Visitors flock to the French Quarter in New Orleans to partake in, or at least witness, pleasures that are legally forbidden in more restrained parts of the United States. You can drink in the streets. The bars don't have to close. Strip clubs advertise the performance of "world famous love acts." (We're pretty sure they don't mean exchanging flowers.) And for just a few more weeks, visitors are likely to encounter the shocking behavior of cigarette smokers casually lighting up indoors.
Much like "Sin City" Las Vegas, vice is part of the appeal of New Orleans. But whereas Vegas presents a marketed and manufactured experience, New Orleans is authentically libertine. Its laissez-faire attitude toward personal behavior is woven into the fabric of the city, which has thus far resisted the government-mandated lifestyle regulations that have swept into so many other places.
In April, however, New Orleans will become a bit more domesticated. In January, the city council voted to enact a comprehensive ban on smoking and vaping indoors. The proposal ignited debate, but its passage arrived with an air of inevitability. Smoking bans have successfully transitioned from California quirk to the new normal. The American Nonsmokers' Rights Foundation, which tracks smoking laws, reports that 36 states and nearly 900 cities have laws requiring bars and restaurants to be smoke free.
"New Orleans is a city where people have been largely free to make their own mistakes." — T. Cole Newton
Adding one more mid-sized city to the list may not seem like a big deal, but banning smoking in New Orleans is a symbolic success for the anti-smoking movement. Public health advocates will soon be able to take a victory lap around newly smoke-free bars in the French Quarter. Others will wistfully lament that the city has given up part of its unique charm, becoming a little more like the rest of the country. "New Orleans is a city where people have been largely free to make their own mistakes, and to many the smoking ban is, so far, the biggest step in a continuing effort to roll back that freedom," says T. Cole Newton, owner of the New Orleans bar Twelve Mile Limit, although he's quick to point out that plenty of permissiveness remains.
As in most cities, New Orleans' smoking ban debate centered on the trade-offs between the interests of business owners who fear lost patronage and the interests of customers and employees in avoiding secondhand smoke. It's an apt time to inquire into what's really at stake with smoking bans. Will the sky fall for bars and casinos in New Orleans? And will banning smoking save as many lives as advocates promise?
How do smoking bans impact the bottom line?
Owners of bars and others businesses that rely upon a smoking clientele worry that smoking bans will cause them to lose customers. Many fear that the loss won't be compensated with increased revenue from non-smokers who had previously stayed away. Measuring the economic impact of smoking bans can be difficult, since there are many other factors that can influence the hospitality industry — the performance of the economy in general, changing demographics and cultural tastes, and even the weather. Studies on the topic usually examine tax receipts or employment data before and after smoking bans go into effect. Are the fears of lost business justified? As with many questions regarding tobacco, the answer depends on whom you ask.
Anti-smoking advocates argue that smoking bans do not negatively impact the hospitality industry and may even increase revenues. Americans for Nonsmokers Rights goes so far as to claim that "the only negative economic effect that smoke-free laws have is on the tobacco industry itself." Research on the economic impact of smoking bans does suggest that their net economic impact is generally fairly small. A 2014 meta-analysis of 39 studies concludes that the existing literature shows "no substantial economic gains or losses" to the hospitality sector as a whole.
But that rosy conclusion only applies to the aggregate impact. Many of the published studies examine the hospitality sector as a whole, making no differentiation between bars and restaurants. Digging deeper into those that do yields a more complicated picture. These studies did not find a significant effect on restaurant sales, but total sales in bars showed a decline of six percent following the implementation of a smoking ban.
There could be economic benefits to bars that expand options for non-smokers while catering to smokers.
Another interesting finding is that although comprehensive smoking bans had a neutral impact on the hospitality sector, partial bans were associated with positive growth. This suggests that there could be economic benefits to policies that expand options for non-smokers while also allowing some businesses to cater to the preferences of a smoking clientele.
One unstudied complication unique to New Orleans bars is the legality of taking alcoholic drinks to go. T. Cole Newton voluntarily made his bar Twelve Mile Limit smoke free, but only after opening a patio. "Once a guest steps outside the front door to smoke, they're practically gone," he says. Bars in all cities have to deal with potentially losing customers when they step outside to smoke; the fact that guests in New Orleans can take drinks with them could make the problem even more acute. Newton predicts that bars that are unable to offer outdoor accommodations will be the hardest hit by the ban, and worries that noise from smokers who can no longer gather indoors will lead to greater restrictions on casual neighborhood bars.
The economic impact on gambling is also of particular interest to New Orleans. Data on this is harder to come by, but evidence suggests that businesses that rely on gambling may be negatively affected by laws that require smokers to head outside. Research on casinos in Illinois found that revenues declined by about 20 percent following the imposition of a statewide smoking ban, whereas riverboat casinos in nearby states saw very little change. A 2014 report from Oregon's Office of Economic Analysis concluded that a statewide smoking ban was a contributing factor causing massive declines in video lottery revenues. Anecdotal evidence collected on bingo parlors also suggests a negative impact, as does the failure of the Revel Casino in Atlantic City, which tried to lure gamblers by offering the first completely smoke-free facility in AC. For better or worse, forcing gamblers to disrupt play to take smoke breaks could plausibly harm New Orleans casinos.
Are indoor smoking and vaping bans justified?
With New Orleans' reliance on tourism, reputation for vice, and unusual drinking laws, it's difficult to extrapolate the potential economic impact from "culturally normal cities." But how will the ban affect bar-goers' health? The case for smoking bans has historically been predicated on the need to protect non-smoking bystanders — including restaurant employees — from the risks of secondhand smoke, the two most prominent of which are lung cancer and heart disease.
Ban advocates have hammered home the message that secondhand smoke is lethal. Upon the release of its 2006 report on secondhand smoke, the U.S. Surgeon General's Office warned that "breathing even a little secondhand smoke can be dangerous." In 2003, researchers in Helena, Montana made headlines around the world by claiming the city's smoking ban reduced the rate of heart attacks by 60 percent in just six months. Subsequent studies in other small cities also found dramatic results, lending support to the case for smoking bans in bars and restaurants.
But newer studies call this into question. Recent research on larger populations has found much smaller short-term declines in heart attacks associated with smoking bans — or often no relationship at all. A 2014 study published in the American Journal of Medicine concluded that the link between smoking bans and reduced heart attacks "may be substantially lower than originally estimated," explaining that small sample sizes, failure to account for existing downward trends in heart attack rates, and publication bias led researchers to overestimate the danger.
The effects of secondhand smoke may be smaller than once believed, but taken as a whole, evidence points to dangers from chronic exposure.
Recent research also suggests that non-smokers' risk of developing lung cancer from exposure to secondhand smoke may be smaller than once believed. Though many studies found a link, the effect has been difficult to replicate. For example, a 2013 large cohort study of 76,000 women in the Journal of the National Cancer Institute found no statistically significant association between lung cancer and secondhand smoke. "We've gotten smoking out of bars and restaurants on the basis of the fact that you and I and other non-smokers don't want to die," one of the study's authors told the journal. "The reality is, we probably won't."
That doesn't mean that no effect exists. "You have to look at the totality of the evidence," says Michael Siegel, a professor at the Boston University School of Public Health and a longtime advocate of smoking bans. "Individual studies may not have the statistical power to show that secondhand smoke causes lung cancer." Taken as a whole, however, he says they point to a real danger from chronic exposure to secondhand smoke, both for lung cancer and heart disease, that justifies restricting indoor smoking at bars and restaurants.
Outdoor bans are another matter. Although the New Orleans smoking ban does not include outdoor areas, many laws do. According to the Americans for Nonsmokers Rights Foundation, 322 local jurisdictions and five states have laws restricting smoking in outdoor dining areas. An additional 275 cities and counties, along with three states, also ban the use of e-cigarettes in smoke-free venues, even though the devices do not burn tobacco. The New Orleans ban joins with this contemporary trend, forcing users of e-cigarettes to go outside. Siegel is sharply critical of efforts to extend smoking bans to outdoor areas or to ban e-cigarettes. The anti-smoking movement, he says, "is now guided more by ideology and politics than by science." Siegel worries that in the long run, this may undermine support for smoking bans where they are most justified.
Changing cultural norms
Many smoking bans allow for some exceptions, and New Orleans residents will still have a few rooms of their own in which to light up. Cigar and hookah bars will still be able to operate, although they will not be allowed to permit cigarette smoking. They will also be protected from future competition, since only businesses operating as of December 2014 will granted exemptions from the ban.
"New Orleans... isn't going to change because you have to go outside to light up." — Newton
Nationally, however, the trend is clearly for more bans and fewer exceptions. In the 1980s, banning smoking on airplanes was seen as a major victory; today, hardly anyone would contemplate going back to smoke-filled cabins. To contemporary travelers, visiting a city that allows people to smoke in bars can seem an equally unpleasant anachronism. That's a substantial change in norms in a short amount of time.
To see that change arrive in the Big Easy is even more surprising and distresses those who love its free-wheeling nature. "While the fear that soon New Orleans will be just like every other American city is grounded in reality, it is also greatly exaggerated," says T. Cole Newton. "New Orleans has been weird, exotic, and dangerous for almost 300 years now, and that isn't going to change because you have to go outside to light up." Today, smoking ban advocates can look to New Orleans and say, "You've come a long way, baby." But don't be surprised if many residents, even the supportive ones, have their fingers crossed that the city goes no further.