The Joy of Non-Smoking: Employees Benefit From Ban on Smoke

Two strangers' eyes meet over the brief flare of a freshly lit match. A jazz chanteuse croons through a haze of smoke. Around midnight, a bartender clears away the islands of empty cocktail glasses and lipstick-smudged cigarette butts left in the revelers' wake. For generations, immortalized in Edward Hopper paintings and Humphrey Bogart movies, inseparable from the sounds of Miles Davis and Sarah Vaughn, smoking was synonymous with nightlife glamor and romance.

But for California musicians like Bill Arnold and tavern owners like Carol Brookman, smoking is also synonymous with red eyes, scratchy throats, and racing hearts. When the last phase of the California law banning smoke in workplaces went into effect, Arnold and Brookman were finally free of the smoking culture that threatened to smother them in secondhand smoke.

A way of life

For decades, Brookman has run Heinold's First and Last Chance, an Oakland, California, bar once favored by Jack London. Until the workplace smoking ban, working in a smoky haze was a way of life. "I had never had a job where people didn't smoke, even when I worked in an office," Brookman said. "But the bar was the worst. I'd stand outside and look in and sometimes I couldn't see the back of the room for the smoke."

Brookman, who has never smoked, said she often wished she'd had the courage to ban smoking in her bar before the law passed. Besides worrying over the effect those eight-hour shifts behind a smoky bar were having on her health, she feared another consequence of allowing smoking: fire.

"This is a wooden building, almost 120 years old. I used to go home at night and lie awake thinking about the garbage. That's where bar fires start -- in the garbage. I started sleeping so much better when the (smoking) ban started. I wasn't inhaling all that smoke, and I didn't have to worry about cigarette fires anymore."

Arnold, the drummer and lead vocalist in a band based in Chico, quit smoking more than nine years ago. Like many former smokers, he has realized over time how sensitive his re-pinked lungs are to secondhand smoke.

"I was literally sick and tired of playing in smoke-filled rooms," Arnold said. "I was becoming super-sensitive to secondhand smoke and would have heart palpitations whenever exposed. My voice was always sore and raspy."

After the smoking ban

California has led one of the most aggressive antismoking campaigns, one that includes numerous media ads. As early as the 1990s, the first phase of California's antismoking law banned smoking in restaurants and most workplaces, although the tobacco lobby's opposition led to postponement of the ban in bars and nightclubs. Before the phase covering nightclubs and bars took effect, Arnold was afraid to complain to club bookers. "It was a very touchy situation with the band because getting gigs is very competitive. For a band to make a complaint or ask the owner to not allow smoking would be economic suicide. Without the law on our side, we were out of luck."

According to the California Department of Public Health, inhaling secondhand smoke ranks behind smoking and alcohol abuse as the third most preventable cause of death. The agency also reports that for every eight smokers who die of tobacco-related causes, one person dies of illness from exposure to someone else's smoke.

Since the ban, Brookman and Arnold have seen dramatic improvements in their health. Brookman no longer suffers from chronic flu-like symptoms. And in the first year after her bar went smoke-free, none of her staff called in sick. Arnold had considered giving up music rather than continue trying to sing in smoky venues, but after the ban his voice improved and his heart stopped racing.

"My lung capacity feels much better, and I don't have any phlegm to deal with," Arnold said. "Overall, I don't feel like I've been dragged through a rat hole after every gig."

Study finds bartenders breathing better

Arnold and Brookman's experiences echo the findings of a study by researchers at the University of California at San Francisco. A team led by Dr. Mark Eisner, an assistant professor of pulmonary medicine, looked at the lung health of 53 bartenders before and after the smoking ban. The study was designed to measure the effect the law might have on workplace health. Researchers surveyed the bartenders about incidences of respiratory irritations; they also measured their lung function and capacity.

"About eight weeks after the workplaces became smoke-free, we saw a small but significant improvement in lung health," said Eisner. "There was a reduction in respiratory symptoms, coughing, wheezing, irritation to eyes, nose and throat."

After two smoke-free months, 59 percent of those who'd complained of respiratory problems no longer had any symptoms. Lung function also improved after just two months.

Interestingly, about half the bartenders in the study smoked. But even the smokers saw an improvement in their health when they were no longer subjected to inhaling secondhand smoke during long shifts.

Concentration of nicotine

Although most studies have looked at the effect of secondhand smoke in the home, researchers around the country are increasingly studying the influence of smoking bans on workplace health. For instance, in a study of 25 Massachusetts work sites, Dr. Katherine Hammond found much greater concentrations of nicotine in the air in workplaces that allowed smoking on the job than in those that banned it.

California's was probably the first most wide-ranging state law, according to Stanton Glantz, professor of medicine and a member of the Institute for Health Policy Studies and the Cardiovascular Research Institute at the University of California at San Francisco. "It has, to some extent, been a model for laws in other states," said Glantz, one of the most outspoken anti-smoking crusaders in America.

In fact, many California cities have also passed laws prohibiting smoking in areas such as entryways, playgrounds, multi-unit housing facilities, college campuses, and in cars with children. Dozens of California beaches also ban cigarettes. But the state now has a lot of company: 39 U.S. states and more than 22,000 municipalities have passed laws making workplaces, restaurants, casinos or bars smoke-free. More than 600 municipalities have 100 percent smoking bans in all workplaces, including restaurants and bars.

Initially, Glantz had opposed the law, fearing there would be problems with compliance. In fact, cooperation can be spotty. Although the workplace smoking limits cover the entire state, local health departments are responsible for enforcement. How vigilant those departments are depends on the local administration.

"I have had some bad experiences with a few non-compliant bars, and there are still some out there," Arnold said. "Some bars slip in and out. It is very annoying when I show up for a gig and people are smoking. I want to turn around and leave, but I am outvoted by the band. It is still awkward to complain to the management, but I always file a complaint with the local authorities. Those wheels grind very slowly. But overall, within the two-and-a-half years, I've seen a steady improvement."

Bar owner Brookman said despite dire predictions by smoking ban opponents, she hasn't seen any drop in business. "My old customers didn't leave and I actually got some new customers. "Smoking in a bar is not a right," Brookman continued. "As far as I'm concerned, the smoking section is outdoors."

Further Resources

Americans for Nonsmokers' Rights http://www.no-smoke.org

BREATH http://www.breathla.org

American Heart Association http://www.americanheart.org

American Lung Association http://www.lungusa.org

References

Smoke-Free Ordinances. Americans for Nonsmokers Rights, May 2014.

Glantz, Stanton; Balbach, Edith. Tobacco War. University of California Press. Recounts the history of the political battle in California over the fight for smoke free public spaces.

Sweeney CT, Shopland DR, Hartman AM, Gibson JT, Anderson CM, Gower KB, Burns DM. Sex differences in workplace smoking policies: results from the current population survey. J Am Med Womens Assoc, 55(5):311-5.

Zhang ZF, Morgenstern H, Spitz MR, Tashkin DP, Yu GP, Hsu TC, Schantz SP. Environmental tobacco smoking, mutagen sensitivity, and head and neck squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev, 1043-9. Farkas AJ, Gilpin EA, White MM, Pierce JP. Association between household and workplace smoking restrictions and adolescent smoking. JAMA, 284(6):717-22.

Parrott S, Godfrey C, Raw M. Costs of employee smoking in the workplace in Scotland. Tobacco Control, 9(2):187-92.

California Department of Public Health. Secondhand Smoke in California. http://www.cdph.ca.gov/programs/tobacco/Documents/CTCPFactShSHSinCA2008.pdf

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