[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2005 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                S. 2005

  To amend the Public Health Service Act to provide education on the 
  health consequences of exposure to secondhand smoke, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 3, 2007

Mrs. Clinton (for herself, Mr. Sanders, and Mrs. Murray) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To amend the Public Health Service Act to provide education on the 
  health consequences of exposure to secondhand smoke, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Secondhand Smoke Education and 
Outreach Act of 2007''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Secondhand smoke contains more than 50 carcinogens 
        (California Environmental Protection Agency, 2005; ``The Health 
        Consequences of Involuntary Exposure to Tobacco Smoke'', A 
        Report of the Surgeon General, 2006).
            (2) Secondhand smoke causes approximately 46,000 cardiac 
        deaths in the United States annually (California Environmental 
        Protection Agency, 2005).
            (3) Secondhand smoke causes 3,000 lung cancer deaths a year 
        in the United States (California Environmental Protection 
        Agency, 2005).
            (4) There is a causal relationship between infants' and 
        children's exposure to secondary smoke and their development of 
        lower respiratory illnesses. Involuntary exposure to tobacco 
        smoke causes an estimated 150,000 lower respiratory tract 
        infections each year in infants and children under 18 months of 
        age. These illnesses result in as many as 15,000 
        hospitalizations every year (``Respiratory Health Effects of 
        Passive Smoking: Lung Cancer and Other Disorders'', 
        Environmental Protection Agency, 1992; ``Health Effects of 
        Exposure to Environmental Tobacco Smoke'', National Cancer 
        Institute Report, 1999; ``The Health Consequences of 
        Involuntary Exposure to Tobacco Smoke'', A Report of the 
        Surgeon General, 2006).
            (5) Children exposed to secondhand smoke are at an 
        increased risk for acute respiratory infections and more severe 
        asthma, among other diseases (California Environmental 
        Protection Agency, 2005; ``The Health Consequences of 
        Involuntary Exposure to Tobacco Smoke'', A Report of the 
        Surgeon General, 2006).
            (6) Secondhand smoke exposure has both immediate and long-
        term adverse health effects on the adult cardiovascular system. 
        Exposure to secondhand smoke for 30 minutes can damage coronary 
        arteries, potentially leading to the constriction of blood 
        vessels, abnormal fatty deposits in arteries, and blood clot 
        formation. Sustained exposure to secondhand smoke can increase 
        the risk of coronary heart disease by 25 to 30 percent (Otsuka 
        et al., ``Acute Effects of Passive Smoking on the Coronary 
        Circulation in Healthy Young Adults,'' Journal of the American 
        Medical Association, 2001; ``The Health Consequences of 
        Involuntary Exposure to Tobacco Smoke,'' A Report of the 
        Surgeon General, 2006).
            (7) Living with a smoker increases a non-smoker's risk of 
        developing lung cancer by 20 to 30 percent (Hackshaw et al., 
        ``The Accumulated Evidence on Long Cancer and Environmental 
        Tobacco Smoke.'' British Medical Journal, 1997; Zhong et al., 
        ``Exposure to Environmental Tobacco Smoke and the Risk of Lung 
        Cancer: A Meta-Analysis.'' Lung Cancer, 2000; ``The Health 
        Consequences of Involuntary Exposure to Tobacco Smoke'', A 
        Report of the Surgeon General, 2006).
            (8) The Surgeon General declared that there is no safe 
        level of exposure to secondhand smoke.
            (9) Although more than 20 States have passed smoke-free 
        laws, including laws that ban smoking in restaurants and bars, 
        Americans of all age groups are involuntarily exposed to 
        tobacco smoke through exposure in workplaces, homes, cars, 
        apartments, and even outdoor public spaces.
            (10) Annually, an estimated 11 percent of American children 
        aged 6 years were reported to be exposed to secondhand smoke in 
        their homes on a regular basis. Nearly 60 percent of children 
        between the ages of 3 and 11 years of age are exposed to 
        secondhand smoke each year (``The Health Consequences of 
        Involuntary Exposure to Tobacco Smoke'', A Report of the 
        Surgeon General, 2006).
            (11) Air conditioning, ventilation, and heating systems can 
        not reduce or eliminate the risks associated with exposure to 
        secondhand smoke in indoor environments (ASHRAE position 
        document on environmental tobacco smoke, American Society of 
        Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), 
        2005).
            (12) Racial and ethnic minorities in the United States have 
        higher rates of occupational exposure to secondhand smoke, with 
        Latinos and Native Americans having the highest rates (National 
        Cancer Institute, 1997).
            (13) Nationally, an estimated of 20.9 percent of American 
        adults currently smoke cigarettes. This statistic includes the 
        estimated 16.2 percent of Hispanic adults, 13.3 percent of 
        Asian Americans, 21.9 percent of Caucasians, 21.5 percent of 
        African Americans, and 32.0 percent of American Indians/Alaska 
        Natives who smoke cigarettes in the United States (Centers for 
        Disease Control and Prevention, 2005).
            (14) Nationally, an estimated 69.5 percent of current adult 
        smokers want to quit smoking, this includes the estimated 61.5 
        percent of Hispanic adult smokers, 70.3 percent of Caucasian 
        adult smokers, 70.7 percent of African American adult smokers, 
        and 68.8 percent of Asian American adult smokers who want to 
        quit smoking (National Center for Health Statistics, 2005).
            (15) Racial and ethnic minority communities are 
        disproportionately targeted with advertising campaigns for 
        tobacco products (U.S. Department of Health and Human Services, 
        1998).
            (16) The tobacco industry has contributed to primary and 
        secondary schools, funded universities and colleges, and 
        supported scholarship programs targeting racial and ethnic 
        minorities. Tobacco companies have also placed advertising in 
        community publications and sponsored cultural events in racial 
        and ethnic minority communities (U.S. Department of Health and 
        Human Services, 1998).

SEC. 3. SENSE OF CONGRESS ON HEALTH AND ENVIRONMENTAL CONSEQUENCES OF 
              SECONDHAND SMOKE.

    It is the sense of Congress that--
            (1) scientific research has found that children and adults 
        suffer adverse health consequences from exposure to tobacco 
        smoke;
            (2) individuals, especially children, who do not smoke 
        should not be exposed to tobacco smoke;
            (3) there is a continued need for--
                    (A) the dissemination of educational material on 
                the adverse health consequences of secondhand smoke; 
                and
                    (B) parents to receive education about the adverse 
                health consequences that they and their children may 
                suffer as a result of exposure to tobacco smoke so that 
                they no longer expose their children and themselves to 
                secondhand smoke; and
            (4) in order to lessen the human and economic toll of 
        tobacco, it is critical that the Department of Health and Human 
        Services take action to ensure that all healthcare 
        professionals receive training in the delivery of evidence-
        based tobacco dependence treatment.

SEC. 4. GRANTS FOR EDUCATION CAMPAIGNS ON THE CONSEQUENCES OF 
              SECONDHAND SMOKE IN MULTI-UNIT HOUSING, DEMONSTRATION 
              PROJECTS TO SUPPORT EDUCATION IN PUBLIC SPACES ON THE 
              CONSEQUENCES OF SECONDHAND SMOKE, AND TOBACCO CONTROL 
              EDUCATION.

    Part A of title V of the Public Health Service Act (42 U.S.C. 290aa 
et seq.) is amended by adding at the end the following:

``SEC. 506C. GRANTS FOR EDUCATION CAMPAIGNS ON CONSEQUENCES OF 
              SECONDHAND SMOKE IN MULTI-UNIT HOUSING.

    ``(a) In General.--The Secretary, acting through the Administrator 
and in consultation with the Secretary of Housing and Urban 
Development, shall award grants for the implementation of educational 
campaigns, developed or disseminated, with emphasis on, but not limited 
to, organizations that involve the participation of youth, on the 
health consequences of secondhand smoke in multi-unit housing.
    ``(b) Requirements.--To be eligible to receive a grant under this 
section an entity shall--
            ``(1) be a private nonprofit entity, a State or local 
        Government, a faith-based or community-based organization, or 
        other tax exempt organization;
            ``(2) not accept anything of value from, or have any 
        affiliation or contractual relationship with, any tobacco 
        company, its affiliates, its subsidiaries, or its parent 
        company, or enter into any affiliation or contractual 
        relationship that could create a conflict or perceived conflict 
        of interest at any time during the term of the grant; and
            ``(3) include with any grant application, a statement that 
        discloses information (if any) on the applicant's existing 
        affiliations and contractual relationships with tobacco 
        companies or their subsidiaries.
    ``(c) Considerations in Awarding Grants.--
            ``(1) In general.--In awarding grants under this section, 
        the Secretary, to the extent feasible and acting through the 
        Administrator, shall ensure that--
                    ``(A) grant activities are funded in a variety of 
                geographic areas, including urban and rural areas and 
                frontier areas as well as American Indian/Alaskan 
                native and native Hawaiian communities; and
                    ``(B) grant activities impact a variety of 
                populations, including racial and ethnic minorities, 
                including American Indian, native Alaskan, native 
                Hawaiian, and low-income.
            ``(2) Special consideration.--In awarding grants under this 
        section, the Secretary shall give special consideration to--
                    ``(A) organizations whose participants include 
                secondary school or college-age individuals and that 
                provide adult supervision and mentorship; and
                    ``(B) organizations that reach racial or ethnic 
                populations that experience a disproportionate share of 
                the cancer burden through community-based participation 
                in education, research, and training.
    ``(d) Duration.--A grant shall be awarded under this section for a 
period of not to exceed 3 years, with an extension period of an 
additional 2 years, at the discretion of the Secretary.
    ``(e) Application.--To be eligible to receive a grant under this 
section, a entity shall--
            ``(1) submit an application to the Secretary (at such time, 
        in such form, and containing such information as the Secretary 
        may specify); and
            ``(2) agree to report to the Secretary a description of the 
        manner in which grant funds were used, and the degree of 
        dissemination of the information produced under the grant 
        concerning the health consequences of exposure to secondhand 
        smoke in multi-unit housing.
    ``(f) Evaluation.--Not later than July 31 of the second calendar 
year after the date of enactment of this section, and July 31 of every 
year thereafter, the Secretary shall submit to Congress a report, 
consistent with the Government Performance and Results Act of 1993, 
evaluating the activities conducted under grants awarded under this 
section for such year.
    ``(g) Supplement, Not Supplant.--Funds made available under this 
section shall supplement, and not supplant, other Federal, State, or 
local funds available to an entity to carry out activities of the type 
described in this section.
    ``(h) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out this section 
for fiscal year 2008 and each fiscal year thereafter.

``SEC. 506D. DEMONSTRATION PROJECTS TO SUPPORT EDUCATION IN PUBLIC 
              SPACES ON CONSEQUENCES OF SECONDHAND SMOKE.

    ``(a) In General.--The Secretary, acting through the Administrator, 
shall award grants to public and private nonprofit entities for the 
conduct of projects to demonstrate ways of educating the public about 
the health consequences of secondhand smoking in public spaces, 
including public parks, playgrounds, and national parks.
    ``(b) Requirement.--To be eligible for a grant under this section--
            ``(1) the grantee shall be a private nonprofit entity, a 
        State or local government, an Indian or tribal organization, a 
        faith-based or community-based organization, or other tax 
        exempt organization;
            ``(2) the project to be carried out by the entity under the 
        grant shall be designed to provide information on the health 
        consequences of secondhand smoking in public spaces, including 
        the findings from the 2006 Surgeon General's report entitled 
        `The Health Consequences of Involuntary Exposure to Tobacco 
        Smoke';
            ``(3) the grantee may not accept anything of value from, or 
        have any affiliation or contractual relationship with, any 
        tobacco company, its affiliates, its subsidiaries, or its 
        parent company, or enter into any affiliation or contractual 
        relationship that could create a conflict or perceived conflict 
        of interest at any time during the term of the grant; and
            ``(4) the grantee shall include with any grant application, 
        a statement that discloses information (if any) on the 
        applicant's existing affiliations and contractual relationships 
        with tobacco companies or their subsidiaries.
    ``(c) Considerations in Awarding Grants.--
            ``(1) In general.--In awarding grants under this section, 
        the Secretary, to the extent feasible and acting through the 
        Administrator, shall ensure that--
                    ``(A) projects are funded in a variety of 
                geographic areas, including urban and rural areas and 
                frontier areas as well as American Indian/Alaskan 
                native and native Hawaiian communities; and
                    ``(B) a variety of populations, including racial 
                and ethnic minorities, including American Indian, 
                native Alaskan, native Hawaiian, and low-income 
                populations, are served by projects funded under this 
                section.
            ``(2) Special consideration.--In awarding grants under this 
        section, the Secretary shall give special consideration to
                    ``(A) organizations whose participants include 
                secondary school or college-age individuals and that 
                provide adult supervision and mentorship; and
                    ``(B) organizations that reach racial or ethnic 
                populations that experience a disproportionate share of 
                the cancer burden through community-based participation 
                in education, research, and training.
    ``(d) Duration.--A project may receive funding under a grant under 
this section for a period of not to exceed 3 years, with an extension 
period of an additional 2 years, at the discretion of the Secretary.
    ``(e) Application.--To be eligible to receive a grant under this 
section, a public or private nonprofit entity shall--
            ``(1) submit an application to the Secretary (at such time, 
        in such form, and containing such information as the Secretary 
        may specify); and
            ``(2) agree to report to the Secretary the information, and 
        accompanying citations, on health consequences of exposure to 
        secondhand smoke that will be disseminated through the 
        demonstration project.
    ``(f) Evaluation.--Not later than July 31 of the second calendar 
year after the date of enactment of this section, and July 31 of every 
year thereafter, the Secretary shall submit to Congress a report 
evaluating the projects receiving awards under this section for the 
year involved.
    ``(g) Supplement, Not Supplant.--Funds made available under this 
section shall supplement, and not supplant, other Federal, State, or 
local funds available to an entity to carry out activities of the type 
described in this section.
    ``(h) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out this section 
for fiscal year 2008 and each fiscal year thereafter.

``SEC. 506E. GRANTS FOR THE IMPLEMENTATION OF REGIONAL OR LOCAL TOBACCO 
              CONTROL EDUCATION FOR HEALTH CARE WORKERS AND PROVIDERS.

    ``(a) In General.--The Secretary, in consultation with the 
Administrator, may award competitive grants to eligible entities to 
implement regional or local education programs at medical schools, 
hospitals, health centers and Federally qualified health centers, and 
rural health clinics as well as through medical professional membership 
organizations to provide health care providers and workers (including 
primary care physicians, nurses, licensed mental health professionals, 
and addiction counselors) with minimum tobacco cessation training as 
part of their ongoing medical education.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a) an entity shall--
            ``(1) be a--
                    ``(A) medical school;
                    ``(B) hospital (including a hospital that provide 
                services to low income and underserved populations such 
                as critical access or disproportionate share hospitals 
                as well as native hospitals);
                    ``(C) health center or Federally qualified health 
                center;
                    ``(D) medical professional membership organization; 
                or
                    ``(E) rural health clinic or American Indian/
                Alaskan native and native Hawaiian clinic;
            ``(2) demonstrate that the entity has included tobacco 
        cessation training to improve healthcare quality and curricula;
            ``(3) ensure that healthcare providers will be required to 
        complete course work in training curricula as described in 
        subsection (e), appropriate to their practice, regarding 
        treatment of tobacco use and dependence;
            ``(4) not accept anything of value from, or have any 
        affiliation or contractual relationship with, any tobacco 
        company, its affiliates, its subsidiaries, or its parent 
        company, or enter into any affiliation or contractual 
        relationship that could create a conflict or perceived conflict 
        of interest at any time during the term of the grant; and
            ``(5) prepare and submit to the Secretary an application in 
        accordance with subsection (c), that includes a statement that 
        discloses information (if any) on the applicant's existing 
        affiliations and contractual relationships with tobacco 
        companies or their subsidiaries.
    ``(c) Application.--To be eligible to receive a grant under this 
section, an entity shall--
            ``(1) submit an application to the Secretary (in such form, 
        containing such information, and at such time as the Secretary 
        may specify); and
            ``(2) agree to report to the Secretary standardized 
        performance data necessary to facilitate evaluations across 
        participating programs.
    ``(d) Use of Funds.--Amounts received under a grant under 
subsection (a) shall be used to establish and implement a regional or 
local tobacco control education program for health care workers in 
accordance with this section. Such education program may include 
cessation training relevant to other substances (legal or illegal, 
including alcohol and drugs). Grantees may provide services under a 
grant under this section through the use of technology, including 
telemedicine technology, to educate patients about tobacco use 
remotely, as opposed to educating patients through person-to-person 
contact.
    ``(e) Training Curricula.--
            ``(1) Purpose.--The training curricula to be funded under 
        this section shall provide the knowledge and skills necessary 
        to implement evidenced-based strategies to--
                    ``(A) assist smokers to quit smoking;
                    ``(B) educate smokers and nonsmokers about the 
                health consequences of secondhand smoke; and
                    ``(C) promote at the community level, as well as 
                the healthcare system level, self-sustaining networks 
                for the delivery of affordable, accessible, and 
                effective cessation services.
            ``(2) Content.--The training curricula to be funded under 
        this section shall--
                    ``(A) be consistent with the recommendations of the 
                Public Health Service Clinical Practice Guideline: 
                `Treating Tobacco Use and Dependence' and the 
                Department of Health and Human Service Interagency 
                Committee on Smoking and Health's `National Action Plan 
                for Tobacco Cessation';
                    ``(B) ensure that individuals providing tobacco 
                cessation services have received education and training 
                consistent with current best practices described in 
                this section and have demonstrated competency in core 
                skills associated with such practices;
                    ``(C) enhance the capacity of communities to 
                provide tobacco cessation services at multiple levels 
                of intensity; and
                    ``(D) incorporate--
                            ``(i) behavioral treatment;
                            ``(ii) pharmocotherapy;
                            ``(iii) relapse prevention; and
                            ``(iv) smoking cessation in special 
                        populations including pregnant women, 
                        adolescents, and individuals with comorbidities 
                        including psychiatric illness and other 
                        chemical illnesses.
    ``(f) Evaluation.--
            ``(1) In general.--Not later than July 31 of the second 
        calendar year after the date of enactment of this section, and 
        July 31 of every year thereafter, the Secretary, in 
        consultation with the Administrator, shall submit to Congress a 
        report evaluating the tobacco cessation education programs 
        receiving awards under this section for such year.
            ``(2) Contracts.--The Secretary, in consultation with the 
        Administrator of the Substance Abuse and Mental Health Services 
        Administration, may enter into contract where appropriate, with 
        public health organizations with established infrastructure, 
        research, and experience for the conduct of evaluations of 
        tobacco dependence treatment and educational programs under 
        this section.
    ``(g) Clarification.--An eligible entity that receives a grant 
under this section shall not mandate tobacco use training as a 
condition of employment.
    ``(h) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2008 through 2012.''.
                                 <all>