# Correlating Smoking Bans with Hospitalization **URL:** \ **Category:** Great Debates\ **Created:** [April 14, 2010, 1:56am UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011 "2010-04-14T01:56:47Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\ **Post date:** [April 15, 2010, 1:37am UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/21 "2010-04-15T01:37:07Z")
> [@Inbred\_Mm\_domesticus](#): > > Not to answer for **Ruken** but “smokers smoking less” was the first thing that popped into my head as well. I smoked when Connecticut introduced a ban in bars. Before the ban, when I went out to drink/play pool I smoked about 20 - 30 cigarettes over the course of the evening. After the ban, I maybe smoked 5 in that same time period. > > My anecdotal observations support the notion that most smokers were affected by bans in the same way - they simply smoke less. I imagine smoking less has a great benefit on one’s health. I also wonder if less smoking contributes to less drinking and overeating while at a bar as well. Yes, I was thinking about smokers smoking less, rather than bar-goers being exposed to less smoke. I hadn’t thought of the later. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [April 15, 2010, 2:03am UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/22 "2010-04-15T02:03:31Z")
> [@Napier](#): > > Of the different ways of dying, the ones enhanced by smoking tend not to be very expensive ones. Maybe you drop dead of a heart attack in your 60s or 70s, or maybe its a few months of chemo and maybe a lung removal, but you don’t usually spend years in bed. Heart disease is extremely expensive. A coworker’s dad died very slowly of emphysema and that was incredibly expensive, too. Stroke is expensive. I don’t think your statement is correct. ---
**Author:** ![Declan](https://avatars.discourse-cdn.com/v4/letter/d/ecae2f/32.png) [@Declan](https://boards.straightdope.com/u/Declan)\ **Post date:** [April 15, 2010, 5:36am UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/23 "2010-04-15T05:36:18Z")
> [@Jackmannii](#): > > Maybe Toronto was radically different :dubious:, but I’d have to see something better than anecdotes to demonstrate that. I cant speak for any jurisdiction outside the country , but Molson Breweries has been tracking beer stats/sales for quite a while and they did at one point release data on bar sales tracking areas that had banned smoking in bars. I’ll look it up. Declan ---
**Author:** ![Declan](https://avatars.discourse-cdn.com/v4/letter/d/ecae2f/32.png) [@Declan](https://boards.straightdope.com/u/Declan)\ **Post date:** [April 15, 2010, 5:44am UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/24 "2010-04-15T05:44:26Z")
> [@Sri\_Theo](#): > > Well doesn’t he say that they look at other cities that didn’t ban smoking and compared the decline? Surely they’ll have the same impact from better healthcare. From the linked PDF, it tracks three area’s Toronto , Durham region, and Thunderbay. It does not give the political demarcation for Toronto, so I have no idea if they also used Missisaugua, Vaughn, Markam etc. Durham, I can’t think of any major population center thats above 100k. It probably has the same land mass as the GTA , but thats about it. T’bay is about 23 hours north of Toronto, close to the manitoba border. And, unless there is a section I did not read, that was the extent of their survey. What I would have expected was Vancouver/Victoria in BC, Edmonton/Calgary in Alberta, Saskatoon/? and so forth right across the country and yet they picked three disimilar locations. Declan ---
**Author:** ![Declan](https://avatars.discourse-cdn.com/v4/letter/d/ecae2f/32.png) [@Declan](https://boards.straightdope.com/u/Declan)\ **Post date:** [April 15, 2010, 6:06am UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/25 "2010-04-15T06:06:19Z")
> [@Euphonious\_Polemic](#): > > How sad for you that your social life was somewhat curtailed. I guess that’s why you’re upset at a study that shows that the ban reduced serious hospitalizations, and want to deny that it is accurate. > > Do you have any actual studies that show that “the scene” is measurably poorer, or is it simply all about you? I was not upset by the study in itself, that was simply confusing too me. The question was posted to me as to why I thought that emacknight had made the city a poor place to be. You might also note in my reply that I had stated I had no idea what the scene today is like, only that it was not my toronto, so that would suggest that time has moved on from then and I was not the best judge of what Toronto’s social scene might be like. I would like to bring this to your attention though, simply as an afterthought instead of making it a post in itself. [QUOTE=CMAJ] Legislated bans on smoking are associated with reduced rates of admission to hospital, reinforcing the value of such bans for public health. Our study suggests that such legislation is related to admissions for both cardiovascular and respiratory conditions. Our findings are consistent with the evidence that exposure to second-hand smoke is detrimental to health and legitimize legislative efforts to further reduce exposure. Further research is needed to establish the types of settings in which smoking bans are most effective. [/QUOTE] I’l leave aside the fact that the good folks who compiled the study are making as much a political statement as much as they are making medical statements, right now its neither here nor there. The question is why now It shows trends in three diverse areas that have nothing really in common, except for being in the same province, when for the most part , most major metropolitan areas in Canada have smoke bans for the past ten years, even leaving aside the fact that Calgary was forced to go non smoking only two years ago, you could have omitted that city and had a wealth of cities to choose from and still might have gotten the same results. I don’t read the other two papers so I cant speak for them, but for the last several days, the Toronto Sun has had major articles on smoking again, for no apparent reason, ie, your war has supposedly been won. It may be something to think about, that your “smoke free” enviroment may be coming up for a realignment of thought. Declan ---
**Author:** ![Declan](https://avatars.discourse-cdn.com/v4/letter/d/ecae2f/32.png) [@Declan](https://boards.straightdope.com/u/Declan)\ **Post date:** [April 15, 2010, 6:09am UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/26 "2010-04-15T06:09:00Z")
> [@Ruken](#): > > It would be interesting to see how tobacco sales are affected by such bans. That could confirm that people are in fact smoking less. Hardly, I have not bought retail smokes in two years, mine come from various indian reservations. Declan ---
**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\ **Post date:** [April 15, 2010, 12:23pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/27 "2010-04-15T12:23:00Z")
> [@Declan](#): > > Hardly, I have not bought retail smokes in two years, mine come from various indian reservations. A quick search shows me that contraband tobacco sales constitute ~25% of Canadian tobacco sales. I didn’t realize it was so large. That said, unless a smoking ban affects the ratio of legal to illegal\* tobacco sales, a decrease in smoking will be reflected by a decrease in “retail smokes”. \*I’m not actually sure of the legality. ---
**Author:** ![Ludovic](https://avatars.discourse-cdn.com/v4/letter/l/7ab992/32.png) [@Ludovic](https://boards.straightdope.com/u/Ludovic)\ **Post date:** [April 15, 2010, 12:30pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/28 "2010-04-15T12:30:28Z")
Maybe if it’s true that there was a spate of restaurant and bar closures, that the ban caused people to drink less and eat healthier 🙂 ---
**Author:** ![Bridget\_Burke](https://avatars.discourse-cdn.com/v4/letter/b/7cd45c/32.png) [@Bridget\_Burke](https://boards.straightdope.com/u/Bridget_Burke)\ **Post date:** [April 15, 2010, 1:22pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/29 "2010-04-15T13:22:35Z")
> [@jsgoddess](#): > > Heart disease is extremely expensive. A coworker’s dad died very slowly of emphysema and that was incredibly expensive, too. Stroke is expensive. > > I don’t think your statement is correct. Smoking definitely causes emphysema & contributes to cardiac problems, which can have long & tortuous courses. Then there’s head & neck cancer–some people survive but they often don’t go out much anymore. However, lung cancer is the disease most connected to smoking. A doctor I know is fond of recounting what he was told the day they began studying that disease–that it isn’t that bad “for society”: 1. Lung cancer tends to strike after the most productive years. 2. The course of the illness is usually short. 3. Then, there are all those pensions that don’t need to be paid. (This was in Sweden.) I’ve already lost some friends who probably would have had many more good years without the damn ciggies… ---
**Author:** ![emacknight](https://avatars.discourse-cdn.com/v4/letter/e/3ec8ea/32.png) [@emacknight](https://boards.straightdope.com/u/emacknight)\ **Post date:** [April 15, 2010, 3:02pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/30 "2010-04-15T15:02:54Z")
> [@Declan](#): > > From the linked PDF, it tracks three area’s Toronto , Durham region, and Thunderbay. > > It does not give the political demarcation for Toronto, so I have no idea if they also used Missisaugua, Vaughn, Markam etc. Durham, I can’t think of any major population center thats above 100k. It probably has the same land mass as the GTA , but thats about it. > > T’bay is about 23 hours north of Toronto, close to the manitoba border. > > And, unless there is a section I did not read, that was the extent of their survey. > > What I would have expected was Vancouver/Victoria in BC, Edmonton/Calgary in Alberta, Saskatoon/? and so forth right across the country and yet they picked three disimilar locations. > > Declan Part of the problem the study faced was finding “control” cities without anti-smoking legislation. Second problem was that they would want to keep all the comparison cities in the same province: same medical system, same taxation, same governmental influences. To try and compare Toronto and Calgary would have opened up the world’s largest can of worms and quite literally people would have stopped reading at that point and started yammering about the differences between Toronto and Calgary. Trying to compare cities in different provinces would require controlling for changes in the medical system between provinces\*. Then controlling for different rates of taxation, provincial anti-smoking campaigns, education, funding for the medical system, and so on and so on. Most importantly the anti-smoking legislation in Ontario was done (or not done) by individual cities, not the province as a whole. With that said, it’s readily apparent to me that this team of rouge scientists need to get off their soap box and keep studying. Start looking at all cities that have had anti-smoking legislation implemented and show how their methodology compares. It needs to be done for every city in Canada. \*for dopers in the US, note that the provinces control their own health care, not the federal government woot for state’s rights. ---
**Author:** ![Cat\_Whisperer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cat_whisperer/32/4839_2.png) [@Cat\_Whisperer](https://boards.straightdope.com/u/Cat_Whisperer)\ **Post date:** [April 15, 2010, 4:35pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/31 "2010-04-15T16:35:53Z")
> [@emacknight](#): > > \ > To try and compare Toronto and Calgary would have opened up the world’s largest can of worms and quite literally people would have stopped reading at that point and started yammering about the differences between Toronto and Calgary. \ Must…resist…obvious…response. 😃 (“Rouge scientists?”) ---
**Author:** ![conway](https://avatars.discourse-cdn.com/v4/letter/c/ec9cab/32.png) [@conway](https://boards.straightdope.com/u/conway)\ **Post date:** [April 15, 2010, 5:04pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/32 "2010-04-15T17:04:58Z")
> [@RingsOfPylon](#): > > I haven’t seen the actual data yet, and the only thing online was this graph from one of the appendices, comparing the Toronto results with the control cities: [http://www.cmaj.ca/cgi/data/cmaj.091130/DC1/3](http://www.cmaj.ca/cgi/data/cmaj.091130/DC1/3) > > I get a very different read from this graph. > > The Tuscany study, which I believe came out this past winter (January?) concluded there was no statistically significant difference in AMI rates before and after a smoking ban was introduced, and the Tuscany study used both linear and non-linear trends to arrive at their conclusions. [There was a 1 percent increase in AMIs the year following the ban, but that percentage is so small that one cannot draw any conclusions from that. It’s just natural variance.] > > We’ve been finding these issues with the various analyses; in some places, rates of specific heart disease cases fall after a smoking ban is implemented. In other places they go up despite the implementation of a ban. Short term meta analysis have their weaknesses. Within any given population, rates will rise and fall from year to year. > > Then there’s the question of how much of the reduction in various heart disease is due to better/different diagnostic techniques over time. And, certainly, the increasing use of statins has had a dramatic impact as well. Just sayin’. 🙂 Better diagnostic techniques lead to an increase in cases, not a reduction. ---
**Author:** ![Maastricht](https://avatars.discourse-cdn.com/v4/letter/m/a88e57/32.png) [@Maastricht](https://boards.straightdope.com/u/Maastricht)\ **Post date:** [April 15, 2010, 5:33pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/33 "2010-04-15T17:33:26Z")
The [Wikipedia article on the effects of the smoking bans in the US and Europe](http://en.wikipedia.org/wiki/Smoking_ban#Effects_on_health) is quite extensive. ---
**Author:** ![kopek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kopek/32/337_2.png) [@kopek](https://boards.straightdope.com/u/kopek)\ **Post date:** [April 15, 2010, 6:00pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/34 "2010-04-15T18:00:49Z")
> [@emacknight](#): > > Okay, just so I don’t come running back too soon, exactly how many cities does this have to be replicated in before you’ll talk? 6 Our smoking ban in restaurants is fairly young but my doctor has already said its reduced my risk of another heart attack. I smoke just as much as always (and he knows that) but now I’m eating more at home or the cigar club and not the usual overly-rich-and-fatty restaurant meals I had come to love and enjoy while they slowly killed me. On the other hand, one of the restaurant owners I used to frequent had a major coronary after his business tanked as a result of the ban. So there could be two sides/causes and effects to the actual clinical results. ---
**Author:** ![kopek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kopek/32/337_2.png) [@kopek](https://boards.straightdope.com/u/kopek)\ **Post date:** [April 15, 2010, 6:19pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/35 "2010-04-15T18:19:08Z")
> [@Jackmannii](#): > > The positive health effects recorded after institution of public smoking bans are suggestive if not conclusive. > > The quality of that evidence is better, however than the anecdotal reports cited by anti-smoking ban advocates claiming that such bans have caused lots of bars/restaurants to shut down. What evidence we have on that score suggests that public smoking bans have had a neutral or mildly positive impact on business. [For example](http://www.cleveland.com/nation/index.ssf/2010/04/state_smoking_bans_appear_to_p.html): > > \*"When Ohio adopted its ban in 2006, “there was a lot of concern that [bar and restaurant owners] would lose business, but none of our members have said that the ban has impacted them negatively,” said Jarrod Claybaugh of the Ohio Restaurant Association. > > Instead, the smoking cessation has encouraged nonsmokers, once fearful of smoke’s effect on their health and dry-cleaning budgets, to enjoy nightlife and visit bars and restaurants more often, he said. > > Businesses in cities and states around the country – Michigan’s will become the 38th state ban – have noticed a similar effect."\* > > And I’ve seen similar data for bar patronage in Boston following institution of its smoking ban. > > Maybe Toronto was radically different :dubious:, but I’d have to see something better than anecdotes to demonstrate that. 1. If you are right about the economics, why aren’t casinos rushing to go non-smoking rather than looking to extending their smoking areas? 2. Have you or Mr Claybaugh looked at the impact along the PA/Ohio border where both states share bans but Ohio’s is a little more draconian in respect to bars? Our “smoking” bars in places like Sharon, Girard and Erie often have more Ohio plates than PA. However you rarely see PA plates across the Ohio border at their smoke-free joints. Don’t get me wrong; smoking is bad - m’kay? But if “antis” aren’t going to make it illegal (or at least admit that this is the goal they are working towards) then stop blowing their version of smoke up my ass with these stupid non-bans. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [April 15, 2010, 6:24pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/36 "2010-04-15T18:24:02Z")
> [@Declan](#): > > I was not upset by the study in itself, that was simply confusing too me. The question was posted to me as to why I thought that emacknight had made the city a poor place to be. Apparently all the creativity and joie de vivre have vanished along with the clouds of indoor cigarette smoke. :dubious: > [@](#): > > I’l leave aside the fact that the good folks who compiled the study are making as much a political statement as much as they are making medical statements, right now its neither here nor there. They’re making a public health statement. A focus on public health necessarily involves getting public officials, including lawmakers involved where necessary. The implication that “political” involvement means something more, is paranoid and foolish. > [@](#): > > I don’t read the other two papers so I cant speak for them, but for the last several days, the Toronto Sun has had major articles on smoking again, for no apparent reason Ooo, there must be some nasty subterranean plot going on to keep people healthy! > [@](#): > > It may be something to think about, that your “smoke free” enviroment may be coming up for a realignment of thought. There are still people, albeit an every-shrinking minority, who long for the good old days when they could puff away in indoor venues and think they can browbeat the great majority into letting them get away with it again. Studies of the type mentioned in the OP serve as excellent reminders of why we’ve instituted public smoking bans. ---
**Author:** ![kopek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kopek/32/337_2.png) [@kopek](https://boards.straightdope.com/u/kopek)\ **Post date:** [April 15, 2010, 6:34pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/37 "2010-04-15T18:34:48Z")
> [@Bridget\_Burke](#): > > (This was in Sweden.) I’ve already lost some friends who probably would have had many more good years without the damn ciggies… I could say the same thing you do about cigarettes about gay sex, sex in general, motorcycles, cars, jobs, Democrats, Republicans, fast food, prescribed drugs and suntanning. I can’t quite bring myself to pick one as the “evil above all evils” as you do. Personally I just came to terms with the fact that many of my friends (most tobacco free in tobacco free workplaces) will die way before what I consider “their time”. Tell me how to change _that_ fact and I’ll be impressed. ---
**Author:** ![kopek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kopek/32/337_2.png) [@kopek](https://boards.straightdope.com/u/kopek)\ **Post date:** [April 15, 2010, 6:41pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/38 "2010-04-15T18:41:25Z")
> [@Jackmannii](#): > > There are still people, albeit an every-shrinking minority, who long for the good old days when they could puff away in indoor venues and think they can browbeat the great majority into letting them get away with it again. > > Studies of the type mentioned in the OP serve as excellent reminders of why we’ve instituted public smoking bans. Close but no electronic cigar. What we long for is the day when a businessman had some control over his own future and property. Or when that future was at least controlled by his customers and local community. But to have it decided by people who will probably never cross his doorstep? Silly me, that just doesn’t sound quite like a really great idea. Why we’ve instituted the bans is because we can; and something in the average person just loves telling his/her neighbor what is and is not allowed. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [April 15, 2010, 8:26pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/39 "2010-04-15T20:26:04Z")
> [@kopek](#): > > What we long for is the day when a businessman had some control over his own future and property. I suggest a time machine to take you back to those thrilling days of yesteryear (to be on the safe side, better set the dial for pre-Teddy Roosevelt days, circa 1900 or earlier). You’d be able to run restaurants, slaughterhouses, coal mines, textile mills and all sorts of businesses with minimal to no concern for the health and well-being of customers and employees. ---
**Author:** ![Bridget\_Burke](https://avatars.discourse-cdn.com/v4/letter/b/7cd45c/32.png) [@Bridget\_Burke](https://boards.straightdope.com/u/Bridget_Burke)\ **Post date:** [April 15, 2010, 8:31pm UTC](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011/40 "2010-04-15T20:31:08Z")
> [@kopek](#): > > I could say the same thing you do about cigarettes about gay sex, sex in general, motorcycles, cars, jobs, Democrats, Republicans, fast food, prescribed drugs and suntanning. I can’t quite bring myself to pick one as the “evil above all evils” as you do. Personally I just came to terms with the fact that many of my friends (most tobacco free in tobacco free workplaces) will die way before what I consider “their time”. > > Tell me how to change _that_ fact and I’ll be impressed. When did I use the phrase “evil above all evils”? Personally, I’m glad that restaurants & bars in Houston are now smoke free–just because I find clearer air more pleasant. The good ones have no problem staying open. [Previous page](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011.md?page=1) [Next page](https://boards.straightdope.com/t/correlating-smoking-bans-with-hospitalization/536011.md?page=3)