More Kentuckians would hear lung cancer diagnoses from their physicians if the legislature weakens local smoke-free ordinances by imposing an exemption for cigar bars. (Getty Images)

House Bill 211 would threaten Kentuckians health by requiring local smoke-free ordinances to allow smoking in cigar bars. HB 211 could undo the dramatic public health protections afforded by the 44 strong smoke-free ordinances in Kentucky.

Smoke-free hospitality venues are popular. Tourists like to breathe smoke-free air.?

Kentucky has a long history of yielding authority to local municipalities. The Kentucky Supreme Court ruled local governments have the right and the responsibility to protect the public health by regulating smoking inside workplaces and buildings open to the public. Since 2003, 44 communities from Prestonsburg to Paducah have chosen to prohibit indoor smoking, including cigar smoking, equally in all establishments. HB 211 would leave local government powerless to regulate cigar and pipe tobacco smoking in hospitality venues.

Once cigar bars are exempt, there is nothing to stop other bars, hospitality venues or tobacco retailers from becoming cigar bars. In communities that allow indoor cigar smoking, youth and young adults may perceive that it is socially acceptable to use cigars and pipe tobacco, and they may get the false impression that cigars or pipes are safer or a status symbol.

If HB 211 becomes law, Kentuckians will pay more and suffer more from lung cancer, preterm births, emphysema, heart attacks, asthma? and youth smoking. The science is clear. Cigar and pipe smoke contain the same toxic chemicals found in cigarette smoke, including those that cause cancer. Strong smoke-free laws save lives and money by lowering smoking and saving health care costs. Smoke-free laws that exempt certain businesses, like cigar bars, do not confer these same benefits.

If a community with a smoke-free law wants to allow smoking in cigar bars, they already have the authority to do so. HB 211 takes away local communities’ ability to choose what’s best for their families and neighbors. It undermines home rule. It makes sense to leave local smoke-free laws up to local officials.

HB 211 would wipe away all the progress we have made in smoke-free protections in the state, plunging us from nearly 40% covered with strong smoke-free protections to 0%.?

This commentary also was signed by Lisa Maggio, PhD, RN, Lexington; Karma Clara Bryan, RN, PhD, Lexington; Alison Connell, Rockcastle County; Audrey Darville, PhD, APRN, CPAHA-Tobacco Treatment, Danville; Carol Riker, RN, MSN, Lexington.

They are members of Nurses who Stand Up for Health, made up of nurse practitioners, school nurse leaders, environmental health researchers and health policy experts, representing both political parties.

A United States postage stamp commemorated the development and 1955 federal approval of the polio vaccine. (Getty Images)

This commentary also was signed by Alison Connell, PhD, APRN, Rockcastle County;?Audrey Darville, PhD, APRN, CPAHA-Tobacco Treatment, FAANP, Danville;?Ellen J. Hahn, PhD, RN, FAAN, Lexington;?Lisa Maggio, PhD, RN, Lexington.

We count on the U.S. Senate to put the health of the nation first and not confirm Robert F. Kennedy Jr. as the secretary for the Department of Health and Human Services (DHHS). He is not qualified and would risk endangering the public’s health if charged with leading this agency.

We see an urgent need to preserve the exceptional public health advances our country has achieved over the past decades. Our country needs us now more than ever to stand up for health.

Health is neither political nor partisan. Health is more than the absence of disease. Public health is the foundation of a healthy society, free of disease and disability.?

Public health is essential to economic prosperity. If workers are sick, they are not productive. Workers need their health to be a productive member of society.?

If governmental leaders are not qualified, there are consequences. We would not recommend taking your car to a nurse to fix it. Just as you would not call a mechanic or a lawyer to care for people during a flu outbreak. We need a head of Health and Human Services who is qualified and has a broad understanding of public health. RFK Jr. has neither.?

RFK Jr. tries to sell his vision that we were healthier before we had vaccines, pasteurization of milk and fluoridation of water. This is not true. A lawyer or someone with no medical or public health background in charge of the nation’s health constitutes medical malpractice on a national scale. His call to eviscerate the vaccine program risks our children’s lives, subjecting them to potentially fatal diseases that currently exist only in the least developed nations.

The leader of DHHS must have a broad vision of public health and the qualifications necessary to evaluate and employ proven strategies based on science. RFK Jr. does not have the necessary qualifications to lead DHHS. The head of DHHS needs to move the nation forward, not backwards, basing decisions on the known public health successes and the latest science.

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Trust in science is essential to making good decisions about the health of the public. Science and regulatory agencies provide the best guidance to make reasonable decisions about health. If we ignore science, we are destined to go back to a time in the not too distant past when, for example, children died from (now) preventable childhood illnesses.?

RFK Jr. has a long history of being skeptical of vaccines. He would take us back to an era of sickness by stopping the clear march forward to population health. It has only been a generation since polio was a devastating illness; vaccines work! Between 1993 and 2023, routine vaccinations in the United States prevented 508 million cases of disease or death with direct savings of $540 billion.?

We can recall a time when we and those around us missed weeks of school with measles, rubella and chickenpox, to name a few. We knew people who suffered lifelong consequences of polio, were hospitalized or even died of measles, chickenpox and whooping cough. Fortunately, most people vaccinate their children today, trusting the public health guidance and clear evidence that vaccines will improve their lives. A leader who is skeptical of these benefits can harm us for generations to come.

Do we want to risk making Americans sick again? Do we want to return to a time when society expected children to die young? We would rather celebrate the long and healthy lives of our children, thanks to public health. Younger generations who have benefited from the monumental public health interventions such as vaccines should not be taken back to the era of our childhood.?

Vaccines are only one example of effective public health in a great nation. Clean air, avoidance of carcinogens in our soil and water, pasteurized milk that does not contain tuberculosis or avian flu are other hallmarks of a great nation.

Nurses who Stand Up for Health are a passionate team of highly educated nurses — with master’s or doctoral degrees — and a wide range of clinical experiences. We are nurse practitioners, school nurse leaders, environmental health researchers, and health policy experts. Nurses are highly qualified and trusted members of the medical team who care for the health of people and entire communities. During this extraordinary time of transition in the U.S., we take responsibility to care for and give voice to those in need.