Earlier this week, the New York Times editorial page opined about the effectiveness of banning smoking in public places as a means of cutting down heart disease risk. Citing a very small, six-month study of heart attack admissions to a hospital in Helena, Montana, the Times editors concluded that "a six-month ban on smoking in public places...appears to have sharply reduced the number of heart attacks."
The Times editorial is an example of dozens of news stories and editorials in recent months that uncritically accept the findings that a reduction of heart attack admissions from 40 to 24 in a six-month period was sufficient justification for banning smoking in public places.
The Times should know better.
First, the literature linking secondhand smoke and heart disease reveals that if there is a causal link, environmental tobacco smoke is at best a very weak risk factor. How could the temporary removal of a weak risk factor for heart disease cause a 40% reduction in six months? It defies common sense.
Second, the Times attempts to deflect criticism of its editorial by wrapping around themselves the medical journal that published the Helena, Montana data, noting "the study gains weight from being published in the prestigious British Medical Journal." Not so at all. Prestigious medical journals, unfortunately, do occasionally publish meaningless or misleading data. What makes a study "gain weight" is its being part of a consistent pattern of similar findings. No other study has ever suggested that a short-term reduction in secondhand smoke in public places (which presumably represents exposures of just a few hours a day, maximum) reduces heart disease risk. This study was not "prestigious." It was aberrant.
Third, the Times goes on to acknowledge that "it remains possible that some factor other than the ban was at work in reducing heart attacks." (Like chance, perhaps?) But even while conceding that the smoking ban may not explain the drop in heart attack admissions, the editors still recommend that the "Helena experience should certainly encourage the politicians who have been fighting to keep public places free of cigarette smoke." This is a non sequitur, in essence an argument that the data may be completely flawed but that we should move forward with public policy anyway.
Fourth, if the Times is convinced that smoking bans in public places reduce heart disease risk (convinced enough to dedicate a full editorial to the subject), why did they not wonder in their commentary why similar declines in heart attack admissions did not occur in large cities like New York or Los Angeles following the ban on smoking in bars and restaurants in those places?
The bottom line is that cigarette smoking is annoying and causes a spectrum of deleterious, acute health effects (like upper respiratory distress and earaches). There are lots of good reasons why we should not be subjected to the assault of secondhand smoke in public places. But using the results of dubious scientific studies to justify smoking bans only reinforces the idea that there are "enemies of pleasure" in the public health arena. Policies aimed at protecting our health should be based on sound science, not hype and political correctness.
