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A new article published in The Lancet Oncology
claims that the recent smoke-free policy initiatives have resulted in
numerous public health gains. The special report from the International
Agency for Cancer Research (IARC) reveals that the
policies have been instrumental in reducing heart disease related to
smoke exposure, diminishing the number of adults who smoke, and curbing
second-hand smoke exposure to adults and children. In addition, the
report finds -Â to the benefit of the main critics of the
policies - that there is no noticeable decrease in restaurant and bar
business activity due to these policies. It is too early to say whether
or not the policies have led to a reduction in lung cancer, but the
study believes it to be a likely outcome after they process the
required data.
The lead writers of the report, Dr John Pierce (University of
California, San Diego, CA, USA) and Dr MarÃa León (IARC's Tobacco and
Cancer Team), collaborated with a Working Group of world scientists and
researchers from the IARC secretariat to prepare the Special Report.
The group analyzed smoke-free policies in several jurisdictions and
then placed into three categories 11 causal statements about the
policies. The three classifications were:
- Sufficient evidence - the association was judged
to be causal
- Strong evidence - the association is consistent but there
is not enough evidence to mark as causal
- Insufficient data - the researchers lacked the necessary
data to come to a conclusion
Placement into these three categories was guided by a comprehensive
assessment of peer-reviewed published work as well as governmental
reports on the effects of smoke-free policies.
The following statements were classified as having sufficient evidence
to make a causal statement:
- Smoke-free policies decrease second-hand smoke exposure
- Smoke-free workplaces decrease the number of cigarettes
that existing smokers consume
- Smoke-free policies do not harm the business activity of
the restaurant and bar industry
- Smoke-free policies decrease respiratory problems in workers
- Voluntary smoke-free policies in the home reduce children's
second hand smoke-exposure
- Smoke-free home policies decrease adult smoking
The following statements were classified as having strong evidence:
- Smoke-free workplaces decrease the number of adults who
smoke
- Smoke-free policies decrease youth tobacco consumption
- Smoke-free legislation decreases death due to heart disease
- Smoke-free policies in the home reduce smoking in youths
Since it takes 20 years or more to diagnose lung cancer after
carcinogenic exposure, the researchers maintain that, "Data
are not yet available regarding the expected decline in lung cancer
after implementation of smoke-free policies."
The authors argue that the evidence found in this and other studies
suggests that governments should implement smoke-free policies that are
in line with the WHO Framework Convention on Tobacco Control (FCTC).
They conclude: "Implementation of such policies can have a broader
population effect of increasing smoke-free environments. Not only do
these policies achieve their aim of protecting the health of
non-smokers by decreasing exposure to second-hand smoke, they also have
many effects on smoking behaviour, which compound the expected health
benefits. These benefits will be greater if these policies are enacted
as part of a comprehensive tobacco-control strategy that implements all
of the provisions called for by the WHO-FCTC." The researchers also
call for policy assessments to be conducted in low- and medium-resource
countries, not just high-resource countries.
Effectiveness of smoke-free policies
John P Pierce and MarÃa E León, on behalf of the International Agency
for Cancer Research (IARC) Handbook
The Lancet Oncology (2008). 9(7): pp.
614-615.
DOI:10.1016/S1470-2045(08)70167-0
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Here to View Journal Website
Written by: Peter M Crosta
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
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