Post-Dispatch 10/24/09: “Vote Yes on Proposition N.”

“Proposition N is less comprehensive than clean air laws in Illinois or Kansas City, which means it’s not as strong as it should be. But it’s much better than the current state of affairs.”

That was a conclusion of the editorial board in its endorsement of Prop. N. Missouri GASP agrees.

After interviewing both proponents and opponents of Prop. N, the smoke-free air ordinance on the November 3rd St. Louis County ballot, the Post-Dispatch editorial board came down on the side of health.

That was really no surprise, and is consistent with their editorial position on the subject of secondhand smoke. What would have been surprising is if they’d come out against it, for example by buying the argument that it was too weak to support, or it was causing overwhelming economic harm out of all proportion to the public good. But those arguments simply don’t stand up.

With the full Board of Aldermen of the City of St. Louis just overwhelmingly approving their own smoke-free air ordinance, conditional on Prop. N succeeding at the polls, everything comes down to a strong positive vote on November 3.

Following the Post-Dispatch endorsement on-line are readers’ comments, with several from Bill Hannegan. The endorsement is reproduced below, followed by a long rebuttal I posted to Hannegan’s comments.

cd_ssc__smoke_2_opt-300x246Vote Yes on Proposition N.
By Editorial Board
10.23.2009 9:00 pm

About 60 percent of Americans – 175 million people – now live in communities that restrict smoking in public places.

On Nov. 3, voters in St. Louis County can add the county’s nearly 1 million residents to the list by voting for Proposition N. That would protect the right of nonsmokers to breathe clean air in enclosed public spaces, including restaurants and bars.

Approval would trigger a similar ban in the city of St. Louis. The city’s Board of Aldermen approved the ordinance Friday, contingent on passage of the county ban.

The smoking restrictions could cause some economic hardship and dislocation. But regardless of what opponents may argue, there is indisputable scientific evidence that secondhand tobacco smoke is a serious public health threat.

Most recently, the Institute of Medicine, part of the National Academies of Science, reported Oct. 15 that exposure to secondhand smoke increases the risk of heart attack. Clean indoor air laws significantly reduce that risk, the Institute found.

The report confirms what the U.S. surgeon general and scores of peer-reviewed studies have concluded: Clean indoor air laws reduce the incidence of heart disease and heart attacks.

That’s the overwhelming reason to Vote Yes on Proposition N.

People who own smoke shops, some bowling alleys and restaurants are opposing Proposition N. It’s only natural that small-business owners would be concerned about the potential economic impact. The tobacco industry has spent years – and millions of dollars – fanning those fears.

An association of bowling center owners worries, in particular, about the “double standard” inherent in the ordinance. Bowling alleys would have to restrict smoking in their establishments, but large casinos that are their competitors are exempted.

We agree. Just because big casinos have more political clout than bowling centers, they shouldn’t get a pass.

The good news for worried restaurant and bar owners is that scores of peer-reviewed economic analyses show clean indoor air laws have minimal adverse economic impact. That certainly has been the case in Ballwin and Arnold.

Some opponents say Proposition N would infringe on the rights of business owners, who should be able to decide whether smoking is allowed. Should we also allow them to serve tainted food from unsanitary kitchens or block fire exits or disable fire sprinklers?

Secondhand smoke is a public health threat, just like unsanitary restaurant kitchens or unsafe stores. For workers who spend their days and nights in smoke-filled bars and restaurants, the danger is magnified.

They include many young people working at their first jobs. Often, those workers aren’t offered health insurance and aren’t in an economic position to quit.

People shouldn’t be forced to risk their health just to earn a living.

Proposition N is less comprehensive than clean air laws in Illinois or Kansas City, which means it’s not as strong as it should be. But it’s much better than the current state of affairs.

More than 75 percent of St. Louis County residents are nonsmokers. Their health shouldn’t be held hostage to the minority’s tobacco addiction.

Bill Hannegan wrote: “Almost all the “scores of peer-reviewed economic analyses” mentioned have been conducted by public health people, peer-reviewed by other public health people, and published in medical and public health journals. Almost every study concerning the economic effects of smoking bans conducted by real economists and published in economics journals have found that smoking bans cause economic harm to bars and restaurants.”

I can’t speak to this subject, although I would assume the studies in peer-reviewed medical and public health journals would be rigorous, but I can speak from personal experience. The study I co-authored, titled “Airport smoking rooms don’t work,” which was finally accepted for publication in the BMJ peer-reviewed journal, Tobacco Control, went through at least 11 iterations of critique before being accepted and published in March 2004. Since I was working on this sporadically it took most of a year, as I recall. I submitted it to Tobacco Control not because I thought they would simply give me a pass on anything I submitted but because of their area of focus. I stand by the validity and accuracy of the data presented. It was objective and intended to be rebuttal-proof.

Bill Hannegan also wrote: “Federal Reserve economists have determined that smoking bans cut bar revenues in Columbia, Missouri 11 percent and Illinois casino revenues over 20 percent. Why shouldn’t St. Louis County businesses worry?”

These were not peer-reviewed studies appearing in journals. However, on the subject of loss of business due to smoke-free air laws, the studies seems to give mixed results, although many indicate either no effect or a positive effect. Personally, I would guess that some businesses would lose business, e.g. standalone bars might, especially initially, whereas others might actually gain, e.g. restaurants. That’s been the overall result seen in the City of Ballwin since it implemented a comprehensive smoke-free air ordinance. Ballwin has actually done better since, economically, than its immediate neighboring communities.

However, the economic arguments against such laws invariably ignore the hidden costs resulting from the ill-health caused by exposure to secondhand smoke (SHS), e.g. increased healthcare costs that we all bear, and the negative impact on people’s curtailed lives which is unquantifiable. Plus, as I’ve noted repeatedly, these arguments would NEVER be advanced if we were dealing with any other major health threat like swine flu, or environmental issues like asbestos or lead paint mitigation.

We really don’t need the new Institute of Medicine (IOM) study referenced by Bill Hannegan to make the case against SHS. We have more than enough evidence for its harmful effects on exposed healthy nonsmokers in the various U.S. Surgeon General’s reports on SHS, on-line at, starting with the first, published in December, 1986: “The Health Consequences of Involuntary Smoking: A Report of the Surgeon General.”

Martin Pion, President, Missouri GASP

— Martin Pion
2:50 pm October 24th, 2009

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