Ontario to Consider Smoking Ban in Cars with Children Because "We Need to Everything We Can to Keep Our Children Safe and Healthy"

According to a CBC News article, the government of the province of Ontario will introduce legislation that would ban smoking in any car with a child passenger.

According to the article: "The Ontario government plans to introduce legislation this spring to ban smoking in cars where young children are present. Premier Dalton McGuinty announced in Toronto on Wednesday that the new law will be brought in for the spring session of the legislature, which is scheduled to begin March 17."

"'We know that this is harmful to children,' McGuinty said. 'We need to do everything we can to keep our children safe and healthy.' " ...

"McGuinty said that being exposed to one hour of second-hand smoke in a car is the same for a young child as smoking an entire pack of cigarettes."

"Ontario doctors welcomed the decision. The Ontario Medical Association said in a news release on Wednesday that it has been calling for such a ban since it released a report on the issue in 2004. Dr. Janice Willett, president of the OMA, said Ontario doctors have tried to educate the public about the dangers to children of second-hand smoke in vehicles and build public support for a ban on smoking in cars carrying children."

The Rest of the Story

If it is true that we need to do everything we can to keep our children safe and healthy, then it seems undeniably true that we should ban smoking in the home, since that is overwhelmingly the chief source of secondhand smoke exposure for children.

You see - the reasoning used by Premier McGuinty to support the need for the car smoking ban reveals its own weakness: the policy is inconsistent because it fails to take an easy action that would help to keep our children safe and healthy (banning smoking in the home). Moreover, it is not only inconsistent but illogical, since exposure to secondhand smoke in cars is staggeringly lower than exposure to secondhand smoke in the home. The burden of health effects due to tobacco smoke exposure among children in cars is dwarfed by the burden of health effects attributable to tobacco smoke exposure in the home. Thus, it makes no sense to ban smoking in cars, but to allow smoking in the home with children present.

The one way out of this predicament would be to argue that government needs to respect the autonomy of parents to make their own decisions about what health risks to which they will expose their children. However, by admitting that it is acceptable for the government to interfere with parental autonomy (by prohibiting parents from smoking in their own cars), this escape hatch is effectively closed. Proponents of car smoking bans can no longer argue that a home smoking ban to protect children is not acceptable because it interferes with parental autonomy about children's health risks. They have taken that argument away from themselves. And that's exactly the problem.

You just can't have it both ways. If you are willing to interfere with parental autonomy over children's health risks by regulating smoking in cars with children, then you should also be willing to interfere with parental autonomy over children's health risks in the home, especially if the health risk from exposure in the home is much greater than that in cars.

Apparently, the Ontario Medical Association has been trying to educate people about "the dangers to children of second-hand smoke in vehicles" and working to promote "public support for a ban on smoking in cars carrying children." I would then ask: why has the Ontario Medical Association not also been trying to educate people about the dangers of secondhand smoke in homes and working to build public support for a ban on smoking in homes with children present? These health risks are undoubtedly greater than those posed by smoking in cars.

Enough on that point. The second point I wish to make is that whether one supports or opposes car smoking bans, hopefully we would all agree that factual and accurate statements would be made by government officials to support the policy.

Unfortunately, it appears that a misleading claim is being used to support this legislation. Premier McGuinty was quoted as stating that "being exposed to one hour of second-hand smoke in a car is the same for a young child as smoking an entire pack of cigarettes."

This is not accurate. The exposure to toxic substances resulting from one hour of secondhand smoke exposure in a car is not equivalent to that of actively smoking a pack of cigarettes. It may be true for one or two of the constituents of tobacco smoke, but it is certainly not true for all of them. If you had a choice between your kid being exposed to secondhand smoke for an hour or actively smoking a pack of cigarettes, you should definitely choose the secondhand smoke.

My point here is not to minimize the danger of childhood exposure to secondhand smoke for an hour in a car. In fact, I've spent most of my career trying to highlight the dangers of childhood exposure to secondhand smoke. My point is simply to explain why the statement made by this public policy maker is inaccurate.

I myself have used cigarette equivalents to communicate messages about the hazards of secondhand smoke to the public. However, I have always made it clear exactly what constituent of the smoke I am talking about. Cigarette equivalents vary for every different constituent. So while a child exposed to tobacco smoke for an hour in a car may be exposed to the equivalent of one pack worth of one chemical, he will be exposed to the equivalent of far less than one pack worth of many other chemicals. This doesn't mean that the exposure is safe; it merely means that the statement is inaccurate.

I don't support the use of these kind of inaccurate statements to promote public health policies (even if I agree with those policies) for two reasons. First, and most importantly, I think it is wrong. I think we in public health and public policy have an obligation to communicate information accurately to the public.

Second, I think it serves to discredit the tobacco control and public health movements and to undermine our scientific reputations. If people find out that we are exaggerating and distorting the truth, we will lose their trust. But their trust is essential if we are to remain effective as public health advocates.