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Brian Rank, M.D.
, member of the Quality committee
Editor's note: This article appeared in the Pioneer Press March 17, 2005.
It's too bad that members of the Minnesota House Commerce Committee, who recently rejected a statewide smoking ban, don't have a chance to meet some of the patients I see in my oncology practice. If they had the opportunity to look into the eyes of a patient and deliver the bad news that they have cancer, they might have not voted against continuing the legislative process on a statewide ban on smoking in restaurants.
Limiting public exposure to smoke and secondhand smoke in the workplace is a public health issue. If the threat were unsafe food or water, legislators would act decisively and there would be no debate. Somehow the health benefits of breathing fresh air are lost in the debate.
The National Cancer Institute lists tobacco use as the No. 1 cause of preventable death in the United States while secondhand smoke is the third leading cause of preventable deaths. State legislators have a historic opportunity to join hundreds of cities, six states and eight nations that have passed laws to protect their citizens.
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 secondhand 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, Mont., fell by 40 percent during a six-month period in 2002 when the city's 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 in June found that cities with smoke-free workplace laws, bars and restaurants have 82 percent less indoor air pollution than cities that allow smoking. The study by the Roswell Park Cancer Institute in Buffalo, N.Y., 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.
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's 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.
HealthPartners has historically supported efforts to reduce tobacco use and exposure to secondhand smoke. Our patients' health depends in part on public policy, which is why our public policy platform favors legislative initiatives that encourage and support healthy lifestyles including tobacco prevention and cessation.
Our first statewide grass-roots comprehensive cancer control plan, Cancer Plan Minnesota, will soon be published. The plan aims to decrease the burden cancer places on Minnesotans. Banning smoking in bars and restaurants is so important, it is one of the top priorities in its first year.
Medical evidence strongly supports smoke-free laws and so do a majority of Minnesotans. Behind the studies and statistics are the victims and future victims of smoke and secondhand smoke. They are our friends, neighbors and relatives. They deserve better public policy from our legislators.
Rank is medical director of the HealthPartners Medical Group and chair of the Cancer Plan Minnesota Steering Committee.
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