"At least there's a discussion going on at a local and a state level as to what the appropriate course of action is," he said. "I think what has to happen is that those responsible for our health and safety and welfare need to have these challenges put before them, and the debate needs to go on as to how to best protect the public."
Last summer, Carmona released the 28th U.S. surgeon general's report titled "The Health Consequences of Involuntary Exposure to Tobacco Smoke," which outlined a number of deleterious effects of secondhand smoke and emphasized that even nonsmokers can and do develop disease from exposure to tobacco smoke.
"The debate is over. There is no safe level of secondhand smoke," he said. "This is a toxic substance. So every community should do what it can to achieve smoke-free environments because it is a health hazard."
Carmona said that while he would like to see individual people, businesses and communities respond to the surgeon general's report by making better health choices on their own, he believes there is a time and place for government intervention.
"I would prefer that people take the best information and make the decisions on their behalf as the standard," he said. "When they don't, I do think the government has a responsibility to inform and help to bring together policy that will protect the public, because ultimately if they don't, the government ends up paying for a lot of that health care in an increased disease burden and economic burden.
"As the individual expresses their right to smoke ... then where does that individual right end as you become disease laden and society has to pay for your health care?"
State Rep. Matthew Hill, R-Jonesborough, said recently that he believes some kind of smoking ban will pass in Tennessee this legislative session.
"It'll probably wind up being an administration bill," he said. "They'll let one Democrat who maybe needs a good headline carry the bill."
Hill said the word in Nashville is that 80 percent of Tennesseans want to see smoking banned, and whether that figure is accurate or not, the attention it has generated has turned the proposed legislation into "an emotional issue."
"It just gets rolling, and once it gets rolling you can't stop it," he said. "It's like a train, and you don't want to stand in front of that train, because what happens? You get run over."
Carmona dismissed criticism from individuals who allege that the science behind the surgeon general's report is flawed.
"When you hear some of the complaints or criticisms ... I always ask who is the person? Who do they work for? Where do they get their funding from? And sometimes you find a paper trail that goes back to the tobacco industry," he said.
"There have been very few detractors because the surgeon general's report on secondhand smoke was a report that took four years. It was not just the surgeon general, but scientists from around the country from different disciplines who came together.
"We have a consensus document from the world's leaders in science. It's not politics; this is science that says secondhand smoke is deleterious to your health at a cellular level. ... We know it causes cancers, it causes lung disease, it causes a higher incidence of other diseases and chronic lung problems like emphysema and so on. These are indisputable facts now, based on the science."
Tuesday was the second day of Carmona's two-day visit to Johnson City. He spent part of the day meeting with students from East Tennessee State University's College of Public and Allied Health.