Restaurateurs and publicans are worried about a smoking ban. However, the experience of such bans in America suggests that business increases when people do not have to endure passive smoking, writes James Repace.
The debate initiated by Micheál Martin in recent days about smoking in pubs has been energetic and at times a little clouded and lacking in light. As a result, passive smoking, or involuntary smoking or environmental tobacco smoke (ETS), or as we say in the US, second-hand smoke - call it what you will - is an issue that is now firmly on the public health agenda in Ireland.
However, for this debate to be conducted properly, it is vital that it is premised on the facts about ETS. It is important that people realise that passive smoking has real and detrimental effects on their health. Working or relaxing in a smoky environment, such as a bar, poses grave health risks.
ETS is now classified as a known human carcinogen and a cause of fatal heart disease in the US. For example, the average excess risk of lunk cancer for passive smoking spouses is 24 per cent. For non-smokers heavily exposed to second-hand smoke the risk can be considerably greater.
Ireland's own Dr Luke Clancy has estimated that people exposed to passive smoking run an increased risk of heart disease of 30 per cent over those not exposed to it. Passive smoking, which is an entirely avoidable public health risk, has been shown to carry a staggering 82 per cent increase in the risk of stroke. Passive smoking also can kill or cause permanent health problems in the unborn and infants. Ironically, the people exposing non-smokers to these frightening risks are primarily unwitting work-mates, spouses and family-members.
The area that has caused most debate around the current Tobacco Control Bill is the granting of a power to the Minister for Health and Children to issue a ban on smoking in places such as bars, hotels and restaurants. Much of the comment to date has been about the end of the "traditional Irish bar" or even civilisation as we know it. However, this ignores the grave health effects of passive smoking on people who work in these locations.
Ireland's Western Health Board conducted a study on the levels of smoke in bars in its area. Based on this study and my own studies of the effects of ETS on such workers in Hong Kong and Boston, I would estimate that approximately 150 bar workers a year in Ireland will die from ill health caused by ETS.
Irish people have to ask themselves is this a price they are willing to pay? Should workers be forced to trade their health for their pay cheque? On the potential loss of earnings in the industry due to the introduction of smoking bans, it's worthwhile to consider the experience in the US in areas where such bans have applied.
In California, with 34 million people, hospitality industry revenues increased significantly following smoking bans in both restaurants and bars.
In New York City in 1995, smoke-free laws were introduced for eating and drinking establishments. A study conducted in 1999 showed that sales in bars and restaurants had increased by 2.1 per cent, while they had increased by 37 per cent in hotels in the city. This compares with a decline in sales in the rest of the State, which did not introduce such laws.
In Massachusetts, more non-smokers avoided smoky restaurants and bars, according to a recent University of Massachusetts study, than the sum total of all smokers in the state.
Most smokers know that each cigarette they smoke is robbing them of life. When faced with a combination of hospitality, industry and workplace smoking bans, they are often induced to quit. This is why the tobacco industry opposes these bans.
Because this industry manufactures a product which, when used as intended, causes one out of two of its consumers to die 16 years prematurely, it has no credibility. Because of this, Big Tobacco has recruited the hospitality industry to carry its water. It has also employed legal challenges and public relations strategies: usually seeking to raise questions about the legal competence of the person to conduct the research or to challenge the motives of the authors.
During recent hearings before the Joint Oireachtas Committee the industry refused to discuss its research or to provide the Oireachtas with copies of its findings. During the course of litigation in the US many secret documents were discovered in court which would suggest that the tobacco industry is well aware that secondhand smoke kills and has sought to create an artificial controversy surrounding it.
It is important that we debate the question of environmental tobacco smoke in a rational manner and that we base our conclusion on the harm or otherwise posed by passive smoking on science. In the US, a national consensus has emerged among occupational health, environmental health and public health authorities that second-hand smoke kills more than 60,000 people annually and that workers and the public should not be exposed to this involuntary hazard.
However, because of the determined opposition of Big Tobacco and its hospitality industry bedfellows, the political system has not kept pace with scientific knowledge in many places. How this debate develops and is concluded is essentially a political question. Society needs to determine the degree to which it will or will not tolerate the risk posed by second-hand smoke or how it will otherwise manage or reduce the risk. The rights of every life supersedes the right of other individuals to pollute.
Some commentators have suggested that smoking is a fundamental right and to deprive or restrict someone in this practice is an infringement of their civil liberties. However, bar workers have a right to a safe and healthy workplace. And it is the duty of their employers to provide it. This obligation is ignored at an employer's peril.
The right to a safe and healthy workplace may not be abrogated by an employer who seeks to cater to patrons who consume a poisonous product in public.
• James Repace is a health physicist in the Unites States and is speaking at a seminar hosted by the Office of Tobacco Control, in Dublin Castle on Ash Wednesday, No Smoking Day