brighid

Other negative effects of smoking on health:

http://www.asrm.org/Patients/FactSheets/smoking.pdf

A short summary on the impact of smoking on male and female reproductions. It seems that smoking activates a gene that leads to infertility in some women. It can also cause erectile dysfunction in men. It is recommended to avoid SHS if infertility is a problem, or if one desires to become pregnant.

"In a study published in the July 16 issue of Nature Genetics, researchers exposed female mice to toxic chemicals found in cigarette smoke called polycyclic aromatic hydrocarbons, or PAH. They found that inside the mouse ovaries, PAH turns on a dangerous gene called Bax, leading to the early death of mouse egg cells."

http://my.webmd.com/content/article/33/1728_83878

Obviously this won't happen in every smoker, because many don't seem to have reproductive issues but I wonder if that process has any genetic factor, such as with those smokers who don't seem to suffer from cancer, heart disease or other problems related to smoking.

Direct Medical Costs:

" Direct medical costs for medical care attributed to smoking in this country were an estimated $50 billion in 1993 -- $26.9 billion of which was for hospital care, $15.5 billion for physician visits, $4.9 billion for nursing-home stays, $1.8 billion for prescription drugs, and $900 million for home health care visits.[4] Lost productivity and earnings from smoking-related disability were estimated to cost an additional $47 billion.[3, 4] Finally, cigarette smoking annually costs the nation 1.1 million years of potential life lost before reaching 65 years of age, and 5 million years of potential life lost in total life expectancy.[5]" http://www.medscape.com/viewarticle/446803

Brighid

Viti

Brighid, of course smoke will exacberrate in those with asthma as will any airborn irritant, this is not in dispute. What is at issue is the causal relationship between SHS and severe asthma attacks, IMO.

Pollution, allergens, and chemicals of all kinds can trigger serious or deadly asthma attacks. Several studies have shown the highest mortality rates for asthma tend to cluster in the poorest urban neighborhoods and among African American...they are not necessarily related to smoking.



Smoking is the most common cause of adult onset asthma in the elderly however

[QUOTE]In one study of elderly people with severe adult-onset asthma, smoking was the most significant risk factor for developing this condition. Smoking, in any case, contributes to decline in lung function in everyone. cite

Asthma is also confounding for other reasons

Note: Louisiana does not have smoking bans in restaurants or most public places

So the way I read this is that smoke can irritate the lungs of asthma patients as can any airborn irritant. There is not enough yet known about the disease or enough evidence to state with any confidence that banning smoking in public places would correlate to a decline in asthma attacks, or that children of smokers are at higher risk for severe or fatal attacks.

Viti

The more I think about it, the more I think we could cite opposing studies all day. I sorta wanted to make my main point again.

The sensationilistic headlines by the antismoking lobby exagerrate the dangers of SHS. I hate misinformation in all of its forms and think that this widespread "panic" will cost us in unnecessary legislation and results in the demonization of smokers.

Here's a few items I found doing a quick google search

Please read the article or scan it...WHAT STUDY?? There is no true citation (only the names of the doctors) so that the parents who may now be frantic with worry can view the results for themselves. The study itself is based on previous literature and is not available at the AMA website any longer. Now that is a pretty heavy ssertion to make, yet the layman has no access to the relevent information. SOmething is just wrong with that to me.

Viti

I had heard this, and since I am infertile (for no reason we can find) I will be reading the studies provided...thank you!

scigirl

The guest urologist told our class last week that smoking also decreases male fertility. He stated that for every year men smoke, they lose a year off their potential sex life.

This is an interesting thread - lots of questions raised. Should we have the right to expose ourselves to smoke? Maybe - but then should we demand health care for problems that the smoke led to? How much damage *does* second hand smoke do, and how much is too much, before we ban the stuff? How does addiction play into this - are people really choosing to smoke, after they are addicted? What responsibility does society have to prevent smoking, or do they even have this responsibility? What works better - anti-smoking ads, legislation, putting Philip Morris in jail, cigarette taxes, etc? All of the above? None of the above? How about research into addiction and prevention?

Anyway, lots to think about...

scigirl

ps418

That's interesting. But its obviously a one-sided equation. What I'm wondering about are lifetime net medical costs of smokers vrs non-smokers. For instance, is the 50B/yr offset by the treatment that is not given later in life due to the loss of 5 million person-years of life-expectancy? I don't know one way or the other, but of course the assumption behind the very large tobacco taxes is that the net cost is very large, and not offset by the loss in years of life-expectancy. I've heard once before that the lifetime medical cost is more than offset by the lost years, but I dont know it thats true or not. I do know one thing though -- we need to start taxing twinkies and Big Macs, given the epidemic of obesity and its health consequences (which are second only to tobacco).


I agree with a smoking ban in places where people have no choice but to be, like the DMV or the hospital. That's not what bothers me. For instance, what if I wanted to open a bar, called Patrick's Smoking Bar: By Smokers, For Smokers, which allowed smoking. You can feel free not to visit this bar, or to work in this bar. Should smoking be banned in this privately-owned business because it happens to be open to the public?

You said something about poorly ventilated restaurants. This brings up the point that in well-ventilated buildings (most new buildings), concentrations of SHS are so extremely low that there is no reason to expect any negative health consequences. With proper partitioning and ventilation, a facility could easily limit the SHS exposure of nonsmokers to mere nannograms, and with minimal inconvenience to smokers.

Again, this may be true, but not necessarily. Its not necessarily true that someone routinely exposed to low levels of SHS will be at increased risk. It may or may not be true, and only experiments or epidemiological data will answer the question.

For example, there is evidence that very low doses of radiation have beneficial effects, even though higher does of radiation are extremely harmful or fatal. This is called radiation hormesis. There is also chemical hormesis, that is, many chemicals which, though displaying 'harmful effects' at high doses, display beneficial effects at very low doses. You can do a web search for "chemical hormesis" or check out the BELLE (Biological effects of Low Level Exposures) website.

With regards specifically to cancer risk and SHS exposure, the epidemiological data is remarkably weak, depsite the fact that common sense would lead one to expect a great risk factor to jump right out of the data (as it does with epidemiological surveys of smokers themselves).

Let me be clear, though, I do not think that there is any evidence that low level exposure to SHS is beneficial. The childhood asthma data at least seems to be well-supported. My point is only to caution against extrapolating from High dose/Very Harmful to Low Dose/Somewhat harmful.

I have the total lifetime dose in mind, which is what is most relevant here. And by small amount, I mean small compared to the doses ingested by smokers themselves. The dose of smoke inhaled through SHS is a very small fraction of what smokers themselves inhale.

Patrick

brighid

I agree that it is rather one sided. It may be difficult to determine (with great certainty) the overall health costs of smokers vs. non-smokers, but I do think educated approximations be concluded (and revised) with the amount of data we thus far have. I am going to make general assumptions with my following statements. I think smoking is ONE negative factor in the overall health of an individual and in general, smokers follow a certain health or even lifestyle trend (of course exceptions exists on both ends of this spectrum.) I would assume that in general smokers tend to be less physically active in the exercise department. This is in part due to the harmful effect smoking can have on cardio-vascular health and fitness. In general I would assume that smokers aren’t as concerned about an optimally, healthy lifestyle (as compared to a physically active vegetarian, but not that smokers are unconcerned about health) because smoking is known to be bad for ones health. A person more concerned about their health, or even very concerned about ones health tend to make dietary, environmental and physical fitness choices that are beneficial, or optimal for health and physical fitness. The cessation of smoking, or the choice never to begin smoking is generally a choice this group of people would logically make. Some smokers are also overweight (and some non-smokers are as well) and therefore doubly at risk of diseases attributable to obesity and smoking. Therefore, some smokers are more likely to tax the health care system because within their shorter lifetimes they require more, and expensive health care because of the nature of their diseases. Unfortunately, I do not have any data at the moment to support my theory on that, but to me it seems to be a logical conclusion based on the presently available evidence.

I want to state that I do not believe that SHS (as thus far determined by scientific evidence) has been conclusively proven to be the cause of cancer in people subjected to repeated exposure to SHS. I think it is a factor for some individuals, but I have not yet seen the strong line of evidence I think is required to make that conclusion. That does not mean that evidence isn’t out there, but that I have not yet observed it.

I would agree that taxing fast food and the such would also be beneficial in one aspect of fighting obesity in the US.


I think a bar developed specifically for smoking and smokers should be allowable as a private business with general regulation regarding appropriate ventilation and coded safety measures. I do think this is different then a restaurant in general. As a person physically and medically aggravated by smoke I do my best to avoid bars, although I have found some clubs be well ventilated and affect little or no aggravation to my asthma. I have left restaurants that do a poor job segregating smokers and non-smokers, and prefer to frequent restaurants that have a no-smoking policy. I very much dislike sitting in an open air setting (for the fresh air) and have to share that space with a smoker, unless a vigorous wind is blowing.

There is a restaurant that I went to once that has a rather well established wine and cigar bar. They have a specific and lovely room specifically for smoking of cigars and cigarettes. The restaurant area and cigar area are well segregated and I could not even tell that a cigar section existed in other parts of the restaurant, or while at the wine bar and it is in close proximity to the cigar room/bar.

I think that the public interests of smokers and non-smokers can be balanced, but it requires very specific regulations and properly segregated areas with adequate ventilation.

So I would say it depends on the situation. I would not chose to enter a “smoking bar”, nor would I chose to work there either. I do think the government has a vested interest in protecting the public against the yet undetermined disease possibilities of second hand smoke, and should err on the side of caution until conclusive and convincing studies can be made. As the scientific information evolves, so should public policy.


I agree with this as well, but I do think distinctions must be made with regard to the well supported data linking SHS with childhood illness and asthma, and the other yet poorly supported claims of SHS and cancer, etc.

I also think the dose and exposure issues should be dealt with on an individual basis when applicable. For instance, my personal tolerance of SHS is different then perhaps yours.

No one knows yet, who will or who will not develop known diseases from smoking or SHS. We do know that there are increased risks, some of the risks are lower and others are very high. SHS might not cause cancer in passive smokers, but it does harm children, fetuses, and those will aforementioned illnesses.

I have not found that SHS is NOT harmful, but in some cases it might be less harmful then some have said. I think the pro-smoking reaction to the anti-smoking overreaction has been to overstate those differences. SHS is harmful and no one can disagree with that. They can only disagree on how harmful it may be (because neither side has the applicable and supportive data) in some cases.

I figured this is what you meant, but I wanted to be clear. I would also like to differentiate the risks between those people exposed in utero to smoking, further in childhood, and those exposed merely as adults in occassional situations.

The data supports that children are most at risk, and although some children will not be immediately harmed, many more will be. The overall impact on lifelong health has not been determined for these children because often times some illnesses don't manifest until decades later.

I think that the average, non-smoking persons risks to exposure to SHS and it's potential harm is rather negligible. I don't think that occassionally inhaling SHS in public settings will cause the majority of people to contract any disease. It is those who are repeatedly exposed and exposed by large numbers of people that concerns me, as well as those who are naturally at higher risk for harm.

Although I think some of the anti-smoking campaign has taken some aspects of the dangers of smoking and the known and potential dangers of SHS too far, I do not believe those instances should negate the sound results we do have. More research needs to be done, but should we caution people to be, or sorry?

I think people should be able to make up their own minds, but as skeptics well understand ... most people want some one else to make up his/her mind and not think through, or research one and much less both sides of the argument.

Brighid

ps418

So, then, you would not have a problem with allowing smoking in public places so long as the smoking areas were adequately partitioned and ventilated? That's my opinion, but of course some of the smoking bans that have been enacted do not allow for that possibility.

Patrick

brighid

Yes Patrick, I would not have a problem with it. I think this solution balances the needs and rights of all adult parties involved equally. It allows a place where smokers can congregate and have a before, after, or even during a meal smoke while maintaining the proper atmosphere of those who do not smoke, and do not wish to be in a smoking environment.

I do agree that some laws, thus far enacted go a bit far and are reactionary in certain instances. Unfortunately, I do not know the logisitics of enacting the kind of requirements to make older public establishments similar to the one I have mentioned. I think for some of those business such a change would be cost prohibitive and some of the legislature may have been enacted with that in mind. It is certainly cheaper and easier to say absolutely no smoking in public places, albeit unfair to smokers it does serve a general public health improvement.

Brighid

Vesica

If nothing else, the media attention and the amount of debate surrounding public smoking has certainly drawn attention to the issue. But I wonder if most people aren't missing the second issue here...The smoking is a highly stigmatized personal choice.

I will admit I am a smoker. I rountinely 'step out' from social gatherings, announcing "I'll be right back, I'm going to go be a social pariah now". True, there are a lot a people who are very allergic to SHS, but there are also many allergic to perfumes and other scents people assult thier fellow humans with. Why this rabid distaste for smoking??

We can't say it's because we as a nation care so much about the smoker's health. After all, as another poster pointed out, we are not heavily taxing foods dripping in saturated fats and cholesterol. And as much as we regulate alcohol, the nation would gasp if we stopped serving it in public - ignoring the fact that this would lessen accidents caused by those intoxicated and then choosing to drive.

I have been told numerous times that I don't look like a smoker. When I ask, Well what does a smoker look like? people cannot answer. Why are they surprised I smoke, and can even agree with each other that I 'don't look like a smoker' but can't define what a smoker lookk like?? This points to the picture of a 'typical smoker' these people believe and buy into but aren't even aware of!

Incidentally, those that could answer coherently have informed me that I don't have enough burn marks on myself or my clothes. One even anwered that, for a woman who smokes, I wear too little eyeliner and am not bitter enough!