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James L. Holly, M.D. |
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| James L. Holly,M.D. |
| October 26, 2006 |
| Your Life Your Health - The Examiner |
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As Beaumont approaches the end of the first three months of our city-wide smoking ban, this column repeats part of a January 2005 Your Life Your Health column in which we called for a state-wide ban of public use of tobacco products. Following that, the current column discusses the nostalgia some profess for the wonderful days of “public smoking” in Beaumont. By the way, no one has yet reported a single business which has closed, or which is experiencing a significant down-turn in volume since the ban took effect.
From the January, 2005 Examiner
Sir, do you prefer smoking or non-smoking seating in our restaurant? No smoke! Pardon me? I want a seat with no smoke; I want to walk through no smoke in order to get to my seat and I want to go to a restroom with no smoke! This is not an uncommon exchange when I go to a restaurant. During a recent trip to New York City, I kept asking for "no-smoke" seating and kept being reminded, "Sir, you must be from Texas; in New York City, all of our seating is non-smoking."
Each puff of cigarette smoke contains billions of destructive free radicals, all of which are damaging to your health. In the September 9, 2004 Examiner, this column commented: "In one of the more amusing events in recent political history, a candidate for public office claimed that he had 'smoked marijuana' but that he had never "inhaled." While that may be a "distinction without a difference," its converse is not. Everyday, millions of non-smokers, people who have never and would never place a tobacco product in their mouth and set it on fire, inhale tobacco smoke.
Many parents, who smoke, are eager to keep their children from smoking, while every day, they cause them to inhale the toxins and poisons contained in tobacco smoke. Recently, a patient indicated an absolute unwillingness to stop smoking. I asked, "Do you smoke around your children?" The answer was, "Yes," to which I responded, "Then, while your children may not be smoking, they are inhaling."
Second-hand Tobacco Smoke or Inhaling the Smoke of others
Environmental tobacco smoke, a mixture of exhaled mainstream smoke and non-inhaled, side-stream smoke, contributes to respiratory illnesses of children. Burning tobacco produces multiple toxic compounds. Infants and toddlers may be especially at risk when exposed to environmental tobacco smoke. Exposure to toxic compounds in infancy is particularly dangerous because early lung development appears to be a critical determinant of respiratory health.
Respiratory infections are frequent in childhood, and about 30% of all infants are treated by a physician for bronchiolitis, croup, or pneumonia. Risk of respiratory illness is increased in infants and children whose parents smoke. Infants exposed to maternal smoking have an increased incidence of lower respiratory tract infection. Infants whose mothers smoke at least one pack per day have 2.8 times the risk of developing a lower respiratory infection as children not exposed to tobacco smoke. Children hospitalized for acute lower respiratory illness before age 2 are 1.8 times as likely to live with smokers than control subjects hospitalized for non-respiratory illness. A doubling in risk attributable to passive smoking clearly represents a serious pediatric health problem.
Stopping Exposure to Passive Smoke
As SETMA's LESS Initiative swung into full force on the first clinic day of 2005, every patient was confronted with:
- Losing weight
- Exercising
- Stopping Smoking
For both adults and pediatric patients, questions concerning smoking address not only active smoking but exposure to passive smoking. In one family, this effort has already resulted in a smoke-free home. The mother brought her child to SETMA's pediatric department; the clinic completed the LESS Initiative and gave the mother material on stopping smoking and on the dangers for children of passive smoking. She accidentally left it in her truck. When her husband found the material, he read it and announced that he and everyone in the family was quitting smoking.
Community Smoking Policies
Community smoking policies that restrict access to cigarettes or the acceptability of smoking are an important component of the social environment that supports nonsmoking among young people. They contribute to the perception by young people that nonsmoking is normal and public smoking is unacceptable. Most schools have policies on smoking; those with more restrictive policies for both students and staff have lower smoking rates. National studies show public smoking restriction is associated with lower smoking rates.
Adolescents report that obtaining cigarettes is easy, and these reports have been confirmed by studies of successful buying by underage teens. There is preliminary evidence that a direct relationship also exists between tobacco access and smoking among young people. Efforts to prevent access have included the regulation and banning of vending machines and greater enforcement and monitoring of age-of-sale laws, with preliminary data suggesting that these measures can reduce access to cigarettes and prevalence of smoking. To date, however, no state in the United States has tobacco regulations that can be considered comprehensive.
Banning Smoking in Texas
Texas is not a major tobacco-producing state. Therefore, banning smoking will not have the same political risk as it might have in the Carolinas, and there is no doubt that the tobacco lobby has used oppressive tactics to resist banning of tobacco use in public places.
Where bans have been introduced the response has been mostly favorable. In California, 73% of the people were in favor of the ban. In Ireland, where a total national ban is in effect, the feared negative responses have not developed. A small study in Helena, Montana showed that a ban decreased the incidence of heart attacks by half. This was a short and small study but the implications are intriguing.
Smoke-filled bars and casinos have higher levels of cancer-causing particles in the air than highways and city streets packed with heavy traffic, according to just-published research. The study, in the latest issue of the Journal of Occupational & Environmental Medicine, concluded that ventilation systems do nothing to protect workers in smoke-filled bars and casinos, a finding that contradicts tobacco industry claims.
Research using state level prevalence statistics has shown that smoking rates declined faster in Massachusetts than in other states after Massachusetts began its comprehensive tobacco control efforts in 1993. The current study, using individual level data, shows that the Massachusetts effect did not result from differing demographic composition or shifts in composition over time, and therefore can reasonably be attributed to the state's tobacco control efforts. It also shows that the Massachusetts effect has to date been concentrated among males, suggesting the need for additional or revised efforts to influence female smoking behavior.
The American Heart Association
The AHA maintains that physicians have an obligation to tell every smoker to quit smoking in a "clear, strong and personalized manner," and they should also warn non-smokers to avoid all exposure to secondhand smoke. In a tough new set of guidelines for preventing heart disease and stroke, the Heart Association said the goal of every person who wants to avoid cardiovascular disease should be "complete cessation" and "no exposure to environmental tobacco smoke."
Banning Smoking in Texas
Texans should demand:
- That tobacco use be banned in all public buildings, restaurants, bars, and stores.
- That increased efforts be made to prevent children from buying or using tobacco products.
It is not enough that you not smoke yourself; in order to protect your health and that of your children, you must make sure there is not exposure to second-hand, environmental or passive smoke. No one is legislating away a person's freedom to choose to harm themselves by smoking; Texans simply need to declare that they will no longer passively submit to the harmful effects of passive smoke exposure.
Call your State Senator and State Representative. Let them know that you want them to introduce legislation to bring Texas up to the health standards of other states. Let them know that you will no longer endure exposure to passive smoke in public places. Let them know that in the future, this issue will be one of your considerations for supporting of a candidate.
Remember, it is the life and health of your children and grandchildren which is at stake and it is your life and your health, also.
New Material for this column
Nostalgia for smoking-days of yore
A Whimper -- remembering the halcyon days of lead paint, asbestos, public smoking
A whimper! Yes, a "low whining, plaintive" sound ushered in the day of no smoking in public places in Beaumont. In 2000, we were told that calamity would befall all of us due to "Y2K." Some -- I had friends who did -- stocked up on food and prepared for "nuclear winter." It was another whimper. For all of the moaning and for all of the silliness which saw non-smokers "light up" on July 31st in solidarity with their tobacco-addicted friends, the arrival of the day of enforcement of the smoking ban in Beaumont has been a non-event.
A New Society
For those who will recall the pre-August 1, 2006 smoking liberties in Beaumont as the halcyon days of freedom and actualization, I would like to recommend that we start a new society. Its purpose will be to make certain that our children never forget that once upon a time their fathers and mothers were free to smoke anywhere. To that remembrance, we will add the lamentation that we are no longer free to use lead in our paint. Of course, lead in paint poisoned our children, but we're talking liberty here. Who are you to tell me that I'm not free to use lead in my paint, if I choose? And besides, we need the lead in our paint to make paint durable on the Gulf Coast. It will cost millions of dollars in additional maintenance of wood homes if we don't have lead in our paint. People will leave town and move to Lubbock. It will be the end of prosperity for our region, if we take the lead out of paint.
We'll also have a subchapter which will celebrate the days of asbestos use and we'll have an annual march protesting the fact that we can't exercise our freedom to use asbestos siding and insulation, if we choose. We, of course, will have to get someone to speak up for us because most of us who used asbestos either can't breath, or have succumbed to the complications of our exposure to asbestos, but that's a small price to pay for liberty and freedom. Give us back our asbestos, our lead paint and our public use of tobacco; we want to be free. We can't breath, but we are free!!
Our new society will add other issues to our agenda as we attempt to roll back the tide of responsible citizenship in favor of unfettered freedom regardless of the consequences. We will certainly be joined by those who want to make automatic weapons loaded with armor piercing bullets available over the internet. No matter that our young men and women who patrol our streets are placed at risk by this choice. After all, we are for total freedom.
The Breath of Fresh Air
However, it is possible that our new society may not do so well, as nothing will invigorate our community like the "breath of fresh air" which became available to all in Beaumont, Texas on August 1, 2006. Parents may be glad to use lead-free paints for the benefit of their children. We may find little sympathy for the use of asbestos with the disease and death which it caused. We may find that the overwhelming majority are willing to relinquish their "right" to own automatic weapons with armor-piercing bullets for the increased safety that brings to our law enforcement officers.
Congratulations, Beaumont. No lead, no asbestos, no tobacco smoke - what will we think of next to improve the health of Southeast Texas. And, by the way, no thank you, I don't want to join the new society which I proposed above. Beaumont must remain vigilant lest the tobacco lobbies undo our progress. Don’t forget, tobacco companies spend $1.2 billion a year promoting their product. Don’t forget it is your life and it is your health, promote both by sustaining the smoking ban and expanding it state-wide to all of Texas.
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