Public Health Issues

Smoking is one of the leading causes of death among smokers and the dangers to the health of secondhand smokers – those who live and work in close proximity to smokers -- is well established. States regulate tobacco sales and use and are active in controlling the use of tobacco aimed at reducing the known negative health outcomes from its use on the general public and smokers. States differ on the degree to which they have implemented smoking bans, in workplaces, restaurants, and on public transit and other enclosed, non-residential spaces. In the U.S., 27 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands, plus hundreds of cities and counties, have enacted comprehensive smoke-free laws covering workplaces, restaurants, and bars. The states are: Arizona, California, Colorado, Delaware, Hawaii, Illinois, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington and Wisconsin. Another 3 states and Guam have enacted strong smoke-free laws covering all restaurants and bars: Connecticut, New Hampshire, and North Carolina. Hundreds of cities and counties across the country have also taken action.

Climate change has led to more extreme-weather days, increased the number and intensity of natural disasters, and changes in infectious disease patterns. Older adults, people with disabilities, people of color, people with low incomes, and people with chronic illnesses bear the greatest burden of disease and death related to climate change. Extremely hot and cold days, which are increasing because of climate change, can be lift-threatening for older adults. Older adults and people with disabilities also face greater challenges in evacuating safely during a natural disaster (see also Chapter 13, Livable Communities: Disaster Planning and Recovery).