jayh

[BTW I am a lifetime nonsmoker]

I certainly can! Before the government gets involved in stepping into people's affairs, it needs DAMN good reason. Erring on the side of caution is incompatible with free society.

Some jobs have higher risk than others. People should make those choices, not the government.

At the price of nanny state intrusion. It's NOT the government's job to coerce (beyond informational means) peoples choices.

j

charlie d

jayh:
in an ideal situation, I would agree with you. Alas, governments must make decisions that limit individual freedoms to maximize public interest all the time. Achieving the right balance is where the difficulty lies. I will not go out of my way to defend excessive anti-smoke crusading, but I do understand where certain public health decisions are coming from.

jayh

What 'ideal situation' are you talking about? An ideal situation is where the government stays out of private decisions. In the current somewhat socialist mentality, the government decides what risks we can take, what is healthy for us, how we should think.

I'm talking about exactly this situation, where the government is making choices for people it simply is not qualified to make. Especially when whatever reasoning is based at least somewhat on ideologically driven science (interestingly one argument for proposed banning of public smoking in LA was that it was a 'bad example' for children--how much more ideological can you be).

If you don't wish to go to a smoking restaurant don't. Certainly there are enough non smokers to financially support such businesses. But the government gets politically involved (as in so many areas) of protecting people from themselves.

brighid

Ladyshea,

Here is the information I posted in the original thread:

medical study from NZ:

http://www.ndp.govt.nz/tobacco/Morb...aretteSmoke.pdf

The Health Effects of Passive Smoking - A scientific information paper :
http://www.health.gov.au/nhmrc/publ...ses/ph23syn.htm

"Summary of findings "

This scientific information paper is an extensive review of evidence published in peer-reviewed scientific journals linking passive smoking (the intake of second hand smoke or environmental tobacco smoke) to disease.

This review has found important associations between passive smoking and a number of serious illnesses including asthma in children, lower respiratory illness, lung cancer, major coronary conditions and other illnesses.

As there are very few Australian data on the exposure to environmental tobacco smoke outside the home, this information paper estimates the risk of illness from exposure to tobacco smoke at home for people who have never smoked. "

Chapter 3 of this paper is of particular interest: http://www.health.gov.au/nhmrc/advi...chap3/index.htm

"The weight of evidence indicates that exposure to ETS is associated with asthma in childhood, and this association is most likely causal. Does ETS cause asthma, or does it only increase the severity of asthma among children who already have this condition? This question is not one that can be answered readily, as it is difficult to pinpoint the beginnings of asthma, and it may be argued that the condition, once acquired, is lifelong. However the scientific literature suggests that passive smoking may influence both aetiology and severity. Prospective studies have shown that first-ever episodes of asthma occur more commonly among children whose mothers smoke than among children whose mothers do not smoke [Martinez et al. 1992]. Furthermore, studies of children known to suffer from asthma have shown that exposure to ETS tends to make the condition worse [Murray and Morrison 1989, Chilmonczyk et al. 1993]. A review of children with asthma admitted to Davis Medical Center in California found that exposure to ETS was the strongest risk factor for severe disease requiring intubation (odds ratio = 22.4; 95% confidence interval: 7.4-68.0) [LeSon and Gershwin 1995]. In a small US study, children admitted to hospital with acute asthma were found to recover more slowly if they were exposed to ETS at home [Abulhosen et al. 1997]. The mechanisms of action are likely to be the same for induction of new cases and aggravation of existing cases, distinguished only by the diagnostic threshold above which symptoms attract medical attention and lead to a diagnosis of asthma. "

Here is one article (doesn't give the details of the report in scientific terms, just results)

http://www.efc.co.nz/infocat.php3?category=7


Second hand smoke increases both the severity and prevalence of asthma in children. Second hand smoking by children impairs lung function.

Children of parents who smoke are twice as likely to suffer serious respiratory illness. This effect is greater for children under two, but significant for older children too.

From the OMA -

"For more than 30 years, the U.S. Surgeon General's reports, based on strong scientific evidence, have identified tobacco use and exposure to second-hand smoke as serious public health hazards. In 1986, reports by both the U.S. National Research Council and the U.S. Surgeon General concluded that second-hand smoke causes lung cancer in adult non-smokers, and that children of parents who smoke have an increased frequency of respiratory symptoms and acute lower respiratory tract infections, as well as evidence of reduced lung function.5, 6 These facts were confirmed and strengthened by the 1992 U.S. Environmental Protection Agency (EPA) assessment of the health effects of second-hand smoke.7

A scientific consensus has emerged during the past 10 years that second-hand smoke is a major cause of lung cancer and respiratory disease in young people. More recently, evidence has accumulated of a causal link to heart disease. These facts have led to a growth in concern for the health of individuals not addicted to tobacco, but exposed to second-hand smoke."

"There is sound evidence that exposure to second-hand smoke in childhood is associated with an increased probability of developing asthma among certain at-risk children, and suggestive evidence that children who are not at risk and are exposed to second-hand smoke may have a higher-than-average risk of developing asthma. For asthmatic children, second-hand smoke has a causal role in asthmatic-related morbidity. Exposure to second-hand smoke represents a serious pediatric problem which has been estimated to double the risk of infection and death in children.17 They must be protected from the adverse health hazards of involuntary exposure to second-hand smoke. "

Brighid

charlie d

jayh:
an ideal situation is one in which people are free to make the best and best informed choices on their own. Alas, such freedom of choice and information availability are not always possible.

People cannot always choose their job, indeed in most cases they don't, and the inherent imbalance of power in any employer-employee relationship in a society operating below full employment simply requires a certain level of regulation. Therefore, it is the government's duty to do things like limiting the possibility of exploitation and maximizing safety on the workplace, if the people democratically decide this is a worthy social goal (which, to different extents in different countries, they have).

No matter how "annoying" government regulation seems to you now, in the past century it has banned child and indentured labor, ensured basic warranties of fairness in wages and career, eliminated obvious and unneeded workplace safety risks with a societal benefit that is truly immesurable, both economically and ethically.

Anyone swooning for laissez-faire capitalism should learn about workplace conditions at the turn of the 19th century, and imagine themselves as a 10 year old coal miner. Oh, wait, if 10 year olds didn't want to work in coal mines, they didn't have to, right?

ps418

Interesting thread. Whenever possible, please post information on the 'effect size' of passive smoke on risk, or odds ratios of developing cancer for exposed/not exposed groups. A risk can and often is 'statistically signficant' while at the same time adding very, very little risk in absolute terms, compared to other environmental carcinogens. Whether or not passive smoke adds to risk for lung cancer, the added risk must be extremely low, as even large-scale epidemiological studies show passive smoking risks hovering around the level of statistical significance. Also, it would be interesting to compare the results of the various studies with their sample sizes, and see if any relationships are found. For instance, if smaller sample size consistently yielded more evidence for an effect, this may be evidence for publication bias.

I remember reading once that smokers, despite the increased incidence of things like cancer and copd, actually use less health care dollars than non-smokers, by virtue of their dying earlier. I have no idea if this is true or not. Does anyone know the source of this? Perhaps its an urban legend?

Patrick (9 months without a cigarette)

brighid

http://www.mskcc.org/mskcc/html/11838.cfm - by Sloan Kettering


A good article addressing many of the discrepancies I have found regarding the passive smoking debate:

“Researchers such as Richard Doll at the University of Oxford, one of the world's leading authorities on smoking and health, admits the jury is still out. In the face of this, many doctors say it would be prudent for people to minimise their exposure to cigarette smoke--especially if they already have symptoms of coronary disease.’ http://193.78.190.200/ns1/ns_file/newsstory9.html

From what I can discern (from the research I have thus far done, which is not in any way conclusive) is that there is evidence that links second hand smoking to a number of different illnesses. The strongest evidence is found with the links to damage to fetuses, children, asthmatics and those with other lung and pulmonary dysfunctions. I have not come across any commentary disputing the effects SHS has on the unborn, children and those already at increased risk. That doesn’t mean that information doesn’t exist, but I have been unable to uncover it at this point.

There doesn’t appear to be a unanimous conclusion by the medical community regarding the exact extent and role SHS has in coronary heart disease and cancer. It appears more research needs to be done, but it also does not appear that even the skeptics in the medical community dispute that SHS is not healthy.

I think it is plausible that some in the medical community may have overstated initial findings because of the alarming risks active smoking posses to a person, and the undisputed risks posed to the new born, child, etc. I am not sure if that equates to a conspiracy, but rather an overreaction to something with potentially lethal, or harmful consequences.

I think that more research needs to be done. There are definite risks that no credible medical establishment can dispute with regard to the extensive studies done on active smoking. It seems logical that those exposed (and isn’t the duration or amount of exposure key in toxicology, not that one has been exposed?) to diluted amounts of the toxic products of tobacco smoke SOME of these people will suffer ill effects. It would seem the longer one is exposed, and the greater volume one ingests of any toxic substance the more likely one is to suffer some side effect. Unfortunately, we cannot easily determine (except for the aforementioned cases) who will or will not suffer these ill effects over short, and extended periods of time. All we know is that some people do and some people will suffer because of this exposure.

Some people have a genetic predisposition that allows then to remain relatively unharmed by long term, active smoking. These people (as with other cancer causing agents) seem to be the exception, rather then the rule. Most of us do not know what our genetic predisposition might be to any cancer, but it is more likely then not that smoking cigarettes will lead in large part lead to increased risk of heart disease, cancer, diabetes and other life threatening illnesses.

I know how I am affected by SHS and it has never been a positive, healthy reaction. At times that exposure has been life threatening as the major contributor to the aggravation of my physical condition (asthma.) I know that I can barely handle short-term exposure, and I am (even when medicated) immediately impacted by SHS. There is no other toxic irritant that I come in regular contact with that causes such a dire reaction. I live in a smoke free environment and my health has increased dramatically.

I know that if I had to live in an environment where I was exposed to smoke on a constant basis (such as when I live at home with parents who smoked) it would cause a serious deterioration in my health, and very likely lead to my death. I realize that SHS is diluted, but I honestly can’t imagine ingesting that “actively” into my lungs at such higher concentrations. SHS is literally painful for me to inhale and although the studies are not yet conclusive, I cannot even begin to imagine that SHS isn’t in at least minor terms (although not insignificant), but most likely more significant terms harmful to the health of the general public (given the proportion of children, asthmatics, and others.)

Brighid

Calzaer

Is anyone here old enough to remember the state of some of these "higher risk" occupations before the inception of OSHA?

ps418

It may be the case, but it is not necessarily the case, that small amounts of environmental smoke increases the risk for cancer, etc. There is a relationshio between duration/dose of smoking and smoking-related illnesses in smokers, but it is quite possible that there is a threshold effect, such that below a certain level of exposure, there is no increased risk.

IMHO, smoking should be banned in some public places, for example the DMV or whatever, because we all have to go there are some people do not want to be forced to inhale the smoke, regardless. But banning smoking in all public places I think is goinf too far.

Patrick

brighid

I would agree that it seems logical that below a certain level and volume of exposure there is no increased risk for disease. I am not sure what quantifies a "small amount" of exposure. Is that small amount quantified on a per exposure basis, or over a lifetime?

It also seems logical that someone exposed to SHS on rare occassion will unlikely be harmed, but someone exposed regularly will likely be at an increased risk of harm through attributable illnesses.

It would also seem that children, due to the nature of their developing immune systems, smaller lung capacity and deeper breathing would ingest a larger amount of toxins from SHS then an adult exposed to the same environment (volumen and duration). This seems to be one explanation put forward by the medical community regarding the increased danger to fetuses and young children.

I do not necessarily agree with a public ban on smoking going too far. Personally, because of the nature of my health I would prefer many laws curbing pollution to come into being. It would vastly improve my quality of life, and that of millions of other people suffering from identical and similar illnesses. If I never have to sit in a poorly ventalated restaurant that does not do a good job with proper barrier methods between smoking and non-smoking sections it won't be too soon enough. If I never again walked out into the public hallway in my place of employment where I am bombarded by dozens, and sometimes hundreds of smokers, immediately requiring me to hold my breath and then medicate I would be oh so happy. I would also be happy if pollution laws were strenghtened and the Clean Air Act remained intact by this, or any other administration.

I do realize that smokers have a right to do as they please with their bodies. The public arena is different and you just don't know how smoking will affect the person sharing your space. I believe that ones rights end where anothers begins.

Brighid