Question of the Week

January 12, 2004


Forty years ago, the FDA was telling the public that cigarettes were bad.

Thirty years ago, students at some universities could sit in class and smoke without issue.

Twenty years ago, a study was underway to determine whether some cigarettes were healthier than others. Their results included:

  • "The risk of lung cancer was no different in people who smoked medium tar cigarettes, low tar cigarettes, or very low tar cigarettes
  • "Men and women who smoked non-filtered cigarettes with tar ratings 22 mg had even higher risks of lung cancer.
  • "All current smokers, regardless of the tar level of their current brand, had substantially greater risks of lung cancer than those people who had never smoked or who had quit smoking"

Ten years ago, California began putting significant restrictions on where cigarette smokers were allowed to smoke:

"In California, where the 1994 law took effect in stages, restaurants went smoke-free in 1995. Bars, taverns and casinos followed in 1998. After the legislation passed, there were repeated attempts over five years to convince legislators it should be changed, Glantz said. Yet, efforts to get the law repealed have been unsuccessful."

Last month, the issue was in the news from coast to coast.

In the Northwest:
"King County was scared off by legal questions. Puyallup backed down after opposition from the tobacco industry. Now Pierce County has decided to do what no community in Washington has done: ban smoking in all indoor, public places, including bars, taverns, restaurants and bowling alleys."

In the Northeast:
"Smoking ban makes 2004 a fresher start
Beginning tomorrow [January 1, 2004], more Mainers can breath easier, especially if they are hanging out -- or working -- at a saloon or even a pool hall."

In the same article which informs you that you can no longer smoke in public locations in Maine, you are given many reasons why these laws have been implemented:

  • "Consider the following information from U.S. and Canadian health agencies:
  • "Two-thirds of smoke from a cigarette is not inhaled by the smoker, but enters the air around the smoker.
  • "Second-hand smoke has at least twice the nicotine and tar as the smoke inhaled by the smoker.
  • "Second-hand smoke is a complex mix of more than 4,000 substances, at least 42 of which are known to cause cancer in humans and animals, and many more of which are strong irritants.
  • "Regular exposure to second-hand smoke increases the chances of contracting lung disease by 25 percent and heart disease by 10 percent.
  • "Second-hand smoke is the third-ranking known cause of lung cancer after active smoking and indoor radon.
  • "Second-hand smoke ranks third as a major preventable cause of death behind only active smoking and alcohol.
  • "Second-hand smoke aggravates symptoms in people with allergies and asthma, and can cause eye, nose and throat irritations, headaches, dizziness, nausea, coughing and wheezing in otherwise healthy people.
  • "Children have a higher metabolism and can absorb higher amounts of smoke than adults.
  • "Infants and children exposed to second-hand smoke are more likely to suffer chronic respiratory illness, impaired lung function, middle-ear infections, food allergies and can even succumb to sudden infant death syndrome.
  • "Electronic air-cleaning systems would need to increase the air-exchange rate a thousand fold to be effective -- resulting in gale-force winds.
  • "And the list goes on...."

Those who have been alive for this progression can remember:

"There was a time when the decision of whether to permit smoking in enclosed public places or in enclosed workplaces was primarily an issue of balancing smokers‚ convenience with the potential annoyance to nonsmokers. One reasonable, if not always effective, way to accommodate everyone was to have smoking and nonsmoking sections in restaurants, for example. This situation radically changed in the late 1980s as research on the health effects of second-hand tobacco smoke piled up. If even limited exposure to second-hand smoke could cause an asthmatic child to be hospitalized and consistent exposure could cause lung cancer and heart disease in nonsmokers, the convenience versus annoyance calculation had to be superceded by a public health calculation."

As these laws gradually enter the books across the country, there are still those who do not want you to forget that this is not a one-sided issue--and it is not just smokers who are against the new laws.

"The Illinois Restaurant Association has always opposed a government mandated smoking ban. The decision should be available for the individual restaurant operators and customers who patronize a restaurant, to be smoke free or allow smoking in specific areas. As an association of employers and business owners, the Illinois Restaurant Association is well aware how important it is to maintain a healthy workforce and cater to the wishes of our customers. In fact, the market has demanded an increasing level of restrictions on smoking. In recent years, the amount of non-smoking seats in Chicago restaurants and fully smoke-free restaurants has dramatically increased. Nearly all private office buildings are now smoke-free. The market, with the assistance of effective education campaigns, has created a strong anti-smoking bias, but we do not believe a total ban on smoking in most public places, and particularly in restaurants, is warranted....According to a report from KPMG on behalf of the American Beverage Institute, a majority of establishments (59.3%) experienced a decrease in business when the smoking ban went into effect in California. The average decline in sales was 26.2%. In addition, the City will receive less revenue from the decline of liquor sales normally associated with smoking bans."

Even those who argue that it is a business issue, and not just a health issue, are on both sides.

"Multnomah County loses $277 million annually due to tobacco-related problems, including health care costs and lost productivity, according to Oregon Health Division statistics. The health division also reports that 32 percent of county workers are exposed to secondhand tobacco smoke at work. At least 43 percent of the county's food-service workers were exposed to secondhand smoke while working, according to a 1998 survey. These statistics and others on the dangers of secondhand smoke in the workplace helped convince the Board of Multnomah County Commissioners, the county's public health authority, to adopt Ordinance 937, which requires most workplaces in the county to be smoke-free."

Questions of the Week:
Who should decide whether or not smoking is to be permitted in indoor public places? Should it be a legal issue, a business issue, a health issue, or a combination of issues? What information should be taken into account when making these decisions? What are the laws where you live? What choices do you have as a patron? What choices do local business owners have? How can the choices that you make as a patron affect the decisions of the business owners and the lawmakers?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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