Passive smoking

An commentator on an earlier posting pointed to an excellent paper (by Jerome Adda and Francesca Cornaglia) looking at the implications of taxes and bans on smoking in public places. To quantify passive smoking impacts data on cotinine concentrations are measured in populations of non-smokers. Cotinine is a metabolite (byproduct) of nicotine as it is processed by the human body. It is an indicator that nicotine has been inhaled or otherwise introduced into the body and can be used to measure the impact of passive smoking.

As background Adda/Cornaglia point out that while 15% of Americans smoke that 84% have detectable levels of nicotine in body fluids. Such passive smoking kills 35,000 Americans annually from heart disease and about 3,000 from lung cancer.

The main findings are that excise taxes have significant effects on passive smoking – particularly among children - while smoking bans do not reduce the average incidence of passive smoking. Bans in public transport or in schools reduce passive smoking impacts but bans in bars, restaurants and recreational facilities in fact increase the incidence of passive smoking. The latter bans displace smokers to private places where they contaminate non-smokers – and particularly young children – even more severely. If smoking is banned in a bar then smokers may be more inclined to stay at home to drink and smoke thereby inflicting increased damage on children.

Furthermore bans increase the exposure of poorer individuals to passive smoking but decrease it to more wealthy people.

This suggests outright smoking bans in pubs cannot be justified on the grounds of reducing passive smoking. They might induce a less smelly and more pleasant environment for non-smokers and they might be one factor that helps support smokers quit by limiting smoking-booze complementarities but, if the analysis is sound, bans will not reduce the average incidence of passive smoking. Bans work best if alternative places – such as an outdoor bar area - are offered where smokers can turn to but where children are not exposed to smoking.