Secondhand Smoke Exposure and Cardiovascular Effects Making Sense of the Evidence (2010) / Chapter Skim
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5 The Background of Smoking Bans
5 The Background of Smoking Bans
Pages 109-124
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From page 109... ...
. The committee here discusses some of the issues around smoking bans that are relevant to the evaluation and interpretation of the literature on the effect of bans on the incidence of acute coronary events.
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From page 110... ...
1983 San Francisco passes a law to place private workplaces under smoking restrictions. 1986 A report of the surgeon general focuses entirely on the health consequences of involuntary smoking, proclaiming secondhand smoke a cause of lung cancer in healthy nonsmokers.
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From page 111... ...
1992 Hospitals applying to the Joint Commission on Accreditation of Healthcare Organizations for accreditation are required to develop a policy prohibiting smoking by patients, visitors, employees, volunteers, and medical staff. EPA releases its report classifying secondhand smoke as a group A carcinogen (known to be harmful to humans)
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From page 112... ...
2002 New York City holds its first hearing on an indoor smoking ban that would include all bars and restaurants. The amended Clean Indoor Air Act enacted by the state of New York (Public Health Law, Article 13-E)
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From page 113... ...
EPA also cited other respiratory health effects in that report. As can be seen in Table 5-1, following the release of that report and with an increasing body of evidence demonstrating the adverse health effects of secondhand smoke, during the 1990s state and local governments across the country enacted an increasing number of more restrictive bans, including bans on smoking in most workplaces in some states.
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From page 114... ...
in 1999, the treaty was adopted by the World Health Assembly in 2003. It commits ratifying nations to "protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke by providing a framework for tobacco control measures to be implemented by the Parties at the national, regional and international levels in order to reduce continually and substantially the prevalence of tobacco use and exposure to tobacco smoke" (WHO, 2005)
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From page 115... ...
As can be seen in Figure 5-2 (IARC, 2008) , the health of nonsmokers after the implementation of a smoke-free policy can be affected not only by reduced secondhand-smoke exposure but also by concurrent changes (such as home smoking bans and decreases in smoking by people in other environments)
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From page 116... ...
Figure 3-2 editable FIGuRE 5-3 Adult per capita cigarette consumption and major smoking and health events, United States, 1900–1999.
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From page 117... ...
. Even if there is not an active multiprong approach, the approval and implementation of a smoking ban at the local or state level usually involves much public debate, which itself increases public awareness of the health effects of smoking and secondhand smoke (IOM, 2007)
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From page 118... ...
Thus, in interpreting the results of studies that looked at a possible relationship between smoking bans and acute coronary events, caution must be taken not to attribute a decrease in adverse events solely to a reduction in secondhand smoke or to attribute a decrease in secondhand smoke solely to bans; other factors rather, contribute to the decreases. One major change that could occur with the implementation of smoking bans is a decrease in smoking -- both through an increase in the number of people who quit smoking and through a decrease in the number of cigarettes smoked by smokers.
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From page 119... ...
. Previous Regulations and Characteristics and Enforcement of Smoking Bans Other factors that could affect the results of studies of smoking bans and acute coronary events are the extent of smoking restrictions in place before the bans, the characteristics of the smoking bans themselves, and how well the bans are enforced.
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From page 120... ...
Although it is possible that outside smoking could attenuate the benefits of a smoking ban, the concentrations of secondhand smoke in those areas, and the safety or hazardousness of such areas in human populations has yet to be evaluated. If smoking bans decrease acute coronary events, the inclusiveness of a ban (for example, the types of buildings and establishments included and the number of exemptions allowed)
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From page 121... ...
2008. Disparities in secondhand smoke exposure -- United States, 1988–1994 and 1999–2004 MMWR -- Morbidity & Mortality Weekly Report 57(27)
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2007. Declines in hospital admissions for acute myocardial infarction in New York state after implementation of a comprehensive smoking ban.
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From page 123... ...
2008. Effect of nationwide tobacco control policies on smoking cessation in high and low educated groups in 18 European countries.
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