Sunday, June 27, 2010

Jace Smith's Misstatement in News-Leader

Dear Springfield City Council,

Jace Smith, director of Missouri State Advocacy for the American Heart Association, in his News-Leader June 26th op-ed, "Support Workplace Smoking ban in Springfield", cites a study published last October in Journal of the American College of Cardiology which found that smoking bans cut heart attack rates 17 percent in communities that impose them. But the Kansas University researchers who conducted that study now admit they made a mistake and have published a correction of their study in the Journal of the American College of Cardiology. The corrected rate of decline is 8 percent. Boston University researcher Dr. Michael Siegel points out that 8 percent is "a rate of decline not significantly different from the levels of decline in heart attacks that are being observed in the absence of smoking bans, which have varied between 5 percent and 10 percent per year in many communities."

Springfield Councilmen, smoking ban proponents in both St. Louis and Springfield argue that only strict smoking bans should be passed in order to cut heart attack rates. I wanted to let you know that the most comprehensive study yet conducted concerning the public health effects of smoking bans has found that smoking bans do not decrease mortality rates, hospital admissions orheart attack rates in communities that impose them. The study was conducted by researchers from the Rand Corporation, Stanford University, the University of Wisconsin and the Congressional Budget Office. The National Bureau of Economic Research has already circulated this study, CHANGES IN U.S. HOSPITALIZATION AND MORTALITY RATES FOLLOWING SMOKING BANS, as a working paper, and it will soon be published in a major medical journal. Please find this study attached.

The researchers summarize their study:

"U.S. state and local governments are increasingly restricting smoking in public places. This paper analyzes nationally representative databases, including the Nationwide Inpatient Sample, to compare short-term changes in mortality and hospitalization rates in smoking-restricted regions with control regions. In contrast with smaller regional studies, we find that workplace bans are not associated with statistically significant short-term declines in mortality or hospital admissions for myocardial infarction or other diseases. An analysis simulating smaller studies using subsamples reveals that large short-term increases in myocardial infarction incidence following a workplace ban are as common as the large decreases reported in the published literature."

I also want to alert you to the October publication of a major heart attack study in the European Journal of Epidemiology. The study also found no association between heart attacks and smoking bans. Please find this study, ON THE RELATIONSHIP BETWEEN SMOKING BANS AND INCIDENCE OF ACUTE MYOCARDIAL INFARCTION, attached to this e-mail. Dr. Michael Siegel of the Boston University School of Public Health says of this study:

"Importantly, this published study was not considered by the Institute of Medicine committee which reviewed this issue and released its report in October of last year. It was also not considered in published meta-analyses on this topic. Because of the high sample size of this study, it is likely that inclusion of this study in the previous meta-analyses would have negated their results."

Councilmen, when St. Louis City and County were considering a smoking ban last summer, we asked Dr. Geoffrey Kabat, PhD, Senior Epidemiologist at Department of Epidemiology and Population Health at the Albert Einstein College of Medicine, who conducted the largest secondhand smoke study ever done, completed too late to be included in Surgeon General Carmona's 2006 Report, to summarize his secondhand smoke research as it relates to smoking bans. Dr. Kabat wrote to the St. Louis County Council:

"Yet, since the available evidence suggests that the effects of environmental tobacco smoke, particularly for coronary heart disease, are considerably smaller than generally believed, lawmakers may therefore have greater latitude than generally believed to consider the segregation of smokers and nonsmokers and the use of air filtration as adequate and responsible ways to address the health concerns of ETS in workplaces such as bars and restaurants. If it is possible, through segregation of smokers and
nonsmokers and the use of air filtration, to reduce all components of environmental tobacco smoke in establishments where smoking is permitted to the level of the air in non-smoking establishments, there is reason to believe that any risk would be undetectable."

Bar owners across Missouri fear the 11 percent business loss experienced by bars in Columbia. The best science does seem to indicate that workplace smoking can be tolerated by lawmakers if proper ventilation and air filtration is in place.


Bill Hannegan

Monday, June 21, 2010

E-mail to Springfield Mayor Jim O'Neal

Dear Mayor O'Neal,

Smoke Free St. Louis City and One Air Alliance have tested the air in St. Louis and Springfield bars that allow smoking and found their air on averageVERY UNHEALTHY according to the EPA Air Quality Index. This is a tough standard for a bar to be judged by. It is a standard set to reflect 24 hour air conditions from which there is no escape and which the very elderly, the very sick, and the very young are all forced to breathe. Yet affordable, readily available air filtration technology can make the air in a bar that allows smoking clean as the air outdoors. So I plan to suggest this exemption for St. Louis City which could also work in Springfield:

"Any public place or place of employment whose owner or operator can demonstrate to the Director of Health that the air within said public place or place of employment, despite indoor smoking, consistently tests to be ofMODERATE or GOOD quality as designated by the EPA Air Quality Index."

Both St. Louis and Springfield usually have either GOOD or MODERATE air quality according to the EPA Air Quality Index, so the exemption basically requires places that allow smoking to have air as clean as the air outdoors.


Bill Hannegan

Sunday, June 20, 2010

Springfield Air Quality Monitoring Study

Dear Springfield City Council members,

I want to warn you concerning the "Springfield Air Quality Monitoring Study" being used by the group One Air Alliance to push for a Springfield smoking ban. A similar study was used by Smoke Free St. Louis City to push for a St. Louis smoking ban. Both studies achieve startling conclusions by misapplying the EPA’s Air Quality Index. Both studies take the EPA outdoor standard, a standard set to reflect 24 hour outdoor air conditions, and use that standard to judge the safety of indoor workplace air, a use for which it was never designed and never intended.

In the "Springfield Air Quality Monitoring Study", ten Springfield establishments that allow smoking were found to have on average level 162 ug/m3 of pm 2.5, a level of respirable particles which would be of concern according to the EPA if generally present in outdoor air. But OSHA, the governmental agency charged with the protection of health in indoor workplaces, recognizes that such a strict standard is not necessary to protect worker health indoors. Indeed, if imposed, such a standard would shut down many industries. OSHA allows up to 5,000 ug/m3 in workplace air before it requires a business to clear particles from the indoor air with ventilation or filtration. Clearly, Springfield bars and restaurants are already well within OSHA air safety standards.

Of course, any bar or restaurant would do well to install the best ventilation and filtration technology available. Affordable air filtration machines are readily available that remove even the finest airborne particulates and that can make the air of a bar or restaurant that allows smoking cleaner than the air outdoors. Would One Air Alliance be willing to exempt Springfield "smoking allowed" establishments from a smoking ban that earn a GOOD or MODERATE rating on the EPA Air Quality Index through air filtration, despite their indoor smoking?

A further caution concerning the One Air Alliance study is that its tests were done furtively, without the permission or cooperation of the tested establishments, with technology that had to be small enough to remain hidden and escape detection, and were conducted in part by inexperienced, activist volunteers. Roger Jenkins, formerly a lead secondhand smoke researcher at the Department of Energy’s Oak Ridge National Laboratory, has written concerning the difficulty of conducting such tests even under ideal circumstances, with full cooperation of tested establishments, with the best equipment and a team of trained researchers. (Please see the attached peer-reviewed study.) According to Dr. Jenkins, unless expertly calibrated, testing machines can readily show three times the actual level of respirable particles present. Even measurements taken too close to clothing can cause readings to spike. The inexperience of the One Air Alliance volunteers may well account for the two oddly high readings reported in the "Springfield Air Quality Monitoring Study". Without those two high readings of 237.5 and 829.8, the average reading of tested Springfield establishments would be 69 ug/m3, not 162.

As a researcher for the Oak Ridge National Laboratory, Dr. Jenkins conducted the largest studies ever conducted of worker exposure to secondhand smoke in bars and restaurants across the country. In a letter to the St. Louis County Council last year, Dr. Jenkins reported the results of his research:

“Overall concentrations of ETS were fairly low: the highest concentration of particles measured in any facility were still 1/7th of the OSHA Permissible Exposure Limit, and the median area concentration of nicotine was less than 1 part per billion.”

Please find this letter and the Oak Ridge National Laboratory bar and restaurant secondhand smoke studies attached.

Springfield City Council members, I would strongly suggest that Springfield bars be retested by a professional, nonpartisan air quality testing firm. Given the economic harm Missouri cities such as Columbia and Ballwin have seen due to their smoking bans, it seems only fair that Springfield bars have their air accurately measured and the test results competently interpreted.


Bill Hannegan


314.315.3779 (cell)

Wednesday, June 16, 2010

Tuesday, June 01, 2010