Passive Smoking (and Bar Workers)--what firm conclusions can we draw?

[Jervoise]

A point raised in an IMHO thread discussing smoking bans in bars raised this question in my mind. I’ve always accepted that passive smoking is harmful, but it appears that the link between passive smoke and tobacco-related disease does not enjoy universal acceptance. From the linked thread:

Jervoise: You’re missing the major argument: that this is a occupational safety measure designed to protect the health of bar workers.

Dogface: Of course, that there is no non-fraudulent science to back it up makes it fairly shaky.

Jervoise: There’s no non-fraudulent science to back up (i) that bar workers are more at risk from smoking-related illnesses than the general population; or (ii) that passive smoking is damaging to one’s health?

Dogface:

Both. The one big “study” that all the antismokers keep citing is massive scientific malfeasance. Here is what they did:

The EPA announced their “results” before they had finished.
The EPA pre-excluded data that did not not agree witht their predetermined results.
EVEN if one only uses the EPA’s data, if one analyses it according to ethical scientific standards, one cannot get a significant correlation between ETS and health conditions. Therefore, one must VIOLATE scientific standards to get a significant correlation. In addition, the EPA classified ETS as a “class A carcinogen” even though risk was 10% or less of substances that the EPA has REFUSED to so classify. Politics have been permitted to violate science.

The World Health Organization released a larger, more comprehensive, HONEST, and ethically analysed study that contradicts the EPA’s findings.

So what does the current scientific literature tell us? I haven’t heard of the EPA study referred to by Dogface (and I’m unwilling to blindly accept the conclusions as quoted), but I am aware of another controversy surrounding a 2003 study by Enstrom and Kabat. This study, published in the British Medical Journal, looked at the effect of passive smoking (“environmental tobacco smoke”) on the non-smoking spouses of smokers. It has been interpreted in some quarters as evidence that the link between passive smoking and smoking-related diseases in non-smokers has been overstated.

An editorial on the study may be found here. (The Enstrom and Kabat study is linked to at #3 of the editor’s references.) The editorial accept that the link between passive smoking and adverse health effects is controversial–a tone that lead to some fairly furious responses.

Finally, this page published earlier this month by Britain’s National Health Service walks us through the Enstrom & Kabat kerfuffle and eventually questions the conclusiveness of that study.

I’m sure this topic has been raised before, but it appears debate still continues. So what is the straight dope:

(i) Is passive smoking harmful (and if so, to what extent)?

and

(ii) Do bar workers demonstrate a higher incidence of tobacco-related diseases that can be attributed to their work environment rather than confounding factors?

[Jervoise]

Bumpity.

[Shayna]

The Master himself tackled this one, “Does second-hand smoke really cause cancer?” and “Followup: Does second-hand smoke cause heart disease?” in which he concludes that “I don’t claim ETS doesn’t cause serious health problems, just that it hasn’t been proven yet.” Seems hard to believe, but there you have it.