No smoking at work: Let's broaden effort

For decades, Americans have known the health risks associated with smoking and secondhand smoke. A generation of children who grew up with posters and buttons featuring a frog with the slogan "If you smoke, I'll croak" have grown up, and their children now need help to steer clear of direct and indirect exposure.

Despite the overwhelming evidence of tobacco's danger, and all that's been done to communicate those risks, there's plenty more to be done to prevent needless deaths. Taking on smoking in the workplace is a sensible strategy that protects nonsmokers while providing a powerful tool to help motivate current smokers to kick the habit.

In December 2005, Chicago took a step in the right direction when it joined a dozen states and a number of cities that ban smoking in the workplace. (Some of those laws include restaurants and bars, as is the case in Chicago; others do not.) But Chicago's ordinance doesn't go as far as it could in helping stop preventable deaths.

The American Medical Association has two concerns.

While the new law requires most workplaces to go smoke-free this month, bars and restaurants have more than two years phase-in period to comply with the law.

Those who work in restaurants and bars will, in the short run, continue to be exposed to the more than 4,000 chemicals that have been identified in secondhand smoke, including at least 60 carcinogens and six substances that interfere with normal cell development.

The Chicago law also exempts all public places and work sites that install air ventilation systems that meet a clean indoor air standard that the city had not defined as of press time.

No matter how the standard is defined, studies have shown that ventilation systems are not effective in protecting people from smoke's toxins.

Chicago business owners should go above and beyond the newly adopted requirements and prohibit smoking today. Businesses in other cities should do the same.

Environmental tobacco smoke, or ETS, is associated with increased risk of sudden infant death syndrome and of cardiovascular disease. It also can result in low birth weight for babies of women who are exposed to ETS while pregnant. In addition, children can develop more severe asthma and severe lower respiratory tract infections, such as bronchitis, when they are exposed to secondhand smoke.

Under extensive policy on smoke-free environments and workplaces that the AMA adopted in 2004, the Association encourages state medical societies to support legislation ranging from mandates for smoke-free schools to elimination of smoking in public places and businesses.

The AMA took that policy a step further at its Interim Meeting in November 2005 by saying it will "actively support national, state and local legislation and actively pursue regulations banning smoking in all workplaces." The Association also will work to ensure that federal legislation doesn't prohibit or weaken existing state or local regulations that are stricter than any federal legislation.

If more people quit and fewer people are exposed to secondhand smoke, more lives will be saved. Among the 160,000 deaths from lung cancer in a year, 87% of the cases are attributed to smoking, according to the National Cancer Institute. The group says another 3,000 lung cancer deaths among nonsmokers each year are a result of secondhand smoke.

"If you smoke, I'll croak" is the right message and has its place. With all these lives in the balance, so do tough laws banning workplace smoking.