Dr. Timothy Mullett, one of the state's leading cardiothoracic surgeons, will be in Somerset on Monday night to address city council.
Why would the Chair of the Commission on Cancer of the American College of Surgeons make his way from Lexington, where he works at the University of Kentucky, to Somerset because someone wants to open a cigar bar?
"Somerset has been a leader in making its community safe," Mullett said. "Why would they take a step backward now?"
Local businessman Anthony Cox has asked Somerset City Council for an exemption to its iron-clad smoke-free ordinance that was put in place in January 2012. Cox's Birdies and Barrels downtown will feature a cigar bar, among other attractions.
The health care community thinks that's a bad idea.
"I'm not opposed to creating more opportunity for small business. But this idea is founded on having a place for people to smoke at a public venue," said Dr. Joe Weigel, the Internal Medicine Program Director and Medical Student Educational Director at Lake Cumberland Regional Hospital. "That question has been asked and has been answered in Somerset.
"We took the step as a community to go smoke-free because of the issues with secondhand smoke and the effects it can have on people," Weigel continued. "I think we have a responsibility, not only for our own health, but for the health of our neighbors."
Mullett said Somerset's move to go smoke-free nearly a decade ago has been a huge success in deterring tobacco use in Pulaski County.
"Somerset City Council should be congratulated for putting a strong policy in place," Mullett said. "When they went smoke-free in 2012, 30% of the population there smoked.
"Since the smoke-free ordinance has been in place, those rates have dropped significantly," Mullett added. "Our cancer registry shows a decrease in cancer deaths in Pulaski County and the number of cases of lung cancer has decreased. Deaths from heart disease has decreased. There's real value to what Somerset City Council put in place in 2012."
Tracy Aaron, Health Education Director for the Lake Cumberland District Health Department, confirmed the statistics have moved in a very positive direction:
• Pulaski County has seen decreases in the percentage of residents who smoke, from 30% in 2008-2010 to 24% in 2017-2019.
• Pulaski County has seen a decrease in cancer deaths (from 284 in 2006-2010 to 198 in 2017-2019; age-adjusted rate per 100,000 population).
• Pulaski County has seen a decrease in heart disease deaths (from 251 in 2003-2007 to 220 in 2017-2019; per 100,000 population).
• Pulaski County has seen a decrease in stroke deaths (from 43 in 2003-2007 to 39 in 2017-2019; per 100,000 population).
"Research shows that Kentucky communities with partial smoke-free laws that allow exemptions (for certain kinds of businesses like cigar bars) do not experience these same population health gains," Aaron said.
The smoking ordinance passed in 2012 with an 11-1 vote, with the only "no" coming from former councilman Jim Rutherford. Current councilors John Ricky Minton, Jim Mitchell, Jerry Girdler and Jerry Wheeldon all voted in favor of the ordinance nine years ago.
"Why would you want to weaken a policy that has been considered a leader in the state?" Mullett said. "This ordinance shows Somerset cares about people's health."
Both Mullett and Weigel fear that one exemption could lead to requests for another. And another.
"Creating an exemption is a slippery slope — because then you will have other people who will want exemptions and other current establishments wanting to be exempt," Weigel said. "Then all of a sudden we're not smoke-free — it's a partial thing because you're having smoking in bars and other public venues.
"The decision to go smoke-free wasn't an economic one — it was just the right thing to do," Weigel said. "Somerset was at the forefront of this public health movement, especially for a smaller town. It wasn't like Louisville or Lexington doing it — this is a rural town where tobacco has a heritage. We were once considered part of the burley belt, but we decided to say enough is enough. We don't want to take steps backward here."
Mullett said smoke-free ordinance exemptions are just what the doctor ordered for the tobacco industry.
"The tobacco industry looks for an Achilles heel in these ordinances," the UK surgeon said. "What once was an iron-clad ordinance now allows a cigar bar. Next it might be smoking in bingo halls, businesses that claim to have independent ventilation and restaurants who want to allow smoking in its bar area — and remember how that was, having to smell smoke when we eat.
"The tobacco industry looks for these laws to be narrowed so they can exploit it," Mullett added. "The best policy is something that applies to all public venues."
Former Somerset Mayor Eddie Girdler, who presided over the 2012 smoking ordinance, clearly hopes the law will not be changed.
"The statements made (in the ordinance exemption read during the last council meeting) in regards to cigar smoking and pipe smoking as being safer than cigarettes is totally false," Girdler said. "Promoting the indoor use of tobacco products is extremely dangerous in that smoking in any form contributes to heart disease, heart attacks, COPD, and many other severe illnesses. There are no cultural justifications in promoting deadly products."
Aaron confirmed there is no "safer" type of smoking.
"Cigar smoke is not safe for the public. Secondhand cigar smoke is harmful for workers and patrons," Aaron said. "Cigar smoking is not safer than other tobacco products. The Center for Disease Control and Prevention makes it clear that there is no safe level of exposure to secondhand smoke.
"Cigar smoking is associated with an increased risk for cancer, heart disease and lung diseases like emphysema and chronic bronchitis," Aaron added. "Cigars can have more nicotine than a pack of cigarettes and have higher levels of toxins."
Cox said his business will have a special commercial-grade ventilation system in place that will filter and push air to the outside, negating some of the effects of secondhand smoke. Aaron says that isn't really possible.
"Ventilation systems cannot sufficiently remove smoke from the air to make it safe to breathe. According to the American Society of Heating, Refrigerating and Air-Conditioning Engineers, the only means to avoid health effects and eliminate indoor environmental tobacco smoke exposure is to ban all smoking activity inside and near buildings,"Aaron said. "Even separately enclosed, separately exhausted, negative-pressure smoking rooms do not keep secondhand smoke from spilling into adjacent areas. Secondhand smoke exposure causes heart disease, lung cancer, strokes and breast cancer in young women; Sudden Infant Death Syndrome; and is one of the most common asthma triggers. No employee should have to be exposed to secondhand smoke at work."
Girdler said city government researched tobacco use tirelessly before enacting the current ordinance.
"The City Council and I spent hundred of hours for over a year holding many meetings at the Center, Rocky Hollow, city hall and other venues to discuss in detail the indoor smoke-free ordinance. We reached agreement and it appears to have been highly successful for nearly 10 years," the former mayor added. "If the City Council approves a 'cigar bar' or 'pipe smoking bar' then I would assume that any bar and others would immediately open 'cigarette bars' because each would be tobacco-based. To say that cigar smokers and pipe smokers are more culturally refined than cigarette smokers and on-smokers is not appropriate and demeaning to our citizens."
Weigel fears an exemption would send the wrong message to young people.
"It sets a bad example — that wealthy, influential and successful people behave like that," Weigel said.
"If the City Council approves any form of indoor smoking, it will encourage our young people to take up the habit," Girdler added. "Also, wet pipe smoking called hookahs is the fad for persons aged 18-24 in our country and those are not only used for tobacco but various illegal drugs. They indicated that pipe-smoking hookahs would not be allowed but who believes that non-tobacco drugs will not be used unless monitored every minute.
"The proposal means the end of our accepted and highly successful indoor non-smoking lifestyle for our city and county," Girdler continued. "I would hope the council values the health of our citizens and children over the need to be culturally enriched by cigar and pipe smoking."
"We are very proud of Somerset’s effective comprehensive smoke-free ordinance," Aaron said. "For nearly a decade, this ordinance has protected our residents, their kids, workers and guests from the harmful effects of secondhand smoke in public places and workplaces equally. A comprehensive smoke-free ordinance provides protection for everyone and treats everyone fairly."
A Commonwealth Journal online poll showed that nearly 52% of respondents favored leaving the smoking ordinance intact. Forty percent said they were OK with the cigar bar exemption, while nearly 8% said they were indifferent.