• By Dartington SRU
  • Posted on Monday 06th September, 2010

Do everyone a favor - stub it out completely

Indoor bans have forced smokers in bars and restaurants into doorways, on to patios and down dark alleys, but there seems to be no safe hiding place. A University of Georgia (UGA) study in collaboration with the US Centers for Disease Control and Prevention suggests that these outdoor smoking areas might be creating a new health hazard.Thought to be the first to assess environmental levels of cotinine, a nicotine by-product, in non-smokers exposed to second-hand smoke outdoors, the study found levels up to 162 percent greater than in the control group. The results have been published in the Journal of Occupational and Environmental Hygiene.Luke Naeher, associate professor in the UGA College of Public Health explains that cotinine is a marker of exposure to tobacco – not a carcinogen. The next step would be to measure levels of a carcionogenic molecule known as NNAL among people exposed to second-hand smoke outdoors.Athens-Clarke County, Georgia, enacted an indoor smoking ban in 2005, providing Naeher and his colleagues and ideal environment for their study. The team recruited 20 non-smoking adults and placed them in one of three environments: outside bars, outside restaurants and, for the control group, outside the UGA main library. Immediately before and after the six-hour study period, the volunteers gave a saliva sample that was tested for levels of cotinine.The team found an average increase in cotinine of 162 percent for the volunteers stationed at outdoor seating and standing areas at bars, a 102 percent increase for those outside of restaurants and a 16 percent increase for the control group near the library.Naeher acknowledges that an exposure of six-hours is greater than n average patron would experience, but said that employees can be exposed for even longer periods."Anyone who works in that environment – waitresses, waiters or bouncers – may be there for up to six hours or longer. Across the country, a large number of people are occupationally exposed to second-hand smoke in this way."Studies that measured health outcomes following indoor smoking bans have credited the bans with lowering rates of heart attacks and respiratory illness, but Naeher says the health impacts of outdoor second-hand smoke are still unknown.An investigation by public health specialists at Ohio State University took a different slant, reporting on the economic consequences of anti-smoking legislation. It weighed the effect on the number of employees working in restaurants and bars where there were partial bans, complete bans and no bans at all – and found nothing to choose between them.“Because partial bans, total bans and no bans on smoking in public places have no differential effect on employment in restaurants and bars, it is obvious that a total ban on smoking is the only way to protect employees and patrons from second hand smoke,” reports Elizabeth Klein, from Ohio’s College of Public Health. Klein studied ten cities in Minnesota from 2003 to 2006, using data from the Minnesota Department of Employment and Economic Development. Employment was based on per capita figures to allow comparison among non-urban, small cities, suburban and large cities for a 45-month period.In communities where there was a total ban on smoking in public places, there were two fewer employees per 10,000 residents compared to those without any ban on smoking. There were fewer employees per 10,000 compared to communities with partial bans.“These differences are not statistically significant, they are not disastrous, and they are not long-term, as are often predicted by opponents of any type of bans on smoking in public places,” Klein argues.Her paper in Prevention Science, the journal of the Society for Prevention Research notes that the concern for the economic health of bars was one of the reasons that led to a rollback of a county level, comprehensive clean indoor air policy in Hennepin County in Minnesota, which includes Minneapolis. The rollback in Hennepin County was eventually reversed by the comprehensive state level ban on smoking in all public places.See: Klein E G, Forster J L, Erickson D J, Lytle L A and Schillo B “Does the Type of CIA Policy Significantly Affect Bar and Restaurant Employment in Minnesota Cities?” Prevention Science 10, 2 pp 168-74.

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