A drag from a cigarette now and then can't hurt, right?

Wrong, according to a new study that finds even low levels of smoke exposure can cause irreparable damage to cells essential to breathing.

The damage occurred among "casual" smokers and even after exposure to secondhand smoke. The initial damage, while not usually severe, can be cumulative and prolonged exposure to tobacco smoke could lead to chronic obstructive pulmonary disease (COPD) and even lung cancer, the researchers reported.

"It has been known for a long time that secondhand smoke or smoking occasionally can be risky for your health," said study author Dr. Ronald Crystal, chief of the division of pulmonary and critical care medicine at New York-Presbyterian Hospital/Weill Cornell, in New York City.

Just how much a little exposure might damage airway cells hasn't been clear, however.

"We found that if we could detect nicotine in the urine we could also detect changes in the genes in the cells lining the airways," said Crystal, who is also chair of the department of genetic medicine at Weill Cornell Medical College.

The bottom line: "There is no level of cigarette smoking or exposure to cigarette smoke that does not make the cells in your lungs sick," he said. "If you are an occasional smoker you are still at risk. Don't think that smoking one or two cigarettes a week means you are home free."

As for secondhand smoke, "if you are working in a place where people smoke, either get them to stop or go get another job," Crystal advised. "If you have somebody at home who smokes, send them outside to smoke. Don't be exposed to secondhand smoke."

The report is published in the Aug. 20 issue of American Journal of Respiratory and Critical Care Medicine.

For the study, Crystal's team recruited 121 people who were nonsmokers, active smokers or low-exposure smokers. To determine who belonged in which group, all participants had their urine tested for levels of nicotine.

Crystal's group next scanned each person's entire genome to determine whether genes governing airway cells were turned on or off.

They found that there was no level of nicotine or cotinine, no matter how small, that did not produce genetic abnormalities.

"These cells are like canaries in the mine, they're crying out for help -- this gene is being turned on, this gene is being turned off," Crystal said. "This now gives us clues to what are the earliest events in terms of what makes our cells go wrong and is the start of these lung diseases, like COPD and lung cancer."

Knowing which genes are damaged could provide targets for new drugs that could protect the lungs, Crystal said.

Dr. Norman H. Edelman, chief medical officer at the American Lung Association and a professor of preventive medicine, internal medicine and physiology & biophysics at Stony Brook University in New York, applauded the study. "I like this one because it cleverly uses molecular biology to answer a very important question, one that I get asked very often... 'Is there a threshold below which inhalation of tobacco smoke is safe?'" he said. The question is usually asked as, " Is it safe to smoke a few cigarettes a week?" or, "Is it safe to hang out with smoking friends a few times a week?" Edelman added.

"Within the limits of their detection methods, the answer is 'no,'" Edelman said. "Whether the changes they see in folks with minor exposure will eventually lead to disease is unclear, but it is getting more and more clear to me that there really is no totally safe level of tobacco exposure."

HANNIBAL, Mo. -- On a 4-3 vote, the Hannibal City Council upheld the recommendation of the Parks and Recreation Board to make the Admiral Coontz Armory a smoke-free environment.

Council members Jason Janes, Kevin Knickerbocker and Jeff Lyng voted against the measure, with Mayor Roy Hark, Mayor Pro Tem Jim Behymer, Louis Barta and Barry Louderman voting for it.  [CORRECTION: Lyng voted for the measure and Louderman voted against it]

"We're very pleased," said Chris Atkinson, director of the Parks and Recreation Department. "Now we can begin work on making the building smoke free as of July 1. We can be a leader in the community (on a move to make more of Hannibal's buildings smoke free)."

The vote removes the provision that entities that rent the armory have the option to allow smoking. Smoking was already banned at city-sponsored events there. The ban goes into effect at the beginning of the next fiscal year and does not affect groups that had already contracted to rent the armory through this year.

But smoking will not be allowed at events next year, including several popular activities sponsored by the Jaycees, such as the Wing Ding and Chili Cook-off.

The measure sparked a lengthy debate among council members.

"To me, it wasn't a vote about smoking," said Knickerbocker, a member of the Jaycees. "I'm a non-smoker and I'll probably enjoy the events more now. But I don't believe in government regulation of personal choices."

Atkinson reassured the council that if events are not rescheduled next year, the Parks and Recreation Department will not lose money. The armory breaks even, billing for what is spent in overtime employee costs, he said. On the other hand, he said, in the years that he's been in Hannibal, he's always heard complaints about second-hand smoke in the place people go to get exercise.

The armory hosts walkers and athletic teams sponsored by the Parks and Recreation Department. It's their only indoor facility, and the only building large enough to host citywide events.

Hark said he waited until he heard what council members had to say before deciding which way he would vote. In the end, his decision broke a tie.

"It looked like to me it needs to be smoke-free," he said. "I feel like if you want to go down there and you don't smoke (you won't stay). People who are down there and smoke can step outside."

Dana Blase with the American Cancer Society called the vote a "barometer." She predicted that the Jaycees would pleasantly surprised at how the smoking ban affects their attendance.

The Breathe Easy Hannibal coalition supported the Run or Ride for the Ribbon Event at the James E. Cary Cancer Center and also was present to support the American Heart Association 5k/Run/Walk at Hannibal LaGrange College, in Hannibal on October 24.  Members gathered support for clean indoor air and gave out over 300 T-shirts with educational messaging on them.

Breathe Easy Hannibal is working hard to spread the word about the dangers of secondhand smoke and the benefits to smoke-free workplaces.  Our ads are popping up all over our fair city - take a look at the one below in Hannibal Magazine.

While the premise for smoke-free laws is protecting public health, that message is far too often lost in the debate over economic impact.  Yesterday, officials from Indiana University released a report illustrating that the fear of business loss is unfounded.

New Report from Indiana University:
Smoke-Free Workplace Laws Save Lives and Money Without Hurting Business
March 24, 2009

INDIANAPOLIS--In the debate over smoke-free workplace laws, both sides brandish research about the health and economic impact of such measures. The studies often contradict one another. That makes it difficult for legislators voting on the issue and reporters covering it to know what to believe.
 
To help alleviate the confusion, the Indiana University Center for Health Policy conducted a comprehensive review of existing research about the health and economic impact of smoke-free workplace laws. It released the findings of that review today.
 
"There's a lot of information out there about whether smoke-free laws hurt business. Some of that information is intentionally misleading," said lead author Eric Wright, Ph.D., director of the Indiana University Center for Health Policy and associate dean of the IU School of Public and Environmental Affairs at IUPUI. "As a neutral, university-based research organization, we were able to sort through the conflicting research and draw bottom-line conclusions that should help legislators at the state and local level in their consideration of smokefree workplace laws."   
 
"What's more," said Wright, "Studies based on unverified data or published in journals that are not peer-reviewed are not credible. Our review shows that when biased, unqualified studies are left out, what remains is clear: Smoke-free workplaces are good for business and good for workers."
 
Key findings of the research analysis:

While secondhand smoke has been definitively linked to many kinds of health problems, the most significant health consequence related to secondhand smoke is death. Some 50,000 nonsmokers die annually in the United States due to secondhand smoke-related illnesses. In 2007, 1194 Hoosiers died from diseases definitively tied to secondhand smoke.

Servers, bartenders, dealers and other workers in restaurants, bars and casinos may regularly be exposed to high levels of secondhand smoke. The levels of secondhand smoke in bars are 240 to1850 percent higher than those in other workplace smoking environments, such as offices, factories, warehouses, hotels and other service-oriented places. Casinos have secondhand smoke levels 300 to 600 percent higher, while restaurant smoke levels are 160 to 200 percent higher than those in other workplace smoking environments.

Smoke-free workplace laws do not have a negative economic impact on restaurants and bars. Though business owners fear that smokers will stay away from restaurants and bars that ban smoking, the data show that the hospitality industry has not lost revenue because of smoke-free workplace laws. The IU Center for Health Policy's analysis found that 47 of the 49 studies on the economic impact to the hospitality industry concluded no adverse affect.

Smoke-free workplace laws do not hurt casino business. While fewer objective peer-reviewed studies have been conducted on this issue, available research shows no negative revenue impact on total gambling revenue or the average revenue per machine.

The public supports smoke-free casinos. Surveys show that 70 percent of New Jersey residents and 91 percent of California residents prefer smoke-free casinos. 

Smoke-free workplaces save employers money. Employers who protect their workers from secondhand smoke see savings as a result of improved worker health. Workers are more productive and less likely to be absent, and their employers also enjoy reduced health insurance costs and facility maintenance costs.

Secondhand smoke exposure costs Indiana money. Indiana spends $390 million dollars per year on healthcare costs related to secondhand smoke in the workplace.

Hoosiers support smoke-free workplaces. Three out of four Hoosiers support smoke-free workplace laws.

Click here for the full report

Update: Smoke-Free Columbia, Missouri

In January 2007, Columbia, MO became 100% smoke-free in its bars and restaurants. 

More than 2 years later, sales tax data shows that the bar and restaurant industry has increased and there are now more bars and restaurants post-ordinance compared to pre-ordinance.

Most importantly, the health of bar and restaurant employees and patrons is fully protected from the hazards of secondhand smoke.  Congrats Columbia!

USA Today
 Study: Smoking ban leads to major drop in heart attacks

ATLANTA (AP) -- A smoking ban in one Colorado city led to a dramatic drop in heart attack hospitalizations within three years, a sign of just how serious a health threat secondhand smoke is, government researchers said Wednesday. The study, the longest-running of its kind, showed the rate of hospitalized cases dropped 41% in the three years after the ban of workplace smoking in Pueblo, Colo., took effect. There was no such drop in two neighboring areas, and researchers believe it's a clear sign the ban was responsible.
The study suggests that secondhand smoke may be a terrible and under-recognized cause of heart attack deaths in this country, said one of its authors, Terry Pechacek of the U.S. Centers for Disease Control and Prevention.

"This study is very dramatic," said Dr. Michael Thun, a researcher with the American Cancer Society.

"This is now the ninth study, so it is clear that smoke-free laws are one of the most effective and cost-effective to reduce heart attacks," said Thun, who was not involved in the CDC study released Thursday.

Smoking bans are designed not only to cut smoking rates but also to reduce secondhand tobacco smoke. It is a widely recognized cause of lung cancer, but its effect on heart disease can be more immediate. It not only damages the lining of blood vessels, but also increases the kind of blood clotting that leads to heart attacks. Reducing exposure to smoke can quickly cut the risk of clotting, some experts said.

"You remove the final one or two links in the chain" of events leading to a heart attack, Thun said.

Secondhand smoke causes an estimated 46,000 heart disease deaths and about 3,000 lung cancer deaths among nonsmokers each year, according to statistics cited by the CDC.

In the new study, researchers reviewed hospital admissions for heart attacks in Pueblo. Patients were classified by ZIP codes. They then looked at the same data for two nearby areas that did not have bans -- the area of Pueblo County outside the city and for El Paso County.

In Pueblo, the rate of heart attacks dropped from 257 per 100,000 people before the ban to 152 per 100,000 in the three years afterward. There were no significant changes in the two other areas.

"The need for protection from secondhand smoke in all workplaces and public places has never been clearer," said Matthew Myers of the Campaign for Tobacco-Free Kids, in a prepared statement. He is president of the Washington, D.C.-based advocacy organization.

But the study had limitations: It assumed declines in the amount of secondhand smoke in Pueblo buildings after the ban, but did not try to measure that. The researchers also did not sort out which heart attack patients were smokers and which were not, so it's unclear how much of the decline can be attributed to reduced secondhand smoke.

Copyright 2009 The Associated Press. All rights reserved.

On Saturday, December 6th, Breathe Easy Hannibal, American Cancer Society, Hannibal La Grange College and the Star Theatre hosted Winter Wonderland. 

Over 800 people attended (see picture below of people lined up around the block to see Santa), enjoyed cookies and milk, got pictures with Santa and signed up to be a supporter of smoke-free indoor air in Hannibal! Special thanks to those volunteers who helped out, the Hannibal Children's Choir and area Smokebuster students. 

Remember to enjoy the GIFT of clean indoor air at Hannibal area smoke-free venues.  Happy Holidays!

We had a great time handing out goodies at last Saturday's Healthy Halloween Parade in Hannibal with our disco-themed float, "Stayin' Alive". 

Be safe & smoke-free this Halloween!

Smoke-free is now the norm, not the exception.

The Americans for Nonsmokers Rights have a great map and list that was just updated.

Click here for the list of smoke-free policies around the country.

Click here for the map.

While some restaurants offer "no smoking" sections, it doesn't take away from the effect of the smoke that travels from the other section. All it takes is for a person to light up maybe a few feet away to add nicotine to everyone else's diet.

With Hannibal public schools now joining Hannibal Regional Hospital and the Hannibal Clinic in touting a smoke-free campus, perhaps other surrounding businesses can follow their example.

Approximately 19 restaurants in Hannibal already do, according to the Breathe Easy Hannibal web site. It would only seem natural for others to follow suit, but only time will tell.

Marion County Health Department Health Educator Jean McBride is making a strong effort to educate others about the health risks of smoking and the benefits of having a smoke-free city through the Breathe Easy Hannibal program.

According to the organization's Web site, Springfield, Ill. enacted a 100 percent smoke-free policy in September 2006. In the first two quarters since the ban, city tax revenue from restaurants grew twice as fast as before the ban.

Numerous studies from all over the country, including the Centers for Disease Control, show that banning smoking can lead to increased tax revenues. At the very least, removing the smoke doesn't hurt business. That means more people are dining out and may also be spending more per meal when there isn't smoking.

Revenues and sales aside, a person could pick out of a hat all the associated health risks of smoking. In fact, it wouldn't be a surprise if tobacco companies did just that when they have to pick one to put on a package.

When a person orders the 20 ounce steak, it's better for the business and customers when additional heart risk isn't offered with the menu. Hannibal should consider a smoke-free ordinance this year.

Hannibal school district seeks public's help

to create tobacco-free campuses

By DANNY HENLEY, Hannibal Courier-Post

August 21, 2008

With the first day of a school year frequently comes new guidelines. In Hannibal, where the 2008-09 school year begins today, one of the biggest adjustments will have to be made by the public, which is being asked to refrain from using tobacco products on any district property.
"It's not really a policy change. We have always had a policy of being a tobacco-free campus. It's been that way for some time," said Dana Ruhl, business manager of the Hannibal public school district. "However, it has been more focused on students and not necessarily on adults or the community at-large. We feel it's time for all of us as adults to be good role models. We have made that decision, with the blessing of the board of education, to start posting signage. They're requesting the public cooperate with us and be that good role model and let our kids know that we would hope that they would not begin the habit of smoking or using other tobacco products."
The "no smoking" request applies to all district property.
"That property would be our campuses, it would be our buses wherever those buses might be, it would be in other vehicles that are representing the school district, at functions that the school district actually sponsors, so property premises go with all of those areas and our students and staff. We'd like the community to know that all of those times when the school is being represented we are looking for that tobacco-free policy to be in place," said Ruhl.
Reminder signs are going up around the district.
"When the public comes to our games or other activities at Porter Stadium they will see signage as they approach the ticket booth. They will see signage attached to the west end of the stadium itself that is indicating we are a tobacco-free campus and it will say 'thank you for not smoking or using other tobacco products.' Hopefully people will understand that we are trying to be role models to our students and hopefully they will not get into that habit, or at least discourage that habit," said Ruhl.
While a special emphasis is being placed on the public to be tobacco free on district property, students and staff are still expected to adhere to the policy.
"Students do receive penalties for smoking or using other tobacco products," said Ruhl. "If an adult employee of the district violates that (policy), we will be talking with that person and working with them to no longer do that. We would hope that would be the end of it. If it was not we would have to have a further conversation. I suppose it would be appropriate to say that that could get into employment concerns."
Members of the public who "light up" will likely be reminded of the district's policy.
"At a game, if I for instance would see someone smoking, I would just simply walk up to them and ask them to please respect the signage that's up and to please put the cigarette out for the sake of all those watching and we would expect them to do so," said Ruhl.
District officials are hopeful the public will understand the purpose behind the added emphasis on being tobacco free and will cooperate.
"In the environment today where so many people have stopped smoking I think that it will not be as hard of a transition to make as it may have been years ago," said Ruhl. "I do think some people will have a tough time but again we're going to ask them to respect that. Hopefully they'll understand why and will agree with it."