"...it's literally true that something like a thousand people will not die each year that would have otherwise died..."
New York City mayor Michael Bloomberg, annoucing a sweeping ban on smoking in bars and restaurants, as quoted by the New York Times December 12, 2002
We are delighted that bars, restaurants, and offices in New York City are soon to be smoke-free although we do question the means (municipal legislation) used to achieve this end. But what we are not delighted with is hyperbole about the alleged health benefits of such a ban.
Who exactly are these 1,000 New Yorkers whose deaths Mayor Bloomberg claims will be prevented by his legislation?
If, as we suspect, he is referring to deaths caused by exposure to secondhand smoke in restaurants and bars, the estimate of 1,000 deaths prevented is patently absurd. Our best estimate of the number of deaths prevented is somewhere between zero and a hypothetical ten to fifteen. There is no evidence that any New Yorker patron or employee has ever died as a result of exposure to smoke in a bar or restaurant.
Secondhand smoke is annoying. It makes your clothes and hair stink and can ruin an otherwise delightful dining experience. Regular exposure to someone else's smoking (as from living in the same household as a smoker) can increase the risk of upper respiratory disease, ear infections, and, among other acute effects, asthma attacks. Theoretically, an individual with severe asthma could suffer acute, fatal attack in a smoky bar, thus the hypothetical 10-15 hypothetical deaths indicated on the upper end of our estimates.
The link between secondhand smoke and premature death, however, is a real stretch. The evidence here is far less established than are the acute effects (see the American Council on Science and Health report Environmental Tobacco Smoke: Health Risk or Health Hype?).
There are some 60,000 deaths annually in the city of New York. Public health officials estimate that one-fifth of these deaths l2,000 can be specifically and causally linked to cigarette smoking. Will Mayor Bloomberg's prohibition of smoking in bars and restaurants cause more smoking New Yorkers to kick the habit? Possibly. But even if the Mayor's estimate of 1,000 lives saved referred to deaths prevented among smokers who quit, the number is enormously inflated.
The majority of New Yorkers will welcome a smoking ban primarily for aesthetic reasons, not for health reasons.
Dr. Whelan, President of ACSH, holds doctoral and master's degrees in public health.
December 13, 2002
Dr. Whelan's article on the gross exaggerations used by Mayor Bloomberg and anti-smoking lobbyists to achieve their ends is a ray of sunshine in a nasty storm. If those seeking to advance the cause of public health were generally this honest in their approach we would all be better off.
Dr. Whelan, I wish you my best in fighting against a very nasty and well-financed pressure group! While we may not fully agree on the health effects of smoking (I imagine you would rank them as at least somewhat greater than I would), I think we would find ourselves in great agreement on the shoddiness of some of the methods used by those fighting it.
Michael J. McFadden
December 14, 2002
I was disappointed that the lady who wrote A Smoking Gun and said that the "bulk of those who die from smoking lose an average of twenty-three years" took a position minimizing the health benefits of banning smoking in restaurants and bars. Since the colleagues of Stanton Glantz have already established the direct and rather dramatic improvement in the respiratory health of bartenders that occurred when the ban on smoking went into effect in California in 1998, it is not ridiculous to make estimates of the deaths and diseases of personnel who must work in secondhand smoke. Since lowball estimates of lung cancer and heart attack fatalities alone caused by secondhand smoke are in the vicinity of 38,000 for the nation and upper end estimates are around 65,000 for these two sources of death without examining things like stroke, SIDS, pneumonia, adult onset leukemia, etc. why does she say that deaths prevented by banning secondhand smoke from bars and restaurants would only save 0 to 15 lives per year?
December 16, 2002
The last statement made in this article may be enormously understated. Let's say there are 500,000 smokers in New York City. Philip Morris has stated in the past that secondhand smoke policies in workplaces result in a 20% reduction in smokers. So the Mayor is potentially closer than you think. The action may result in 100,000 fewer smokers, and ultimately this action would result in 33,000 fewer deaths. This "savings" would be over the course of many years. However, you would also have to look at the "preventive" factor: fewer kids taking up the habit because fewer parents would be smoking, less opportunity to smoke in many places kids have their first jobs in, etc. From a public health standpoint, there probably isn't another policy that would give New York such a preventive health booster shot!
December 16, 2002
I am delighted that city after city and state after state is making the sensible, health-concerned decision to protect the employees and patrons of all sorts of businesses from secondhand smoke.
It's about time we recognized that the norm for behavior is not to use an addictive drug and expose others to its side effects. We recognize this in the case of heroin, cocaine, marijuana, and certain alcohol effects but somehow continue to allow tobacco to remain a legal substance that non-addicts are simply told to avoid by not shopping, dining, or working where it is used.
But for the tobacco addict, restrictions are seen as threats to their very existence; they are beginning to feel pressured everywhere, since their need cannot be satisfied in airports, airliners, stores, and workplaces. I wonder if they know how difficult their addictive habits have made life for the rest of us.
Suffice to say, therefore, that I have no sympathy for the tobacco addict and even less for the livelihoods of those who grow, manufacture, transport, sell, finance, and advertise this evil substance. I hope, in my lifetime, to see their livelihoods changed into ventures less destructive and less harmful to their customers and those around them.
Onward against tobacco.
Dr. Melvin Anderson
December 19, 2002
The responses to Dr. Whelan's position are sad but understandable. The anti-smoker forces have deluged and inundated the media with bad science and unjustified scare statistics to the point at which most of the population is brainwashed into not using basic critical thinking skills.
One would hope that sensible people with the appropriate experience in statistics and epidemiology and a working knowledge of the very badly flawed studies touted by the anti-smoker forces would speak out if only to save science from the alchemistic notions of Stanton Glantz and his cadre of self-serving apostles.
I congratulate Dr. Whelan on her courageous (and correct) stand and have sympathy for her at the same time she is certainly making herself into a walking pinata, and I am sure that she will be subjected to the same kinds of abuse that smokers have been experiencing with increasing frequency over the last decade.
December 19, 2002
Dr. Whelan's comments are sadly uninformed; mortality is not the only aspect that needs to be focused on.
The truth of the matter is that legislating smoke-free policies has improved employee health and protected millions of adults and children in many public environments (many who have respiratory and heart problems), and in turn has helped families to create smoke-free home policies. It has prevented much illness from secondhand smoke and has been one of the greatest public health achievements ever. It has encouraged the smoking rate to fall by half in just a generation.
There is no comparable success in public health that has taken place in such a short time.
People have a right to be free from the secondhand smoke of others.
I would hope that a colleague in public health such as Dr. Whelan would recognize and support this basic need.
Herm Perlmutter, CHES
I must stress, in response to some of the comments above and a comment made on the pro-smoking site Forces.org about my piece, that I am in substantial agreement with those who want to reduce smoking. My objection is to Bloomberg's specific claim of 1,000 lives saved. For an accurate account of the real secondhand smoke risks, though, see ACSH's book on ETS.
Dr. Elizabeth Whelan
February 13, 2003
While I am neither a smoker nor employed at a bar, I must say that this ban irritates me. No one is forced to work at a bar or restaurant. No one is forced to go to a bar or restaurant. If you're in a bar or restaurant and you're worrying about secondhand smoke as opposed to the unhealthy meal and alcohol you're consuming, then you've got your priorities skewed. I'm generally against any legislation that is government interference in our personal lives, even if it is on our behalf. If you don't like the smoke, don't go out drinking, or find a pub that voluntarily places such regulations upon itself.
The government sure plays the "we hate big tobacco" routine well even while they make more money off cigarette sales than the companies do, and they certainly don't object to the thousands upon thousands of jobs the industry supplies.
Editor's note: Mr. Asta also wrote to suggest that people living in apartment buildings near smokers consider getting air filters instead of banning smoking from their buildings, and weighed in on alcohol with the observation that it makes some sense to warn people more vigorously about hard liquor than about beer, since liquor is easier to down quickly.
February 28, 2003
Dear Dr. Whelan:
I commend you for your sensible commentary on Mayor Bloomberg's implausible claim that 1,000 New Yorkers' lives will be "saved" by prohibiting smoking in all bars and restaurants in the city. He is not the first neoprohibitionist to toss out bogus "body counts" to further the anti-smoking agenda.
Thanks also for providing a link to ACSH's "Health Risk or Health Hype?" report on environmental tobacco smoke. One flaw jumped out at me on first reading. The report says that some tobacco smoke components are present in "greater concentration" in sidestream smoke (the smoke that comes directly off the end of a burning cigarette) than in mainstream smoke (the smoke inhaled and then exhaled by the smoker). By itself the statement can be misleading to lay readers by suggesting that a nonsmoker who is in the vicinity of a smoker is inhaling more of those components than the smoker, because what they're getting is "more concentrated." The report should have pointed out that the nonsmoker is getting much less of those components than the smoker despite the higher concentration in sidestream smoke, because the volume of sidestream smoke is much smaller than the volume of mainstream smoke.
As you know, the actual dose of anything is determined by both its concentration and its absolute quantity.
Peter L. Petrakis, Ph.D. (biochemistry), M.P.H. (epidemiology)
May 4, 2003
Dear Dr. Whelan,
You may know, Mayor Bloomberg is merely repeating what he and other legislators across the country are being told by the anti-smoking zealots. It is well documented that the misrepresentation as to the number of deaths from secondhand smoke originated from the 1992/1993 Environmental Protection Agency (EPA) report on Environmental Tobacco Smoke (ETS). It is indeed unfortunate the EPA has decided to misinform the public about secondhand smoke or ETS because now all of the "science" that EPA produces is suspect. For example, EPA has published that radon measuring 4 picoCuries per liter (pCi/L) or higher requires abatement while lower concentrations do not. With the junk science coming out of EPA, you have to wonder if radon measuring less than 4 pCi/L is nothing to worry about.
It is difficult to believe those who you cannot trust and who misinform and mislead. Hopefully one day there will be a body created to overhaul the junk science coming from the EPA and restore the confidence the public needs to take notice of the EPA's recommendations.
September 12, 2003
I wish to respond to Dr. Melvin Anderson (Colorado Springs) and his so-called applied pressure by Stalin-resembling health nuts. The sole reason so many cities are succeeding with banning smoking in public is the simple fact that a majority of the time (85-90%), the smoke-free issue is being submitted before the city's council or commission by the anti-tobacco lobbyists in the hopes of its adoption in as quiet and quick a manner as possible. Most of the citizens are oblivious to what their local leaders are discussing and/or voting for on their behalf. They walk around with blinders on until the announcement that a public smoking ban has been enacted, and then they raise their objections to losses of civil liberties.
The word got out in our small, sleepy community of 35,582 that a ban was to be discussed at the next meeting of the city commission, and their normally empty meeting chambers suddenly filled up with a standing-room-only crowd. The smoking opponents had even persuaded neighboring smoke-free cities' leaders to present their stories of success passing the ban. However, the seven-member commission crumbled under the fear of losing their positions and announced it would best be decided on by their employers (us!) and brought it up for citywide vote.
The anti-smokers' argument was that they thought they should be able to go anywhere and everywhere they wanted to. (Hell, I agree with that! I should be able to go to Hawaii but cannot afford to, or should be able to stroll right on into the White House anytime I desire but do not think I would make it very far!) We, the compassionate smokers, even attempted to meet them halfway and reach some sort of compromise or agreement. A poll of local restaurants uncovered the fact that 63% of them already had a no-smoking policy in place. You non-smokers already had more than what is considered fair for both sides of the argument. Numerous businesses had been catering to the non-smokers' beliefs and had provided environments to dine risk-free from second-hand smoke. We then suggested the adoption of a policy requiring that all smoke-friendly establishments post large notices at each entrance warning any unsuspecting people of the dangers that they may find upon entering, such as:
"WARNING, UPON ENTERING THIS ESTABLISHMENT, YOU MAY BE ACCOSTED BY OR EXPOSED TO SECOND-HAND SMOKE AND MAY FACE SERIOUS HEALTH RISKS AS A CONSEQUENCE"
Apparently, your tobacco- and hazard-causing-chemical-deprived brains have been rendered illiterate because this would not even suffice. The final issue that stood before the city's registered voters was a total smoking ban in all local businesses.
The citizens spoke, and their roar was deafening: the smoke-free mob that pushed us to live our lives in a disinfected, sterile, hazard-free environment were denied their dream for total control of all of our city's health and welfare. We have decided it is now time for you to grow up and quit trying to make society responsible for everyone's health concerns and face the consequences of your own actions.
March 2, 2004
If we stuck close to the scientific facts in the great secondhand smoking debate, the antis would have shriveled up and died long ago. Show me one death certificate with "SHS" written on it.
On smoking bans, it would seem to me, using the logic of the antis, that if smoking bans were good for business, allowing smoking would be bad for business and business owners wouldn't be putting up the fight to allow smoking.
Mayor Bloomberg Exaggerates Secondhand Smoke Risk
By ACSH Staff — December 12, 2002
By ACSH Staff