(cache)Smoking restrictions having huge benefit for the next generation

Smoking restrictions having huge benefit for the next generation

Preterm births, asthma treatments down in countries that restrict public smoking.

John Timmer – Apr 1, 2014 3:12 AM | 225

Credit: CDC

Bans on smoking in public places were justified on the basis of limiting involuntary exposure to the hazards of second-hand smoke. On some levels, this seems to have worked; in areas where bans were implemented, cardiovascular events dropped by 15 percent, while hospital admissions for respiratory problems are down by a quarter.

But it’s hard to tell whether those benefits are being enjoyed by non-smokers who were exposed to second-hand smoke or smokers who cut back or quit in response to the inconveniences imposed by the new laws. Now, a recent study shows pretty definitively that non-smokers are benefitting, as improved health was seen in a population that clearly isn’t smoking: newborns and children.

Getting meta with smoking

The study, published in The Lancet, involved what’s called a meta-analysis. This technique involves identifying a collection of small studies that all meet a pre-determined standard for experimental rigor. The results of the studies are then pooled, providing a statistical rigor that the individual papers wouldn’t be able to reach. In this particular meta-analysis, the authors focused on three factors: rates of pre-term births, the weight of newborns, and hospitalization for asthma in children under 12.

In combination, the studies provided the meta-analysis with well over a million participants in the two questions related to births and 225,753 hospitalization cases for asthma in children. These came from a variety of countries; all of these restricted public smoking, but the details varied (some involved workplace smoking, others just bars and restaurants).

While birth weight showed an insignificant difference, there were clear health benefits for the other two issues. Preterm births dropped by more than 10 percent with the smoking ban, with the 95 percent confident interval ranging from two percent to 19 percent. For hospitalization due to asthma, the rate also dropped by 10 percent, and the 95 percent confidence interval was somewhat narrower (five to 15 percent).

The biggest limitation of the work is that it is largely limited to developed nations; very few bans, and even fewer studies, have been instituted in the industrializing world. It’s an open question whether the same benefits would be obtained in areas where access to healthcare isn’t uniform.

A history of success, despite opposition

Realistically, the results should be no surprise. The health risks of second-hand smoke were well established by the time smoking bans began to be passed, and the authors of the new study are able to cite six different papers that all show that rates of maternal smoking have dropped significantly after smoking bans went into effect. This isn’t even the first indication that smoking bans help out the next generation. Sudden Infant Death Syndrome, or SIDS, is associated with smoking, and its rates have also dropped in concert with the adoption of smoking bans.

Additionally, these results highlight what a large impact public health measures can have. Ten percent may not seem like much, but 10 percent of an entire national population can be substantial. It’s especially significant given that things like premature birth and early childhood diseases can leave children with health issues that last into adulthood. Overall, we tend to think about health breakthroughs in terms of the development of new, blockbuster drugs. But some of the largest benefits to humanity have come through public health campaigns, such as vaccinations and the fight against smoking. The latter is responsible for some of the most significant gains in our war on cancer.

It’s also worth noting that one of the key motivators of these smoking bans was a report by the EPA that declared second-hand smoke a carcinogen back in 1993. At the time of its release, the report was savaged by a wide variety of groups as being filled with bias and weak science; opponents said it was motivated by a desire for regulation and control.

If you see parallels to the climate debate, there’s a good reason—some of the same organizations were involved. Up until recently, the Heartland Institute (yes, those guys) featured “smoking” as one of its areas of focus on the top of its main page. Although that’s gone, it was still highlighting any indications it could find that second-hand smoke was harmless as recently as last year, and the Heartland Institute ran an editorial that trashes the EPA’s report as recently as 2011.

The author of that report? Fred Singer. Just today, I received an e-mail from the Heartland’s press group highlighting a press conference with Singer to be held later this week. The goal? Trashing the latest IPCC report.