Monday, June 27, 2005

Restaurants Begin to Exploit Loopholes in Georgia Smokefree Law

As the implementation date of July 1 for Georgia's smoke-free workplace law approaches, restaurants are scrambling to make two important business decisions: first, whether to be an adult-only or a family-oriented establishment come July 1; and second, for those which decide to be family-oriented, whether to provide a separately ventilated smoking room for smoking patrons.

Georgia's Smokefree Air Act of 2005 eliminates smoking in restaurants, but exempts adult-only establishments as well as separately ventilated smoking rooms in all establishments. Thus, restaurants must decide by July 1 whether or not they wish to declare themselves to be adult-only establishments in order to continue to allow smoking. Alternatively, restaurants that wish to continue both to allow children and to allow smoking can create separately ventilated smoking rooms for their smoking patrons.

Apparently, there are at least a number of restaurants that have decided to become adult-only establishments in order to continue to allow smoking or to take advantage of the exemption for separately ventilated smoking rooms.

The decision faced by Georgia restaurants is summarized by the title of a article on the law: "Georgia Law Offers Restaurants a Choice: Ban Cigarettes or Kids."

The article quotes the manager of one Atlanta restaurant that has decided to become adult-only: "This is one of those really tough business decisions that you just have to make.'' "He estimates the restaurant would lose 20 percent of its customers if it banned smoking instead of children."

The Rest of the Story

The choice faced by restaurant owners of whether to ban smoking or to ban kids highlights the complete senselessness of this law from a public health perspective. Essentially, what the law does is to allow decisions about whether restaurant workers will be exposed to secondhand smoke to be made by their employers. This is an absurd public health policy. If secondhand smoke is truly as hazardous as Georgia anti-smoking organizations allege, then how can they justify supporting a law that allows restaurant owners to make the decision about whether to protect employees from this hazard, rather than dictating that employees must be protected?

Similarly, how can public health advocates defend having supported a law that now puts the health of restaurant workers in their employers' hands by forcing those employers to determine whether those workers must serve patrons in very smoky, designated smoking rooms? These rooms have been shown to have extremely high concentrations of secondhand smoke, and there is little question that if secondhand smoke is as hazardous as advocates allege, it is going to be devastating to the health of restaurant workers who serve customers in such areas.

The first tenet of medical practice, and I believe public health practice as well is "to do no harm." The Georgia Smokefree Air Act of 2005 is going to do a lot of harm, not only to the health of restaurant workers who end up being forced to serve customers in separately ventilated smoking rooms, but also to the tobacco control movement itself, whose lack of reason in promoting these inconsistent policies is starting to be widely exposed.

There is a very compelling argument that can be made for an incremental policy making process, which I think is quite appropriate. It is very true that if we can protect some workers, and then later extend the protection to all workers, that is a reasonable and effective approach.

My argument, however, is different. My argument is that the Georgia law, by "requiring" many restaurant workers to work in highly contaminated smoking rooms, is actually going to hurt many workers and result in lives lost, rather than lives saved. Or at best, it will balance off lives saved with lives lost.

In other words, the policy is actually going to make the situation much worse for many. The average level of nicotine in a restaurant that allows smoking is about 8 micrograms per cubic meter, but in a separately ventilated smoking room, it is about 70. That means that workers in these restaurants will be subjected to levels of secondhand smoke that are 9-times higher. If one argues that a reduction from 8 to 0 is going to save lives, then clearly, an increase from 8 to 70 is going to increase mortality for some workers.

I'm simply suggesting that a policy which significantly increases risks for workers makes little sense. I'm not suggesting that a policy which takes steps in the right direction, but not all the way, is inappropriate. Actually, that's the only way to eventually protect all workers.

The rest of the story suggests that the Georgia law will substantially set back public health efforts not only in Georgia, but elsewhere in the country as well. It clouds the real issue that should be the focus of public health efforts - the need to protect workers from secondhand smoke exposure - with two issues that are not relevant public health concerns: (1) a perceived need to protect youth patrons; and (2) a perceived acceptability of forcing some restaurant workers to breathe in extremely high levels of carcinogens in order to protect many customers.

I can find no public health justification for either of these two approaches. By diverting the issue away from what it should be, I think this approach actually sets back, rather than propels forward, the movement to protect all workers from the alleged hazards of secondhand smoke.

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