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Medical evidence supports smoke-free laws
by Brian Rank, M.D.,medical director HealthPartners Medical Group
It is sad and frustrating to see patients like the 41 year old woman who is in our clinic today getting chemotherapy for lung cancer even though she has never smoked in her life. Both of her parents however were smokers, as were many co-workers. This patient has now had one lung removed and despite undergoing chemotherapy, there is a greater than 50 percent chance that the cancer will recur and she will die of the disease. The tragedy is compounded by the fact that her cancer could have been prevented.
The National Cancer Institute lists tobacco use as the number one cause of preventable death in the U.S. while secondhand smoke is the third leading cause of preventable deaths. City officials in Minneapolis and St. Paul have an historic opportunity to join hundreds of cities, six states and eight nations that have passed laws to protect citizens like my patient.
Effects of passive smoke
Beginning with the first major report from the Surgeon General in 1964, which concluded that smoking causes lung cancer, there have been hundreds of medical studies documenting the adverse health affects of smoking. Evidence is now mounting that even short term exposure to passive smoke is also very dangerous to health.
In April, the Centers for Disease Control advised anyone with heart disease to avoid indoor settings where smoking is allowed. The CDC issued the advisory after a landmark study revealed evidence that even short-term exposure to secondhand smoke can trigger heart attacks. The study, published in The British Medical Journal, found the number of heart attacks reported in Helena, Montana, fell by 40 percent during a six-month period in 2002 when the citys comprehensive smoke-free law was in effect. The CDC estimates that secondhand smoke causes 35,000 heart disease deaths a year in the United States and expects to revise that estimate upward as a result of the Helena study.
A study released last month found that in cities that have smoke-free workplace laws, bars and restaurants have 82 percent less indoor air pollution than in cities that allow smoking. The study by the Roswell Park Cancer Institute in Buffalo, found that in cities that did not have smoke-free laws, full-time bar and restaurant employees are exposed on the job to more than four times the average annual limits of fine particulate air pollution recommended by the U.S. Environmental Protection Agency.
Children most vulnerable
Children exposed to secondhand smoke are especially vulnerable, suffering more asthma, bronchitis, ear infections and other ailments. Since 1997, HealthPartners has been working to reduce childrens exposure to secondhand smoke. As a result, 14,500 fewer children of HealthPartners patients are exposed to passive smoke. The kids are healthier. The effort has reduced medical expenses for treating the illnesses associated with exposure to passive smoke by nearly $1 million.
Good medicine, good business
While the medical evidence supporting smoke-free policies is clear, there is also evidence that smoke-free policies are good business. A recent report by New York City found that since New York Citys smoke-free policy took effect a year ago, business receipts for restaurants and bars have increased and employment has risen. Virtually all establishments are complying with the law, the vast majority of New Yorkers support the law, and customers and workers alike are being protected from the harmful health effects of secondhand smoke. The smoke-free law is one factor that has contributed to an 11 percent decrease in tobacco use in New York City.
Good public policy, better public health
HealthPartners has historically supported efforts to reduce tobacco use and exposure to secondhand smoke. In January, we implemented a policy that bans smoking on the grounds of our headquarters in Bloomington and at Regions Hospital in St. Paul. This summer that ban will extend to all of our 23 clinics. Our patients health depends in part on public policy, which is why we also developed and released our public policy platform with a position in favor of government initiatives that encourage and support healthy lifestyles including tobacco prevention and cessation.
Medical evidence strongly supports smoke-free laws. Behind all of the studies and statistics are the human lives like my 41 year old patient. They have families, they have children and they have friends who care about them. They lead productive lives that contribute to our community. I went into medicine because I wanted to make a difference in my patients lives. With their votes on this important issue, city council members have the opportunity to do the same.
Editor's note: This article appeared June 15, 2004 in the Minneapolis Star Tribune
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