Tuesday, June 28, 2011

Smoking Bans And Evidence

ew York City’s ban on smoking cigarettes in parks, beaches, and pedestrian plazas has been in effect for less than a month, and big-government health activists are crowing. This latest “success” comes from a coalition of federally funded anti-smoking cigarettes groups and city officials trying to impose on us their personal preferences. But their justification for the ban is a gross distortion of the science.

The policy’s impetus was a Centers for Disease Control (CDC) program that provides grants to cities to promote smoking cigarettes bans and other policy changes, such as soda taxes, at the local level. While the Obama administration claims to finally recognize the need to limit spending, the CDC is using hundreds of millions of dollars from the stimulus bill and Obamacare as slush funds to promote “evidence-based” approaches to obesity and smoking cigarettes.

But an examination of the smoking cigarettes ban illustrates that the “evidence” justifying these initiatives lacks merit, and that further, in some ways, smoking cigarettes bans cause harm.

There are three purported reasons for the outdoor smoking cigarettes ban: 1) As the number of places one can legally smoke cigarettes is reduced, people will smoke cigarettes less, or quit altogether. 2) A ban will reduce exposure to secondhand smoke, benefiting non-smokers’ quality of life (it smells bad) and health (it kills). 3) Smoking bans reduce litter from cigarette butts. (Yes, Mayor Bloomberg actually said, “This summer, New Yorkers who go to our parks and beaches for some fresh air and fun will be able to breathe even cleaner air and sit on a beach not littered with cigarette butts.”) However, these arguments ignore the ban’s unintended consequences, such as moving smoking cigarettes indoors, exposing others to higher, actually harmful concentrations of smoke.

The smoking cigarettes ban will undoubtedly reduce exposure to outdoor secondhand smoke. But any argument that there is a health risk from transient exposure to outdoor secondhand smoke cigarettes is absurd, and certainly not based in evidence. The city’s press release touting the ban relies on a U.S. Surgeon General statement that there is “no safe level of exposure to secondhand smoke.” That’s true only in that no study has defined a safe level; it’s not the case that there isn’t one.

Outdoor-smoking cigarettes-ban advocates cite studies that simply aren’t relevant. Reports of disease from long-term indoor exposure to secondhand smoke cigarettes do not imply that short-term outdoor exposure will have the same effects. The city refers to studies that “suggest that sitting three feet away from a smoker outdoors can expose you to the same level of second-hand smoke cigarettes as if you were sitting indoors.” That may be. But why would anyone bothered by smoke cigarettes stay that close to a smoker in the park?

And finally, there are already laws on the books against littering. Why not punish those who litter, rather than those who smoke?

All of this is not to say there aren’t legitimate quality-of-life concerns that could justify the ban. But claiming the mantle of science only works when you’ve got the facts to back it up, explains an expert who supported indoor smoking cigarettes bans. Michael Siegel, a professor of community health sciences at Boston University, accuses officials of “purposely avoiding the critical issue here, which is that secondhand smoke cigarettes in parks is simply not a significant source of secondhand smoke cigarettes exposure.”

But perhaps the most interesting development related to New York City’s outdoor-smoking cigarettes ban is a new Reynolds American ad campaign alerting New Yorkers to an alternative to cheap cigarettes — snus, or smokeless cigarettes — that is not banned in parks . . . at least not yet. The campaign is brilliant because it capitalizes on the ban, encouraging smokers to migrate to a different product when they are in places where they are not allowed to smoke.

Some public-health advocates argue that the snus ads undermine the already questionable quitting effect of the ban. Instead of quitting, New Yorkers might engage in so-called dual-use: using discount cigarettes where it’s still legal to smoke, and meeting their tobacco needs with snus elsewhere.?

There may be some truth to this, but if so, the news isn’t all bad: Snus is non-combustible and far less harmful than cigarettes. But the advocates that push the dual-use theory, like the Campaign for Tobacco-Free Kids, refuse to see it that way. In fact, they helped draft the law that forbids smokeless-tobacco companies to advertise the fact that their products are safer than cigarettes, and that switching — whether permanently, or as a way station to quitting — can save lives.

We need a strong and credible public-health community to face today’s leading health problems, cigarette smoking cigarettes foremost among them. But ironically, activists and government officials are now using the same type of scientific sophistry once employed by the tobacco industry itself. And we know what happened to their credibility.

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