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Smoking ban

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Smokefree laws are government public policies enacted to create smokefree workplaces and/or public places in a country, state or city.

Voluntary smokefree policies are established by owners and managers of businesses as a means to eliminate tobacco smoking in indoor areas of workplaces and are presented as a way to prevent employees from incurring health harm due to occupational exposure to secondhand smoke.

History

Pope Urban VII's short papal reign gave way to 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".[1]

In the later part of the 20th century, as research studies on the health risks of tobacco smoking were made public, tobacco industries launched courtesy awareness campaigns (asking if people around the smoker are bothered by smoke before lighting up, blowing smoke away from other people).

Different attempts at accommodating both smokers' desire to smoke where they wished and the need to effectively reduce or isolate environmental tobacco smoke have been suggested and tested in practice: designated smoking and non-smoking sections, ventilation systems and enclosed smoking rooms. However, these measures are immediately dismissed by anti-smoking organizations as a reasonable compromise solution.

By the year 2000, smoking bans were often limited to individual cities. 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.

Rationale

Laws implementing bans on smoking have been introduced by many countries in various forms over the years, with legislators citing health statistics that show tobacco smoking is often harmful to or fatal for the smokers themselves and for those subjected to passive smoking (also known as secondhand smoke or ETS, environmental tobacco smoke). Additional bases for smoking bans are reduced risk of fire and reduced quantities of litter.

Those supporting bans cite the reduction in the incidence of lung cancer and other diseases caused by smoking, and avoiding being forced to inhale smoke.

Medical and scientific basis for bans

The detrimental effects of smoking have been known for decades, including causing and/or exacerbating a wide variety of medical problems, such as lung cancer, bronchitis, emphysema, and heart disease.

Incidence of impotence is approximately 85 percent higher in male smokers compared to non-smokers[2], and it is a key cause of erectile dysfunction (ED)[3] [4]. Smoking causes impotence because it promotes arterial narrowing[5].

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[6]. 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%[7].

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[8]. Sidestream smoke contains more than 4000 chemicals, including 69 known carcinogens such as formaldehyde, lead, arsenic, benzene, and radioactive polonium 210 [9], 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[10] because passive smokers do not gain the benefit of the filter.

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. [11] 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[12].

Research has also shown that improved air quality translates to decreased toxin exposure among employees[13]. 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). [14]

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]. These views are more widely supported in some European countries, such as France than in the United States.

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 has been suggested as a reason for the UK not having a smoking ban in place.[15]

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. However, this principle is not generally accepted, at least in relation to workers. Business owners are legally required to maintain a safe working environment, and cannot contract with their workers to relax this ban, nor can trade unions ignore the issue.

A further 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. So, while smokers do have the right to harm themselves, so too do the people chosen by governmental authorities to enforce the smoking ban have the right to impose penalties on them for smoking in places where it is prohibited. However, smokers may argue that they are being singled out unfairly if other activities that endanger health are not restricted[citation needed].

Questions over health costs of smoking

The main arguments against smoking being a "victimless crime" are the health risks of passive smoking and increased health costs borne by society. On the latter point, certain studies suggest that complete smoking cessation might actually result in an increase in total health care costs in the long run[16]. This paradoxical possibility stems from the fact that nonsmokers live longer on average and can thus incur higher total lifetime health care costs obscuring the fact that if nonsmokers live longer they also pay during their lifetime more taxes than smokers that statistically become ill and die earlier.

Psychoanalytic

The psychoanalytic theorist, Slavoj Žižek, has argued that the contemporary trend of introducing smoking bans in the Western world is part of a much larger cultural trend towards "absolute narcissism", in which it is always assumed "that whenever you are in contact with another person, somehow he or she can infect you".[17] In this sense, although Žižek does not smoke and dislikes tobacco companies, he views smoking bans as symptomatic of a culture whose narcissistic citizens cannot cope with social interaction as well as previous generations.


Smoking bans by country

See: list of smoking bans

Bhutan, Ireland, Norway, Sweden, Italy, New Zealand and Scotland have instituted country-wide smoke-free legislation.

Bhutan

In November 2004, Bhutan became the first country in the world to ban tobacco sale completely. There is a 100% import tax on tobacco products brought into the country for personal consumption[18].

Scotland

Scotland became smoke-free on the 26th March 2006, after the Smoking, Health and Social Care (Scotland) 2005 Act took effect. This legislation prohibited smoking in all enclosed public places, including bars, restaurants, shopping malls, theatres and offices. Some exemptions were granted on grounds of human compassion or safety, and as such smoking is permitted on board submarines, oil rigs, adult care homes and psychiatric units, among others. It is interesting to note that the Scottish smoke-free legislation also prohibits the smoking of herbal/other lit materials not just tobacco products. Since implementation, compliance rates have been high, and as of 14th June 2006, only one premises has been fined for permitting smoking. Additionally, the Swallow Group of hotels, who had launched a legal challenge to the legislation, formally abandoned their attempt on the 13th June 2006, after being advised that they would not succeed.

Three months after implementation, the comprehensive smoking ban was deemed a success. Phonecalls to smokeline (smoking support line run by NHS Health Scotland) had increased before and after the ban and smoking cessation services reported an increase in clients.

United Kingdom

The British medical journal The Lancet called for a national ban on smoking in public places in the UK in the December 2003 issue.[15]

United States

Within the United States, an increasing number of states have proposed bans against smoking in indoor public places, with 11 having them in place in January 2006. In states such as California, these have been followed by outdoor smoking bans. However, not all states have adopted proposed antismoking legislation - Virginia, New Hampshire, and Maryland had not done so in January 2006.

Most bans have some exemptions for business owners, mostly for adult-only establishments such as bars and nightclubs, or where adults-only periods exist, as in some bowling alleys. Some states exempt restaurants where enclosed rooms separate smokers from non-smokers.

Many areas that do not have statewide bans still have bans on a city-by-city basis. On December 28, 2005, USA Today reported that "six states enacted indoor smoking bans in 2005, more than in any previous year, as public sentiment appears increasingly anti-tobacco." The same news article states that 39% of U.S. citizens live in areas that "are covered by statewide or local laws limiting smoking, according to Americans for Non-smokers' Rights. In 1985, there were fewer than 200 such state and local laws in the USA. Today, there are more than 2,000. Of those, 118 state or local governments ban all smoking in restaurants, bars and other workplaces."[19]

In 2003 New York City amended its antismoking law to include all restaurants and bars, 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.[20] A 2006 study by the state of New York found similar results.[21]

US Surgeon General Richard Carmona has called for smoking cessation based upon the fact that smoking kills 440,000 Americans each year via numerous types of cancers and leukemia. However, opponents of smoke-free legislation cite the experience of the US prohibition of alcohol in the 1920s and, more recently, the War on Drugs, which showed that banning a harmful but popular product leads to widespread drug trafficking, which generates organized crime.

Alternatives to bans

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.[3]

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."[22]

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."[23] 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[24], 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[25]. A 2006 US surgeon general review[26] of studies suggests that business may actually improve[27]. 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.

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".[28] 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 is prohibited on streets in some areas of Tokyo, hence smokers retreat into smoking lounges.

Outdoor smoking bans

In some places with long-established strict indoor smoking bans, experiments with outdoor smoking 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. Proposed bans pertaining to smoking in cars and private homes also have been introduced also by antismoking crusaders. Custody suits are readily encouraged by ash.org, an extremist antismoking organization. The unfortunate thing is many antismoking organzations present their initial policies as "clean indoor air acts", but move on to these other agendas if their initial smokefree policies are adopted by communities.

See also

References

  1. ^ Nicotine: An Old-Fashioned Addiction, pp 96-98, Jack E. Henningfield, Chelsea House Publishers, 1985
  2. ^ "The Tobacco Reference Guide". Retrieved 2006-07-15.
  3. ^ Peate I (2005). "The effects of smoking on the reproductive health of men". Br J Nurs. 14 (7): 362–6. PMID 15924009.
  4. ^ Korenman SG (2004). "Epidemiology of erectile dysfunction". Endocrine. 23 (2–3): 87–91. PMID 15146084.
  5. ^ Kendirci M, Nowfar S, Hellstrom WJ. (2005). "The impact of vascular risk factors on erectile function". Drugs Today (Barc). 41 (1): 65–74. PMID 15753970.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  6. ^ Boyle P, Autier P, Bartelink H; et al. (2003). "European Code Against Cancer and scientific justification: third version (2003)". Ann Oncol. 14 (7): 973–1005. PMID 12853336. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  7. ^ 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.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. ^ "Disparity in Protecting Food Service Staff from Secondhand Smoke Shows Need for Comprehensive Smoke-Free Policies, Say Groups".
  9. ^ "Involuntary smoking". Retrieved 2006-07-15.
  10. ^ 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.
  11. ^ "Indoor Air Quality in Hospitality Venues Before and After Implementation of a Clean Indoor Air Law --- Western New York, 2003".
  12. ^ "Study Finds That New Jersey Bars and Restaurants Have Nine Times More Air Pollution than Those in Smoke-Free New York".
  13. ^ "Smoking ban leads to healthier bar staff".
  14. ^ "Airborne exposure and biological monitoring of bar and restaurant workers before and after the introduction of a smoking ban".
  15. ^ a b "Passive Commitment". Lancet Oncol. 4 (12): 709. 2003. PMID 14662425.
  16. ^ "The Health Care Costs of Smoking".
  17. ^ "I Am A Fighting Atheist: Interview With Slavoj Žižek".
  18. ^ "Bhutan seeks to ban smoking". Retrieved 2006-07-15.
  19. ^ "39% live in areas limiting smoking".
  20. ^ " Bars and Restaurants Thrive Amid Smoking Ban, Study Says." 29 March 2003, The New York Times.[1]
  21. ^ "Cig Ban no Bar Burden; Biz up Despite Law." 25 July 2006, The New York Post.[2]
  22. ^ Jamie Doward (June 19, 2005). "Smoking: (Tony) Blair will push for total ban". The Guardian.
  23. ^ "High compliance with the smoke-free workplace law means dramatic reduction in exposure to second-hand smoke in enclosed workplaces".
  24. ^ "The Effects of Smoke-Free Restaurants". Retrieved 2006-07-21.
  25. ^ "Disparity in Protecting Food Service Staff from Secondhand Smoke Shows Need for Comprehensive Smoke-Free Policies, Say Groups".
  26. ^ "The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General". Retrieved 2006-06-27.
  27. ^ "Richard Roesler: Surgeon general: No safe level of secondhand smoke". Retrieved 2006-06-27.
  28. ^ "Twin Cities bars and restaurants which closed after one year of the smoking bans".
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