RSS feed“Do you mind putting out that cigarette please?” I remember saying that to a smoker at the next table when I was having lunch with my three children last year. I wish more people would say that to smokers when they find themselves sitting next to them. SHS has been around for years and few do anything about it. The detrimental health effects of SHS have been suspected for a long time but society has been slow to act. Indeed, it was not until two and a half years ago that smoking in pubs (or bars) was made illegal in a whole country, the Republic of Ireland. Scotland followed by prohibiting smoking in confined public places only on March 26th 2006. When the concept of banning smoking in pubs was first mooted, there was uproar from the owners of pubs (called publicans) because they feared that business would suffer and people who smoke would no longer frequent the pubs. This proved to be unfounded and the trade did not suffer. Has this action led to any beneficial health effects?
A study from Dundee, Scotland investigated the association of smoke-free legislation with symptoms, lung function and markers of inflammation in bar workers (JAMA 2006; 296: 1742 – 1748). The symptoms monitored were in two domains, namely, respiratory and sensory. Respiratory symptoms included wheeze, cough, phlegm and shortness of breath. Sensory symptoms included red or irritated eyes, painful throat, nasal itch, runny nose and sneezing. For lung function, the force expiratory volume in the first second (FEV1) and the exhaled nitric oxide content were monitored. One month before the smoking ban, 79.2% of the bar workers experienced respiratory or sensory symptoms. However, one month after the smoking ban, only 53.2% of the workers reported any symptoms. The median number of symptoms experienced by these workers decreased from 2 at 1 month before the ban to 1 a month after the ban and then to 0 at 2 months after the ban. The FEV1 of these workers at 1 month after the smoking ban had also improved by 8.2% and there was a 20% reduction in the nitric oxide content in the exhaled air. Two months after the introduction of the smoking ban, the absolute white cell and total neutrophil (a type of white blood cell) counts in these workers were also significantly lower, indicating a reduction in the degree of inflammation in the body.
Another study from Colorado, USA, studied the effect of a citywide public smoke-free ordinance on the incidence of acute myocardial infarction in Pueblo, Colorado (Circulation 2006; 114: 1490 – 1496). The incidence of acute myocardial infarction (AMI) in the residents was significantly reduced after the introduction of the public smoke-free ordinance. The risk of AMI was reduced by 27%.
Despite these gestures of banning smoking in some countries, SHS is still a major health hazard in most of the world. In some countries, new legislation has been introduced to limit the percentage of outdoor eating areas where smoking is permitted. In such situations, one could be sitting at a no-smoking table next to a smoking table. The distance apart is no more than a single arms length!! Do the law makers believe that the smoke somehow would not waft across the imaginary line of division between the smoking and non-smoking areas? How much protection would this legislation afford people against SHS? The mind boggles!
Smokers have always used the argument that banning smoking would impinge on their civil liberties. What about the civil liberties of those around them? When smokers light up, are they not impinging on the civil liberties of the non-smokers around them? The next time you find yourself experiencing SHS, do speak up. The simple sentence “Do you mind putting out that cigarette please?” will not only be beneficial to your health but also the health of those around you.
