May 11, 2017

The Honorable Brad Wenstrup
Chairman
Subcommittee on Health
Committee on Veterans’ Affairs
337 Cannon House Office Building
Washington, DC 20515

Dear Chairman Wenstrup:

We write in support of H.R. 1662, which would make facilities of the Veterans Health
Administration (VHA) smoke-free. Tobacco use is the leading preventable cause of death in the
United States and exposure to secondhand smoke has a significant impact on Americans’ health.

The Surgeon General has determined there is no safe level of exposure to secondhand smoke,
and sick and disabled veterans should not be subjected to secondhand smoke in order to receive
medical care. As a nation, we must do more to improve and protect the health of our veterans.
Providing a smoke-free VHA system for our veterans is an important step in the right direction.

Cigarette smoke contains more than 7,000 chemicals and compounds. Hundreds are toxic and at
least 69 cause cancer. A December 2016 U.S. Surgeon General report found that “e-cigarette
aerosol is not harmless and can contain harmful and potentially harmful constituents, including
nicotine.” The only effective way to protect people from secondhand smoke is to provide 100
percent smoke-free air. Designated smoking rooms, expensive ventilation systems and similar
partial approaches do not protect people from the dangers of secondhand smoke.

People with heart and lung disease are at higher risk for health complications if they are exposed
to secondhand smoke. According to a 2015 health survey of veteran enrollees’ health, of the 5.7
million users of VHA services in 2014, 5.2 percent, or nearly 300,000, had COPD; 25.5 percent,
or nearly 1.5 million, had hypertension; and 7.7 percent, or nearly 439,000, had coronary artery disease. These former service members will benefit more than most as a result of your bill.

Our organizations are pleased that your bill’s definition of ‘smoke’ includes the smoking of cigarettes, e-cigarettes, cigars, pipes, and any other combustible tobacco products. While we are strong supporters of H.R. 1662, we believe the legislation could be further strengthened to prohibit the use of smokeless tobacco products and to shorten the lengthy five year implementation date regarding the smoke-free outdoors policy at VHA facilities. We urge you to consider these recommendations as the bill proceeds through the legislative process.

We look forward to the improved health that veterans will enjoy as a result of this legislation.

Sincerely,

Action on Smoking & Health
American Academy of Family Physicians
American Academy of Oral and Maxillofacial Pathology
American Association for Dental Research
American Association for Respiratory Care
American Cancer Society Cancer Action Network
American College of Occupational and Environmental Medicine
American College of Preventive Medicine
American Dental Association
American Heart Association
American Lung Association
American Medical Association
American Medical Student Association
American Psychological Association
American Public Health Association
American Society of Clinical Oncology
American Thoracic Society
Americans for Nonsmokers’ Rights
Association of State and Territorial Health Officials
Association of Women’s Health, Obstetric and Neonatal Nurses
Campaign for Tobacco-Free Kids
ClearWay Minnesota
Community Anti-Drug Coalitions of America
Eta Sigma Gamma – National Health Education Honorary
International Association for the Study of Lung Cancer
Lung Cancer Alliance
National African American Tobacco Prevention Network
National Association of County and City Health Officials
National Association of Pediatric Nurse Practitioners
National Association of Social Workers
National Center for Health Research
National Hispanic Medical Association
National Latino Alliance for Health Equity
National Network of Public Health Institutes
Oncology Nursing Society
Prevention Institute
Public Health Solutions
Society for Cardiovascular Angiography and Interventions
Society for Public Health Education
Society for Research on Nicotine & Tobacco
Students Against Destructive Decisions
The Society of State Leaders of Health and Physical Education
The Society of Thoracic Surgeons
Trust for America’s Health