By Jeffrey Barg

There was a time when the decision of whether to permit smoking in enclosed public places or in enclosed workplaces was primarily an issue of balancing smokers’ convenience with the potential annoyance to nonsmokers. One reasonable, if not always effective, way to accommodate everyone was to have smoking and nonsmoking sections in restaurants, for example. This situation radically changed in the late 1980s as research on the health effects of second-hand tobacco smoke piled up. If even limited exposure to second-hand smoke could cause an asthmatic child to be hospitalized and consistent exposure could cause lung cancer and heart disease in nonsmokers, the convenience versus annoyance calculation had to be superceded by a public health calculation. The public health calculation is that second-hand tobacco smoke is the second leading preventable cause of death among nonsmokers. The U.S. Environmental Protection Agency has designated second-hand tobacco smoke a class A carcinogen, which causes more deaths than asbestos, radon and benzene put together. Despite smoke-free policies in many workplaces, close to a quarter of American workers who work indoors are exposed to second-hand smoke there, according to the Occupational Safety and Health Administration. If you have a white-collar job in a high-rise office building, you might be protected from environmental tobacco smoke, but if you are a food service worker, you probably are in a position in which you must either risk premature death or lose your livelihood. Philadelphia is just now beginning to fully come to terms with this paradigm shift. Philadelphia City Councilman Michael A. Nutter has introduced a bill with moderate restrictions on smoking in enclosed workplaces and public places. It exempts establishments whose primary business is selling alcohol, private clubs, retail tobacco stores, cigar cafes, conference rooms for private functions, workplaces covered by a collective bargaining agreement, and private residences. But it includes all other workplaces, including establishments whose primary business is serving food. In light of OSHA’s estimate that close to a quarter of Americans working indoors are exposed to second-hand smoke in their workplace, Councilman Nutter’s bill would protect a substantial number of people from premature death and disability. Philadelphia, being years behind more than 200 local governments in passing such an ordinance, has the benefit of other cities’ and states’ experience. Research reports, in most cases published in scientific, peer-reviewed journals, show:

• Following the passage of smoke-free restaurant ordinances in California, Utah, Vermont, Los Angeles, San Francisco, New York City, Boulder, Flagstaff and Mesa (Arizona), there was an increase or no change in tourism in all but Flagstaff, where the rate of increase merely slowed.

• Restaurants and bars in California, New York, Massachusetts, Arizona, Colorado, West Lake Falls (a suburb of Austin, Texas), and North Carolina showed no decrease in sales after going smoke-free. Informal discussions with Philadelphia bars and restaurants that have gone smoke-free shows that the same is true here.
• Bartenders who worked for as little as one month in smoke-free conditions after a California law banned smoking in their workplace reported a significant drop in coughing and other respiratory problems and showed improved lung function. Many bartenders would be similarly protected under Councilman Nutter’s bill.
• A survey of 2,000 smoke-free workplaces revealed that 60% of those surveyed saw a reduction in maintenance and cleaning costs following implementation of no smoking policies.
• The U.S. Environmental Protection Agency estimated that the economic benefits of most workplaces and public places going smoke-free would exceed the cost by $39 to $72 billion annually.
• Voluntary compliance with smoke-free ordinances has been high.

This research data rebuts virtually all of the standard arguments against smoke-free ordinances, but I have no doubt that they will be carted out nonetheless. Opponents of the measure will say that smokers should not be inconvenienced even though their second-hand smoke is literally killing non-smokers. They will say that the ordinance is unnecessary because most workplaces are already smoke-free even though almost a quarter of indoor workplaces are not smoke-free. They will argue that the bill is too broad even though at other times the same people will argue that the bill is too narrow. They will argue against this or that exemption even though the bill would never pass without the exemption. They will argue that it is bad for business even though there is overwhelming evidence to the contrary. But let’s return to the smokers. Yes, they may be inconvenienced by the ordinance. But research shows that many smokers will be motivated by a smoke-free workplace to successfully quit smoking. In the end, they will benefit the most. Jeffrey Barg is chairman of the Philadelphia-based Tobacco-free Education and Action Coalition for Health as well as editor and publisher of Physician's News Digest.