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I posted this last year, but given the discussion of a St. Paul smoking ban,
I thought it might be good to post an edited version again.

Elizabeth Dickinson
West Side

The Secondhand Smoking Gun

October 15, 2003
 By ROSEMARY ELLIS 

Six months into New York City's smoke-free ordinance, there
has been a spate of criticism about the wisdom of sticking
by such a ban. The most notable came in a roundabout swipe
from none other than former Mayor Rudolph W. Giuliani, who
declared during a trip to Ireland last month that Irish
citizens should have the choice to smoke in public places.
(Mr. Giuliani later tried to distance himself from his
comments.) 

But if New York - as well as other cities and
municipalities - is ever tempted to rescind its smoking
ban, it should look at the goings-on in Helena, Mont. The
citizens of Helena voted in June 2002 to ban smoking in all
public buildings - including restaurants, bars and casinos.
Soon after, doctors at the local hospital noticed that
heart-attack admissions were dropping. So they, in
conjunction with the University of California, San
Francisco, did a study to measure the potential short-term
effects of a smoking ban.

Helena is a perfect place for such a study: relatively
isolated, with enough people in the region (66,000) for a
meaningful population sample, and only one cardiac-care
hospital within a 60-mile radius. So it was easy to control
the study sample and methodology: if you get a heart attack
in Helena, there's only one place to go for treatment.

The study showed two trends. First, there was no change in
heart attack rates for patients who lived outside city
limits. But for city residents, the rates plummeted by 58
percent in only six months.

"We know from longer-term studies that the effects of
secondhand smoke occur within minutes, and that long-term
exposure to secondhand smoke is associated with a 30
percent increased risk in heart attack rates," says Stanton
Glantz, a professor of medicine who conducted the study's
statistical analysis. "But it was quite stunning to
document this large an effect so quickly."

It was also stunning to witness what happened next. The
Montana State Legislature, under pressure from the Montana
Tavern Association and tobacco lobbyists, rescinded the ban
in December. The result: heart-attack rates bounced back up
almost as quickly as they dropped.

The bottom line of Helena's plummeting, then soaring, heart
attack rate is painfully obvious: secondhand smoke kills.
Only 30 minutes of exposure to it causes platelets in the
bloodstream to become stickier. When that happens, blood
clots form more easily, which can block arteries and cause
heart attacks. 

Dr. Richard Sargent, one of the study's authors, points out
that eight hours of working in a smoky bar is equivalent to
smoking a pack of cigarettes a day. In such an environment,
other studies have shown, workers more than double their
chances of developing cancer and asthma, and pregnant
workers put themselves at risk for miscarriage and
premature delivery.

All of which make Mr. Giuliani's comments particularly ill
informed. In addition, despite the dire economic
predictions that preceded it, the smoking ban in New York
City does not appear to have drastically depressed
business. From March to June, the city created 10,000 new
restaurant and bar jobs, according to the Department of
Labor. The state Department of Taxation and Finance's most
recent report of alcohol and beer tax collections (which
measures both on-premises consumption and retail sales)
shows that revenues rose to $15.2 million this past August,
from $14.4 million in August 2002. And although the tobacco
lobby continues to finance a campaign claiming that New
Yorkers are unhappy with the ban, a poll released earlier
this month by Quinnipiac University reported that 59
percent of voters in the state favor prohibiting smoking in
public places; another survey, commissioned in August by
antismoking groups, found that 70 percent of New York City
voters support it. 

At a time when the city's budget is in tatters, smoking in
public places also sets off an enormous domino effect in
public-health spending by creating or worsening illnesses
whose treatment costs are eventually shouldered by
taxpayers. For all of these reasons, New Yorkers can't
afford to be as easily defeated as the unfortunate citizens
of Helena - nor as easily manipulated by the tobacco lobby
and the politicians who are in its pocket.

Rosemary Ellis is editorial director of Prevention
magazine. 

http://www.nytimes.com/2003/10/15/opinion/15ELLI.html?ex=1067228995&ei=1&en=
b8134393232930eb



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