Almost time to put out smokes

Business to pick up, some observers say

Bill Scanlon, Rocky Mountain News

Published June 24, 2006 at midnight

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Bartender Lisa Nieto, 38, coughs and rasps like a woman twice her age.

By the end of a shift, "Your throat hurts, you're coughing, your eyes are irritated, you stink of secondhand smoke in your clothes and hair," she said. "I have super-intense allergies to cigarette smoke along with other things. It's broken down my immunity. I can't fight off the chemicals."

Nieto can't wait until a week from today, when Colorado's statewide smoking ban begins, and patrons no longer can lean in, tell their life stories and blow smoke in her face.

Observers in cities, states and countries where smoking bans are in place say that Colorado should expect a decline in heart attacks, a spike in the lung capacities of bartenders, faster bone-healing after surgery and a huge wave of popular support.

Not everyone will be happy, and some bars and taverns - those that derive most of their income from alcohol - will suffer, they say.

But overall, the observers say that business, like health, will pick up.

Look at Ireland, said Dr. Stanley Glantz, director of the Center for Tobacco Control, Research and Education at the University of California at San Francisco.

A year after a nationwide ban went into effect in that country, the number of non-smoking bar workers with respiratory problems decreased 17 percent, according to the British Medical Journal.

A California study by Glantz's UCSF colleague, Dr. Mark Eisner, found that 59 percent of bartenders there who had respiratory problems before the ban no longer had them a year later. It also found that bartenders and waitresses had increased lung capacity as measured by peak-flow meters after the ban.

Another study found that heart attacks fell by 45 percent in Bowling Green, Ohio, a year after its smoking ban went into effect.

A third study found a 40 percent drop in heart attacks in the six months after a smoking ban went into effect in Helena, Mont., and a 40 percent rise after the ban was rescinded. Glantz helped two Helena physicians on that study.

Closer to home, a study last year by the Pueblo City-County Health Department found a 27 percent drop in heart attacks in the 18 months after a smoking ban was imposed there, and Greeley saw a decrease after the ban there.

Could it be faulty science?

Yes, say skeptics.

New York epidemiologist Geoffrey Kabat told the British Medical Journal that the Helena study is flawed because the researchers couldn't prove that exposure to secondhand smoke had changed as a result of the ban.

He said the drop in heart attacks was based on a few cases, meaning it could easily be due to chance or an unknown factor.

Kabat also is skeptical that a smoking ban could have such a dramatic and quick effect. Even if all smokers in Helena had quit for a year, he wouldn't have expected such a big decline.

Retired Missouri chemist David W. Kuneman looked at government statistics from California, New York, Florida and Oregon, all states with widespread smoking bans, and found no drop in heart attacks after the bans.

Skeptics say anti-tobacco researchers cherry-pick the cities that happened to have a decline in heart attacks after a ban, and ignore the places such as New York and California that haven't seen a decrease in heart attacks.

They call the studies linking smoking bans with declines in heart attacks "junk science."

But Glantz said there are good scientific reasons why a smoking ban can lead to an immediate sharp cut in heart attacks - and sinister reasons why such findings are labeled "junk science" by opponents.

"The whole concept of 'junk science' was invented by the tobacco companies in the early 1990s," Glantz said. "It was all done to try to discredit the evidence of secondhand smoke."

He noted that the California Environmental Protection Agency last year produced a study that links secondhand smoke to heart disease, lung cancer, early breast cancer, sudden infant death, learning and behavioral problems in kids, asthma and other problems.

While the cumulative effect of secondhand smoke can be devastating, it also can cause acute events, he said. Secondhand smoke "can trigger a heart attack within minutes and at low doses," he said.

Dr. Don Parsons, a retired surgeon now living in Dillon, explained that when non-smokers are exposed to secondhand smoke, their coronary artery blood flow falls 30 percent, similar to that experienced by smokers.

But it can be even worse for non-smokers because "their bodies haven't had a chance to adapt to decreased blood flow."

That's why secondhand smoke can cause acute heart failure, he said. "Platelets get stickier, and that results in more blood clots. It's blood clots in coronary arteries that cause heart attacks."

Secondhand smoke also diminishes the oxygen content in the blood, by increasing the amount of carbon monoxide, he said.

"It causes a perfect storm - decreased blood flow, more blood clots and decreased oxygen."

Parsons said the Centers for Disease Control estimates that 50,000 Americans a year die from the effects of secondhand smoke.

Parsons added that the heart-attack studies in Pueblo, Helena, Mont., and elsewhere, far from being junk science, are good predictors of what to expect.

It's cities like Helena and Pueblo, where almost everyone goes to the same one or two hospitals, that can produce the most accurate data, he said.

Back behind the bar, Nieto says she's "excited, very happy" that the ban is just a week away.

"This is a long time overdue," she said. "I'm going to have an increased desire to go to work."

The ifs, ands or buts about law

Question: Where can and can't you smoke after July 1?

Answer: Smoking is banned in indoor public places, including restaurants, bars, bingo halls, racetracks, billiard or pool halls, bowling alleys, public buildings, sports arenas, hospitals, grocery stores, theaters, museums, nursing homes, common areas of retirement facilities or public- owned housing, lobbies, elevators, buses and light rail trains, taxis, and no less than 75 percent of hotel or motel rooms.

• Smoking will be allowed in some cigar bars that were in business before Dec. 31, 2005, in smoking lounges at Denver International Airport and at casinos.

Q: How many bars and restaurants will be affected?

A: More than 14,000 restaurants. Of that number, 70 to 90 percent already are completely or partially smoke free.

• Currently, 4,000 restaurants and bars allow smoking. They have received kits from the Colorado Department of Health and Environment with no-smoking signage and other information to display and pass on to customers. The remaining bars and restaurants were sent brochures about the law.

Q: Can I smoke outside the door of a bar, restaurant or public building?

A: You must be at least 15 feet from the door, unless local laws are stricter.

Q: What if my town's no-smoking laws are stricter than the state's?

A: The town's laws prevail. In Avon, for example, you must be at least 25 feet outside a doorway to smoke.

Q: Can restaurants and bars offer outdoor patios for smokers?

A: In many cities, yes, but they must be 15 feet from the doorway or comply with local smoking-ban ordinances. Some towns, including Avon and Lafayette, bar smoking at outdoor patios.

Q: Can I can smoke at the Pepsi Center, Coors Field or the Colorado Convention Center?

A: Smokers looking to light up at the Pepsi Center must do it outside the arena. Coors Field has designated smoking areas, usually boxed off, on various levels of the ballpark. At the convention center, the only place you can smoke is outside, 15 feet from the doorway.

Q: What about workers in high rises?

A: No indoor smoking, unless the business has fewer than three employees and isn't open to the public. Smoking is allowed on private ranches and farms with annual gross incomes of $500,000 or less.

Q: What's the price of cigarettes at a grocery store?

A: Name brands average $3.64 for a pack and $31 for a carton.

Q: How much is tax?

A: $1.05 per pack.

Q: How much did the state receive in cigarette-tax revenue last year?

A: $115 million, more than double the $53 million collected in 2004, due to a tax hike. Retailers sold 266 million packs of cigarettes in 2005.

• Taxes on other tobacco products, including cigars, netted $15 million in 2005.

Q: How is the tax spent?

A: About 55 percent funds health and smoking-prevention programs. The remainder is split between the state and cities.

Q: Are cigarette vending machines still popular?

A: A handful remain, mostly in casinos, neighborhood bars and racetracks. Under law, they must be in public view and supervised.

Q: How will the no-smoking law be enforced? Will the smoker be cited, the bar owner, or both?

A: Possibly both. Restaurant and bar owners are responsible for complying with the law and making their patrons aware of it. Cities and counties will be responsible for enforcing the new statewide ban.

Q: What are the fines?

A: Owners and smokers are subject to a $200 fine for the first violation, $300 for the second and $500 for every violation per day thereafter within a calendar year. Fines will be retained by cities to offset enforcement costs.

Q: Can restaurants with cigar bars keep them? If I open a new restaurant, can I have a cigar bar?

A: Restaurants that derived 5 percent of their annual gross sales or $50,000 from tobacco sales as of Dec. 31, 2005, can have smoking bars. Sales from vending machines don't count. Any cigar bar opened after Dec. 31 must go smoke free, and cigar bars currently exempted cannot move or expand in size. A cigar bar that fails to sell at least 5 percent or $50,000 in tobacco products in future years will lose its exemption, cannot get it back and must go smoke free.

Source: Colorado Legislative Council, Colorado Liquor and Tobacco Enforcement Division, Colorado Restaurant Association, Denver Police Department.

Things to know about smoking

• A study found that people who were exposed to smoke in the workplace were 17 percent more likely to develop lung cancer than those who were not exposed.

• An estimated 50,000 Americans a year die from the effects of secondhand smoke.

• In Pueblo, heart attacks dropped 27 percent in the 18 months after a smoking ban was imposed.

• A poll of Californians showed 90 percent favor the state's smoking ban. In Ireland, 83 percent say the nationwide ban is "a good idea."

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