Tuesday, February 21, 2012

National Post Article Considers Whether Smoking Bans in Wide-Open Outdoors Areas Go Too Far

An article in Saturday's National Post considers the issue of whether smoking bans in wide-open outdoor areas such as parks go too far. The issue is now of interest in Canada because a number of municipalities have enacted or are debating outdoor smoking bans. For example, Barrie, Ontario, Cornwall, Ontario, Belleville, Ontario, Squamish, British Columbia, Vancouver, British Columbia, Bridgewater, Nova Scotia, and Kentville, Nova Scotia have all banned smoking completely in all city parks.

According to the article:

"Dr. Michael Siegel has been an anti-smoking advocate for 25 years, even testifying as an expert witness in a U.S. lawsuit that slapped the tobacco industry with a $145-billion verdict. He has stood before Congress and fought for smoking bans in restaurants, bars and casinos, and he supports smoke-free playgrounds because they are designed specifically for children."

"Today though, Dr. Siegel is breaking ranks with his own movement because he fears it has gone too far, jeopardizing itself from within by crusading for bans in even the largest of outdoor public places such as parks and beaches."

"By treading into the realm of Times Square or Stanley Park, as New York and Vancouver have done, the movement risks losing the science-based argument it has long won — because, Dr. Siegel said, there is no evidence that fleeting second-hand exposure in an open space is significantly harmful."

"'Once we leave the firm ground of science, we could be viewed as zealots — fanatics trying to eliminate smoking anywhere and everywhere,' said Dr. Siegel, a professor at the Boston University School of Public Health."

Also according to the article: "The Canadian Council for Tobacco Control says ... that even passing exposure to second-hand smoke is harmful."

The Rest of the Story

This is an issue that I have discussed at length here at the Rest of the Story, so it is nice to see the issue getting some attention in the media. The problem, exposed by the article's citation of a statement from the Canadian Council for Tobacco Control asserting that even fleeting exposure to secondhand smoke is harmful, is that the tobacco control movement appears to be straying from its science base.

It's one thing to argue that bar and restaurant workers who are exposed to high levels of secondhand smoke for 40 or more hours per week are at risk of suffering significant health problems because of that exposure. We can back that up with strong scientific evidence. However, it is quite another thing to assert that fleeting secondhand smoke exposure - such as occurs in public parks - is a major public health problem requiring government intervention. Moreover, it's difficult for me to understand why an affected nonsmoker who might be sensitive to the acute effects of secondhand smoke could not simply walk away from a smoker in a park.

By asserting that fleeting exposure to secondhand smoke is a substantial health risk, are we not inadvertently making a mockery of the very strong case we have put together to argue that chronic secondhand smoke exposure, such as that experienced by bar, restaurant, and casino workers, is a huge hazard - one from which the government must protect workers by banning smoking in these environments?

What's the point of putting together a strong case of scientific evidence and studies to support our efforts to promote workplace smoking bans if we are going to, at the same time, put forward the argument that even a whiff of secondhand smoke is a significant health hazard?

Why the need to do research on the effects of secondhand smoke in the first place if we are going to put forward the argument that all it takes to significantly harm your health is a single whiff of secondhand smoke? If that assertion is true, then much of my career's work has been a waste of time. What contribution did my research make? It documented that bar and restaurant workers face higher lung cancer risks because of their high exposure to secondhand smoke. But what does that matter if merely a fleeting exposure to secondhand smoke is significantly harmful?

Moreover, if all it takes to significantly harm health is a passing exposure to secondhand smoke, then what justification is there for allowing smoking anywhere outside? Why are not these same advocates calling for complete bans on smoking in all outdoors locations? Why just restrict the bans to public parks and beaches? What about crowded streets and sidewalks? Outdoor malls? Busy outdoor shopping areas? Parking lots? The outdoor grounds of hospitals and doctors' offices? Outdoor areas of college campuses?

What I fail to understand is how public health advocates who truly believe that fleeting secondhand smoke exposure is a substantial public health problem can justify their own failure not to promote or advocate for or support complete bans on outdoor smoking, which would include all of the above locations? It seems to me that there is a major inconsistency in their argument.

The rest of the story is that by putting forward this inconsistent treatment of secondhand smoke exposure, and by moving away from a strong science base and towards the arena of fanaticism, I'm afraid that we are risking the erosion of the scientific and policy legitimacy that we worked so hard to establish. And this could make it much more difficult to pass smoking bans where they are truly needed to protect people's very lives: in bars, restaurants, and casinos in the many states which still have not taken steps to protect these workers' ability to make a living and support their families without having to breathe in carcinogens for 40+ hours a week at their places of employment.

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