Occupational Health & Safety

Let's Clear the Air

Banning smoking in workplaces would improve everyone's health.

• By Jerry Laws
• Jul 01, 2004

I am momentarily taken aback whenever I pass one of the smokers' rooms set aside in some large airports. What I feel at those moments is pity, both because the people inside look unhappy and because they're kept apart from the rest of us almost like zoo animals. I don't smoke and never have been a smoker, but I remember an era when smokers weren't pariahs. Cigarette smoke clouded our living room when my parents hosted parties, and none of us thought anything of it.

Now, indoor smoking has practically disappeared in public places. Smoking bans remain controversial and can be difficult to pass, but cities continue to enact them. Those efforts may benefit from the Centers for Disease Control and Prevention's recent warning that people at risk of heart disease should avoid buildings and gathering places that allow indoor smoking. CDC's reasoning: Secondhand smoke increases the risk of a heart attack. Exposure to secondhand smoke increases a non-smoker's risk of fatal and non-fatal coronary heart disease (CHD) by about 30 percent, Terry F. Pechacek and Stephen Babb of CDC's Office on Smoking and Health wrote in a commentary published by the British Medical Journal. Pechacek, the office's associate director for science, and Babb, coordinator of its secondhand smoke work group, cited as support for this conclusion a U.S. surgeon general's report and studies published in BMJ and the New England Journal of Medicine.

The risk of heart attack and CHD is non-linear at low doses, meaning it increases rapidly with the relatively small doses a person receives from secondhand smoke or by smoking one or two cigarettes daily. At higher doses the risk increases more slowly. Prompting their commentary was a study in Helena, Mont., that found heart attack hospital admissions dropped by 40 percent when the city banned indoor smoking but rebounded after the law was overturned. Smoke-free policies in the United States have helped, they write, but CDC estimates secondhand smoke still causes more than 35,000 deaths from CHD every year. They said if future studies replicate the Helena study's findings, thousands of heart attacks could be prevented among non-smokers in countries around the world each year.

Secondhand smoke is a completely preventable occupational health hazard (as are many persistent hazards discussed in this magazine). I believe we already know enough to ban it entirely.

This article originally appeared in the July 2004 issue of Occupational Health & Safety.

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