California is somewhat of a trendsetter when it comes to stupid public policy. We build expensive trains nobody wants to ride, enact inane global warming legislation, and spend money at an offensive pace. So it probably doesn't come as a surprise to learn that our local governments are terrific health mullahs. They'll tell you how to be healthy, and they'll force you to change your behavior if you won't do it yourself.
The city of San Francisco perfectly illustrated this point last week with the introduction of yet another public smoking ban. The proposal is currently being considered by the city's Board of Supervisors and would prohibit smoking at "... street fairs, festivals and other outdoor events held on city property," according to CBS News.
Proponents of the ban argue that secondhand smoke kills many thousands of people each year and the proposal will help address this "critical public health danger." It's the same rationale that underlies any restriction on personal behavior, and in the case of secondhand smoke, it's been shot full of holes by the relevant science over and over again.
Whatever politicians may say, researchers have determined that developing any disease or dying as a result of secondhand smoke requires a lot of exposure to the stuff. Combine that with the dramatic drop in smoking we've observed in the last few decades, and it becomes clear that most people simply don't live long enough to die from secondhand smoke exposure. For this reason, researchers writing in the Archives of Internal Medicine in 2006 suggest that "... cumulative lifetime exposure to [secondhand smoke] may not be as important a risk factor for [heart attacks] as previously thought." A meta-analysis published in the same year reveals that the risk of coronary heart disease (CHD) associated with secondhand smoke exposure is dramatically lower than often estimated. When all the relevant data are included, the authors explain, "the association of [secondhand smoke] with CHD death in U.S. never smokers is very weak."
The same has been found of other risks associated with secondhand smoke exposure. Multiple studies suggest that secondhand smoke has no impact on breast cancer survival rates, and that secondhand smoke likely doesn't increase the risk of developing breast cancer for non-smokers. A 2003 study published in the British Medical Journal found that the relationship between secondhand smoke and lung cancer in non-smokers is just as weak, concluding that "The results do not support a causal relation between environmental tobacco smoke and tobacco related mortality, although they do not rule out a small effect."
While there are many indications in the peer-reviewed literature that the risks of secondhand smoke have been exaggerated, there's a lot of research on this topic, and nothing resembling a consensus can be found when you begin examining the different epidemiological studies that have been done. That means everybody with an interest in the debate can pick the papers that support their cause.
But when sifting through the different studies, and carefully looking at their methodology, a clearer conclusion begins to emerge. And it's not helpful to cities like San Francisco. In many of these studies, the researchers attribute a drop in heart attacks to the enactment of a smoking ban, though their study can't possibly tell them that. Or, they design a study that is in no way comparable to the real world. Or, they just completely make things up.
This isn't to say that smoking is a safe habit. It's without a doubt harmful, and you should stop if you can help it. But even as a non-smoker, I find the ongoing culture war against smoking annoying at this point. If it's going to continue, anti-tobacco advocates need to bring some better evidence to the table or just leave smokers alone.