P-D 9/9/2010: “Danger in the air”

The headline in the printed newspaper on the front of the Health section of the St. Louis Post-Dispatch was “Danger in the air” with the subheading “Ventilation systems don’t protect against secondhand smoke, study shows.” That got somewhat watered down in the on-line version, reproduced below. However, the results speak for themselves.

After posting this blog I received a long critique of the study results from Michael McFadden (please see below following article), pointing out alleged errors and failings with the study. Subsequently, I asked Dr. Michael Siegel of Boston University School of Public Health for an opinion. Dr. Siegel is a stern critic of the tobacco control movement, which he frequently takes to task on his widely read blog, The Rest of the Story: Tobacco News Analysis and Commentary, for exaggeration or misstatements in its claims about SHS. Here’s the reply from Dr. Siegel:

From: mbsiegel@bu.edu
Subject: RE: Secondhand smoke: Ventilation systems are not the answer, says new study
Date: September 10, 2010 3:31:28 PM CDT

Hi Martin,
The study is solid.
Mike

Michael Siegel, MD, MPH
Professor
Department of Community Health Sciences
Boston University School of Public Health
801 Massachusetts Avenue, 3rd Floor
Boston, MA 02118

Study: Venues with smoking have more nicotine in air

BY BLYTHE BERNHARD • bbernhard@post-dispatch.com > 314-340-8129 | Posted: Thursday, September 9, 2010 12:10 am | (96 comments at 1:32 pm)

9/8/10 Wednesday Kirkwood Server Rachel Kelly, 25, serves a customer at the Highlands Restaurant and Brewery in Kirkwood Wednesday afternoon. Kelly said that she really likes the smoking ban in Kirkwood. When she is out to eat, she will leave a restaurant if they do allow smoking. J.B. Forbes jforbes@post-dispatch.com

Ventilation systems in St. Louis bars and restaurants don’t protect employees and patrons from secondhand smoke, according to a new study.

The findings, which replicate studies done elsewhere, were released Wednesday by Washington University’s Center for Tobacco Policy Research.

The study involved placing monitors in a sample of 10 bars and 10 restaurants in St. Louis and St. Louis county for seven days in the summer of 2009 to measure nicotine levels in the air.

Venues that allow smoking had 31 times the amount of nicotine in the air compared to smoke-free establishments, the monitors showed. Bars and restaurants with smoke ventilation systems also had higher concentrations of nicotine, contributing to a long-standing theory that the systems just recirculate the polluted air.

“No, the results are not surprising, but we didn’t have this data specific to St. Louis,” said Sarah Moreland-Russell, the center’s research manager. Moreland-Russell said the numbers would be helpful in the push for more laws banning smoking in Missouri.

Researchers asked the owners of 68 establishments if they would participate in the study and remain anonymous before finding 20 to agree. Four of the participating businesses already had voluntary smoking bans.

Moreland-Russell said even though they did not test the air in most restaurants and bars in the area, she’s confident the study’s findings would be universal.

“Don’t go to an establishment that allows smoking, because you’re going to find the same results,” she said.

Ten of the venues had ventilation systems beyond air conditioning, but the study does not specify the type of system.

That’s a flaw in the study, said Bill Hannegan, who has fought against smoking bans in the area. Air purification systems can range from a simple fan to sophisticated machines that cost thousands.

The Double D Lounge in Brentwood has the area’s best purification system, Hannegan said.

“If the air is bad there, I’ll concede their point,” he said.

Researchers would not disclose which venues participated in the study. The cost of the study, funded by the Barnes-Jewish Hospital Foundation, was also not released.

Prior studies have shown that ventilation can redistribute the smoke throughout a building, limiting its effectiveness. Purification systems can remove the appearance and odor of smoke, but not all of the small particulate matter that can reach the lungs.

The Atlanta-based American Society of Heating, Refrigerating and Air-Conditioning Engineers put out a statement in 2005 saying that ventilation systems cannot protect against the health risks of secondhand smoke.

A report from the U.S. Office of the Surgeon General a year later said indoor smoking bans are the only effective way to eliminate exposure to secondhand smoke, and that ‘separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate exposures of nonsmokers to secondhand smoke.”

An earlier study of 10 St. Louis city bars (including two that voluntarily banned smoking) showed that indoor air pollution was six times higher in the smoking establishments. That study, released in 2008, was funded in part by the Missouri Foundation for Health.

The latest study came a day after the Centers for Disease Control and Prevention released the U.S. smoking rate, which has remained at 20 percent since 2005.

Missouri’s smoking rate, 23.1 percent, is higher than all states except Indiana, Kentucky, Mississippi, Oklahoma and West Virginia.

Thirty states, including Illinois, have bans on smoking in restaurants, according to the CDC. Of those, 24 states have also outlawed smoking in bars.

John Postel, a manager at the Highlands restaurant and brewery in Kirkwood, said that city’s smoking ban has improved business, especially among families.

“We’ve seen an uptick in business overall,” Postel said at a news conference Wednesday at Barnes-Jewish Hospital. “The sky did not fall, and things keep moving in a good direction.”

5 responses to “P-D 9/9/2010: “Danger in the air”

  1. I’d like to address several statements/points raised in the article.

    1: “Prior studies have shown that ventilation can redistribute the smoke throughout a building, limiting its effectiveness. ”

    R1 (i.e. “Response to 1”): I’m quite sure that’s true for SOME poorly designed systems. Decent systems wouldn’t do that of course. Do fire codes allow systems designed to spread the smoke during a fire?

    2: Purification systems can remove the appearance and odor of smoke, but not all of the small particulate matter that can reach the lungs.

    R2: The key word here is “all.” As I’ve pointed out elsewhere, if you want to claim that nanogram/picogram type exposures must be eliminated by law, then you’d also have to claim that patio dining and alcohol service in restaurants must also be eliminated: neither are “necessary and inherent” to eating food.

    3: “The Atlanta-based American Society of Heating, Refrigerating and Air-Conditioning Engineers put out a statement in 2005 saying that ventilation systems cannot protect against the health risks of secondhand smoke.”

    R3: If you read the ASHRAE codes you will find that they NEVER guarantee that their equipment will protect against ALL health risks from airborne substances. ETS is the only substance for which they felt pressured enough to make an explicit statement however. Legally they may now be subject to some very serious lawsuits for not placing similar warnings in the rest of their codes when individuals claim damages from low exposures to other things they address.

    4: A report from the U.S. Office of the Surgeon General (etc) “separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate exposures of nonsmokers to secondhand smoke.”

    R4: The same thing can be said of the deadly cooking fumes at a Burger King, or the ultarafine copier particles in the Xerox room, or the alcohol molecules in a drunk-friendly restaurant. That does not mean that the heavy hand of government needs to eliminate those things (After all, Burger King could always switch from “flame broiled burgers” to “electrically heated BOILED burgers.”

    5: “An earlier study of 10 St. Louis city bars (including two that voluntarily banned smoking) showed that indoor air pollution was six times higher in the smoking establishments. That study, released in 2008, was funded in part by the Missouri Foundation for Health.”

    R5: First of all, the study measured FPM 2.5 which is not “air pollution” but just one of a number of measures of air pollution. Secondly, the FPM 2.5 from the quiet burning of a few leaves and a scrap of paper is likely to be VERY different chemically from the heavy chemical/industrial/automotive/hi-temp-incineration produced FPM that the term normally addresses. It’s sort of like taking a teaspoon of sugar crystals and declaring they are just as deadly as deadly as a teaspoon of arsenic crystals because they’re the same size. You need to compare the chemical compositions before the crystal size becomes relevant to health.

    6: “Venues that allow smoking had 31 times the amount of nicotine in the air compared to smoke-free establishments,”

    R6: This is like saying “Offices with copy machines had 31 times the amount of deadly toner toxins in the air compared to offices without copy machines.” or “The air in a house adjacent to a backyard swimming pool had 31 times the amount of deadly chlorine gas in the children’s bedrooms than a house without such a pool.” The statements by themselves are absolutely meaninglesss in terms of anything to do with human health.

    7: John Postel of Highlands said “We’ve seen an uptick in business” since the ban.

    R7: That is what is known as anecdotal evidence. If you’d like to see a few hundred examples, along with many other quotes from bar/restaurant owners contradicting John, just visit:

    http://www.smokersclub.com/banloss3.htm

    I would like to challenge SmokeFree St. Louis, or MOGASP etc, to sponsor a study surveying the alphabeticallyfirst 50 *bars* (not restaurants) in the St. Louis or nearby major area who have had complete government bans placed on them in the last two years and get quotes from THEIR owners for all to see. (Using a 2008/09 Yellow Pages should work for the selection.)

    Obviously those owners happy with the ban will all be happy to provide such quotes. Those places that have closed will support the negative to some extent even without quotes. And those places who have been hurt will have a certain tendency to hang up on the interviewer if the interviewer ID’s him/herself as with the SmokeFree group. Still, a full listing of the first 50 alphabetical places, with quoted responses from owners, could be published for all to see and for critics to check up on.

    And the “study” would certainly be a helluva lot cheaper to perform than measuring nicotine in dozens of places with expensive technical monitoring equipment so there’s no defensible reason for not doing it if the Antismokers believe the claims they’re pushing to the public.

    Think it’ll happen? Heh… think the next rainfall will consist of cookies ‘n creme?

    Michael J. McFadden,
    Author of “Dissecting Antismokers’ Brains”

    • Michael, This is a long reply, and contains over 5,000 characters. I notice that the Post-Dispatch is now limiting submissions from readers to only 500 characters, which makes for more concise comments. I’ll allow your comment but in future I plan to implement a policy of conciseness. That will help the reader and also the commenter, who will need to refine his or her views.

  2. It’s odd that they tested for nicotine in the air. Nicotine isn’t known to be harmful. It’s in tomatoes and potatoes and in an assortment of patented nicotine delivery products made by “anti smoking” competitors to the cigarette industry.

    mogasp comment: Contrary to your assertion, nicotine is “an extremely toxic poison …. Sixty milligrams of nicotine (about the amount in three or four cigarettes if all of the nicotine were absorbed) will kill an adult.”
    According to what I learned years ago, one drop of pure nicotine on the tongue would be enough to kill an adult. The reason this doesn’t happen with smokers is that it is ingested in small enough doses and is then metabolized to cotinine and excreted in the urine.]

    Nicotine has been used as a natural insecticide and can be made simply by allowing cigarette butts to steep in water.

    If any health officials get around to testing for the still-legal but deadly non-tobacco components (pesticides, dioxins, chlorine, radiation from certain fertilizers, etc.) of smoke from typical cigarettes, this whole matter can be turned around. We need a ban on any non-tobacco cigarette ingredients unless they can be proven to not increase risk. Then we can end this socially-fracturing, scientifically fraudulent war on tobacco and begin the liability (and criminal) suits against those responsible for contaminating typical cigarettes with more industrial waste, toxins, untested substances and carcinogens than exist in any other product. Don’t forget that many of the officials now wearing the halos of “anti smoking” are the very ones who knew about, approved, ignored, and failed to warn about those industrial toxins and carcinogens in most cigarettes.

    And notice that no “studies” presented about the “harms of smoke” bothers to mention if they researched smoke from plain tobacco, from multi-adulterant tobacco, or from any of the brands made with no tobacco at all. (No law requires tobacco in a cigarette unless it’s labeled as containing tobacco.)
    We do not know what they studied. There is actually zero scientific or public health justification yet shown for the smoking bans…certainly none for bans on plain tobacco.

    To demonize and penalize smokers for the health effects of stuff they didn’t even know about is to penalize the victims, a profound injustice on its face.

  3. Airborne nicotine indicates there may be SHS in the air; but, that says nothing about the amount of toxins in the air.
    For instance arsenic, which is both a poison and a carcinogin.

    There are about 56,000 times as much nicotine in cigarette smoke as there is arsenic.

    Here is how it works.
    http://www.hsph.harvard.edu/nicotine/trends.pdf
    A Report of the Tobacco Research Program
    Division of Public Health Practice
    Harvard School of Public Health

    Page 12:
    The mean fitted smoke nicotine yield in each model was 1.79 mg per cigarette.
    (NOTE: This indicates that the total nicotine in all the smoke from a cigarette, both mainstream and side stream, is 1.79mg.)

    The average cigarette has 32ng of arsenic in all of it’s smoke,mainstream and side stream.
    (The 1999 Mass. Benchmark Study. Final Report 07/24/00)

    MG = milligram, 1,000th(thousandth) of a gram

    NG = nanogram, 1,000,000,000th(billionth) of a gram.

    1 MG = 1,000,000(one million) NG

    1.79 mg = 1,790,000 ng.

    1,790,000 divided by 32 = about 56,000.

    There are about 56,000 times as much nicotine in cigarette smoke as there is arsenic.

    • Gary, Thanks for your comment, which I’ve approved. This was submitted before the newly imposed 1,000 character limit but it only exceeds it by 69.
      Regarding your statement that there is no correlation between nicotine present and toxins, that is contrary to a groundbreaking paper “An Enforceable Indoor Air Quality Standard for Environmental Tobacco Smoke in the Workplace” by James L. Repace and Alfred H. Lowrey, Risk Analysis Vol. 23, No. 4, 1993 pp 463-475. In that paper, the authors deduced from scientific studies that the ETS RSP-to-nicotine ratio is 10:1. (RSP = Respirable Suspended Particulates.)

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