________ 14

Outreach _____________________________________________________________ 15
3.1
3.2
3.3
3.4

4.0

Background ______________________________________________________________________ 2
Roles and Responsibilities of ADHS __________________________________________________ 3
Roles and Responsibilities of the County Health Departments ______________________________ 4
Education and Compliance _______________________________________________________ 4
Enforcement of the Law __________________________________________________________ 6
Amount and Source of Program Funding _______________________________________________ 7

State of Tobacco Control Report Card: Smoke-Free Arizona Scores a Grade A ________________ 27
Empower Pack __________________________________________________________________ 27

Conclusion ___________________________________________________________ 29

Smoke-Free Arizona Annual Report – June 2012

Executive Summary
On November 7, 2006, Arizona voters approved Proposition 201, the Smoke-Free Arizona Act, A.R.S. §
36-601.01 (the Act or the Law). The Law went into effect on May 1, 2007, prohibiting smoking inside
and within 20 feet of entrances, open windows, and ventilation systems of most enclosed public places
and places of employment, with a few exemptions.
While the Act prohibits smoking inside most enclosed public places and places of employment in
Arizona, smoking is allowed in establishments that meet specific exemption criteria. There are seven
exemptions, including private residences, designated smoking rooms in hotels and motels, retail tobacco
stores, Veterans and fraternal clubs, smoking when associated with a religious ceremony pursuant to the
American Indian Religious Freedom Act of 1978, outdoor patios, and theatrical performances upon a
stage or in the course of a film or television production.
Also included in Proposition 201, was the imposition of a two-cent tax per pack of cigarettes to be
deposited into the Smoke-Free Arizona Fund, which must be used to enforce the provisions of the Law.
If a proprietor of an establishment does not correct violations as requested, demonstrates willful
violations, or exhibits a pattern of noncompliance with the Act, they are subject to enforcement action.
They may receive a Notice of Violation (NOV) or an assessment of civil penalty fines between $100 and
$500 for each violation. If injunctive relief is requested, the Superior Court may impose appropriate
injunctive relief and civil penalty fines up to $5,000 per violation.
The Arizona Department of Health Services (ADHS) and all but one of Arizona’s fifteen counties work
together, through delegation agreements, to ensure that Arizonans are protected from secondhand smoke
exposure in most enclosed public places and places of employment. The county health departments
conduct consultations and on-site visits at public places and places of employment, including but not
limited to, local businesses, bars, and restaurants to provide education and to ensure continued
compliance with the Smoke-Free Arizona Act. Between May 1, 2011 and April 30, 2012, a total of
49,203 educational visits, consultations, and on-site visits were conducted. Many business proprietors
have made steps to go above and beyond the requirements of the Smoke-Free Arizona Act. In addition to
making the necessary changes to comply with the Act, such as posting the required “No Smoking” signs
and moving ashtrays, proprietors have also continued to build outdoor patios, provide designated smoking
areas, and establish in-house policies that are more strict than the Act to accommodate their employees
and customers.
During the fifth year after the Law went into effect, between May 1, 2011 and April 30, 2012, a total of
1,594 complaints alleging violations of the Smoke-Free Arizona Act were filed statewide. Most of the
complaints were regarding people smoking outside within twenty feet of an entrance and the presence of
ashtrays located outside within twenty feet of an entrance.
A total of 17 NOVs were issued statewide between May 1, 2011 and April 30, 2012, 1 of which was
issued by the ADHS Smoke-Free Arizona Program. The majority of the NOVs were issued to proprietors
that permitted employees, customers, or visitors to smoke inside enclosed public places and places of
employment. A total of $4,500 in civil penalty fines was collected statewide.
In 2011, Arizona earned an “A” grade on the American Lung Association State of Tobacco Control
Report for maintaining a strong and comprehensive enforcement program of the Smoke-Free Arizona
Act. For the fourth year in a row, the report has awarded a grade “A” recognizing the continued success
of the Smoke-Free Arizona Act.
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1.0

Smoke-Free Arizona Program

1.1

Background

S

econdhand smoke is defined as the combination of smoke exhaled
by a smoker and the smoke generated by the burning end of a
cigarette (or other tobacco product). Secondhand smoke is a
mixture of 4,000 chemical compounds that are released into the air
as gases and particles. Of these 4,000 compounds, 69 have been
identified as carcinogens or cancer-causing agents, 11 of which have
been specifically identified as human carcinogens.
Exposure to secondhand smoke is a health concern for people of all ages.
In 1992, the U.S. Environmental Protection Agency (EPA) officially
listed secondhand smoke as a Class A carcinogen. In 2006, the U.S.
Surgeon General’s report stated that there is no risk-free level of
exposure to secondhand smoke. Breathing even a little secondhand
smoke can be harmful to your health.
In November of 2006, Arizona voters made their voices heard by passing
the Smoke-Free Arizona Act, A.R.S. § 36-601.01 (“the Act” or “the
Law”). The Act protects all Arizonans from the harmful effects of
secondhand smoke exposure in most enclosed public places and places of
employment and within 20 feet of entrances, open windows, and
ventilation systems. Also included in the Act, is a two-cent tax per pack
of cigarettes to be deposited in the Smoke-Free Arizona Fund, which
must be used to enforce the provisions of the Law. The Act went into
effect on May 1, 2007.
The Act prohibits smoking inside enclosed public places and places of
employment with a few exemptions:
1) Private residences, except when used as a licensed child care, adult
day care, or health care facility;
2) Hotel and motel rooms that are rented to guests and are designated as
smoking rooms; provided however that not more than fifty percent of
rooms rented to guests in a hotel or motel are so designated;
3) Retail tobacco stores that are physically separated so that smoke
from retail tobacco stores does not infiltrate into areas where
smoking is prohibited under the provisions of this section;
4) Veterans and fraternal clubs when they are not open to the general
public;
5) Smoking when associated with a religious ceremony practiced
pursuant to the American Indian Religious Freedom Act of 1978;
6) Outdoor patios so long as tobacco smoke does not enter areas where
smoking is prohibited through entrances, windows, ventilation
systems, or other means; and
7) A theatrical performance upon a stage or in the course of a film or
television production.
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Smoke-Free Arizona Annual Report – June 2012

For each exemption to the Act, there are specific requirements that must
be met to qualify. These criteria are defined in the Act and in the
Arizona Administrative Code, Title 9, Chapter 2, Article 1.
Under the Act, the proprietor of a public place or a place of employment
is responsible for:
• Removing all indoor ashtrays and smoking receptacles and
moving all outdoors ashtrays and smoking receptacles at least 20
feet away of entrances;
• Posting the required “No Smoking” signs at every entrance into
the establishment;
• Educating their employees about the Act;
• Prohibiting anyone, such as employees, vendors, visitors, and
customers from smoking within 20 feet of all entrances, open
windows, and ventilation systems, and inside the establishment;
• Informing violators by politely requesting that they extinguish
their lit tobacco product or that they smoke outside at least 20
feet away from the entrance, open window, or ventilation
system.
If a proprietor of an establishment does not correct violations as
requested, demonstrates willful violations, or a pattern of noncompliance
with the Act, they are subject to enforcement action. They may receive a
Notice of Violation (“NOV”) or an assessment of civil penalty fines
between $100 and $500 for each violation. If injunctive relief is
requested, the Superior Court may impose appropriate injunctive relief
and civil penalty fines up to $5,000 per violation.

1.2

Roles and Responsibilities of ADHS

The provisions of the Act assign implementation and enforcement of the
Law to ADHS. In order to accomplish this, the Office of Inspection and
Compliance, due to its extensive experience with education, inspections,
investigations, and enforcement, oversees the Smoke-Free Arizona
Program.
The Smoke-Free Arizona Program is responsible for:
• Providing free signage to businesses
• Maintaining the Smoke-Free Arizona website:
www.smokefreearizona.org
• Answering inquiries coming via the information line: 1-877AZSTOPS
(1-877-297-8677), or from the smokefreearizona@azdhs.gov
mailbox
• Taking complaints coming through the complaint line: 1-8774AZNOSMOKE (1-877-429-6676), or from the
nosmokingarizona@azdhs.gov mailbox
• Conducting on-site advisory visits
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Smoke-Free Arizona Annual Report – June 2012

•
•
•
•
•
•
•

Maintaining a statewide database used by the county health
departments for complaint investigations and referrals
Providing training to new and existing health educators and
environmental health inspectors
Providing educational materials to county health departments
Assisting county health departments during complaint investigations
or advisory visits by riding along with the health educators or the
environmental health inspectors
Providing guidance to the county health departments with regards to
education, compliance, and enforcement
Initiating enforcement procedures for cases referred by Maricopa,
Gila, Pinal, Yavapai, Cochise, and Santa Cruz counties
Conducting education and compliance activities in Santa Cruz
County

1.3

Roles and Responsibilities of the County Health Departments

1.3.1

Education and Compliance

ADHS and the county health departments work diligently to protect all
Arizonans from secondhand smoke exposure and to ensure uniform
compliance with the Law throughout the State. Delegation agreements
have been signed with all but one of the State’s fifteen counties to assist
ADHS with education and compliance assistance. Funding is provided
to these counties using money from the Smoke-Free Arizona Fund.
Depending on the infrastructure of the county health department,
education and compliance assistance are performed by either health
educators from their Tobacco Education and Prevention Program or by
environmental health inspectors from their Environmental Services
Division. The map below represents the lead program for each county:
Map 1.1 Lead Program Responsible for Education and Compliance
for Each County Health Department

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Smoke-Free Arizona Annual Report – June 2012

Environmental Services Division
The Environmental Services Division is the lead program for education
and compliance in Cochise, Gila, Graham, Greenlee, Mohave, Navajo,
and Pinal counties. Environmental health inspectors verify compliance
and provide education about the Act during routine food safety and
environmental health inspections. Smoke-Free Arizona violations have
been included on inspection checklists to monitor compliance with the
Act. In addition, environmental health inspectors carry “No Smoking”
signs and educational brochures for distribution during routine
inspections and complaint investigations.
Tobacco Education and Prevention Program
The Tobacco Education and Prevention Program is responsible for
compliance and education in Apache, Coconino, La Paz, Pima, Yavapai,
and Yuma counties. Health educators have been actively working with
businesses in their communities by providing education about the
Smoke-Free Arizona Act and explaining the benefits of smoke-free
environments.
In these counties, a solid partnership exists between the Tobacco
Education and Prevention Program and the Environmental Services
Division. For example if an environmental health inspector observes a
smoking violation during a routine inspection in a food establishment, he
or she will notify the health educator about their observation(s). The
health educator will follow-up with the person in charge of the food
establishment to ensure compliance with the Law.
Dual Lead Programs – Environmental Services Division & Tobacco
Education and Prevention Program
With a population of 3,817,117, Maricopa County
is by far Arizona's most populous county,
encompassing more than half of the State's
residents. Joining efforts of health educators from
the Tobacco Education and Prevention Program
and environmental health inspectors from the
Environmental Health Services Division is the key
to ensuring compliance in Maricopa County.
For establishments permitted under the Maricopa County Health Code,
such as restaurants, bars, grocery stores, hotels/motels, and public
accommodations, education and complaint investigations are conducted
by environmental health inspectors. For non-permitted establishments
such as retail stores, repair shops, business offices, and shopping centers,
education and complaint investigations are conducted by health
educators from the Tobacco Education and Prevention Program.

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Smoke-Free Arizona Annual Report – June 2012

Environmental health inspectors and health educators use the same
approach with regards to education and compliance.
ADHS – Santa Cruz County
The ADHS Smoke-Free Arizona Program is
responsible for education and compliance in Santa
Cruz County. This includes investigating
complaints, conducting on-site inspections, and
educating the community about the Law and its
requirements.

1.3.2

Enforcement of the Law

Nine county health departments have the delegated authority for
enforcement activities such as issuing NOVs, assessing civil penalty
fines, attending administrative hearings, and seeking injunctive relief.
The map below illustrates who is responsible for enforcement in each
county.
Map 1.2 Enforcement Responsibilities for each County Health
Department

The counties conducting their own enforcement activities are Apache,
Coconino, Graham, Greenlee, La Paz, Mohave, Navajo, Pima and Yuma.
For these counties, the delegation agreement delineates the enforcement
duties and additional funding is provided.
For the remaining six counties, Maricopa, Gila, Cochise, Yavapai, Pinal,
and Santa Cruz, ADHS provides assistance for enforcement. This means
that once a pattern of noncompliance is documented, or there is evidence
of willful violations of the Act, the county health department refers the
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Smoke-Free Arizona Annual Report – June 2012

case to ADHS for enforcement. The enforcement procedures are
explained in Section 5.0 of this report.

1.4

Amount and Source of Program Funding

The Smoke-Free Arizona Act includes a two-cent tax that is imposed on
each pack of cigarettes. The money collected from this tax is deposited
into the Smoke-Free Arizona Fund and used to enforce the Act. Any
money remaining in the Smoke-Free Arizona Fund, after ADHS and its
delegates have met enforcement obligations for the fiscal year, is
deposited into the Tobacco Products Tax Fund and used for education
programs to reduce and eliminate tobacco use.
The graph below shows the amount of money received monthly in the
Smoke-Free Arizona Fund from May 1, 2011 to April 30, 2012.
Graph 1.1 Smoke-Free Arizona Fund Monthly Tax Revenue from May 1, 2011 to
April 30, 2012

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Smoke-Free Arizona Annual Report – June 2012

The graph below shows the amount of money received quarterly in the
Smoke-Free Arizona Fund from May 1, 2007 to April 30, 2011.
Graph 1.2 Smoke-Free Arizona Fund Quarterly Tax Revenue from May 1, 2007 to
April 30, 2011

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Smoke-Free Arizona Annual Report – June 2012

2.0

Education

A

s we cross the threshold of the fifth year after implementation of
the Smoke-Free Arizona Act, we continue to make major strides
to improve the communication and educational information
about the Act that is disseminated to the public and businesses of
Arizona.

2.1

Enhancing the Website: www.smokefreearizona.org

As the main channel of communication with the public, business owners,
and other partners throughout Arizona, the Smoke-Free Arizona website
is an essential part of the educational outreach of the Smoke-Free
Arizona Program. The website explains the benefits of smoke-free
enclosed public places and places of employment, and provides
information about the requirements of the Act both of which result in a
better understanding of the Act. Useful information explaining the
dangers of secondhand smoke, news archives, tips for compliance,
program updates, answers to frequently asked questions about the Law,
and links to valuable resources are also available. In addition, users can
now download the mySmokeFreeAZ mobile phone application.
The Smoke-Free Arizona website is maintained continuously by
updating or adding relevant information that can aid in reaching the
general public and assisting proprietors on how to comply with the Act.
This year, the “Downloads” page was updated to add the Smoke-Free
Arizona newsletters. These newsletters were created to inform
proprietors and citizens of Arizona about the requirements of Act. The
first issue, created in November 2009, reviewed the basic information the
public should know about the Act. Every issue since then has explained
a different requirement of the Act thus helping citizens to have a deeper
understanding of the Law. These newsletters have covered information
about outdoor patios and the 20 Foot Rule, outdoor areas, and multifamily housing.
To date, the most popular features of the website are still the sign order
page and the online reporting system. Since the Law went into effect,
business owners have been able to order required “No-Smoking” signage
free of charge from the website. In addition, concerned citizens continue
to report violations of the Act by filing a complaint form online in three
easy steps. Allowing concerned citizens to file complaints alleging
violations of the Law is not only mandated by the Act, but it is also an
effective tool to aid in education and compliance assistance.

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Smoke-Free Arizona Annual Report – June 2012

The image below is a print screen of the Smoke-Free Arizona Program
website.

An approximate combined
total of 1,385 calls were
received between May 1,
2011 and April 30, 2012.
ADHS received 789 calls
during business hours.

2.2

Answering the Information Hotline: 1-877-AZ-STOPS (1877-297-8677)

As required by the Smoke-Free Arizona Act, ADHS provides a 24/7 tollfree information line to answer inquiries from the general public and
business owners. During business hours, ADHS Smoke-Free Arizona
Program staff answers the calls. After business hours, live assistance is
provided by an answering service agency. The answering service agency
staff is trained to answer general questions about the Act, fulfill requests
for free signage, and document reports of violations. ADHS Smoke-Free
Arizona Program staff returns calls from people requesting further
assistance during the next business day. An approximate combined total
of 1,385 calls were received between May 1, 2011 and April 30, 2012.
ADHS received a total of 789 calls during business hours. Half of the
calls received were inquiries about the Smoke-Free Arizona Act, while
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Smoke-Free Arizona Annual Report – June 2012

the remaining calls were either requests for free signage or from
individuals reporting violations of the Act.
The graph below shows the number of calls received during and after
business hours.
Graph 2.1 Number of Calls Received by ADHS and by the After Hours Answering
Service between May 1, 2011 and April 30, 2012

The pie chart below shows the categories of calls (by percentage)
received during business hours by ADHS.
Pie Chart 2.1 Percentage of Calls by Category Received by ADHS between May 1,
2011 and April 30, 2012

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Smoke-Free Arizona Annual Report – June 2012

Of these calls, the top five types of inquiries received during business
hours were regarding:
1. The reasonable distance from entrances where smoking is prohibited
(the “20 Foot Rule”),
2. Smoking in multi-family housing,
3. Cessation information,
4. Complaint follow-up, and
5. “No Smoking” signage requirements.
The pie chart below illustrates the types of calls received and the most
frequent questions received.

Pie Chart 2.2 Percentage of Calls by Category Received by ADHS between May 1,
2011 and April 30, 2012 including the Top Five Inquiries

2.3
Maintaining the Email Addresses:
smokefreearizona@azdhs.gov and nosmokingarizona@azdhs.gov
The smokefreearizona@azdhs.gov email address is solely dedicated to
answering questions and providing information to the general public and
business owners about the requirements of the Smoke-Free Arizona Act.
The ADHS Smoke-Free Arizona Program Specialists are responsible for
replying to all inquiries received in this email mailbox.
The nosmokingarizona@azdhs.gov email address is used to process
reports of violations. Occasionally this email mailbox will receive
general questions from citizens and business owners, which are answered
by an ADHS Smoke-Free Arizona Program Specialist.

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Smoke-Free Arizona Annual Report – June 2012

2.4

“No Smoking” Signs

The Smoke-Free Arizona Act requires that most enclosed public places
and places of employment in Arizona have a “No Smoking” sign posted
at every entrance. All entrances should have signs posted except for
doors leading to an outdoor patio and doors used as an emergency exit.
Signs should include all the required information and be clearly and
conspicuously posted.
Business owners have the option to order “No-Smoking” signs free of
charge from the Smoke-Free Arizona Program or they may choose to
create their own signs as long as the required information is included.
The Smoke-Free Arizona Program offers 4 x 6 inch “No-Smoking”
stickers with an adhesive on the back that can attach to any surface in
four different designs. New this year, the Smoke Free Arizona Program
has created a 4 x 12 inch sticker that includes all the required information
and the 20 Foot Rule. This new and improved design makes these signs
more clearly visible and accentuates the 20 Foot Rule. Due to its design
and size, we are confident that this new sign will aid businesses to
achieve compliance with the Act by keeping employees and customers at
least 20 feet away from entrances.
The Smoke-Free Arizona Program provides the following types of signs:
• 3 x 5 inch vehicle sticker
• 4 x 6 inch English sticker (with or without the 20 Foot Rule
disclosure)
• 4 x 6 inch Bilingual sticker (with or without the 20 Foot Rule
disclosure)
• 4 x 12 inch English sticker (with the 20 Foot Rule disclosure)
The 4 by 6 sticker is the most popular sign because of its ease of use due
to the adhesive on the back, its design, and its UV coating on the front to
protect the sign from fading in the Arizona sun.
The demand for free signs has remained steady over the last year. A
total of 1,447 sign orders were placed by businesses. In addition, signs
are distributed to businesses during complaint inspections, advisory
visits, educational visits, and routine inspections conducted by county
health educators and health inspectors. A total of 51,750 signs were
distributed statewide.
The image below is the new 4 x 12 “No-Smoking” sticker.

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Smoke-Free Arizona Annual Report – June 2012

2.5

Advisory Visits

Smoke-Free Arizona Program staff provides compliance assistance to
proprietors by performing advisory visits at their public place or place of
employment. Upon request, county environmental health inspectors,
county health educators, and ADHS Smoke-Free Arizona Program
Specialists visit public places and places of employment to clarify any
questions that the proprietor may have about a specific area of concern.
In 2011, the Smoke-Free Arizona Program created two advisory forms as
a tool to document compliance efforts during these educational visits and
provide information to business proprietors. The standard Advisory
Form not only documents the visit and the establishment’s information,
but it also includes a list of requirements of the Act to which proprietors
must comply.
Since most advisory visits are requested by proprietors that have
questions about outdoor patios and/or designated smoking areas, the
Smoke-Free Arizona Program also created an Outdoor Patio Advisory
Form. The purpose of this advisory form is to provide guidance about
the requirements of outdoor patios as defined by Arizona Administrative
Code R9-2-108. This advisory form also defines the 20 Foot Rule and
further clarifies how it applies to outdoor patios. County environmental
health inspectors, county health educators, and Smoke-Free Arizona
Program Specialists do not perform plan review for outdoor patios;
however, they can ensure that proprietors understand the requirements of
the outdoor patio exemption. The Outdoor Patio Advisory Form informs
proprietors that the advisory visit does not indicate compliance with any
other code, law, or regulation that may be required - federal, state, or
local - and that it does not constitute endorsement or acceptance of the
current or proposed patio.

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Smoke-Free Arizona Annual Report – June 2012

3.0

Outreach

3.1

Reaching Out to Public Places and Places of Employment

A

rizona county health departments conduct consultations and onsite visits at local businesses, bars, and restaurants and provide
education to ensure continued compliance with the Smoke-Free
Arizona Act. Between May 1, 2011 and April 30, 2012, a total of 49,203
educational visits and consultations were conducted.
Between May 1, 2011 and April 30, 2012, the ADHS Smoke-Free
Arizona Program Specialists as well as county health educators and
county environmental health specialists conducted 209 educational
presentations to large employers and community partners such as WIC
clinics, Head Start programs, juvenile probation and transitional housing
facilities, multi-family housing management, and collegiate campuses.
Combined, an estimated 6,370 people attended these educational
presentations.
ADHS Smoke-Free Arizona Program Specialists and county health
educators used health fairs as an effective forum to provide education to
the public regarding the requirements of the Smoke-Free Arizona Act.
Some of the health fairs attended by program specialists and health
educators included: large distributing companies, hotels, health clubs,
insurance providers, and car dealerships.

MySmokeFreeAZ App
In response to the emergent mobile media surge, the ADHS Smoke-Free
Arizona Program launched a phone application that will allow Arizonans
to quickly and easily submit complaints when they observe violations of
the Smoke-Free Arizona Act. This free phone App will allow Arizonans
to take a picture of the violation and send it, along with GPS coordinates
and other descriptive information about the business in violation, to the
Smoke-Free Arizona Program. The App can be downloaded for iPhones
and Androids by searching for the keyword “mysmokefreeaz.” Once
installed, users can open the App and follow the prompts under the
“Report” tab to submit their complaints.
Cottonwood and Surrounding Areas Mass Mailing
Due to an increased volume of complaints in Yavapai County, the
Smoke-Free Arizona Program decided to focus education efforts towards
the city of Cottonwood and its adjacent surrounding areas. In February
2012, letters were mailed to 646 businesses in the Verde Valley area of
Yavapai County explaining the requirements of the Act. An educational
brochure and a required “No Smoking” sign were included with the
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Smoke-Free Arizona Annual Report – June 2012

letter. Proprietors were encouraged to order or make additional signs as
needed.
Property Management Outreach Project
Throughout the year, the Smoke-Free Arizona Program received
numerous inquiries regarding how the requirements of the Act apply to
office buildings, commercial and retail properties, and enclosed areas of
apartment buildings, condominiums, or other multi-family housing
facilities. For this reason, in April 2012, the Smoke-Free Arizona
Program outreached to property management companies of such
facilities statewide. 456 letters and 193 emails were sent to these
management companies to assist them in achieving compliance with the
Act.
Health Fairs
The Smoke-Free Arizona Program actively participates in forums that
can reach the community on a one-to-one basis. A perfect example of
such forums is health fairs. The Smoke-Free Arizona Program partners
with the Wellness Council of Arizona to outreach to large employers and
distribute information at wellness health fairs. This year, the SmokeFree Arizona Program attended 5 employee health fairs hosted by
Earnhardt Ford, Desert Mountain Club, Blue Cross Blue Shield, The
Hilton Squaw Peak Resort, and Golden Eagle Distributors. Information
about the Act was distributed to approximately 650 combined attendees.

3.2

Reaching Out to the Community: Success Stories

Maricopa County: Multi-Family Housing Workshop
The Maricopa County Office of Tobacco and Chronic Disease
Prevention convened a smoke-free multi-housing workshop of more than
thirty stakeholders in the community in March 2012. Key partners who
assisted in the recruitment of participants included Tanner Community
Development Corporation, Asian Pacific Community in Action, Inter
Tribal Council of Arizona, Native Health, and Arizonans Concerned
About Smoking. Day one of the workshop included presentations on
working with multi-family housing properties by two out of state experts
from Minnesota and Colorado. Day two of the workshop entailed a Call
to Action Round Table Brainstorming Session. The Call to Action
Round Table Brainstorming Session addressed the following four areas:
1) Coalition Formation, Recruitment, and Consensus Building, 2)
Education/Marketing, 3) Technical Assistance to Properties Wanting to
go Smoke-Free, and 4) Policies, Laws, and Initiatives. These
partnerships with multi-family property management companies will
hopefully raise awareness about the Act in the multi-family complex
industry and have a positive impact on families’ health.
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Smoke-Free Arizona Annual Report – June 2012

Mohave County: Reducing Complaints through Educational Visits
For the past year, the Mohave County Department of Public Health made
a conscious effort to increase their educational on-site visits to businesses
throughout the county. In addition to the county health department
inspectors that conduct routine inspections, the department had a fulltime employee dedicated to the Smoke-Free Arizona Program.
Unfortunately, this full time position was reduced to a part-time health
educator position. Due to this reduction, the department was able to save
salary funds for future projects. The Mohave County Health Department
decided to have the health educator focus his time and efforts on
conducting mostly educational visits while still responding to complaints
that were filed. The department’s active participation and focus on
education drastically reduced complaints received in Mohave County.
As the number of educational visits increased from 1,028 in 2011 to
2,177 in 2012, the number of complaints decreased from 41 to 31. As
illustrated on the graph below, there is no doubt that educational visits
had a huge impact on complaint reduction in Mohave County.

Graph 3.1 Number of Complaints vs. Educational Visits in Mohave County between
May 1, 2007 and April 30, 2012

Santa Cruz County: Working Towards Compliance through
Partnerships and Educational Advisory Visits
Reaching out to businesses located in Santa Cruz County has been
successful despite the distance between the ADHS Smoke-Free Arizona
Program located in Phoenix and the Santa Cruz County communities. A
continuing partnership with the Nogales Chamber of Commerce is an
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Smoke-Free Arizona Annual Report – June 2012

effective channel used to stay in touch with business owners. The
Chamber of Commerce provides Smoke-Free Arizona “No Smoking”
signs and educational brochures to the community of Nogales and to
business proprietors that are members of this organization.
As previously mentioned, Smoke-Free Arizona staff provide compliance
assistance and education to businesses and proprietors throughout the
State. This year’s compliance efforts focused on advisory visits in Santa
Cruz County. During the month of June, advisory visits were conducted
in Tubac and Nogales. During the month of January 2012, advisory
visits were conducted in Sonoita and Nogales. A combined total of 111
advisory visits were conducted in Santa Cruz County. Proprietors
received the required “No Smoking” signs to post at all business
entrances as well as a general brochure that explains the basic
information about the requirements of the Smoke-Free Arizona Act. In
addition, Advisory Forms were used to document these educational
visits, the establishment’s information, and provide a list of requirements
of the Act that proprietors must comply with. The Smoke-Free Arizona
Program hopes to see increased compliance in Santa Cruz County as a
result of conducting proactive advisory visits.

A total of 111 advisory visits
were conducted by SmokeFree Arizona Program
Specialists in Tubac,
Sonoita, and Nogales in
Santa Cruz County.

3.3

Educational Newsletter

In a continued effort to disseminate information about the Act, three new
Smoke-Free Arizona newsletters were created and distributed to citizens
and businesses of Arizona during the last year. The second issue of the
second volume of the newsletter was designed with the intent of
reviewing how the Act applies to outdoor areas such as sidewalks,
walkways, breezeways, parks, swimming pools, outdoor venues, and bus
stops. This newsletter was distributed electronically to approximately
12,670 business proprietors. The third issue of the second volume of the
newsletter contained information about private residences and multifamily housing complexes. Many inquiries received by phone and email
by the Smoke-Free Arizona Program are regarding multi-family housing
complexes. This newsletter provided information about how the Act
applies to enclosed common areas, outdoor common areas, and outdoor
swimming pools in these residential complexes. This newsletter was
sent to approximately 11,046 recipients via email. The first issue of the
third volume of the newsletter discussed difference between the SmokeFree Arizona Act, local ordinances, and in-house smoking policies. This
newsletter also featured the new mysmokefreeaz mobile phone App that
was recently launched. Approximately 9,777 business proprietors
received this newsletter by email.
The three Smoke-Free Arizona newsletters were distributed
electronically to a collective approximate total of 33,583 business
proprietors throughout Arizona. The distribution of the Smoke-Free
Arizona Newsletter is a successful and cost efficient educational
outreach effort.
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Smoke-Free Arizona Annual Report – June 2012

The images below are copies of the Smoke-Free Arizona Newsletters.

Volume 2, Issue 2

Volume 2, Issue 3

Volume 3, Issue 1

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Smoke-Free Arizona Annual Report – June 2012

3.4

Working with Smoke-Free Arizona Partners

One of the most important and constant partnerships the Smoke-Free
Arizona Program has is with the county health departments. Through
delegation agreements, county health departments play a major role in
providing education, compliance assistance, and in some instances
enforcement of the Smoke-Free Arizona Act. Each year, an annual
training session is arranged to provide standard and consistent
information to county health educators and county health inspectors. In
previous years, the Smoke-Free Arizona Program Specialists have
traveled to each individual county to provide these training presentations.
In other instances, two or three counties have come together to be part of
the annual training and thus minimizing travel. Last year, the training
was offered using i-Linc – a system that enabled users to join a
conference call and log in from their computer and follow the
PowerPoint presentation.

This year, for the first time,
the Smoke-Free Arizona
annual training for new
and existing employees was
offered as a YouTube video.

As technology advances, the Smoke-Free Arizona Program is always
looking for new ways to provide continuing education to county health
educators and county health inspectors. This year, for the first time, the
training was offered as a YouTube video. Recorded audio was added to
each slide of the PowerPoint training presentation and then it was
uploaded as a video on YouTube. This training format was cost effective
and also allowed educators and inspectors to take the training when
convenient for their schedule. Each county health inspector who is a
Registered Sanitarian is required to have at least 12 hours of continuing
education units (CEUs). This training offered Registered Sanitarians
1CEU hour.
For those counties in which county health inspectors play a major role in
the Smoke-Free Arizona Program, there is also one more chance at
continuing education about the Smoke-Free Arizona Program during the
year. Towards the end of the year, in November, the ADHS and the
Arizona Sanitarians’ Council put together a conference to help those
inspectors who have not yet fulfilled the CEU requirement. Registered
Sanitarians can obtain 12 CEU hours by attending this conference. For
the past five years, the Smoke-Free Arizona Program has been invited to
present relevant information about the Act.

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Smoke-Free Arizona Annual Report – June 2012

4.0

Compliance

4.1

Verifying Compliance through Complaint Response and
Routine Inspections

C

ompliance with the Smoke-Free Arizona Act is continuing to
increase throughout the State. Compliance is monitored through
complaint response inspections at enclosed public places and
places of employment. Additionally, compliance is verified during
routine food safety inspections conducted at foodservice establishments,
such as bars and restaurants.
During the fifth year of the Smoke-Free Arizona Act business proprietors
have continued to go above and beyond the requirements of the SmokeFree Arizona Act. In addition to making the necessary changes to
comply with the Act, such as posting the required “No Smoking” signs
and moving ashtrays, proprietors continue to build outdoor patios,
provide designated smoking areas, and establish in-house smoking
policies that are more strict than the Act to accommodate their
employees and customers.
4.2

Complaint Investigation

Complaints alleging violations of the Smoke-Free Arizona Act are
investigated by all but one of the State’s fifteen counties (See Map 1.2).
Once a complaint is received and it is determined that the allegations are
valid violations of the Act, an unannounced inspection will take place
and/or the business proprietor is notified within 15 days of the complaint.
When necessary, investigators go in pairs to perform inspections, for
example, during night inspections and for cases where the evidence may
be difficult to find. If a violation of the Act is observed during an
inspection, the proprietor is requested to correct the violation at the time
of the inspection. If the violation is not corrected at that time, a reinspection will take place to verify that a corrective action has been
made. Re-inspections have shown to be an effective approach in
achieving compliance.
Complainants may follow-up on their complaints by calling the ADHS
Smoke-Free Arizona Program or their county health department.
Complaint investigation findings are entered into a database that can be
accessed by Smoke-Free Arizona Program officials only. Complaints
can be located with a complaint identification number that is issued when
a complaint is filed, the complainants’ last name (if provided), the
business name, address, or cross streets.

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Smoke-Free Arizona Annual Report – June 2012

4.3

Complaint Numbers Stabilize With Increased Compliance
throughout Arizona

The ADHS Smoke-Free Arizona Program continues to encourage
members of the public to report violations of the Smoke-Free Arizona
Act. Complaints can be filed by one of the following:
• Filling out an online complaint form at
www.smokefreearizona.org,
• Calling the toll-free Smoke-Free Arizona hotline at 877-4-AZNOSMOKE (877-429-6676), or
• Sending an e-mail to nosmokingarizona@azdhs.gov, or
• Capturing and sending a complaint using the mysmokefreeaz
App available for smartphones.
During the fifth year after the Law went into effect, between May 1,
2011 and April 30, 2012, a total of 1,594 complaints alleging violations
of the Smoke-Free Arizona Act were filed statewide. The numbers of
complaints filed this year resulted in a slight increase when compared to
last year’s total of 1,450 complaints and the previous year’s total of
1,389 complaints filed statewide. Overall the complaint trend during the
last three years has been consistent. Most of the complaints were
regarding people smoking outside within twenty feet of an entrance and
the presence of ashtrays located outside within twenty feet of an
entrance.
The graph below illustrates the number of complaints filed monthly
statewide between May 1, 2011 and April 30, 2012.
Graph 4.1 Total Complaints Filed Statewide from May 1, 2011 to April 30, 2012

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Smoke-Free Arizona Annual Report – June 2012

The counties that received the highest number of complaints are:
Maricopa (58%), Yavapai (16%), Pima (13%), Pinal (4%), and Mohave
(2%). Of the 1,594 complaints received, 1,471 complaints reporting
violations of the Act were located in these five counties.
The top five counties that received the highest percentage of complaints
between May 1, 2011 and April 30, 2012 are shown in the map below.
Map 4.1 Top Five Counties with the Highest Percentage of
Complaints

The number of complaints received for each county between May 1,
2011 and April 30, 2012 is shown in the map below.
Map 4.2 Number of Complaints for Each County between May 1,
2011 and April 30, 2012

The complaints received during the fifth year after the Law went into
effect remained consistent in comparison to the previous two year’s May
1, 2010 to April 30, 2011 and May 1, 2009 to April 30, 2010. A total of
4,803 complaints were filed during the first year and a total of 1,776
complaints were filed during the second year. During the third year, the
number of complaints continued to decline to a total of 1,389 complaints
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Smoke-Free Arizona Annual Report – June 2012

filed statewide. The fourth year remained consistent with a total of 1,450
complaints filed statewide. The current year, saw the number of
complaints slightly increase but generally followed a similar pattern to
the two previous years with a total of 1,594 complaints filed statewide.
Efforts to educate business owners and to incorporate compliance checks
into routine food safety inspections continue to result in maintaining a
steady number of complaints and thus continuing to achieve compliance
statewide.
The line graph below illustrates the comparison between the number of
complaints received during the first, second, third, fourth, and fifth year
after the Law went into effect.
Graph 4.2 Comparison of Complaints Filed Monthly Statewide between May 1, 2007 and
April 30, 2012

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Smoke-Free Arizona Annual Report – June 2012

5.0

Enforcement

5.1

Initiating Legal Procedures

N

ine of the fifteen Arizona county health departments have the
delegated authority to enforce the provisions of the Smoke-Free
Arizona Act. These include Apache, Coconino, Graham,
Greenlee, La Paz, Mohave, Navajo, Pima, and Yuma counties. The
ADHS Smoke-Free Arizona Program is responsible for enforcement in
the remaining six counties, including Cochise, Gila, Maricopa, Pinal,
Santa Cruz, and Yavapai (See Map 1.2).
If a proprietor of an establishment does not correct violations as
requested, demonstrates willful violations, or a pattern of noncompliance
with the Act, he or she is subject to enforcement action and may receive
a Notice of Violation (“NOV”) or an assessment of civil penalty fines
between $100 and $500 for each violation. If injunctive relief is
requested, the Superior Court may impose appropriate injunctive relief
and civil penalty fines up to $5,000 per violation.

A total of 17 NOVs were
issued and a total of $4,500
in civil penalty fines was
collected statewide between
May 1, 2011 and April 30,
2012.

To attain consistent statewide enforcement of the Act, a 5th annual
training was given by ADHS to each county health department. The
annual training provides an opportunity for all existing and new
inspectors to receive uniform training to ensure all inspectors are
implementing the Smoke-Free Arizona Act consistently throughout the
State. The annual training also gives inspectors a chance to ask
enforcement questions specific to their County.

5.2

Achieving Compliance through Legal Proceedings

Enforcement actions take place when educational efforts fail to result in
compliance with the Smoke-Free Arizona Act in a timely manner. The
ADHS Smoke-Free Arizona Program has had tremendous support from
the Education & Health Section attorneys from the Office of the Arizona
Attorney General and from the Office of Administrative Rules at ADHS.
This support, combined with an effective enforcement protocol, allows
ADHS to better serve the county health departments when cases are
referred to the ADHS Smoke-Free Arizona Program for enforcement.
Notices of Violation are issued in response to a pattern of noncompliance
or willful violations of the Law. An NOV details violations that have
been observed and documented during complaint investigations. A total
of 17 NOVs were issued statewide between May 1, 2011 and April 30,
2012, 1 of which was issued by the ADHS Smoke-Free Arizona
Program. A total of $4,500 in civil penalty fines was collected statewide.
The majority of the NOVs were issued to proprietors that permitted
employees, customers, or visitors to smoke inside enclosed public places
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Smoke-Free Arizona Annual Report – June 2012

and places of employment. No new cases were brought before the
Superior Court for injunctive relief this year.
The number of NOVs issued to proprietors of public buildings and places
of employment were greater than the number of NOVs issued to retail
food establishments. 10 NOVs were issued to proprietors of places of
employment and public places, such as jewelry stores, vehicle repair
shops, and hair salons. 7 NOVs were issued to proprietors of retail food
establishments, such as bars, restaurants, and gas station convenience
stores.
The 1 NOV issued by the ADHS Smoke-Free Arizona Program, has
completed the enforcement process and was successfully closed. The
proprietor of the establishment chose not to appeal the NOV and
assessment of civil penalties. A total of $2,600.00 in possible civil
penalty fines was assessed. The proprietor paid the civil penalty amount
of $2,600.00 in full.
In previous annual reports, ADHS indicated that settlement agreements
have been met which included a lesser fine; however, the remainder of
the original fine was deferred, as long as the business is not found in
violation of the Act at any time in the future. Should a business be found
in violation after signing a settlement agreement, the deferred amount
must be paid and additional fines may be assessed. Between May 1,
2011 and April 30, 2012, ADHS did not reach any settlement agreements
with any enforcement proceedings. Additionally, ADHS has previously
reported enforcement cases which have been referred to the Attorney
Generals collections department for non-payment of civil penalties. 8
enforcement cases are currently referred to collections.
During the fifth year, 2 administrative hearings were held to determine
the outcome of 17 enforcement cases statewide. The outcome for both
hearing decisions were issued in favor of ADHS and found the
proprietors to be in violation of the Smoke-Free Arizona Act.

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Smoke-Free Arizona Annual Report – June 2012

6.0

Protecting Arizonans Health

6.1

State of Tobacco Control Report Card: Smoke-Free Arizona
Scores a Grade A

T

he American Lung Association State of Tobacco Control report
tracks progress on key tobacco control policies at the state and
federal level and assigns grades to tobacco control laws and
regulations enacted.
Arizona is one of 35 states, along with American
Samoa, the Northern Mariana Islands, Puerto
Rico, the U.S. Virgin Islands and the District of
Columbia, that have passed comprehensive
smoke-free air laws that protect the public and
workers from the dangers of secondhand smoke
by requiring that workplaces and/or restaurants
and/or bars be 100% smoke-free (as of April 1,
2012).

Empower Pack kits were
sent out to 350 childcare
centers in Arizona
containing a Smoke-Free
Arizona “No Smoking” sign
and an educational
brochure.

This year once again and for the fourth
consecutive year, Arizona earned a grade A in The American Lung
Association State of Tobacco Control 2010 report, for maintaining a
strong and comprehensive enforcement program of the Smoke-Free
Arizona Act. The report states that Arizona’s statewide smoke-free
workplace law, also known as Smoke-Free Arizona, has had continued
success. The American Lung Association works diligently with
organizations, state departments, and legislators to address tobacco
control issues. The Arizona Department of Health Services continues to
work in partnership with the Arizona American Lung Association to
make sure that the Law is appropriately enforced throughout the state.
6.2

Empower Pack

As in years past, the Smoke-Free Arizona Program has partnered with
the ADHS Bureau of Nutrition and Physical Activity to provide
educational materials for the Empower Pack Program. The Empower
Pack Program is a nutrition and tobacco-free program that childcare
centers may choose to participate in to receive discounted state licensing
fees, with the agreement that centers will adopt more healthy habits by
implementing program standards. Empower Centers teach children how
to live healthy lives by using the following ten curriculum requirements:
1. Facilities should encourage physical activities as part of their
curriculum by scheduling at least 60 minutes of planned activity
(which can be broken up in shorter time periods) per day.
Encourage “sun safe” physical activities.
2. Limit kids’ screen time to under one hour a day.
3. Avoid more than 60 minutes of sedentary activity at a time,
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Smoke-Free Arizona Annual Report – June 2012

except while the child is sleeping.
4. Offer water at least 4 times during the day.
5. Serve 1% low fat or fat free milk for all children over two
years of age.
6. Serve only 100% percent fruit juice (with no added sugars),
and limit kids to (4 ounces) per day.
7. Serve meals family style and let the child decide how much to
eat. Avoid rewarding good behavior or a clean plate with foods
of any kind.
8. If able, participate in the USDA Child and Adult Care Food
Program.
9. Facilities and homes should be totally (24-hour) smoke-free
campuses.
10. All families should receive education and referrals regarding
tobacco prevention cessation and second hand smoke at least 4
times per year.
The Smoke-Free Arizona Program provided one “No Smoking” 4 x 6
sticker sign per Empower Pack kit. Also included was The Smoke-Free
Arizona Act Clearing the Air for Employers brochure. This year,
Empower Pack kits were sent out to 350 childcare centers in Arizona in
addition to the 1,469 centers that received Smoke-Free Arizona materials
in 2010. A link to the Smoke-Free Arizona website,
www.smokefreearizona.org, can also be found on the Empower Pack
website as a resource for Empower Centers to utilize.

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Smoke-Free Arizona Annual Report – June 2012

7.0

Conclusion

T

he fifth year of the Smoke-Free Arizona Act saw a continuous
number of inquiries from Arizona citizens and a continued
stabilization although with a slight increase in the number of
complaints filed by concerned citizens. Partnerships with county
health educators and county environmental health inspectors provided
education and timely complaint assistance to citizens and business
owners throughout their communities.
Providing awareness of the Act results in higher levels of compliance.
This was achieved in multiple ways including but not limited to:
educational outreach, compliance assistance during complaint
inspections, advisory visits, health fairs, conferences and the media. For
the fourth consecutive year The American Lung Association State of
Tobacco Control report card awarded an “A” to the Smoke-Free Arizona
Program recognizing the success the program has achieved by using the
previously mentioned methods.
The ADHS Smoke-Free Arizona Program continues to encourage
members of the public to report violations of the Act by filling out a
complaint form online, by calling the toll-free complaint line, by sending
an email, or using the new mysmokefreeaz smartphone application. A
total number of 1,594 complaints were filed between May 1, 2011 and
April 30, 2012. Most of the complaints, as in years past, were regarding
people smoking outside, but within 20 feet of an entrance, and the
presence of an ashtray outside within 20 feet of an entrance. Compared
to the number of complaints, only a minimal number of complaints
resulted in legal proceedings. Enforcement took place only when
educational efforts did not result in timely compliance.
We are pleased to report that the fifth year of implementation of the
Smoke-Free Arizona Act has continued to provide cleaner air for the
citizens of Arizona demonstrating “It’s a Benefit, Not a Ban.”

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Smoke-Free Arizona Annual Report – June 2012

For questions regarding this report please contact:
Krystal Colburn
Program Manager, Smoke-Free Arizona
Arizona Department of Health Services
Office of Inspection and Compliance
150 North 18th Avenue, Suite 130
Phoenix, AZ 85007
602-364-3449
Krystal.colburn@azdhs.gov

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