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8 <br /> Internal tobacco industry documents show that starting in the early 1990s the tobacco industry <br /> recognized the important role played by local tobacco control policymaking and sought to block it by <br /> promoting enactment of state legislation preempting local action in some or all tobacco control policy <br /> areas [6,12,15]. For example, an internal industry document states that a Tobacco Institute priority <br /> for 1993 was to "encourage and support statewide legislation preempting local laws, including <br /> smoking, advertising, sales, and vending restrictions" [12]. A total of 31 states incorporated <br /> preemptive provisions in their tobacco control laws from 1982 through September 1998 [12]. <br /> During the past decade, as the public health community became aware of the damaging impact of <br /> state preemption laws, the number of new laws of this type fell sharply [14]. Eight states have <br /> rescinded provisions preempting local ordinances restricting smoking in workplaces and public places <br /> through legislative action, ballot measures, or state court rulings [14]. As a result, the number of <br /> states that preempt local smoking restrictions decreased from 18 at the end of 2000 to 12 at the end of <br /> 2010 [2,14]. However, 18 states still preempt local advertising restrictions and 22 states still preempt <br /> local youth access restrictions [2]. A total of 27 states preempt local restrictions in any of these three <br /> policy areas —local restrictions on smoking, advertising, and youth access [2]. North Carolina is one <br /> of only seven states that preempt local action in all three of these policy areas [2]. North Carolina also <br /> preempts local smoke-free air policies in private worksites, though not in restaurants, government <br /> worksites, or bars [2]. <br /> An example of the public health effect of rescinding preemption is provided by Illinois. In 2005, the <br /> Illinois Legislature passed legislation repealing a provision in state law preempting local smoking <br /> restrictions, effective January 1, 2006 [17]. During the next year, 36 Illinois communities adopted <br /> smoking restrictions [17]. Building on this local progress, in 2007 the Illinois Legislature enacted a <br /> comprehensive statewide law making workplaces and public places, including restaurants and bars, <br /> smoke-free, effective January 1, 2008 [17]. <br /> In summary, local restrictions on smoking in workplaces and public places, on advertising, and on <br /> youth access have played an important role in changing community social norms, reducing tobacco <br /> use and exposure to secondhand smoke, advancing our understanding of effective tobacco control <br /> interventions, and laying the groundwork for adoption of important tobacco control policies at the <br /> state level. State laws preempting local policy action prevent communities, states, and their residents <br /> from realizing these benefits and retard progress toward full adoption of comprehensive, evidence- <br /> based tobacco control interventions. This is especially true when these laws preclude local action in <br /> all three major local policy areas. <br /> Thank you for your interest in this important public health issue. Please let us know if you would like <br /> CDC to provide additional information regarding the evidence base for effective tobacco control <br /> interventions. <br /> Since y, <br /> Ti McAM.P.H. <br /> Director, Oking and Health <br /> National Conic Disease Prevention <br /> and <br /> Health Promotion, <br /> Centers for Disease Control and Prevention <br /> 4770 Buford Hwy, MS K-50 <br /> Atlanta, Georgia 30341 <br />