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 2013
“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
1.4

2.0

Education _____________________________________________________________ 9
2.1
2.2
2.3
2.4
2.5

3.0

Initiating Legal Procedures _________________________________________________________ 26
Achieving Compliance through Legal Proceedings ______________________________________ 26

Protecting Arizonans Health _____________________________________________ 28
6.1
6.2
6.3

7.0

Verifying Compliance through Complaint Response and Routine Inspections _________________ 22
Complaint Investigation ___________________________________________________________ 22
Complaint Numbers Stabilize With Increased Compliance throughout Arizona ________________ 23

Enforcement __________________________________________________________ 26
5.1
5.2

6.0

Reaching Out to Public Places and Places of Employment ________________________________ 16
Reaching Out to the Community: Success Stories _______________________________________ 17
Educational Newsletter ____________________________________________________________ 20
Working with Smoke-Free Arizona Partners ___________________________________________ 21

Compliance ___________________________________________________________ 22
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: ___________________________________________________ 13
“No Smoking” Signs ______________________________________________________________ 14
Advisory Visits __________________________________________________________________ 15

Outreach _____________________________________________________________ 16
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
Amount and Source of Program Funding _______________________________________________ 7

State of Tobacco Control Report Card: Smoke-Free Arizona Scores a Grade A ________________ 28
Empower Pack __________________________________________________________________ 28
Indoor Air Quality at Nine Large-Hub Airports With and Without Designated Smoking Areas Study
– Phoenix Sky Harbor International Included __________________________________________ 29

Conclusion ___________________________________________________________ 31

Smoke-Free Arizona Annual Report – June 2013

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 counties work 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, 2012 and April 30, 2013, a total of 23,587 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 sixth year after the Law went into effect, between May 1, 2012 and April 30, 2013, a total of
1,681 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 6 NOVs were issued statewide between May 1, 2012 and April 30, 2013, 4 of which were
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. The proprietors that were issued these NOVs faced a total of $7,750 in civil penalty fines.
Numerous settlements were reached with the said recipients and a total of $650 in civil penalty fines was
collected statewide.
In 2012, 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 sixth 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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Smoke-Free Arizona Annual Report – June 2013

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 2013

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 all existing and prospective 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;
and
• 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, or 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 2013

•
•
•
•
•
•
•

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; and
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 2013

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.
Maricopa County: No Longer a Dual Lead Program
With a population of 3,942,169 Maricopa County
is by far Arizona's most populous county,
encompassing more than half of the State's
residents. Joining efforts with Maricopa County
Department of Public Health is the key to
ensuring compliance in Maricopa County.
In previous years, education and complaint
investigations were conducted by environmental
health inspectors at establishments permitted under the Maricopa County
Health Code, such as restaurants, bars, grocery stores, hotels/motels, and
public accommodations. For non-permitted establishments such as retail
stores, repair shops, business offices, and shopping centers, education
and complaint investigations were conducted by Maricopa County
Department of Public Health. In July 2012, the Maricopa County
Department of Public Health took sole responsibility for conducting
education and compliance investigations at both permitted and nonpermitted establishments. Complaint statistics show the number of
complaints in Maricopa County was more than twice as high in non5

Smoke-Free Arizona Annual Report – June 2013

permitted establishments than in permitted establishments, causing the
shift in focus to non-permitted establishments that were handled by
Maricopa County Department of Public Health.
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.

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 to support these duties.
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 violation of the Act, the county health department refers the
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Smoke-Free Arizona Annual Report – June 2013

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 purchased. 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, 2012 to April 30, 2013.
Graph 1.1 Smoke-Free Arizona Fund Monthly Tax Revenue from May 1, 2012 to
April 30, 2013

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Smoke-Free Arizona Annual Report – June 2013

The graph below shows the amount of money received quarterly in the
Smoke-Free Arizona Fund from May 1, 2007 to April 30, 2013.
Graph 1.2 Smoke-Free Arizona Fund Quarterly Tax Revenue from May 1, 2007 to
April 30, 2013

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Smoke-Free Arizona Annual Report – June 2013

2.0

Education

A

s we cross the threshold of the sixth 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 (SFA) Program. The SFA website contains detailed information
about all the requirements of the Act and how these requirements apply
to different indoor and outdoor areas. 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
order free “No Smoking” signs, and report violations by either filling out
an easy online form or by downloading the mySmokeFreeAZ mobile
phone application.
The Smoke-Free Arizona website is continuously maintained by
updating or adding relevant information that can aid in reaching the
general public and assisting proprietors to comply with the Act. This
year, the entire Smoke-Free Arizona website was revamped and updated.
In addition, a new Smoke-Free Arizona Timeline was created in a more
contemporary format. This timeline provides an overview of the most
important milestones in the Smoke-Free Arizona Program history. It
also provides a quick insight into the types of activities and
responsibilities of the Smoke-Free Arizona Program.
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 2013

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

An approximate combined
total of 1,216 calls were
received between May 1,
2012 and April 30, 2013.
ADHS received 648 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. This year, a
training video was sent to the answering service agency for new
employees and to serve as a refresher for existing staff. ADHS SmokeFree Arizona Program staff returns calls from people requesting further
assistance during the next business day. An approximate combined total
of 1,216 calls were received between May 1, 2012 and April 30, 2013.

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Smoke-Free Arizona Annual Report – June 2013

ADHS received a total of 648 calls during business hours. Over half of
the calls received were inquiries about the Smoke-Free Arizona Act,
while 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, 2012 and April 30, 2013

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Smoke-Free Arizona Annual Report – June 2013

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,
2012 and April 30, 2013

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. Outdoor patios;
3. Smoking in multi-family housing;
4. “No Smoking” signage requirements; and
5. Cessation information.

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Smoke-Free Arizona Annual Report – June 2013

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,
2012 and April 30, 2013 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 2013

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 four unique 4 x 6 inch “No
Smoking” stickers with an adhesive on the back that easily attaches to
any surface. The newest sign created is a larger, more conspicuous 4 x
12 inch sticker. This sign is clearly visible, contains all the required
language and reporting information, and accentuates the 20 Foot Rule.
The larger 20 Foot Rule helps businesses communicate to their
employees and customers that smoking is prohibited inside and within 20
feet of 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 x 6 sticker is the most popular sign because of its size and design,
adhesive back, and its ultraviolet (UV) coating on the front to protect the
sign from fading in the Arizona sun.
A total of 1,240 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 56,592 signs were
distributed statewide. The demand for free signs has remained steady
over the last four years. On average, the Smoke-Free Arizona Program
has distributed approximately 55,949 signs yearly in the last five years.
The images below include each of the “No Smoking” stickers provided
by the Smoke-Free Arizona Program.

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Smoke-Free Arizona Annual Report – June 2013

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 assist with
answering 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 to 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 in September of 2009, an
Outdoor Patio Advisory Form. This advisory form is used frequently to
provide guidance about the requirements of outdoor patios as defined by
Arizona Administrative Code R9-2-108. The 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.
Over the last two years, both the Advisory Form and the Outdoor Patio
Advisory Form have proven to be useful tools. These two forms serve as
documentation for the advisory visits and as a tracking method used to
account for educational activities conducted. For this reason, the ADHS
Smoke-Free Arizona Program has shared the forms with the county
health departments and encouraged their use.

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Smoke-Free Arizona Annual Report – June 2013

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, 2012 and April 30, 2013, a total of 23,587
educational visits and consultations were conducted.
Between May 1, 2012 and April 30, 2013, the ADHS Smoke-Free
Arizona Program Specialists as well as county health educators and
county environmental health specialists conducted 189 educational
presentations to large employers and community partners such as
grocers, hotels, churches, childcare centers, Head Start programs, after
school programs, juvenile detention centers, women’s transitional
housing facilities, multi-family housing, and collegiate campuses.
Combined, an estimated 8,664 people attended these educational
presentations.
The Smoke-Free Arizona Program 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 small businesses, large pharmaceutical and biotechnology
companies, insurance providers, and car dealerships.
Multi-Family Housing Mass Mailing
In May 2012, the Smoke-Free Arizona Program had the opportunity to
sponsor a part-time internship position. The objective of the internship
project was to outreach to multi-family housing complexes through a
mass mailing. The Smoke-Free Arizona Program intern worked
diligently to put together a list of contact information for multi-family
housing complexes statewide. Once the list was compiled, messaging
was created, which educated business proprietors about how the Act
applies to individual units, enclosed common areas, outdoor common
areas, and swimming pools in multi-family housing complexes. In
December 2012, a total of 1,284 letters and 447 emails were sent to these
multi-family housing complex proprietors to assist them in achieving
compliance with the Act. The proprietors received a letter or email, an
informative Private Residence and Multi-Family Housing brochure, and
a required “No Smoking” sign. Proprietors were encouraged to contact
the Smoke-Free Arizona Program with questions or for further
information about their specific complex. As a result, the Program saw
an increase in sign orders from multi-family housing facilities.

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Smoke-Free Arizona Annual Report – June 2013

County Health Department Assessments
Beginning in October 2012 and concluding in February 2013, the
Smoke-Free Arizona Program conducted on-site assessments at each of
the delegated county health department in the State. The assessments
provided the counties with a platform to showcase their educational and
outreach efforts, share experiences, discuss difficult inspections, seek
guidance, and detail enforcement practices. As a result, the assessments
not only gave the Smoke-Free Arizona Program an opportunity to
become more familiar with how the counties operate their programs, but
to also improve communication between partners and provide feedback
and resources that were geared toward creating Smoke-Free programs
that are more consistent statewide.
Health Fairs
The Smoke-Free Arizona Program actively participates in forums that
can reach the community on a one-to-one basis, such as 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 Smoke-Free Arizona Program
attended 5 employee health fairs hosted by Earnhardt Lexus and Dodge,
Blue Cross Blue Shield, Medicis Pharmaceutical Corporation, and GE
Capital. Information about the Act was distributed to approximately 450
attendees.
3.2

Reaching Out to the Community: Success Stories

Coconino County: Continued Success in Multi-Family Housing
Complexes
In 2009-2010 with the help of other professionals in several different
states, the Coconino County Public Health Services District worked with
some proactive apartment communities in Flagstaff to develop plans for
voluntary smoke-free policies. Some apartment communities designated
select units as smoke-free, while others designated entire buildings.
Other communities designated all units as smoke-free, one of which went
even further to make all units and the entire grounds smoke-free. Two
more communities adopted a smoke-free policy for some of their
apartment buildings. Those buildings filled up so quickly and received
so much interest that additional buildings were projected to be phased
into the smoke-free policy in the near future.
In 2012-2013, the Coconino County Public Health Services District
continued its outreach to multi-family housing complexes and added two
additional apartment communities and 704 units of smoke-free housing
to the area. At this time, Flagstaff has 1,042 units and Page has 120
units, bringing the county’s total up to 1,162 smoke-free units. Coconino
County residents seeking a smoke-free apartment complex may search
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Smoke-Free Arizona Annual Report – June 2013

the county’s website to find smoke-free apartments under the section,
Multi-Unit Rental Properties with Non-Smoking Policies Available.
Through a tremendous amount of education and “pavement pounding,”
the Coconino County Health Department has seen this idea sprout from a
seedling of an idea into a pretty nice blossom of reality that will
hopefully continue to grow.
Maricopa County: Helping Businesses Through Education
As the most populated county in the state, Maricopa County receives the
highest amount of complaints statewide. During the past year, the
Maricopa County Department of Public Health had the opportunity to
use their educational abilities to turn some of their inspections into a
positive experience for the proprietors. After inspecting multiple bars,
employees educated on the Smoke-Free Arizona Act said that they felt
empowered to tell customers to move 20 feet away from entrances, open
windows and ventilation systems in their establishments. Additionally,
these same employees reported feeling relieved knowing the Law was
being enforced to protect them from secondhand smoke while on the job.
For one company in Maricopa County, after a complaint inspection was
conducted and education was provided on the Smoke-Free Act, the
business voluntarily chose to go smoke-free. A designated smoking area
was created outside the gated area of the entrance to the business. This
company also posted signage declaring their worksite as a smoke-free
facility and grounds. Likewise, after receiving a complaint inspection,
an apartment complex in Surprise requested information on becoming
smoke-free. This apartment manager is the coordinator of the West
Valley multi-housing meetings and wanted to develop a collaboration
and partnership with the Maricopa County Health Department of Public
Health to address apartment managers about going smoke-free. As a
result of continued education and enforcement, new collaborations are
being formed that intend to aid in prolonged benefits to many families
and individuals in multi-family housing complexes.
Santa Cruz County: Working Towards Compliance through
Partnerships and Educational Outreach Efforts
ADHS Smoke-Free Arizona Program has remained successful in
reaching out to businesses located in Santa Cruz County despite some
challenges caused by the distance between the ADHS Smoke-Free
Arizona Program and the Santa Cruz County communities. A continuing
partnership with the Nogales Chamber of Commerce is an 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.

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Smoke-Free Arizona Annual Report – June 2013

The Smoke-Free Arizona
Program conducted 20
advisory visits, attended a
health fair, and sent 218
letters as part of the
educational outreach efforts
in Santa Cruz County.

As previously mentioned, Smoke-Free Arizona staff provides
compliance assistance and education to businesses and proprietors
throughout the State. This year, Smoke-Free Arizona Program
Specialists focused on three different methods to conduct educational
outreach efforts in Santa Cruz County. During the month of July 2012,
20 advisory visits were conducted in Nogales. 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
with which proprietors must comply. In the same month, the SmokeFree Arizona Program attended the Carondelet Health Network Wellness
Fair at the Holy Cross Hospital in Nogales. A total of 83 participants
received information about the Act as well as smoking cessation
resources. In April 2013, the Smoke-Free Arizona Program completed a
mass mailing educational outreach project. 218 businesses received a
letter with information about the Act, a brochure, and a required “No
Smoking” sign. Proprietors were encouraged to order additional “No
Smoking” signage if necessary. The Smoke-Free Arizona Program
hopes to see increased compliance in Santa Cruz County as a result of
successful outreach efforts.
Yuma County: Educating RV Resorts and Parks
Yuma County is one of the most popular destinations in Arizona for
winter visitors and residents. The mild winter climate and the
inexpensive RV resorts geared towards active retirees lures over 83,000
winter residents each year to the county. Yuma County has more than 60
RV resorts and parks in the area to accommodate such visitors. Most
visit the county from northern states and/or Canada; consequently many
are not familiar with the Smoke-Free Act and/or have misconceptions of
the Law. With such an influx of people residing in the county during the
months of October through March, the Yuma County Tobacco Use
Prevention Program experiences a rise in the number of complaints
against RV resorts and parks. This year the program worked diligently
with RV resorts and parks managers to ensure proper education of the
Law was made available to them and their staff. The Yuma County
Tobacco Use Prevention Program provided advisory visits to several RV
resorts that requested inspections of their premises to provide assistance
on how to clearly mark areas as designated smoking-areas. In addition,
the program provided practical suggestions on how to inform their guests
about the Act and how to report violations. Yuma County staff focused
on providing a clear definition of what the Smoke-Free Arizona Law
defines as “common areas” as this seemed to be the most common reason
for complaints. Yuma County’s goal was to ensure that all visited resorts
and parks had proper signage where needed and that all staff and guests
obtained a basic knowledge of the Law in hopes of reducing the number
of invalid complaints filed by residents and guests of these communities.
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Smoke-Free Arizona Annual Report – June 2013

3.3

Educational Newsletter

In a continued effort to disseminate information about the Act, two new
Smoke-Free Arizona newsletters were created and distributed to citizens
and businesses of Arizona during the last year. The second issue of the
third volume of the newsletter was designed with the intent of educating
business proprietors and property management companies on how the
Act applies to office buildings, strip malls, high-rise buildings, and
commercial and retail properties. In certain facilities, some of the
requirements of the Act may fall under the property management’s
responsibility and some fall on business proprietors. This newsletter
discussed the differences. This newsletter was distributed electronically
to approximately 10,881 business proprietors. The first issue of the
fourth volume of the newsletter contained information for proprietors
about educating existing and prospective employees. It also provided
useful tips for proprietors to consider when designating smoking or
smoke-free areas. This newsletter was sent to approximately 9,921
recipients via email.

The two Smoke-Free
Arizona newsletters were
distributed electronically to
a collective approximate
total of 20,802 business
proprietors throughout
Arizona.

The two Smoke-Free Arizona newsletters were distributed electronically
to a collective approximate total of 20,802 business proprietors
throughout Arizona. The distribution of the Smoke-Free Arizona
newsletter is a successful and cost efficient educational outreach effort.
The images below are copies of the Smoke-Free Arizona newsletters.

Volume 3, Issue 2

Volume 4, Issue 1

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Smoke-Free Arizona Annual Report – June 2013

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, the Smoke-Free
Arizona Program offers a training session to provide standard and
consistent information to county health educators and county health
inspectors. 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. Last 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.
The Smoke-Free Arizona Program strives for consistent program
education, compliance, and enforcement throughout the State. For this
reason, this YouTube training video has been used recurrently by county
health departments as the primary training for new staff and as a
refresher for existing staff. This training was cost effective and also
allows 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 1 CEU hour.

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Smoke-Free Arizona Annual Report – June 2013

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 sixth year of the Smoke-Free Arizona Act business
proprietors have continued 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 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 2013

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);
• Sending an e-mail to nosmokingarizona@azdhs.gov; or
• Capturing and sending a complaint using the mysmokefreeaz
App available for smartphones.
During the sixth year after the Law went into effect, between May 1,
2012 and April 30, 2013, a total of 1,681 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 1,594 complaints and the previous year’s total of
1,450 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, 2012 and April 30, 2013.
Graph 4.1 Total Complaints Filed Statewide from May 1, 2012 to April 30, 2013

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Smoke-Free Arizona Annual Report – June 2013

The counties that received the highest number of complaints are:
Maricopa (81%), Pima (8%), Mohave (2%), Pinal (2%), and Yavapai
(2%). Of the 1,681 complaints received, 1,596 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, 2012 and April 30, 2013 are shown in the map below.
Map 4.1 Top Five Counties with the Highest Percentage of
Complaints between May 1, 2012 and April 30, 2013

The number of complaints received for each county between May 1,
2012 and April 30, 2013 is shown in the map below.
Map 4.2 Number of Complaints for Each County between May 1,
2012 and April 30, 2013

With the exception of year 1, May 1, 2007 – April 30, 2008, which
showed 4,803 complaints filed, yearly complaint numbers have been
consistent since May 1, 2008, averaging 1,578 complaints per year. A
total of 1,681 complaints were filed statewide in year six, May 1, 2012 –
April 30, 2013. Efforts to educate business owners and to incorporate
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Smoke-Free Arizona Annual Report – June 2013

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 graph below illustrates the comparison between the number of
complaints received monthly since May 1, 2007.
Graph 4.2 Comparison of Complaints Filed Monthly Statewide between May 1, 2007 and
April 30, 2013

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Smoke-Free Arizona Annual Report – June 2013

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 6 NOVs were
issued statewide between
May 1, 2012 and April 30,
2013, 4 of which were
issued by the ADHS Smoke
Free Arizona Program.

To attain consistent statewide enforcement of the Act training is 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. During the sixth year after the Law went into effect, between
May 1, 2012 and April 30, 2013, ADHS did not provide an annual
training; however, ADHS began performance of county assessments with
each county health department as a way to ensure uniform education and
enforcement of the Smoke-Free Arizona Program statewide. During the
assessments, ADHS met with each individual County to discuss how
education, compliance assistance, and enforcement were conducted. The
assessments afforded the opportunity to create dialog to address county
specific items and strengthen the lines of communication and
collaboration. ADHS also was able to join several county health
departments on a handful of advisory visits for businesses which there
were questions or had a difficult history. The county assessments served
as an opportunity to provide a training module for ADHS and each
respective county to verify uniformity when implementing and enforcing
the Smoke-Free Arizona Act throughout the State.
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
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Smoke-Free Arizona Annual Report – June 2013

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 6 NOVs were issued statewide between May 1, 2012 and April 30,
2013, 4 of which were issued by the ADHS Smoke-Free Arizona
Program. The proprietors that were issued these NOVs faced a total of
$7,750 in civil penalty fines. Numerous settlements were reached with
said recipients and a total of $650 in civil penalty fines was collected
statewide. There were no civil penalty fines issued for the 2 NOVs filed
from county health departments. The total 6 NOVs were issued to
proprietors that permitted employees, customers, or visitors to smoke
inside enclosed public places 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. 6 NOVs were issued to proprietors of places of
employment and public places, such as vehicle repair shops, retail store,
and a pest control business. No NOVs were issued to proprietors of
retail food establishments, such as bars, restaurants, and gas station
convenience stores.
The 4 NOVs issued by the ADHS Smoke-Free Arizona Program, have
completed the enforcement process and successfully closed. The
proprietors of the establishments chose not to appeal the NOVs and
assessment of civil penalties.
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,
2012 and April 30, 2013, ADHS reached settlement agreements with all
of the 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.
Between May 1, 2012 and April 30, 2013, no enforcement cases are
currently referred to collections.
During the sixth year, no administrative hearings were held to determine
the outcome of the six enforcement cases statewide.

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Smoke-Free Arizona Annual Report – June 2013

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 based on recognized criteria for effective tobacco
control measures. The grading criteria were developed by an advisory
committee assembled by the National Cancer Institute. This grading
system provides scoring in nine main categories: Government
Workplaces, Private Workplaces, Schools, Child
Care Facilities, Restaurants, Retail Stores, Recreational/Cultural Facilities, Penalties and
Enforcement.
The grade for each state is based on a total of all
points received in all categories. A grade of “A”
is assigned for excellent tobacco control policies
while an “F” indicates inadequate policies.

Empower Pack kits
included 3,000 Smoke-Free
Arizona “No Smoking”
signs and educational
brochures to be sent to
childcare centers in Arizona

Arizona is one of 36 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 nonhospitality workplaces and/or restaurants and/or bars be 100% smokefree (as of April 5, 2013).
This year once again and for the sixth consecutive year, Arizona earned a
grade A in The American Lung Association State of Tobacco Control
2013 report, for maintaining a strong and comprehensive enforcement
program of the Smoke-Free Arizona Act. 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 American
Lung Association in Arizona 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:
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Smoke-Free Arizona Annual Report – June 2013

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, 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, 3000
signs and brochures were provided to be included in the Empower Pack
kits. 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.
6.3

Indoor Air Quality at Nine Large-Hub Airports With and
Without Designated Smoking Areas Study – Phoenix Sky
Harbor International Included

The Centers for Disease Control and Prevention ’s (CDC) Office on
Smoking and Health and its National Center for Chronic Disease
Prevention and Health Promotion (NCCDPHP) conducted the “Indoor
Air Quality at Nine Large-Hub Airports With and Without Designated
Smoking Areas” study (see November 23, 2012 Morbidity and Mortality
Weekly Report) in collaboration with representatives from Arizona,
Colorado, Florida, Georgia, Illinois, Massachusetts, Nevada, Utah, and
Virginia. For this comparison study, five large-hub U.S. airports with
designated indoor smoking areas accessible to the public and four largehub U.S. airports that prohibit smoking in all indoor areas (smoke-free)
were chosen. The U.S. airports with designated smoking areas
accessible to the public included Denver International, HartsfieldJackson Atlanta International, McCarran International in Las Vegas, Salt
Lake City International, and Washington Dulles International. The four
smoke-free large-hub airports selected for comparison included Chicago
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Smoke-Free Arizona Annual Report – June 2013

O'Hare International, Fort Lauderdale-Hollywood International, Orlando
International, and Phoenix Sky Harbor International. These specific
airports chosen for the study were selected based on their similar
boarding totals in 2011.
CDC epidemiologists measured the levels of respirable suspended
particulates (RSPs), specifically particulate matter ≤2.5 microns in
diameter (PM2.5), a marker for secondhand smoke (SHS). This sized
particle was selected because it is similar to the particles released from
burning cigarettes and inhaled via secondhand smoke into the lungs. The
study took place between October 19 – November 1, 2012, and included
the use of an air monitor (TSI Sidepak AM510 Personal Aerosol
Monitor) that measured the PM2.5 levels at several areas within each
airport. The average time spent at each site was 30 minutes.
The results of the study showed that the average level of RSPs in the
smoking areas of the five airports with indoor designated smoking areas
was 16 times the average level in nonsmoking areas (boarding gate
seating sections) and 23 times the average level of RSPs in the four
smoke-free airports. In the five airports with designated indoor smoking
areas, the average RSP level in areas adjacent to the smoking areas was
four times the average level in the nonsmoking areas. Additionally,
these RSP levels were shown to be five times the average level in smokefree airports.
The Smoke-Free Arizona Program commends the Phoenix Sky Harbor
International Airport for maintaining a smoke-free airport and protecting
travelers, employees, and other visitors of the airport from involuntary
secondhand smoke exposure.

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Smoke-Free Arizona Annual Report – June 2013

7.0

Conclusion

T

he sixth 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 sixth 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 filing a complaint through a smartphone application.
A total number of 1,681 complaints were filed between May 1, 2012 and
April 30, 2013. 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 total 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 sixth 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 2013

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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