The Case of Galila Huff
Consider the case of Galila Huff (pictured on the right), which was reported in the New York Times in 2008. Galila is a chain-smoking restauranteur who lives in a condominium in New York. Her neighbors, the Selbins, are lawyers who live in the same building. They sued Galila because of their concerns that her smoking would have an adverse effect on the health of their 4 year-old son. The Selbins claim that Galila's cigarette smoke drifts down the hallway and enters their condo. The smell bothers them, and they are particularly concerned about the health effects on their four year old son. In their law suit the Selbins are demanding Galila "cease and desist from causing smoke to enter into the common hallway," and that she pay punitive damages. Galila, who has been smoking since age 17, says that she is doing everything she can to control the smoke. Ms. Huff says, "You see, I'm not into harming anyone."
This case pitted Ms. Huff's rights as a homeowner against the legitimate desire of the neighbors down the hall to protect the health of their son. But Ms. Huff claimed that her cigarette smoke wasn't harming anyone.
Active smoking has clearly been shown to be a cause of lung cancer and heart disease. Many studies have confirmed a very strong association (relative risk = 20-25 for lung cancer), with strong statistical significance. Studies done in a wide variety of circumstances have consistently demonstrated a strong association and also indicate that the risk of lung cancer and cardiovascular disease (e.g. heart attacks) increases in a dose-related way. These studies have led to the conclusion that active smoking is a cause of lung cancer and cardiovascular disease.
A growing body of evidence demonstrated that non-smokers exposed to secondhand smoke in bars and restaurants had an increased risk of lung cancer, heart disease, and other adverse health effects.
- Involuntary smoking in the restaurant workplace - A review of employee exposure and health effects
(Siegel, Michael. JAMA. 1993;270:490-493)
- Exposure to environmental tobacco smoke and risk of lung cancer: the epidemiological evidence.
(Trédaniel J, Boffett P, et al.. Eur Respir J. 1994;7:1877–1888)
This evidence provided the rationale for smoking bans in bars, restaurants, and a growing number of public buildings.
- Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study
(Sargent RP, Shepard RM, and Glantz SA. BMJ. Apr 24, 2004; 328(7446):977–980.)
- Commentary: How acute and reversible are the cardiovascular risks of secondhand smoke?
(Pechacek TF, Babb S. BMJ. 2004;328:980-983.)
It should be noted that some scholars, including Dr. Michael Siegel, a well-known anti-tobacco researcher and advocate, felt that the evidence did not support these claims.
- Is the tobacco control movement misrepresenting the acute cardiovascular health effects of secondhand smoke exposure? An analysis of the scientific evidence and commentary on the implications for tobacco control and public health practice.
(Siegel, Michael. Epidemiologic Perspectives & Innovations. 2007;4:12.
In the abstract of Dr. Siegel's commentary he states the following:
"This paper reviews the claims being made by a number of anti-smoking and public health groups regarding the acute cardiovascular effects of secondhand smoke exposure among otherwise healthy adults, analyzes the validity of these claims based on a review of the scientific evidence, and discusses the implications of the findings for tobacco control and public health practice. Based on the analysis, it appears that a large number of anti-smoking organizations are making inaccurate claims that a single, acute, transient exposure to secondhand smoke can cause severe and even fatal cardiovascular events in healthy nonsmokers. The dissemination of inaccurate information by anti-smoking groups to the public in support of smoking bans is unfortunate because it may harm the tobacco control movement by undermining its credibility, reputation, and effectiveness."
Despite these concerns, many states and municipalities have enacted statutes and regulations that impose strict limits on where smoking is permissible. Consider the following partial list of bans in California:
- 1995 Statewide ban on smoking in all enclosed workplaces in California, including restaurants and bars (there were some specific exemptions, however).
- 2004 Ban of smoking within 20 feet of the entrance or operable window of a public building
- 2008 Ban on smoking in a moving vehicle while in the presence of a minor (18 years or younger)
A Sample of Local Regulations in California
- Belmont, 2007, banned in parks and other public places, as well as inside apartments and condominiums
- Berkeley, 2008, banned on all commercially zoned sidewalks, and within 20 feet of a bus stop
- Beverly Hills, 2007, banned in all outdoor dining areas
- Burbank, 2007, banned in most public places including outdoor dining & shopping areas, parks, service lines, and within 20 feet of all building entrances/exits
- Escondid, 2009, banned smoking in parks, city open spaces, and trails, including the parking areas for city properties
- Marin County, 2012, banned in all condos and apartments, as well as all patios within residential units
Dr. Siegel's point is that our endeavors to promote health should be based on evidence, not on fears or unjustified beliefs. This case exercise will expose you to some selected pieces of evidence regarding ETS and air pollution that will help you to:
- sharpen your ability to critically evaluate evidence, and
- arrive at an evidence-based decision about recommendations for bans on smoking.