Making the Case

Northern Kentucky has a public-health crisis that is putting our children and our future at risk.


By just living in the Northern Kentucky region, our children are 18 percent more likely to develop cancer than anywhere else in the country.[1] In fact, the Commonwealth of Kentucky’s cancer mortality rate — 243.7 case per 100,000 people – is much higher than the states that surround it, including West Virginia (227), Indiana (217.8), Ohio (212.9), and Virginia (184).[2]

pie charts showing: NKY 24%; USA 14%Considering that 34 percent of cancer occurrences in Kentucky are associated with smoking-related illnesses [1](including secondhand smoke), smoking is a critical factor driving the high rates of cancer in our community.

Northern Kentucky has among the highest rates of smoking in both Greater Cincinnati and the United States. 

  • 24 percent of all adults in the Northern Kentucky region are smokers compared to 19 percent in Greater Cincinnati and 14 percent nationally. [3]
  • 38 percent of adults living in the nine-county North Kentucky Area currently use some type of tobacco product including cigarettes, e-cigarettes, cigars/cigarillos, and smokeless tobacco [3]

Worse, we are creating an entire new generation of potential smokers in our region as e-cigarette usage among Northern Kentucky children has spiked to historically high levels.

  • 31 percent of teen e-cigarette users are more likely to start smoking within six months after using e-cigarettes. [4]
  • More than 20 percent of Northern Kentucky’s 10th graders reported e-cigarette use in the past month. [5]
  • More than 27 percent of all high school students have used electronic cigarettes in the past month. [6]

Students sitting on campus: text that reads: More than 27 percent of all high school students have used an electronic cigarette in the past month

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Smoking is costing all of us (non-smokers and smokers) money and putting our community at an economic disadvantage.

Smoking is not only adversely affecting our population’s overall health, but it’s also impacting the pocketbook of every single taxpayer in Northern Kentucky. According to a study commissioned by the Campaign for Tobacco-Free Kids, Kentucky households pay on average $1,158 in federal and state taxes related to cover healthcare costs due to smoking-related illnesses.[7] Some other statistics:

$1.92 BILLION in annual healthcare costs

  • Kentucky’s annual healthcare costs are $1.92 billion due to smoking-related illnesses. [7]
  • Total smoking-related illnesses in Kentucky cost Kentucky taxpayers $590 million in annual Medicaid costs. [7]
  • The total healthcare cost per year, per smoker in Kentucky is $22,285.

Higher rates of smoking hamper our workforce productivity and make our region less attractive for economic development. Quality of life and the health of the workforce are key factors new companies consider when choosing to relocate or start new operations in a community.

Lost worker productivity due to smoking is estimated to cost Kentucky businesses $2.79 billion annually. [8] Every year, these businesses incur $5,816 per employee in lost productivity due to smoking-related illnesses. [8]

$5,816 per employee in lost productivity every year due to smoking.

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Comprehensive smoke-free ordinances reduce rates of smoking and overall healthcare costs.

Communities that have enacted comprehensive smoke-free ordinances have experienced lower rates of overall smoking, a reduction in second-hand smoking cancer rates, a decrease in healthcare costs, and a decline in rates of smoking among children.

Several research studies performed in communities that enacted a comprehensive smoke-free ordinance show a dramatic improvement in the overall health and healthcare costs of populations in these communities.

$21 Million in annual healthcare savings for Lexington, Ky

  • After Lexington, Kentucky passed a comprehensive smoke-free ordinance, the city saw a 32 percent reduction in adult smoking – 16,500 fewer smokers in the Lexington/Fayette County region. [9]
  • Because of its smoke-free ordinance, Lexington has seen approximately $21 million in annual healthcare savings. [9]
  • According to the Centers for Disease and Control, enacting comprehensive smoke-free ordinances in 387 U.S. counties led to a 20-21 percent decrease in hospital admissions in those communities.[10]

Public smoke-free ordinances also have a positive impact on the health of our children. 

  • Children living in counties with comprehensive smoke-free ordinances are 15 percent less likely to smoke. [11]
  • Students living in counties with comprehensive smoke-free ordinances are less likely to use smokeless tobacco. [11]

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Comprehensive smoke-free ordinances foster a more competitive business environment.

As a region, we’re in competition for new economic development with other nearby communities and regions across the United States. Enacting a comprehensive smoke-free ordinance saves local businesses money, improves productivity, and reduces potential legal liability.

  • Studies examining the impact of smoke-free ordinances in Kentucky as well as in other states show either a positive impact or no impact on the revenues of restaurants and bars. [12]
  • Employees at these businesses are less likely to miss work due to smoking-related illnesses. [12]
  • Businesses that allow smoking in the workplace pay increased health, life, and fire insurance premiums. [12]
  • Businesses that allow smoking in the workplace also pay higher workers’ compensation payments on average. [12]
  • Businesses have been found liable in lawsuits filed by sick employees seeking damages related to smoking in the workplace. [13]



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[1] CA Cancer J Clin 2019;69:7-34.© 2019 American Cancer Society – Table 12 Incidence Rates for Selected Cancers by State, United States 2011-2015
[2] CA Cancer J Clin 2019;69:7-34.© 2019 American Cancer Society – Table 13 Mortality Rates for Selected Cancers by State, United States 2012-2016
[3] Interact for Health. (2020) Tobacco Use in Northern Kentucky
[5] 2018 Kentucky Incentives Prevention Survey
[9] Science Direct – “Smoke-free laws and adult smoking prevalence” Ellen J. Hahn, Mary kay Rayens Karen M. Butler, Mei Zhang, Emily Durbin, Doug Steinke – University of Kentucky Study.
[13] Uhbi v. State Compensation Insurance Fund (CA, 1990).,  Magaw v. Middletown Board of Education (NJ, 1998)., Shimp v. New Jersey Bell (NJ, 1976)., Smith v. Western Electric Co. (MO, 1982)., McCarthy v. Department of Social and Health Services (WA, 1988).