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Smoking ban

Smoking bans are public policies, including legal prohibitions and occupational health and safety regulations, that restrict smoking in workplaces and public places.

The main rationale for smoking bans is to protect workers and citizens from heart disease, cancer and respiratory illnesses and other chronic and acute diseases caused by exposure to secondhand smoke. [1] [2] 

most direct and effective method of reducing tobacco smoke exposure in buildings,[3] although tobacco smoke may still enter a building via ventilation and infiltration.  Laws implementing bans on indoor smoking have been introduced by many countries in various forms over the years, with legislators citing scientific evidence that shows tobacco smoking is often harmful to or fatal for the smokers themselves and for those subjected to passive smoking. Additional bases for smoking bans are reduced risk of fire, decreased legal liability, potentially reduced energy use via decreased ventilation needs, and reduced quantities of litter.

Smokefree workplace laws aim primarily at reducing preventable deaths, diseases and disabilities caused by passive smoking.[4] In addition, such laws may reduce health care costs, improve work productivity and lower the overall cost of labor in a community, thus making a community more attractive for bringing new jobs into the area and keeping current jobs and employers in an area. In Indiana for example, the state's economic development agency wrote into its 2006 plan for acceleration of economic growth that it encourages cities and towns to adopt local smokefree workplace laws as a means of promoting job growth in communities.

US Surgeon General Richard Carmona has called for smoking cessation based upon the fact that smoking is estimated to cause about 440,000 people each year in the United States to die via numerous types of cancers, emphysema and other diseases.


Contents

Medical and scientific basis for bans

Research has generated scientific evidence that secondhand smoke (e.g. smoke passively inhaled by non-smokers after it was exhaled by active smokers) causes the same problems as direct smoking, including lung cancer, cardiovascular disease and lung ailments such as COPD, bronchitis and asthma[5]. Specifically, meta-analyses have shown lifelong non-smokers with partners who smoke in the home have been shown to have a 20-30% greater risk of lung cancer, and those exposed to cigarette smoke in the workplace have an increased risk of 16-19%[6].

A study issued in 2002 by the International Agency for Research on Cancer of the World Health Organization concluded that nonsmokers are exposed to the same carcinogens as active smokers[7]. Sidestream smoke contains more than 4000 chemicals, including 69 known carcinogens such as formaldehyde, lead, arsenic, benzene, and radioactive polonium 210 [8], and several well-established carcinogens have been shown by the tobacco companies' own research to be present at higher concentrations in sidestream smoke than in mainstream smoke.[9]

Although there is a general scientific consensus that passive smoking creates a wide range of health risks, this issue is still debated (see main article on passive smoking).

Air quality

Bans on smoking in bars and restaurants can substantially improve the air quality in such establishments. For example, one study listed on the website of the CDC (Center for Disease Control) states that New York's statewide law to eliminate smoking in enclosed workplaces and public places substantially reduced RSP (respirable suspended particles) levels in western New York hospitality venues. RSP levels were reduced in every venue that permitted smoking before the law was implemented, including venues in which only secondhand smoke from an adjacent room was observed at baseline. [10] The CDC concluded that their results were similar to other studies which also showed substantially improved indoor air quality after smoking bans.

A 2004 study showed that in New Jersey (which had not yet enacted its ban), bars and restaurants had more than nine times the levels of indoor air pollution of neighboring New York City, which had enacted its ban[11].

Research has also shown that improved air quality translates to decreased toxin exposure among employees[12]. For example, among employees of the Norwegian establishments that enacted smoking bans, tests showed improved (decreased) levels of nicotine in the urine of both smoking and non-smoking workers (as compared with measurements prior to the ban).[13]

History

Pope Urban VII's five year papal reign included the world's first known public smoking ban (1590), as he threatened to excommunicate anyone who "took tobacco in the porchway of or inside a church, whether it be by chewing it, smoking it with a pipe or sniffing it in powdered form through the nose".[14]

In the later part of the 20th century, as research studies on the health risks of second hand tobacco smoke were made public, the tobacco industry launched "courtesy awareness" campaigns. Fearful of revenue losses, the industry created a media and legislative program that focused on "accommodation." Tolerance and courtesy were encouraged as a way to ease heightened tensions between smokers and those around them. States were encouraged to pass laws providing separate smoking sections.[15]

Up to this point, bans were limited to individual cities and counties. In 1998 California enacted a complete smoking ban (including bars). The California ban encouraged other states such as New York to implement bans of their own. Since then, there has been an increasing trend for entire states or countries to pass laws banning smoking in various indoor public sites and workplaces, including bars, restaurants, and social clubs. There are now 33 states with some form of smoking ban on the books.[16]

Critique of bans

Smoking bans have been criticised on a number of grounds. The most common criticism is phrased in terms of a general dislike of government regulation of personal behavior. Those opposing bans, such as the artist Joe Jackson and essayist and political critic Christopher Hitchens, claim that they are misguided efforts of retrograde Puritans [citation needed].

Economic loss

It is sometimes argued that smoking bans hurt the business of those hospitality businesses, especially those near a border with a place that does allow smoking, such as another state or an Indian reservation. They argue that smokers will choose the venue where smoking is allowed, or opt to not go out at all. [17] However, this factor seems to be offset by non-smokers who choose to go out to the smoke-free venues: although certain businesses may attribute their failure to a smoking ban going into effect, many localities taken as a whole have seen an increase in hospitality business. [18]

Disputes over scientific basis for bans

Some critics have disputed the scientific basis for bans on smoking (see tobacco smoking and passive smoking).

Perceived hypocrisy

Some countries hardly enforce their smoking prohibitions, and continue to profit from tax on tobacco products. This was suggested as a reason for the UK not having a smoking ban in place.[19]. However, bans over all the UK are now soon to be enforced (see below).

The victimless crime

It is argued that smokers who freely choose to smoke and are harming themselves, have the right to, in the same way that they are free to choose to take their own lives. Prohibition of smoking should then create a "victimless crime". However, while this argument stands up when applied directly to groups composed entirely of adult smokers who have a conscious desire to breathe other smokers' secondhand smoke, this supposition does not take account of whether these groups include the parents of minors, children or disabled people unable to choose their environments, pregnant women, nor of the effects of passive smoking, or involuntary smoking (as it has been described in the 2006 report of the United States Surgeon General entitled "Health Consequence of Involuntary Exposure to Tobacco Smoke) on others. Hence, in its strongest form, the "victimless crime" argument applies only to bans on smoking in private, which have rarely been imposed.

A common way of framing the issue to argue against bans on smoking in bars and similar public venues is one of property rights: workers and customers who enter a private establishment or household that allows smoking are said to have implicitly consented to the rules set by the owner of the establishment. Some argue that this principle does not hold up in relation to workers. Business owners are legally required to maintain a reasonably safe working environment, and cannot contract with their workers to relax this standard, nor can trade unions ignore the issue. However, cases based on injuries suffered by bar or restaurant employees due to second hand smoke have not, as of yet, been brought under any state's safe place law[citation needed]. Furthermore, most proposed smoking bans are advocated more heavily by potential patrons rather than bar or restaurant employees.

A further perceived problem that arises in countries where there is a public health system is that when a smoker becomes ill the rest of the society has to pay for his medical care expenses through increased taxes. Smokers may argue that they are being singled out unfairly if other activities that endanger health are not restricted[citation needed]. Many economists also note that smokers do not increase health care costs, they decrease them. Heavy smokers generally don't live long enough to develop ailments that generally affect the elderly, many of which last longer and are more expensive to treat than smoking related diseases.

Several studies, including one conducted by Philip Morris in the Czech Republic[20] and another by the CATO institute[21], support this position, although neither study was peer-reviewed nor published in a scientific journal. Philip Morris have explicitly apologised for the former study, saying: "The funding and public release of this study which, among other things, detailed purported cost savings to the Czech Republic due to premature deaths of smokers, exhibited terrible judgment as well as a complete and unacceptable disregard of basic human values. For one of our tobacco companies to commission this study was not just a terrible mistake, it was wrong. All of us at Philip Morris, no matter where we work, are extremely sorry for this. No one benefits from the very real, serious and significant diseases caused by smoking."[20]. This possibility stems from the fact that nonsmokers live longer on average and can thus incur higher total lifetime health care costs. Some argue that if nonsmokers live longer they also pay during their lifetime more taxes than smokers that statistically become ill and die earlier. Because smoking related deaths often occur around retirement age for many people, and thus around the time when a person begins to pay much lower income taxes, the premature death of a smoker probably presents a net gain for the government in health care costs.

Bans may move smoking elsewhere

Bans on smoking in offices and other enclosed public places often result in smokers going outside to smoke, frequently congregating outside doorways and therefore shifting the problem elsewhere. Many jurisdictions that have banned smoking in enclosed public places have extended the ban to cover areas within a fixed distance of entrances to buildings[3].

A more serious concern is that bans on smoking in public places may lead to more smoking at home, as claimed by former British Secretary of State for Health John Reid[22]. However, both the House of Commons Health committee and the Royal College of Physicians disagreed, with the former finding no evidence to support Reid's claim after studying Ireland[22], and the latter finding that smoke-free households increased from 22% to 37% between 1996 and 2003[23].

Smoking bans by country

Most countries impose some restrictions on smoking, the most stringent being a total ban on smoking and the purchase of tobacco in Bhutan. The United States has no national restrictions but many restrictions are imposed at state and local level. See List of smoking bans and List of smoking bans in the United States.

Alternatives to bans

Incentives for Voluntarily Smoke-Free Establishments

Some smoking ban opponents nonetheless concede that in many localities, the number of smoke-free bars and restaurants is insufficient to meet the needs and wants of residents who prefer a smoke-free environment. In order to encourage the creation of more smoke-free businesses, some experts and politicians support tax credits and other financial incentives for businesses that enact nonsmoking policies. During the debates over the Washington, DC smoking ban, city Councilmember Carol Schwartz proposed legislation[4] that would have enacted either a substantial tax credit for businesses that chose to ban smoking or a significant additional licensing fee for bars and restaurants that wished to allow smoking. Proponents of such policies claim that they would help to increase the options for customers and employees who prefer a smoke-free bar or restaurant without infringing on the rights of business owners. Opponents of such tax measures counter that only a complete ban can fully protect patrons and employees.

Tradable Smoking Pollution Permits

One solution to the problem of smoking "externalities" favored by some economists is a system of tradable smoking pollution permits, similar to other cap-and-trade pollution permits systems successfully used by the Environmental Protection Agency in recent decades to curb other types of pollution. The proposal has been suggested by Profs. Robert Haveman and John Mullahy of the University of Wisconsin-Madison.[5]

Emissions trading systems are generally favored by economists as a market-based alternative to direct regulation, because they yield a given reduction in pollution at lower cost, and may permit a reduction in administrative costs. However, the idea is not applicable in all contexts, and there has been little analysis of the costs and benefits in relation to smoking.

Tradable pollution permits as a market-based alternative to smoking bans can be applied as follows: Lawmakers decide the optimal level of smoking establishments for an area. The total fire occupancies of those establishments is totaled up, and one smoking pollution permit is issued for each fire occupancy. Permits are then auctioned off, and establishments are required to hold permits equal to their fire occupancy if they wish to allow smoking -- in essence, they are required to own the property rights over the clean air space of every occupant before any can smoke. Establishments with unused permits can sell them on the open market to smoking establishments.

The effects of bans

Effects on tobacco use

A 1960 document from Phillip Morris Impact of Workplace Restrictions on Consumption and Incidence', summarized the results of its long-running research into the effects of a ban. "Total prohibition of smoking in the workplace strongly affects industry (i.e., smoking industry) volume. Smokers facing these restrictions consume 11% to 15% less smoking products than average and quit smoking at a rate that is 84% higher than average."[24]

Effects on businesses

Although one of the most common sources of resistance to bans comes from businesses concerned that they will suffer financial losses due to lost customers, research seems to offer them some reassurances.

In Ireland, the main opposition was from publicans, along with a minority of pub-goers. The Irish workplace ban was introduced with the intent of protecting others, particularly workers, from passive smoking ("secondhand smoke"). By and large, since the ban's introduction it has become accepted, due in part to "outdoor" arrangements at many pubs (involving heated areas with shelters). It is viewed as a success by the government and much of the public, and many other European governments are considering similar legislation. Public health lobbyists in Northern Ireland have lobbied for a similar ban there also.[citation needed]

Ireland's Office of Tobacco Control website indicates that "An evaluation of the official hospitality sector data shows there has been no adverse economic effect from the introduction of this measure (the March 2004 national ban on smoking in bars, restaurants, etc). Bar the most significant quarterly increase in employment since the second quarter of 2002."[25] Thus, even in a country with a relatively high percentage of smokers, the smoking ban did not seem to have a negative effect on business in bars or restaurants.

In the USA, smokers and hospitality businesses initially argued that businesses would suffer from smoking bans. Some restaurateurs argued that smoking bans would increase the rate of dine and dashes where patrons declare they are stepping outside to smoke, while their intent is to leave. Others have countered that even if this occurred it could decrease the leisure (non-eating) time spent in the restaurants, resulting in increased turn-over of tables, which could actually benefit total sales. The experiences of Delaware, New York[26], California, and Florida have shown that most businesses do survive (and many hospitality businesses show increased revenues). According to the 2004 Zagat Survey, which polled nearly 30,000 New York City restaurant patrons, by a margin of almost 6 to 1, respondents said that they eat out more often now because of the city's smoke-free policy[27]. A 2006 US surgeon general review[28] of studies suggests that business may actually improve[29]. Thus, research generally indicates that business incomes are stable (or even improved) after smoking bans are enacted, and many customers appreciate the improved air quality.


In 2003 New York City amended its antismoking law to include all restaurants and bars, including those in private clubs, making it one of the toughest in the nation. The city's Department of Health found in a 2004 study that air pollution levels had decreased sixfold in bars and restaurants after the ban went into effect, and that New Yorkers had reported less secondhand smoke in the workplace. The study also found the city's restaurants and bars prospered despite the smoking ban, with increases in jobs, liquor licenses and business tax payments.[30] A 2006 study by the state of New York found similar results.[31]


By contrast, it has been claimed on a blog opposed to bans that "the experiences of Minneapolis and the St. Paul area showed that between April 2005 to April 2006 after the implementation of a smoking ban, 73 establishments closed, compared to 15 in the previous year".[32] Similarly, in Ontario, many business owners invested a significant amount of money in ventilated smoking rooms; however, these were made completely illegal in a matter of years, forcing them to suffer financially.[citation needed]
Smoking ban:Smoking is prohibited on streets in some areas of Tokyo, hence smokers retreat into smoking lounges.
Enlarge
Smoking is prohibited on streets in some areas of Tokyo, hence smokers retreat into smoking lounges.

Effects on health

In the first 18 months after the town of Pueblo, Colorado enacted a smoking ban in 2003, hospital admissions for heart attacks dropped 27%. Admissions in neighboring towns without smoking bans showed no change. The American Heart Association said, "The decline in the number of heart attack hospitalizations within the first year and a half after the non-smoking ban that was observed in this study is most likely due to a decrease in the effect of secondhand smoke as a triggering factor for heart attacks." [33]

Similar findings are beginning to emerge from other areas which have enacted bans. Researchers at Dundee university found significant improvements in the health of bar staff in the two months following the ban. They tested bar workers' lung function and inflammatory markers a month before the ban came in, and again two months after it had been introduced. The number showing symptoms related to passive smoking fell from more than 80% to less than half, with reduced levels of nicotine in the blood and improvements in lung function of as much as 10%.[34]

Outdoor smoking bans

In some places with long-established strict indoor smoking bans, experiments with outdoor bans in specific contexts, especially in public or government-owned spaces, have begun. The state of California, known to be a leader in anti-smoking policy, has also enacted certain outdoor smoking bans. The advent of outdoor smoking bans has been seen as one of the final frontiers in the tobacco prohibition movement. [citation needed]Smoking has been banned on the streets of Tokyo's Chiyoda Ward since October 2002. Ward employees patrol the streets and hand out ¥2000 fines to violators. According to the cigarette company Japan Tobacco, Inc., 60 municipalities, whose residents make up 10% of Japan's population, have regulations to ban or discourage people smoking on the street. However, only 3 municipalities assess fines for violations.

See also

References

  1. ^ Smokefree legislation consultation response, The Institute of Public Health in Ireland. Retrieved on 2006-09-05.
  2. ^ New health bill will ban smoking in majority of workplaces (UK Health Secretary: The smoking ban "is a huge step forward for public health and will help reduce deaths from cancer, heart disease and other smoking related diseases"). Retrieved on 2006-09-05.
  3. ^ Ventilation for Environmental Tobacco Smoke, (c) ASHRAE, Elsevier, Burlington, MA, USA, 2006
  4. ^ WHO Framework Convention on Tobacco Control; First international treaty on public health, adopted by 192 countries and signed by 168. See in particular Article 8 Protection from exposure to tobacco smoke.
  5. ^ Boyle P, Autier P, Bartelink H et al. (2003). "European Code Against Cancer and scientific justification: third version (2003).". Ann Oncol. 14 (7). PMID 12853336.
  6. ^ Sasco AJ, Secretan MB, Straif K. (2004). "Tobacco smoking and cancer: a brief review of recent epidemiological evidence.". Lung Cancer 45 (Suppl 2): S3-9. PMID 15552776.
  7. ^ Disparity in Protecting Food Service Staff from Secondhand Smoke Shows Need for Comprehensive Smoke-Free Policies, Say Groups.
  8. ^ Involuntary smoking. Retrieved on 2006-07-15.
  9. ^ Schick S, Glantz S. (2005). "Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke.". Tob Control. 14 (6): 396-404. PMID 16319363.
  10. ^ Indoor Air Quality in Hospitality Venues Before and After Implementation of a Clean Indoor Air Law --- Western New York, 2003.
  11. ^ Study Finds That New Jersey Bars and Restaurants Have Nine Times More Air Pollution than Those in Smoke-Free New York.
  12. ^ Smoking ban leads to healthier bar staff.
  13. ^ Airborne exposure and biological monitoring of bar and restaurant workers before and after the introduction of a smoking ban.
  14. ^ Nicotine: An Old-Fashioned Addiction, pp 96-98, Jack E. Henningfield, Chelsea House Publishers, 1985
  15. ^ Tina Walls (1994-06-30). Preemption/Accommodation presentation (PDF). Retrieved on 2006-11-23.
  16. ^ How many Smokefree Laws? (PDF) (2006-10-06). Retrieved on 2006-11-23.
  17. ^ The Facts.
  18. ^ Restaurants, bars gain business under smoke ban.
  19. ^ (2003) "Passive Commitment". Lancet Oncol. 4 (12): 709. PMID 14662425.
  20. ^ a b Public Finance Balance of Smoking in the Czech Republic.
  21. ^ Snuff the Facts.
  22. ^ a b MPs to challenge ministers' veto on total smoking ban. Retrieved on 2006-10-07.
  23. ^ Smoking ban in public places also cuts smoking at home. Retrieved on 2006-10-07.
  24. ^ Jamie Doward (June 19, 2005). Smoking: (Tony) Blair will push for total ban. The Guardian.
  25. ^ High compliance with the smoke-free workplace law means dramatic reduction in exposure to second-hand smoke in enclosed workplaces.
  26. ^ The Effects of Smoke-Free Restaurants. Retrieved on 2006-07-21.
  27. ^ Disparity in Protecting Food Service Staff from Secondhand Smoke Shows Need for Comprehensive Smoke-Free Policies, Say Groups.
  28. ^ The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Retrieved on 2006-06-27.
  29. ^ Richard Roesler: Surgeon general: No safe level of secondhand smoke.. Retrieved on 2006-06-27.
  30. ^ " Bars and Restaurants Thrive Amid Smoking Ban, Study Says." 29 March 2003, The New York Times.[1]
  31. ^ "Cig Ban no Bar Burden; Biz up Despite Law." 25 July 2006, The New York Post.[2]
  32. ^ Twin Cities bars and restaurants which closed after one year of the smoking bans.
  33. ^ Heart attacks decline after smoking bans CNN.com accessed 9/26/2006
  34. ^ Scots bar staff health 'improved'

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