Rapid Improvement In Health Of Bar Workers Associated With Smoking Ban

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Article 13 Oct 2006 - 4:00am (PDT)

 

Bar workers in Scotland showed significant improvements in

respiratory symptoms and lung function within 2 months following a

ban on smoking in confined public places, according to a study in the

October 11 issue of JAMA.

 

Exposure to secondhand tobacco smoke is a major worldwide public

health issue, according to background information in the article. The

effects on individuals has been difficult to measure, but a number of

studies have established an increased risk of coronary artery

disease, cerebrovascular disease and lung cancer, and the 2006 report

by the U.S. surgeon general highlighted the causal relationship

between secondhand smoke and premature death. In addition, for

patients with preexisting respiratory conditions such as asthma,

secondhand smoke leads to poorer disease control and more frequent

hospital admission.

 

As the harmful effects of secondhand smoke become more widely

appreciated, a number of countries have attempted to limit the health

risks to the population at large by prohibiting smoking in public. On

March 26, 2006, Scotland introduced a legislative ban on smoking in

enclosed public places. One group of people most likely to benefit

from this legislation is bar workers, who are exposed to high levels

of secondhand smoke as part of their occupation.

 

Daniel Menzies, M.B.Ch.B., and colleagues from Ninewells Hospital and

Medical School, Dundee, Scotland examined the effect of the recently

introduced smoke-free legislation on bar workers' health in Scotland.

The study, conducted in Tayside, Scotland from Feb. - June 2006,

initially included 105 nonasthmatic and asthmatic nonsmoking bar

workers, of whom 77 completed the study. The participants were

evaluated for respiratory symptoms (wheeze, shortness of breath,

cough, and phlegm) and sensory symptoms (red or irritated eyes,

painful throat and nasal itch, runny nose, and sneeze), and also had

pulmonary tests and blood tests performed before the ban and at 1

month and 2 months after the ban went into effect.

 

The researchers found that a total of 79.2 percent (n = 61) of the

bar workers experienced respiratory or sensory symptoms before the

introduction of the smoke-free policy, whereas 1 month afterward,

53.2 percent (n = 41) reported these symptoms, a decline of 26

percent. At 2 months after introduction of the smoke-free policy,

this improvement was maintained, with 46.8 percent of participants

reporting any symptom (a decrease of 32.4 percent from baseline).

There were also improvements on certain measurements of lung function

and reductions in serum cotinine (metabolized nicotine) levels.

Asthmatic bar workers also had less airway inflammation and an

increase in quality of life scores. (JAMA. 2006;296:1742-1748.)

 

Please see the article for additional information, including other

authors, author contributions and affiliations, financial

disclosures, funding and support, etc.

 

Editorial: Banning Smoking in Public Places - Time to Clear the Air

 

In an accompanying editorial, Mark D. Eisner, M.D., M.P.H., of the

University of California, San Francisco, comments on the erroneous

arguments made against banning smoking in certain places.

 

" Three common arguments are advanced against mandating smoke-free

bars, restaurants, and other hospitality businesses. Each is

fallacious. First, laws to prevent smoking in bars will not be

effective. Four years after the California ban on smoking in bars,

adherence with the law was high: 99 percent of bars in restaurants

and 76 percent of freestanding bars were smoke-free. Near perfect

adherence has been reported in Boston, Ireland, and New Zealand.

Second, the general public will not accept smoke-free bars and

restaurants. In fact, a series of international studies shows that

most people do support smoke-free bars and restaurants. Moreover,

public opinion becomes increasingly positive following smoke-free

legislation. Third, smoke-free laws will cause bars and restaurants

to lose money. Using sales tax and other objective financial data,

studies now conclusively demonstrate that bars, restaurants, and

hotels do not lose revenue after becoming smoke-free. In fact, some

of these studies actually show a growth in income. In sum, smoke-free

legislation is effective, accepted by the public, and has no negative

economic impact. "

 

" Mandating smoke-free workplaces will decrease secondhand smoke

exposure and will improve respiratory health, prevent chronic

disease, and extend life span. Important salutary health effects

occur in as little as 1 month after cessation of secondhand smoke

exposure. The comprehensive body of research documenting the serious

adverse health effects of passive smoking provides a powerful

rationale for prohibiting smoking in all public places. The time has

come to clear the air, " Dr. Eisner writes.

 

(JAMA. 2006;296:1778-1779.)

 

Financial disclosures - none reported.

 

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Contact: Daniel Menzies, M.B.Ch.B.

JAMA and Archives Journals