April 5-11 is National Public Health Week and while many steps have been taken to improve public health, several significant challenges remain. One such challenge is addressing the dangers of secondhand smoke.

As secretary of the Kansas Department of Health and Environment and as a Lawrence resident who has a deep concern for the health of our citizens, I am pleased that the city commission is reviewing this important issue. It is vital that we work together to look at ways to improve our health and one significant way this can be accomplished is through the promotion of smoke-free workplaces.

Smoke-free environments remain the most effective method for reducing secondhand smoke exposure and for protecting the health of Lawrence residents as well as all Kansans.

Dr. C. Everett Koop, former surgeon general of the United States, may have summed it up best in his 1986 report, “The Health Consequences of Involuntary Smoking.” He stated: “It is my judgment that the time for delay is past; measures to protect the public health are required now. The scientific case against involuntary smoking as a health risk is more than sufficient to justify appropriate remedial action, and the goal of any remedial action must be to protect the nonsmoker from environmental tobacco smoke.”

Although tobacco use remains the leading preventable cause of death in the United States, and its dangers are widely known (an estimated 440,000 Americans die annually of tobacco-related illnesses), the hazards of secondhand smoke are less well known.

Secondhand smoke, also called environmental tobacco smoke (ETS), is a mixture of smoke from the burning end of a cigarette, pipe, or cigar and the smoke exhaled by smokers. This contains more than 4,000 substances; 50 are known to cause cancer in humans or animals and many are strong irritants.

Secondhand smoke can also have devastating effects on children. Every year, secondhand smoke is associated with 8,000 to 26,000 new asthma cases in children and 150,000 to 300,000 new bronchitis and pneumonia cases in children less than 18 months (from CDC and Environmental Protection Agency statistics). Secondhand smoke is also associated with an increased risk for SIDS (sudden infant death syndrome).

Shockingly, a CDC report released this year shows approximately 60 percent of people in the United States have biological evidence of secondhand smoke exposure. Much of this exposure occurs during work or social settings.

Since 1999, 70 percent of the U.S. work force has worked under a smoke-free policy. The result is a work force with fewer health problems and lower medical costs, according to the World Health Organization (WHO), which reports most employers who go smoke-free end up saving money by reducing insurance coverage costs, increasing worker productivity, not to mention reducing maintenance and cleaning costs of the facility.

When discussing smoke-free ordinances, a key concern often expressed by business owners relates to impact on revenues. This concern is understandable; however, recent studies have shown businesses such as restaurants and bars do not lose revenue after going smoke-free. In fact, a CDC study published in February showed an El Paso, Texas, anti-smoking law, effective in January 2002, has had “no significant impact” on restaurant and bar revenues in that city. The researchers of the study note that these findings are consistent with findings of other studies that reviewed the impact of smoking bans on restaurant and bar revenues. Some studies have found the sales even go up after a smoking ban.

With an estimated 440,000 people dying every year of tobacco-related illness, the result is $75 billion a year in direct medical costs and $82 billion annually in lost productivity (according to a CDC report). These disturbing statistics coupled with the fact that a lower percentage of workers in the hospitality industry do not have health insurance, means we all share these costs through higher taxes to support rising Medicare and Medicaid costs, and higher health insurance premiums.

Each pack of cigarettes sold in the U.S. costs approximately $7.18 in medical care costs and lost productivity, according to CDC. To bring this into perspective, 22 billion packs were sold in 1999 alone.

So while the issue of secondhand smoke may appear to be one of individual rights, it is clearly a public health concern due to the effects upon persons consuming ETS in public places.

Surgeon General Koop made another important observation in the 1986 report on secondhand smoke exposure: “The rights of smokers to smoke ends where their behavior affects the health and well-being of others.”