"Going Smoke Free" – BMA booklet review

Going smoke-free 1 from the Tobacco Advisory Group of the Royal College of Physicians presents a well thought out and documented approach to the " medical case " for establishing smoke-free environments at home, work, and in public areas. It addresses the medical evidence and present a convincing argument in favor of smoke-free policy. The authors conclude from their information that enacting " legislation to make all workplaces and public spaces smoke-free " should be pursued as quickly as possible citing many medical benefits as well as economic spin-offs and public support. However, it is not medical concerns that directly stimulate passage of legislation but rather political concerns, which are informed by medical, as well as practical, social, economic and ethical issues. Therefore Going Smoke Free devotes the first four chapters specifically to the medical case for legislation supporting smoke-free environments. These address a comprehensive array of medical conditions that appear to be related in one manner or another to environmental tobacco smoke (ETS). The remaining chapters provide interesting information and compelling arguments in favor of smoke-free policies that support the political case for legislation and address many of the tobacco industry's tactics to negate the anti-smoking criticisms they have endured in the recent past. Going smoke free is a comprehensive primer that balances critical analyses of the evidence in a format that is concise and accessible. The discussions are well cited, and the lists of references alone will be resources to advocates of smoke-free policy. This publication from the Royal College of Physicians brings together substantial epidemiological research from several countries providing the evidence that overwhelmingly supports the institution of smoke-free policies. While many studies have shown that direct smoking induces a wide array of health problems, few other all-encompassing works are available particularly related to second hand smoke exposure. Environmental tobacco smoke exposure has been studied sufficiently over the last few years for links between ETS and a number of diseases to be evident. ETS increases by between 20 and 40 percent the risk of developing lung cancer, ischaemic heart disease, COPD, and stroke. Going s m o k e-f r e e applies to these data a published statistical model to estimate the number of deaths from the above four diseases that can be attributed to ETS exposure, and they estimate that almost 500 deaths per year can be attributed solely to ETS exposure in the workplace. …