They've been booted out of the workplace, restaurants, and bars.
Now, smokers in San Francisco are facing new restrictions not only on where they can light up, but where they can buy tobacco in the first place.
This city is weighing a new ordinance that would, in effect, prevent any new tobacco retail outlets in the city.
If approved, it would be one of America's most restrictive antitobacco measures, though it would follow a national pattern of getting tougher on smokers.
The move to squeeze tobacco businesses is one of the newest fronts in a national battle that has included massive legal settlements against the tobacco industry, and a growing web of state and local limits on tobacco use and availability.
While many cities and towns have taken steps to curtail how tobacco retailers advertise, the San Francisco approach goes directly after the businesses themselves. Advertising restrictions have been challenged in the courts as limits on freedom of expression, and some analysts say using land-use laws and zoning to curtail tobacco sales may be less vulnerable legally.
"It's a brand new tool," says Marice Ashe of the Technical Assistance Legal Center, which advises community organizations and cities on how to fight tobacco.
The "tool" was first used in Oakland, Calif., earlier this year. Plans for a tobacco retail outlet across from a neighborhood library so outraged locals that the city council approved a ban on any new large-scale tobacco stores near homes or facilities frequented by children. The areas roped off all but precluded new tobacco outlets in most of Oakland.
San Francisco is now attempting an even more sweeping ban, which would block any tobacco retail business in the city if it devotes more than 25 percent of its floor space to tobacco products.
Critics are already decrying the move as a politically motivated targeting of an unpopular, but legal, product.
Backers of the measure counter that smoking is a public health hazard and should be more tightly controlled.
"The social norms have changed," says Cynthia Hallett of Americans for Non-smokers' Rights. "This really isn't about pitting smokers against nonsmokers. It's about the health impact of smoking."
Cities across the country are enacting ever greater limits on where people can smoke. Anchorage, Alaska, recently joined the ranks of more than 170 cities and towns nationwide that prohibit smoking in workplaces and restaurants.
States are also increasingly active. Most now restrict smoking in government offices and indoor public places, from arenas to grocery stores. About half have non-smoking requirements on workplaces.
The San Francisco measure, introduced by Tom Ammiano, a member of the city's board of supervisors, would not close existing tobacco shops.
Ashe says cities are on solid legal footing in applying land-use laws to prohibit or control tobacco businesses - "as long as there is some reasonable purpose, like protecting children and health."
The Technical Assistance Legal Center has developed a template of the Oakland model and is offering it to other cities.
While attacking tobacco has become politically safe in many areas, the fate of such restrictions depends heavily on local dynamics. In Oakland, says Serena Chen of the American Lung Association, the measure sailed through the city council because it was driven by community outrage over the planned tobacco-store opening.
The San Francisco ordinance is not driven by any comparable example, though the city's left-leaning board of supervisors could well prove receptive.
California has long been out front on restricting smoking. It was the first large state to impose a controversial ban on smoking in bars two years ago.
Meanwhile, cities and counties nationwide are stepping up punishment of businesses that violate restrictions on tobacco sales, according to the National Lung Association. A number have a version of "three strikes, you're out" whereby a retailer can be shut down for a third offense such as selling to minors.
A major issue for antismoking advocates is how states spend billions of dollars from the 1998 settlement of a lawsuit against the tobacco industry. By one count, only 15 of the 46 states getting funds have made substantial commitments of the new money toward tobacco prevention.
Antismoking advocates were heartened by election results from Oregon and Arkansas, where voters showed support for spending more settlement money on prevention programs.
(c) Copyright 2000. The Christian Science Publishing Society