Exposure to secondhand smoke has declined sharply in the United States in recent years because of legal restrictions, but it remains a “health hazard that is entirely preventable,” a federal report has found.
According to the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report (MMWR), from 1999 to 2004, 10 states passed tougher restrictions on smoking in private-sector workplaces; nine strengthened smoking restrictions in restaurants; and five tightened such restrictions in bars.
The picture has improved further this year, with six more states enacting smoking restrictions, researchers said.
Although “secondhand smoke exposure among U.S. nonsmokers has decreased sharply … a substantial portion of nonsmokers continue to be exposed to secondhand smoke,” the authors wrote. They added that a large concentration of nonsmokers work in the food-preparation, food-service and bartending fields.
Report co-authors Ann Malarcher and Stephen Babb, both of the CDC, said their findings indicate a rise in both the number and restrictiveness of laws regarding smoking in private-sector work sites, restaurants and bars.
For example, at the end of 1998, Maryland was the only state that banned smoking in private-sector workplaces, the report found. By the end of 2004, six more states had done so.
“This increase [in protection from smoke] is continuing, but more needs to be done,” Miss Malarcher said.
“One very big concern,” she said, is the “different levels of protection that exist across work force populations.”
From 1998 to 1999, the report said, fewer than 13 percent of bartenders and 28 percent of waiters reported being covered by smoke-free policies. That compared with a national average of nearly 70 percent.
Coverage for workers who prepared and served food was about 43 percent near the end of the last decade. It was 91 percent for primary-school teachers at that time.
And, previous research has indicated that food-service workers have a 50 percent greater risk for getting lung cancer than the general population, the authors wrote. This has resulted, in part, from their “higher level of occupational exposure to secondhand smoke,” they said.
Mr. Babb said the lower prevalence of smoke-free protection for bar and restaurant workers is undoubtedly related to concerns that such establishments could suffer a disproportionate adverse economic effect from policies to restrict smoking. But he said peer-reviewed studies on “such objective indicators as sales tax revenue and employment levels have consistently found” no such negative economic effect.
A national health goal calls for enactment of laws restricting or banning smoking in all states and the District by 2010. Mr. Babb says he is not ready to predict whether that will happen.
“But I wouldn’t have predicted all the progress that’s been seen to date, and it seems to be accelerating,” he said.