TABLE OF CONTENTS

REPORTS OF THE STANDING COMMITTEES

AND OTHER COMMITTEES

As Considered by

The Council of the City of Toronto

on July 6, 7 and 8, 1999

BOARD OF HEALTH

REPORT No. 5

1 Harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto

City of Toronto

REPORT No. 5

OF THE BOARD OF HEALTH

(from its meeting on June 28 and 29, 1999,

submitted by Councillor John Filion, Chair)

As Considered by

The Council of the City of Toronto

on July 6, 7 and 8, 1999

Harmonized Environmental Tobacco Smoke (ETS)

By-law for the City of Toronto

(City Council on July 6, 7 and 8, 1999, amended this Clause by:

(1) striking out Recommendation No. (I) of the Board of Health and inserting in lieu thereof the following:

"(I) the adoption of the report dated June 21, 1999, from the Medical Officer of Health, entitled 'Harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto - Review of Community Council Meetings and Update', subject to:

(i) amending Recommendation No. (A) (3) by striking out the words 'and into which no employee is required to enter;';

(ii) striking out Recommendations Nos. (B) (7), (8) and (9) of the Medical Officer of Health and inserting in lieu thereof the following:

'(B) Smoke-free Provisions - the following recommendations apply to workplaces and public places that have not already become smoke-free under the harmonization provisions of the by-law:

(7) that restaurants and bowling centres become smoke-free by June 1, 2001, and that bars, bingo halls, billiards halls, casinos and racetracks become smoke-free by June 1, 2004;

(8) that restaurants, bowling centres, bars, billiard halls, casinos and racetracks be permitted to have designated smoking rooms (DSR's) that are fully enclosed and separately ventilated to the outdoors, provided that:

(a) the DSR's comprise no more than 25 percent of the floor space for principal use, and that the remainder of the area be smoke-free;

(b) all other areas, such as food preparation, purchasing, washrooms and workers' areas be smoke-free; and

(c) the smoking section be separately ventilated to the outdoors and fully separated by a wall or glass partition from the smoke-free portions of the facility;

(9) that bingo halls be permitted to have designated smoking rooms provided that:

(a) the DSR's comprise no more than 50 percent of the floor space for gaming and that the remainder of the gaming area be smoke-free;

(b) all other areas, such as food preparation, card purchasing, lounges, washrooms, and the callers' area be smoke free;

(c) the smoking section be separately ventilated to the outdoors and fully separated by a wall or glass partition from the smoke-free portions of the facility;

(10) that the proprietors of public places that are permitted to have designated smoking rooms be required to post health warning signs, such signs to be multilingual, depending on the needs of the area, at the entrances to the designated smoking room which clearly indicate that smoking is permitted and that those entering run the risk of serious illness; and

(11) that Council request Health Canada to conduct a scientific and technical review of the air ventilation solution as proposed by the Ontario Restaurant Association and the Greater Toronto Hotel Association including but not limited to the following disciplines: toxicology, epidemiology, risk assessment, medicine and ventilation engineering; and further, that if the system is proven to provide a comparable quality of air as measured in other publicly regulated non-smoking facilities, then the technology be accepted as an alternative to the fully enclosed designated smoking rooms;'

(iii) amending Recommendation No. (C) (12) by adding the words 'a multilingual' before the word 'education' and by adding the words 'depending on the needs of the specific area' after the word 'Health';

(iv) amending Recommendation No. (C) (14) of the Medical Officer of Health by striking out the date of 'April 30, 2001' and inserting in lieu thereof the date of 'June 1, 2001'; and

(v) renumbering the recommendations of the Medical Officer of Health accordingly;' "

(2) striking out Recommendation No. (II) of the Board of Health;

(3) amending Recommendation No. (III) of the Board of Health to provide that authority be granted to introduce the necessary Bill in Council in the form or substantially in the form of the by-law attached to the report dated June 10, 1999, from the City Solicitor, amended to reflect the recommendations of Council,

so that the recommendations embodied in the report dated June 21, 1999, from the Medical Officer of Health shall now read as follows:

"(A) Harmonization Provisions - the following recommendations pertain to the interval between enactment of a harmonized by-law and subsequent changeover to smoke-free:

(1) that the smoking by-laws of the former municipalities of Metropolitan Toronto be repealed when the harmonized ETS by-law comes into force;

(2) that the harmonized ETS by-law come into force three months after its enactment by City Council;

(3) that all workplaces in the City of Toronto be smoke-free, except in fully enclosed, designated smoking rooms (DSRs) that are separately ventilated to the outside, that make up no greater than 25 percent of the occupiable space;

(4) that all public places be smoke-free, except for restaurants, bars, bowling centres, billiard halls, bingo halls, casinos and racetracks which are permitted to have unenclosed smoking in 25 percent of occupiable public space;

(5) that restaurants, bars, bowling centres, billiard halls, bingo halls, casinos and racetracks that permit unenclosed smoking be required to post health warning signs at all entrances which clearly indicate that smoking is permitted; and

(6) that employers/proprietors of workplaces and public places be required to post 'no smoking' signs where smoking is prohibited;

(B) Smoke-free Provisions - the following recommendations apply to workplaces and public places that have not already become smoke-free under the harmonization provisions of the by-law:

(7) that restaurants and bowling centres become smoke-free by June 1, 2001, and that bars, bingo halls, billiards halls, casinos and racetracks become smoke-free by June 1, 2004;

(a) the DSR's comprise no more than 25 percent of the floor space for principal use, and that the remainder of the area be smoke-free;

(b) all other areas, such as food preparation, purchasing, washrooms and workers' areas be smoke-free; and

(c) the smoking section be separately ventilated to the outdoors and fully separated by a wall or glass partition from the smoke-free portions of the facility;

(9) that bingo halls be permitted to have designated smoking rooms provided that:

(a) the DSR's comprise no more than 50 percent of the floor space for gaming and that the remainder of the gaming area be smoke-free;

(b) all other areas, such as food preparation, card purchasing, lounges, washrooms, and the callers' area be smoke free; and

(c) the smoking section be separately ventilated to the outdoors and fully separated by a wall or glass partition from the smoke-free portions of the facility;

(C) Additional Recommendations - the following general recommendations apply to the ETS by-law:

(12) that a multilingual education campaign be initiated by Toronto Public Health, depending on the needs of the specific area, prior to enactment of the ETS by-law, that:

(a) informs proprietors, employers and the general public of their responsibilities under the new by-law;

(b) encourages compliance with the new by-law through community-based prevention and cessation activities;

(c) markets the benefits and opportunities available under the new by-law; and

(d) has an ongoing, multi-year component;

(13) that the Medical Officer of Health continue to assist in the advertisement of smoke-free restaurants to the general public in collaboration with the Commissioner of Economic Development, Culture and Tourism, community-based organizations and the private sector, and thereby encourage the creation of additional smoke-free restaurants;

(14) that the Medical Officer of Health evaluate the effectiveness of the ETS by-law, including economic and other measures of impact, and report thereon to the Board of Health;

(15) that institutions such as hospitals and nursing homes continue to be covered by the provisions of the provincial Tobacco Control Act;

(16) that the City of Toronto develop a corporate policy to prohibit smoking in all municipal facilities, whether located in municipal or commercial buildings, except in such cases where this space is reserved for a private function such as a wedding, and that any such exemptions be time limited until June 1, 2001;

(17) that upcoming reviews of the City's licensing by-law and local zoning by-laws give consideration to the definitions and requirements of the harmonized ETS by-law, as they pertain to restaurants and bars, in order to achieve standard definitions;

(18) that City Council urge the Provincial Minister of Health and the Premier of Ontario to:

(a) review and strengthen the Tobacco Control Act to ensure greater protection from Environmental Tobacco Smoke across the Province and to further reduce access to tobacco products by young people;

(b) implement immediately the recommendations of the Minister's Expert Panel to Renew the Ontario Tobacco Strategy, including adoption of provincial legislation that assures the attainment of smoke-free workplaces and public places across Ontario; and

(c) release previously announced funds for school-based tobacco prevention education and cessation as soon as possible; and

(19) that City Council urge the federal Minister of Health and the Prime Minister of Canada to implement regulations pursuant to the federal Tobacco Act, aimed at: preventing children from starting to smoke; improving health warning messages on tobacco packages; plain packaging of tobacco products; increasing tobacco taxes; and further restricting tobacco advertising;"; and

(4) adding thereto the following:

"It is further recommended that:

(a) the Ontario Tobacco Research Unit, in conjunction with the Provincial Ministry of Health, be requested to conduct a study to assess the health impacts of both smoke-free and smoking environments on hospitality workers;

(b) the Medical Officer of Health be requested to develop a communications strategy and plan to educate the public about the ETS by-law; such strategy to involve stakeholders which reflect the multicultural diversity within the hospitality industry and Toronto's local communities, and report thereon to Council, through the Board of Health; and

(c) the Medical Officer of Health be requested to submit reports to Council, through the Board of Health, on:

(i) a public education campaign aimed at workers, including hospitality workers, to better inform them of the public health risks associated with working in a smoking environment, and their rights as workers;

(ii) the process to be implemented for restaurants and bars to so designate themselves; and

(iii) the implementation of the ETS by-law, how effective it has been and the kinds of problems that have been encountered, such report to be provided on an annual basis.")

The Board of Health recommends:

(I) the adoption of the report dated June 21, 1999, from the Medical Officer of Health, entitled "Harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto - Review of Community Council Meetings and Update", subject to:

(i) striking out the date of "April 30, 2001" in Recommendations Nos. (7) and (14) and inserting in lieu thereof the date of "June 1, 2001"; and

(ii) striking out all references to designated smoking rooms (DSRs), thereby amending Recommendation No. (3) and striking out Recommendations Nos. (8) and (9); and

(iii) renumbering the recommendations accordingly,

so that the recommendations embodied in such report shall read as follows:

"(A) Harmonization Provisions - the following recommendations pertain to the interval between enactment of a harmonized by-law and subsequent changeover to smoke-free:

(1) that the smoking by-laws of the former municipalities of Metropolitan Toronto be repealed when the harmonized ETS by-law comes into force;

(2) that the harmonized ETS by-law come into force three months after its enactment by City Council;

(3) that all workplaces in the City of Toronto be smoke-free;

(6) that employers/proprietors of workplaces and public places be required to post "no smoking" signs where smoking is prohibited;

(B) Smoke-Free Provisions - the following recommendation applies to public places that have not already become smoke-free under the harmonization provisions of the by-law:

(7) that restaurants, bars, bowling centres, billiard halls, bingo halls, casinos and racetracks become 100 percent smoke-free no later than June 1, 2001;

(C) Additional Recommendations - the following general recommendations apply to the ETS by-law:

(8) that an education campaign be initiated by Toronto Public Health, prior to enactment of the ETS by-law, that:

(a) informs proprietors, employers and the general public of their responsibilities under the new by-law;

(b) encourages compliance with the new by-law through community-based prevention and cessation activities;

(c) markets the benefits and opportunities available under the new by-law; and

(d) has an ongoing, multi-year component;

(9) that the Medical Officer of Health continue to assist in the advertisement of smoke-free restaurants to the general public in collaboration with the Commissioner of Economic Development, Culture and Tourism, community-based organizations and the private sector, and thereby encourage the creation of additional smoke-free restaurants;

(10) that the Medical Officer of Health evaluate the effectiveness of the ETS by-law, including economic and other measures of impact, and report thereon to the Board of Health;

(11) that institutions such as hospitals and nursing homes continue to be covered by the provisions of the provincial Tobacco Control Act;

(12) that the City of Toronto develop a corporate policy to prohibit smoking in all municipal facilities, whether located in municipal or commercial buildings, except in such cases where this space is reserved for a private function such as a wedding, and that any such exemptions be time limited until June 1, 2001;

(13) that upcoming reviews of the City's licensing by-law and local zoning by-laws give consideration to the definitions and requirements of the harmonized ETS by-law as they pertain to restaurants and bars in order to achieve standard definitions;

(14) that City Council urge the provincial Minister of Health and the Premier of Ontario to:

(a) review and strengthen the Tobacco Control Act to ensure greater protection from Environmental Tobacco Smoke across the Province and to further reduce access to tobacco products by young people;

(c) release previously announced funds for school-based tobacco prevention education and cessation as soon as possible; and

(15) that City Council urge the federal Minister of Health and the Prime Minister of Canada to implement regulations pursuant to the federal Tobacco Act aimed at: preventing children from starting to smoke; improving health warning messages on tobacco packages; plain packaging of tobacco products; increasing tobacco taxes; and further restricting tobacco advertising";

(II) the adoption of the following recommendations embodied in the report dated June 21, 1999, from the Medical Officer of Health, entitled "Ventilation and ETS":

"(1) a ventilation option not be included in the proposed ETS by-law.

However, if Toronto Council decides to consider ventilation systems as an alternative to being smoke-free in the future:

(2) (a) such systems must be designed, installed, and maintained in a manner that will control ETS so as to meet or exceed standards for ETS and/or its components, that may become established in Canada by federal and/or provincial government bodies for health protection purposes; and

(b) problems with enforceability combined with the additional workload and costs to the City for ventilation system approvals, inspections and enforcement must be taken into consideration";

(III) that authority be granted to introduce the necessary Bill in Council in the form or substantially in the form of the by-law attached to the report dated June 10, 1999, from the City Solicitor, amended to reflect the recommendations of the Board of Health;

(IV) that City Council request the provincial Minister of Health to develop a Province-wide standard similar to that envisaged by the City's ETS by-law; and

(V) that the financial implications of the ETS by-law adopted by Council be incorporated into the Year 2000 Public Health Operating Budget submission for consideration by the Policy and Finance Committee during the Year 2000 budget process.

The Board of Health reports, for the information of Council, having:

(1) requested the Medical Officer of Health, in consultation with the Commissioner of Economic Development, Culture and Tourism, to submit a report directly to Council for its meeting commencing on July 6, 1999, on the economic impacts relating to bingo halls and charities that have occurred as a result of smoke-free legislation in other jurisdictions; and

(2) requested the Medical Officer of Health and the Solicitor to review any opportunities for regulation of smoking in private clubs, and report back thereon to the Board of Health.

The Board of Health submits the following report (June 21, 1999) from the Medical Officer of Health, entitled "Harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto - Review of Community Council Meetings and Update":

Purpose:

This report responds to the motions and requests for information arising from public deputations at local Community Councils on options for a harmonized Environmental Tobacco Smoke (ETS) by-law. It also provides final revised staff recommendations for an ETS by-law that is as health-protective as possible while taking a pragmatic approach. These revised recommendations will be the focus for city-wide public deputations to the Board of Health on June 28, 1999. The staff recommendations and input from deputants will be used by the Board to formulate its own recommendations to City Council, which will consider this issue on July 6, 7, and 8, 1999.

Financial Implications:

One-time funding will be required in each year of the multi-year education plan until the by-law is fully implemented. Funding would also be required for the promotion of smoke-free restaurants. In addition, provincial funding will be sought for an assessment of the economic impact of implementing the by-law. The estimated range of funding for the education plan is $250,000.00 to $400,000.00 per annum.

Additional resources will be required for enforcement in the early months after implementation of smoke-free provisions. This will be to compensate for the temporary internal reallocation of inspection staff combined with a one-time funding requirement for after-hours by-law enforcement. The amount required will reflect the extent of the public education that precedes the by-law implementation and the actual provisions of the by-law, i.e., the timing and degree of change experienced by proprietors and the public. The estimated range of these additional costs is $200,000.00 to $300,000.00. Full provincial funding will be sought for these initiatives.

Recommendations:

(A) Harmonization Provisions - the following recommendations pertain to the interval between enactment of a harmonized by-law and subsequent changeover to smoke-free:

(1) that the smoking by-laws of the former municipalities of Metropolitan Toronto be repealed when the harmonized ETS by-law comes into force;

(2) that the harmonized ETS by-law come into force three months after its enactment by City Council;

(6) that employers/proprietors of workplaces and public places be required to post "no smoking" signs where smoking is prohibited;

(B) Smoke-free Provisions - the following recommendations apply to workplaces and public places that have not already become smoke-free under the harmonization provisions of the by-law:

(7) that restaurants, bars, bowling centres, billiard halls, bingo halls, casinos and racetracks become 100 percent smoke-free no later than April 30, 2001;

(8) that public places be permitted to have designated smoking rooms that are separately ventilated to the outside and are no greater than 25 percent of occupiable public space; and

(9) that employers/proprietors of workplaces and public places that provide a designated smoking room be required to post health warning signs at the entrances to the designated smoking room which clearly indicate that smoking is permitted;

(10) that an education campaign be initiated by Toronto Public Health, prior to enactment of the ETS by-law, that:

(a) informs proprietors, employers and the general public of their responsibilities under the new by-law;

(b) encourages compliance with the new by-law through community-based prevention and cessation activities;

(d) has an ongoing, multi-year component;

(11) that the Medical Officer of Health continue to assist in the advertisement of smoke-free restaurants to the general public in collaboration with the Commissioner of Economic Development, Culture and Tourism, community-based organizations and the private sector, and thereby encourage the creation of additional smoke-free restaurants;

(12) that the Medical Officer of Health evaluate the effectiveness of the ETS by-law, including economic and other measures of impact, and report thereon to the Board of Health;

(13) that institutions such as hospitals and nursing homes continue to be covered by the provisions of the provincial Tobacco Control Act;

(14) that the City of Toronto develop a corporate policy to prohibit smoking in all municipal facilities, whether located in municipal or commercial buildings, except in such cases where this space is reserved for a private function such as a wedding, and that any such exemptions be time limited until April 30, 2001;

(15) that upcoming reviews of the City's licensing by-law and local zoning by-laws give consideration to the definitions and requirements of the harmonized ETS by-law as they pertain to restaurants and bars in order to achieve standard definitions;

(16) that City Council urge the provincial Minister of Health and the Premier of Ontario to:

(a) review and strengthen the Tobacco Control Act to ensure greater protection from Environmental Tobacco Smoke across the Province and to further reduce access to tobacco products by young people;

(c) release previously announced funds for school-based tobacco prevention education and cessation as soon as possible; and

(17) that City Council urge the federal Minister of Health and the Prime Minister of Canada to implement regulations pursuant to the federal Tobacco Act aimed at: preventing children from starting to smoke; improving health warning messages on tobacco packages; plain packaging of tobacco products; increasing tobacco taxes; and further restricting tobacco advertising.

Background and Comments:

As part of the community consultation plan, the Board of Health forwarded a policy options and recommendations paper to the six local Community Councils to be the subject of public deputations and for Community Councils to make recommendations back to the Board of Health. In an effort to ensure that members of the public and other stakeholders had sufficient opportunity to provide input, business operators and the public were informed about the scheduled deputation meetings through several means.

Notices were mailed to hospitality industry operators (such as restaurant, bar, billiard, bowling and bingo establishments) in the City of Toronto to inform them about the meetings and invite them to make deputations. There were also notices posted in the Toronto print media and on the City of Toronto Internet site. In addition, letters were mailed to people who had previously expressed interest in the by-law development process through contact with public health staff. The discussion paper was available for review at each of the local public health offices and on the Internet.

Discussions:

Summary of Deputations:

There were 106 people present at the six Community Council meetings to make deputations. Deputants included the operators of a variety of large and small hospitality establishments and representatives from related associations. Several health organisations were represented and there were a significant number of individual citizens that came out to speak on this important issue. Most of the Community Councils also received written comments from a variety of sources.

The opinions expressed by the deputants were similar in nature to public and stakeholder opinion received during the public consultation over the past year and in previous years when the by-law development process was before the Councils of the former Toronto municipalities.

Deputants in support of the by-law expressed their concern about the health effects of ETS, and asked City Council to move quickly towards 100 percent smoke-free public places. Concerns included the protection of both workers and patrons, and in particular the need to protect children by setting an example. It is important to note however, that there has been a noticeable shift in the opinions presented by those opposed to further restrictions on smoking in public places; most of these deputants no longer dismiss the health effects of environmental tobacco smoke. Those in opposition do not object to restrictions on smoking; they simply believe that the proposed requirement for 100 percent smoke-free would have a negative economic impact on the hospitality industry.

There were also several deputants from the hospitality industry and from heating, ventilation and air-conditioning companies that proposed a ventilation alternative to 100 percent smoke-free. When questioned by Councillors, these deputants were unable to identify a product name or provide supporting documentation for the ventilation alternative. Towards the end of the Community Council process, the Ontario Restaurant Association (ORA) announced that a ventilation alternative would be demonstrated at a later date. The ORA's demonstration and a discussion on the appropriateness of including a ventilation option in the proposed ETS by-law are contained in a companion report on this agenda entitled "Ventilation and ETS", June 21, 1999.

The deputations from those that supported increased restrictions on smoking in workplaces and public places were very consistent. They were clearly in favour of a 100 percent smoke-free by-law. While many thought such a by-law is long overdue for Toronto, some felt that an adjustment period may be necessary to ensure a smooth transition. There were also restaurateur deputants that supported increased smoking restrictions both for health reasons and to ensure a level playing field within the City of Toronto.

The opportunity for Community Council members to discuss the recommendations for a smoke-free by-law at the local level and then forward their own recommendations to City Council was also an important part of the by-law development process. This step also gave the City Councillors an opportunity to propose questions to staff prior to debate at the Board of Health and City Council, and to assess public opinion in their local community. A table summarising the Community Council recommendations and questions to staff can be found in Appendix 1. Also contained in that summary is an overview of staff recommendations pertaining to each issue.

The remainder of this report contains more detailed analysis and discussion of those issues in the order that they appear in Appendix 1.

(1) Restaurants and Bars:

A central point of discussion about smoking control by-laws often involves comparing restaurants to bars, and whether these establishments should be treated differently with respect to smoking restrictions.

Leading up to the Community Council meetings, public opinion indicated that a smoking control by-law should separately define restaurants and bars. Community members, including some who support smoking restrictions, have a perception that smoking is more of a fixture in bars and night clubs but should not be permitted in fine dining establishments or family restaurants. However, commitment to those beliefs wavers when the discussion turns to establishments in which patronage may vary with the time of the day or the day of the week (e.g., premises which function as "restaurants" by day and "bars" by night).

Even though there is a perceived difference between restaurants and bars, many of the deputants and Councillors expressed concern about treating these establishments differently in the by-law or delaying the smoke-free requirement for bars. This reflects concerns about the potential economic advantage or disadvantage that could result from a lack of a clear-cut definition of restaurants versus bars. This concern was clearly illustrated by a restaurateur at one of the Community Council meetings. As part of his deputation, he described how a lunch-time sandwich sale could be lost to a neighbouring establishment which happens to derive most of its income from evening alcohol sales, simply because that regular customer may choose to have a cigarette with his lunch.

Staff have reviewed local zoning and licensing by-laws and provincial legislation in search of clear definitions that separate bars from restaurants. None of this legislation clearly distinguishes restaurants and bars. Without the benefit of clear definitions, municipalities throughout Ontario have struggled to come up with workable alternatives to the parameters that exist in some other provinces. If Council chooses to distinguish restaurants and bars, it is suggested that the best method would be to define bars as establishments with liquor licences that prohibit admission to persons under 19 years of age at all times. This method is being used in a draft by-law by health department staff in Peel Region. The draft by-law was recently approved in the Town of Caledon and the City of Brampton. A City of Mississauga sub-committee voted in favour of the same draft by-law on June 16, 1999, and it will go before Mississauga Council on June 23, 1999.

An alternative approach could follow the example set by the insurance industry that defines bars by the revenue derived from alcohol sales as a percentage of total sales, with 80 percent alcohol sales being the norm in that industry. This option is problematic, as it may be difficult for City staff to accurately determine the percentage of alcohol sales.

It was also recommended at one of the Community Council meetings that restaurants under 40 seats be exempt from the smoking by-law and, similarly, that Toronto adapt the New York City smoking by-law for use in the City of Toronto. The New York City Smoke-free Air Act prohibits smoking in all restaurants except those with fewer than 35 seats and any separate stand-up bar areas of restaurants with more than 35 seats, provided that there are at least six feet separating the bar area from table seating. This Act became law in 1995. At the time of its passage, New York had minimal smoking restrictions and this step was considered a progressive step to 100 percent smoke-free. Since the early 'nineties however, there have been considerable advances in the knowledge of the harmful effects of ETS and of strategies to reduce exposure to ETS.

In the City of Toronto, more than 40 percent of the over 6,000 restaurants with seating have fewer than 40 seats (1998 data). If Council were to adopt similar requirements for Toronto, it would be regressive and result in a significant rollback in protection against ETS exposure for workers and the public. It would also be difficult to determine the bar areas of restaurants, as many Toronto restaurants also have seating near the bar and the separation from the dining area is not always well defined.

Another Community Council recommendation would require that all new restaurants, bars, bowling centres, billiard halls, bingo halls, casinos, and racetracks that open after passage of the by-law be smoke-free. All such establishments that existed prior to passage of the by-law would be permitted to have unenclosed smoking in 25 percent of the establishment until May 3, 2004. The desired intent would be to gradually increase the number of smoke-free public places as new establishments open or as these types of businesses change ownership. Such an option would address the concerns that current hospitality business operators may have about possible economic loss, giving them added time to adjust. At the same time, new operators would be aware of the by-law requirements as they consider entering this business sector. A requirement that was similar to this was part of the ETS by-law for the former Borough of East York. However, businesses that changed ownership were not required to be smoke-free. Only when a business was closed for a period greater than two months did the requirement for smoke-free take effect. The result was that over a three-year period, less than ten percent of these businesses were actually smoke-free, thereby leaving the vast majority of establishments without protection for their workers or patrons. If the smoke-free requirement were to be initiated upon change of ownership, by-law enforcement staff would have to ensure that ownership changes could be monitored and verified.

Throughout all of the discussions, the health argument remains consistent. Exposure to ETS clearly presents a health risk, whether the exposure takes place in a workplace or a public place. The concentration of ETS and duration of exposure is usually much higher in establishments that focus primarily on serving alcoholic beverages. The concentration of ETS would also be greater in smaller establishments. Some estimates indicate that non-smoking employees in bars, where exposures to ETS can be six-fold higher than in homes where there is at least one smoker, may have up to a 50 percent greater chance of contracting lung cancer as compared to the general population. The immediate health benefits of going smoke-free have also been demonstrated. A recent study showed that bartenders who work in establishments that became smoke-free saw their lung functions improve significantly. From a pure health point of view, bars and restaurants, regardless of how they are defined, should be smoke-free.

(2) Bowling Centres, Billiard and Bingo Halls:

These establishments present a separate set of issues mostly surrounding exposure of young people to ETS. Billiard halls are traditionally considered adult establishments but are often part of mixed-use restaurant/bar establishments. Bowling centres and bingo halls are more difficult to address when determining ETS control measures. Bowling centres are often filled with children although some say that their facilities are frequented only by adults during evening league play and, as twenty-four hour operations, through the night.

(3) Workplaces:

It is important to understand how the ETS by-laws are applied to public places and workplaces and how these types of premises are differentiated. The first efforts to control exposure to ETS began in workplaces. Recognizing that workplaces exist in various forms, the first by-laws prohibited smoking in workplaces that were frequented by employees only. This step was the first phase in the gradual increase in protection from ETS. As we learned more about the health risks of ETS and as the public became more accepting of increased smoking controls, policies restricting smoking were developed at various levels of government. Service establishments such as banks, learning institutions and government offices soon became smoke-free and this paved the way for many smoke-free entertainment facilities.

(4) Designated Smoking Rooms:

Public Health initiatives combined with public expectation for smoke-free indoor air, resulted in more and more smoke-free buildings. Currently, in the City of Toronto enclosed smoking is only permitted in selected public places, specifically hospitality establishments. Even though these types of establishments are workplaces and the employees deserve the same level of protection from ETS, they have been primarily considered public places as opposed to workplaces since they cater to the general public. However, these public places must also be viewed in a different light with respect to designated smoking rooms in consideration of employee exposure to ETS when serving within these rooms.

Currently, most of the ETS by-laws across the city permit designated smoking rooms (DSRs) in workplaces although only a very small percentage of workplaces have installed them. The option to allow DSRs within the workplace is reasonable because non-smoking employees are protected if they are not required to enter these rooms as part of their work duties. The issue is not as simple in public places where employees are expected to enter the DSRs in the course of their work. Only in the former City of Toronto were DSRs permitted in public places, as a means of easing the impact of the by-law on smoking patrons, although fewer than 20 restaurants have had them installed. The requirement for full enclosure and adequate separate ventilation is essential for health protection but can result in significant installation costs. Therefore, DSRs are recommended in workplaces and public places as a reasonable alternative to a complete prohibition on smoking.

The Ontario Tobacco Control Act (TCA) currently permits DSRs in certain public places. The Act is very specific in it's requirements for DSRs and only allows then in such places as homes for the aged and hospitals where extended stays would cause significant duress to smokers that are unable to leave the premises. It is not the intention of Toronto Public Health to be any more restrictive in these locations, and there is no need to duplicate the TCA in the Toronto by-law.

In public places such as restaurants, municipalities can choose to allow DSRs or be more stringent and health protective. If restaurants were to become smoke-free and allow the construction of DSRs, there would be an expectation that the DSRs would be permitted indefinitely.

(5) Ventilation:

Please refer to a companion report on this agenda entitled "Ventilation and ETS", dated June 21, 1999.

(6) Public Education:

Public education is an essential part of an ETS by-law. An effective communication campaign supports the implementation and enforcement of the by-law and helps everyone understand the serious health issue behind the by-law development. It is also important that the campaign be linked to other activities involving tobacco cessation and prevention.

A summary and discussion of the ETS by-law communication and implementation plan can be found in the April 6, 1999 public discussion paper entitled "A Harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto - Policy Options and Recommendations".

One-time funding will be required in each year of the multi-year education plan until the by-law is fully implemented and for the assessment of economic impact for which provincial funding will be sought. Additional funding would be required for the promotion of smoke-free restaurants. The estimated range of funding is $250,000.00 to $400,000.00 per annum.

(7) Economic Impact of Smoke-Free By-laws:

Discussions with representatives of the restaurant industry showed that restaurant operators fear a smoking ban in restaurants will have a negative impact on business. In public policy debates, informal surveys of restaurateur opinion have often been presented as "evidence" of this negative impact. It is not surprising that some operators feel this way considering the information that is provided to them from hospitality associations and through the media. It is also possible that the opinion of the operator, if based on observations within their own businesses, may be influenced by the skewed perception of the prevalence of smoking within their potential customer base. If the presence of ETS is discouraging patronage by non-smokers, then it is more likely that operators would regularly see a greater percentage of smokers.

Many operators have also said that their customers that smoke will not come back if they are not permitted to smoke. If we look at the effect that smoking restrictions had on other types of public places such as movie theatres or other entertainment facilities we see that this is not the case. The primary attraction for customers would remain. It is more likely that smokers will continue to visit bars and restaurants and wait until they leave or step outside for a moment, as they would in other entertainment facilities.

It is important to note that the fear of negative economic impact is not shared by all restaurant and bar operators. More than 700 restaurants in Toronto have already chosen to voluntarily prohibit smoking. This would indicate public demand for smoke-free environments and suggests economic viability for such establishments.

A review of studies that have used a systematic, econometric analysis of restaurant sales based on sales revenues consistently shows no evidence of negative effects from smoke-free by-laws. This is true whether or not the restaurant serves alcohol. A 1994 study that analysed sales tax data for the first 15 cities in the U.S. to enact smoke-free ordinances affecting restaurants, showed there is no significant effect on business when comparing restaurant sales data in cities with smoke-free restaurant ordinances with those in similar cities without ordinances (Glantz et al., 1994 & 1997). In addition, longitudinal analysis showed no significant change in business following the introduction of smoking prohibitions. This study was expanded in 1997, and confirmed the earlier study's results. A more recent analysis conducted in Flagstaff, Arizona also demonstrated that prohibiting smoking in restaurants did not affect sales (Sciacca et al., 1998).

This lack of economic impact was also documented in two communities where earlier surveys claiming significant loss of business based on less objective measures had been used to persuade municipal legislators to overturn restaurant smoking by-laws. The 15 municipalities included in this study varied widely, and included several that were part of larger contiguous urban areas. No loss of business to adjacent municipalities with less restrictive smoking legislation was documented. The only other published study using objective revenue data examined 19 U.S. cities with restaurant smoking restrictions and 87 neighbouring communities without restrictions. It showed no consistent economic impact of smoking restrictions regardless of the extent of restrictions (Maroney et al, 1994).

A report by the California State Board of Equalization compared taxable sales for 6,211 bars and bar/restaurants for the first quarters of 1997 and 1998, following the introduction of smoke-free bars January 1, 1998. It found a 12 percent increase in taxable sales. As well, public opinion polls show that support for smoke-free bars is increasing. A 1998 statewide poll found that 85 percent of bar patrons go to bars as much or more than they did prior to the legislation coming into effect.

The scientific evidence of the economic impact of a restaurant smoking ban should be reassuring to concerned restaurateurs. It is consistent with data from the 1996 Angus Reid survey for Toronto, which suggests that smoke-free restaurants will be more attractive to consumers overall.

A recent study by the Ontario Tobacco Research Unit found no evidence that increased restrictions in the former City of Toronto, from 50 percent to 90 percent (the majority were 75 percent) designated non-smoking space, had any negative impact on taxable sales (Lothian et al, 1999).

Concerns were also raised at a Community Council meeting about the potential impact of smoke-free by-laws on small sized restaurants. A study was recently completed by researchers at the University of California School of Medicine using data from the California State Board of Equalization. The study has not yet been submitted for publication. However, a telephone conversation with one of the researchers indicated that the data shows that smoke-free legislation does not have a negative economic impact on sales revenues for small bars and restaurants. The study looked at changes in sales tax revenues for 6,211 small bars and restaurants in the State of California between the first quarter of 1997 and the first quarter of 1998. The State-wide smoke-free legislation went into effect on January 1, 1998.

The effectiveness of the by-law, including economic and other measures of impact, will be monitored by the Medical Officer of Health in consultation with interested parties and reported to Council through the Board of Health following one year of implementation. A funding application to the provincial and/or federal governments will also be sought to assist with the evaluation process.

(8) Corporate Policy:

At the current time there are inconsistencies with regard to workplace corporate smoking policies across the amalgamated City. City workplace policies are consistent with the current smoking by-laws for the respective former municipality. That is, smoking is prohibited in the areas of municipal facilities considered workplaces. There are inconsistencies in areas such as workplace cafeterias and underground garages. The City should set a positive example and adopt the most restrictive policy possible to protect all City employees and the public visiting City facilities by prohibiting smoking in all municipal facilities whether located in municipal or commercial buildings. In cases where space is rented or leased for a private function such as a wedding, the City could permit smoking for the time-limited period of that function. Should the City choose to allow this exception, it should be time limited until April 30, 2001.

(9) Licensing:

A Community Council also recommended that licensing requirements be changed to increase tobacco retail license fees to $10,000.00 and prohibit the sale of tobacco where products likely to attract young people, such as candy or potato chips, are sold. These recommendations will be put forward as part of the review of the Ontario Tobacco Control Act as these recommendations relate primarily to the sale and consumption of tobacco products. Three of the Community Councils also supported a need to review licensing and zoning by-laws after enactment of an ETS by-law to eliminate conflicting or confusing definitions. A report from the Commissioner of Urban Planning and Development Services will address these and other issues relating to zoning and licensing by-laws.

(10) Other Issues:

(a) Public Places Covered by Other Legislation:

In Ontario, the Tobacco Control Act, 1994 (TCA) regulates smoking in some public places as well as the sale of tobacco to minors. The TCA also gives municipalities the authority to pass more restrictive no-smoking legislation. The TCA also states that where a more restrictive law exists, that law will prevail. The public places that will be covered under the TCA for Toronto are outlined in the following table.

Establishment

Smoking Restriction

- Hospitals
- Psychiatric facilities

- Nursing homes

- Homes for special care

- Charitable homes for the aged
100 percent smoke-free

DSR permitted

(b) Other Cities:

The six former municipalities of Toronto have been working on initiatives to eliminate exposure to ETS for decades now. Some of the measures taken earlier have provided motivation for many other municipalities that have embarked on similar initiatives following our successes. During this last decade, there has been significant progress made by hundreds of municipalities across North America with regard to eliminating or reducing exposure to ETS within the hospitality industry.

It is important to note that Toronto is no longer the leader in creating responsible, health protective ETS by-laws that we once were. There has been great momentum created across North America over the last few years and we are well behind. Municipalities such as Vancouver, and the Capital Region District in British Columbia have implemented smoke-free legislation with great success. Just recently, the municipalities of Peel passed by-laws that will prohibit smoking in restaurants June 1, 2001, and in bars June 1, 2004. Several other municipalities such as Guelph, Peterborough, Waterloo, and Hamilton-Wentworth have passed by-laws making all public places smoke-free by the year 2000.

Although the media and some deputations at Community Council meetings indicated that many existing smoke-free by-laws across North America are not working well and that changes to alter or weaken these by-laws are being considered, all evidence leads us to believe that this information is not accurate. It is expected that the implementation of any smoke-free by-law will take some time to achieve a high level of compliance. For example, in the former City of Toronto, it took several years of public education and enforcement of our smoke-free workplace by-law (which applied to over 40,000 workplaces) to achieve the high level of compliance we have today. Please see Appendices 2, 3 and 4 from Vancouver, Capital Health Region (British Columbia) and California, and for their individual comments.

Only 17 out of 859 smoking control by-laws across the US have been repealed, and only four out of several hundred across Canada (including former Toronto and North York).

On January 1, 1997, a by-law was enacted in North York requiring all public eating establishments to be smoke-free until 9 p.m. each day. On March 3, 1997, all public places in the former City of Toronto including restaurants and bars became totally smoke-free. Both of these by-laws were repealed shortly after implementation.

In order to successfully implement any by-law, it is necessary to establish a major public education campaign directed to all persons affected by the by-law. Everyone must be made aware of the new requirements and that there will be strict enforcement of the by-law by public health staff following the education phase. The short lead in period before enactment of the Toronto and North York by-laws and limited funds seriously inhibited the education campaign that was necessary to support the implementation of the by-law.

Both of the by-laws were implemented in cold weather months whereas enactment in May or June would have had smokers more willing to step outside or sit in an outdoor patio in warmer weather to smoke.

Proprietors had limited responsibilities under the by-law. They realized that they were only responsible for notifying people that they were not allowed to smoke but there was no requirement to remove ashtrays. This resulted in a mixed message to operators and customers. As a result, when smoking patrons realized that proprietors were not required to do more than notify, they began to feel that they could light up with impunity. Enforcement staff found a compliance rate during daytime business hours of up to 80 percent. However, this rate dropped to 50 percent during the evening and weekend hours when there was a public perception that enforcement staff would not be on duty.

Public disobedience was also a significant barrier as some media and a minority of vocal bar and restaurant owners encouraged non-compliance. This resulted in smoking throughout some establishments making the situation worse than when there were non-smoking and smoking sections.

The absence at that time of a level playing field was also a major issue for Toronto and North York. Proprietors who initially supported the by-law expressed concern about an unfair playing field when they lost customers to restaurants in neighbouring jurisdictions, a risk that will be greatly reduced in the current environment due both to amalgamation within Toronto and the passage of smoke-free by-laws in Mississauga, Brampton and Vaughan.

Finally, it should be noted that most jurisdictions have experienced a couple of months of turbulence when smoke-free by-laws first take effect. Had the by-laws remained in place and more implementation resources been made available, far greater and more lasting levels of compliance would have been achieved.

(d) Private Clubs:

The City's authority to create smoking legislation in workplaces and public places does not extend to private clubs. However, the provincial Smoking in the Workplace Act, 1990 would have authority in this domain. Therefore, under that legislation private clubs could have up to 25 percent unenclosed smoking.

(e) Enforcement:

As with many municipal by-laws, ETS by-laws are largely self-regulating through increased voluntary compliance by owners/operators, employers, staff, and public over an introductory period.

It is essential that Public Health first educate and raise awareness of all parties including the public, employers, owners, operators and employees. It is essential that prior to and during implementation, everyone understand the reason for the by-law, their responsibilities under it, what the penalties are and whom the public can call with complaints or inquiries.

Public Health staff will be responsible for enforcing the ETS by-law, primarily through monitoring and education during routine visits to premises they regularly inspect and in response to complaints. A great deal of the work that enforcement staff do is education so that people understand the reasons for the by-law and have an opportunity to comply with it voluntarily before measures such as ticketing or court action are initiated.

To make a new ETS by-law as understandable and as easily enforceable as possible, it must apply equally across the city and have clearly defined requirements and responsibilities.

The hospitality industry feels strongly that the public must receive clear information about where they can and cannot smoke. In general, the greater and more restrictive the change, the greater the need for education and enforcement. As with other by-laws to protect health, the owner/operator should be responsible for complying with the by-law. Removing ashtrays from non-smoking areas, posting No Smoking and Health Warning signs to ensure patrons are aware of the by-law and the health risks of ETS, and providing conforming seating space or having smoke-free establishment where applicable are all reasonable responsibilities for the proprietor. Penalties for non-compliance range from $205.00 for a ticket to a maximum $5,000.00 for a prosecution and conviction in Court.

To ensure that owners of establishments receive information and that owners and patrons are complying with the by-law, each establishment will be visited during the three-month education phase. An on-going program monitoring will be undertaken to measure the effectiveness of the implementation and enforcement by routinely collecting inspection records to determine compliance rates and the number of public complaints and enquiries.

It is expected that there will be some complaints when the by-law is harmonized, and an increasing number again when premises are required to go totally smoke free. Consideration is being given to having staff work evenings and weekends to address complaints that occur during these time periods and for monitoring purposes. To that end, additional resources will be required for enforcement in the early months after implementation of smoke-free provisions, which will reflect temporary internal reallocation of inspection staff combined with a one-time funding requirement for after-hours by-law enforcement. The amount required will reflect the extent of the public education that precedes by-law implementation and the actual provisions of the by-law, i.e., the timing and degree of change experienced by proprietors and the public. The estimated range of these additional costs is $200,00.00 to $400,000.00.

(f) Role of Provincial and Federal Governments:

The roles of the various levels of government with regard to tobacco issues are clearly defined. Local governments have the authority under the Municipal Act to pass legislation regarding smoking in public places. The Province also has authority to pass legislation regarding smoking in public places. However, the provincial Tobacco Control Act (TCA) indicated that where a municipal by-law is more restrictive, that law would prevail. The TCA also deals with sale of tobacco to minors. However, the TCA was enacted in 1994 at which time it was considered progressive. Recently an Expert Panel on Renewal of the Ontario Tobacco Strategy produced a report to the Ontario Minister of Health (upon request), entitled "Actions Speak Louder Than Words". This report recommends that the TCA be reviewed. The report also recommends that the provincial government take action in nine areas: tobacco prices, public education, marketing including packaging, labelling information disclosure, and retail controls, smoke-free spaces, supports for smoking cessation, finance and infrastructure, research, monitoring and evaluation and cost recovery litigation.

The federal government has jurisdiction over the federal Tobacco Act, which came into effect on April 25, 1997. The Act deals with tobacco product advertisement and sponsorship; sales to minors; health warnings and other tobacco packaging labels; and regulates the display of cigarette products at the retail level. The Act also establishes powers for the government to control the way cigarettes are manufactured, and the maximum allowable levels of nicotine, tar and other toxic substances. The federal government also has jurisdiction over tobacco taxation.

(g) Woodbine Racetrack:

The impact of the proposed harmonized smoking by-law on the addition of slot machines to the Woodbine Racetrack was discussed at Etobicoke Community Council.

The Woodbine Racetrack is currently regulated as a place of public assembly such as bingo halls and casinos. As such, a maximum of 25 percent of the area can be designated for smoking without enclosure. The proposed harmonized smoking by-law and the addition of the slot machines will not affect the smoking and non-smoking ratio allowed.

The proposed harmonized smoking by-law initially will allow the same 25 percent of the occupiable space for smoking. During a meeting with the racetrack representatives, it was suggested that a 50 percent designated smoking room would be required to give more flexibility especially for the slot machine areas. These would not be in a separate area but rather part of the existing spectator/betting area at level two of the racetrack. With a higher designated smoking room percentage, it would be easier for the racetrack to accommodate players as there would be more smokers in casinos. (The same theory would apply for bingo halls.)

The Club House for members would remain as a private club (see discussion of private clubs). The racetrack stated that requirements to become a member have not been changed. Membership was limited and the Club House was not open to the public.

Conclusions:

The majority of employees in the City of Toronto are protected from ETS at work. The continued exposure to tobacco smoke of workers and the visiting public in restaurants, bars and entertainment facilities is an unacceptable health risk given the current knowledge of the effects of ETS. The Board of Health must address the significant risk to public health in these establishments. A new ETS by-law is therefore required for the City, as well as the development and implementation of a communications strategy to make the transition toward the goal of smoke-free public places. For this to become a reality, it is essential that City Council implement the recommendations contained in this report.

Contact Name:

Liz Janzen Dr. Monir Taha

Regional Director, South Region Associate Medical Officer of Health

Public Health Director of Healthy Environments

Tel: 392-7485 Tel: 392-1356

Fax: 392-0713 Fax: 392-0713

Appendix 1

Summary of Community Council Resolutions and Requests for Information

Insert Page 1 of Appendix 1

Insert Page 2 of Appendix 1

Insert Page 3 of Appendix 1

Insert Page 4 of Appendix 1

Insert Page 5 of Appendix 1

References:

Angus Reid Group. No Smoking Bylaw Survey, April 1996.

California State Board of Equalization. Taxable Sales in Restaurants and Bars Following Enactment of Smoke-free Legislation, January 1999.

Eisner, Mark D., Smith, Alexander K., & Blanc, Paul D. Bartenders' Respiratory Health After Establishment of Smoke-Free Bars and Taverns. Journal of the American Medical Association, December 9, 1998, Vol. 280, No. 22, 1909-1914.

Glantz, Stanton, A., & Charlesworth, A. Tourism and Hotel Revenues Before and After Passage of Smoke-free Restaurant Ordinances. Journal of the American Medical Association, May 1999, Vol. 281, No. 20, 1911-1918.

Glantz, Stanton, A., & Smith, Lisa, R.A. The Effects of Ordinances Requiring Smoke-free Restaurants on Restaurant Sales. American Journal of Public Health, July 1994, Vol. 84. No.7, 1081-1085.

Glantz, Stanton, A., & Smith, Lisa, R.A. The Effects of Ordinances Requiring Smoke-free Restaurants and Bars on Revenues: A Follow-Up. American Journal of Public Health, October 1997, Vol. 87, No. 10, 1687-1693.

Lothian S., Ferrence R., Ope M. The Impact of Increased Smoking Restrictions on Restaurant Sales in the City of Toronto. Ontario Tobacco Research Unit, February, 1999.

Maroney, Neal, Sherwood, Deborah, & Stubblebine, Wm., Craig. The Impact of Tobacco Control Ordinances on Restaurant Revenues in California. Claremont, CA, January, 1994.

Ontario Health Survey, 1996, Toronto Tables.

Sciacca, John, & Ratliff, Michael. Prohibiting Smoking in Restaurants: Effects on Restaurant Sales. American Journal of Health Promotion, January/February, 1998, Vol. 12, No. 3, 176-184.

Siegel, M. Mass Media Antismoking Campaigns: A Powerful Tool for Health Promotion, Annals of Internal Medicine, Vol. 129, No. 2, July 15, 1998

The Board of Health also submits the following report (June 21, 1999) from the Medical Officer of Health, entitled "Ventilation and ETS":

Purpose:

To report on the appropriateness of including a ventilation option in a harmonized ETS by-law as an alternative to being smoke-free.

Financial Implications:

None, if a ventilation option is rejected. If a ventilation option is approved, additional staffing and expenses for system approvals, inspection, laboratory analysis and enforcement will be required.

Recommendations:

It is recommended that:

(1) a ventilation option not be included in the proposed ETS by-law.

However, if Toronto Council decides to consider ventilation systems as an alternative to being smoke-free in the future:

(b) problems with enforceability combined with the additional workload and costs to the City for ventilation system approvals, inspections and enforcement must be taken into consideration.

Background:

On May 6, 1999, the Board of Health passed a resolution requesting the Ontario Restaurant Association to provide the Medical Officer of Health with "specific details on the ventilation technology which they believe to be an effective alternative to 100 percent smoke-free status for hospitality establishments, along with independent scientific evidence supporting the effectiveness of this technology". No such information was received by the Board's May 31, 1999 deadline, although by that point an upcoming demonstration of an "air quality solution" had been announced by the Ontario Restaurant Association. On June 3, 1999, the Board of Health passed a further resolution that the Medical Officer of Health report back to the Board with "details of a health-based evaluation protocol that could be used to assess any ventilation system put forth by the hospitality industry to achieve the equivalent of a smoke-free indoor environment". This report responds to that request and comments on the Ontario Restaurant Association's ventilation system demonstration - Appendix (b).

Discussion:

The following issues must be taken into account in assessing the effectiveness of ventilation as an alternative to being smoke-free:

(1) Air quality standards for ETS exposure.

The effectiveness of a ventilation system can only be assessed in relation to an appropriate standard for ETS exposure, either for workers or the general public. No such standard has been set in any North American jurisdiction despite consideration of this matter by a number of regulatory bodies in both Canada and the United States. However, the National Institute of Public Health in Norway has established guidelines for indoor air quality which are not legally binding. Exposure standards for air pollutants (such as ETS) are normally set by the federal and/or provincial governments, not by local municipalities. It is strongly recommended that the City not attempt to set an arbitrary standard for ETS in the proposed by-law because:

(a) scientific consensus has not determined a safe level of exposure to ETS; and

(b) scientific regulatory bodies, on which the City normally relies for standard setting, have themselves been unable to establish an air quality standard for ETS.

Exposure to harmful components should be eliminated as a first choice in protection strategies whenever possible, especially in indoor environments. Only when a health risk cannot be eliminated must it be managed. For example, when the health risk associated with asbestos was confirmed, governments took action to eliminate the risk of exposure to asbestos wherever possible. It was removed from public places and controls were put in place to ensure that people are not exposed to asbestos fibres. Asbestos was not banned completely because it continues to be essential as a heat resistant material and insulator. However, when asbestos is used there are restrictions put in place to protect workers and the general public. In contrast, ETS has no useful functions.

(2) Factors that affect the concentration and measurement of ETS within an indoor environment.

ETS is a complex mix of gaseous compounds and particulates which may be measured using a variety of markers, none of which are ideal. ETS levels are influenced by many factors in addition to the type of ventilation system, including:

(a) the number of cigarettes being smoked per unit time;

(b) the degree of absorption of ETS components to furniture and other surfaces;

(d) air exchange rates;

(e) whether other ventilation systems are in operation elsewhere in the building; and

(f) how often windows and doors are opened.

The complexities of ETS measurement make it difficult to incorporate ventilation standards into the by-law as any guarantee of effectiveness in removing ETS from all portions of a given indoor space. The mechanical specifications of a proposed system, along with the maintenance procedures and associated costs that are required to ensure that it operates to the manufacturer's specifications, must also be taken into account.

(3) The requirements for inspection and enforcement to ensure such systems are operating effectively.

If an air quality standard is developed by an appropriate body along with engineering requirements by which to achieve this standard, there are still substantial issues related to operational feasibility that must be taken into account. While the manufacturer's specifications regarding installation, operation and maintenance must be complied with if a system is to be effective, there are many potential areas for "short-cuts" to be taken either by contractors, proprietors or their designates in order to reduce costs. This may limit the effectiveness of the system. Hence, a strong set of checks and balances by the City is required to ensure the by-law is enforced and that the public and workers are protected from ETS. These include:

(a) Inspection of ventilation systems prior to their approval by a duly qualified engineer, at the expense of either the applicant or the City.

(b) Collection of maintenance records by the proprietor (including operation of vents, cleaning and exchange of filters, etc.) and inspection of these records on a regular basis by the City.

(c) Collection, analysis and interpretation of airborne ETS levels (assuming agreement could be found on the appropriate markers and collection methods), with the associated expense for laboratory analysis to be borne either by the proprietor or the City.

(d) Enforcement of non-compliance, including collection of sufficient evidence to mount a successful case, since the onus would fall on the City to prove non-compliance - given the technical complexities of ETS measurement, overall enforceability and the associated costs are a major consideration.

(e) Given the large number of restaurants in the City, even a 10 percent uptake on ventilation systems as an alternative to smoke-free would mean an additional 700 premises requiring detailed inspections, many of which would likely proceed to enforcement given the inadequacies of current ventilation technologies in removing ETS from indoor air. As ventilation companies produce ever-increasing and cheaper systems that they claim to be satisfactory, uptake by restaurants could increase substantially while the onus of disproving claims will invariably fall onto the City.

(f) While some proprietors will make a genuine attempt to install, operate and maintain an appropriate system, others may claim their system works and tie up the City's resources in having to prove the contrary. This scenario could be exacerbated with the aid of tobacco companies, which would benefit greatly if a municipality of Toronto's stature makes smoking permissible in public places, with a possible influx of "consultants" claiming to have better and cheaper systems, etc. Problems with enforceability would only add to the negative public relations that could result from this situation.

Comments on the ORA Demonstration:

On June 8, 1999, the Ontario Restaurant Association held a demonstration for the Board of Health, Toronto Councillors and the media of a newly installed ventilation system at the Black Dog Pub in the east end of Scarborough. As part of their presentation, a consultant in toxicology and environmental health stated that the components of tobacco smoke can arise from other sources and therefore that exposure to these substances cannot be avoided. It should be noted that the ORA did not describe their ventilation solution as being able to eliminate ETS.

The visual demonstration involved a single smoker seated in one room which connected through an open doorway to an adjacent "smoke-free" room. While smoke from the burning cigarette was clearly flowing away from the direction of the "smoke-free" room towards the vents in the smoking room, this scenario failed to simulate the conditions more typical of a bar on a weekend night, in which many more smokers would be present and in which air movement may be much more complex. A ventilation system that appears to clear the air when one cigarette is burning may fail entirely to be effective when many cigarettes are burning.

The technology presented was an energy recovery ventilator, also known as a heat recovery ventilator (HRV). These systems are designed to remove a portion of stale or contaminated air and replace it with fresh air from the outside. The main concept behind this technology is that heating or cooling (depending on the season) is transferred from the exhausted air to the fresh air. This allows for more air exchanges while controlling increases in energy costs. However, these types of systems are not designed to be health protecting systems, since their primary function is to save energy costs while exchanging some percentage of the indoor air in a certain period of time.

At the presentation, the ORA presented a series of charts describing the air quality results at the Black Dog Pub before and after implementation of the ventilation system, and compared these results with those obtained in a smoke-free food court. Their study results showed ETS levels in the "smoke-free" food court which, according to their findings, exceeded those at the Black Dog Pub with ventilation in effect. It must be noted, however, that this food court shares an airspace with two restaurants in an adjacent building which do allow smoking. This situation would be rectified in the proposed by-law by prohibiting smoking in non-enclosed restaurants that are adjacent to food courts and other public areas.

Finally, the ORA has not provided Public Health with any of the information needed to properly interpret their study's methodology or results, including such basic facts as the number of cigarettes that were burned during the test, how samples were collected or how the data were analyzed (see attachment for list of questions posed to the ORA). As such, their results are considered uninterpretable at this time.

Conclusions:

I have considered at great length the appropriateness of including a ventilation option in a harmonized ETS By-law as an alternative to being smoke-free. My recommendation against such an option is based on the current state of scientific consensus which has not determined a safe level of exposure to ETS. Further, no Canadian jurisdiction has set an air quality standard for ETS exposure, either for workers or for the general public. Regulation of air pollutants (such as ETS) is a federal/provincial responsibility and should not be undertaken by one municipality acting in isolation. Methods to assess the effectiveness of ventilation in meeting air quality standards, should one be established in the future, would also be the responsibility of the federal and/or provincial government which sets the standard.

Should such a standard be developed and ventilation systems be designed that are capable of achieving this standard, the associated installation and maintenance costs to proprietors and the inspection and enforcement costs to the City would have to be taken into account when considering the appropriateness of this approach at a future point in time.

A protocol to critically assess a study of ventilation system effectiveness in achieving the equivalent of a smoke-free indoor environment was developed in consultation with a ventilation engineer with ETS expertise. The results of the Ontario Restaurant Association's demonstration of its "air quality solution" are uninterpretable at this time, due to the continuing unavailability of such basic information as the number of cigarettes being smoked during the testing period. Further, their results must be subjected to independent scientific analysis to assess their replicability not just in this setting but also in a variety of others.

In summary, the ORA has not provided any supporting evidence to confirm their claim that ventilation technology can provide an acceptable alternative to removing the source of contamination, that is, smoking.

Contact Name:

Dr. Sheela Basrur

Medical Officer of Health

Tel: 392-7402

Fax: 392-0713

The Board of Health also submits the following report (June 10, 1999) from the City Solicitor:

Purpose:

To report to the Board of Health respecting the form and content of a harmonized environmental tobacco smoke by-law which reflects the recommendations proposed by the Medical Officer of Health in her report dated March 26, 1999.

Funding Sources, Financial Implications and Impact Statement:

Funding implications of the proposed harmonized environmental tobacco smoke (ETS) by-law will be addressed by the Medical Officer of Health in a companion report to the Board of Health.

Recommendation:

That authority be granted to introduce the necessary Bill in Council in the form or substantially in the form of the by-law attached to this report.

Council Reference/Background/History:

The Board of Health at its meeting on April 6, 1999, adopted the report, dated March 26, 1999, from the Medical Officer of Health, outlining the community consultation process for a harmonized ETS by-law for the City of Toronto. That process included a request that the City Solicitor prepare a draft ETS by-law for a special meeting of the Board of Health on June 28 and 29, 1999.

The attached by-law reflects the recommendations of the Medical Officer of Health respecting a harmonized ETS by-law for the City of Toronto. It should be noted that the draft by-law repeals the ETS by-laws which are currently in force in each of the former area municipalities. Unless these by-laws are repealed, the smoking/smoke free provisions in those by-laws (and any exemptions to those provisions) will continue to be in force. For instance, in the former Cities of Toronto and Etobicoke and in the former Borough of East York, all restaurants will become smoke free by January 1, 2000. In Toronto, existing designated smoking rooms would continue to be permitted. In the former City of York, the existing by-law requires all workplaces to be smoke free; designated smoking areas are not an option.

Comments and Conclusion:

A draft ETS by-law is attached for the consideration of the Board of Health. The by-law has been prepared in consultation with Toronto Public Health staff and incorporates the policies and recommendations of the Medical Officer of Health for a harmonized ETS by-law for the City of Toronto.

Contact Name:

Jane Speakman

Solicitor

392-1563

--------

DRAFT

Authority:

Enacted by Council:

CITY OF TORONTO

Bill No.

BY-LAW No.

WHEREAS continued exposure to environmental tobacco smoke in public places and workplaces is an unacceptable health risk; and

WHEREAS it is desirable to promote the health and well being of persons, especially children, in the municipality; and

WHEREAS subsection 213(2) of the Municipal Act authorizes the Council of a local municipality to pass a by-law regulating the smoking of tobacco in public places or workplaces and designating public places or workplaces or classes or parts of such places as places in which smoking tobacco or holding lighted tobacco is prohibited;

The Council of the City of Toronto HEREBY ENACTS as follows:

PART I

DEFINITIONS

1. In this by-law,

"class "A" public place" means an enclosed building or an enclosed portion of building used for the sale and service of food or drink or both food and drink to the public for consumption on the premises but does not include a food court, indoor patio or a class "E" public place. A class "A" public place includes a dinner theatre and a restaurant;

"class "B" public place" means a public place which is used for bowling and includes a bowling centre;

"class "C" public place" means a public place used primarily for playing billiards and includes a billiard hall;

"class "D" public place" means a public place used for the playing of games of chance as defined by the Gaming Control Act, 1992, and includes a bingo hall, a casino and a race track;

"class "E" public place" means an enclosed building or an enclosed portion of a building used for the sale and service of food and drink to the public for consumption on the premises to which no patron under the age of nineteen (19) years of age is admitted to the premises at any time. A class "E" public place includes a bar, an entertainment lounge and a night club. A class "E" public place does not include a premises otherwise defined in this by-law;

"designated smoking room" means a room in which smoking is permitted and that,

(a) is fully enclosed and not required by the public for thoroughfare;

(b) in the case of a workplace, is not greater in size than twenty-five percent (25%) of the occupiable space;

(d) has a capacity of not more than twenty-five percent (25%) of the occupancy load; and

(e) is equipped with a separate ventilation system that maintains a minimum ventilation rate of thirty (30) litres per second per person, based on the maximum occupancy load that is ventilated directly to the outside air and exhausted at a rate of at least one hundred and ten percent (110%) of supply. Such exhaust must be no less than three (3) metres from any air intake or opening.

"employee" means a person who performs any work for or supplies any service to an employer, and includes a volunteer and a person who is self employed and employment has a corresponding meaning;

"employer" means any person who, as the owner, manager, contractor, superintendent or overseer of any activity, business, work, trade, occupation, or profession, has control over or direction of, or is directly or indirectly responsible for the employment of an employee, whether paid or not, therein;

"enclosed" means closed in by a roof or ceiling and walls with an appropriate opening or openings for ingress or egress, which openings are equipped with doors which are kept closed except when actually in use for ingress or egress;

"food court or indoor patio" means an area located within a public place that is used in conjunction with a restaurant or take-out eating establishment, where unenclosed seating accommodation is provided or where meals or refreshments are consumed by the public;

"Medical Officer of Health" means the Medical Officer of Health for the City of Toronto Health Unit or any person acting under his or her authority;

"proprietor" means the person who ultimately controls, governs or directs the activity carried on within the premises referred to in section 6, and includes the person actually in charge of the premises;

"private club" means a not for profit corporate establishment that operates solely for the benefit and pleasure of its members, that directs its publicity and advertisements to its members and has passed by-laws regulating the admission of persons and the conditions of membership, the fees and dues of members, the issue of membership cards, the suspension and termination of memberships, the qualification of and the remuneration of the directors, the time for and the manner of electing directors and the time, place and notice to be given for the holding of meetings of the members and of the board of directors;

"public place" means the whole or part of an indoor area, whether covered by a roof or not, to which the public has access as of right, expressed or implied;

"public transit vehicle" includes a school bus and a passenger vehicle used for hire;

"smoke or smoking" includes the carrying of a lighted cigar or cigarette, pipe or any other lighted smoking equipment;

"workplace" means a building or part of a building in which one or more employees work, including employees' eating and lounge areas, includes a public transit vehicle (other than a taxi cab or livery cab) and any other conveyance in which an employee works. In the case of Toronto City Hall, workplace includes the taxi tunnel, the official parking garage, the main employee parking garage and the glass house.

PART II

WORKPLACES

2. (1) Where a workplace is also a public place, the provisions of this by-law respecting public places shall prevail.

(2) Where a workplace is also a private club, the provisions of this by-law do not apply.

3. (1) No person shall smoke in a workplace except in a designated smoking room.

(2) The designated smoking room referred to in subsection (1) shall be used for no other purpose than a designated smoking room.

4. Section 3 and subsection 5(a) does not apply to those areas of a workplace where smoking is otherwise permitted by this by-law.

5. Every employer shall,

(a) prohibit smoking in the workplace except where smoking in the workplace is permitted by this by-law;

(b) conspicuously post no smoking signs in areas where smoking is prohibited;

(c) where designated smoking rooms are established, conspicuously post health warning signs at the entrance of each designated smoking room;

(d) prohibit ashtrays and like paraphernalia in areas where smoking is prohibited; and

(e) conspicuously post signs at every entrance to the workplace indicating that smoking is prohibited in the workplace except in designated smoking rooms.

PART III

PUBLIC PLACES

6. (1) No person shall smoke in a public place.

(2) The prohibition set out in subsection (1) does not apply to

(a) a designated smoking room in a public place, or

(b) a smoking area established and designated pursuant to subsections 6(3), 6(4), 6(5), 6(6) or 6(7).

(3) Despite subsection (1), a proprietor of a class "A" public place may establish and designate an unenclosed smoking area no greater in size than twenty-five percent (25%) of the occupiable public space in the premises. The designated smoking area must be contiguous and clearly identifiable.

(4) Despite subsection (1), a proprietor of class "B" public place may establish and designate an unenclosed smoking area no greater in size than twenty-five per cent (25%) of the occupiable public space in the premises. The designated smoking area must be contiguous and clearly identifiable.

(5) Despite subsection (1), a proprietor of a class "C" public place may establish and designate an unenclosed smoking area no greater in size than twenty-five per cent (25%) of the occupiable public space of the premises. The designated smoking area must be contiguous and clearly identifiable.

(6) Despite subsection (1), a proprietor of a class "D" public place may establish and designate an unenclosed smoking area no greater in size than twenty-five per cent (25%) of occupiable public space in the premises. The designated area must be contiguous and clearly identifiable.

(7) Despite subsection (1), a proprietor of a class "E" public place may establish and designate an unenclosed smoking area no greater in size than twenty-five per cent (25%) of occupiable public space in the premises. The designated smoking area must be contiguous and clearly identifiable.

(8) This by-law does not apply to,

(a) a hospital as defined in the Public Hospitals Act;

(b) a private hospital as defined in the Private Hospitals Act;

(d) a nursing home as defined in the Nursing Homes Act;

(e) a home for special care as defined in the Homes for Special Care Act;

(f) an approved charitable home as defined in the Charitable Institutions Act;

(g) a home for special care as defined in the Homes for the Aged and Rest Homes Act.

7. Every proprietor shall,

(a) prohibit smoking except where smoking is permitted;

(b) post no smoking signs conspicuously where smoking is prohibited in the premises;

(d) conspicuously post a health warning sign at the entrance of every designated smoking room;

(e) prohibit ashtrays and like paraphernalia in areas where smoking is prohibited;

(f) ensure that an unenclosed designated smoking be contiguous; and

(g) clearly identify an unenclosed designated smoking area.

PART IV

SIGNAGE REQUIREMENTS

8. (1) Where a health warning sign is required to be posted by this by-law the sign shall,

(a) carry the text "Warning This area contains tobacco smoke which causes cancer, heart disease, lung disease and can harm your baby";

(b) display the graphic symbol having the measurements, proportions and characteristics as illustrated in Schedule A at the end of and forming part of this by-law;

9. (1) Where a no smoking sign is required to be placed or posted pursuant to this by-law, the sign shall

(a) have the proportions, characteristics and minimum measurements illustrated in Schedule B at the end of and forming part of this by-law;

(b) consist of two (2) contrasting colours, or if the lettering and graphic symbol is to be applied to a surface or to be mounted on a clear panel, the lettering and the graphic symbol shall contrast to the background colour;

10. Where an employer or proprietor prohibits smoking throughout the entire workplace or public place under the control, supervision or ownership of that employer or proprietor, the Medical Officer of Health may permit that employer or proprietor to post signs in a form, size and location satisfactory to the Medical Officer of Health that indicate that the entire workplace or public place is smoke free and, where permission has been given under this section, paragraph 5(b) and paragraph 7(b) do not apply to that workplace or public place provided that smoking continues to be prohibited throughout that workplace or public place.

PART V

OFFENCES

11. Any person who contravenes any provision of this by-law is guilty of an offence.

PART VI

REPEAL PROVISIONS

12.(1) The following are repealed,

(a) Borough of East York By-law Number 148-96, as amended, being a by-law to Protect East York Workers and Inhabitants from Environmental Tobacco Smoke;

(b) City of Etobicoke Municipal Code Chapter 220-Smoking By-law;

(c) City of North York By-law 32931, as amended, being a by-law to regulate or prohibit smoking in public places or workplaces;

(d) City of Scarborough By-law Number 24983, being a by-law to protect City of Scarborough workers and inhabitants from secondhand tobacco smoke;

(e) City of Toronto Municipal Code Chapter 301, Smoking, as amended;

(f) City of York By-law Number 3320-96 being a by-law to protect inhabitants and workers in the City of York from environmental tobacco smoke.

(2) Despite subsection (1), the by-laws referred to in subsection (1) continue to apply to offences that occurred before the by-laws were repealed.

PART VII

TRANSITION PROVISIONS

13.(1) Subsections 6(3) and 6(4) of this by-law are repealed on April 30, 2001.

(2) Subsections 6(5), 6(6) and 6(7) of this by-law are repealed on May 3, 2004.

(3) Despite subsections (1) and (2), this by-law, as it read before subsections 6(3), 6(4), 6(5), 6(6) and 6(7) were repealed, continues to apply to proceedings in respect of offences that occurred before subsections 6(3), 6(4), 6(5), 6(6) and 6(7) were repealed.

14. This by-law comes into force three months after the date it is enacted and passed by Council.

ENACTED AND PASSED this day of , A.D. 1999.

MayorCity Clerk

Insert Schedule A

Insert Schedule B

The Board of Health also submit the following report (March 26, 1999) from the Medical Officer of Health:

Purpose:

The purpose of this report is to outline a process to obtain community input on proposed options for a harmonized Environmental Tobacco Smoke (ETS) by-law and strategies to achieve smoke-free public places in the City of Toronto, as set out in the attached document dated March 26, 1999, from the Medical Officer of Health, entitled "A Harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto".

Financial Implications:

None, for the public consultation process prior to Council approval. Additional one-time funding will be required in 1999 and 2000 for public communication, for which provincial funding will be sought.

Recommendation:

It is recommended that the Board of Health:

(1) adopt the process outlined in this report to seek public input on the proposed ETS by-law for the City of Toronto; and

(2) forward the attached policy options and recommendations paper to Community Councils for staff presentation and deputations.

Background and Discussion:

Historically, public consultation has played an important part in the development of Environmental Tobacco Smoke (ETS) by-laws in all of the former municipalities. Public and stakeholder input towards the policy options has been obtained through a variety of means, including community meetings, focus groups and public opinion surveys. Public input to the proposed by-law has been formally sought through deputations at boards of health and at city councils.

During the past year, Toronto Public Health has consulted with the health and hospitality sectors as well as the public, on an Environmental Tobacco Smoke by-law that is protective of health for the new City of Toronto. The attached document from the Medical Officer of Health provides a comprehensive review of issues related to environmental tobacco smoke, along with policy options and recommendations for a new by-law.

Public and stakeholder input on the recommendations can be obtained through a deputation process similar to that followed in the past, with the addition of deputations at Community Councils to ensure local input. The following process and time-line is recommended:

Process

Meeting Date(s)

Board of Health Board of Health to refer the Medical Officer of Health's public consultation document to Community Councils for staff presentation and deputations. April 6, 1999

Community Councils Public deputations with recommendations from Community Councils referred to the Medical Officer of Health and the City Solicitor for consideration and recommendations back to the Board of Health. May 26 and 27, 1999

Board of Health The Medical Officer of Health and the City Solicitor to report back to Board of Health on June 28, 1999, at which time the Board will hear deputations on the original public consultation document and any follow-up staff reports, including the solicitor's draft by-law. The Board of Health will debate the issue at a special meeting on June 29, 1999, and forward its recommendations to City Council for consideration. June 28 and 29, 1999

Conclusion:

The public consultation process outlined in this report will ensure input from a variety of interests prior to the by-law's enactment by Council.

Contact Name:

Liz Janzen, Regional Director, South Region

Tel: 392-7458, Fax: 392-0713

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A Harmonized Environmental Tobacco Smoke

(ETS) By-law for the City of Toronto

Policy Options and Recommendations

For Public Discussion

Toronto Public Health

April 6, 1999

Introduction:

The purpose of this report is to describe the outcome of stakeholder consultations and to outline policy options with recommendations from Toronto Public Health for a harmonized Environmental Tobacco Smoke (ETS) by-law and strategies to achieve smoke-free workplaces and public places.

Recommendations:

(1) That workplaces in the City of Toronto be smoke-free, except in fully enclosed, separately ventilated designated smoking rooms (DSRs) that make up no more than 25 percent of the work space, and which no employee is required to enter;

(2) that the six existing municipal by-laws respecting smoking in public places be replaced with one ETS by-law from one of the two following options:

(i) that public places be smoke-free, except for restaurants, bars, bowling centres, casinos and bingo and billiard halls, which may have unenclosed smoking in 25 percent of space until April 30, 2001, when they become smoke-free;

(ii) that public places be smoke-free, except for restaurants, bars, bowling centres, casinos, billiard and bingo halls, which may have 25 percent of their space for unenclosed smoking for a time limited period, such that:

(a) restaurants and bowling centres become smoke-free April 30, 2001; and

(b) casinos, bars, billiard and bingo halls become smoke-free May 3, 2004, with the distinction between bars and restaurants being that a bar is where alcohol is served and where admittance is restricted to persons 19 years of age and older at all times;

(3) that one of the following options be selected regarding designated smoking rooms (DSRs) in public places:

(i) no DSRs, except where permitted in the Tobacco Control Act, 1994, (e.g., Homes for the Aged);

(ii) DSRs up to 25 percent of space; OR

(iii) DSRs up to 50 percent of space;

(4) that the Corporation of the City of Toronto develop a corporate policy to prohibit smoking in all municipal facilities including workplaces, whether located in municipal or commercial buildings, except in such cases where this space is reserved for a private function such as a wedding. Where exemptions apply, they should be time limited until April 30, 2001;

(5) that the Commissioner of Urban Planning and Development Services be requested to consult with the Medical Officer of Health regarding revisions to the Licensing By-law to ensure these revisions have regard for the ETS By-law; and

(6) that the new harmonized by-law be implemented three months following its enactment by City Council.

Background:

At its meeting January 26, 1998, the Board of Health requested the then Acting Medical Officer of Health to report back on the status of ETS by-laws in the new City along with suggestions for next steps towards reaching smoke-free workplaces and public places in the amalgamated City of Toronto.

At its meeting February 4 to 6, 1998, City Council referred a motion to the Board of Health for recommendations and public hearings on phasing in a harmonized smoke-free by-law for the entire City which would be protective of health.

The Medical Officer of Health reported to the Board of Health at the April 21, 1998 meeting on the status of ETS by-laws, and recommended that stakeholders be consulted regarding the components of a uniform by-law and strategies to achieve the goal of smoke-free public places.

Upon the request of the Board of Health, the Medical Officer of Health made a presentation on a Stakeholder Consultation Plan for an ETS by-law at the June 23, 1998 Board meeting.

The changes proposed by Toronto Public Health for a harmonized ETS by-law and the eventual attainment of smoke-free public places are highlighted in Section 8. The rationale for the proposed changes is summarized below.

Discussion:

(1) Government Response to Environmental Tobacco Smoke (ETS):

During the past 20 years, governments across North America have moved steadily toward ensuring that residents, workers and visitors are fully protected from ETS by implementing legislation that prohibits smoking in the workplace and in public places. Currently 76 percent of Toronto residents do not smoke tobacco, but are exposed to ETS in a variety of public places, such as restaurants, bars, bowling centres, billiard and bingo halls and other entertainment centres, or at work if they are employed in the hospitality industry. Each of the six former municipalities has a by-law requiring employees to be protected from ETS, with the exception of employees in the hospitality industry. This report focuses on harmonizing the six ETS by-laws as a first step to providing full protection for all employees, as well as for the non-smokers who visit these public places.

The omission of restaurants, bars and other entertainment facilities from ETS by-laws is being addressed in jurisdictions across North America. In the State of California all public places and workplaces, including restaurants and bars, are smoke-free. The Capital Region of British Columbia introduced smoke-free restaurants and bars January 1, 1999. The City of Vancouver prohibits smoking in restaurants that allow children. Closer to home, municipalities that have passed progressive ETS by-laws include Vaughan, Guelph, Windsor, London and Waterloo. (See Appendix V for a detailed outline.)

(2) Health Hazards of Environmental Tobacco Smoke (ETS):

The move to full employee and public protection is a direct result of increasing scientific evidence that links regular exposure to ETS to a variety of illnesses in non-smokers, including lung and heart disease, asthma, and numerous childhood conditions. The full impact of ETS on health is not yet known, but the direct link to ill health is not surprising given that ETS contains 4,000 chemicals; among them benzene, formaldehyde and arsenic. More than 43 of these chemicals are known to cause cancer in humans.

The most immediate effects of exposure to ETS occur in children and in people with chronic lung and heart conditions. They range from itchy eyes, runny nose, coughing, wheezing and sore throat to exacerbated asthma attacks. Children, whose developing bodies are especially susceptible to poisonous fumes inhaled at home, in restaurants, and in other places with open smoking (Glantz, 1995), because they breathe in more air compared to their body weight than an adult and absorb more harmful chemicals than an adult. With 11 percent of children affected by asthma, any exposure to ETS is of significant concern. Other common childhood illnesses linked to ETS include ear infections and pneumonia. The more insidious long-term effects of ETS can emerge later in life as full blown cancers or heart disease. It is estimated, for example, that 3,000 non-smokers die each year in Canada from preventable heart disease attributed to exposure to ETS. Another 330 die from preventable lung cancer. The health effects experienced by individuals depend upon such factors as personal sensitivity and frequency of exposure. As with some other cancer causing agents, such as asbestos, health experts generally agree that there is no safe level of exposure to ETS.

As the scientific evidence on ETS has increased so has public awareness of its dangers. More than 90 percent of Toronto residents now believe ETS harms health (Smaller World Communications, 1998, Appendix VIII), and one third of all Ontario residents avoid certain bars and restaurants because they are too smoky (OTRU, 1997/1998). Given that non-smokers are protected from ETS at work and in many public places, there is public demand for smoke-free places, including restaurants and entertainment facilities, such as bowling centres, casinos, billiard and bingo halls and bars. It should be noted that the provision of separate but unenclosed spaces for smoking in public places is not health protective to non-smokers, or to employees, since ETS travels freely through the air. Full protection is achieved only in a smoke-free environment, or where there is a fully enclosed and separately ventilated DSR.

(a) Exposure to ETS in Restaurants, Bars and Entertainment Facilities:

It is troubling that the least protected employees in the new City of Toronto are those working in places with the highest levels of ETS (See Appendix I). A 1994 review of many studies on indoor air quality concluded that, on average, ETS levels in restaurants were 1.6 to 2.0 times higher than in other workplaces that permit smoking, and 1.5 times higher than in homes where at least one person smokes (Siegel, 1993). ETS levels in bars were found to be 3.9 to 6.1 times higher than in workplaces that allow smoking, and 4.4 to 4.5 times higher than in homes where at least one person smokes (Siegel, 1993). The same review concluded that the increased risk of lung cancer among food service workers may be as high as 50 percent compared with the general population. In a recent study, San Francisco bartenders reported a substantial reduction in ETS exposure after the State of California made bars smoke-free. The study concluded that implementation of smoke-free legislation has an immediate beneficial effect on the respiratory health of employees (Eisner et al, 1998). The exposure of employees, children and susceptible adults to the high levels of ETS in restaurants, bars, bowling centres and bingo and billiard halls is a serious health concern. It is important to note in this regard that youth are exposed to ETS not only as patrons of these places, but also as workers since youth make up a significant percentage of food service workers.

(3) Stakeholder Consultation:

Not surprisingly, moves to protect non-smoking employees and the non-smoking public from exposure to ETS in the workplace have been welcomed by the majority of non-smokers and health experts, and resisted by those who believe such laws are unworkable, or will have a negative impact on business. The introduction of the workplace by-law in 1979 in the former City of Toronto, for example, engendered many complaints in its initial stages, including some from individuals who felt it was an unnecessary infringement of their "right" to smoke.

To guide development of the by-law, Public Health consulted with the public and with stakeholders from the hospitality and health sectors, including health agencies, hospitality organizations and operators of food premises, bowling centres and bingo and billiard halls. The hospitality industry was asked for advice on the development of a consultation plan that would be used to gather information from interested parties in the hospitality/entertainment sector on the components of a uniform by-law for the city, as well as on strategies to achieve smoke-free public places. The consultation included a public opinion survey, focus group discussions, and meetings. As well, stakeholders were invited to provide written submissions to the Board of Health, or to depute to the Board during future public hearings on the proposed by-law. Results from the community consultation were similar to those found during extensive consultations carried out by the six former municipalities of Toronto in past years. The following is a summary of the results.

(a) Public Opinion Survey:

An independent research firm was contracted to conduct a public opinion survey to gauge the level of support regarding details of a harmonized ETS by-law for the city, and to provide ideas on how to move forward to smoke-free public places. The survey of a random selection of 1,000 Toronto residents was done by telephone in October 1998. Survey results show that more than 90 percent of people believe ETS is harmful to non-smokers. This is in line with Health Canada's National Population Health (Cycle 2, 1996/97) which found that 77 percent of current smokers and 88 percent of non-smokers believe ETS can cause health problems in non-smokers. The majority of respondents in the public opinion survey believe the best way to reach smoke-free status is by increasing the percentage of non-smoking space each year, and that fully enclosed and separately ventilated designated smoking rooms should be permitted. Support for non-smoking space was higher among non-smokers and among individuals who believe ETS is harmful to non-smokers. These individuals support a significantly greater percentage of space for non-smoking patrons across all public places. (See Appendix VIII for detailed results.) This highlights the need for comprehensive education campaigns with regard to the health risks of ETS. With respect to the harmonized by-law, the survey showed that 78 percent of residents believe restaurants should be at least 75 percent non-smoking.

(b) Health Agencies:

Health agencies were consulted by phone and/or invited to meetings. Not surprisingly there is a high level of support among agencies for achieving smoke-free public places as soon as possible, particularly given the increased smoking rates in young people and the epidemic of lung cancer in women. While ETS by-laws are primarily aimed at protecting non-smokers and children from ETS, they also help reduce direct smoking rates by reducing the number of places where people can smoke. Health agencies are particularly cognizant of studies that show that youth who do not take up smoking in their early and mid teens are much less likely to become regular smokers later in life. Some agencies believe that although DSRs with separate ventilation may be a necessary step for restaurants, bars and entertainment facilities to become completely smoke free, no worker should be required to enter a DSR as part of their job. The majority of agencies said that where public places are not already smoke-free, a harmonized by-law should require a minimum non-smoking area of 75 percent as a step towards becoming smoke-free.

During the past decade public health departments in the six former municipalities have worked with representatives of the hospitality industry and owner/operators to obtain input on various public health issues, including ETS by-laws. In past consultations with staff, the Ontario Restaurant Association (ORA) has suggested: allowing smoking in bars and bar areas, in "smoke rooms"; increasing non-smoking areas incrementally, rather than going directly to smoke-free; and allowing individual operators to designate their establishments a "smoke house". Since the beginning of this current consultation and research process, various approaches have been used to solicit input on a harmonized by-law, including letters, telephone conversations and meetings. Staff met with the ORA and the Ontario Hotel and Motel Association (OHMA) to plan the consultation process. Both organizations recommended focus groups as the best way to get direct input from operators of food premises. A total of 38 operators from six former municipalities attended the focus group discussions. The executive summary of the report is attached as Appendix VII. In March 1998, Ryerson Polytechnic University conducted a random survey of 200 food premise operators on ETS by-laws in the former City of Toronto (Sly, 1998). The survey found that about half of the respondents wanted either no change in current by-laws, or a more restrictive by-law. The other half preferred a less restrictive by-law. The survey found that operator attitudes towards ETS by-laws are highly associated with whether smoking is allowed in their premises (i.e., operators of a smoke-free premises are more likely to call for a more restricted by-law than operators of premises which allow smoking).

In general, hospitality organizations and food premise operators are sympathetic to health concerns related to ETS with some operators preferring a smoke-free environment for themselves and their families. However, they are more concerned about any potential for lost business. They believe that the cost of providing fully enclosed and separately ventilated DSRs is prohibitive and not structurally feasible for many establishments. They believe the level of non-smoking seating should be market driven. The ORA suggested a multi-faceted approach to a by-law amendment should be considered to address the uniqueness of establishments within the food-service industry. There is strong advocacy for ventilation systems as a way to deal with ETS.

(d) Bowling Centre Operators and Bingo Hall Operators:

Telephone consultations were conducted with a random sample of bowling centre and bingo hall operators; 17 of 34 bowling centres and 12 of 22 bingo halls were included for consultation. Because of the similarity in responses, the results have been combined. In general, these operators believe they attract a larger percentage of smokers than found in the general population and have strong concerns about the economic impact of ETS by-laws. The majority of operators support a harmonized standard of 60 percent non-smoking space, reflective of the current average across the former municipalities. There is mixed support for DSRs and the eventual achievement of smoke-free. Responses ranged from no support for smoke-free, to support if required province-wide. Some operators did identify an interest in ideally operating smoke-free establishments.

(e) Billiard Hall Operators:

Telephone consultations were conducted with a systematic sample of 21 billiard hall operators. Respondents recommended a harmonized smoking standard ranging from completely open smoking to 50 percent non-smoking, less than the current average of 60 percent. There was no general support for smoke-free and only five operators indicated the years 2001-2005 as a target for being smoke-free. Economic concerns were most commonly stated as the reason for the low level of support. There was general support for DSRs. The majority of operators said their clientele is largely composed of smokers.

(4) Issues Related to By-law Development:

(a) Economic Hardship:

There is considerable concern about any possible economic loss resulting from ETS by-laws. During this consultation, many members of the hospitality industry said they would prefer to be smoke-free but fear they will lose business if a smoke-free by-law is implemented. A review of many studies indicates that over the long term there is no overall negative impact on business, and that the effects of such by-laws are either neutral or result in positive economic gain as non-smokers replace smokers. It should be noted that 700 Toronto restaurants are voluntarily smoke-free. However, there may be an initial negative impact in some establishments where the majority of patrons are smokers. Some jurisdictions in the United States have included a hardship clause in smoke-free legislation, also known as a variance or waiver, which exempts restaurants from smoke-free by-laws if they can demonstrate financial hardship in complying with the law. The burden of proof is placed on the applicant to demonstrate both a loss of business, and that the law is the cause of that loss. (See Appendix II for detailed information.)

(b) Differentiating Between Restaurants and Bars:

There are more than 6,000 restaurants in the City, about half of which are in the former City of Toronto. They vary from family type establishments serving no alcohol, to cafes, pubs and establishments which cater mainly to adults and offer a variety of food and entertainment, including dancing, billiards and live music. For some of these establishments, the sale of food is incidental to the sale of alcohol and provision of entertainment. During past public consultation on smoke-free public places, some industry advocates have requested that bars be treated differently than restaurants, as is the case in some other municipalities, especially outside Ontario. As well, recent surveys (Appendix VII and VIII) suggest somewhat lower levels of public support for smoke-free bars. The concept of differentiating between restaurants and bars has been extensively researched by City staff now and in the former municipalities, and has been found to contain numerous problems. These problems arise primarily because the Ontario Liquor Licence Act does not distinguish between restaurants and bars for licensing purposes. Instead it provides a single class of liquor licence for all establishments that serve alcohol and, in an attempt to reduce public harm associated with alcohol use, establishments that serve alcohol must also serve food.

Without this distinction, the City must develop its own method of deciding what is a restaurant and what is a bar. There is no easy way to do this because restaurants often change their services and primary mode of business depending on the time of day, or day of the week, so that an establishment may function primarily as a restaurant during the day and as a bar at night. City staff have considered distinctions based on an establishment's percentage of alcohol sales and the age of its patrons; e.g., exclusion of children and youth under 19 years of age, from premises that allow unenclosed smoking. Recommendation No. (2) (ii), which contains an age exclusion, is designed to help protect children from the effects of ETS, and is in keeping with other health protective provincial legislation aimed at youth that prohibits the sale of cigarettes to those under 19.

Only the former City of Scarborough ETS by-law defines restaurants separately from bars, essentially categorizing bars as establishments that derive at least 75 percent of revenues from the sale of alcohol. Although the by-law exempts bars from any smoking restrictions, it also permits any eating establishment to have smoking in up to 100 percent of the premises, based on customer demand. In practice, therefore, it has not been necessary for an establishment to identify itself as a bar to be exempt from smoking restrictions. Therefore it is recommended that in the by-law for the new City of Toronto, bars be distinguished from restaurants based on the existence of a liquor licence combined with a restriction on the age of patrons to 19 years and over. Nineteen is selected as the age limit as this is the minimum legal age for purchasing tobacco products and the minimum age for legal alcohol consumption. However, it should be noted that youth age 18 would remain eligible to work in bars.

Although some jurisdictions have differentiated between bars and restaurants, the fact that there is an increased ETS exposure risk in bars (Siegel, 1993) should be considered sufficient health grounds to make all such premises smoke-free. However, should the City wish to phase in the elimination of smoking in bars, Recommendation No. (2) Option (ii) is recommended. The administrative procedures for implementation must clearly differentiate these establishments and minimize any burden placed on the City and the hospitality industry

Ventilation technology is often proposed as an alternative to smoke-free by-laws by the hospitality industry. While some ventilation systems have been utilized to improve air quality, the improvement is purely aesthetic. The concept that ETS could be reduced to "acceptable levels" is also flawed as there is no safe level of ETS. Studies conducted in the former City of Toronto and elsewhere clearly indicate that non-smoking areas in restaurants that are not physically separated from the smoking area and not separately ventilated offer little or no protection from exposure to ETS (Abernathy & O'Grady, 1996; see Appendix II for descriptions of ventilation systems currently available). Decreasing the concentration of ETS through exhaust or dilution offers less protection than restricting smoking to a percentage of the premises.

In order for a ventilation system to be considered effective it must be capable of removing ETS in both the gas and the particulate phase. According to ventilation experts, such a system does not exist. In order to achieve a de-minimus risk (one death/million) for lung cancer, the ventilation rate in a hospitality establishment with unenclosed smoking would have to be increased 40,000 times, creating wind speed similar to that of a severe tornado. Accordingly, many experts advise that the most appropriate use for ventilation is to remove ETS from fully enclosed designated smoking rooms.

At a meeting on November 24, 1998, to discuss ventilation technology, one expert in ventilation engineering proposed a scenario in which an establishment could have an open passage way between the smoking and non-smoking rooms, provided that the opening was constructed with a tunnel that protruded at least eight feet into the non-smoking area. However, other experts at the meeting were skeptical of this theory, feeling that complete structural separation of smoking from non-smoking areas is essential. A recent article in a hospitality industry publication also concluded that "in the majority of conventional forced air heating/ventilation/air-conditioning systems, air is typically recirculated with generally only 10 to 15 percent fresh air added per hour. Therefore, even when the best efforts are made to physically isolate smokers from non-smokers, a single ventilation system will distribute some smoky air throughout a restaurant." (LaRiviere, February 98)

If an effective ventilation system becomes available, there are still practical issues to consider. Ventilation systems can be expensive to design and install, and there are physical limitations as to the type of buildings that can be retrofitted. As well, heating and cooling costs would rise with the required increase of air flow. Without regular maintenance the effectiveness of these systems declines very quickly, which presents particular difficulties for enforcement. While the system design and installation would require approval from the building department, the responsibility to monitor the operation, maintenance and overall effectiveness would be passed on to other enforcement staff. Even if one assumed the system was on and operating, the task of checking the filters, measuring air flow and grading effectiveness could be onerous.

Without the possibility of removing ETS from the air, the most logical option is to remove the source of the ETS. If at some point in the future a ventilation system is developed that could provide air quality equivalent in health terms to that in a smoke-free environment, it could be considered as an alternative to a ban on smoking.

The ASHRAE Standard:

In 1989, the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) developed a ventilation standard applicable to all indoor or enclosed spaces that people may occupy. The current edition is entitled ANSI/ASHRAE 62-1989 Ventilation for Acceptable Indoor Air Quality. This standard is the basis for almost all ventilation requirements contained in North American building codes. The purpose of the standard is to specify minimum ventilation rates and indoor air quality that will be acceptable to human occupants with the intent of minimizing the potential for adverse health effects. However, the standard does not ensure protection from ETS.

(d) Designated Smoking Rooms (DSRs):

Most of the existing ETS by-laws in the city permit DSRs in workplaces. This is because employees are not required to enter these rooms as part of their work duties. DSRs are not recommended for public places on health grounds because employees in public places should be provided with the same protection from ETS, and it would be impractical to expect them not to have to enter DSRs in the course of their work. (See Appendix IV for discussion of DSRs.) Nonetheless, DSRs may be considered as a means of easing the impact of the by-law on smoking patrons. In the former City of Toronto, DSRs have been approved for fewer than 20 restaurants. The Board of Health/City Council will have to decide what to do about these existing DSRs. The provincial Tobacco Control Act currently permits DSRs in certain public places, including homes for the aged and hospitals. For consistency, this policy should remain in effect for the present time.

(e) Enforcement:

As with many municipal by-laws, ETS by-laws are largely self-regulating through voluntary compliance by owners/operators, employers, staff, and public over an introductory period of 6-12 months. Public Health staff will be responsible for enforcing the ETS by-law, primarily through education of operators and ticketing, if necessary. To make a new ETS by-law as understandable and as easily enforceable as possible, it must apply equally across the city and have clear standards for the size and location of smoking and non-smoking space. Education of all parties, including the public, employers, owners, operators and staff, is essential prior to and during implementation to ensure everyone understands the reason for the by-law, and their responsibilities under it. The hospitality industry feels strongly that the public must receive clear information about where they can and cannot smoke. In general, the greater and more restrictive the change, the greater the need for education and enforcement. As with other by-laws to protect health, the owner/operator should be responsible for complying with the by-law, removing ashtrays from non-smoking areas, posting No Smoking and Health Warning signs to ensure patrons are aware of the by-law and the health risks of ETS, providing legal seating space and operating a smoke-free establishment where applicable. Penalties for non-compliance range from $205.00 for a ticket to a maximum $5,000.00 for a prosecution and conviction in Court.

(5) By-law Interpretations:

The by-law will set out classes of establishment by which to define public places. These will include public places that serve food whether or not they serve alcohol, bowling centres, billiard halls, and gaming halls (e.g. bingo). By-law requirements will be interpreted and applied to these and other public places as outlined below.

Establishment By-law Interpretation

Mixed Use Establishments:

an establishment which could fit the criteria for more than one class of premises

by-law interpretation will depend upon the primary use of the establishment and the degree of physical separation among its different uses

enclosed spaces within public places which are used for a separate purpose (e.g. a restaurant within a theatre) will comply with the section of the by-law which pertains to that type of facility

Private Establishments

will be exempt from by-law

criteria to define a private establishment will include the presence of:

- objective rules to approve or reject members

- use of the facility being limited to members and bona-fide guests

- mechanisms that give members some control of the facility

- records documenting fees and/or annual membership dues

- evidence that the facility is operated not for profit and solely for the benefit and pleasure of its members

- evidence that the establishment directs its publicity and advertisements exclusively to members (or potential members) for their information and guidance

Private Functions

a time limited period that any public place is being leased or rented for a function that is not open to the general public e.g. a wedding; private functions will be exempt from by-law restrictions for that time limited period

Public Places Not Specifically Mentioned in By-law or Other Legislation including:

theatres and entertainment centres

sports facilities, recreations and sports arenas

hotels (common areas)

financial institutions

retail stores

video or amusement arcades

laundromats

hairdressing salons and barber shops

day nurseries

elevators and escalators

lobbies and reception areas

stairwells, corridors and hallways

public washrooms

etc

.

the general definition of public places will apply, making them 100 percent smoke-free

(6) Public Places Covered by Other Legislation:

In Ontario, the Tobacco Control Act, 1994 (TCA) regulates smoking in some public places as well as the sale of tobacco to minors. The TCA also gives municipalities the authority to pass more restrictive no-smoking legislation. The TCA also states that where a more restrictive law exists, that law will prevail. The public places that will be covered under the TCA for Toronto are outlined in the following table.

Establishment Smoking Restriction

Hospitals

psychiatric facilities

nursing homes

homes for special care

charitable homes for the aged

100 percent smoke-free

DSR permitted

(7) Guiding Principles for a Harmonized By-law:

At the beginning of this process, Public Health developed guiding principles for the development of an ETS by-law for the new City of Toronto. These principles are that a new by-law should:

(a) achieve a maximum level of protection from ETS exposure;

(b) continue to make progress overall towards smoke-free status;

(d) include future dates upon which public places become smoke-free;

(e) be supported by continuing city initiatives that encourage restaurants to go smoke-free voluntarily; and

(f) be accompanied by a comprehensive education campaign.

(8) Options for a Harmonized ETS By-law:

To protect health, a new ETS by-law should prohibit smoking in all workplaces and public places as soon as possible. Four of the six former municipalities (the exceptions being York and Scarborough) have by-laws committing to smoke-free workplaces and public places by 2000. To make the transition to a smoke-free standard for Toronto and to provide the most health protective environment possible, it is recommended that the City adopt Recommendations Nos. (1) and (2)(i). Recommendation No. (2)(ii) is provided for consideration, in the event the City decides to increase the amount of time operators and the public have to adjust to smoke-free premises. Appendix III describes other possible options along with their pros and cons. Once fully implemented, the by-law would protect the public and workers from ETS in all public places. If the Board of Health and/or Council decide to adopt a by-law that reduces current restrictions in some former municipalities in order to have a single standard across the city, it should encourage owners/operators to maintain their existing higher standard as a natural progression to being fully smoke-free (see Appendix I for current standards). A chart outlining these recommendations follows.

Option 1: Recommendation No. (2)(i)

Establishment

Recommendation

Workplaces

maintain 100 percent smoke-free

permit designated smoking rooms to be used for no other purpose than smoking

Public Places Not Already Smoke-free:

restaurants

bars

banquet halls

bowling centres

bingo halls

billiard halls

casinos

public places not already smoke-free become 75 percent non-smoking

three months after by-law is passed by City Council

100 percent smoke-free April 30, 2001

Option 2: Recommendation No. (2)(ii)

Establishment Recommendation

Workplaces

maintain 100 percent smoke-free

permit designated smoking rooms to be used for no other purpose than smoking

All Public Places Not Already

Smoke-free:

restaurants

banquet halls

bars

bowling centres

bingo halls

casinos

billiard halls

public places not already smoke-free become 75 percent non-smoking

three months after by-law is passed by City Council

Transition of Public Places to

Smoke-free:

restaurants

bowling centres

banquet halls

100 percent smoke-free

April 30, 2001

bars

bingo halls

billiard halls

casinos

100 percent smoke-free

May 3, 2004

(9) Public Communication Plan:

To successfully implement a harmonized ETS by-law for the City of Toronto and prepare for smoke-free public places, it is necessary to implement a communications plan (Appendix VI) that will inform and assist owners, operators and employees in the hospitality and entertainment industry, as well as the patrons of these establishments. All parties need clear, effective targeted information on the reasons for the by-law and their obligations under it. A subsequent campaign is needed to implement smoke-free public places when the time-limited exemption for certain establishments ends. The campaign should include up-to-date information on the health risks associated with ETS as well as a continuation of the successful Go for the Green smoke-free dining campaign, which encourages restaurants to go smoke free voluntarily. Past experience in the former municipalities and elsewhere has shown that ETS by-laws engender significant debate as employers, the public and media try to come to terms with restrictions on the places in which this addictive and harmful substance may be used.

(10) City of Toronto Corporate Smoking Policy:

At the current time, there are inconsistencies with regard to workplace corporate smoking policies across the amalgamated City. City workplace policies are consistent with the current smoking by-laws for the respective former municipality. That is, smoking is prohibited in the areas of municipal facilities considered workplaces. There are inconsistencies in areas such as workplace cafeterias and underground garages. The City should set a positive example and adopt the most restrictive policy possible to protect all City employees and the public visiting City facilities: to prohibit smoking in all municipal facilities whether located in municipal or commercial buildings. In cases where space is rented or leased for a private function such as a wedding, the City could permit smoking for the time-limited period of that function. Should the City choose to allow this exception, it should be time-limited until April 30, 2001.

Conclusion:

The majority of employees in the City of Toronto are protected from ETS at work. The continued exposure of workers and the visiting public in restaurants, bars and entertainment facilities is an unacceptable health risk given the current knowledge of the effects of ETS. The Board of Health must address the significant risk to public health in these establishments. A new ETS by-law is required for the city and there is a need to develop and implement a communications strategy to make the transition toward the goal of smoke-free public places.

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Appendix 1

Comparison of Smoking By-laws in the

Six Former Municipalities in the New City of Toronto * (February 1999)

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Appendix II

Issues to be Considered for By-law Development

(1) Economic Impact:

Discussions with representatives of the restaurant industry showed that restaurant operators fear a smoking ban in restaurants will have a negative impact on business. In public policy debates, informal surveys of restaurateur opinion have often been presented as "evidence" of a negative impact of smoking by-laws on business. However, not all restaurant and bar operators share this opinion. More than 700 restaurants in Toronto have already chosen to voluntarily prohibit smoking his would indicate public demand for smoke-free environments and suggests economic viability for such establishments.

A review of studies that have used a systematic, econometric analysis of restaurant sales based on sales revenues consistently shows no evidence of negative effects from smoke-free by-laws. This is true whether or not the restaurant serves alcohol. A 1994 study that analysed sales tax data for the first 15 cities in the U.S. to enact smoke-free ordinances affecting restaurants showed there is no significant effect on business when comparing restaurant sales data in cities with smoke-free restaurant ordinances with those in similar cities without ordinances (Glantz et al., 1994 & 1997). In addition, longitudinal analysis showed no significant change in business following the introduction of smoking prohibitions. This study was expanded in 1997, and confirmed the earlier study's results. A more recent analysis conducted in Flagstaff, Arizona also demonstrated that prohibiting smoking in restaurants did not affect sales (Sciacca et al., 1998).

Prior to New York City passing smoke-free restaurant legislation in restaurants with more than 35 seats, several restaurant operators predicted business would suffer. However, a survey by the Centre for Hospitality Research at Cornell University found non-smokers were eating out more frequently since restaurants became smoke-free (Corsun et al., 1995). More recent surveys (Hyland et al, 1999 and Hyland and Cummings, 1999) found that taxable sales for restaurants increased by 2.1 percent, compared with sales two years prior to the legislation coming into effect. An 18 percent increase in restaurant jobs was also found. A telephone survey of 434 restaurant owners found no evidence to suggest that the smoke-free legislation had a detrimental effect on the city's restaurant business.

In 1996, the Conference Board of Canada published the results of case studies of 16 restaurants in Canada that voluntarily converted to smoke-free. The study included a variety of restaurants, including family, fast food, fine dining, casual, independents and franchises. Self-reported gross and net sales before and after the smoke-free policy indicated that two-thirds of the restaurants experienced a sales increase or no change in sales and 29 percent reported a decrease. None of the fine dining establishments reported a decline.

The scientific evidence on the economic impact of a restaurant smoking ban should be reassuring to concerned restaurateurs. It is consistent with data from the 1996 Angus Reid survey for Toronto, which suggests that smoke-free restaurants will be more attractive to consumers overall.

A recent study by the Ontario Tobacco Research Unit found no evidence that increased restrictions in the former City of Toronto, from 50 percent to 75 percent/90 percent designated non-smoking space, had any negative impact on taxable sales (Lothian et al, 1999).

(2) Ventilation Systems:

The following describes the types of ventilation systems currently available:

Negative Pressurization uses airflow to create an environment where the air pressure in the smoking area is lower than in the non-smoking area. Theoretically, this would prevent the movement of tobacco smoke from the smoking area to the non-smoking area. In reality, without physical separation the ETS can flow backward against the pressure. The difference in pressure required to make this system effective would have to be so great, the application would be totally impractical.

Heat Recovery Ventilation involves total removal of the air in a room and replacement with fresh air. The system allows heat to be recovered from the exhausted air to save on heating costs. However, if such a ventilation system were designed to sufficiently remove ETS, the ventilation rate would have to be increased to an unachievable rate.

Air Cleaning Devices include a variety of products that recycle air but in the process use different methods to filter the air. The main problem is that most of the hazardous components of ETS exist in a variety of physical states. There are solid particles of various sizes, gases, and some components that exist in both gas and particle form. Some air cleaning devices can remove gases while others can remove particles. If it were possible to develop a system that would remove both the gases and particles, it would also require the same air exchange rate as the heat recovery systems to get the ETS to the filters. The required maintenance for these systems must also be considered. If the filters are not replaced frequently, the effectiveness of the system suffers. It is also difficult to determine when the filters need to be replaced.

Included in this Appendix is a letter to Dr. Sheela Basrur from James Repace, M.Sc., physicist and ventilation expert, dated November 15, 1996, providing a more thorough analysis of these ventilation systems.

Appendix III

Options for a New ETS By-law

The following options for a new ETS by-law were considered during the research and consultation process :

Workplaces

Pros: Cons:

Smoke-free workplaces without DSRs (a) consistent with goal of establishing an ETS by-law that adopts the most restrictive standards within existing by-laws; i.e. former City of York does not permit DSRs

(b) no concerns about DSRs not functioning properly and exposing non-smoking employees to ETS
(a) workplaces with existing DSRs may object

(b) a grandfather clause may be needed for places with existing DSRs

Smoke-free workplaces with DSRs (a) most ETS by-laws across Ontario allow workplace DSRs

(b) five of six former municipalities allow DRS in existing by-laws

(c) DSRs can only be used for smoking, i.e. no employees required to enter for the purpose of work
(a) former City of York does not permit DSRs in workplaces; therefore this would be less restrictive

(b) there is no process/City policy to ensure that DSRs function properly

(c) only larger workplaces can afford to build DSRs

Public Places

Pros:

Cons:

All public places become smoke-free immediately (a) all non-smoking employees and the public protected from ETS in public places
(b) consistent with goal of eliminating exposure to ETS in all public places

(c) all public places treated the same
(a) no time to build up industry and public acceptance of smoke-free standard

(b) additional staff and resources needed to immediately ensure compliance

Maintain status-quo: allow six different by-laws (a) the industry would not experience any change (a) confusion about standards among owners/operators of public places and patrons

(b) establishments that must comply with more restrictive measures feel they are treated unfairly

(c) undermines goal of harmonization across the city

(d) enforcement and prosecution very difficult; one side of the street may have different restrictions than the other side

(e) makes the goal of smoke-free more difficult for establishments with less restrictive requirements

Public places not yet smoke-free provide at least 80 percent non-smoking space (a) moves Toronto further towards goal of smoke-free (a) impact on smaller restaurants; 65 percent of restaurants would have to increase non smoking space

(b) industry may feel too restrictive as a first step in harmonization

Establish consistent requirement for all public places not already smoke-free to provide at least 75 percent of space for non-smoking (a) surveys show this percentage is most acceptable to the public and the industry

(b) most establishments already at this level; less than 20 percent have to increase non-smoking space

(c) easy to implement and enforce
(a) set back for one former municipality

Appendix IV

Designated Smoking Rooms (DSRs) for Public Places

The following chart sets out some of the options for DSRs for restaurants, bars, bowling centres, casinos and bingo and billiard halls.

Designated

Pros: Cons:

Do not permit DSRs (a) employees protected from ETS

(b) larger establishments would not have unfair advantage over smaller establishments
(a) public and industry feel strongly about permitting DSRs

Permit DSRs in maximum space of 25 percent (a) consistent with workplace restrictions for DSRs

(b) 75 percent of space available for non-smokers
(a) smaller restaurants may feel disadvantaged

Permit DSRs in maximum space of 50 percent (a) more flexibility for operators (a) lower than existing standards

(b) less space for non-smokers

Permit DSRs but do not allow employees to work in them (a) employees not exposed to ETS (a) industry does not support

Permit DSRs with employees providing full service (a) industry supports (a) employees exposed to ETS

Appendix V

Smoke-Free Initiatives in Other Jurisdictions

The following gives detail on smoke-free by-laws in Canada and the United States; starting with those with the tightest restrictions:

CANADA

VANCOUVER, B.C. - Smoke-free workplaces and smoke-free in restaurants that allow minors.

History:

March 12, 1996, Vancouver City Council approved a series of recommendations to prohibit smoking in workplaces, restaurants and common public areas in other buildings that allow access to minors, and workplaces.

By-law effective May 31, 1996; active enforcement not pursued until December 1, 1996, to allow for education of the public and operators.

By-law Components:

Exclusions for adult-oriented establishment including bars, cabarets, casinos, bingo halls.

By-law Effectiveness:

Vancouver Health Department indicates operator compliance is high.

Miscellaneous Information:

By-law has withstood an appeal by the B.C. Restaurant Association to the B.C. Court of Appeal.

The Province of British Columbia introduced legislation to ban smoking in all workplaces effective April 15, 1998; hospitality type establishments exempted until January 1, 2000.

CAPITAL REGIONAL DISTRICT, B.C. - Smoke-free.

History and By-law Components:

The Board of the Capital Regional District passed the Capital Regional District Clean Air By-law which prohibits smoking in all public places (including restaurants and bars) as of January 1, 1999. The by-law affects 12 municipalities and 4 electoral areas in and around Victoria.

By-law Effectiveness:

Early stages of implementation, with changes being made to the by-law to require owners to ensure compliance.

VAUGHAN, ONT. - Smoke-free.

History and By-law Components:

January 29, 1996, the City of Vaughan endorsed a draft by-law making workplaces and all public places including restaurants smoke-free May 1, 1996. As a result of a later amendment, banquet halls, bars/tavern, billiard and bingo halls and institutional-residential buildings were exempted until October 1996. A further amendment allowed restaurants, bars, banquet halls, bowling alleys and billiard halls to construct DSRs of up to 25 percent of the floor area, and bingo halls to construct DSRs of up to 50 percent of their floor area.

By-law Effectiveness:

Strictly enforced, operator compliance high.

WINDSOR, ONT. - Smoke-free commitment for May 1999.

History and By-law Components:

On January 3, 1995, the City of Windsor passed a by-law making all restaurants smoke-free by May 31, 1999. Mixed use establishments (restaurant by day, bar by night) will also be smoke-free when they are operating as restaurants.

Windsor has a licensing system that allows for the differentiation of establishments, e.g., restaurants vs. adult establishments and mixed use establishments. Adult and mixed use establishments are not required to have non-smoking space, but they must prohibit minors. Failure to comply may result in non-renewal of licence.

HAMILTON-WENTWORTH, ONT. - Smoke-free commitment for 2000.

History:

During the November 1997 municipal election, Hamilton-Wentworth had a plebiscite on tobacco control. Results indicated that 73 percent of voters favour a model by-law to prohibit smoking in all public places and workplaces (with exceptions) by June 1, 2000.

By-law Components:

Restaurants:

Five of six municipalities currently require 70 percent or more of seating to be non-smoking; four of six require 75 percent non-smoking for restaurants less than 100 square metres and 90 percent for larger restaurants, or proprietors can have up to 50 percent smoking if they provide fully enclosed separately ventilated DSRs. As of June 1, 2000, smoking will only be allowed in DSRs in these four municipalities.

Bars:

Restrictions are more lenient for establishments that have a "no minors" policy, ranging from 25 percent-50 percent throughout the municipalities.

Other:

Billiard and bingo halls, bowling and gaming centres and public halls can have a maximum of 50 percent smoking. Most other public places, including taxi cabs and food courts, are smoke-free.

GUELPH, ONT. - Smoke-free commitment for 2000.

History and By-law Components:

July 17, 1995, the City of Guelph adopted Municipal Code amendments that make all public places, including restaurants, smoke-free in 2000.

Currently, restaurants must designate 75 percent of their seating as non-smoking. Workplaces became smoke-free January 1, 1996.

PETERBOROUGH, ONT. - Smoke-free commitment for 2000.

History and By-law Components:

Workplaces: smoke-free as of January 1998; food courts, theatres and common areas of residential and municipal buildings smoke-free since 1997.

Restaurants and entertainment facilities, smoke-free in 2000. Currently over 40 seats, 75 percent smoke-free until 9:00 p.m., 50 percent after 9:00 p.m. Bingo halls, 50 percent non-smoking; bowling centres, 75 percent.

WATERLOO, ONT. - Smoke-free commitment for 2000.

History and By-law Components:

(a) November 1, 1996, restaurants must designate 50 percent of seating area as non-smoking, and will be smoke-free in 2000. Food courts smoke-free since November 1, 1996.

(b) DSRs will not be permitted.

(c) Bars may have up to 100 percent of their floor space as a smoking area until the year 2000, at which time they must be smoke-free.

(d) Bingo halls must be 25 percent smoke-free: 50 percent in 2000. Places of amusement (bowling alleys, billiard halls, etc.) must designate 25 percent of their space non-smoking, and be smoke-free in 2000.

(e) Private and public facilities (hall, room or banquet area) must designate 25 percent of the seating area non-smoking and all public and private facilities must be smoke-free in 2000. (Note: a private facility means any hall, banquet area or room that is privately owned and actually in use which has more than 10 people in attendance for the purpose of eating and/or consuming alcohol.)

PEEL REGION, ONT. - Smoke-free commitment for 2001.

History:

The Region of Peel has gone through a public consultation on smoke-free public places and workplaces. Peel Regional Council has endorsed the goal of smoke-free public places and workplaces by 2001. The Health Department is currently working with the municipalities of Brampton, Caledon and Mississauga. The aim is to be consistent with the new ETS by-law in the new City of Toronto. At the current time, restaurants in each of the three municipalities are 70/30 non-smoking.

BRANTFORD, ONT. - Smoke-free commitment for 2002.

History:

June 1997, City Council considered a by-law making public places smoke-free by 2000. In March 1998, a by-law was passed making public places smoke-free by 2002. Percentages of smoke-free seating will be increased gradually.

LONDON, ONT. - Smoke-free commitment for 2002.

History:

November 15, 1993, the City of London passed a by-law making restaurants smoke-free by January 1, 2002. The by-law was created in consultation with the Ontario Restaurant Association (ORA) and will be reviewed with the ORA in 2000.

By-law Components:

Restaurant:

Less than 25 seats, unrestricted smoking. More than 25 seats, 75 percent non-smoking.

Bars and Billiard Halls:

Playing area may be 100 percent smoking.

Bingo Halls:

60 percent of the total area may be smoking.

HALTON REGION, ONT.

Oakville:

History and By-law Components:

Workplaces are smoke-free; DSRs permitted.

Restaurants are 70 percent non-smoking. The percentage is reviewed each year to keep pace with current smoking rates.

Burlington:

History:

In May 1998, City Council passed a by-law making restaurants 70 percent non-smoking. Restaurants that have DSRs or a house policy prohibiting minors under 19 may have 50 percent of the seating area for smoking. Bingo halls, bowling centres and billiard halls are 50/50.

PICKERING, ONT.

By-law Components:

Municipal by-law requires a minimum of 70 percent non-smoking seating in restaurants and bars. Bingo halls, bowling alleys and billiard halls must provide 50 percent of the floor area as non-smoking.

YORK REGION, ONT. - Smoke-free commitment for 2001 .

History:

In 1998, York Regional Council formed a committee with representatives from all nine municipalities, school boards, health associations, police and Youth Advisory Board, to develop a uniform ETS by-law for the region for public places. Each of the nine municipalities would then adopt the by-law locally. There is a desire for each municipality to maintain control over their respective ETS by-laws.

The committee wants all community centres and arenas in the region to become smoke-free, with a phased in approach for other public places until smoke-free is reached by the end of 2001. Current restrictions for smoking in restaurants vary within each of the York Region municipalities, e.g., smoke-free in the City of Vaughan, 50 percent non-smoking in Markham, and 20 percent non-smoking in Richmond Hill. The municipalities of Aurora and King City have no restrictions for smoking in public places.

DURHAM REGION, ONT.

There is no regional activity for smoke-free by-laws at this time. However, individual municipalities have been making changes to their respective by-laws in the past few years.

UNITED STATES

STATE OF CALIFORNIA - Smoke-free:

By-law History and Components:

Assembly Bill 13 (AB 13) prohibits smoking in all California's enclosed workplaces, including restaurants, bars, taverns and casinos. Workplace by-law came into effect January 1, 1995; bars, taverns and casinos in February 1998.

Smoking prohibition in effect until the Occupational Safety and Health Standards Board or the Federal Environmental Protection Agency adopts a regulation reducing the level of employee exposure to smoke to a level that would prevent anything other than an insignificantly harmful effect to exposed employees.

In February 1998, the Legislative Assembly of California voted to suspend the ban on smoking in bars and taverns for two years. This must be confirmed by the State Senate. Reports from California Health Department and media indicate the Senate will not support suspension. Therefore, at the current time restaurants and bars are required to be smoke-free.

VERMONT - smoke-free:

Components of Legislation:

The State of Vermont prohibits smoking in all public places including restaurants and bars as of July 1, 1995. Establishments with a "cabaret" licence may permit designated smoking areas. A cabaret licence is issued to establishments providing primarily entertainment, dancing and the sale of alcoholic beverages to the public and not the service of food.

NEW YORK CITY

By-law Components:

Smoking is prohibited in dining areas of all restaurants seating more than 35 people; permitted in bars and bar areas of restaurants.

ERIE COUNTY, N.Y.

By-law Components:

Smoking is banned in open-air arenas of more than 5,000 seats; lobbies, hallways and other common areas in apartment buildings, condominiums and multiple residential facilities; all enclosed areas in places of employment; entertainment facilities, including places for lectures and music recitals; places of worship; lobbies, hallways and other common areas in multiple unit commercial facilities; polling places. Restaurants whose establishments include bars, limited smoking to 20 percent of seating by January 1, 1997, and all dining rooms, rest rooms and waiting areas became smoke-free in 1998. Bowling centres were required to provide smoke-free areas for minors as of January 1, 1998.

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Appendix VI

Summary of Communication and Implementation Plan for a Harmonized ETS By-law for the City of Toronto and the progression to smoke-free public places.

Goal:

To reduce exposure to Environmental Tobacco Smoke (ETS) by supporting the implementation of a harmonized by-law and preparing operators and the public for smoke-free public places.

Overall Strategy:

Former municipalities have supported ETS by-law changes with communication campaigns to inform and educate operators and the public about the health effects of exposure to ETS, and to increase acceptance of health protective by-laws. As well, during the past ten years there have been campaigns designed to supplement, rather than implement, ETS by-laws. The most recent is the "Go for the Green" campaign, which promotes smoke-free dining and is in the process of becoming City-wide. During recent community consultations, representatives from the restaurant and hospitality industry identified the need for more education on ETS by-laws. As well, the Ontario Mandatory Health Programs and Services Guidelines requires that the proportion of smoke-free public places and workplaces be increased to 100 percent by the year 2005; and that tobacco-free living be promoted through ongoing use of community mass media including television, radio, print, transit/billboard ads.

Toronto Public Health will be the communications lead for the by-law, liaising with other City Divisions as appropriate and partnering with other health agencies for communications activities to avoid duplication and to enhance the acceptance of the ETS by-law.

Key audiences:

(a) owners/operators of restaurants, bars, billiard halls, bingo halls, bowling alleys and casinos, and their respective employees and customers;

(b) restaurants choosing to become smoke-free;

(c) parents and care givers concerned about the health of their children, and wanting to take them to smoke-free public places;

(d) people choosing to patronize smoke-free dining establishments; and

(e) smokers deciding to quit smoking.

Strategic communications considerations:

Tobacco companies spend millions of dollars each year to advertise and promote their products. The Council for Tobacco Free Ontario states that in 1991 the Canadian tobacco industry spent an estimated $80 million on advertising. To try to counteract some of these messages, Public Health must deliver clear, concise messages about the health risks of ETS and on the requirements of health protective ETS by-laws.

To be effective, messages must:

(a) be consistent and from many sources (Siegel, 1998);

(b) repeated often, over a long period of time (Siegel, 1998);

(c) delivered through paid advertising since media relations and public service announcements alone will not guarantee coverage;

(d) delivered through a variety of media to generate integrated messages;

(e) reach both key stakeholders and secondary audiences;

(f) create awareness; and

(g) encourage behaviour change.

In consideration of the above, the ETS communications plan attempts to be:

(a) comprehensive; i.e. communications messages and elements relate to each other to maximize impact and use budget effectively;

(b) sustained and targeted both for specific events, such as the by-law implementation date, and occur at regular intervals for maximum effect;

(c) integrated to inform and educate a variety of audience stakeholders, to continue to build support for and compliance with the harmonized by-law, to promote 100 percent smoke-free public places, and to change attitudes regarding second-hand smoke;

(d) consistent in its messages, and using standard graphics for clarity;

(e) repetitive, that is, messages are stated many times (multiple strikes), to maximize recall and retention; and

(f) timed appropriately. For example, advertising may need to be booked several months in advance in order to obtain space during peak periods, e.g., holiday season, key dining out periods, or during special promotions such as National Non-Smoking Week.

Specific communication elements:

To have multiple messaging, as outlined in the strategy, the media mix may include;

(a) dailies, including newspaper and specialty print;

(b) radio, including advertising during part of the program, and event or traffic sponsorships;

(d) television, which delivers a powerful emotional impact and appeals to more of the viewers' senses than any other medium. There are opportunities to purchase :30 second ads on cable TV, such as the Rogers and Shaw Cable TV Guide channel, which can be less costly than producing and purchasing TV ad space. (4)

Strategy:

Informs and educates business owners and operators, food service and hospitality patrons, and the public about:

(a) the health effects of ETS;

(b) how the by-law affects them and how to comply; and

Elements include:

(a) letters to food premises and public places;

(b) signs, as required by the by-law, i.e. "No Smoking" and "Health Warning";

(d) reprints of existing Public Health brochures, including "Facts About Second-Hand Smoke" and "What's the Big Attraction?" (smoke-free dining);

(e) media relations, including, media packages with releases, back grounders, fact sheets, PSAs, copies of ads, dubs of radio spots, brochures; designated spokespersons from Public Health and elsewhere, as appropriate, and tracking media coverage;

(f) telephone help line, staffed with Public Health staff;

(g) internet website, using the City's existing Public Health site, partnered with the Toronto Star's website toronto.com;

(h) employee communications, including intranet, "Inside Toronto" staff newsletter, divisional newsletters, as well as staff newsletters in health agencies, organizations and companies;

(i) promotion of restaurants that voluntarily choose to be smoke-free;

(j) encouragement of more establishments to become smoke-free prior to smoke-free coming into effect;

(k) radio advertising, including several 30 second spots, production and placement several times throughout the year during key periods, e.g. winter holiday season, Valentine's Day, Mother's and Father's Day, graduation, and special events such as World No Tobacco Day and National Non-Smoking Week;

(l) print ads for specialty food and hospitality publications such as Ontario Restaurant News and Food Service and Hospitality Magazine;

(m) interior transit cards, including development, production and placement in subway and bus cars;

(n) exterior transit in bus shelters, including development and production, and placement using the 55 free spaces provided for the City from Mediacom; and

(o) promotion of smoking cessation materials and programs for smokers.

To build on the Go for the Green smoke-free dining campaign, and to produce advertising items such as radio spots, Public Health may consider contracting with an external ad agency, through a request for proposal process. The agency may help secure appropriate sponsorship funds; e.g. with a pharmaceutical company or drug store not affiliated with a tobacco company.

Agency fees have been factored in. Newspaper line rates increase each year; cable TV rates may increase. Some taxes may be extra. Translation costs are extra (at approximately 25 to 30 cents a word).

References

Abernathy, Tom, & O'Grady, Bill. Exposure to Environmental Tobacco Smoke (ETS) in Public Places: An Exploratory Study, 1996.

Angus Reid Group. No Smoking Bylaw Survey, April 1996.

California State Board of Equalization. Taxable Sales in Restaurants and Bars Following Enactment of Smoke-free Legislation, January 1999.

Corsun, David, L., Young, Cheri, A., & Enz, Cathy, A. Should New York City's Restaurateurs "Lighten Up?": Ithaca, New York, 1995.

Council for Tobacco Free Ontario fact sheet, 1993.

Glantz, Stanton, A., & Parmley, William, W. Passive Smoking and Heart Disease. Journal of the American Medical Association, April 5, 1995, 1047-1053.

Glantz, Stanton, A., & Smith, Lisa, R.A. The Effects of Ordinances Requiring Smoke-free Restaurants on Restaurant Sales. American Journal of Public Health, July 1994, Vol. 84. No.7, 1081-1085.

Health Canada. Smoking Behaviour of Canadians. National Population Health Survey Highlights, January, 1999, No. 1.

Health Canada. The Effects of Tobacco Smoke and Second-Hand Smoke in the Prenatal & Postpartum Periods: A Summary of Literature, February, 1995.

Hyland, A., Cummings, M.K. & Nauenberg, E. Analysis of taxable sales receipts: Was New York City's Smoke-Free Air Act bad for restaurant business. J. Public Health Management Practice, 5(1), 14-21.

Hyland, A. & Cummings, M.K. Restaurant Employment Before and After the New York City Smoke-Free Air Act. J. Public Health Management Practice, 1999, 5(1), 22-27.

La Riviere, A. Room to Breathe, Food Service and Hospitality Magazine, February, 1998, 96-99.

Lothian S., Ferrence R., Ope M. The Impact of Increased Smoking Restrictions on Restaurant Sales in the City of Toronto. Ontario Tobacco Research Unit, February, 1999.

Makomaski-Illing, Eva, M, & Kaiserman, Murray, J. Mortality Attributable to Tobacco Use in Canada and its Regions, 1991. Canadian Journal Of Public Health, July-August, 1995, 257-265.

Maroney, Neal, Sherwood, Deborah, & Stubblebine, Wm., Craig. The Impact of Tobacco Control Ordinances on Restaurant Revenues in California. Claremont, CA, January, 1994.

Ontario Tobacco Research Unit. Monitoring the Ontario Tobacco Strategy, 1997/1998.

Sciacca, John, & Ratliff, Michael. Prohibiting Smoking in Restaurants: Effects on Restaurant Sales. American Journal of Health Promotion, January/February, 1998, Vol. 12, No. 3, 176-184.

Siegel, M. Involuntary Smoking in the Restaurant Workplace. A Review of Employee Exposure and Health Effects. Journal of the American Medical Association, 1993, 270, 490-493.

Siegel, M. Mass Media Antismoking Campaigns: A Powerful Tool for Health Promotion, Annals of Internal Medicine, Vol. 129, No. 2, July 15, 1998

Sly, Tim. Toronto's 1997 Restaurant Smoking By-law: Evaluation of Awareness and Acceptance. November, 1998.

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Appendix IX

Summary of Economic Impact Analysis of 100 Percent Smoke-Free By-laws Studies

In order to objectively analyze the economic impact of smoke-free by-laws, it is important to adjust for other economic trends that influence restaurant and bar sales. These include seasonal fluctuations, general economic trends (e.g., recession periods) as well as trends in the local restaurant economy. Restaurants experience quarter to quarter fluctuations in sales, and long-term seasonal patterns (e.g., sales peak during the Christmas and summer periods and lulls post-Christmas). Many of the economic studies that are reported have been based on sales tax data and have included data over a period of time before and after enactment of smoke-free legislation. The advantages of using sales tax revenue data are that the data is objective (e.g., data is collected by tax authorities with no interest in the issue) and complete as it includes all restaurants.

Following is a summary of key published studies that have been conducted on cities or states with smoke-free legislation in effect.

California Smoke-Free Legislation:

California's bars and restaurants are smoke-free. A state wide poll conducted in June 1998 by the Field Institute (a non-partisan research agency) showed that 85 percent of bar patrons go to bars as much or more than they did before the ordinance. Local health departments also reported that compliance is good (90 percent in restaurant-bar combinations, and 70 percent in stand alone bars), and is improving over time (Glantz, 1999). Data from the California State Board of Equalization also indicates that there has been no decrease in sales tax revenues for restaurants and bars. The report compared taxes for 6,211 of the smallest bars and bar/restaurants in the state for the first quarter of 1997 to the first quarter of 1998. An increase of +0.12% in taxable sales from 1997 to 1998 was reported.

New York City's Smoke-Free Act:

New York's Smoke-Free Air Act took effect in April 1995. Economic impact information published in January 1999 looked at taxable sales from eating and drinking establishments, hotels and retail trade from 1990 to 1997. The study found that taxable sales increased by 2.1 percent for restaurants and 36.9 percent for hotels compared with levels two years before the smoke-free law took effect. In that same time period, taxable sales for eating and drinking establishments and hotels in the rest of the state (without smoke-free legislation) experienced a 2 percent to 4 percent decrease in sales. Furthermore, New York City added 19,347 restaurant jobs (18 percent increase) two years after the Smoke-Free Act while the rest of the State added 7,423 jobs (5 percent increase) between April 1993 and April 1997. A consumer response survey also found that the Smoke-Free Air Act had little impact on the dining out patterns of consumers (January 1999). A telephone survey of 434 restaurant owners/managers of restaurants in New York City showed no evidence to suggest that a smoke-free law had a detrimental effect on restaurant business. A survey of 251 restaurant owners/managers, from independent restaurant inspections of these 251 restaurants and complaint records from the New York City Health Department, indicated that most restaurants complied with the Smoke-Free Act with relative ease and little expense (Clarke, Wilson, Cummings and Hyland, 1999).

Other economic impact studies are summarized below. All of these studies also support the conclusion that smoke-free by-laws do not have a negative economic impact on restaurant sales.

- The Conference Board of Canada conducted case studies on 16 restaurants that had converted to smoke-free status. The restaurants included a mix of quick service, family type, casual style and fine dining. The case studies looked at identifying characteristics common to successful and unsuccessful conversion to going smoke-free. The study found that almost 80 percent of restaurants experienced successful conversion. Of the eight restaurants that did experience hardship, three were quick service and four were casual-style. There were no unsuccessful conversions among franchise operations. Self-reported gross and net sales before and after smoke-free policy indicated that two-thirds of the restaurants experienced a sales increase or no change in sales. (Conference Board of Canada, 1996)

- In 1994, University of California researchers found that 100 percent smoke-free restaurant ordinances had no effect on restaurant sales in 15 cities in California and Colorado. In a follow-up study, published in 1997, the authors reviewed sales tax data from cities and counties that had banned smoking in restaurants with bars or specifically in bars. The study looked at the ratio between bar sales and total retail sales in cities with ordinances in comparison cities without ordinances. The study concluded that smoke-free ordinances had no significant effect on bar sales. (Glantz et al, 1994, 1997)

- A study conducted at the Northern Arizona University found that the smoke-free restaurant ordinance in Flagstaff, Arizona had no negative impact on restaurants, based on restaurant sales tax data. (Sciacca and Ratcliff, 1998)

- Researchers at the U.S. Centres for Disease Control and Prevention analyzed restaurant sales tax data in West Lake Hills, Texas and found that the total sales of the restaurants did not decrease after implementation of the 100 percent smoke-free ordinance (1997).

- A 1995 study by Health Economics Research found that Brookline, Massachusetts smoke-free bar and restaurant ordinance did not have an effect on the City's restaurant patronage. Total restaurant revenue did not change in the first quarter following the introduction of the ordinance compared to the same quarter a year earlier (before the ordinance came into effect). These findings have been supported by more recent research (Bartosch and Pope, 1999).

- A study by Glantz/Smith looked at the impact of a 100 percent smoke-free by-law in San Luis Obispo, a popular tourist destination on the Californian Coast. The results showed that 48 percent of the visitors knew of the smoking ban prior to their visits. Smokers and non-smokers were equally aware of the ban. None of the smoking visitors reported avoiding San Luis Obispo because of the ban. Three Colorado cities of Aspen, Snowmass Village and Telluride are popular ski resorts and rely heavily on tourism. The City received favourable comments from visitors about their 100 percent smoke-free ordinance.

A study was circulated in 1996 by the Ontario Restaurant Association which concluded that a ban on smoking in restaurants and other entertainment facilities in Toronto would reduce business by 8.8 percent - 12.2 percent. The study is based on survey data from Insight Canada Research. A critique of the study reveals many methodological flaws which lead to erroneous conclusions. The data used in this report are unreliable (e.g., based on assumptions and estimates) and lead to excessively large estimates of the impact of a smoking ban on employment. The study also contains many internal contradictions. For example, smokers interviewed in the survey reported that they would reduce their consumption of hospitality based services by amounts that in many cases exceeded what they were already consuming. Also, it is possible that smokers may have answered questions posed in the survey in a strategic way so as to have maximum influence on possible legislation, rather than accurately reporting their economic reactions to legislation (CCG Consulting Group Study, 1996).

In conclusion, the results of several objective analyses of sales tax data, taking into account factors such as seasonal variations and economic conditions, has shown either no effect or even a small increase in business following the introduction of smoke-free legislation.

References:

Bartosch, W.J., and Pope, G.C. (1999). The economic effect of smoke-free restaurant policies on restaurant business in Massachusetts. Journal of Health Management Practice, 5(1), 53-62.

CCG Consulting Group Limited (1996). The Food Services and Hospitality Sector and a Metro Toronto Smoking Ban - An Analysis of Economic Consequences. A study conducted for the Hotel and Restaurant Employees Union, Ontario Hotel and Motel Association and the Ontario Restaurant Association.

Clarke, H., Wilson., Cummings, K.M., and Hyland, A. (1999). The Campaign to enact New York City's Smoke-Free Air Act. Journal of Public Health Management Practice, 5(1):1-13.

Conference Board of Canada (1996). The Economics of Smoke-Free Restaurants.

Glantz, S.A. (1994). The effects of Ordinances requiring smoke-free restaurants and bars on revenues. American Journal of Public Health, 84(7): 1081-1085.

Glantz, S.A, and Smith, L. (1997). The effects of ordinances requiring smoke-free restaurants and bars on revenues: A follow-up. American Journal of Public Health, 87(10): 1687-1693.

Glantz, S.A. (1999). Smoke-Free Restaurant Ordinances do not affect Restaurant Business. Journal of Public Health Management Practice, 5(1): vi-x.

Sciacca, J., and Ratcliff, M. (1998). Prohibiting smoking in restaurants: Effects on restaurant sales. American Journal of Public Health, 12(3): 176-184.

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Appendix X

Inclusion of an Economic Hardship Clause in a 100 Percent Smoke-Free By-law

None of the smoke-free by-laws in Canada (Cities of Vaughan, London, Windsor, Vancouver, Victoria) include an economic hardship clause.

Some smoke-free laws in the United States (e.g., Cities of Oakland, Sacremento, San Francisco, Aspen, San Luis) contain an economic hardship clause exempting restaurants that demonstrate financial hardship in complying with the law. An economic hardship clause typically requires applicants to provide evidence demonstrating that the smoke-free legislation is harmful to their business. Applicants may be required to pay a small fee to cover hearing costs. The burden of proof is placed on the applicant to demonstrate both a loss of business and that the smoke-free legislation is the cause of that loss. On a practical note, few establishments have actually applied for an exemption. For example, before California's State Law for a Smoke-Free Workplace came into effect, no restaurants in Sacremento, California (whose local smoke-free ordinance contained an economic hardship clause) had applied for a waiver during the two years that it had been in effect.

Protocol for Determining Economic Hardship:

Few cities have actually developed an objective protocol for determining economic hardship.

Prior to 1995, San Francisco's no-smoking legislation contained a hardship clause that allowed a restaurant operator to apply to the controller for an exemption or modification from being 100 percent smoke-free. The no-smoking legislation is no longer in effect since the passage of California's State Law for a Smoke-Free Workplace (which includes restaurants and bars) in 1995. This state law is more restrictive than San Francisco's legislation and, therefore, takes precedence. This state law does not include an economic hardship clause.

San Francisco's hardship clause allowed the health department to review relevant information with respect to the application for exemption. The applicant had the burden of proof in establishing that being smoke-free created an unreasonable economic effect on the applicant's business, threatened the survival of the restaurant and that the adverse economic effect was not the result of seasonal fluctuations or other conditions unrelated to the requirements of the legislation. Under this clause, no exemptions or modifications would be granted to any restaurant unless it had been smoke-free for a period of at least six months. Should the restaurant be granted an exemption, they would be required to provide 75 percent non-smoking seating. The exemption would be valid for only one year.

The City of Oakland adopted the following principles for determining economic hardship resulting from enactment of smoke-free legislation (Siegel, 1992).

- Sales tax data from the state collection agency is the only acceptable data that can be used for evaluation of the overall economic impact of the legislation.

- All available sales tax data after the ordinance and for several years prior to the ordinance must be used.

- A statistical model must be used to determine the significance of any change in restaurant sales in light of the baseline fluctuation in the data. A linear regression should be performed on the ratios of restaurant to total retail sales to determine whether or not this ratio is significantly different for quarters after ordinance implementation compared to those before the implementation of the ordinance.

- Trends in sales over time (changes by quarter and by year) must be controlled by calculating a ratio of restaurants to total sales, which is relatively stable over time.

A model developed by Glantz and Smith (1992) was recommended to determine if there has been a significant change in the ratio of restaurant to total retail sales for the quarters after implementation. This model requires restaurant and retail sales data for each quarter from which to calculate ratio of restaurant to total retail sales.

Resource Requirements:

Extra resources would be required from the restaurant owners and the City in evaluating economic hardship if this clause is included in the smoke-free legislation. Applicants would have to demonstrate that complying with the by-law is having negative economic impacts on their business. The restaurant owners have to produce sale data over a period of time to show the impact on their business. They would likely be asked to provide financial statements prepared by professionals. The City would need to provide staff time to process and examine these requests. Even if an objective protocol for economic hardship can be established, City Council (or a committee assigned to perform this function) will need to spend time hearing requests for exemptions under the clause.

The above noted concerns should be carefully considered by the Board of Health and City Council when considering the provision of an economic hardship clause in a smoke-free by-law for the City of Toronto.

References:

Glantz, S.A, and Smith, L.R.A. (1992). The effect of ordinances requiring smoke-free restaurants on restaurant sales in California. Institute of Health Policy Studies, School of Medicine, University of California, San Francisco.

Siegel M. (1992). Proposed protocol for evaluation of the economic impact of Oakland's restaurant ordinance. University of California at Berkeley.

The Board of Health also submits the following report (June 22, 1999) from the Commissioner of Urban Planning and Development Services:

Purpose:

To respond to the requests of the York Community Council from its meeting of May 26, 1999, that the Commissioner of Urban Planning and Development Services report to the Board of Health on the licensing issues specified in Recommendation No. (7), as adopted.

Funding Sources, Financial Implications and Impact Statement:

Not applicable.

Recommendation:

That this report be received for information.

Council Reference/Background/History:

The York Community Council, at its meeting of May 26, 1999, requested in Recommendation No. (7):

"the Commissioner of Urban Planning and Development Services to report to the Board of Health on:

(a) whether the City of Toronto should consider increasing the fee for a tobacco vending licence to $10,000.00 or other amount to be recommended by the Commissioner, with the intent of increasing the overall per package cost of tobacco; and

(b) whether the City of Toronto should impose a ban on the issuance of a tobacco vending licence in combination with other vending licences, (i.e., confections) with a view to preventing the sale of tobacco in commercial establishments where children and youth frequent."

Comments and/or Discussion and/or Justification:

With respect to Recommendation No. (7)(a), the Municipal Act does not permit the City to increase the fee for a tobacco vending licence, to an amount greater than the costs which the City expends in administration and enforcement for the licence. It may be possible to include the actual health inspection costs which are likely far less than $10,000.00.

With respect to Recommendation No. (7)(b), further consultation with the Medical Officer of Health on this issue is necessary. It is virtually impossible to discriminate between establishments where children and youth frequent, and those where adults alone would be permitted entry. Subject to a legal opinion, it may be possible to impose a condition on a tobacco vending licence that the premises will restrict access to individuals under the age of eighteen years and post signs notifying the public of such restricted access. However, the enforcement of such conditions would not be very feasible.

The York Community Council also requested that the Commissioner of Urban Planning and Development Services consult with the Medical Officer of Health regarding revisions to the Licensing By-law to ensure these revisions have regard to the ETS By-law. The Commissioner will do so when substantive revisions to the by-law are being considered.

Conclusions:

Licence fees may not be used to generate revenue greater than the costs associated with administering and enforcing the licence. Further work will be required to determine if effective conditions can be imposed upon a tobacco vending licence to limit the access to premises of children and youths.

Contact Name:

Frank Weinstock, Manager, Policy and Transition Unit

Metro Hall, 22nd Floor, 392-0404

The Board of Health also submits the following communication (May 27, 1999) from the City Clerk (York Community Council):

The York Community Council on May 26, 1999, heard public deputations regarding the above proposed by-law; and also had before it a communication (April 26, 1999) from the Secretary, Board of Health, advising that the Board on April 6, 1999:

(1) adopted the report dated March 26, 1999, from the Medical Officer of Health with respect to the community input process for a harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto; and

(2) forwarded such report to the Community Councils for staff presentation and deputations on the Policy Options and Recommendations document attached thereto, at the Community Council meetings scheduled to be held on May 26 and 27, 1999, with recommendations from the Community Councils to be referred to the Medical Officer of Health and the City Solicitor for consideration and recommendations back to the Board of Health at its meeting on June 28 and 29, 1999.

Recommendations:

The York Community Council recommended approval of the following:

(1) Recommendation No. (2)(i), viz:

"That public places be smoke-free, except for restaurants, bars, bowling centres, casinos and bingo and billiard halls, which may have unenclosed smoking in 25 percent of space until April 30, 2001, when they become smoke-free;"

(2) Recommendations Nos. (3)(i) and 3(ii) regarding designated smoking rooms (DSRs) in public places, viz:

"(i) No DSRs, except where permitted in the Tobacco Control Act, 1994, (e.g., Homes for the Aged); and

"(ii) DSRs up to 25 percent of space."

(3) Recommendation No. (4), viz:

"That the City of Toronto develop a corporate policy to prohibit smoking in all municipal facilities including workplaces, whether located in municipal or commercial buildings, except in such cases where this space is reserved for a private function such as a wedding. Where exemptions apply, they should be time limited until April 30, 2001."

(4) Recommendation No. (5), viz:

"That the Commissioner of Urban Planning and Development Services be requested to consult with the Medical Officer of Health regarding revisions to the Licensing By-law to ensure these revisions have regard for the ETS By-law."

(5) Recommendation No. (6), viz:

"That the new harmonized by-law be implemented three months following its enactment by City Council."

The York Community Council also:

(6) requested the Medical Officer of Health to submit a status report to the Board of Health in January 2001, on the implementation of the aforementioned recommendations; and

(7) requested the Commissioner of Urban Planning and Development Services to report to the Board of Health on:

(b) whether the City of Toronto should impose a ban on the issuance of a tobacco vending licence in combination with other vending licences, (i.e. confections) with a view to preventing the sale of tobacco in commercial establishments where children and youth frequent.

Background:

The York Community Council also had before it the following communications during consideration of the foregoing matter:

(i) (May 6, 1999) from the Secretary, Board of Health, advising that the Board on May 6, 1999, adopted the report dated April 28, 1999, from Councillor John Filion, Chair, Board of Health, which recommended that:

(1) the Ontario Restaurant Association provide to the Medical Officer of Health, by May 31, 1999, specific details on the ventilation technology which they believe to be an effective alternative to 100 percent smoke-free status for hospitality establishments, along with independent scientific evidence supporting the effectiveness of this technology; and

(2) the Medical Officer of Health report to the Board of Health by June 28, 1999, regarding the appropriateness of including a ventilation option in the proposed ETS by-law;

and advising that the Board of Health further requested the Medical Officer of Health to:

(1) report back to the next meeting of the Board on whether the Ontario Restaurant Association has responded; and

(2) circulate the final consolidated report on the ETS by-law in sufficient time to provide members of the Board the opportunity for review prior to the Board meeting on June 28 and 29, 1999;

(ii) (May 25, 1999) from Mr. Michael Perley, Director, Ontario Campaign for Action on Tobacco, providing a summary of their views regarding the proposed harmonization of an environmental tobacco smoke by-law for the City of Toronto; and

(iii) (May 25, 1999) from Mr. Enrico Codogno, Canadian Cancer Society, submitting comments on the positive economic impact regarding the ban on smoking in restaurants and bars in the United States; and on the negative effects of smoking and second-hand smoke.

The following persons appeared before the Community Council in connection with the foregoing matter:

- Mr. Paul Sudolski, Volunteer President, Canadian Cancer Society Unit in the York District; and submitted a brief in regard thereto;

- Ms. Heather Laughlin, employee of the Canadian Cancer Society; and submitted a brief in regard thereto;

- Ms. Judy Myrvold, Chair, Council for a Tobacco-Free Toronto; and submitted a brief in regard thereto;

- Ms. Louisa Cantelon, Volunteer, Canadian Cancer Society; and submitted a brief in regard thereto;

- Ms. Marjorie Sutton, President, Mt. Dennis Community Association;

- Ms. Lyba Spring, Toronto; and submitted a brief in regard thereto;

- Mr. David Spring, Toronto; and submitted a brief in regard thereto;

- Mr. John Kiru, Coordinator, Weston Business Association;

- Mr. Cameron Johnstone, operator of Delta Bingo and Mayfair Bingo;

- Mr. Tom Bunda, owner, Central Restaurant; and

- Mr. Mike McCallum, owner, Irish Rose Restaurant.

The Board of Health also submits the following communication (May 28, 1999) from the City Clerk (East York Community Council):

The East York Community Council on May 27, 1999, had before it a report (April 6, 1999) from the Secretary, Board of Health, advising that the Board of Health, on April 6, 1999, adopted the report (March 26, 1999) from the Medical Officer of Health with respect to the community input process for a Harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto; and forwarding such report for staff presentation and deputations on the policy options and recommendations paper attached thereto, at the Community Council meetings scheduled to be held on May 26 and 27, 1999, with recommendations from the Community Councils to be referred to the Medical Officer of Health and the City Solicitor for consideration and recommendations back to the Board of Health at its meeting on June 28 and 29, 1999.

The East York Community Council also had before it the following communications:

(i) (May 6, 1999) from the Secretary, Board of Health, advising, for information, that the Board of Health, on May 6, 1999, adopted a report (April 28, 1999) from the Chair, Board of Health, recommending that the Ontario Restaurant Association provide the Medical Officer of Health with specific details on ventilation technology and that the Medical Officer of Health report to the Board of Health by June 28, 1999, regarding the appropriateness of including a ventilation option in the proposed ETS By-law; further advising that the Board requested the Medical Officer of Health to:

(1) report back to the next meeting of the Board on whether the Ontario Restaurant Association has responded; and

(2) circulate the final consolidated report on the ETS By-law in sufficient time to provide members of the Board the opportunity for review prior to the Board meeting on June 28 and 29, 1999;

(ii) (undated) from Mr. and Mrs. H. Kane, Downsview, advising that they are in favour of the ETS By-law;

(iii) (May 18, 1999) from Mrs. Pauline Culley, Toronto, in favour of a non-smoking by-law;

(iv) (May 25, 1999) from the Chair, Council for a Tobacco-Free Toronto, in favour of a smoke-free society;

(v) (May 25, 1999) from the Vice-President Food and Beverage, Bowlerama Limited, outlining concerns with the proposed by-law; and

(vi) (May 26, 1999) from the President, Ontario Restaurant Association, inviting the Board of Health and Members of Council to a demonstration on the indoor air quality initiative on June 8, 1999.

Ms. Liz Janzen, representing the Medical Officer of Health, gave an overhead slide presentation with respect to the proposed harmonized Environmental Tobacco Smoke By-law.

The following persons appeared before the East York Community Council in connection with the foregoing matter:

- Mr. Danny Gayle, Richmond Hill;

- Mr. Victor Miller, Bartending School of Ontario, Toronto;

- Mr. Steven Mastoras, Whistler's Restaurant, East York;

- Mr. Donald MacMillan, The Wee Jaggy Nettle, East York;

- Mr. George Koninis, Mr. Greek, Toronto;

- Mr. Sean Meehan, The Beach Bar, Toronto;

- Mr. Peter Viris, The Donlands Restaurant, East York;

- Ms. Barbara McEachern, East York;

- Ms. Lisa Sparrow, East York;

- Mr. Byron Yankou, Toronto;

- Ms. Donna-Lynn McCallum, East York;

- Mr. Steven Williams, Downsview; and

- Mr. Brian Scott, Toronto.

The East York Community Council referred the following recommendations with respect to the Policy Options and Recommendations discussion document (April 6, 1999), to the Medical Officer of Health and the City Solicitor for consideration and recommendations back to the Board of Health at its meeting on June 28 and 29, 1999:

(1) that Recommendation No. (1) be adopted;

(2) that Recommendation No. (2) option (ii) be adopted subject to deleting (a) and adding the following provisions:

(a) no restaurant, banquet hall, bowling centre, bar, bingo or billiard hall, or casino shall allow smoking if it opens for business after the implementation of the proposed harmonized ETS by-law;

(b) that existing restaurants, banquet halls, bowling centres, bars, bingo and billiard halls, and casinos be grandfathered, provided they have 75 percent of their space for non-smoking and the business remains in the ownership of the person or corporation as it was on the date the ETS by-law takes effect, until May 3, 2004; and

(c) on May 4, 2004, all restaurants in the City of Toronto shall be smoke-free unless, in the opinion of the Medical Officer of Health and with the concurrence of City Council, adequate ventilation apparatus has been developed and is installed in such restaurants; and

(3) that Recommendation No. (4) be adopted subject to deleting the last sentence.

The East York Community Council requested the Medical Officer of Health to submit a report to the Board of Health for its meeting to be held on June 28 and 29, 1999, with respect to the following:

(1) other cities in Canada where there is a total ban on smoking in restaurants, bars, bowling centres, casinos, billiard and bingo halls;

(2) the problems that arose when the former City of Toronto tried to implement an ETS by-law several years ago and providing comment with respect to enforcement costs, etc.;

(3) the feasibility of private clubs having 75 percent of their space smoke-free;

(4) after May 3, 2004, allowing 25 percent of public space for smoking where the smoking section can be adequately ventilated and sealed-off from the non-smoking section;

(5) that restaurant guides indicate which restaurants provide a smoke-free or smoking environment;

(6) signage be posted at entrances of restaurants, etc., indicating a smoke-free or smoking environment; and

(7) the impact on tourism by the proposed ETS by-law.

The Board of Health also submits the following communication (June 1, 1999) from the City Clerk (Scarborough Community Council):

Recommendation:

The Scarborough Community Council reports:

(1) having received the reports on the harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto and the associated staff presentation; and

(2) having made no recommendation to the Board of Health respecting this matter.

Background:

The Scarborough Community Council, at its meeting on May 27, 1999, had before it the following communications:

(May 6, 1999) from the City Clerk (Board of Health) advising that the Board of Health, at its meeting on May 6, 1999, adopted the report, dated April 28, 1999 from the Chair, Board of Health, and requested the Medical Officer of Health to:

(i) report back to the next meeting of the Board on whether the Ontario Restaurant Association has responded to the request for specific details on the ventilation technology; and

(ii) circulate the final consolidated report on the ETS By-law in sufficient time to provide members of the Board the opportunity for review prior to the Board meeting on June 28 and 29, 1999.

(May 6, 1999) from the City Clerk (Board of Health) advising the options available for holding of a public meeting on the Environmental Tobacco Smoke By-law.

(April 6, 1999) from the City Clerk (Board of Health) forwarding report of the Medical Officer of Health, dated March 26, 1999, to the Community Council for staff presentation and deputations on the policy options and recommendations paper attached thereto, with the request that recommendations thereon be referred to the Medical Officer of Health and the City Solicitor for consideration and recommendations back to the Board of Health on June 28 and 29, 1999.

The following persons appeared before the Scarborough Community Council in connection with the foregoing matter:

- Ms. Wendy Whittam, Toronto;

- Ms. Marion Boyce, representing The Council for A Tobacco Free Toronto;

- Mr. Chris Lund, General Manager, C.P. Hotel East, accompanied by Mr. Terence O'Brien, General Manager, Howard Johnson Scarborough Hotel, representing the hotel industry and its employees;

- Mr. Ryan Sellick, President of Local 582 OPSEU;

- Mr. Frank Dwyer, President, Canadian Council for Non-Smoking;

- Ms. Paola Scorziello, representing the Canadian Cancer Society, Scarborough Unit;

- Mr. Jim Park, Owner, Mark and Larry's Pub and Grill;

- Mr. Norman Hutchinson, President, International Air Technologies, who provided copies of material describing ventilation practices, a copy of which was provided to all Members of Community Council, and a copy thereof is on file in the Office of the City Clerk, Scarborough Civic Centre;

- Mr. Louis Tzanis, Owner, Kalas Garden Restaurant;

- Mr. Robert McMullan, President, Abbeyfield Houses;

- Ms. Yolande Meloche, Toronto; and

- Mr. Rudy Leyk, Toronto.

The Community Council received the following written submissions:

- (May 6, 1999) from the Ontario Restaurant Association regarding the deputation procedures relating to this issue;

- (May 26, 1999) from the Ontario Restaurant Association inviting the Board of Health and all Councillors to a demonstration relating to the indoor air quality initiative;

- (May 14, 1999) from Leida Sepp, Toronto, in support of the by-law;

- (May 20, 1999) from five students at Winston Churchill Collegiate Institute in support of the by-law;

- (May 25, 1999) from Mr. Roger Marrelli, Vice President, Food and Beverage, Bowlerama Limited, on behalf of nine Bowling Centres in the greater Toronto area, expressing their views and concerns;

- (May 27, 1999) from Councillor Shaw forwarding a list of telephone messages received in her office supporting the by-law; and

- posters in support of anti-smoking initiatives from the students of Woburn Junior Public School.

The Board of Health also submits the following communication (June 3, 1999) from the City Clerk (Etobicoke Community Council):

The Etobicoke Community Council at its meeting held on May 26 and 27, 1999, had before it the following communications from the Secretary, Board of Health:

(i) (April 6, 1999) advising that the Board of Health on April 6, 1999, adopted the report dated March 26, 1999, from the Medical Officer of Health with respect to the community input process for a harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto; and forwarded such report to the Community Councils for staff presentation and deputations on the 'Policy Options and Recommendations' paper attached thereto, with recommendations from the Community Councils to be referred to the Medical Officer of Health and the City Solicitor for consideration and recommendation back to the Board of Health at its meeting on June 28 and 29, 1999; and

(ii) (May 6, 1999) from the Secretary, Board of Health, advising that the Board of Health on May 6, 1999:

(1) adopted the report (April 28, 1999) from the Chair, Board of Health, headed "Ventilation Option for the Environmental Tobacco Smoke (ETS) By-law"; and

(2) requested the Medical Officer of Health to report back to the next meeting of the Board on whether the Ontario Restaurant Association has responded; and to circulate the final consolidated report on the ETS By-law in sufficient time to provide members of the Board the opportunity for review prior to the Board meeting on June 28 and 29, 1999.

The Etobicoke Community Council also had before it the following communications:

(a) (May 19, 1999) from Miss E. Black, supporting the proposed by-law;

(b) (May 25, 1999) from Ms. Judith Myrvold, Chair, Council for a Tobacco-Free Toronto, forwarding a list of needs identified by the public with respect to the smoke-free by-law for the City of Toronto, and supporting a smoke-free, progressive world class city; and

(c) (May 25, 1999) from Mr. Roger Marrelli, Bowlerama Limited, expressing concern about the proposed restrictions being put on business and the potential for not being able to meet the needs of all customers.

The following persons appeared before the Etobicoke Community Council in connection with the foregoing matter:

- Representing the Greater Toronto Hotel Association: Mr. Paul Martin, Wyndham Bristol Place Hotel; Ms. Leanne Waller, Raddison Suites Airport Hotel; and Ms. Jill McGoey, Valhalla Inn;

- Mr. Michael Perley, Director, Ontario Campaign for Action on Tobacco;

- Mr. Michael Lindsey, representing the Boy Scouts, on behalf of the Canadian Cancer Society;

- Mr. Wm. Barley, President, Etobicoke Unit, Canadian Cancer Society;

- Mr. John Stefanidis, Sizzling Jak's Restaurant;

- Mr. Bob Chapman, Kingsway Kiwanis;

- Mr. Dennis Hunter, Etobicoke Swim Club;

- Mr. Murray Rideout, Enerplace Inc.;

- Ms. Teresa Bodzan, Oasis-on-the-Lake Restaurant;

- Mr. Roger Marrelli, Bowlerama Limited;

- Mr. Derek Brown;

- Mr. Eduardo Riviezzi, Casa Barcelona;

- Mr. Donald C. Kerr, Kingsway Kiwanis;

- Ms. Louise Peacock;

- Ms. Ann Louise Hall, Rose & Thorne Pub;

- Ms. Sandi Lublin;

- Mr. John Walmach;

- Mr. Wayne Randall;

- Mr. Bruce Davis; and

- Ms. Kate Barclay, Squire & Firkin Pub.

The Etobicoke Community Council:

(1) endorsed Recommendations Nos. (1), (4), (5) and (6) contained in the 'Policy Options and Recommendations' paper appended to the report (March 26, 1999) from the Medical Officer of Health;

(2) recommended that:

(a) the six existing municipal by-laws respecting smoking in public places be replaced with one ETS by-law from the following option (ii), as amended:

"That public places be smoke-free, except for restaurants, bars, bowling centres, casinos, billiard and bingo halls, which may have 25 percent of their space for unenclosed smoking for a time limited period, such that:

(i) restaurants, casinos, bars, bowling centres, billiard and bingo halls become smoke-free April 30, 2001, with the distinction between bars and restaurants being that a bar is where alcohol is served and where admittance is restricted to persons 19 years of age and older at all times; and

(ii) the smoke-free date be revisited if there is an acceptable initiative to clear the air to an acceptable level;"

(b) the following options be selected regarding designated smoking rooms (DSRs) in public places:

(i) DSRs up to 25 percent of space, and where permitted in the Tobacco Control Act, 1994, (e.g., Homes for the Aged), including restaurants and bars; and

(ii) DSRs up to 50 percent of space for bowling centres, billiard and bingo halls; and

(3) requested the Medical Officer of Health to provide a further report with respect to Woodbine Race Track.

The Board of Health also submits the following communication (June 8, 1999) from the City Clerk (North York Community Council):

Recommendation:

The North York Community Council received the report (March 26, 1999) from the Medical Officer of Health and referred the following recommendations to the Medical Officer of Health and the City Solicitor, that:

(1) Recommendations Nos. (1), (4), (5) and (6) embodied in the policy options and recommendations attached to the report (March 26, 1999) from the Medical Officer of Health, be adopted;

(2) Recommendations Nos. (2)(ii)(a) and (2)(ii)(b) embodied in the policy options and recommendations attached to the report (March 26, 1999) from the Medical Officer of Health be amended to read as follows:

"2(ii)(a) Restaurants become smoke-free June 1, 2000, and bowling centres become smoke-free April 30, 2001"; and

"2(ii)(b) Casinos, bars, billiard and bingo halls become smoke-free June 1, 2001, with the distinction between bars and restaurants being that a bar is where alcohol is served and where admittance is restricted to persons 19 years of age and older at all times"

and the recommendations as so amended, be adopted;

(3) Recommendation No. (3) embodied in the policy options and recommendations attached to the report (March 26, 1999) from the Medical Officer of Health be amended to reflect Option No. 1 outlined in the Fact Sheet summarizing the options being recommended by the Medical Officer of Health to the Board of Health; and the recommendation as so amended, be adopted;

(4) the Provincial Government be requested to implement uniform Province-wide legislation to prohibit smoking in all public places, bars and restaurants, similar to the proposed harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto;

(5) the Federal Government be requested to make tobacco an illegal substance; and

(6) the Medical Officer of Health and City Solicitor be requested to report on the following:

(a) the filtration devices and ventilation equipment referred to in the deputations made by owners of hospitality establishments, which are currently available; and

(b) the feasibility of instituting performance standards which would be related to air quality.

Background:

The North York Community Council on May 26, 1999, had before it the following report and communications:

(i) (May 26, 1999) from Mr. David K. Foot and Ms. Joyce S. Feinberg, advising of their support of a by-law to prohibit smoking in public places;

(ii) (May 25, 1999) from Mr. Roger Marrelli, Vice President, Food and Beverage, Bowlerama Limited, advising of his concerns with the proposed smoking restrictions;

(iii) (May 25, 1999) from Judith Myvold, Council for a Tobacco-Free Toronto, in support of the proposed harmonized Environmental Tobacco Smoke By-law;

(iv) (May 14, 1999) from the Secretary, Board of Health, forwarding the Notice advising of the public meetings to be held by Community Councils and the Board of Health with respect to the proposed harmonized Environmental Tobacco Smoke (ETS) By-law together with a fact sheet summarizing the changes;

(v) (May 6, 1999) from the Secretary, Board of Health, regarding ventilation option for the Environmental Tobacco Smoke (ETS) By-law; and

(vi) (April 6, 1999) from the Secretary, Board of Health, advising that the Board of Health at its meeting held on April 6, 1999:

(a) adopted the report dated March 26, 1999, from the Medical Officer of Health with respect to the community input process for a harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto; and

(b) forwarded such report to the Community Councils for staff presentation and deputations on the policy options and recommendations paper attached thereto, at the Community Council meetings scheduled to be held on May 26 and 27, 1999, with recommendations from the Community Councils to be referred to the Medical Officer of Health and the City Solicitor for consideration and recommendations back to the Board of Health at its meeting on June 28 and 29, 1999; and

(vii) (March 26, 1999) from the Medical Officer of Health.

A presentation was made by Dr. Monir Taha, Associate Medical Officer of Health and Director of Health Environments.

The following persons appeared before the North York Community Council in connection with the foregoing matter:

- Mr. Douglas Bennett;

- Dr. John Luik, on behalf of the Ontario Restaurant Association;

- Mr. Paul Readings, on behalf of Travelodge Toronto East; and on behalf of the following: Mr. Michael Singer, Novotel North York; Mr. Joe Kamal, Toronto Don Valley Hotel; and Mr. Robert Housez, Inn on the Park;

- Mr. Michael Perley;

- Mr. Cliff Jenkins;

- Mr. Ken Baxter on behalf of The Fish House Restaurants at 2035 Sheppard Avenue East and 144 Front Street West;

- Mr. Michael Dawson, Victoria Village Ratepayers Association;

- Dr. Jim Woodgett;

- Ms. Sylvia Warriner;

- Dr. Peter Webster; Sunnybrook and Women's College Health Science Centre: and

- Mr. Gord Cooke.

The Board of Health also submits the following communication (June 11, 1999) from the City Clerk (Toronto Community Council):

Recommendations:

The Toronto Community Council recommends that:

(1) restaurants, bars, bowling centres, casinos and bingo and billiard halls have 75 percent non-smoking and 25 percent smoking;

(2) the report (April 6, 1999) from the Medical Officer of Health, titled "A Harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto - Policy Options and Recommendations" be amended by:

(a) adding a new Recommendation No. (7) to read:

"That the City make requests for proposals for a multi-year publicity and education campaign that:

(a) reflects Council's decisions on smoking in restaurants, bars and similar places, and

(b) is aimed at reducing smoking;

and that such a campaign involve funding partnerships with the private sector;

(b) adding a new Recommendation No. (8) to read:

"That the City, in co-operation with appropriate business associations, monitor carefully the economic impact of any smoking regulations on the restaurant sector;

(3) the Medical Officer of Health, the Commissioner of Economic Development, Culture and Tourism, and the Commissioner of Urban Planning and Development Services report on the appropriate technology which will help to minimize second-hand smoke.

The Toronto Community Council reports, for the information of the Board of Health, having requested:

(1) the Medical Officer of Health, in consultation with appropriate officials to report to the Board of Health, at its special meeting to be held on June 28 and 29, 1999, on the following motion by Councillor Bossons:

"That the report (April 6, 1999) from the Medical Officer of Health, titled "A Harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto - Policy Options and Recommendations" be amended by adding a new Recommendation No. (3)(iv) to read:

'That restaurants with 40 or fewer seats be exempted from any smoking regulation on condition that they decide themselves whether to be 'wholly smoking' or 'smoke-free' and post the chosen arrangement at their door.' "

(2) the Medical Officer of Health, in consultation with the Commissioner of Economic Development, Culture and Tourism and the City Solicitor, and in consultation with stakeholders, to report to the Board of Health, at its special meeting to be held on June 28 and 29, 1999, on the possibility of creating separate rules for restaurants and bars; and

(3) the Medical Officer of Health to report to the Board of Health, at its special meeting to be held on June 28 and 29, 1999, on the New York by-law, and in her opinion, how it can be altered to make it applicable to the City of Toronto.

Recommendations Nos. (1) and (3) were adopted on the following division of votes:

Yeas: Councillors Rae, Bossons, Fotinos, Johnston, Korwin-Kuczynski and Silva - 6

Nays: Councillors Miller and Walker - 2

The following motion, placed by Councillor Johnston, lost on the following division of votes:

"As a 100 percent ban on smoking in Toronto's restaurants has an obvious economic impact; and

Because suburban councillors have not heard the concerns of downtown restaurants and the hospitality industry;

The Toronto Community Council recommends that:

(1) a joint or concurrent meeting be held on June 28 and 29, 1999, between the Board of Health and the Economic Development Committee to hear deputations before a final recommendation is made to City Council; and

(2) the City Clerk be requested to submit proposed rules of order for the joint meeting."

Yeas: Councillors Bossons, Johnston and Miller - 3

Nays: Councillors Rae, Disero, Fotinos, Korwin-Kuczynski, Silva and Walker - 6

Background:

The Toronto Community Council on June 8, 1999, had before it a communication (April 6, 1999) from the Secretary, Board of Health, respecting a harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto: Community Input Process advising that the Board of Health at its meeting on April 6, 1999:

(2) forwards such report to the Community Councils for staff presentation and deputations on the policy options and recommendations paper attached thereto, at the Community Council meetings scheduled to be held on May 26 and 27, 1999, with recommendations from the Community Councils to be referred to the Medical Officer of Health and the City Solicitor for consideration and recommendations back to the Board of Health at its meeting on June 28 and 29, 1999.

The Toronto Community Council also had before it the following reports/communications:

- (May 6, 1999) from the Secretary, Board of Health respecting Ventilation Option for the Environmental Tobacco Smoke (ETS) By-law;

- (May 17, 1999) from Ms. Elizabeth and Mr. Ian White;

- (May 19, 1999) from Mr. Allan S. McPherson;

- (May 18, 1999) from Mr. Alan Warren;

- (May 25, 1999) from Mr. Jack Micay;

- (May 25, 1999) from President, Council for a Tobacco-free Ontario;

- (May 19, 1999) from Mr. James Panousopoulos, Victoria Restaurant;

- (May 25, 1999) from Vice-President Food and Beverage, Bowlerama Limited;

- Petition with 107 signatures in opposition to total ban on smoking in coffee shops;

- Presentation (May 26, 1999) from the Greater Toronto Hotel Association/Ontario Restaurant Association;

- (May 26, 1999) from Mr. Fred Luk, Filet of Sole;

- (May 26, 1999) from Mr. Michael Perley, Ontario Campaign for Action on Tobacco;

- (May 26, 1999) from Lobsang Samchok, Everest Cafe;

- (May 26, 1999) from Ms. Judith Myrvold, Council for a Tobacco-Free Toronto (CTFT);

- (Undated) from Ms. Debbie Thuston;

- (Undated) from Ms. Winnie Leung;

- (Undated) from Ms. Diane Finkle;

- (May 26, 1999) from Terry Mundell,Ontario Restaurant Association;

- (May 24, 1999) from Ms. Barbara West;

- (May 26, 1999) from R. Alter;

- (May 31, 1999) from Jean Walker;

- (undated) from Beth Theis; and

- (undated) from F. Barry.

The Community Council's recommendations are noted above.

The Board of Health also submit the following extract of Minute No. 8.69 from the Toronto Community Council meeting held on May 26 and 27, 1999:

The Toronto Community Council had before it a report (April 6, 1999) from the Secretary, Board of Health, advising that the Board of Health at its meeting on April 6, 1999:

The Toronto Community Council also had before it the following reports/communications:

- (May 6, 1999) from the Secretary, Board of Health respecting Ventilation Option for the Environmental Tobacco Smoke (ETS) By-law;

- (May 17, 1999) from Ms. Elizabeth and Mr. Ian White;

- (May 19, 1999) from Mr. Allan S. McPherson;

- (May 18, 1999) from Mr. Alan Warren;

- (May 25, 1999) from Mr. Jack Micay;

- (May 25, 1999) from President, Council for a Tobacco-free Ontario;

- (May 19, 1999) from Mr. James Panousopoulos, Victoria Restaurant;

- (May 25, 1999) from Vice-President Food and Beverage, Bowlerama Limited;

- Petition with 107 signatures in opposition to total ban on smoking in coffee shops;

- Presentation - May 26, 1999 - Greater Toronto Hotel Association - Ontario Restaurant Association;

- (May 26, 1999) from Mr. Fred Luk, Filet of Sole;

- (May 26, 1999) from Mr. Michael Perley, Ontario Campaign for Action on Tobacco;

- (May 26, 1999) from Lobsang Samchok, Everest Cafe;

- (May 26, 1999) from Ms. Judith Myrvold, Council for a Tobacco-Free Toronto (CTFT);

- (Undated) from Ms. Debbie Thuston;

- (Undated) from Ms. Winnie Leung;

- (Undated) from Ms. Diane Finkle;

- (May 26, 1999) from Terry Mundell, President, Ontario Restaurant Association;

- (May 24, 1999) from Ms. Barbara West.

The following persons appeared before the Toronto Community Council in connection with the foregoing matter:

On May 26, 1999:

- Mr. Danny Gayle;

- Mr. Michael Perley, Ontario Campaign for Action on Tobacco;

- Mr. Al Carbone;

- Ms. Marilyn Soper, Hilton Toronto;

- Mr. Mike O'Connor, Joe Badali's Restaurant;

- Mr. Victor Miller, Bartending School of Ontario;

- Mr. Leslie Major, Reillys Restaurant;

- Mr. John Anderson, Yonge Street Small Business;

- Mr. G. Francis Deck, Fran Restaurants Ltd;

- Mr. Peter Chen, Ontario Chinese Restaurant & Food Association;

- Mr. Jonathan Dixit, The Duke of Gloucester;

- Ms. Judith Myrvold, Council for a Tobacco-Free Toronto;

- Mr. Marvin Greenberg, The Hospitality Network Inc.;

- Ms. Debra DeMonte, The Longest Yard Restaurant and North Toronto Merchants Association;

- Mr. Tony Florsham, Elephant and Castle;

- Mr. David Blosdale;

- Ms. Judy Perly, Free Times Cafe;

- Ms. Kathleen Morris;

- Ms. Fran Walsh;

- Ms. Debbie Thurston, Mary John's Restaurant;

- Ms. M. Kennedy Baker, Canadian Council for Non-Smoking;

- Ms. Heli Donaldson; and

- Ms. Neila Poscente.

On May 27, 1999:

- Mr. Paul Manna, Manna Franchise Corporation;

- Ms. Jo-Anne Azzarello, The Toronto Entertainment District Association;

- Mr. Dino Magnatta, Living Well Cafe and Zelda's Living Well;

- Mr. Samy Chong;

- Mr. Martin McSkimming, Hemingway's Restaurant;

- Ms. Diane Finkle;

- Ms. Joanna Kirton

- Mr. Thomas Hutchison;

- Mr. Colin Finkle;

- Mr. Douglas Ibbitson;

- Mr. Srdjan Kisin;

- Ms. Virginia Rae;

- Sandi Lublin;

- Ms. Susan Aaron;

- Ms. Lilieth Pottinger, The Real Jerk Restaurant; and

- Mr. Gordon Hemsley, Madison Avenue Pub.

At 2:15 p.m. on May 27, 1999, the Clerk called the roll and recorded the names of those present:

Councillors Rae, Bossons, Jakobek, Johnston, Korwin-Kuczynski, McConnell, Walker.

There being only 7 members present, the meeting failed through lack of quorum:

The following motions were placed but not voted on:

By Councillor Korwin-Kuczynski:

(1) That restaurants, bars, bowling centres, casinos and bingo and billiard halls have 75 percent non-smoking and 25 percent smoking;

(2) that the Medical Officer of Health, the Commissioner of Economic Development, Culture and Tourism, and the Commissioner of Urban Planning and Development Services report on the appropriate technology which will help eliminate second-hand smoke.

By Councillor Walker:

(3) That Recommendations Nos. (1), 2(i) and 3(i) of the report (March 26, 1999) from the Medical Officer of Health, addressed to the Board of Health, be adopted;

(4) that Recommendation No. (1) of the report (March 26, 1999) from the Medical Officer of Health, addressed to the Board of Health, be amended to read:

"(1) That workplaces in the City of Toronto be smoke-free and existing separately ventilated Designated Smoking Rooms be permitted to remain."

(5) that existing Designated Smoking Rooms in public places be permitted to remain; and

(6) that a public education campaign be undertaken to publicize the City's position in this regard.

--------

The Board of Health reports for the information of Council, having had before it during consideration of the foregoing matter copies of the following Resolutions adopted by the Association of Local Public Health Agencies:

(i) Resolution No. A99-2 entitled "Ontario Tobacco Strategy", wherein it is resolved that:

"the Association of Local Public Agencies (alPHa) urge the Minister of Health to renew the Ontario Tobacco Strategy by adopting all of the recommendations made by her Expert Panel and ensuring their timely implementation immediately following the provincial election; and

the Minister be requested to consult with alPHa during the planning and implementation of the renewed Ontario Tobacco Strategy."

(ii) Resolution No. A99-3 entitled "Smoke-Free Environments" wherein it is resolved that:

"the Association of Local Public Health Agencies (alPHa) urge the Minister of Health to amend the Smoking in the Workplace Act and the Tobacco Control Act in order to phase in a complete ban on smoking in workplaces and public places by 2005; and

the Minister be requested to consult with alPHa on the planning and implementation of the legislative amendments and the associated public education campaign."

The Board of Health also had before it the following communications and submissions:

(i) (April 16, 1999) from Ms. Judith Myrvold, Chair, Council for a Tobacco-Free Toronto, forwarding a petition from 510 persons urging the adoption of a 100 percent smoke-free public place by-law for the City of Toronto;

(ii) (May 26, 1999) from Dr. Martin J. Yaffe, Ph.D., Sunnybrook Health Science Centre, University of Toronto;

(iii) (May 29, 1999) from Ms. Sandra Pavan, Beacon Hill Tenants Association;

(iv) (May 29, 1999) from Ms. Karen L. Bass, Recording Secretary of the Kennedy Bingo Sponsors' Association;

(v) (May 31, 1999) from Mr. Gordon Brown, President, Coping In Tough Times;

(vi) (May 31, 1999) from Mr. Alf Grigg;

(vii) (May 31, 1999) from Mr. Thomas W. Laprade, Thunder Bay;

(viii) (June 18, 1999) from Ms. Judith Myrvold, Chair, Council for a Tobacco-Free Toronto;

(ix) Petition submitted by the Council for a Tobacco-Free Toronto signed by 200 persons requesting that all public spaces, including restaurants, bowling alleys, bingo halls, billiard halls and bars become 100 percent smoke-free, no later than the year 2001.

(x) (June 23, 1999) from The Honourable Colin Kenny, The Senate of Canada;

(xi) (June 25, 1999) from Mr. Paul Garfinkel, President and Chief Executive Officer, Centre for Addiction and Mental Health;

(xii) (June 25, 1999) from Ms. Pamela L. Chart, Medical Director, Preventive Oncology Program, Toronto Sunnybrook Regional Cancer Centre, submitting a petition from 143 patients, family, members, staff and volunteers affiliated with the Toronto-Sunnybrook Regional Cancer Centre, urging the harmonization of the smoking by-law in the City;

(xiii) (June 25, 1999) from Mr. Leonard J. Parente, President, Kennedy Bingo:

(xiv) (June 27, 1999) from Dr. Peter Moore;

(xv) (June 28, 1999) from Dr. Anthony F. Graham, Chair of External Relations, Heart and Stroke Foundation;

(xvi) Petition submitted by Ms. Penny Thomson, Executive Director, Canadian Cancer Society - Ontario Division, signed by 33 persons in support of a new harmonized by-law which would make all bars, restaurants, casinos, bowling centres, bingo and billiard halls 100 percent smoke-free by April 30, 2001;

(xvii) (June 28, 1999) from Mr. Michael Perley, Director, Ontario Campaign for Action on Tobacco;

(xviii) (June 28, 1999) from Ms. Judith Myrvold, Chair, Council for a Tobacco-Free Toronto, and petition from 105 persons requesting that all public spaces, including restaurants, bowling alleys, bingo halls, billiard parlours and bars become 100 percent smoke-free, no later than the year 2001;

(xix) (June 28, 1999) from Ms. Linda Vannucci-Santini, Toronto Workers' Health and Safety Legal Clinic;

(xx) (June 28, 1999) from Mr. Joseph Mansour, President, YAWMA of Canada Enterprises;

(xxi) Document entitled "Toronto Environmental Tobacco Smoke (ETS) Air Monitoring Project" prepared for the Ontario Restaurant Association and the Greater Toronto Hotel Association, submitted by Mr. Terry Mundell, President, Ontario Restaurant Association;

(xxii) (June 28, 1999) from Ms. Lynn Cassidy, Executive Director, Provincial Bingo Charitable Activities Association;

(xxiii) (June 28, 1999) from Mr. Lou Innocente, Operations Manager, Bingo Country;

(xxiv) (June 28, 1999) from Ms. Debbie Thurston, Manager, Mary John's Restaurant;

(xxv) (June 8, 1999) from Mr. Sean Bayley, General Manager, Toronto Eaton Centre;

(xxvi) (February 4, 1999) from Mr. George C. Glover, Jr.;

(xxvii) (June 2, 1999) from Ms. Debbie Connor;

(xxviii) (May 20, 1999) from Mr. Thomas Lyons;

(xxix) (May 26, 1999) from Mr. Jim Whan Youn, Owner, Coffee Time Donuts;

(xxx) (May 31, 1999) from Mr. Neil Vosburgh;

(xxxi) (May 31, 1999) from Imago Restaurants;

(xxxii) (May 31, 1999) from J.W. Meakin;

(xxxiii) (June 1, 1999) from Ms. Anne Wong;

(xxxiv) (May 28, 1999) from J.C. Laidlaw, Director of Education, Cancer Care Ontario;

(xxxv) (June 29, 1999) from Mr. George Mendes, General Manager, Vinnie's Restaurant;

(xxxvi) (June 28, 1999) from Ms. Hilary Balmer, Executive Director, RAINET; and

(xxxvii) (June 29, 1999) from Mr. Ira T. Kagan, Kagan, Zucker, Feldbloom, Shastri, Solicitors for

Delta Bingo.

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Dr. Sheela Basrur, Medical Officer of Health for the City of Toronto Public Health Unit, gave a presentation to the Board of Health with respect to the foregoing matter, and submitted a copy of her presentation.

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The following persons appeared before the Board of Health in connection with the foregoing matter:

- Mr. Manny Dreukier, Idler Pub;

- Ms. Sharon Moore, owner/operator, The Retro Cafe;

- Regional Councillor Joyce Frustaglio, Chair of the York Region Health and Social Services Committee, and Ms. Cathy Jaymes, Health Educator, Region of York;

- Dr. Anthony Graham, Chair of External Relations, Heart and Stroke Foundation, and submitted material with respect thereto;

- Mr. Danny Gayle;

- Dr. Jim Woodgett, Princess Margaret Hospital;

- Ms. Jules McCowan;

- Mr. Bill Barley, representing Toronto Chapter of the Canadian Cancer Society;

- Ms. Diane Finkel;

- Ms. Penny Thomson, Executive Director, Canadian Cancer Society - Ontario Division, and submitted a petition with respect thereto;

- Mr. Michael Perley, Director, Ontario Campaign for Action on Tobacco, and submitted material with respect thereto;

- Ms. Judith Myrvold, Chair, Council for a Tobacco-Free Toronto, and submitted material and a petition with respect thereto;

- Ms. Linda Vannucci-Santini, Toronto Workers' Health and Safety Legal Clinic;

- Ms. Hilary Balmer, RN, and Executive Director, RAINET, and submitted material with respect thereto;

- Ms Wendy Whittam;

- Dr. Richard Stanwick, Medical Officer of Health, Capital Region District, British Columbia;

- Mr. Garfield Mahood, Executive Director, Non-Smokers' Rights Association;

- Mr. Andrew Gibson, member of Youth Tobacco Coalition;

- Ms. Darpan Sondhi, member of Youth Tobacco Coalition;

- Mrs. Eva Brass, on behalf of her daughter, Tiffani;

- Ms. Roslyn Levi, PHN;

- Mr. Michael Lindsey, representing the Boy Scouts and Canadian Cancer Society;

- Dr. Allan Coates, Chief, Paediatric Respiratory Medicine, Hospital for Sick Children, representing the Ontario Lung Association;

- Mr. Douglas Bennett, Council for a Tobacco-Free Ontario;

- Mr. Cliff Jenkins;

- Mr. Steve Mastoras, Proprietor, Whistler's Restaurant, East York;

- Mr. Joseph Mansour, President, YAWMA of Canada Enterprises;

- Mr. Mike O'Connor, General Manager, Joe Badali's Italian Restaurant;

Mr. Byron Yankou;

- Mr. Peter Chen, President, Ontario Chinese Restaurants' Association;

- Mr. Sean Meehan, Beaches Bar Restaurant;

- Mr. Marvin Greenberg;

- Mr. Terry Mundell, on behalf of the Ontario Hotel/Motel Association, and submitted material with respect thereto;

- Dr. Paul Garfinkel, President, Centre for Addiction and Mental Health;

- Ms. Jill Palmer Abbott, and family;

- Mr. Fran Deck, Fran's Restaurant;

- Mr. David Blosdale;

- Mr. Vance Latchford, Latchford Associates;

- Mr. David Crocker;

- Ms. Amanda Long, Ms. Courtney Scanlon, and Ms. Stephanie Brown, students at Leaside High School;

- Mr. Derrick Finn, Finn Projects;

- Dr. Philip Goad;

- Mr. Paul Manna;

- Mr. Ken Rueter, Black Dog Pub;

- Mr. Roger Marrelli, Vice-President - Food and Beverage, Bowlerama Limited;

- Mr. Don Kerr, Kingsway Kiwanis Club;

- Ms. Debra DeMonte, The Longest Yard Restaurant and North York Merchants Association;

- Mr. Dennis Hunter, Etobicoke Swimming Club;

- Mr. Lou Innocente, Operations Manager, Bingo Country, and submitted material with respect thereto;

- Mr. John Garcia, Director, Prevention Unit for Cancer Care Ontario;

- Mr. Gordon E. Cooke, Air Sollutions Inc.;

- Mr. Tom Lexovsky, Superior Restaurant; and

- Ms. Linda Wexeloh, North York Aquatic Club.

(A copy of the following material referred to in the foregoing Clause has been forwarded to all Members of Council, and a copy thereof is on file in the office of the City Clerk:

- Appendices 2, 3 and 4 to the report dated June 21, 1999, from the Medical Officer of Health, entitled "A Harmonized Environmental Tobacco Smoke (ETS) By-law for the City of Toronto - Review of Community Council Meetings and Update";

- Appendices (a) and (b) to the report dated June 21, 1999, from the Medical Officer of Health, entitled "Ventilation and ETS";

- Appendix VII to the report dated March 26, 1999, from the Medical Officer of Health;

- communications and submissions to Community Councils; and

- communications and submissions to the Board of Health.

The following material is also on file in the office of the City Clerk:

- petitions from approximately 991 persons in favour of a harmonized Environmental Tobacco Smoke by-law; and

- document entitled "Toronto Environmental Tobacco Smoke (ETS) Air Monitoring Project" submitted by Mr. Terry Mundell, President, Ontario Restaurant Association.)

(City Council on July 6, 7 and 8, 1999, had before it, during consideration of the foregoing Clause, the following report (July 6, 1999) from the Medical Officer of Health:

Purpose:

To provide City Council with available information on the economic impact on bingo halls arising from smoke-free legislation in other jurisdictions.

Financial Implications:

Not applicable.

Recommendation:

That this report be received for information.

Background:

At its meeting on June 28-29, 1999 the Board of Health adopted a series of motions related to the proposed ETS By-law, one of which requested specific information on the economic impact on bingo halls arising from smoke-free legislation in other jurisdictions. The following provides a brief response to this request.

Staff have been in contact with researchers in California, where all bingo halls state-wide are smoke-free under the Smoke-free Air Act which went into effect on January 1, 1998. Apparently there have been no studies to date (either in California or elsewhere) on the economic impact of smoke-free legislation on bingo halls. Similarly, staff in Toronto's Economic Development Division are not aware of any studies that have been done in this area.

Vaughan's bingo halls are smoke-free under their by-law (with provision for designated smoking rooms up to 50 percent of floor space). At the time its ETS by-law took effect, Vaughan had only one bingo hall which is still in operation. Formal economic impact data are not available.

Bingo halls in British Columbia's Capital Region District (Victoria) have been entirely smoke-free since January 1999; economic impact data are not yet available. Vancouver's bingo halls will go smoke-free on January 1, 2000.

Conclusion:

There is no information from Canada or the United States regarding the specific economic impacts of smoke-free legislation on bingo halls. However, economic analyses of the impact of smoke-free legislation on the hospitality and tourism sectors generally have consistently shown either a neutral or net positive effect on these industries as a whole.

Contact:

Romilla Gupta, Public Health

Telephone: 395-7602

Fax: 395-7691)

(City Council also had before it, during consideration of the foregoing Clause, the following communications:

(i) (July 1, 1999) from Mr. Edward T. Flis;

(ii) (July 5, 1999) from Ms. Evelyn Johnston; and

(iii) (July 7, 1999) from Mr. David R. Graham.)

(Councillor Chow, at the meeting of Council on July 6, 7 and 8, 1999, declared her interest in the foregoing Clause, in that her stepson is an employee of a bar.)

(Councillor Layton, at the meeting of Council on July 6, 7 and 8, 1999, declared his interest in the foregoing Clause, in that his son is an employee of a bar.)

Respectfully submitted,

JOHN FILION

Chair

Toronto, June 28 and 29, 1999

(Report No. 5 of The Board of Health, including additions thereto, was adopted, as amended, by City Council on July 6, 7 and 8, 1999.)

	Process	Meeting Date(s)
Board of Health	Board of Health to refer the Medical Officer of Health's public consultation document to Community Councils for staff presentation and deputations.	April 6, 1999
Community Councils	Public deputations with recommendations from Community Councils referred to the Medical Officer of Health and the City Solicitor for consideration and recommendations back to the Board of Health.	May 26 and 27, 1999
Board of Health	The Medical Officer of Health and the City Solicitor to report back to Board of Health on June 28, 1999, at which time the Board will hear deputations on the original public consultation document and any follow-up staff reports, including the solicitor's draft by-law. The Board of Health will debate the issue at a special meeting on June 29, 1999, and forward its recommendations to City Council for consideration.	June 28 and 29, 1999

Establishment	By-law Interpretation
Mixed Use Establishments: an establishment which could fit the criteria for more than one class of premises	by-law interpretation will depend upon the primary use of the establishment and the degree of physical separation among its different uses enclosed spaces within public places which are used for a separate purpose (e.g. a restaurant within a theatre) will comply with the section of the by-law which pertains to that type of facility
Private Establishments	will be exempt from by-law criteria to define a private establishment will include the presence of: - objective rules to approve or reject members - use of the facility being limited to members and bona-fide guests - mechanisms that give members some control of the facility - records documenting fees and/or annual membership dues - evidence that the facility is operated not for profit and solely for the benefit and pleasure of its members - evidence that the establishment directs its publicity and advertisements exclusively to members (or potential members) for their information and guidance
Private Functions	a time limited period that any public place is being leased or rented for a function that is not open to the general public e.g. a wedding; private functions will be exempt from by-law restrictions for that time limited period
Public Places Not Specifically Mentioned in By-law or Other Legislation including: theatres and entertainment centres sports facilities, recreations and sports arenas hotels (common areas) financial institutions retail stores video or amusement arcades laundromats hairdressing salons and barber shops day nurseries elevators and escalators lobbies and reception areas stairwells, corridors and hallways public washrooms etc .	the general definition of public places will apply, making them 100 percent smoke-free

Establishment	Smoking Restriction
Hospitals psychiatric facilities nursing homes homes for special care charitable homes for the aged	100 percent smoke-free DSR permitted

Establishment	Recommendation
Workplaces	maintain 100 percent smoke-free permit designated smoking rooms to be used for no other purpose than smoking
Public Places Not Already Smoke-free: restaurants bars banquet halls bowling centres bingo halls billiard halls casinos	public places not already smoke-free become 75 percent non-smoking three months after by-law is passed by City Council
	100 percent smoke-free April 30, 2001

Workplaces
	Pros:	Cons:
Smoke-free workplaces without DSRs	(a) consistent with goal of establishing an ETS by-law that adopts the most restrictive standards within existing by-laws; i.e. former City of York does not permit DSRs (b) no concerns about DSRs not functioning properly and exposing non-smoking employees to ETS	(a) workplaces with existing DSRs may object (b) a grandfather clause may be needed for places with existing DSRs
Smoke-free workplaces with DSRs	(a) most ETS by-laws across Ontario allow workplace DSRs (b) five of six former municipalities allow DRS in existing by-laws (c) DSRs can only be used for smoking, i.e. no employees required to enter for the purpose of work	(a) former City of York does not permit DSRs in workplaces; therefore this would be less restrictive (b) there is no process/City policy to ensure that DSRs function properly (c) only larger workplaces can afford to build DSRs
Public Places
	Pros:	Cons:
All public places become smoke-free immediately	(a) all non-smoking employees and the public protected from ETS in public places (b) consistent with goal of eliminating exposure to ETS in all public places (c) all public places treated the same	(a) no time to build up industry and public acceptance of smoke-free standard (b) additional staff and resources needed to immediately ensure compliance
Maintain status-quo: allow six different by-laws	(a) the industry would not experience any change	(a) confusion about standards among owners/operators of public places and patrons (b) establishments that must comply with more restrictive measures feel they are treated unfairly (c) undermines goal of harmonization across the city (d) enforcement and prosecution very difficult; one side of the street may have different restrictions than the other side (e) makes the goal of smoke-free more difficult for establishments with less restrictive requirements
Public places not yet smoke-free provide at least 80 percent non-smoking space	(a) moves Toronto further towards goal of smoke-free	(a) impact on smaller restaurants; 65 percent of restaurants would have to increase non smoking space (b) industry may feel too restrictive as a first step in harmonization
Establish consistent requirement for all public places not already smoke-free to provide at least 75 percent of space for non-smoking	(a) surveys show this percentage is most acceptable to the public and the industry (b) most establishments already at this level; less than 20 percent have to increase non-smoking space (c) easy to implement and enforce	(a) set back for one former municipality
Appendix IV Designated Smoking Rooms (DSRs) for Public Places The following chart sets out some of the options for DSRs for restaurants, bars, bowling centres, casinos and bingo and billiard halls.
Designated
	Pros:	Cons:
Do not permit DSRs	(a) employees protected from ETS (b) larger establishments would not have unfair advantage over smaller establishments	(a) public and industry feel strongly about permitting DSRs
Permit DSRs in maximum space of 25 percent	(a) consistent with workplace restrictions for DSRs (b) 75 percent of space available for non-smokers	(a) smaller restaurants may feel disadvantaged
Permit DSRs in maximum space of 50 percent	(a) more flexibility for operators	(a) lower than existing standards (b) less space for non-smokers
Permit DSRs but do not allow employees to work in them	(a) employees not exposed to ETS	(a) industry does not support
Permit DSRs with employees providing full service	(a) industry supports	(a) employees exposed to ETS