On Jul 28, 2004, at 2:16 PM, Michael Atherton <MA> wrote:
<MA> Okay, enough of this theoretical quibbling. I contacted the Vancouver Health Department and checked the city's ordinance. Their Smoking Rooms are required to have completely separate heating, cooling, and ventilation systems. These rooms are required to maintain negative air pressure and at least 6 air exchanges per hour. Smoking Rooms are only permitted in bars, not restaurants. Some bars have installed Smoking Rooms, others have not. Recently, some bar owners went to the city council to request that the maximum size of Smoking Rooms be increased, which indicates that the cost of such rooms is with profitability and that there is a demand for them.
<AR> I would not have a problem with that solution. Personally I would like to see double entrance doors before I would enter the establishment. But I think that could work. I would also put in the caveat of licensing fees to pay for added inspections to make sure the buildings actually do have separate HVAC systems and are up to code. But I also do like the idea that those rooms would be unserviced, thus not exposing the workers to dangers of secondhand smoke.
<AR> On to the British Medical Journal study.
<MA> Citing this study illustrates why statistics should be required in high school.
<AR> This is not high school level statistics. :-) And the study is considered groundbreaking. Again it shows that even small amounts of secondhand smoke can cause major increases in the risk of developing heart disease. Up to to a 60% increase, depending on exposure.
There are a number of problems in using this study in a discussion of whether to regulate second hand smoking in bar and restaurants. First, it is a correctional study and no claim can be made as to causality.
<AR> The term used most often in medical studies is a "correlational study." A correctional study only seems to relate to psychology studies, although the meanings seem to be quite similar. That aside, correlational studies are basically the foundation of medical science. For instance, there is no "causal" (I do mean causal, not casual here) study that proves if you smoke you will get lung cancer. It certainly has come to be known that if you smoke, you are increasing your chances of getting lung cancer, and doing so by a significant amount. It is next to impossible to prove causality over long periods of time, due to the complexity of people's lives. There are simply too many variables in the world to remove to absolutely prove causality. That is why it is so important to have a large sample size, and do your best to remove as many outside variables as possible. This study looked at a very large number of male adults -- over 4,700, and it checked blood levels of the participants for a by-product of nicotine that forms in the bloodstream called cotinine. Cotinine only forms in the bloodstream through exposure to smoke, and measuring the level in the bloodstream shows how much exposure to secondhand smoke has happened. This study did much to remove as many outside variables as possible.
<MA> Second, they looked at the relation between second hand smoke exposure to subjects with "partners" who smoked not second-hand smoke exposure in bars and restaurants.
<AR> It did however look at people whose partners smoked very low levels of cigarettes in a day -- 1 to 9. The correlation between this group and heart disease is relevant, and I promise you that the concentrations of secondhand smoke is much higher in a bar than a house where 1 to 9 cigarettes are smoked in a day.
<MA> Third, this study was done in Great Britain, not the U.S.
<AR> Wow. Aside from being completely regional-centric, a British doctor by the name of Sir Richard Doll was one of the first to show the correlation between lung cancer and smoking. The British knighted him for his pioneering studies on the effects of smoking. He was one of the first in the world to show the correlation between smoking and heart disease over fifty years ago. The Brits have actually been the leaders in the world when it comes to smoking studies, and I for one am glad they are now studying secondhand smoke. They do not suffer the same pressure from the tobacco companies that our researches do in this country. PACs, Politics, Lobbyists and Lawyers all enter into the equation here -- not so much there.
<MA> Fourth, the authors reported that some of the subjects may have been smoking
themselves when they claimed not to be. All of these facts,
illustrate why replication and the avoidance of over-generalizing results
are important considerations in science.
<AR> Again, studying cotinine levels in such a large sample size all but eliminates the relevance of small number of individuals misrepresenting their own smoking levels. The study is still valid. In fact, with a confidence level of 95%, it is a slam dunk in the world of medical studies.
<AR> But here is a question for you or anyone else that gets to the other side of the equation. I challenge anyone to show a study published in a MAJOR medical journal that shows there are NO adverse health effects from secondhand smoke. :-)
<MA> REGARDLESS, my arguments for individual rights and Smoking Rooms have never been based on the lack of health risks. I will readily concede that second-hand smoke may be hazardous.
<AR> For this I go back to one of your recent posts and your statement: "Neither ban advocates or opponents can make strong cases for the dangers of second hand smoke, there is simply not enough evidence at this point in time." This is what I am responding to. That there is no strong evidence is a myth that I am trying to dispel. There is good evidence at this point, and it keeps getting better and better everyday as more and more studies are looking at secondhand smoke rather than smoking itself.
<MA> My proposal is based on the position that Smoking Rooms protect non-smokers from significant risks, WHICH, by-the-way, the current ordinance does not.
<AR> OK, big concession time here. If the room has a totally separate HVAC system that is in no way connected to the rest of the building, then it becomes it's own separate building. The only point of entry is the doorway between these separate areas. That doorway would need to be worked on for me to provide full support for this idea, as I can see many times where the number of people coming in and out of these rooms might be in large enough numbers to keep that one door open all the time, thus defeating the separate systems. A hospital system based on negative pressure needs to "recharge" it's pressure at points -- if the door is open all the time then the pressure will be equalized, and the smoke will then flow. Perhaps a two door system with some form of air removal system between the two doors might work.
<AR> Of course separate smoking rooms does bring up potential disparities between the haves and have-nots. From what I understand, the neighborhood bars were opposed to the idea mainly over concerns that they would not be able to afford the systems necessary to have their own smoking rooms, while bigger bars across the street might. The potential for close proximity competition scared them off. This is not a discussion for me. I simply care that people understand secondhand smoke really is bad for you, and there is evidence out there from credible sources that shows that to be the case.
<AR> While I was searching for information on Vancouver, I came
across this tidbit from the Health Canada site: "Ventilation systems
in homes and workplaces were never designed to remove smoke. Their main
purposes are to limit the accumulation of carbon dioxide, which we exhale,
and to keep odors down. At an average ventilation rate of one air
exchange per hour, it takes three hours to remove 95 per cent of the smoke
from a single cigarette -- and the remaining five per cent can still be
harmful." That is the effect of ONE cigarette. I wonder how many
cigarettes are smoked on average in the typical bar during the evening?
<MA> This point is irrelevant. I think that it is clear (no pun intended) that
smokers will realize that Smoking Room are not designed to protect their
health and if they don't we can place warning signs on the doors.
<AR> Not really irrelevant as it goes to show how an HVAC or filtration system connected to any room where smoking is allowed will not have the desired effect of eliminating the dangers of secondhand smoke from that room full of smokers. Separating the systems would seem to solve that. I am not opposed to smokers doing damage to themselves -- their choice.
Andrew Reineman Linden Hills
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