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The Cambridge Public Health Department and the Boston Public Health Commission led a successful campaign between 2001 and 2004 to protect workers in Greater Boston from exposure to environmental tobacco smoke. At that time, smoking was permitted in private workplaces under Massachusetts law.

Clean Air Works Campaign

Many restaurant owners in Cambridge and other Massachusetts communities opposed tougher smoking regulations because they believed they would lose their smoking clientele to restaurants and bars in neighboring municipalities with less stringent laws.

Acknowledging this concern, Harold Cox, former chief public health officer for the city of Cambridge; John O’Brien, former CEO of Cambridge Health Alliance; and John Auerbach, former director of the Boston Public Health Commission began thinking about a regional approach for securing smoke-free worksites.

In fall 2001, the Cambridge Public Health Department and Boston Public Health Commission invited neighboring communities to work together on a unified approach to establish smoke-free workplaces throughout the region. The result was “Clean Air Works,” a regional initiative to protect all workers in Greater Boston from exposure to environmental tobacco smoke and to educate communities about health risks posed by ETS.

By April 2004, 19 communities and more than 40 organizations had joined the Clean Air Works campaign. In December 2002, the Boston Public Health Commission took the lead by passing a health regulation that will eliminate smoking in all Boston restaurants and bars. In June 2003, the cities of Cambridge and Somerville passed similar bans.

Clean Air Works Partners

The key to Clean Air Works’ success was the collaborations it fostered among city governments, community members, health organizations, tobacco control advocates, businesses, workers, and unions. By 2004, Clean Air Works community members included 19 health departments and boards of health: Boston, Braintree, Brookline, Cambridge, Chelsea, Everett, Framingham, Holliston, Malden, Medfield, Medford, Needham, Norfolk, Newton, Revere, Saugus, Somerville, Watertown, and Wellesley.

Clean Air Works also included 40 organizational members, ranging from health advocates and community-based organizations to labor organizations and small businesses.

Public Awareness Activities

Community education and mobilization activities made tremendous progress toward educating the public about secondhand smoke exposure and creating local demand for policy change. Advocacy work included signature gathering and developing presentations, postcard campaigns, and paid advertisements.

Legislative Progress

The City of Cambridge, along with many other member communities, had legislation pending for months that would establish 100% smoke-free workplaces. In 2002, most cities and towns involved in Clean Air Works held public hearings, and in some communities, most notably Boston, the protective legislation was passed. By April 2004, 17 of the 19 communities belonging to the Clean Air Works campaign had passed legislation establishing 100% smoke-free workplaces. These communities are represented in bold type below.




Clean Air Works North

A sister initiative called Clean Air Works North was launched in nine North Shore communities in 2002. Other communities around the state demonstrated eagerness to repeat the example of Clean Air Works in their regions.

Challenges & Opportunities

Some challenges facing the Clean Air Works campaign in 2002 were:

  • Passing smoke-free workplace ordinances in CAW municipalities.
  • If the amendment is passed, implementation would present the next challenge. Local public health departments would need to work with restaurant and bar owners, the police, and the license commission in their communities to facilitate the transition to smoke-free workplaces.
  • On a larger scale, the devastating reduction of the state’s tobacco control budget posed the greatest challenge to tobacco control in Massachusetts. In 2002 alone, the Massachusetts Tobacco Control Program of the state public health department was slashed from $48.2 million to $31 million to $9.55 million, and finally to $5.8 million. Local public health officials feared that without the financial lifeblood of the tobacco control program, tobacco use in the Commonwealth would rise again after years of decline.

The Cambridge Story

In 1999, the Five City Tobacco Control Collaborative and the Cambridge Public Health Department led a successful campaign to strengthen the Cambridge tobacco control regulations. That June, the Cambridge City Council amended the city’s tobacco control ordinance, which further limited youth access to tobacco products and prohibited smoking in most restaurants. However, establishments whose primary income was derived from alcohol rather than food, or that had distinct bar areas or only served patrons over 18 years of age were given the option to apply for a "permit to allow smoking.”

The Cambridge tobacco control ordinance passed in 1999 had been successful in reducing smoking in many eating establishments, but it did not protect all bar and restaurant workers from exposure to secondhand smoke. These were the only workers in the city who were not protected from this environmental hazard.

During the 1999 ordinance amendment process, the Cambridge Public Health Department worked closely with area restaurant owners and the Massachusetts Restaurant Association. At that time, local restaurateurs predicted that tougher smoking regulations in Cambridge would cause them to lose business to neighboring communities.

Acknowledging this concern, the Cambridge Public Health Department launched the regional Clean Air Works campaign in 2001 to minimize the economic impact on local restaurateurs and bar owners.

After more than a year of intense debate among city councillors, restaurant owners and workers, residents, and health officials, the Cambridge City Council voted on June 9, 2003 to extend the city’s workplace smoking ban to include restaurants, bars, and private clubs. On June 12, 2003, the Somerville Board of Health voted to prohibit smoking in restaurants and bars. Both bans took effect on October 1, 2003.

"This is not about the ability to smoke or not,” said Harold Cox,


the chief public health officer for the city of Cambridge. “This is about having a safe environment for people to work in."


The Massachusetts Story

The Clean Air Works campaign and similar efforts throughout the Commonwealth helped win support for a statewide ban on workplace smoking. On July 5, 2004, Massachusetts became the sixth state in the nation to ban smoking in virtually all workplaces. Since then, the Clean Air Works model has been adopted by other states and U.S. cities as an effective strategy for passing smoke-free legislation.


Cambridge Public Health Department
119 Windsor Street
Cambridge, MA 02139
617-665-3800 (main)
617-665-3888 (fax)
617-643-0744 (TTY)

Hours: Monday-Friday:
8:30 a.m.–5 p.m.
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