Effect of smoke-free workplaces on smoking behaviour: systematic review
BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7357.188 (Published 27 July 2002) Cite this as: BMJ 2002;325:188All rapid responses
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Editor,
I refer to the suggestion contained in Frank Leavitt's response to
Fichtenberg and Glantz's Paper(1):
> One alternative which might be considered is the Japanese
practice of installing smoke-inhalation machines in or near public places.
Surely this does not go quite far enough? Why not have the smoker
inhaled along with the smoke? They could then be turned into garden mulch,
which would assist plants to grow and further help purify the air.
As per my previous response there would be savings not only in less
cancers, but in reduced rates of Attention-Deficit Hyperactivity Disorder,
asthma, diabetes and obesity. Johnson and colleagues(2) showed that
children of mothers who smoke are significantly less intelligent when
tested at both 3 and 5 years old.
So, without smokers breeding, the average intelligence of the
community would also increase. Smarter kids would be less likely to want
to suck in cancer-causing filth, therefore even less smokers!
Smoker-Inhalation machines may be a highly cost effective solution
allowing us all to breath a little easier.
Sincerely,
Tony Floyd
References:
(1) Fichtenberg CM, Glantz SA. Effect of smoke-free workplaces on
smoking behaviour: systematic review. BMJ 2002; 325: 188-191.
(2) Johnson DL. Swank PR. Baldwin CD. McCormick D. Adult smoking in
the home environment and children's IQ. [Journal Article] Psychological
Reports. 84(1):149-54, 1999 Feb.
Competing interests: No competing interests
The study seems to have been conducted in countries where people obey
the law. This is not necessarily the case in all cultures, especially the
Middle East. In Israel, public places and workplaces used to have
"smoking" and "non-smoking" sections. Then a law was passed to forbid
smoking in all public places. But it is a nationally enacted municipal
bylaw. Police have no power of arrest, or even the power to give a
summons. The municipal government has the responsibility of enforcement,
but there is no effective way to put in a complaint. So now -- rather than
having "smoking" and "no smoking" areas -- people smoke everywhere.
I am also not sure that it is a mark of human decency to enforce
smoking bans in all cases. Obviously people "shouldn't" smoke in
hospitals. But when a family has just been called in to an ICU because a
loved one has just been in a serious accident, is this the time to try to
force them to stop smoking? It could be pretty cruel.
One alternative which might be considered is the Japanese practice of
installing smoke-inhalation machines in or near public places. They are
common in Japanese universities. The smoker stands near such a machine,
and the machine draws in and filters the smokey air.
Competing interests: No competing interests
Editor,
The systematic review by Fichtenberg and Glantz(1) should provide
additional ammunition for those who wish to clear the air. It demonstrates
that in addition to protecting innocent bystanders from the hazards of
passive smoke, smoke-free workplaces also encourage smokers to reduce
consumption of cigarettes and even quit.
Workplaces are, however, generally places where the 'innocent' can at
least have their protests heard. The unborn child of a smoking mother is
forced to suffer in silence.
Maternal smoking has been linked to Attention-Deficit Hyperactivity
Disorder(2), asthma(3) and the damage it causes to the developing fetus by
denying it oxygen and nutrition may be more than that done by ingesting
cocaine(4). Children of mothers who smoke are also more likely to develop
type II diabetes and obesity later in life(5). If we cannot defend unborn
children from such abuse than what hope do we have?
Sincerely,
Tony Floyd
Competing Interest: As I enjoy breathing clean air I am unequivocally
and unashamedly biased towards studies that promote it.
References:
(1) Fichtenberg CM, Glantz SA. Effect of smoke-free workplaces on
smoking behaviour: systematic review. BMJ 2002; 325: 188-191.
(2) Mick E, Biederman J, Faraone SV, Sayer J, Kleinman, S. Case-
Control Study of Attention-Deficit Hyperactivity Disorder and Maternal
Smoking, Alcohol Use, and Drug Use During Pregnancy. Journal of the
American Academy of Child & Adolescent Psychiatry. 41(4):378-385,
April 2002.
(3) Annesi-Maesano, I. 1. Moreau, D. 1. Strachan, D. 2. In utero and
perinatal complications preceding asthma. Allergy. 56(6):491-497, June
2001.
(4) Cotton P. Smoking Cigarettes May Do Developing Fetus More Harm
Than Ingesting Cocaine, Some Experts Say. JAMA.
271(8):576-577, February 23, 1994.
(5) Stephenson J. Maternal Smoking-Diabetes Link Is Described. JAMA.
287(6):706, February 13, 2002.
Competing interests: No competing interests
Re: Smoke-Inhalation? How about Smoker-Inhalation Machines?
I enjoyed Tony Floyd's witty response. Medical and scientific
journals need more writing like his, so that we can stop taking ourselves
so seriously. I would like to go even further and suggest turning all
human beings into garden mulch, with beneficial effects so obvious that
they need not be recited. But I have to get serious and ask Tony Floyd, as
a future doctor, to try to understand people a little more
sympathetically. I smoked heavily for 32 years, and paid for it with
double pneumonia, which, in its turn, helped me both to quit smoking
(about 15 years ago) and to understand the struggles of the smoker. In my
own case, and I am sure in the cases of many others, knowing the harm I
was doing did not help me to free myself from an organic addiction, no
matter how hard I tried. Smoke addiction is a disease, and physicians
should look at the afflicted as patients. The Japanese inhalation
machines are not the ideal solution, but they seem to help.
Competing interests: No competing interests