Why government should regulate indoor smoking

Nonsmokers who live or work around smokers have an increased risk of dying from lung cancer and heart disease. Initially these statistics were puzzling, but researchers have recently figured out why tiny amounts of cigarette smoke are dangerous.

The American Heart Association Journal states: "Evidence is rapidly accumulating that the cardiovascular system is exquisitely sensitive to the toxins in secondhand smoke. The effects of even brief... passive smoking are often nearly as large... as chronic active smoking." Spending just 15 minutes in a restaurant where people are smoking can activate blood cells called platelets, which can trigger blood clots. Clots in arteries feeding the heart muscle cause heart attacks. Longer-term exposure to secondhand smoke causes inflammation in the walls of arteries, promoting the formation of cholesterol plaques.

The Center for Disease Control has issued an advisory warning patients with cardiac risk factors to avoid even short periods of secondhand smoke exposure. The surgeon general has concluded that "the scientific evidence is now indisputable: secondhand smoke is not a mere annoyance. It is a serious health hazard that can lead to disease and premature death in children and nonsmoking adults." Furthermore, "there is no risk-free level of secondhand smoke exposure."

The U.S. Environmental Protection Agency classifies secondhand smoke as a "Group A carcinogen," meaning a substance that has been documented to cause cancer in humans. The EPA concludes that "it's time to set the record straight about an indisputable fact: secondhand smoke is a real and preventable health risk."

The surgeon general estimates that each year in the U.S., secondhand smoke is responsible for the deaths of 53,000 nonsmokers, including 46,000 from heart disease and 3,000 from lung cancer. These victims are involuntary smokers, forced to inhale toxins when others around them light up. To put these statistics in perspective, more people die each year from secondhand smoke than from breast cancer (40,000), prostate cancer (30,200) or traffic accidents (40,000).

The surgeon general writes that "Separating smokers from nonsmokers ... cannot eliminate exposures of nonsmokers to secondhand smoke." Heating and air conditioning equipment is designed to be energy efficient, meaning that once air in a building has been heated or cooled, it is perpetually recycled. The odor of smoke can be filtered out, but not the cigarette toxins, and over time these build up.

Smoke can't be vented

The American Society of Heating, Refrigeration and Air Conditioning Engineers has gone on record stating "ventilation systems do not adequately control secondhand smoke." Studies consistently find significant levels of cigarette toxins in the blood of people who have dined in the "nonsmoking" sections of restaurants, even in those who did not smell smoke in the air. If one person in a restaurant or office is smoking, everyone is smoking.

Opponents of smoking restrictions argue that cigarettes are legal, and adults should have the right to choose to smoke. The argument is equally valid however, that citizens should be able to choose not to smoke. I have no problem with smokers lighting up outdoors or in private, but they do not have any constitutional right to risk the health of those around them. As Oliver Wendell Holmes wrote, "The right to swing my fist ends where the other man's nose begins."

Poison in the air

If we knew that a portion of restaurant patrons were regularly releasing traces of plutonium or asbestos into the air, would we tolerate this, based on the proclamation that "it's a free country"? Would the argument that "it's just a tiny bit of poison" carry any weight, when we know the amount is sufficient to kill thousands of people each year?

Should the rights of smokers supersede the rights of employees to a safe workplace?

After Helena, Mont., banned smoking in restaurants and workplaces, the number of patients admitted to local hospitals with heart attacks dropped by 40 percent. A similar study following a ban in Pueblo, Colo., recorded a drop of 27 percent. Currently, 19 states ban smoking in all workplaces, including restaurants and bars. An additional 2,671 American cities and towns have local secondhand smoke laws. Comprehensive bans are also in effect in numerous countries including England, Ireland, Italy, Norway, Sweden New Zealand, France, Portugal and much of Germany.

Restaurant and bar owners invariably worry that smoke-free legislation will drive customers away. Studies have been done in 81 cities and six states. All have demonstrated that laws restricting smoking do not hurt business, and that in many cases, profits rise as patrons driven away by the haze begin to return. A review of all studies based on sales-tax data published through 2005 concluded there is "no negative economic impact from the introduction of smoke-free policies in restaurants and bars."

In the U.S., approximately 20 percent of adults smoke. Of these, about half don't smoke indoors because they know it bothers people around them. In essence this debate comes down to one question -- in order to save 53,000 people each year from premature death, is it reasonable to inconvenience 10 percent of the population, by asking them to take their cigarettes outdoors? The councils of both Rock Hill and York County are currently addressing this issue. I am hopeful they will be able to work together and draft parallel ordinances protecting local citizens.

This weekly column features opposing views from readers. These opinions are contrary to those expressed on this page or which otherwise take issue with something that appears in The Herald. All commentaries submitted become the property of The Herald and may be republished in any format.

This story was originally published January 12, 2008 at 12:55 AM with the headline "Why government should regulate indoor smoking."