City Council Considers Smoking Ban Outside Hospitals

2008_07_cigarette.jpg While smoking is already banned inside hospitals, the NY City Council is considering a bill that would prohibit puffing away outside hospital entrances and on hospital grounds. The AP reports, "The measure seeks to ban smoking on hospital property and within 15 feet of any hospital entrance or exit. It would apply to public and private hospitals, as well as residential health care facilities and diagnostic and treatment centers." However, if the bill passes, those 15 feet from hospital grounds should get some ashtrays ready: When smoking was banned on a Buffalo health facility's campus, the smokers moved across the street—and in front of residential houses. One smoker admitted he was going to throw his cigarette butt in the street; when a TV station reporter asked, "Why can't you throw butt in garbage can?" the smoker answered, "I will. I didn't think of that."

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i'm all for the ban at hospital entrances, no one should be walking through a cloud of smoke to enter a hospital.

if, however, a hospital has a courtyard or some other open area (and really, i don't know the city hospitals well at all to know the answer to this), then i think a small part of it can be for smokers. dealing with security every time you need "some air" while your loved one is in the middle of a six, eight, fourteen hour surgery just adds to the emotional burden.

I agree—I understand that it's a stressful time for smokers. But I was at NY Presbyterian Weill-Cornell the other week and it was just strange, walking through a canyon of smokers, staffers and visitors alike.

on rainy days smokers will stand directly in front of doors to stay dry -- so not only are they very in the way of folks, I get a massive intake of their smoke too. I like this policy at hospitals eventhough it wont be adhered to.

a TV station reporter asked, "Why can't you throw butt in garbage can?" the smoke answered, "I will. I didn't think of that."

I guess neither thought that throwing a lit cigarette in a garbage can will most likely start a fire.

You stub it out first, dummy.

You mean like on your forehead? Most smokers would just throw it on the ground and step on it if they were careful. Some don't even do that.

Mount Sinai recently began enforcing such a policy, I'm not sure the exact distance but it's something around at least 15 feet. There are signs out, and for the most part, people comply. It's been great, running around between the buildings I don't have to inhale a cloud of smoke every time I leave or enter a building. I love it.

Always pleasant when you must enter a hospital and pass a gaggle of nurses puffing away on butts and a wall of smoke at the entrance. Classy. Also classy at elementary schools.

I always wonder about doctors and nurses who smoke. What do they think every time they take care of some sick smoker? I mean they must understand better than I do all the nasty things it does...

That being said, hooray for being able to go into the hospital without a healthy dose of secondhand smoke!

Hospitals and schools should include clauses in contracts that say employees can be fired for smoking. Even the smell of smoke on clothes, and the resulting dust, can be difficult or damaging for children and sick people.

I work in a building, where they required all smokers to stand at one location outside; of course, they didn't think about the fact that the location is next to the air-take vents!

Smokers are selfish - $100 packs for everyone.

if you don't like smoking, then don't smoke. nobody wants to hear you bitch about smokers in order to inflate your own sense of decency. the puritanical anti-smoking sentiment has reached a hysteria not seen since the good ol' witch hunting days.

Thank you, hotstepper. I, too, am sick and tired of all the whining about smokers. Manitoba needs to get a life. It's a good thing he/she/it doesn't live in Europe. Everyone smokes everywhere there.

Just about every European nation now has a smoking ban. Germany is the main exception.

you obviously haven't been to europe lately

Yeah, all those people who prefer not to breathe in toxic chemicals are just crazy!

can you "prefer" without telling everyone about it? proselytizing may be fun, but nobody actually cares how self-righteous you feel for not smoking.

I'll shut up about it just as soon as the cigarette smoke stops entering my lungs. My silence for your fresh air, how does that sound?

since you're a clean air freedom fighter, you may want to shut off all electronic devices and get to work on your garden so you're not eating anything delivered by tractor trailer. industrial and commercial air pollutants are much more toxic and prevalent than tobacco smoke.

http://www.nlm.nih.gov/medlineplus/airpollution.html

"Clean air freedom fighter"? Seriously?

Actually, I'm allergic to nicotine. Thanks for playing, time to go home.

allergic? way to pull that one out in the home stretch. i guess we really should legislate based on your personal comfort. cuz, ya know, it's all about you. smooches!

"cuz, ya know, it's all about you. "

How did this thread start again?

"nobody wants [aka: "I don't want"] to hear you bitch about smokers in order to inflate your own sense of decency"

oh, hello. **petting on head** now, run along.

Further cementing your status as an asshole..

I think most people are fine with smoking in reasonable places. I was never bothered by smoking in bars, because when I went to a bar, I knew people would be smoking there. If I didn't want to be around it, I wouldn't go.

When I go to a hospital, though, I shouldn't have to be around it. If hospitals want to have a space for smokers, they should install a canopy away from the entrance.

Same as when I go to Europe - I know people smoke in movie theaters, restaurants, etc., so if I don't feel like being around it, I don't go to places where people smoke. Regardless, comparing the US to Europe in terms of smoking is impossible; in the US, smokers always seem to look sickly and pathetic, huddled under umbrellas when it's raining, trying desperately to get one last drag before going back to work. Further, giving the way our health-system works, my tax dollars and healthcare premiums go to support people who've made the decision to smoke. In England, they would decide that you made the choice to smoke, so if you get sick, the health system will not exhaust itself to care for you.

Every time someone says "there ought to be a law" there probably oughtn't.

But, there should be common sense. Since that rarely exists, we create laws.

Wow, where will all the nurses smoke? I worked at a major cancer hospital once and it was incredible to see so many co-workers outside smoking. If you're going in for treatment you don't want to have to walk through that.

I guess you worked at MSK too then..

If this is a problem, hospitals should create their own bans. Why does the government need to get involved?

Smokers are inconsiderate litterbugs anyway. I can always tell where a gathering area for smokers outside office buildings are. Even if they have butt cans, urns and other receptacles, you'll see butts absolutely everywhere. I've seen people actually stand by an ashtray and drop their butts on the ground anyway. And if I had a penny for every time I saw a lit butt sailing from the window of a moving car...

Secondhand Smoke: the “no threshold” Scare

A major argument for smoking bans is the claim “there is no safe level”—no threshold—below which tobacco smoke is not dangerous. The ban advocates/activists invoke the well-known link of smoking and lung cancer and assert that, therefore, even secondhand smoke must also be carcinogenic. They claim the air from smoking can never be made clean enough to eliminate the health risk and thus smoking must be banned altogether. But the “no threshold” hypothesis about cancer has never been shown to be true for ANY chemical, much less secondhand smoke. The idea that if something is carcinogenic at high doses it must also be proportionately so at small doses simply does not fit the real world. At least ten elements (including iron and oxygen) are carcinogens at high doses but essential to human life in small doses. And some carcinogens, such as selenium and Vitamin A, are proven anti-carcinogens at low doses. These facts contradict the “no-threshold” idea. Thresholds are a law of nature; the mere title of one treatise says it all: “Environmental Carcinogenesis—The Threshold Principle: A Law of Nature." The authors, Claus and Bolander, state that the no-threshold concept about any dose being dangerous ignores “all the fundamental principles of cell biology.”

Dr. Elizabeth Miller, former president of the American Association for Research on Cancer, has stated: “Chemical carcinogenesis is a strongly dose-dependent phenomenon.” This is opposite to the claim by smoking ban advocates—including the surgeon general—that it is not dose dependent, that any dose is a health hazard.

The no-threshold concept, when applied to secondhand smoke, “incorporates unsound assumptions that are not valid,” says an article by Drs. Huber (pulmonary specialist), Brockie (cardiologist), and Mahajan (a hospital director of internal medicine and professor of medicine.)

Furthermore, thresholds are known to exist for mainstream tobacco smoke in total as well as for each of the individual carcinogens known to be in it. It is preposterous to claim, as the surgeon general has done, that secondhand smoke—which is more than 100,000 times more dilute than mainstream smoke—has no threshold, even though mainstream smoke does. This turns the dose-response principle of epidemiology on its head and means secondhand smoke can be more dangerous than actual smoking! Ridiculous!

The surgeon general should know that thresholds for all carcinogens in—or even assumed to be in—secondhand smoke have been identified. They have been calculated by the American Conference of Government Industrial Hygienists. Below these thresholds, the chemicals are considered safe. To reach the threshold for the carcinogen with the lowest threshold (hydroquinone) would require 1,250 cigarettes to be smoked in a sealed, unventilated room 20 by 22 feet within one hour. This would mean 30 people in that room each smoking slightly more than 2 PACKS of cigarettes per hour. And remember this is in a sealed room, where no one would enter or leave in that hour and where there would be no mechanical ventilation. Open a door or window or add mechanical ventilation, and the number of cigarettes needed to reach the threshold would be even higher. Of course, nobody—much less everyone in a room—will ever smoke 2 packs of cigarettes per hour. Thus it is essentially impossible for secondhand smoke to be a cancer risk despite the pathetic claims of the surgeon general and other smoking ban activist/advocates.

Notice that I began the last paragraph by speaking of all the carcinogens known “or even assumed” to be in secondhand smoke. This is because most of the carcinogens have never actually been found in secondhand smoke. If they exist there at all, they are in quantities too small to be measurable. They are simply assumed to be there because they are known to exist in the smoke from which secondhand smoke is derived. So calculations of their presence in secondhand smoke are based on their proportions in the parent smoke. But they may not exist at all in secondhand smoke because of physical, chemical and behavioral differences from the parent smoke. Secondhand smoke has extremely low concentrations of volatiles. Mainstream smoke is highly concentrated, and its higher gas phase concentrations favor larger respirable particles that condense and retain more volatile compounds. Evaporation is faster from secondhand smoke particles; within fractions of a second, they becomes 50 to 100 times smaller than their mainstream counterparts. Secondhand smoke quickly undergoes a variety of other changes: oxidation, polymerizations, photochemical transformations, and other changes. All these changes take place extremely quickly. So suddenly secondhand smoke is a very different collection of chemicals than the smoke from which it was derived, and carcinogens assumed to be there may, in fact, be absent. But even if present, they are in quantities far below the threshold levels. And secondhand smoke is “so highly diluted,” say Huber/Brockie/Mahajan, “that it is not even appropriate to call it smoke, in the conventional sense. Indeed, the term 'environmental tobacco smoke' is a misnomer.”

THE AIR ACCORDING TO OSHA

Though repetition has little to do with "the truth," we're repeatedly told that there's "no safe level of exposure to secondhand smoke."

OSHA begs to differ.

OSHA has established PELs (Permissible Exposure Levels) for all the measurable chemicals, including the 40 alleged carcinogens, in secondhand smoke. PELs are levels of exposure for an 8-hour workday from which, according to OSHA, no harm will result.

Of course the idea of "thousands of chemicals" can itself sound spooky. Perhaps it would help to note that coffee contains over 1000 chemicals, 19 of which are known to be rat carcinogens.
-"Rodent Carcinogens: Setting Priorities" Gold Et Al., Science, 258: 261-65 (1992)

There. Feel better?

As for secondhand smoke in the air, OSHA has stated outright that:

"Field studies of environmental tobacco smoke indicate that under normal conditions, the components in tobacco smoke are diluted below existing Permissible Exposure Levels (PELS.) as referenced in the Air Contaminant Standard (29 CFR 1910.1000)...It would be very rare to find a workplace with so much smoking that any individual PEL would be exceeded."
-Letter From Greg Watchman, Acting Sec'y, OSHA, To Leroy J Pletten, PHD, July 8, 1997

Indeed it would.

Independent health researchers have done the chemistry and the math to prove how very very rare that would be.

As you're about to see in a moment.

In 1999, comments were solicited by the government from an independent Public and Health Policy Research group, Littlewood & Fennel of Austin, Tx, on the subject of secondhand smoke.

Using EPA figures on the emissions per cigarette of everything measurable in secondhand smoke, they compared them to OSHA's PELs.

The following excerpt and chart are directly from their report and their Washington testimony:

CALCULATING THE NON-EXISTENT RISKS OF ETS

"We have taken the substances for which measurements have actually been obtained--very few, of course, because it's difficult to even find these chemicals in diffuse and diluted ETS.

"We posit a sealed, unventilated enclosure that is 20 feet square with a 9 foot ceiling clearance.

"Taking the figures for ETS yields per cigarette directly from the EPA, we calculated the number of cigarettes that would be required to reach the lowest published "danger" threshold for each of these substances. The results are actually quite amusing. In fact, it is difficult to imagine a situation where these threshold limits could be realized.

"Our chart (Table 1) illustrates each of these substances, but let me report some notable examples.

"For Benzo[a]pyrene, 222,000 cigarettes would be required to reach the lowest published "danger" threshold.

"For Acetone, 118,000 cigarettes would be required.

"Toluene would require 50,000 packs of simultaneously smoldering cigarettes.

"At the lower end of the scale-- in the case of Acetaldehyde or Hydrazine, more than 14,000 smokers would need to light up simultaneously in our little room to reach the threshold at which they might begin to pose a danger.

"For Hydroquinone, "only" 1250 cigarettes are required. Perhaps we could post a notice limiting this 20-foot square room to 300 rather tightly-packed people smoking no more than 62 packs per hour?

"Of course the moment we introduce real world factors to the room -- a door, an open window or two, or a healthy level of mechanical air exchange (remember, the room we've been talking about is sealed) achieving these levels becomes even more implausible.

"It becomes increasingly clear to us that ETS is a political, rather than scientific, scapegoat."

Chart (Table 1)

-"Toxic Toxicology" Littlewood & Fennel

Coming at OSHA from quite a different angle is litigator (and how!) John Banzhaf, founder and president of Action on Smoking and Health (ASH).

Banzhaf is on record as wanting to remove healthy children from intact homes if one of their family smokes. He also favors national smoking bans both indoors and out throughout America, and has litigation kits for sale on how to get your landlord to evict your smoking neighbors.

Banzhaf originally wanted OSHA to ban smoking in all American workplaces.

It's not even that OSHA wasn't happy to play along; it's just that--darn it -- they couldn't find the real-world science to make it credible.

So Banzhaf sued them. Suing federal agencies to get them to do what you want is, alas, a new trick in the political deck of cards. But OSHA, at least apparently, hung tough.

In response to Banzhaf's law suit they said the best they could do would be to set some official standards for permissible levels of smoking in the workplace.

Scaring Banzhaf, and Glantz and the rest of them to death.

Permissible levels? No, no. That would mean that OSHA, officially, said that smoking was permitted. That in fact, there were levels (hard to exceed, as we hope we've already shown) that were generally safe.

This so frightened Banzhaf that he dropped the case. Here are excerpts from his press release:

"ASH has agreed to dismiss its lawsuit against OSHA...to avoid serious harm to the non-smokers rights movement from adverse action OSHA had threatened to take if forced by the suit to do it....developing some hypothetical [ASH's characterization] measurement of smoke pollution that might be a better remedy than prohibiting smoking....[T]his could seriously hurt efforts to pass non-smokers' rights legislation at the state and local level...

Another major threat was that, if the agency were forced by ASH's suit to promulgate a rule regulating workplace smoking, [it] would be likely to pass a weak one.... This weak rule in turn could preempt future and possibly even existing non-smokers rights laws-- a risk no one was willing to take.

As a result of ASH's dismissal of the suit, OSHA will now withdraw its rule-making proceedings but will do so without using any of the damaging [to Anti activists] language they had threatened to include."
-ASH Nixes OSHA Suit To Prevent Harm To Movement

Looking on the bright side, Banzhaf concludes:

"We might now be even more successful in persuading states and localities to ban smoking on their own, once they no longer have OSHA rule-making to hide behind."

Once again, the Anti-Smoking Movement reveals that it's true motive is basically Prohibition (stopping smokers from smoking; making them "social outcasts") --not "safe air."

And the attitude seems to be, as Stanton Glantz says, if the science doesn't "help" you, don't do the science.

FOX NEWS ARTICLE
March 8, 1998

Passive smoking doesn't cause cancer - official By Victoria Macdonald Health Correspondent

THE world's leading health organization has withheld from publication a study which shows that not only might there be no link between passive smoking and lung cancer but that it could even have a protective effect.

The astounding results are set to throw wide open the debate on passive smoking health risks. The World Health Organization, which commissioned the 12-centre, seven-country European study has failed to make the findings public, and has instead produced only a summary of the results in an internal report.

Despite repeated approaches, nobody at the WHO headquarters in Geneva would comment on the findings last week. At its International Agency for Research on Cancer in Lyon , France , which coordinated the study, a spokesman would say only that the full report had been submitted to a science journal and no publication date had been set.


The findings are certain to be an embarrassment to the WHO, which has spent years and vast sums on anti-smoking and anti-tobacco campaigns. The study is one of the largest ever to look at the link between passive smoking - or environmental tobacco smoke (ETS) - and lung cancer, and had been eagerly awaited by medical experts and campaigning groups.

Yet the scientists have found that there was no statistical evidence that passive smoking caused lung cancer. The research compared 650 lung cancer patients with 1,542 healthy people. It looked at people who were married to smokers, worked with smokers, both worked and were married to smokers, and those who grew up with smokers.

The results are consistent with their being no additional risk for a person living or working with a smoker and could be consistent with passive smoke having a protective effect against lung cancer. The summary, seen by The Telegraph, also states: "There was no association between lung cancer risk and ETS exposure during childhood."

A spokesman for Action on Smoking and Health said the findings "seem rather surprising given the evidence from other major reviews on the subject which have shown a clear association between passive smoking and a number of diseases." Roy Castle, the jazz musician and television presenter who died from lung cancer in 1994, claimed that he contracted the disease from years of inhaling smoke while performing in pubs and clubs.

Strangely enough my uncle believed he became stricken with throat cancer due to the fact that he delivered to bars where people were smoking. I found it hard to believe because most of his deliveries were in the morning and early afternoon when there were very few people in the bars.

If the second hand smoke issue was real then there would be very few bartenders alive over the age of thirty.

I'm not saying smoking is good for you, but it appears not to be as bad as some people make it out to be. Especially second hand smoke.

I get cancer just listening to these whiny jerks pontificating about second-hand smoke. Smoke wherever you want, fuck 'em all.

Politicians cause cancer; ban them too. They definitely irritate the nostrils anyway.

they should ban smoking outside the womb/grave.

user-pic

Smoking is stupid. but who gives a shit if it's outside the doorway.

I am not a smoker myself, but I just think about all the freedoms this state and city take away from the individual.

I don't like secondhand smoke myself, especially before entering a hospital, but I really hope they don't fine people for smoking outside.

Sure it would be great if people took the time to realize that if they smoke 2 feet from an entrance that they are sharing their smoke with others, and that's when you assertively tell them to inhale further away from the entrance.

Just another law in New York.

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