Monthly Archives: June 2009

American Heart Association and KEEP ST. LOUIS FREE! team up(?!)

Mr. Bill Hannegan of KEEP ST. LOUIS FREE! writes that he “joins” with Ms. Bonnie Linhardt, Missouri State Advocacy Director, American Heart Association, after her letter appeared in the June 28, 2009, St. Louis Post-Dispatch. What prompted this unholy alliance is that both are opposing the St. Louis City smoke-free air bill introduced by Ald. Lyda Krewson and due to have public hearings on Tuesday, June 30, and Wednesday, July 1, starting at 12 noon. The reason is the trigger language which requires St. Louis County to enact similar legislation before the City’s law will go into effect.

Agreed, if we can get that proviso removed it is preferable, but if not this bill still offers us a way forward towards the goal of a regional comprehensive smoke-free air ordinance that is long overdue.

Ms. Linhardt’s opposition to this effort takes me back to August 2005 on the day of a critical vote on a comprehensive smoke-free air bill then being considered by St. Louis County Council. It had some exemptions, such as the gaming floor of Harrah’s Casino, in order to have a chance of passage. During the public portion before the vote Ms. Linhardt, speaking on behalf of the three local voluntary health agencies – American Heart Association, American Lung Association, and American Cancer Society – argued that because the bill had some flaws it should be rejected. She was evidently persuasive because the bill, which was expected to garner a majority vote, was killed by a vote of 4:3. The councilwoman who switched her vote, Hazel Erby, gave as part of the reason Ms. Linhardt’s testimony against the bill.

I believe that Ms. Linhardt’s arguments are once again flawed and she is letting the perfect be the enemy of the good.

I’m pleased to note that Steve Patterson, in his Urban Review STL blog of June 26, appears to agree.

Mr. Hannegan cannot be allowed to perpetuate his myth about Enstrom and Kabat, whom he describes glowingly in a posted comment on the STL website following Ms. Linhardt’s on-line letter as “Two of the most qualified secondhand smoke epidemiologists.” Yes, they published a paper in the British Medical Journal in 2003, “Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98,” purporting to show “no causal relation between environmental tobacco smoke and tobacco related mortality,” contrary to numerous other studies.

Their paper had been soundly rejected several years before after submission and review by the Journal of the American Medical Association.

The American Cancer Society, which supplied the data on which the study was based, also roundly condemned it, as is clear from this excerpt from a press release, available on-line at and worth reading in its entirety:

“ATLANTA — May 15, 2003 — The American Cancer Society today strongly criticized a misleading tobacco industry-funded study that compromises Society data by using flawed methodology to falsely conclude environmental tobacco smoke (ETS) may not affect lung cancer risk. Dr. James Enstrom, the author of the study published in the British Medical Journal, received funding from a tobacco industry group linked to coordinated attempts to confuse the public about the dangers of secondhand smoke.”

The press release noted that the ACS had done a much larger study using more appropriate and reliable data, called the Cancer Prevention Study II, which “Clearly shows an increased risk of lung cancer and heart disease.”

The press release concluded:

“Bad science can haunt us for generations,” added Dr. Eyre. “And regrettably, if questionable studies make it to publication, the damage is done.”
[Harmon J. Eyre, MD, the Society’s national chief medical officer.]

The study was also heavily criticized at the time by many scientists in the field for being based on flawed methodology such as the following, published on the BMJ website by Jayant S Vaidya, University College London, Dept of Surgery.

Like Eyre of the ACS, Vaidya includes a prescient comment, pointing out that the study will be used to promote vigorous opposition to secondhand smoke laws. Both were so right!

Jayant S Vaidya,
University College London, Dept of Surgery, W1W 7EJ

“There is a major flaw in the study and the Editors may wish to consider a public retraction.
This study assumes that there is a considerable difference in the exposure to ETS of never smokers’ spouse compared to ever smoker’s spouse. This is obviously not true.
Most never smoker’s spouses would have been exposed to considerable ETS before the late 1990s, when the general exposure to ETS in California started reducing. It would be only in the last 3-4 years of the 39-year study when the ETS exposure to workplace might have been so reduced that there might be a difference in the two groups.
So for most of the data, assuming the spouses meet in their non- working hours, they would be exposed to each other- for typically 2-4 hours a day (assuming a 11 hour work+travel and a 9 hour sleep+eat+bath etc.), whereas they would be exposed to ETS at work for up to 8-10 hours.
Thus the study is comparing a 8-10 hour exposure to ETS among spouses of ‘never’ smokers to a 12 hour exposure to tobacco smoke among spouses of ‘ever’ smokers. Assuming a 30% increased mortality for passive smoking and assuming never smokers are exposed to ETS for about 10 hours when they are not with their spouse, compared to 12 hours by spouses of ever smokers, the difference in mortality between the groups should be about ((12- 10)/12) x 30= 5%. In addition, there would be many quitters among the ever smokers – thus reducing the ETS to the spouse and many occasional smokers (mainly at the time when they met their spouse) among the never smokers – increasing the ETS exposure to spouse. Despite the large size of the study, it is well known that a 5% difference in RR is extremely difficult to demonstrate in epidemiological studies, and especially in this study, inability to find a difference especially when only a tiny difference was expected cannot be taken as absence of a difference.
There is no doubt that however flawed this study, unless it is retracted by the BMJ, tobacco industry will use it extensively to promote their vigorous opposition to anti-smoking legislation in general, and anti-ETS laws in specific. Of course they have an urgent need to replace their loss of customer base of about 10,000 to 20,000 per day with new recruits of young smokers.”

Friday the 13th: The cigarette

FDA regulation of Big Tobacco: Really?

FDA regulation of Big Tobacco: Really?

The above rather fearsome editorial cartoon by R. J. Matson depicting newly-enacted FDA regulation of tobacco accompanied an editorial on the same subject in today’s St. Louis Post-Dispatch.

The editorial lists some positive gains expected from the Federal Smoking Prevention and Tobacco Control Act, just signed into law by President Obama. But it also echoes some concerns I share, without going into the details.

For starters, if it’s so bad for Big Tobacco why has it been widely reported that Philip Morris Cos., the largest cigarette maker in the U.S., has been lobbying hard for this legislation for many years, pouring money into those efforts? You can bet it wasn’t doing it to improve the nation’s health by reining in tobacco consumption. The goal appears to be cementing its leadership position in the marketplace and simultaneously regulating out of existence potentially safer products which are currently available and could challenge it. I guess we’ll have to wait and see whether the nation’s health or Big Tobacco was the winner but I’m not sanguine. Here’s the editorial:

Big Tobacco: Regulated, but not vanquished
By Editorial Board
Friday, June 26, 2009

The federal government finally will regulate cigarette manufacturing and marketing. That’s long overdue, as anyone familiar with the tobacco industry’s shameful history can attest.
President Barack Obama — an occasional smoker who admits that he still struggles daily with his nicotine addiction — signed legislation on Monday that gives the U.S. Food and Drug Administration authority over the industry.
Smoking kills an estimated 443,000 Americans every year. For each person who dies, 20 more develop serious illness. Not all of them are smokers. The annual cost of treating tobacco-related disease is $96 billion.
The new law is a major victory for common sense and health. Anti-smoking advocates have hailed it as a “historic blow against the greatest public health menace of our time.”
But is it a death blow? Don’t count on it.
Time and time again, the tobacco industry has absorbed historic blows.
Like Jason, the villain in those “Friday the 13th” slasher flicks, it’s risen each time to inexorably stalk its young prey.

“We are presently, and I believe unfairly, constrained from directly promoting cigarettes to the youth market.”
In 1973, an R.J. Reynolds tobacco company employee named Claude E. Teague sketched out strategy ideas in a memo to his bosses. His handiwork, from which that quote is taken, later landed in the public archives of tobacco industry documents.
“If our company is to survive and prosper over the long term,” Mr. Teague wrote, “we must get our share of the youth market.”
Doing so required more than just inventing new brands that appeal to what he called “pre-smokers and ‘learning’ smokers.” It also involved manipulating the level of nicotine in cigarettes.
“Nicotine should be delivered at about 1.0-1.3 mg./cigarette, the minimum for confirmed smokers,” Mr. Teague wrote. “The rate of absorption of nicotine should be kept low by holding pH down, probably below 6.”
The industry would have you believe that is ancient history. In fact, tobacco companies have continued both marketing to young people and manipulating nicotine levels in its products.
A 2006 study, for example, found that changes in cigarette design between 1998 and 2004 increased the amount of nicotine delivered to smokers by an average of 10 percent.
It increased by a whopping 36 percent in Doral cigarettes, made by — you guessed it — R.J. Reynolds, Mr. Teague’s former employer.

The “pre-smokers and ‘learning’ smokers” of 1973 are today in their 40s and 50s. Many are struggling with the health consequences of their addiction. It’s too late for them.
The Family Smoking Prevention and Tobacco Control Act, which Mr. Obama signed this week, is designed to protect a newer generation of Americans. It bans the sale of candy and fruit-flavored cigarettes aimed at enticing young people into smoking; bans misleading health claims like “light” or “low-tar”; and gives the FDA authority over how tobacco products are manufactured, allowing it to prevent the manipulation of nicotine in cigarettes to addict more smokers.
It also toughens restrictions against marketing cigarettes to children. Those restrictions have been around in one form or another since the early 1970s — and have been skirted by tobacco companies for just as long.
Those are all important protections. They will work better in conjunction with clean indoor-air laws that prohibit smoking in public buildings.
Clayton’s Board of Aldermen is poised to enact such an ordinance protecting the right of nonsmokers in restaurants and bars.
A citizen’s group in Kirkwood is gathering signatures to place a clean indoor-air law on the ballot in November. Arnold, Ballwin and the entire state of Illinois already have such laws.
Effective federal regulation can help curb a rogue industry like Big Tobacco. But it won’t drive a stake through its heart.
As long as cigarette makers continue selling death and disability by the carton, they will be hoping for a sequel.

Group revives anti-smoking initiative in Kirkwood

The following story by reporter Phil Sutin with the above title appeared in today’s ST. LOUIS POST-DISPATCH (06/23/2009). It notes that the Kirkwood citizen’s group Healthy Air for Kirkwood is close to reaching its signature target to put a smoke-free air initiative on the ballot, assuming the city council doesn’t adopt it themselves, which appears unlikely from the remarks of council members reported below. This is the second such effort in three years. The first in 2006 lost by roughly 55% to 45%, thanks in part to deliberate confusion injected by the opposition, as mentioned in the article below.

KIRKWOOD — For a second time, city voters could decide whether to ban smoking in indoor public places.

Promoters of an initiative announced Monday they are close to obtaining enough signatures to put the ban on the ballot. If their petitions are valid, they hope for an election in November, but a combination of city charter and state election deadlines could put off the election until February.

With very few exceptions, the measure would allow smoking only in private homes, private vehicles and outdoors. Hotels could still designate up to 20 percent of their rooms for smoking, and some private clubs and retail tobacco stores would be exempt under the measure.

The initiative is a revised version of a ballot question voters defeated in November 2006, with 54.6 percent of about 14,300 voters opposing it.

Supporters need 1,036 signatures to start the initiative process. A group called Healthy Air for Kirkwood has collected about 950 signatures, said Debra Cotten, group spokeswoman. The group hopes to collect about 1,100 signatures and turn them over to city officials before July 1, she said. The St. Louis County Election Board would check the validity of signatures.

If the petition has sufficient signatures, the City Council has 60 days to either accept the proposal or allow a public vote. The election must be no more than 120 days after the council rejects the proposal. If an initiative election is to occur in November, the council must reject the measure by Aug. 25.

The initiative comes as Clayton aldermen plan a final vote next month on a smoking ban there. Ballwin and Arnold have anti-smoking ordinances. Illinois prohibits smoking in indoor places. St. Louis Mayor Francis Slay has expressed support for an areawide ban; St. Louis County Executive Charlie Dooley says such a ban should be statewide.

Kirkwood Mayor Arthur McDonnell said he polled council members last fall and they agreed that a smoking ban should be regionwide or statewide. “We need to be fair to the business community,” McDonnell said. A ban would hurt local businesses in a difficult economy, he said.

James Wright, president and chief executive officer of the Kirkwood Chamber of Commerce, said the initiative would damage the competitiveness of city businesses.

Mike Duffy, a restaurant owner and president of the Kirkwood restaurant association, declared the ban “is not good for the citizens of Kirkwood. Citizens vote with their money to go to restaurants,” he said. “If they don’t want to go to a place (that allows smoking), they will go someplace else.”

Duffy called the initiative a waste of taxpayers’ money because Kirkwood voters rejected the idea 2½ years ago.

This year’s anti-smoking measure includes several changes from the 2006 version that respond to objections from business people. It specifically defines “smoking”; the 2006 version, by contrast, banned material that was a “combustible substance.” Duffy and other opponents of a smoking ban said that wording would prohibit backyard barbecues and food booths at traditional city events and would even prevent restaurants from making french fries.

I posted the following comment on-line following the above article. I suggest you visit the Post-Dispatch on-line here to check the comments and consider adding your own:

DigitalPariah is spouting a tired tobacco industry argument: That when it comes to this one public health issue of secondhand smoke exposure we should leave it to private businesses to decide. It’s nonsense of course – we have many rules and regulations affecting private business to ensure the health and safety of both patrons and employees – but that doesn’t stop the tobacco industry or its surrogates from repeating the same flawed argument.

The City of Kirkwood is also using another tobacco industry ploy: Punt the issue up the field instead of dealing with this health issue locally. What elected officials are in fact doing is avoiding their responsibility to protect the health and welfare of those whom they were elected to represent and serve. And using the threat of loss of business as cover for their failure to act. No one ever argues “loss of business” when a restaurant is closed down due to a case of food poisoning, for example.

These arguments amount to a smokescreen and should be ignored. I applaud “Healthy Air for Kirkwood” for taking this initiative and doing what their own city council is clearly failing to do, despite having the power to act.

Martin Pion, President, Missouri GASP

Cheshire Lodge goes smoke free, including in the Fox and Hounds Tavern

The following story by Deb Peterson in the St. Louis Post-Dispatch mentions that both the Cheshire Lodge (formerly the Cheshire Inn) and Cardwell’s in Plaza-Frontenac, are now smokefree. That’s good news.

I visited the Cheshire Inn with my wife to attend the birthday celebration of the late Dr. Jerry Himmelhoch, a lively and engaging member of the Gourmet Book Club of which we were then members. His health was starting to fail and family members didn’t want to wait longer to stage this event. I recall being concerned because smoking was still allowed in some public areas but the private upstairs room where the event was held was reasonably smoke-free.

I haven’t been back since but I’m glad to learn they are taking this healthy step in going smoke-free and not waiting for government action.

Plaza-Frontenac is supposedly smoke-free throughout so I was taken aback when I visited Cardwell’s in that location some years ago with friends and discovered that they allowed smoking at the bar. We ended up eating outside the restaurant but that taught me always to ask if a restaurant has a bar where smoking is allowed when checking a restaurant’s smoking status. (I just called to double-check and was told the restaurant went smoke-free April 1, 2009, with smoking only permitted on the patio.)

I checked to see what comments had been left on the Post-Dispatch on-line following the article and of the 6 to date 5 were positive with only one griping, which was roundly condemned by the following post.


06.15.2009 6:19 pm
Cheshire Lodge goes smoke free, including in the Fox and Hounds Tavern

By Deb Peterson
St. Louis Post-Dispatch

MATCHLESS: The Cheshire Lodge has banned smoking in its Fox and Hounds Tavern as of this month. The Cheshire will have two outdoor smoking areas – one in front of the hotel’s Cock and Bear Room and the second in the Cheshire Garden, west of the hotel and accessible from the first floor elevator lobby.

The Cheshire was built in 1965 by Stephen Apted who bought the Cheshire Inn’s restaurant from the Medart family in 1961. Apted’s son and granddaughter, Dan and Dani Apted respectively, run the Cheshire Lodge today. The Apteds say they decided to ban smoking because of the quality of life issue it represents.

“This isn’t about the rules or financial impact, it’s about a quality of life for my family, staff, hotel and bar guests as well as anyone who chooses to use or be in this lodge,” Dan Apted said Monday. “I have gone through the affects (sic) of 9/11, to the highway 40 closures and of course the depression and recession, and no amount of money saved is worth it if I’m not concerned about improving the lives of those around me, and those we serve.”

Dan said he struggled with the decision for about a year and made up his mind after another local restaurateur instituted a ban. “When a good friend of mine, Bill Cardwell, went smoke-free at his restaurant location in Frontenac, I knew that it was time for a revolution,” Dan said.

FDA regulation of Big Tobacco: Good or Bad?

Today’s announcement that both chambers of the Congress have agreed on legislation permitting the FDA to (finally!) regulate tobacco products should be cause for rejoicing. The problem with all legislation is the fine print, not the title. Does this really do what it claims: to finally put the tobacco industry under meaningful regulation in terms of product content, advertising and marketing claims and will it lead to significantly less smoking in the U.S. in the future, as claimed by the law’s proponents?

I’m not sanguine that all of the above will be accomplished, in part because the largest cigarette maker in the U.S., Philip Morris Cos., was closely involved with writing the legislation and approved of it. My experience with the tobacco lobby, going back decades, is that whenever they either remain silent on legislation affecting their bottom line or actively support it, the legislation is likely to be badly flawed and ultimately in their interests.

There appears to have been a troubling alliance between the legislation’s sponsors; the Campaign for Tobacco Free Kids; and Philip Morris, hence my reservations now.

Those concerns have been reinforced by numerous articles I’ve been receiving from Bill Godshall of Smokefree Pennsylvania, whom I’ve known for a long time and whose views I respect. He noted that one commentator had dubbed the legislation “The Philip Morris Protection Act.” Those articles raised numerous red flags about the proposed legislation as it steamrollered its way through the Congress.

There’s a rather bland article in today’s St. Louis Post-Dispatch which generally omits reference to these issues. You can find the article on-line here followed by reader’s comments.

I’ve posted a somewhat detailed response on-line following a number of other comments on the above article. I’ve pasted the text of my post below:

Martin Pion wrote: June 12, 2009 12:19PM
Today’s article, “Congress sics FDA on Big Tobacco” by Janet Hook, Tribune Washington Bureau, on the front page of today’s St. Louis Post-Dispatch, was rather disappointing. It didn’t mention Philip Morris at all or really detail some of the objections of other tobacco companies, such as RJReynolds, to the legislation.

I also have mixed feelings about this legislation, which is being hailed by many in the tobacco control movement as a major step forward in public health.

The federal government has been AWOL in its regulation of tobacco products for decades, due to the monied influence of the tobacco industry in the Congress, the government’s own addiction to cigarette tax revenues, and the large number of addicted smokers. That is well documented in “The Smoke Ring,” for example, first published in 1984.

The reason for my concerns now is the fact that Philip Morris Cos., the largest cigarette manufacturer in the U.S., if not the world, worked with the Campaign for Tobacco Free Kids and others on the actual legislation, and supported what was finally approved. My first-hand knowledge of the tobacco industry is that anything of which they approve is inevitably bad for public health.

The much-touted reductions in cigarette smoking that proponents claim will come from this legislation may also be illusory. Some critics are already claiming that all it will do is cement Philip Morris’s leadership role in the U.S. market while eliminating prospective competition from allegedly less-hazardous nicotine delivery devices, such as so-called e-cigarettes, which are currently the subject of a federal lawsuit.

On another historical note regarding the federal government, the only time it has done something indisputably beneficial in terms of public health and smoking was when it made commercial airline flights smoke-free. Before that you had smokers and nonsmokers segregated, but almost immediately the “No Smoking” sign was switched off shortly after takeoff you could smell tobacco smoke in the no-smoking section. I know of several nonsmoking flight attendants who suffered smoking-related diseases as a consequence, including one lady who was otherwise never exposed to secondhand smoke except at work who lost a lung.

To respond to some of the previous posts:

“Mike_Hunt June 12, 2009 6:01AM CST
Aren’t there more important issues our Congress could be working on? Smoking in the U.S is at an all time low. Typical.”

This attempt to dismiss smoking as a non-issue is totally absurd. Smoking has long been identified as the No. 1 preventable cause of death in the U.S. and it remains so. Deaths due to secondhand smoke rate No. 3 or 4 in that same list, depending on what estimate you accept, but it’s at least 35,000 preventable deaths annually. The incubation period before fatal diseases appear in smokers and exposed nonsmokers is decades, so we can expect these numbers to remain high for years to come.

“w.champion June 12, 2009 7:07AM CST
save me government!! save me government!!”

This comment is in the same vein: dismissive of reality.

“The Legend June 12, 2009 6:43AM CST
What’s next? A ban on alcohol? A ban on fatty foods? A ban on pesticides? A ban on cars? A ban on guns? What else is the government going to ban that could be potentially dangerous to the general public? Let people make their own decisions. It is a free country, correct?”

“Rizzeau June 12, 2009 9:33AM CST
…. In my opinion, this country is becoming less free every single second that passes. From the government choosing what words we can hear on television and on the radio, to now how companies are able to market their product. Where will it end?”

Both the above echo a familiar theme of tobacco industry supporters, the so-called “slippery slope” argument: where will it all end?!

The “choice” argument is also utterly false but is another favorite of the tobacco industry. It’s an example of how they have expropriated words and then twisted their meaning. If smokers can “choose” to smoke in public places and private workplaces, then everyone is subjected to the potentially harmful air pollution it causes. It actually takes away an important choice: that of breathing unpolluted air.

Personally, my interest does not extend beyond the secondhand smoke issue. I just want to live in a society where I’m not forced to breathe secondhand smoke where I work, when I go to a restaurant, etc.

Smoking should remain legal but be confined to the private home among consenting adults: just the same way we treat sex.

Martin Pion, President, Missouri GASP.

Hannegan’s Letter & Pakko’s Casino Study

Bonus points to Hannegan! He posted a comment on-line AND got it published in yesterday’s Letters column of the St. Louis Post-Dispatch. Hannegan contacted Chad Cotti, PhD., who has done similar estimates before, and got him to estimate the loss in employment in the restaurant and bar business if St. Louis City were to go smoke-free. Needless to say, it shows a large drop in bar employment, so once again scare tactics which would never be considered with another health threat, like asbestos exposure or food poisoning, are being used to argue against secondhand smoke legislation.

Incidentally, Cotti also published a study concluding that smoke-free air laws led to more drunk driving fatalities because smokers would drive further to be able to smoke and drink! [See his web page for a list of smoking-related articles including: “Drunk Driving After the Passage of Smoking Bans in Bars” Journal of Public Economics: Vol. 92, Issues 5-6, June 2008: 1288 -1305 (with Scott Adams).]

Here’s Hannegan’s letter:

Pushing unemployment?

Dr. Chad Cotti, a University of Wisconsin economist who specializes in assessing the impacts of smoking bans, has predicted the probable effect of a St. Louis city smoking ban on St. Louis city restaurant and bar employment. Dr. Cotti estimates that the St. Louis City Smoke Free Air Act of 2009 would cut St. Louis city full-service restaurant employment 1.1 percent and bar employment 19.7 percent. Dr. Cotti says that such a large employment drop in the bar industry would be the result not only of layoffs but also the complete closure of some establishments.

Obviously laid-off workers don’t pay the city’s earnings tax and closed bars cease their tax contributions to the city. Why are Alderman Lyda Krewson and Mayor Francis Slay pushing such an economically harmful restriction on businesses — especially at a time when the city is so cash-strapped that 4,000 city employees may soon be asked to take unpaid furloughs and basic city services are being threatened?

Bill Hannegan — St. Louis
Keep St. Louis Free

As I noted in my blog of June 3, I found a recent study on-line “Smoking bans do not cause job losses in bars and restaurants” which disputes the conclusion that smoke-free air laws lead to such loss of business. Lead author of the study, Dr. Elizabeth Klein, assistant professor of health behavior and health promotion at Ohio State University, is quoted as saying:

“In the end we can say there isn’t a significant economic effect by type of clean indoor air policy, which should give us more support for maintaining the most beneficial public health policies.”

Earlier today I visited Hannegan’s blog “KEEP ST. LOUIS FREE! [to pollute your lungs]” and found not only the above letter mentioned but also a link to a new “working paper” by two economists at the Federal Reserve Bank of St. Louis website, posted at

The study is titled: “Casino Revenue and the Illinois Smoking Ban” and its authors are economists Thomas A. Garrett and Michael R. Pakko. It purports to show significant loss of casino revenue directly tied to the Illinois Smoke Free Air Act, which went into effect January 1, 2008.

This is not an officially approved document but by being published on the Federal Reserve website it gives it plenty of credibility. Also, since it’s a “working paper,” it’s not been peer reviewed or published in a journal.

I debated Dr. Michael Pakko, a Libertarian, in St. Louis earlier this year at the event staged by the St. Louis Federalist Society on whether or not St. Louis should go smoke-free. He’s been speaking out against smoke-free air efforts for several years now, presumably motivated by the Libertarian philosophy of minimal government.

The study by Garrett and Pakko is interesting because Missouri GASP has been funding an independent study into this same subject by Jenine Harris, PhD., Assistant Director of Research, Center for Tobacco Policy Research at Saint Louis University School of Public Health.

Her study will compare the impact of different state smoke-free air laws on casino revenues in the adjoining states of Missouri, Illinois and Iowa. Dr. Harris is currently attending the three-day National Conference on Tobacco or Health, Phoenix, AZ, a major tobacco control conference, to report her findings to date under the title “Gambling on clean air: Casinos and the Smoke Free Illinois Act.” [Go here to view conference information and a very effective video.]

Tobacco should be regulated like the drug it is

A St. Louis Post-Dispatch editorial was published on-line with the above title on Thursday, June 4, 2009. The print version’s title was “Trust, but regulate” with the subheading “Tobacco should be controlled like the drug it is.” The editorial is timely, given the current debate in the U.S. Senate on bill S. 982 to give the Federal Drug Administration some control over cigarettes. The House companion bill is H.R. 1256.

Normally, this would be great news, and the legislation has strong support from a number of very influential organizations dedicated to public health and smoking reduction, such as the Campaign for Tobacco Free Kids.

What worries me are some of the details. Leading cigarette maker Philip Morris Cos. is supportive of the legislation, an apparent reason being self-interest: the bill is likely to cement its leadership role in the conventional cigarette market. In fact, in an article by John E. Calfee of the American Enterprise Institute he called the bill the “Marlboro Brand Protection Act.”

Another is a concern that the bill as currently written will outlaw a relatively new nicotine-delivery device, the so-called electronic cigarette which doesn’t burn tobacco leaves but only delivers nicotine to the smoker. These are said to be much safer than conventional cigarettes, and do not emit the carcinogens and other chemicals in conventional cigarettes. It seems the proposal to ban them stems from competitive concerns of cigarette manufacturers like Philip Morris.

Any safety claims for e-cigarettes should be carefully researched but these alternative nicotine delivery devices should not be banned absent that review unless they are found to be as harmful as conventional cigarettes.

The above concerns are being voiced by other critics, such as fellow smoke-free air campaigner Bill Godshall of Smokefree Pennsylvania. He has been keeping me apprised on this issue and sent me John Calfee’s article, “A Public Health Disaster in the Making.”

An alternative legislative approach being proposed is described by John Calfee in his article, which concludes as follows:

“Senators Richard Burr (R) and Kay Hagan (D) of North Carolina have introduced a bill that avoids the worst features of HR 1256 and has the virtue of lodging tobacco regulation in a separate agency and therefore avoiding the FDA, whose snail-like pacing in approving wider use of pure nicotine products has been deplorable. An even better alternative would be to unleash the Federal Trade Commision (FTC), whose regulatory philosophy is the simple toleration if not encouragement of truthful information in marketing. The FTC could regulate tobacco marketing like it regulates marketing for automobiles, computers, and just about everything else. It would require a reasonable basis for health claims. The standard can be tough when the stakes are high; you do not want to claim your car can stop in 100 feet from 60 mph unless you have solid evidence. But if the FTC were free of an implicit obligation to enforce what public health gurus want (sometimes including FDA staff), we could see an extraordinarily fruitful unleashing of methods for safer tobacco use and a consequent decline in the lamentable toll of cigarette smoking.”

Smoke-free air laws: Good or bad for bars & restaurants?

Yvonne Angieri’s OpEd, “A smoking ban would be detrimental to workers,” which appeared opposite mine in the St. Louis Post-Dispatch on June 2, elicited some on-line comments from pro-smoking supporters. Bill Hannegan was among them, posting this:

“Yesterday Dr. Chad Cotti, a University of Wisconsin economist who specializes in assessing the impact of smoking bans, reviewed the St. Louis City situation with respect to a smoking ban. Dr. Cotti estimates that the St. Louis City Smoke Free Air Act of 2009 would cut St. Louis City bar employment 19.7 percent. Dr. Cotti said such a huge job loss means places will be closing, not just cutting back. I have sent his estimate to the Health and Human Services Committee. Mayor Slay’s plan to exempt the casinos will only make the situation worse for St. Louis bars, taverns and clubs. Here is a link to the 2007 research upon which Dr. Cotti bases his estimate.

I cannot vouch for Dr. Cotti’s credentials or the veracity of the study referenced above, “The Effect of Smoking Bans on Bars and Restaurants: An Analysis of Changes in Employment,” published February 8, 2007, in The B.E. Journal of Economic Analysis & Policy.

However, my understanding is that the majority of studies on secondhand smoke (SHS) laws show they have little, if any, effect on either restaurant or bar business overall. To verify this belief I conducted a quick Google search and immediately found the following study which supports this thesis. Evidently the Health and Human Services Committee needs to hear from MOGASP and not just Bill Hannegan, who also continues to ignore the costs associated with secondhand smoke exposure in the workplace.

Please read the following study when you get time.

Smoking bans do not cause job losses in bars and restaurants

Published: Monday, May 18, 2009 – 10:36 in Mathematics & Economics

“New research suggests that exempting bars from community smoking bans makes no economic difference in terms of preserving bar employment, and that even the most comprehensive clean indoor air policies do not lead to a reduction in hospitality jobs. Researchers hope the findings, based on a study in Minnesota, will factor into future debates within municipalities and states considering the economic and health issues surrounding smoking-ban proposals.
The study examined employment trends over three years in eight Minnesota cities with different types of clean indoor air policies and two cities with no laws restricting smoking. Of the policies examined, some were comprehensive bans prohibiting smoking in all workplaces, while others banned smoking in most public places and businesses, but exempted bars.
Though economic effects of smoking bans have been studied in many individual communities, this is the first analysis to compare the economic effects of different levels of clean indoor air policies in multiple cities.
“In the end we can say there isn’t a significant economic effect by type of clean indoor air policy, which should give us more support for maintaining the most beneficial public health policies,” said Elizabeth Klein, assistant professor of health behavior and health promotion at Ohio State University and lead author of the study. “The public health benefit clearly comes from a comprehensive policy where all employees are protected from exposure to environmental tobacco smoke.”
According to the U.S. Department of Health and Human Services, exposure to secondhand smoke increases nonsmokers’ risks of developing lung cancer, heart disease, respiratory conditions and other diseases.
North Carolina and Wisconsin legislatures passed smoking ban bills last week. As of April 20, 2009, 15 states plus Puerto Rico had comprehensive laws in effect prohibiting smoking in all workplaces, restaurants and bars, according to the American Nonsmokers’ Rights Foundation. Three additional states had passed similar laws, or recently added smoke-free bars to their laws, that are not yet in effect. Hundreds of municipalities also have enacted smoking bans of varying levels.
The research is published in the June issue of the journal Prevention Science.
Klein and colleagues used state-mandated reporting data to track monthly employment in full-service restaurants and bars between January 2003 and September 2006 in 10 communities. The locales were not identified, but ranged in population size from about 20,000 to 380,000 residents.
The researchers used job data from the Minnesota Department of Employment and Economic Development. Using industry codes established by the North American Industry Classification System, the researchers selected jobs coded for full-service restaurants and free-standing bars to include in the study. Limited-service restaurants were not included because of the low likelihood that they would be licensed for alcohol sales, Klein said.
“We wanted to look at businesses most likely to be affected by this type of policy based on the smoking and drinking correlation that has been established in previous studies,” Klein said. “Opponents to clean indoor air policies tend to say that having a partial policy, with bars exempted, will be less painful economically for the community. They say people who work in these businesses that are dependent on alcohol sales would experience a catastrophic effect.”
In the study, the researchers calculated the bar and restaurant employment on a per capita basis to allow for the different sizes of the communities examined and the varying number of relevant businesses in each community. For each month, they combined the total number of restaurant and bar employees in each city and divided that number by the community population size based on the 2000 U.S. Census.
Over the 45-month period studied, there was relatively little change in employment levels in bars and restaurants among the communities examined. None of the changes met statistical standards required to determine that the differences – increases or decreases – were significant. The estimated changes also cut both ways in any economic argument about the effects of smoking restrictions.
For example, communities with comprehensive clean indoor air policies had nearly nine fewer employees per 10,000 community members compared to communities with partial smoking bans that exempted bars. On the other hand, communities with any type of clean indoor air policy, partial or comprehensive, had an increase of three employees per 10,000 compared to cities with no tobacco restrictions on the books.
Seasonal trends in employment were related to the effects of severe winter weather in Minnesota, especially in larger cities, and the marked loss of jobs in one community was traced to a closure of three businesses that were failing because of their location, Klein noted.
“We certainly did not detect anything close to the dramatic claims that opponents make based on the concerns that they have for bars,” Klein said. “We were not studying individual businesses. We’re studying the effect of a policy implemented at a community level.”
Klein noted that the study did not use revenue data, another strong economic indicator, because statewide reports of revenues in Minnesota were not readily available. And she said employment trends in the hospitality industry closely match revenues because hospitality businesses operate in a volatile market.
The findings are an important part of the continuing debate over clean indoor air policies, Klein said, because “once a clean indoor air policy is on the docket and discussion begins, oftentimes the conversation quickly turns to economics.”
She also said she doesn’t expect opposition to smoking bans to disappear.
“There is strong evidence that a comprehensive policy provides the greatest protection for all employees, and now it appears that bars do not need to be exempted from clean indoor air policies to protect against severe economic effects.”

Source: Ohio State University

What are we waiting for? It’s 23 years since SHS was declared a carcinogen.

An invited OpEd I wrote and submitted to the St. Louis Post-Dispatch on May 14, 2009, was published today [June 2] with some edits and is reproduced below. Overall I’m happy with the editing with one exception: The three major voluntary health agencies, American Cancer, Heart and Lung, colluded with the tobacco lobby in 1987 to pass a weak state Clean Indoor Air law preempting any stronger local ordinances but that was omitted from the published text. [I’ve left this in as strike-through text below.]

My OpEd, originally 647 words but edited to 656 words, is followed by the pro-smoking counterpoint of 714 words by Yvonne Angieri, a St. Louis University student who manages two area restaurants. Her arguments echo those of Bill Hannegan of KEEP ST. LOUIS FREE and his supporters.

MOGASP Guest Editorial on-line here and reproduced below.

Indoor smoking laws: What are we waiting for?
Health: The surgeon general declared secondhand smoke dangerous 23 years ago.

by Martin Pion


On May 4, during a PBS “Newshour” report on the swine flu outbreak, Manuel Camacho Solis, former mayor of Mexico City, said about how the huge city was responding:

“It’s a simple balance: It’s the health of the people or the economy, and in a case like this the health is more important. These are extreme measures but if you can save some lives, it’s worth it.”

If you can save some lives, it’s worth it — but not when it comes to the smoking pandemic, estimated to kill 420,000 American smokers and 53,000 non-smokers annually. One of government’s primary duties is protecting public health and welfare, so why does it generally fail miserably when it comes to smoking and secondhand smoke?

“The Smoke Ring” by Peter Taylor, published in 1984, was the first book I read to shed light on this paradox. He described the interdependence of the tobacco industry, smokers and government, noting that the industry knows its product is deadly but is addicted to the enormous profits it generates; smokers are addicted to nicotine and many cannot quit; and government is addicted to the almost recession-proof tobacco tax revenues.

To counter smoke-free air laws that threaten its profits, the tobacco industry has worked to create doubt on the science of secondhand smoke and hired lobbyists to defeat or weaken smoke-free air legislation.

U.S. Surgeon General Dr. C. Everett Koop’s landmark 1986 report on environmental tobacco smoke, “The Health Consequences of Involuntary Smoking,” concluded that secondhand smoke caused lung cancer in healthy nonsmokers. The tobacco industry responded by vilifying Dr. Koop, accusing him of bias.

I have seen how the tobacco industry and its surrogates work at both the state and local level.

In 1987, Tobacco Institute lobbyist John Britton worked covertly with a Missouri Department of Health lobbyist supported by American Cancer, Heart and Lung to pass a weak statewide Clean Indoor Air law, provided it pre-empted any stronger local ordinances. The effort failed, but only when Missouri GASP played a leading role in its defeat.

In 1993, St. Louis County considered a bill making Lambert Airport smoke-free, anathema to the tobacco industry, which regards such high-profile locations as strategically important. Former councilman John Shear, chair of the Justice and Health Committee considering the bill, colluded with Tobacco Institute lobbyists to weaken the bill, which ultimately was withdrawn by its sponsor.

In 2005, Harrah’s helped defeat a comprehensive St. Louis County bill that would have included limited smoking in the Harrah’s Maryland Heights casino. Harrah’s bused in hundreds of employees to protest the bill on the night of a crucial St. Louis County Council vote. A just-released National Institute for Occupational Safety and Health report shows gaming-area employees in several Las Vegas casinos are exposed to high levels of secondhand smoke carcinogens.

These days, smoke-free air laws generally are opposed by tobacco industry surrogates, using such industry-inspired arguments as: They infringe on private property rights; drive away smokers; if you don’t like the smoke, patronize or work someplace else; discriminates against smokers; prevent the free market from deciding; interfere with businesses’ decision to display smoking or no-smoking signs; disregard that ventilation will take care of it and it should be a statewide, not local, regulation.

Dr. Koop had it right in his concluding remarks accompanying the release of his 1986 report:

“Therefore, for involuntary smoking and lung cancer: We know ETS (environmental tobacco smoke) contains carcinogens; the exposure to ETS by non-smokers is large enough to expect a lung cancer risk; and human epidemiologic studies have demonstrated an increased risk of lung cancer in involuntary smokers. If this evidence were available on an environmental pollutant other than ETS, we would have acted long ago. To fail to act now on the evidence we currently have would be to fail in our responsibility to protect the public health.”

That was 23 years ago. What are we waiting for?

Martin Pion is president of Missouri GASP [Group Against Smoking Pollution] Inc.

Pro-smoking Guest Editorial on-line here and reproduced below.

A smoking ban would be detrimental to workers
Business: Health issues might be overstated, but the potential for lost revenue is not.

By Yvonne Angieri


The ongoing national debate regarding the relative merits of banning smoking in restaurants and bars has sparked a great deal of controversy here in St. Louis as the issue has come closer to home. This issue interests me personally because, in addition to attending St. Louis University as a full-time undergraduate student, I also am a manager at two of St. Louis’ finest restaurants: Monarch Restaurant in Maplewood and Herbie’s Vintage ’72 in the Central West End.

I am not a smoker, nor do I care for the smell of smoke. But I do believe that private property owners should be trusted with the choice of whether to offer either a smoke-free or a smoking environment in their own establishments to their own clientele.

Neither do I wish to be depicted as “anti-health” or “anti-progress.” But couching the issue of “public” smoking solely in terms of public health is misleading.

I recently learned that the Occupational Safety and Health Administration itself has refused to impose a strict ban, as proposed by St. Louis Alderman Lyda Krewson, D-28th Ward. Furthermore, studies on exposure to secondhand smoke produce very mixed results. A 2003 study by epidemiologists James Enstrom and Geoffrey Kabat, published in the British Medical Journal, found no evidence that secondhand smoke causes lung cancer or heart disease. A recent multi-state study by RAND, the Congressional Budget Office and University of Wisconsin and Stanford University researchers found no link between smoking bans and a reduction of heart attacks or other serious diseases.

Besides, employers already have a means of providing clean indoor air for employees and patrons alike: air filtration. When Herbie’s Vintage ’72 opened in October, the owners installed air filtration systems in both the bar and private cigar lounge. I was pleasantly surprised by their effectiveness. After a busy night, I leave the restaurant with virtually no smell of smoke in my hair or my clothes.

The elimination of this irritation prompted me to re-evaluate my opinion of air filtration. While legal concerns keep filtration manufacturers from making health claims, their technical specifications demonstrate that their machines not only are highly effective in making indoor air cleaner than outdoor air, but they also filter out such threats as swine or avian flu viruses.

The owner of a private establishment, a “house” if you will, should have the right to offer his guests a place to smoke and to choose the most effective means of cleaning the air. Granting establishments the freedom to purify their air using effective modern technology would allow their owners the opportunity to provide a cleaner working environment for employees and achieve a harmonious balance in accommodating both smoking and non-smoking guests — as Herbie’s has succeeded in doing.

It also would ensure that employees like me are secure in a workplace that is not in jeopardy because of lost revenue that might result from a smoking ban. Loss of livelihood and medical insurance caused by closures and cutbacks surely pose a serious and immediate health risk to hospitality employees. This is a real possibility: research by Federal Reserve economists blames the Illinois smoking ban for a 20 percent decline in casino revenues and holds the Columbia, Mo., smoking ban responsible for an 11 percent decrease in bar revenues. For restaurant workers supporting families, these numbers can mean financial ruin and an actual decline in standard of living.

As a manager of a St. Louis city restaurant, I want to know that my interests and those of my colleagues truly are being protected. I am not alone in my concern. St. Louis County Executive Charlie A. Dooley, the Missouri Restaurant Association and the Independent Restaurant and Tavern Owners Association of Greater St. Louis all have opposed a city and county smoking ban in order to avert the grave potential economic damage of such a restriction.

It is clear to many people that a smoking ban would be an unnecessary and intrusive measure, one that would achieve the opposite of its original intent. Instead of protecting workers, it would hurt them. Government exists to safeguard the lives, freedom and self-determination of its citizens. St. Louis would thus do well to live up to its good name and look out for all its citizens.

Yvonne Angieri is a St. Louis University student who manages two area restaurants.