By Dr. Ehrlich
The New York Times this morning says that New York Mayor Michael Bloomberg intends to ratchet up his long anti-smoking campaign another notch, this time to include parks and beaches. Part of it is the gross spectacle of watching small children putting cigarette butts in their mouths before Mom has a chance to grab them away. But of course the worse element is the health effects. Health Commissioner Dr. Thomas Farley studied data for months and found “that someone seated within three feet of a smoker — even in the open air — was exposed to roughly the same levels of secondhand smoke as someone sitting indoors in the same situation.”
Naturally, smokers feel oppressed. As a former occasional smoker myself, I have been following the false personal liberty arguments for 50 years, brought to you by that pillar of bias-free science, the Tobacco Institute. But the case against second-hand smoke continues to accumulate. The New England Journal of Medicine reports a study on the incidence of childhood asthma after a ban on public smoking in Scotland in March 2006.
“Before the legislation was implemented, admissions for asthma were increasing at a mean rate of 5.2% per year (95% confidence interval [CI], 3.9 to 6.6). After implementation of the legislation, there was a mean reduction in the rate of admissions of 18.2% per year relative to the rate on March 26, 2006 (95% CI, 14.7 to 21.8; P<0.001). The reduction was apparent among both preschool and school-age children. There were no significant interactions between hospital admissions for asthma and age group, sex, urban or rural residence, region, or quintile of socioeconomic status.” Smoking cessation, both personal and second-hand, is one of many factors that contribute to the better care of asthma and allergies. I am reminded of a six year old boy whose chronic allergies and asthma caused many sleepless nights and missed school days. He attended a very aggressive school program in New York City, but quickly fell behind because of school absences and difficulty finishing assignments. After returning to school in the fall, mother came to me and was aware of two things. Her son did well while spending the summer with his grandparents in the country (no don't automatically blame city air pollution), and on his return to the apartment in New York he continued to do well. Mother ran into a neighbor on the elevator, and on the trip up learned that a couple who lived directly below her apartment--both heavy smokers--had moved. The neighbor noted that there was no more odor of smoke coming up through vents, and the mother quickly made the connection that that is why her son was feeling so much better: the lack of second-hand smoke from an adjacent apartment. To this day my patient is doing very well.