Doctors’ Group Urges Tough Laws on Smoking : Health: Statewide ban on cigarette vending machines, lighting up in restaurants asked by County Medical Assn. Tobacco industry vows fight.

The Los Angeles County Medical Assn. Wednesday proposed tough anti-smoking legislation that would make California the country’s most inhospitable state to smokers.

The medical association wants statewide bans on cigarette sales through vending machines, and on smoking in restaurants, bars and hospitals. The measures, according to association President David Chernoff, are aimed at making it harder for youngsters to take up smoking, and at reducing health hazards from so-called passive smoking--the inhalation of smoke from the cigarettes of others.

The group expects swift endorsement of the measures next week by the California Medical Assn. at its annual delegates meeting, which would bring the full muscle of organized medicine in California to make the proposals law.

But as news of the doctors’ plan spread Wednesday, so did industry opposition.

“We, of course, will forcefully oppose it,” said Walker Merryman, spokesman for the Tobacco Institute in Washington, the trade association for cigarette manufacturers. Merryman said he wasn’t surprised by such a move in California. The first municipal ordinances banning smoking in public places were passed by California cities, he said, including the most restrictive one in the country, implemented by San Luis Obispo last summer. That ordinance prohibits smoking in all indoor public areas, including shops, restaurant, bars and recreation halls.

Such rules have served primarily to hurt the restaurant and bar business, Merryman said, without evident improvement in patrons’ health. Adoption of the medical association’s proposal would make California the most restrictive state in the country, he added.

“Sometimes, you know,” Merryman said, “those of us on the other coast believe that those in California are on another planet.”

The California Restaurant Assn., meanwhile, said it will oppose the measure because the proposed smoking bans target restaurants and bars, rather than all public places. The association changed its historic stance of opposing such restrictions last June, but the condition for its support is that the laws be statewide and affect all public gathering places.

“It is sending a very mixed message to the public; it is saying second-hand smoke is terrible but only in restaurants,” said Jo-Linda Thompson, lawyer for the association, adding that the medical association should have consulted with her group before going public with the proposal.

“I certainly have spent more time in airports with people smoking around me than I have in restaurants,” Thompson said. “If it is a carcinogen, then it should be prohibited in all public places: bowling alleys, shoe stores, video parlors, any public gathering place.”

The initiative comes on the heels of a plea last month by California’s health services chief, Dr. Kenneth Kizer for the state’s universities and public pension systems to sell off all tobacco-related investments as a statement against smoking.

Kizer is also spearheading a $271-million public education program aimed at reducing by 75% the number of state residents who smoke. An estimated 4 million Californians, many of them youths and minorities, currently smoke.

Chernoff said the association did not consult with Kizer in drafting its proposals, but is pleased with his leadership on the smoking issue. “It has become apparent to us now that smoking . . . is an addiction . . . and a disease,” Chernoff, a reformed smoker, said at a news conference in Los Angeles Tuesday.

A ban on vending machine cigarette sales would cut off a major source of cigarettes to children, Chernoff said. Surveys indicate that 90% of adult smokers began their habit as children or adolescents. Although California and 36 other states prohibit sales of cigarettes to people younger than 18, vending machines in public places permit children to circumvent that restriction.

Chernoff, a cancer specialist, defended the proposed restaurant and bar ban by citing statistics suggesting that as many as 100,000 Americans die each year from heart disease, lung cancer or other illnesses triggered by exposure to other people’s smoke.

“One of the pernicious things about passive exposure in restaurants and bars is that we eat slowly, so we have a long exposure,” he said.

A ban on smoking in hospitals would simply impose statewide what most hospitals have already done on their own, Chernoff said. The exceptions, he said, are mostly found among federally run Veterans Affairs medical centers, which are targeted specifically in the proposal.

Chernoff speculated that “a long tradition of smoking and availability of tobacco products in the military” had created a tolerance for smoking in these hospitals.

But Susan Fishbein, western regional spokeswoman for the VA, said that in 1989 the U.S. Veterans Administration (now called the Department of Veterans Affairs) adopted a policy of gradual abolition of smoking throughout the department. Many VA medical centers have since banned smoking or created separate areas for employees to smoke, Fishbein said.

In light of that national policy, Fishbein said the department probably would have no objection to the medical association’s proposals.

Two California cities, Santa Monica and Rancho Mirage, recently banned vending machine cigarette sales. Los Angeles and West Hollywood are considering similar bans. The Los Angeles City Council last year defeated a ban on smoking in restaurants.

Assemblyman Bruce Bronzan (D-Fresno), who is chairman of the Assembly’s Health Committee and an outspoken foe of smoking, said he welcomed the medical association’s efforts, but hoped the group would lend support to anti-smoking bills already before the Legislature.

Among those are measures to increase the tobacco tax by 10 cents a pack, permit cigarette vending machines only in bars or other places inaccessible to children, ban the free distribution of tobacco products and require licensing of tobacco sellers so that they could be penalized--like liquor sellers--for selling cigarettes or other tobacco products to minors.