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PAPERS: Caroline M Fichtenberg and Stanton A Glantz Effect of smoke-free workplaces on smoking behaviour: systematic review BMJ 2002; 325: 188 [Abstract] [Full text]

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A Smoke-Free Womb Would be a Good Start

Tony Floyd   (27 July 2002)

Can smoking bans be enforced?

Frank J Leavitt   (29 July 2002)

Smoke-Inhalation? How about Smoker-Inhalation Machines?

Tony Floyd   (31 August 2002)

Re: Smoke-Inhalation? How about Smoker-Inhalation Machines?

Frank J Leavitt   (5 September 2002)

A Smoke-Free Womb Would be a Good Start 27 July 2002
Tony Floyd, Medical Student Newcastle University Australia 2308 Send response to journal: Re: A Smoke-Free Womb Would be a Good Start	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.
Can smoking bans be enforced? 29 July 2002
Frank J Leavitt, Chairman, Centre for Asian and International Bioethics, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, ISRAEL Send response to journal: Re: Can smoking bans be enforced?	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.
Smoke-Inhalation? How about Smoker-Inhalation Machines? 31 August 2002
Tony Floyd, Medical Student Newcastle University, Newcastle Australia Send response to journal: Re: Smoke-Inhalation? How about Smoker-Inhalation Machines?	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.
Re: Smoke-Inhalation? How about Smoker-Inhalation Machines? 5 September 2002
Frank J Leavitt, Chairman, Centre for Asian and International Bioethics, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, ISRAEL Send response to journal: Re: 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.