News Should smoking in all the public places (indoors and outdoors) be banned?

[Ryan_m_b]

Studies on second hand smoke focus on indoor conditions over time i.e. living with a smoker. Do you have any references to support the claim that irregular second hand smoke in an open-air environment is a significant public health concern?

That's not to suggest that standing near a smoker outside won't expose you to significant amounts of second hand smoke but given the frequency and length of said exposure is (generally) going to be incredibly low is there anything to suggest there is a significant effect to long term health?

As an example of what I am talking about take this paper which looked at concentration of airborne particles in proximity to smokers in outdoor areas. There's not much that is a surprise, being within 0.5 metres of a smoker exposes one to high concentrations but this drops off significantly with distance. The length of said distance being effected by wind direction but around two metres. Once smoking has stopped exposure ceases unlike indoor conditions where the smoke persists. This article shows that there is a potential risk of second hand smoke in outdoor conditions when in proximity to a smoker however it's not an indication that outdoor smoking is in general a significant health risk as the frequency in which other people are in close proximity to outdoor smokers is unknown.

The current lack of empirical data on outdoor tobacco smoke (OTS) levels impedes OTS exposure and risk assessments. We sought to measure peak and time-averaged OTS concentrations in common outdoor settings near smokers and to explore the determinants of time-varying OTS levels, including the effects of source proximity and wind. Using five types of real-time airborne particle monitoring devices, we obtained more than 8000 min worth of continuous monitoring data, during which there were measurable OTS levels. Measurement intervals ranged from 2 sec to 1 min for the different instruments. We monitored OTS levels during 15 on-site visits to 10 outdoor public places where active cigar and cigarette smokers were present, including parks, sidewalk cafés, and restaurant and pub patios. For three of the visits and during 4 additional days of monitoring outdoors and indoors at a private residence, we controlled smoking activity at precise distances from monitored positions. The overall average OTS respirable particle concentration for the surveys of public places during smoking was approximately 30 microg m(-3). OTS exhibited sharp spikes in particle mass concentration during smoking that sometimes exceeded 1000 microg m(-3) at distances within 0.5 m of the source. Some average concentrations over the duration of a cigarette and within 0.5 m exceeded 200 microg m(-3), with some average downwind levels exceeding 500 microg m(-3). OTS levels in a constant upwind direction from an active cigarette source were nearly zero. OTS levels also approached zero at distances greater than approximately 2 m from a single cigarette. During periods of active smoking, peak and average OTS levels near smokers rivaled indoor tobacco smoke concentrations. However, OTS levels dropped almost instantly after smoking activity ceased. Based on our results, it is possible for OTS to present a nuisance or hazard under certain conditions of wind and smoker proximity.

 

[Averagesupernova]

I don't think the 'moron' is allowed to. I could be wrong.
If you have a link to prove otherwise, I would be glad to see it.

My point for the slow folks on this forum is that when you go to a park where campfires and smoke from them are plentiful why would you complain about a little tobacco smoke?
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Of course there are places where it is illegal to burn plastic. But do you seriously think anyone is going to go around the campground policing it? You would have to be caught in the act before it would go anywhere. The most that would happen is someone from the parks service walking through reminding everyone to keep the plastic out of the campfires.
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Note: I am NOT a smoker but I think burning plastic is WAY more of an offensive smell than tobacco.

 

[Cinitiator]

Are you suggesting that pollution from car exhausts (especially in urban and congestion areas) is not a public health concern?

Studies on second hand smoke focus on indoor conditions over time i.e. living with a smoker. Do you have any references to support the claim that irregular second hand smoke in an open-air environment is a significant public health concern?

That's not to suggest that standing near a smoker outside won't expose you to significant amounts of second hand smoke but given the frequency and length of said exposure is (generally) going to be incredibly low is there anything to suggest there is a significant effect to long term health?

Are you suggesting that pollution from car exhausts (especially in urban and congestion areas) is not a public health concern?

It is a huge concern, and more environment and health solutions should be found. However, I'm suggesting that banning public exhaust in public places would have a far greater cost to society than banning smoking in public places. The means wouldn't justify the ends in the first case, as it would paralyze various socioeconomic mechanisms.

Do you have any references to support the claim that irregular second hand smoke in an open-air environment is a significant public health concern?

Yes.
http://www.sciencedaily.com/releases/2009/11/091118154619.htm
http://news.stanford.edu/news/2007/may9/smoking-050907.html
http://online.wsj.com/article/SB10000872396390444900304577581663323288258.html

 

[Ryan_m_b]

Yes.
http://www.sciencedaily.com/releases/2009/11/091118154619.htm
http://news.stanford.edu/news/2007/may9/smoking-050907.html
http://online.wsj.com/article/SB10000872396390444900304577581663323288258.html

Your second link is a report on the paper I posted before and does not support your position. Your third link is a report on the same paper as the first and it makes me wonder if you've read it. The authors acknowledge that the time scales they are looking at are very atypical (it's very rare for anyone to be in close proximity to second hand smokers outside for periods of 6 hours solid) and even more importantly they say:

Still, the researchers caution that it's too early to draw policy conclusions from their findings. Cotinine is a marker of exposure to tobacco, Naeher said, but is not a carcinogen. The team is currently planning a study that would measure levels of a molecule known as NNAL, which is a marker of tobacco exposure and a known carcinogen, in people exposed to second-hand smoke outdoors.

I don't deny that, as the authors point out, long term close proximity to smokers outside will have health effects but what has not been established is the prevalence of such situations. Beyond occupations which will put you in contact with outdoor smokers for significant amounts of time (e.g. waiting an outdoor cafe) when does the average person ever spend more than a few seconds, perhaps a few times a day, in close proximity to an outdoor smoker?

 

[Cinitiator]

Your second link is a report on the paper I posted before and does not support your position. Your third link is a report on the same paper as the first and it makes me wonder if you've read it. The authors acknowledge that the time scales they are looking at are very atypical (it's very rare for anyone to be in close proximity to second hand smokers outside for periods of 6 hours solid) and even more importantly they say:

I don't deny that, as the authors point out, long term close proximity to smokers outside will have health effects but what has not been established is the prevalence of such situations. Beyond occupations which will put you in contact with outdoor smokers for significant amounts of time (e.g. waiting an outdoor cafe) when does the average person ever spend more than a few seconds, perhaps a few times a day, in close proximity to an outdoor smoker?

You asked me to provide a study which supports the assertion that outdoor smoking is a serious public health concern. As the author said:

"Our study suggests that there is reason to be concerned about second-hand smoke levels outdoors," said study co-author Gideon St. Helen, who is pursuing his Ph.D. through the university's Interdisciplinary Toxicology Program, "and our findings are an incentive for us to do further studies to see what the effects of those levels are."

Of course, a concern and a policy action requirement are different things. And the said concern gains even more credibility when examining the outdoor second hand smoking health effects on children:
http://eurpub.oxfordjournals.org/content/13/1/61.short

 

[Ryan_m_b]

You asked me to provide a study which supports the assertion that outdoor smoking is a serious public health concern. As the author said:

The author says "our study suggests that there is a reason to be concerned" not that it is a public health concern. See the difference? They are pointing out that their study shows that close proximity to smokers even outdoors exposes one to significant levels of second hand smoke. However they acknowledge that this isn't enough to claim that there is a solid public health argument for banning smoking in all public areas because they have not established whether or not the majority of people are in close proximity to outdoor smokers for significant lengths of time as they go about their business. Do you see the difference?

Of course, a concern and a policy action requirement are different things. And the said concern gains even more credibility when examining the outdoor second hand smoking health effects on children:
http://eurpub.oxfordjournals.org/content/13/1/61.short

Are you reading these links?

Further research of the common belief that outdoor smoking is sufficient to protect infants from health effects due to ETS exposure is warranted.

A preliminary study (especially a questionnaire) is not sufficient to suggest an outdoor smoking ban. It's sufficient for advocating more research but we should begin the debate once extensive research with definitive results has been completed.

 

[Dembadon]

In your opinion, should smoking in all the public places, including streets, parks and even rivers be banned? In my opinion, it should. Not only have smoking bans been proven to be highly effective in reducing the overall mortality rate and the incidence of various diseases (Source: http://www.usatoday.com/story/news/nation/2012/10/29/smoking-bans-heart-attacks-strokes/1664193/), but they could also potentially prevent second-hand smoking, which causes close to 50,000 deaths per year (Source: http://articles.cnn.com/2011-05-23/us/new.york.smoking.ban_1_smoking-on-public-beaches-smoking-ban-secondhand-smoke?_s=PM:US ).

Not only do I think that those who smoke should be protected from the negative effects of smoking, but I also think that those who don't smoke and yet are forced to suffer from the consequences of the second-hand smoking should be protected as well. I don't want to suffer an increased risk of various cancers, respiratory disease and heart disease because some people are far too selfish and individualistic.

Then you'd have no problems with someone coming and smoking on your front lawn? It's not indoors, and since they can't do it in public places, private property is pretty much the only other option. You are essentially suggesting all but a complete ban on smoking for densely populated areas, since it's nearly impossible for someone working in, let's say, NYC, to find a place that isn't public to have their smoke break.

I can understand the indoor request, but the outdoor request is unreasonable.

 

[Cinitiator]

The author says "our study suggests that there is a reason to be concerned" not that it is a public health concern. See the difference? They are pointing out that their study shows that close proximity to smokers even outdoors exposes one to significant levels of second hand smoke. However they acknowledge that this isn't enough to claim that there is a solid public health argument for banning smoking in all public areas because they have not established whether or not the majority of people are in close proximity to outdoor smokers for significant lengths of time as they go about their business. Do you see the difference?

Isn't there's a difference between a public health concern and a public health policy? The author of the study in question analyzed its applications, and suggested that it's a concern, but that the evidence presented in the study isn't enough to have a policy effect.

However, despite a lack of outdoor smoking effect studies, there are still some, and namely on its effects on children:
http://news.bbc.co.uk/2/hi/health/3476743.stm (this is another study - I cited the wrong once in the previous post)

"This study shows that despite parents smoking outside for the sake of their children's health, inadvertent exposure still occurs.

"There really is no substitute for giving up smoking altogether - its a win-win situation for the whole family."

This evidence alone is enough to ban outdoor smoking. However, one must always update their views on such policy as new evidence arises.

 

[surajt88]

If this adds anything to the discussion, back here in India, smoking IS banned in public places. As a chain smoker used to smoking in public places, I'd say the system has completely failed as, myself included, people continue to smoke in public.

 

[rootX]

It's the worst thing that can happen when you walk behind a person who is smoking if you don't like all smoke air. Generally, I move faster to overpass them but sometimes it's just too hard.

It would be pleasant to ban smoking in public. I don't like people blowing smoke air at the faces of other people.

 

[Cinitiator]

It's the worst thing that can happen when you walk behind a person who is smoking if you don't like all smoke air. Generally, I move faster to overpass them but sometimes it's just too hard.

It would be pleasant to ban smoking in public. I don't like people blowing smoke air at the faces of other people.

My point exactly. I'm tired of the smoke getting blown in my face during various outdoor activities which I want to participate in. Avoiding such smoke is often very hard to impossible without leaving the activity in such cases.

 

[rootX]

My point exactly. I'm tired of the smoke getting blown in my face during various outdoor activities which I want to participate in. Avoiding such smoke is often very hard to impossible without leaving the activity in such cases.

Sometimes, I also come across people who continue to smoke as they are talking. I always try to keep the conversation short and run out of there. It's not as much of a health concern as is how social is smoke while talking to someone. It's relative and personally, I don't find it very social to talk to non-smokers while you smoke.

I don't even know what smokers think when they shower people behind them with all that air while walking on a busy street!

 

[Ryan_m_b]

Isn't there's a difference between a public health concern and a public health policy? The author of the study in question analyzed its applications, and suggested that it's a concern, but that the evidence presented in the study isn't enough to have a policy effect.

However, despite a lack of outdoor smoking effect studies, there are still some, and namely on its effects on children:
http://news.bbc.co.uk/2/hi/health/3476743.stm (this is another study - I cited the wrong once in the previous post)


This evidence alone is enough to ban outdoor smoking. However, one must always update their views on such policy as new evidence arises.

You are still missing the point. It seems established that being in close proximity to a smoker outdoors exposes one to significant levels of second hand smoke. However it has not been established whether or not this happens regularly to the majority of people to the extent that it is a significant threat to public health. I don't know how much simpler I can put that.

A public health concern is when there is something that poses a significant threat to public health. It has not been demonstrated that outdoor smoking does, it merely has been demonstrated that if you are in close proximity to smokers over a long period of time there is a risk but 99.99% of the time out in public this is not the case.

EDIT: I think the most succinct way I can phrase my point is "given that close proximity to smokers is known to cause significant exposure to second hand smoke what is the lifelong health impact for an average non-smoker going about public spaces". If cohort studies were done in countries with a ban vs without we might find that infrequent, short exposure to outdoor second hand smoke has a negligible effect on life expectancy and health. Or we might find a significant effect. Without data indicating the latter I don't see any medical argument for a ban on public space smoking (with anexception for public places that become crowded by design e.g. public transport stops).

 

[Averagesupernova]

I find it amusing that all this is in the name of protecting people from second hand smoke. Although I don't live in such a place I can imagine that there are places in densely populated cities which would force people living in apartments to smoke inside exposing their family to even more second hand smoke. A ban on smoking outdoors in public is next thing to banning smoking period.

 

[skeptic2]

It seems amazing to me that if one is in close proximity to a smoker outdoors that one cannot remove himself from that close proximity without a lot of difficulty.

When one cannot remove himself easily, why can't one ask the smoker politely if he or she could hold off smoking while you are near?

 

[mege]

Why all the worries about public health? Why not ban smoking on the basis that it's a public nuisance?

All sorts of loud noises and unsightly things are banned in communities. What makes smoking different?

(NB - I'm not advocating for a total smoking ban, but I think too much is focused on the public health concern part as the ONLY justification for a smoking ban of any sort.)

 

[Kholdstare]

I had been a regular smoker for 8 years before I had quit altogether. Now I only smoke in very rare special occasions. I did not quit for cautions and warnings. I knew them but did not pay much attention when I used to smoke. I quit because I did not like the flavor of the smoke regularly (I got quite used to it). I dislike the overbearing effort to make people quit smoking forcibly, although I think smoking should be moderated.

I think if smoking becomes big problem, there should be public smoking zones, only where people can smoke together outside. Bars should not ban smoking, as if someone has the ability to overcome the stench of alcohols, he should not be complaining about smoke. In indoor its a personal matter.

 

[Cinitiator]

You are still missing the point. It seems established that being in close proximity to a smoker outdoors exposes one to significant levels of second hand smoke. However it has not been established whether or not this happens regularly to the majority of people to the extent that it is a significant threat to public health. I don't know how much simpler I can put that.

A public health concern is when there is something that poses a significant threat to public health. It has not been demonstrated that outdoor smoking does, it merely has been demonstrated that if you are in close proximity to smokers over a long period of time there is a risk but 99.99% of the time out in public this is not the case.

EDIT: I think the most succinct way I can phrase my point is "given that close proximity to smokers is known to cause significant exposure to second hand smoke what is the lifelong health impact for an average non-smoker going about public spaces". If cohort studies were done in countries with a ban vs without we might find that infrequent, short exposure to outdoor second hand smoke has a negligible effect on life expectancy and health. Or we might find a significant effect. Without data indicating the latter I don't see any medical argument for a ban on public space smoking (with anexception for public places that become crowded by design e.g. public transport stops).

Evidence isn't all black and white. If it has been demonstrated that outdoor smoking does cause rather significant levels of smoke to be inhaled, and if it has been proven that the cigarette smoke tends to cause various health disorders, one could make inferences based on the evidence up to date. And these inferences are enough for a ban - better safe than sorry.

However, even stronger evidence and more testing are all required in the long term.

 

[Cinitiator]

And not to mention, second hand smoke is hardly the reason for smoking to be banned outside. The main reason is the fact that it harms the smoker. The fact is, some people tend to abuse their freedoms and cause harm to themselves and others. Harm which ought to be stopped.

 

[Ryan_m_b]

You are still somehow missing the point. Can you just answer whether or not you understand what I mean when I talk about the frequency of close proximity to smokers outdoors and why it matters?

As for banning anything that could harm an individual I don't agree at all. So long as that individual is of sound mind and is aware of the risks I think it is way beyond the mandate of government to stop them doing it. If we start using the premise that if it harms an individual it has to be banned we might as well ban alcohol, extreme sports, fast food etcetera. What is so morally wrong about an individual who is well aware of the risks of an activity choosin to partake in it if it does not harm others? What gives anyone else the right to stop them?

 

[Vanadium 50]

. The main reason is the fact that it harms the smoker. The fact is, some people tend to abuse their freedoms and cause harm to themselves and others. Harm which ought to be stopped.

You're right. People should not be allowed to make bad decisions. In fact, I believe the State should decide where you live, where you work, what you eat, who your spouse is and how many children you have. Otherwise, people might make bad decisions.

 

[Greg Bernhardt]

The main reason is the fact that it harms the smoker.

It's not that it harms the smoker. It's that the smoker is addicted and can't stop. Take out the nicotine and we're all good.

 

[russ_watters]

As for banning anything that could harm an individual I don't agree at all. So long as that individual is of sound mind and is aware of the risks I think it is way beyond the mandate of government to stop them doing it. If we start using the premise that if it harms an individual it has to be banned we might as well ban alcohol, extreme sports, fast food etcetera. What is so morally wrong about an individual who is well aware of the risks of an activity choosin to partake in it if it does not harm others? What gives anyone else the right to stop them?

Shared-cost heathcare.

 

[Ryan_m_b]

Shared-cost heathcare.

Unless something is crippling healthcare costs I don't see a reason to ban it (instead tax it as much as practical to mitigate said costs). Not to mention that the point of a socialised health care system is that it helps everyone regardless of their circumstances.

 

[russ_watters]

Smokers pay insurance, social security taxes, income taxes, and cigarette taxes throughout their working age and then they die, right about at retirement age. They are not a big burden on social security and Medicare. Smokers are the optimal aged citizen from the perspective of the government. Social security and Medicare wouldn't be in near the bind they are in if everyone died at 65 the way smokers tend to do.

I'm sure the SS part is true, but I doubt the Medicare part is unless no attempt is made to treat the cancer.

 

[Cinitiator]

You are still somehow missing the point. Can you just answer whether or not you understand what I mean when I talk about the frequency of close proximity to smokers outdoors and why it matters?

As for banning anything that could harm an individual I don't agree at all. So long as that individual is of sound mind and is aware of the risks I think it is way beyond the mandate of government to stop them doing it. If we start using the premise that if it harms an individual it has to be banned we might as well ban alcohol, extreme sports, fast food etcetera. What is so morally wrong about an individual who is well aware of the risks of an activity choosin to partake in it if it does not harm others? What gives anyone else the right to stop them?

"Can you just answer whether or not you understand what I mean when I talk about the frequency of close proximity to smokers outdoors and why it matters?" - Yes. The frequency of close proximity to the smoker is often observed in the real world situations. And outdoor smoking should be banned even before such studies will be carried out, as the evidence up to date is enough to do so. As I've already said, evidence isn't black and white. If one can make logical deductions from the evidence up to date with a mild degree of certainty, and the said degree of certainty provides us with the evidence that there might be a big risk associated with the conclusions of our reasoning, then some action ought to be taken. Of course, this doesn't mean that further studies shouldn't be carried out. Of course they should be - this will give more credibility to the evidence up to date.

For example, if medical studies have been carried out on the effects of cardioversion, and the effects have been proven to be positive in a given set of environments, this means that we can make logical deductions from the said data in order to extrapolate it to different environments in the conditions of an absence of evidence in a different set of environments. And given the logically deduced probable risks of not using cardioversion in various environments and individuals, the procedure should be carried out.

You're right. People should not be allowed to make bad decisions. In fact, I believe the State should decide where you live, where you work, what you eat, who your spouse is and how many children you have. Otherwise, people might make bad decisions.

That's a straw man and a slippery slope fallacy.

 

[russ_watters]

Unless something is crippling healthcare costs I don't see a reason to ban it (instead tax it as much as practical to mitigate said costs). Not to mention that the point of a socialised health care system is that it helps everyone regardless of their circumstances.

Do cigarette taxes get used to pay healthcare costs? Is the tax calculated for that? I always thought cigarette taxes were just made arbitrarily high as a deterrent?

Also, I didn't say "socialized" (I was considering it...). Normal insurance is shared-cost too. Still, isn't it self contradictory say that it is wrong for government to coerce action while simultaneously saying it is fine to force others to pay for one's bad decisions? Why do you not consider that harming others? I get the feeling that people who favor socialized whatever think that simply declaring it socialized changes the moral picture. I don't see that it does.

How about seat belt laws?

 

[Ryan_m_b]

"Can you just answer whether or not you understand what I mean when I talk about the frequency of close proximity to smokers outdoors and why it matters?" - Yes. The frequency of close proximity to the smoker is often observed in the real world situations. And outdoor smoking should be banned even before such studies will be carried out, as the evidence up to date is enough to do so. As I've already said, evidence isn't black and white. If one can make logical deductions from the evidence up to date with a mild degree of certainty, and the said degree of certainty provides us with the evidence that there might be a big risk associated with the conclusions of our reasoning, then some action ought to be taken. Of course, this doesn't mean that further studies shouldn't be carried out. Of course they should be - this will give more credibility to the evidence up to date.

For example, if medical studies have been carried out on the effects of cardioversion, and the effects have been proven to be positive in a given set of environments, this means that we can make logical deductions from the said data in order to extrapolate it to different environments in the conditions of an absence of evidence in a different set of environments. And given the logically deduced probable risks of not using cardioversion in various environments and individuals, the procedure should be carried out.

So you admit that it isn't established whether or not frequency to outdoor smoke is enough to make it a health concern but you're willing to assume it is? It isn't logical what you're doing, it's irrational to suit your beliefs that people shouldn't smoke.

Do cigarette taxes get used to pay healthcare costs? Is the tax calculated for that? I always thought cigarette taxes were just made arbitrarily high as a deterrent?

Also, I didn't say "socialized" (I was considering it...). Normal insurance is shared-cost too. Still, isn't it self contradictory say that it is wrong for government to coerce action while simultaneously saying it is fine to force others to pay for one's bad decisions? Why do you not consider that harming others?

How about seat belt laws?

I admit I was being overzealous in my response that if an adult is in full possession of the facts blah blah because this thread has gone on for 4 pages now and hasn't gone anywhere. It's immensely frustrating. I agree that there are circumstances when certain things, like seat belt usage, should be legally enforced. I don't agree that smoking is one of those things and with regards to socialised healthcare fixing people from bad decisions that they were fully aware of is quite rare. Honestly Russ we both know we have differing views on this, is there any point in having a discussion on it?

 

[Cinitiator]

As for banning anything that could harm an individual I don't agree at all. So long as that individual is of sound mind and is aware of the risks I think it is way beyond the mandate of government to stop them doing it. If we start using the premise that if it harms an individual it has to be banned we might as well ban alcohol, extreme sports, fast food etcetera. What is so morally wrong about an individual who is well aware of the risks of an activity choosin to partake in it if it does not harm others? What gives anyone else the right to stop them?

The problem is, even individuals who are of sound mind can make logical errors, and fail to interpret the risks in question and their implications under the conditions of nicotine addiction. The state should intervene in order to help rehabilitate those who are frequent tobacco smokers.

 

[Ryan_m_b]

The problem is, even individuals who are of sound mind can make logical errors, and fail to interpret the risks in question and their implications under the conditions of nicotine addiction. The state should intervene in order to help rehabilitate those who are frequent tobacco smokers.

That's true but you've failed to take into account that this isn't purely a matter of logic but one of values. You might value all the consequences of smoking lower than the benefits but that doesn't mean everyone will. I'm perfectly fine with the idea of free treatment for giving up smoking but don't try to argue that smokers are illogical or irrational.