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DLW
Registered Member
Date Joined Apr 2003
Total Posts : 2457
| Posted 10/16/2003 6:49 AM (GMT -6) |   | http://www.nytimes.com/2003/10/15/opinion/15ELLI.html
The Secondhand Smoking Gun -> ->
By ROSEMARY ELLIS
Published: October 15, 2003
Six months into New York City's smoke-free ordinance, there has been a spate
of criticism about the wisdom of sticking by such a ban. The most notable
came in a roundabout swipe from none other than former Mayor Rudolph W.
Giuliani, who declared during a trip to Ireland last month that Irish
citizens should have the choice to smoke in public places. (Mr. Giuliani
later tried to distance himself from his comments.)
But if New York — as well as other cities and municipalities — is ever
tempted to rescind its smoking ban, it should look at the goings-on in
Helena, Mont. The citizens of Helena voted in June 2002 to ban smoking in
all public buildings — including restaurants, bars and casinos. Soon after,
doctors at the local hospital noticed that heart-attack admissions were
dropping. So they, in conjunction with the University of California, San
Francisco, did a study to measure the potential short-term effects of a
smoking ban.
Helena is a perfect place for such a study: relatively isolated, with enough
people in the region (66,000) for a meaningful population sample, and only
one cardiac-care hospital within a 60-mile radius. So it was easy to control
the study sample and methodology: if you get a heart attack in Helena,
there's only one place to go for treatment.
The study showed two trends. First, there was no change in heart attack
rates for patients who lived outside city limits. But for city residents,
the rates plummeted by 58 percent in only six months.
"We know from longer-term studies that the effects of secondhand smoke occur
within minutes, and that long-term exposure to secondhand smoke is
associated with a 30 percent increased risk in heart attack rates," says
Stanton Glantz, a professor of medicine who conducted the study's
statistical analysis. "But it was quite stunning to document this large an
effect so quickly."
It was also stunning to witness what happened next. The Montana State
Legislature, under pressure from the Montana Tavern Association and tobacco
lobbyists, rescinded the ban in December. The result: heart-attack rates
bounced back up almost as quickly as they dropped.
The bottom line of Helena's plummeting, then soaring, heart attack rate is
painfully obvious: secondhand smoke kills. Only 30 minutes of exposure to it
causes platelets in the bloodstream to become stickier. When that happens,
blood clots form more easily, which can block arteries and cause heart attacks.
Dr. Richard Sargent, one of the study's authors, points out that eight hours
of working in a smoky bar is equivalent to smoking a pack of cigarettes a
day. In such an environment, other studies have shown, workers more than
double their chances of developing cancer and asthma, and pregnant workers
put themselves at risk for miscarriage and premature delivery.
All of which make Mr. Giuliani's comments particularly ill informed. In
addition, despite the dire economic predictions that preceded it, the
smoking ban in New York City does not appear to have drastically depressed
business. From March to June, the city created 10,000 new restaurant and bar
jobs, according to the Department of Labor. The state Department of Taxation
and Finance's most recent report of alcohol and beer tax collections (which
measures both on-premises consumption and retail sales) shows that revenues
rose to $15.2 million this past August, from $14.4 million in August 2002.
And although the tobacco lobby continues to finance a campaign claiming that
New Yorkers are unhappy with the ban, a poll released earlier this month by
Quinnipiac University reported that 59 percent of voters in the state favor
prohibiting smoking in public places; another survey, commissioned in August
by antismoking groups, found that 70 percent of New York City voters support it.
At a time when the city's budget is in tatters, smoking in public places
also sets off an enormous domino effect in public-health spending by
creating or worsening illnesses whose treatment costs are eventually
shouldered by taxpayers. For all of these reasons, New Yorkers can't afford
to be as easily defeated as the unfortunate citizens of Helena — nor as
easily manipulated by the tobacco lobby and the politicians who are in its
pocket.
Rosemary Ellis is editorial director of Prevention magazine.
Niebuhr thought that sustained moral energy in politics depended on religion's power to mobilize reason along with self-transcending love. The prophetic tradition, meanwhile, gave Jews and Christians some protection against the temptation to identify their social causes with God's will. Lincoln's second inaugural address expressed the prophetic insight, "The almighty has His own purposes." | | Back to Top | | |
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Springs
Registered Member
Date Joined Jul 2001
Total Posts : 636
| Posted 10/16/2003 2:59 PM (GMT -6) | | | | |
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Starkman
Registered Member
Date Joined Oct 2001
Total Posts : 1747
| Posted 10/17/2003 3:24 AM (GMT -6) | | Oh, this whole conversation blows ... smoke! 
I do have a question: how is it proved that someone--actually the "thousands" refered to in statistics--died from second-hand smoke? I mean, okay, if there's cancer in the lungs, perhaps there's a good chance it was second-hand smoke, but I'm really dubious of the claim otherwise.
Starkman | | Back to Top | | |
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Tigress
Registered Member
Date Joined Feb 2003
Total Posts : 1252
| Posted 10/17/2003 6:03 AM (GMT -6) | | quote:
Originally posted by DLW
quote:
Originally posted by GregBoyd
Now I have to post downwind from Spring's ! I'm dying over here! choke. can't breath. need air.
I heard on MPR several months ago of a study that argued the exact opposite. And it wasn't funded by the Tobacco industry. But I don't recall who what where or anything. So I'll shut up. It just seems to me that there ought to be SOME PLACES where people can go to smoke. They still have rights, don't they?
Doc
People can smoke in their homes and their cars...
Its good to see that Boyd is taking his cue on politics from Giuliani !
The reason the study is a "smoking gun" is because a whole area adopted a smoke-free ban for a considerable period of time and then it was found that the level of disease fell for them, but not for other areas that are rather similar in all other respects...
Think of it as a labratory experiment. By politically banning public smoking, Helena is the treatment group. Helena's past history is the control group. Nothing else is really changing in terms of their environment and so the reduction in diseases should be attributable to the treatment and if it has this effect there it should have an analogous effect elsewhere, even NYC.
dlw
dlw
Well, gee.....if something makes you cough a lot; you're eyes water up; your hair, skin, fingers and teeth get discolored and age faster; you smell bad; and your overall health isn't as good as it would be if you didn't smoke; that should be enough to convince anyone that smoking is harmful, if not fatal to the smoker and those around him/her. Why does anyone really need a study to confirm this? Because smokers don't care about anyone but themselves, that's why! No other personal habit bothers other people as much as smoking does, except maybe drinking if the drinker decides to drive after having too much alcohol.
Tigress 
"Name a shrub after me. Preferably one that's prickly and difficult to eradicate."
-Captain Jack Aubrey
"Master and Commander: The Far Side of the World" | | Back to Top | | |
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whasssuuuppp
Registered Member
Date Joined Aug 2001
Total Posts : 210
| Posted 10/18/2003 10:35 AM (GMT -6) | | I would be the first person to support public smoking bans just about EVERYWHERE...because scientific evidence has shown that exposure to smoke (whether it be primary or second-hand) has a myriad of pathophysiologic effects that negatively affect the health of those exposed. Smoking is an independent risk factor for the development of cardiovascular disease in adults. Primary tobacco use is linked to the development of cancers of the lungs and mouth. We KNOW these things, and we've known them for a long time. Some aspects of the second-hand smoke exposure issue are more controversial but I expect that more and more studies in the coming years, like the one cited above, will continue show harm from exposure to second-hand smoke.
BUT...BUT...BUT...the manner in which this was brought up is totally inappropriate. If you want to argue this point, don't post an article from the New York Times. SHOW ME THE ORIGINAL STUDY. Popular new organizations too often mis-interpret scientific studies in the press. I tried to find the original study cited here, but haven't been able to. The best I could find was that this study was presented at the American College of Cardiology's annual meeting back in April, 2003. It's possible the study has been published since then but I don't know. There can be a big distinction between studies presented at meetings and those that are published in peer-reviewed medical journals. Often the results published at specialty meetings are preliminary, and as thus are not intended to be used to draw any major conclusions about a topic.
The NY times article cites a 58% reduction in heart attacks in the 6 months after the ban was put into effect.
I was able to find, at another site (http://www.newscientist.com/news/news.jsp?id=ns99993557), that this statistic is referring to the reduction in the average number of monthly heart attack admissions at a hospital in Helena from "just under seven" before the ban to "less than four" after the ban. Fine. But this tells me little. How were these statistics gathered? If it was through chart review, were the reviewers "blinded" to the study goals? Were there any people evaluated for acute coronary syndrome in the ER and then sent home? Were the people admitted to the hospital with a heart attack smokers themselves, or were they non-smokers exposed to second-hand smoke? What other independent cardiac risk factors did they have? What criteria were used for admission to the hospital (ECG changes? Cardiac enzyme eleveations? Chest pain unrelieved by nitro?) And importantly, were these proven heart attacks (i.e., did the patients undergo cardiac catheterization)? Were any of the people admitted for heart attack from out of town? Is the town of Helena still being followed or did the study end at 6 months? And on and on.
One statistic--a 58% reduction in heart attack rates--looks good on paper but tells one little, without the actual study to back it up. A large number of other statistics are missing. Again, I highly suspect that second-hand smoke exposure is dangerous for non-smokers. And I'd be willing to bet this was probably a good study. But I do not like the way the popular press presents scientific papers and findings.
Greg--I believe the study you're talking about is most likely one that was published in the British Medical Journal May 17, 2003. The full reference is:
**Enstrom JE, Kabat GC. Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98. BMJ 2003;326:1057-61.**
It was and still is VERY controversial and has been extensively discussed both within BMJ's May 17 journal and in other places since its publication, including, it sounds like, on NPR.
And as a final point, Tigress, your comment:
quote:
Well, gee.....if something makes you cough a lot; you're eyes water up; your hair, skin, fingers and teeth get discolored and age faster; you smell bad; and your overall health isn't as good as it would be if you didn't smoke; that should be enough to convince anyone that smoking is harmful, if not fatal to the smoker and those around him/her. Why does anyone really need a study to confirm this? Because smokers don't care about anyone but themselves, that's why!
is completely inappropriate. To group ALL smokers together and say that they don't care about anyone but themselves is judgmental and counterproductive. You may believe that their behavior is self-centered, but to extend this judgment to the person is not right. I have never smoked myself and I never will. But I have talked with NUMEROUS people who are smokers and who are trying to quit smoking. This endeavor, in the opinion of other smokers I've talked to who HAVE successfully quit, appears to be one of the most difficult things a person can ever do. And even if someone quits, the addiction remains. If one has never been addicted to a substance, one CANNOT speak about what it is like.
If you are in a true relationship with someone and they've invited you in on their lives, then you earn the right to speak into their life about what you see as a destructive behavior. I also personally think that I, as a health worker, have a responsibility to tell my patients about the scientific basis for the dangerousness of smoking. And believe me, it's not like I'm telling them something they don't already know. BUT to make this into a morality issue is wrong. Believe me, I stuggle with this too, and I have a tendency to want to judge smokers for their behavior. But I have no right to do so. And along these lines, I don't think this topic belongs anywhere near the "Let's Solve the Problem of Evil" category. | | Back to Top | | |
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Starkman
Registered Member
Date Joined Oct 2001
Total Posts : 1747
| Posted 10/20/2003 3:23 AM (GMT -6) | | Doc: I'm acting like I give two cents about this debate, but actually I just can't sleep ....
You crack me up, Doc! I mean, would that I had half your energy, but ... if I couldn't sleep, I'd be in trouble; I don't own a computer--stuck in a studio apartment at 1:00 or 2:00am in the morning wide awake with no 'puter? Oh, not good!
Starkman | | Back to Top | | |
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DLW
Registered Member
Date Joined Apr 2003
Total Posts : 2457
| Posted 10/20/2003 4:08 AM (GMT -6) | | quote:
Originally posted by GregBoyd
Always the scientific mind Whassuuuppp. I love it.
Okay, somebody please explain to me why BAR OWNERS shouldn't be allowed to decide for themselves whether they want to allow smoking or not? Its their business, their livelihood, their customers. If people stay out because of the smoke, it hurts THEIR business. What right does mother Uncle Sam have to impose her "I know better and care more than you" mindset on the businesses of others? hmmmmmm? (I'm acting like I give two cents about this debate, but actually I just can't sleep. But if iI was a bar owner... well, I'd be hot to trot!)
Doc
Whether or not people develop diseases due to second-hand smoke doesn't affect the bottom-line of the bar-owner. This is what they call in introductory economics textbooks, a negative externality. Hence, the reason for public sanction against such smoke in a public place.
bar-owner's bottom-lines aren't the only bottom-line.
dlw
Niebuhr thought that sustained moral energy in politics depended on religion's power to mobilize reason along with self-transcending love. The prophetic tradition, meanwhile, gave Jews and Christians some protection against the temptation to identify their social causes with God's will. Lincoln's second inaugural address expressed the prophetic insight, "The almighty has His own purposes." | | Back to Top | | |
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Tigress
Registered Member
Date Joined Feb 2003
Total Posts : 1252
| Posted 10/20/2003 8:04 AM (GMT -6) | | quote:
Originally posted by whasssuuuppp
I would be the first person to support public smoking bans just about EVERYWHERE...because scientific evidence has shown that exposure to smoke (whether it be primary or second-hand) has a myriad of pathophysiologic effects that negatively affect the health of those exposed. Smoking is an independent risk factor for the development of cardiovascular disease in adults. Primary tobacco use is linked to the development of cancers of the lungs and mouth. We KNOW these things, and we've known them for a long time. Some aspects of the second-hand smoke exposure issue are more controversial but I expect that more and more studies in the coming years, like the one cited above, will continue show harm from exposure to second-hand smoke.
BUT...BUT...BUT...the manner in which this was brought up is totally inappropriate. If you want to argue this point, don't post an article from the New York Times. SHOW ME THE ORIGINAL STUDY. Popular new organizations too often mis-interpret scientific studies in the press. I tried to find the original study cited here, but haven't been able to. The best I could find was that this study was presented at the American College of Cardiology's annual meeting back in April, 2003. It's possible the study has been published since then but I don't know. There can be a big distinction between studies presented at meetings and those that are published in peer-reviewed medical journals. Often the results published at specialty meetings are preliminary, and as thus are not intended to be used to draw any major conclusions about a topic.
The NY times article cites a 58% reduction in heart attacks in the 6 months after the ban was put into effect.
I was able to find, at another site (http://www.newscientist.com/news/news.jsp?id=ns99993557), that this statistic is referring to the reduction in the average number of monthly heart attack admissions at a hospital in Helena from "just under seven" before the ban to "less than four" after the ban. Fine. But this tells me little. How were these statistics gathered? If it was through chart review, were the reviewers "blinded" to the study goals? Were there any people evaluated for acute coronary syndrome in the ER and then sent home? Were the people admitted to the hospital with a heart attack smokers themselves, or were they non-smokers exposed to second-hand smoke? What other independent cardiac risk factors did they have? What criteria were used for admission to the hospital (ECG changes? Cardiac enzyme eleveations? Chest pain unrelieved by nitro?) And importantly, were these proven heart attacks (i.e., did the patients undergo cardiac catheterization)? Were any of the people admitted for heart attack from out of town? Is the town of Helena still being followed or did the study end at 6 months? And on and on.
One statistic--a 58% reduction in heart attack rates--looks good on paper but tells one little, without the actual study to back it up. A large number of other statistics are missing. Again, I highly suspect that second-hand smoke exposure is dangerous for non-smokers. And I'd be willing to bet this was probably a good study. But I do not like the way the popular press presents scientific papers and findings.
Greg--I believe the study you're talking about is most likely one that was published in the British Medical Journal May 17, 2003. The full reference is:
**Enstrom JE, Kabat GC. Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98. BMJ 2003;326:1057-61.**
It was and still is VERY controversial and has been extensively discussed both within BMJ's May 17 journal and in other places since its publication, including, it sounds like, on NPR.
And as a final point, Tigress, your comment:
quote:
Well, gee.....if something makes you cough a lot; you're eyes water up; your hair, skin, fingers and teeth get discolored and age faster; you smell bad; and your overall health isn't as good as it would be if you didn't smoke; that should be enough to convince anyone that smoking is harmful, if not fatal to the smoker and those around him/her. Why does anyone really need a study to confirm this? Because smokers don't care about anyone but themselves, that's why!
is completely inappropriate. To group ALL smokers together and say that they don't care about anyone but themselves is judgmental and counterproductive. You may believe that their behavior is self-centered, but to extend this judgment to the person is not right. I have never smoked myself and I never will. But I have talked with NUMEROUS people who are smokers and who are trying to quit smoking. This endeavor, in the opinion of other smokers I've talked to who HAVE successfully quit, appears to be one of the most difficult things a person can ever do. And even if someone quits, the addiction remains. If one has never been addicted to a substance, one CANNOT speak about what it is like.
If you are in a true relationship with someone and they've invited you in on their lives, then you earn the right to speak into their life about what you see as a destructive behavior. I also personally think that I, as a health worker, have a responsibility to tell my patients about the scientific basis for the dangerousness of smoking. And believe me, it's not like I'm telling them something they don't already know. BUT to make this into a morality issue is wrong. Believe me, I stuggle with this too, and I have a tendency to want to judge smokers for their behavior. But I have no right to do so. And along these lines, I don't think this topic belongs anywhere near the "Let's Solve the Problem of Evil" category.
Smoking is as bad, if not worse, than drug abuse yet people want to allow it in public places. Something's very wrong with this picture. It IS a morality issue because the smoker is endangering the health of the people around him/her. It's the equivalent of punching us in the face; shoving us into a burning closet and locking us in; drowning us, etc.
I'm sorry for judging ALL smokers. Obviously I wasn't including those who are sincerely trying to quit and who go out of their way to not smoke in the presence of nonsmokers. But, I do have the right to judge those unrepentant smokers who affect my health and the health of people I care about. I have an uncle who smoked for years, and it got to the point where his doctor told him he'd die in 6 months if he didn't quit. So with the help of nicotene gum, he quit. (Now he doesn't need the gum anymore, either.) Now, he can't even be in the same room or proximity to smoking, and he can't even live in urban areas anymore because his lungs are so bad that the urban air pollution affects him negatively. So, I can't help being a bit biased in this debate.
But, again I'm sorry for acting holy-than-thou. I know it must be difficult to quit an addiction. That's why I can never start drinking because my mom is an alcoholic (although she claims not to be) and I know myself all too well - that if I really like something, I tend to want more and more of it. So, I'm very prone to addiction. I just think that allowing something as unhealthy as smoking to be practiced in public places is unfair to those who are trying to remain healthy. Shouldn't healthiness be the standard by which we determine if something is allowed or not? It seems to me that the rights of non-smokers are more important than the rights of those that are being self-destructive by smoking. Heck, suicide is illegal for a very good reason. Smoking is simply a slower form of suicide - and homicide.
Tigress
"Name a shrub after me. Preferably one that's prickly and difficult to eradicate."
-Captain Jack Aubrey
"Master and Commander: The Far Side of the World" | | Back to Top | | |
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