COMPROMISE SHOULD BE REACHED ON SMOKING BAN (2-2003)

The debate on whether or not smoking should be banned in bars and restaurants is 
hitting close to home. The City-County Council in Indianapolis will debate the 
issue, which was introduced this week by a Southside Republican, sometime in 
March or April.

If passed, the measure would prohibit smoking in "all enclosed public places" 
and "within places of employment." That includes employee break rooms, restrooms 
and vehicles. Smokers would also not be able to light up within 25 feet of a 
business.

This would bring the City of Indianapolis and Marion County in line with other 
cities, such as Dallas, which have already banned smoking in public places, and 
with the State of California.

The proposal has already started causing quite a controversy, not only among 
council members, but with the general population of the city as well. Some 
people strongly favor such an ordinance. Others are just as adamant that passing 
such a measure would mean far too much government interference in private 
business.

Prohibiting smoking in all restaurants, and especially in bars, would be a 
serious governmental infringement, which should be made only if there is a 
compelling reason. One reason would be if there is a definite benefit to public 
health. And the health benefit aspects of a smoking ban are what most 
governmental entities cite when proposing or enacting such laws.

But are there definitive studies proving that secondhand tobacco smoke is 
harmful to non-smokers? There are, but the harmful effects of environmental 
tobacco smoke have often been overstated by the media, and by the Environmental 
Protection Agency.

More than three dozen studies have been conducted over the past 20 years or so 
regarding the effects of secondhand tobacco smoke on the health of non-smokers. 
In 1993, the EPA released the results of an analysis which used a number of 
these studies to show a correlation between secondhand smoke and the death rates 
of non-smokers.

What is not generally known, however, is that the EPA analysis was flawed. In 
order to establish a causal relationship, the EPA had to double the margin of 
error from 5 percent to 10 percent. And then the risk ratio was only 1.19, 
meaning that there was a 19 percent increase in risk of lung cancer from 
secondhand smoke.

Generally speaking a risk ratio of less than 2.0 is not considered significant, 
due to biases that are invariably introduced into epidemiological studies. "As a 
general rule of thumb, we are looking for a relative risk of 3 or more before 
accepting a paper for publication." said Marcia Angell, editor of the New 
England Journal of Medicine.

The 1993 EPA study, along with a similar one performed by the World Health 
Organization, are what most governmental entities rely on when introducing 
smoking bans. 

However, a more recent study conducted in Canada does indicate a risk ratio of 
3.0 when those people who have had the longest exposure to secondhand smoke are 
compared with life-long non-smokers.

Dr. Kenneth Johnson and a team at Health Canada analyzed a lifetime of 
information from 761 women who had never smoked, and 71 others with lung cancer. 
"These data absolutely back a smoking ban in bars," said Johnson.

What local politicians really ought to do is come up with a reasonable 
compromise to a complete smoking ban in all businesses. Smoking bans in 
restaurants are, I believe, justified by the data on the health effects of 
secondhand smoke. Do we really want to increase the risk of giving our children 
respiratory disease just to appease someone’s bad habit?

Any environment where children are welcome should be smoke free. That also 
includes a voluntary moratorium on smoking in homes by parents of young 
children. And children should certainly not be allowed in the smoking section of 
any restaurant. Children are a captive audience and must be given the highest 
level of protection since they cannot always choose to go elsewhere.

However, children are not allowed in bars. Therefore, the data indicating risk 
associated with secondhand smoke can be interpreted more loosely, because bars 
are occupied by adults who all chose to go inside. Bartenders and waitresses who 
do not smoke may be at increased risk, but they surely realized when they began 
their profession that almost all bars allow smoking.

The compromise that makes the most sense is to ban smoking in the workplace and 
in all restaurants that serve children, but not in bars or nightclubs that are 
frequented only by adults who know the risks and are willing to accept them.