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Nine months and smoke-free: It’s already paying off

Nine months and smoke-free: It’s already paying off

Congratulations, Minnesota, for making it nine months smoke-free! I know that going smoke-free is old news, but I continue to hear the different sides of discussion even now.

As a physician, I have routinely been hearing cheers and jeers regarding the smoking restrictions. Most of the jeering is focused on an individual’s “right to smoke.”

I am not going to debate what is in the Bill of Rights we all hold so dear. Instead, I would like to bring forth evidence that is very well known to the medical community that supports a smoke-free workplace.

First, a statistic that startles me and should startle you: Secondhand smoke is attributed to 35,000 heart-related deaths and 3,000 lung cancer-related deaths among nonsmokers in the United States every year.

Risks of exposure studied for decades
This is unacceptable. The exposure of nicotine to nonsmokers who work in an environment with unlimited smoking has been studied for well more than 20 years.

The evidence was already clear that nonsmokers who are exposed to secondhand smoke are at a higher risk of smoking-related health problems than nonsmokers who are not exposed to secondhand smoke.

These studies are the basis of many smoking bans in places of employment.

There have been multiple studies looking at the effects of these bans. Here are just a few examples:

The British Medical Journal in 2004 found that there was a significant drop in admissions for heart attacks a mere six months after such a smoking ban was enforced. This study was done in Helena, Mont.

Quick damage to arteries’ inner layers
The New England Journal of Medicine in 1996 published an article that looked at the inner layer of blood vessels in young, healthy nonsmokers who are exposed to secondhand smoke and the vessels of habitual smokers.

Damage to the inner layer of the arteries is responsible for conditions such as heart attacks and strokes — two of the leading causes of death in the United States. After just 30 minutes of exposure to secondhand smoke, the damage to the inner layers of the arteries in the nonsmokers resembled those of the habitual smokers. Imagine what kind of damage can be done in a 12-hour shift serving tables!

In 1998, a study published by JAMA looked at bartenders in San Francisco. About 74 percent interviewed reported some type of respiratory symptoms before the smoking ban in bars.

At that time, they also had lung testing done. After the ban, of those having symptoms before the ban, 59 percent had complete resolution of their symptoms within one to two months. There was also an overall significant improvement of the lung tests just one to two months after the ban as well.

Bans help smokers as well
Although this is a secondhand smoking issue, I do want to point out the benefit of a workplace smoking ban to smokers.

California banned smoking in all restaurants in addition to enforcing “tobacco control,” which focused on education and prevention. Lung-cancer rates dropped by 29 percent in California men and 4.8 percent in California women in a 10-year period.

These just a few of many articles that show the dangers of secondhand smoking. And I haven’t even begun discussing effects of secondhand smoke on children and pregnant women in these establishments.

Many solutions other than smoking bans have been proposed. One of the more popular solutions is ventilation.

There are no studies showing ventilation reducing health-related problems from secondhand smoke. In fact, the manufacturers deny any such claim. Believe me, if a ventilation system manufacturer found a way to completely purify air, it would market these systems like crazy and get rich doing so.

Designations don’t help the staff
Another solution is having designated smoking establishments and nonsmoking establishments. This is fine for the patrons, but does not do any favors for the employees.

During hard times, people take jobs wherever they can get them. It is inevitable that nonsmokers would work in places that allow smoking because of a lack of choices in jobs.

Many people are worried about places closing because of the smoking ban. I know that several establishment owners have actually seen an increase in their business since the ban.

As a nonsmoker, I have enjoyed several establishments that I used to avoid because of the smoke. As someone who was pregnant last year, I was still able to do activities such as bowling and not expose my unborn child to secondhand smoke.

These businesses are now open to more people now that smoking is restricted, not less.

As a physician, I have already seen how this ban has helped people who work in bars finally quit smoking. I have patients who struggled quitting because they were around smoke at work. They have been more successful in quitting now that they are able to completely avoid secondhand smoking.

There are many other states starting to look at banning smoking in bars and restaurants. I’m proud to live in a state that chose health and I hope that our progress helps other states make that commitment as well.

Jennifer Holmes is a doctor at the Mid-Minnesota Family Medicine Center in St. Cloud. This article originally appeared in the St. Cloud Times.

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Comments (10)

  1. Submitted by Thomas Laprade on 07/18/2008 - 01:24 am.

    I have never met a true smoker who quit because of smoking bans.
    I think it is wishful thinking on Dr, jennifer Holmes part.
    The Helena Story and heart attacks has been debunked a year ago.

    First, a statistic that startles me and should startle you: Secondhand smoke is attributed to 35,000 heart-related deaths and 3,000 lung cancer-related deaths among nonsmokers in the United States every year.

    These figures have been derived by a risk computor called SAMMEC

    In other words no one on this planet ever got cancer or died soley from second-hand smoke

  2. Anonymous Submitted by Anonymous on 07/18/2008 - 04:57 pm.

    Air quality test results by Johns Hopkins University, the American Cancer Society, a Minnesota Environmental Health Department, and various researchers whose testing and report was peer reviewed and published in the esteemed British Medical Journal……prove that secondhand smoke is 2.6 – 25,000 times SAFER than occupational (OSHA) workplace regulations:

    All nullify the argument that secondhand smoke is a workplace health hazard.
    Especially since federal OSHA regulations trump, or pre-empt, state smoking ban laws which are not based on scientific air quality test results.
    Mark Wernimont
    Watertown, MN.
    US Supreme court decision 1992 NEVER OVERTURNED…

    A U.S. Supreme court decision during the early 1970’s ((Lloyd Corp v. Tanner, 407 U.S. 551 (1992)) said a place of business does not become public property because the public is invited in.

  3. Anonymous Submitted by Anonymous on 07/18/2008 - 11:06 pm.

    Air filtration can make the air of a venue that allows smoking cleaner than the air outdoors. Minnesota lawmakers were told over and over again but didn’t want to hear about it.

  4. Submitted by Thomas Laprade on 07/18/2008 - 01:28 am.

    There has never been a single study showing that exposure to the low levels
    of smoke found in bars and restaurants with decent modern ventilation and
    filtration systems kills or harms anyone.

    As to the annoyance of smoking, a compromise between smokers and non-smokers
    can be reached, through setting a quality standard and the use of modern
    ventilation technology.

    Air ventilation can easily create a comfortable environment that removes not
    just passive smoke, but also and especially the potentially serious
    contaminants that are independent from smoking.

    Thomas Laprade

  5. Submitted by Ryan Evans on 07/18/2008 - 02:24 pm.

    I find it all very amusing. Yes, the smugness of the victors is irritating, and at this point I think Minnesota is something of a lost cause for the time being…

    As long as you folks keep your mess on your own side of the river, I have no gripes. After all, that’s why we have states. One goes smoke free, another doesn’t, and then people are allowed to make a choice. Those who enjoy a nanny state stay West of the river, those of us who are adult enough to live our own lives and contend with any potential consequences of our choices can stay East.


  6. Anonymous Submitted by Anonymous on 07/18/2008 - 10:59 pm.

    Despite what former Surgeon General Carmona has said, controversy remains concerning secondhand smoke. According to the most recent Gallup Poll, nearly half of Americans are not convinced that secondhand smoke is a severe health risk. The controversy has been further fueled by a recent UCLA study, the longest-running and highest-quality secondhand smoke study ever done, completed “too late” (2003) to be included in Surgeon General Carmona’s report, that found no link between secondhand smoke and lung cancer or heart disease.

    We don’t know if secondhand smoke in a bar or restaurant ever killed anyone. But we do know that there is no need to burden Minnesota bars and restaurants with a smoking ban. Venues that allow smoking should instead turn to the same air filtration technology that other industries have installed to protect their workers from far more dangerous smoke and fumes. Affordable air filtration machines are readily available that will purify bar and restaurant air not only of tobacco smoke but also of all other toxins and pathogens, including viruses, bacteria, chemicals, pollen, dust, mold, fungi and, most importantly, radon decay products, which the EPA claims causes 21,000 lung cancer deaths per year, seven times more than secondhand smoke is reputed to cause. Minnesota bar and restaurant owners that want to allow smoking should be allowed to use air filtration technology to provide truly clean air to their patrons and employees.

  7. Submitted by John Olson on 07/18/2008 - 08:49 am.

    This is one of the very few public policy issues where the victors feel the occasional need to take yet another victory lap and gloat. You won. Move on. Help people without the preaching or smugness.

    Look, I personally prefer the smokefree restaurants and bars, but the tone of this commentary only serves to reopen tired old debates.

  8. Submitted by Robert Moffitt on 07/17/2008 - 10:03 am.

    It will be interesting to see if the next statewide health survey shows a decline in smoking rates decline among Minnesota adults.

    I suspect it will, as that has been the pattern in other states. In California, which has had a comprehensive statewide law in place for a decade, adult smoking rates are among the lowest in the nation — less than 15% of adult Californians smoke.

  9. Submitted by Robert Moffitt on 07/21/2008 - 07:53 am.

    Some have you folks have come a long way to comment on this Minnestoa site! Well, that’s the Internet for you. It’s a small (and increasingly smoke free) world after all.

  10. Anonymous Submitted by Anonymous on 08/11/2008 - 11:26 pm.

    I have a confession to make. I do have an axe to grind when it comes to this subject. I will attempt to refrain from writing about my own personal views and try to be objective.

    First of all, bravo for finding an article that shows there is no causal relationship between second hand smoke and health problems. It was published in BMJ, a respected journal. I have to say, I am disappointed a journal like BMJ would publish such rubbish. The author, although he never directly received funds from tobacco companies, he did receive funds indirectly from tobacco companies. Also, nothing is said about SHS exposure the non-smoking spouses of non-smokers. What exposure did they have in activities throughout the day? Maybe they worked all day at a bar that allowed smoking.

    When you talk about critical reading of scientific studies, you have to look at the methods and study design. This article has been discredited throughout the scientific community. Our own JAMA wrote a letter to James Enstrom (one of the authors) that said “The editors believe that this opinion piece is full of speculative assumptions of doubtful scientific value. We could not judge the merits of your criticisms because your own data and methods were so inadequately described. I should add that your article contains perjorative comments that should have no place in responsible scientific discourse.”

    Also, James Enstrom has been active in FORCES and other pro-smoking groups. How can he not have conflict of interest?

    Maybe there are more dangerous substances out there. Just because there are more dangerous substances, how does that justify exposing the general public to cigarette smoke?

    I would like someone to name one air ventilation system that claims to reduce negative health issues when used to “protect” non-smokers from cigarette smoke. Enlighten me please. And, even if you can name one, would bar and restaurant owners be able to afford it?

    Mr. Wisconsin: it’s only a matter of time before we get your state as well… Believe it, we are already trying.

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