Monday, July 17, 2006

Indianapolis Workplace Smoking Ordinance Supported Based on Misleading and Unsubstantiated Scientific Information

The Marion County (Indianapolis) smoking ban, which was enacted last year, was apparently supported in part based on misleading and unsubstantiated information provided to the City-County Council, presumably by anti-smoking groups.

Two of the Councillors who sponsored the ordinance published a letter to the editor on March 13, 2005 in which they explained their reasoning for supporting the ordinance as follows: "Secondhand smoke stiffens your aorta within five minutes, increases the clotting in your blood within 20 minutes, and can cause a heart attack in as little as 30 minutes. These are not problems that take many years to develop only after repeated exposure."

The Indianapolis law bans smoking in restaurants, but not in any restaurant that serves alcohol and which is adult-only (does not allow children under age 18 as customers or employees).

The Rest of the Story

To me, the statement by the City-County Council members implies that a person is at risk of a heart attack after being exposed to secondhand smoke for just 30 minutes. The councillors did not qualify their statement by noting that the claim holds only for those who already have severe existing coronary artery disease to such an extent that any possible insult to their cardiovascular system could put them over the edge and trigger a myocardial infarction.

However, it is the case that the statement is accurate only for such a narrow part of the population (for whom even eating a hamburger could, by the same logic, trigger a heart attack because it causes damage to the lining of the coronary arteries and could be just enough to put the person over the edge). Moreover, this claim is unsubstantiated, even for people with existing coronary artery disease. There is no study of which I am aware that demonstrates that 30 minutes of secondhand smoke exposure can trigger a heart attack in an individual with coronary artery disease, and I'm not aware of any evidence that such an event has ever occurred.

As far as the rest of the population goes, the statement is just plain false. There is no possible way that a person can develop coronary artery stenosis from just a 30 minute exposure to secondhand smoke. As we know, a person doesn't develop heart disease from just 30 minutes of active smoking. How could 30 minutes of passive smoking do the trick?

Thus, at very best, the claim made to support the Indianapolis ordinance is misleading and unsubstantiated. At worst, it is blatantly false (and this is likely how the statement was interpreted by the other city council members and by the public).

The worst part of the story, however, is not that the fallacious claims of anti-smoking groups were successful in getting Council members to support legislation based on misleading or false scientific claims.

The worst part of the story is that the Council, accepting the "fact" that even a 30-minute exposure to secondhand smoke could cause a heart attack in an innocent bystander, chose to risk the lives of workers in restaurants with a liquor license that chose to become adult-only establishments. In other words, the Council defended its ordinance by arguing that secondhand smoke is so dangerous that even a half hour of drifting smoke can cause a heart attack, yet apparently they don't view it as being so dangerous that people who work 40 or more hours per week in a smoky bar or adult-only, alcohol-licensed restaurant need to be protected.

That hypocrisy is mind-numbing.

You can't have it both ways. You can't exaggerate and distort the science to unduly scare people into thinking that they are going to suffer a heart attack from a mere 30-minute exposure to secondhand smoke and then support a policy that exempts workers based on a decision by their boss to exclude children from the establishment. That's a public health non-sequitur. It's pure public health nonsense.

When I stated back in May 2005 that the enactment of the Indianapolis smoking ban represented a sad day for clean indoor air in Indiana, I didn't even realize at the time how sad a day it was. Not only was it a day that the Indiana tobacco control movement demonstrated its hypocrisy; it apparently was also a day that the fallacious statements of the anti-smoking groups resulted in the public policy being supported based on misleading, unsubstantiated, and perhaps even false scientific information.

That's not something to be proud of. It's really a shame when public policy is made based on false scientific claims. And that goes not only for making policy based on misleading tobacco industry claims. The knife cuts both ways.

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