Scottish smoking ban produces rapid health improvement

October 15 2006 - A Dundee study shows significant improvements in bar workers' lung function and a reduction in reported respiratory symptoms within the first few months of the ban on smoking in confined public places in Scotland.

The study in the October 11 issue of JAMA (Journal of the American Medical Association), 'Respiratory Symptoms, Pulmonary Function, and Markers of Inflammation Among Bar Workers Before and After a Legislative Ban on Smoking in Public Places', Menzies, D. et al, JAMA, 2006;296:1742-1748 was conducted from February to June 2006. Daniel Menzies, M.B.Ch.B., and his colleagues at Ninewells Hospital and Medical School, Dundee looked at the effects of the smoke-free legislation introduced on March 26, 2006 on bar workers' health in Scotland. Bar staff were among the most likely people to benefit from a reduction in passive smoking. 105 nonasthmatic and asthmatic nonsmoking bar workers were involved, of whom 77 completed the study. Participants were evaluated for:

• respiratory symptoms -
• wheezing
• shortness of breath
• cough
• phlegm
• sensory symptoms -
• red or irritated eyes
• painful throat and nasal itch
• runny nose
• sneezing

Participants were also given pulmonary tests and blood tests before the ban and then at 1 month and 2 months intervals after the smoking ban came into effect.

The research team found that 66 of the bar workers (79.2%) had some respiratory or sensory symptoms before the smoking ban was introduced. A month later, this had fallen to 41 (53.2%) reporting these symptoms - a reduction of 26%. After two months, there was a further small improvement with 46.8% still reporting any symptom (32.4% less than the baseline). The Dundee researchers also found improvements on certain lung function measurements and reductions in nicotine traces in their blood. Asthmatic bar staff also showed a reduction in airway inflammation and an improvement in quality of life scores.

Mark D. Eisner, M.D., M.P.H., of the University of California, San Francisco, commented in an accompanying editorial on the fallacious arguments made against banning smoking in certain places.

"Three common arguments are advanced against mandating smoke-free bars, restaurants, and other hospitality businesses. Each is fallacious. First, laws to prevent smoking in bars will not be effective. Four years after the California ban on smoking in bars, adherence with the law was high: 99 percent of bars in restaurants and 76 percent of freestanding bars were smoke-free. Near perfect adherence has been reported in Boston, Ireland, and New Zealand. Second, the general public will not accept smoke-free bars and restaurants. In fact, a series of international studies shows that most people do support smoke-free bars and restaurants. Moreover, public opinion becomes increasingly positive following smoke-free legislation. Third, smoke-free laws will cause bars and restaurants to lose money. Using sales tax and other objective financial data, studies now conclusively demonstrate that bars, restaurants, and hotels do not lose revenue after becoming smoke-free. In fact, some of these studies actually show a growth in income. In sum, smoke-free legislation is effective, accepted by the public, and has no negative economic impact."

"Mandating smoke-free workplaces will decrease secondhand smoke exposure and will improve respiratory health, prevent chronic disease, and extend life span. Important salutary health effects occur in as little as 1 month after cessation of secondhand smoke exposure. The comprehensive body of research documenting the serious adverse health effects of passive smoking provides a powerful rationale for prohibiting smoking in all public places. The time has come to clear the air," Dr. Eisner writes.

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