Respiratory symptoms in bar staff improve after smoking ban
With Wales set to go ‘smoke free' on 1 April, and England this summer, a new study provides a timely analysis of the benefits of Scotland's public smoking ban on the health of workers traditionally exposed to high levels of second-hand smoke.
A total of 105 bar staff in Dundee and Perth were recruited and 77 finished the study. Smokers were excluded and a sub-group of 15 individuals with asthma, of whom 12 finished the study, was identified and subjected to closer scrutiny.
The participants were assessed before the ban came into force in March 2006, and then subsequently at one and two months.
Some fairly sophisticated monitoring was used. This included symptom and quality of life scores, spirometry measurements, serum cotinine levels, inflammatory markers and exhaled nitric oxide levels. In addition, the bar staff with asthma had before and after visits to a respiratory laboratory.
Drawbacks to the study include the fact that the study population were self-selected and it was impossible to ‘blind' the population.
However, it came as no surprise to find that almost every indicator improved after the smoking ban came into effect. Sensory symptoms improved within one month, with respiratory symptoms improving a little later. Individuals with asthma showed the greatest improvement, with very significant score changes in the quality of life questionnaire and in measurements of FEV1 and other parameters of lung function.
Although the study was terminated at two months, there is no reason to think that these benefits would not be sustained. The debate about smoking in public places appears to have been won, but if there is any rearguard action by the smoking lobby later this year, studies like this will offer ammunition in support of such bans.
Menzies D, Nair A, Williamson PA, et al. Respiratory symptoms, pulmonary function, and markers of inflammation among bar workers before and after a legislative ban on smoking in public places. JAMA 2006; 296: 1742-8Reviewer
Dr Peter Saul
GP, Wrexham and hospital practitioner in paediatrics (asthma and allergy)