Monday, April 14, 2008

Berkeley Anti-Smoking Ordinance May Increase Kids' Exposure to Secondhand Smoke, Admit Public Health Officials

Last month, Berkeley approved an ordinance that prohibits smoking on all sidewalks in commercial areas of the city, resulting in a nearly complete outdoor smoking ban in these large areas (see my original post on this ordinance, in which I argue that the measure is largely designed to get homeless people off the streets to make them more attractive for shoppers in the city's business districts). According to an article on the web site, Berkeley City Councillors approved this measure despite concerns that it might lead to increased secondhand smoke exposure among children, whose parents may smoke inside rather than face fines for smoking outside on the sidewalk.

According to the article: "The City Council unanimously passed the ordinance, which goes into effect in May, at its Tuesday night meeting. The ordinance carries fines of up to $100 for a first offense and $500 for a third offense in one year, said Lauren Lempert, senior management analyst for the city. ... Lempert said the officials originally decided not to ban smoking on all commercial sidewalks, because it conflicted with a health department campaign urging people to smoke outside, rather than inside, where others are affected by secondhand smoke. In the end, the city decided that it won't hurt those people who go outside to smoke to walk a few extra blocks to a noncommercial area. 'We felt (the new ordinance) is more supportive of public health goals of the city overall,' Lempert said. 'You have to balance all kinds of needs and interests.' About 10 percent of Berkeley's population, or 11,000 people, smoke, according to the city of Berkeley Health Status Report. City officials hope the new law cuts that number. 'It is known that by expanding restrictions, it reduces the number of people who smoke,' Lempert said."

The Rest of the Story

This appears to be an example of mixed up priorities. The policy makers here appear to acknowledge that the ordinance will likely increase secondhand smoke exposure for children: that is in fact the reason why they did not pass such a policy earlier. However, they are so determined to get homeless people off the streets in front of these stores that the health of the children comes second.

I have long argued that one of the adverse consequences of widespread outdoor smoking bans like this one is that they will result in smokers choosing to smoke inside, rather than face fines for smoking outdoors. For those smokers who have or live with children, this will result in increased secondhand smoke exposure for these kids. What we want, in fact, is for smokers who live with children to smoke outdoors, so as not to expose those children. Banning outdoor smoking virtually everywhere in large areas of a city is the last thing in the world that we want to do if we are concerned about the health of children.

What is telling is that the city officials appear to acknowledge that this is going to be a problem. They apparently decided to expand the ordinance to cover all sidewalks in all commercial areas because they wanted "to
add southern and western Berkeley where a higher proportion of black adults live, who are 1.6 times more likely to smoke than white adults, according to a city of Berkeley Health Status Report. Children under age 5 have a higher rate of asthma in southern and western Berkeley, one consequence of inhaling secondhand smoke, according to the city."

These are precisely the areas of the city where you do not want to send parents the message: "Don't go outdoors to smoke." You absolutely want them to smoke outdoors.

Not surprisingly, it appears that getting the homeless off the streets will come at the expense of the city's black children, who will likely face even higher risks of asthma due to their parents choosing to avoid fines by smoking indoors rather than out.

The argument that this ordinance supports broader public health goals by deterring people from smoking does not hold water. There is no evidence that outdoor smoking bans such as this one results in increased rates of smoking cessation. What does appear to happen is that people change where they smoke, not whether they smoke.

But that's precisely the problem. By pushing smokers from outdoors (where they will not expose their children) to inside (where they may expose children), we are actually harming the public's health, not improving it.

But at least Berkeley business owners won't have to contend with the homeless people outside their doors.

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