The Freedom to Breathe Act Revisited

10 years ago this month, the state of Minnesota banned smoking in restaurants, bars, and just about all other indoor public spaces and workplaces. The Freedom to Breathe Act prohibited smoking by employers, employees, patrons, and visitors of any workplace or indoor public space that had two or more people working there. While this law does exempt two types of indoor venues (casinos and tobacco shops), as well as hotels and motels (which can designate rooms for smokers), this was a highly impactful public health measure that had profound benefits for full-time workers in the restaurant business.

The Freedom to Breathe Act impacted a number of smoking-related behaviors, and almost immediately cleaned up the air inside restaurants and bars. A 2010 University of Minnesota study found that after Minnesota implemented the indoor smoking ban, particulates associated with tobacco smoke were reduced by 95%. Those particulates are associated with respiratory illnesses and are a long-term risk factor for lung cancer.

Those particulates can have massively harmful impacts on full-time workers subjected to second-hand smoke. A study examining respiratory illnesses in bartenders found that 74% of respondents reported symptoms like coughing and shortness of breath before a smoking ban was implemented, but less than half of them still had symptoms one month after the ban took effect. Respondents also reported other health benefits, like better blood flow, as well as qualitative life improvements like not smelling of tobacco smoke. In addition, two more U of M studies found that the economic impacts of the tobacco bans were negligible, with revenues and unemployment unaffected one year following the ban. Overall, the Freedom to Breathe Act was very successful at protecting Minnesotans working in the hospitality and restaurant sectors from the harmful effects of second-hand smoke.

The Freedom to Breathe Act was also successful in improving the broader public’s health. The law contributed to the overall decrease in smoking prevalence in Minnesota, resulting in record lows for smoking in both men and women. The number of those who reported second-hand smoke exposure also dropped from 56% to 31% between 2007 and 2014, according to the Minnesota Adult Tobacco Survey. This has both medical and economic benefits, as a 2009 study found that second-hand smoke cost $44.58 per Minnesota resident in medical costs. When the Freedom to Breathe Act lowered secondhand smoke exposure by almost half, Minnesota saved between $75 million and $165 million per year. Studies in other countries have found that smoking bans can also reduce the rate of asthma-induced emergency room visits.

The health and economic benefits for both restaurant workers and the general public alike are encouraging signs for the benefits of preventative public health measures like the Freedom to Breathe Act. However, tobacco is still the leading cause of death in Minnesota, and costs $3 billion in unnecessary health expenses annually. One of the more promising next steps is to increase the statewide smoking age to 21, which historically cuts off the supply of tobacco to middle- and high-school children, and works as a powerful method to prevent lifelong smoking.