Ah yes, one wee comment to add to Mr Bell's excellent summary of the contribution made by the Scots to what we know about the grrreat benefits of brrreathing air free & clear of smoke: It canna be a matter of "choice" for the folk who work in the pubs or dish out the haggis if they are ever forced to return to working in a smoke-filled workplace. We dinna tolerate an employer knowingly exposing their workers to an airborne carcinogen (that is a cancer-causing agent) - with the sporadic exception of environmental tobacco smoke. Fortunately the Scots continue to lead the way, as they have for much of the past thrrree hundred years (Its a little known fact that the Scots, Western Europe's poorest nation, actually invented the modern world and everything in it - see the book by Arthur Herman if ye don't believe me).

Aye, and to make the circle complete, we must confess that the Scots earlier led the world in the dissemination of the Vile Weed itself: In 1740, Glasgow's great tobacco lords were creating a major trading center for American tobacco, re-exporting tobacco to France, Scandinavia, the Mediterranean and Russia. By 1750 they were unloading 21 million tons of tobacco, and by 1758 their tobacco imports exceeded those of the rest of all English ports combined. By 1771 it grew to 41 million pounds, a third of all Scottish imports, and two-thirds of all exports. It was in part by observing the behaviors of the Glasgow "Tobacco Lords" that Adam Smith formulated some of his economic theories about the nature of large-scale business enterprises laid out in "The Wealth of Nations".

Yet another reason I continue to struggle to help people quit smoking, to clear the debt of History laid down by my ancestors...

And I would add that several years ago a similar experience occurred in Helena, MT. The city invoked a smoke-free indoor air policy and saw cardiac related incidents reduce significantly. This was not noticed until the ban was overruled and the incidence of cardiac events shot back up. Shortly after that the CDC issued an alert to people with heart disease to avoid areas where second-hand smoke was present. The effect is noted in anyone with heart disease, especially non-smokers (since they are normally not exposed to cigarette smoke).

Smoking bans are the real health hazard


The bandwagon of local smoking bans now steamrolling across the nation has
nothing to do with protecting people from the supposed threat of
"second-hand" smoke.

Indeed, the bans themselves are symptoms of a far more grievous threat, a
cancer that has been spreading for decades throughout the body politic. This
cancer is the only real hazard involved - the cancer of unlimited government
power.

Loudly billed as measures that only affect "public places," smoking bans
have actually targeted many privately owned places such as bars and shops -
places whose owners should be free to ban smoking or not and whose customers
are free to patronize or not. Outdoor bans even harass smokers in places
where others' health is obviously not the issue.

The decision to smoke or to avoid "second-hand" smoke, is a question for
each individual to answer based on his own values and judgment. This is the
same kind of decision free people make regarding every aspect of their
lives. All lifestyle decisions involve risks; some have demonstrably harmful
consequences; many are controversial and invite disapproval from others. but
the individual must be free to make these decisions. He must be free,
because his life belongs to him, not to others, and only his own judgment
can guide him through it.

Yet when it comes to smoking this freedom of choice for a minority, is being
seriously limited by a majority made baselessly fearful through massive
media campaigns often funded by tax dollars.


The real threat we face here, no matter how strongly it is denied by the
anti-smoking lobby, is the systematic and unlimited intrusion of government
into our lives.

We do not elect officials to control and manipulate our behaviour. They are
in office to serve us, not vise versa.

Thomas Laprade
Thunder Bay, Ont.

2006: A new study, based on government data and 1,000 times as large as Helena (315,000 heart attacks!)
has shown that smoking bans actually have no effect on overall heart attack rates. This study, available at smokersclubinc.com has been publicicly supported and confirmed by noted Antismoking researcher and physician, Dr. Michael Siegal

Heart Attacks drop because of smoking bans??


The problem with this article is that its conclusion is based on a comparison of apples to oranges. In order to compare the change in heart attacks in Scotland from 2006-2007 to the trend in heart attacks during the preceding ten-year period, one needs to use the same data source to compare these trends.

In this article, the researchers use one source of data to estimate the change in heart attacks from 2006-2007 (observed changes in admissions for nine hospitals representing a portion of the country) and a different source of data to estimate the trend in heart attacks from 1996-2006 (national data from the Scottish National Health Service).

A critical basis for the article's conclusion is that the year-to-year decline in heart attacks in Scotland never exceeded 10%, while the researchers found a 17% decline in heart attacks during the year following the smoking ban.

However, the relevant question is not what the national health service data show, but what changes in heart attack admissions would have been found using the same methods employed by the researchers to count heart attack admissions for 2006-2007. What would the annual changes have been using the same 9 hospitals and using the same method of counting heart attack admissions?

It is important to note that:

(1) The diagnosis of acute coronary syndrome in 2006-2007 was based on an assay for cardiac troponin (a component of cardiac muscle which is released into the blood following heart injury), which is a very sensitive test for cardiac injury. For the period 1996-2006, the diagnosis was likely made based on less sensitive measures, since the use of troponin to diagnose coronary syndrome has greatly increased in recent years.

(2) The random variation and secular trends in coronary syndrome for the 10-year period prior to the smoking ban are based on standardized, national data which include the entire country of Scotland. Thus, the variation is likely to be much lower than the variation in the data from a sample of just 9 hospitals.

The correct way to conduct this analysis would be to examine the trends in heart attacks in all of Scotland for the entire ten-year period using a single, standardized and consistent data source and then to examine the degree of random variation in year-to-year changes in heart attacks and see if the observed change associated with the smoking ban is inconsistent with the magnitude of observed year-to-year changes during the years preceding the smoking ban.

Fortunately, the annual data on heart attack admissions in Scotland is available online, so we can examine the magnitude of year-to-year changes in heart attacks in the past decade and see how the change associated with the smoking ban compares.

Remember that the smoking ban was implemented in March 2006, so changes from 2005 to 2006 would reflect the smoking ban, as would changes from 2006 to 2007.

Between 2005 and 2006, the number of heart attack admissions in all of Scotland declined by 4.2%. Between 2006 and 2007, the number of heart attack admissions in Scotland dropped by 8.0%.

That might sound like a big drop, large enough that we would conclude it was due to the smoking ban.

However, look at the year-to-year declines in heart attacks in Scotland in years prior to the smoking ban.

Between 2003 and 2004, heart attack admissions declined by 4.6%. This is greater than the observed heart attack decline from 2005 to 2006.

Between 1999 and 2000, heart attack admissions in Scotland declined by 10.2%. This is much greater than even the 8.0% decline observed from 2006 to 2007.

Even if we look at the 2-year decline in heart attacks from 2005 to 2007, it is about the same as the 2-year decline observed bewteen 1999 and 2001 (11.9% compared to 10.7%).

If I present the data this way, it makes it clear that the observed change in heart attacks associated with the smoking ban is not at all out of the range of normal declines in heart attacks from year to year in Scotland observed in the absence of the smoking ban.

2005-2006: -4.2% 2003-2004: -4.6%
2006-2007: -8.0% 1999-2000: -10.2%

My point here is not that these data prove there was no decline in heart attacks in Scotland attributable to the smoking ban. My point is merely that there is no way one can conclude that the observed decline in the year following the smoking ban was different from the magnitude of the declines observed in previous years.

The analysis in this paper assumes that the entire observed change in heart attacks is attributable to the smoking ban. However, it is clear that a 10.2% decline in Scotland from 1999-2000 occurred in the complete absence of a smoking ban. Clearly, there are other factors which are contributing to a decline in heart attacks, there is a secular trend of substantially declining heart attacks over time, and in fact, the magnitude of the decline associated with the smoking ban is less than the magnitude of the decline observed in some recent years preceding the smoking ban.

In other words, one cannot rule out the very plausible alternative hypothesis that the observed decline in heart attacks is explained by random variation in the data and the already existing secular trend of declining heart attacks in Scotland.

By Michael Siegal

Who’s Has Smoke in their Eyes?

In reference to the “Smoking Bans are the real Health Hazard” comment, let me offer the following to Thomas. His comment suggested that government has overstepped its role (“cancer of unlimited government”) in smoking bans that include bars and restaurants.

Let me offer the following. If we follow this reasoning we would not have any Health Inspections of restaurants or bars either. Patrons could decide if the establishment was clean enough or the food fresh enough to decide whether or not to frequent the establishment. After all, what right does government have in telling restaurant and bar owners how to run their businesses? What we have learned however, is that the risks are too great to the public to allow bar and restaurant owners to self-regulate their cleanliness. Hence we have health inspections to assure public safety. Thomas, is this an example of “the cancer of unlimited government”?

Smoking is not all that different. Secondhand tobacco smoke is a proven health hazard. Anyone who disputes this fact clearly has their head in the sand. Just as patrons to a restaurant should not be exposed to unsanitary conditions and spoiled food, they should not be exposed to a proven health hazard such as tobacco smoke.

But let’s assume bars and restaurants can choose to be smoke-free or not, and that people can choose which restaurant to go into. What about the employees? Are bar and restaurant employees somehow less valued than those who work in other setting? The US has a set of workplace safety standards called OSHA (Occupational Safety and Health Administration). Should non-smoking workers be exposed to the secondhand smoke of patrons and other employees?

I have heard counter arguments to the effect that people can find places that don’t allow smoking voluntarily, but is that what worker safety is all about? Would we tell a chemical plant worker to “go find another chemical company to work for because the owner doesn’t want to protect their employees from vapors of hazardous chemicals? I don’t think any reasonable person would take that stance. To take that stance takes us back to the early 20th century where workers worked at their own peril.

Let me add that many restaurant and bar employees are poorly educated and many have few other job skills. For many, it is not about finding another profession, and jobs for the unskilled can be hard to come by.

Do smokers have the right to smoke? Certainly. Do smokers have the right to expose others to the dangerous properties of tobacco smoke? Absolutely not. There is a huge amount of scientific evidence that clearly demonstrates the risk of second hand smoke, especially to those who have cardiac and lung disorders.

The United Pro Choice Smokers Rights group, which Thomas Laprade represents, makes some astonishing statements. Among these is a statement that there is no proof that tobacco smoke causes lung cancer. Even the tobacco industry admits a link between cigarette smoke and lung cancer! The Surgeon General clearly identified risks associated with smoking almost 45 years ago, and the scientific evidence has continued to grow. The list of astonishing statements on this site (“The Ten Biggest Lies about Smoke and Smoking” goes on and on, and reading it I get dizzy from the spin.

Michael Siegal is well known to be in the pay of the tobacco industry, as evidenced by the tobacco industry documents turned over years ago. And so is LaPrade.

Did we really need a study for that? Of course smoking bans promote health, why wouldn't they even exist then? Millions of people smoke, even small percent of those who quit smoking bring visible results in health so I think these bans are worth trying because they bring so many benefits.

Smoking bans don't work unless people themselves realize the hazards related to it. Otherwise they are always good for promoting good health.