Family physicians for Proposition N
By Dr. Walt Sumner, President, St. Louis Academy of Family Physicians
The St. Louis Academy of Family Physicians supports the St. Louis County clean indoor air proposal for the following reasons:
1. Fine particles in tobacco smoke hurt smokers and non-smokers alike.
These fine particles carry all sorts of chemicals and cause all kinds of heart and lung trouble. It is hard to separate non-smokers from these fine particles or to remove the particles by ventilation. The less ventilated the space, the thicker and more dangerous these particles get.
Studies suggest that indoor smoke could cause 1,000 asthma attacks among non-smoking children and adults in St. Louis County each year. Clean restaurant air would prevent many attacks, scores of hospital visits, and possibly a few deaths.
Studies show that indoor smoking bans are associated with an immediate drop in heart attack risk. Tobacco smoke probably causes scores of heart attacks among non-smokers in St. Louis County each year. Clean restaurant air would prevent many heart attacks, dozens of hospital visits, and probably a few deaths.
Studies suggest that indoor cigarette smoke could cause a dozen cases of lung cancer in non-smokers in St. Louis County each year. Clean restaurant air would prevent these deadly cancers.
Whether or not the smoking ban passes, please remember that fine particles in tobacco smoke hurt you and the people who matter to you. We ask you not to smoke in homes where children live. Smoke does not go away before the children get home. Smoke anywhere in the house will reach your children’s rooms. Please do not smoke in your car, even by yourself, unless you have a convertible. Holding your cigarette next to a half-open window still increases the number of fine particles in the car to 15 times normal. With the windows closed, you can hit 200 times normal. This is bad for you and your passengers. You do not have to wait for a ban to show people that you care about them.
2. Injuries caused by tobacco smoke affect all of us.
We sympathize with business owners who resent government intrusion and the cost of adapting to changing rules. Nevertheless, we expect that the costs of health problems caused by indoor tobacco smoke outweigh any commercial benefits of indoor smoking. If you buy insurance, get insurance as an employee benefit or pay FICA taxes, then you pay for injuries from indoor smoke. Opponents of clean indoor air need to explain how the burden of a clean air ordinance could outweigh the burden of indoor smoking.
3. The clean indoor air proposal is not perfect, but it is a start.
Some health advocates are disappointed that the proposal does not protect all workers. We share their concern. Partial smoking bans can delay passage of comprehensive smoking bans. The tobacco and hospitality industries will work hard to avoid stronger regulation.
Nevertheless, family medicine is a practical specialty. A comprehensive ban is not an option this year, but we can start to protect our children and neighbors from tobacco smoke as they dine and work. We can hope that exempted franchises will choose to compete for non-smokers’ business.
We can hope that smoke-free nicotine products will make it easier for everyone to stop breathing tobacco smoke. In the meantime, a thousand asthma attacks and dozens of funerals would be a high price to pay to wait another year. Let’s start clearing the air now.
Dr. Sumner and the St. Louis Academy of Family Physicians -
Thank you for your endorsement of Proposition N. It’s truly an issue of public health. YES ON N!
I hate smoking people. They are the dumbest, most worthless people on the planet. Come on folks, they are in the minority. Let’s get this passed. Does anyone know if a tax increase on tobacco is on this proposition as well? It needs to be higher. If these people are going to be morons, we might as well fund a few government programs off their ignorant actions.
There is a simple solution to all of this!
If smokers embrace electronic cigarettes, then the issue of smoking bans will be mute. There is no second-hand smoke, no odor, no carcinogens, no CO2, and no mess like ashes, butts, etc. from electronic cigarettes. If smokers of tobacco cigarettes would switch their habit to a non-tobacco electronic cigarette, we would have no further need to further infringe on the personal freedoms of any one group. Whether you are a smoker, or a non-smoker, you should learn more about this technology.
If you are smoker, consider it as an option. You won’t be inhaling all the chemicals and carcinogens that you currently do from your tobacco cigarette.
If you are a non-smoker, learn about the technology, and pass the information on to your friends who are smokers. The electronic cigarette is a win-win in so many ways.
You can learn all about this technology at my website, http://www.NoTobacco.net
Thank you.
Think - “I hate smoking people. They are the dumbest, most worthless people on the planet.”
Hey “think”…. you might want to do what your name says….. Way to round up support by throwing insults, stereo-types, and overall general hate speech out there….. *rolls-eyes*…. You should be ashamed of yourself, and STLToday should remove your comments and let the adults get back to reasonable, polite debate.
Smoking bans increase the exposure of young children to secondhand smoke:
http://www.ucl.ac.uk/media/library/smokingban
A recently released study by researchers from the Rand Corporation, the Congressional Budget Office, the University of Wisconsin, and Stanford University, “CHANGES IN U.S. HOSPITALIZATION AND MORTALITY RATES FOLLOWING SMOKING BANS”, finds that smoking bans had no effect on hospitalizaton, heart attack or mortality rates in communities that impose them. The researchers found that heart attack rates naturally fluctuate from year to year. Smoking bans had no influence on the fluctuation!
http://keepstlouisfree.blogspot.com/2009/09/smoking-bans-have-no-effect-on-heat.html
Jane - Thanks for the endorsement
Think! - As annoying as smoke is, nicotine is one of our many addictions. Normal human brains love it. Once addicted, normal human brains hate being restricted from using it. None of the addictions make sense to people who do not have that particular addiction. A relative, lying in a hospital bed awaiting surgery for a disease caused by smoking, scoffed at a drug addict in the next bed, “Can’t he see that he’s brought all this on himself?” It is amazing to watch this selective condemnation. The common absence of insight is a compelling reason to take NoTobaccoNet seriously. Meanwhile, I hope that you never suffer from any addictions (alcohol, drugs, gambling, sex, etc), but if you do discover an addiction, I hope that supportive friends will help you cope with it.
NoTobaccoNet - I think that electronic cigarettes are promising, but AFAIK, all of these devices are being manufactured in China (land of lead painted toys and melamine enhanced milk and pet food). Quality control is non-existent and likely to be a problem. Serious studies of health effects need to be done, but have been frustratingly hard to get started. If you want to help facilitate such studies, please say so. It would help just to monitor some folks making the switch.
Bill - It is an interesting and provocative analysis, but the NBER working paper supports our position more than refuting it.
First, the analysis is of “workplace” smoking bans, but it is talking about offices, not restaurants and bars, so it does not directly refute the evidence regarding those settings. Furthermore, smoking in offices was falling fast in the 1980’s and 1990’s. Office smoking bans would tend to extinguish the last few cigarettes in an office, not cause a shift from 100 cigarettes/hour to zero. Many more smokers work in blue collar jobs, where “worksite” bans might not apply. Add the fact that office smokers could stoke up at breaks, and compensatory smoking outside of work (at home and in restaurants and bars) and you might not be looking at much of a reduction in smoke exposure.
Second, the authors conclude that previously reported AMI reductions are possible based on the random distribution of comparisons in figures 2 and 3, and that equally large changes in the opposite direction should be equally likely. We have not seen documentation of those opposite changes. Admittedly, there could be a publication bias against negative studies, but this NBER study got published. We need to see if the counter-examples that this paper predicts actually occur before we conclude that 9 diverse published studies are all from one tail of a zero-centered distribution. Unless there is publication bias, there is only a 1 in 512 chance of 9 studies finding that smoking bans prevent heart attacks if reality were different.
Third, the strongest trend in the data is that children get hospitalized for asthma more often when smoking bans are invoked. How do you think that comes to pass? As you point out in your other post, I would guess that parents restricted from smoking in the workplace go home and, in inexplicable acts of selfishness or ignorance, smoke more around their children. That is why we implore parents not to smoke anywhere in a home with children, and especially not in cars. We have no reason to revise the expectation that smoke hurts bystanders, especially children. PLEASE DO NOT SMOKE AROUND YOUR CHILDREN!
Please vote for clean air. Even you, Bill.
Dr. Sumner,
Thanks for reading the paper. Suspicion concerning the heart attack studies goes back to 2005. This is from the Illinois Licensed Beverage Association website:
“The integrity of the studies cited by these groups is questionable. For example, anti-smoking advocacy groups boast of recent statistics from Pueblo, Colorado citing a dramatic decrease in heart attacks since the inception of their ban. These groups consistently point to the reduction in heart attacks in Pueblo, Colorado and Helena, Montana as incontrovertible proof that secondhand smoke is doubling the heart attack rate among non-smokers.
These two studies comprise a population base of roughly 200,000 people. However, when you look at the 70 million people that comprise the non-smoking states of California, New York, Florida and Oregon-the heart attack rate has either not decreased at all or decreased such a small amount as to be statistically insignificant.
Researchers can deliberately sift through enough small local jurisdictions with smoking bans to find a few aberrations in heart attack rates and then claim that elimination of exposure to secondhand smoke will dramatically reduce incidents of heart attacks. Please don’t be taken in by misleading claims based on very select data samples.”
http://www.ilba.net/cgi-bin/ILBA/info.pl?domain=info&name=SmokingBan