Philadelphia City Council Hearing, March 7, 2005
"Honorable City Council members, my name is Dr. Marla Gold and I serve as Dean of the Drexel University School of Public Health. I am a physician, a former City Assistant Health Commissioner, and a member of the Philadelphia Board of Health. I am also a resident of Philadelphia and the mother of a 13 year old boy with asthma. I am here today wearing all these hats; an expert in public health with knowledge of the potential complexity involved with enactment of legislation; and a citizen who deeply loves this City for all that it has to offer.
"Over the years, I have worked on many, often controversial, public health issues in Philadelphia. Issues that required special public hearings and prolonged task force review. Throughout my work in the public health arena, I have been guided by two main points: first, the mission of public health is to ensure conditions in which people, entire communities, can be healthy, and second; critical decisions affecting the public’s health should be informed by solid data. In regard to both these points, the legislation being considered today, the Clean Indoor Air Worker Protection Law, is a slam dunk.
"You have heard many data-laden testimonies today and been provided with countless fact sheets. In approaching the question as to whether to support smoke-free legislation, the first major area must be a thorough review that addresses the affects of secondhand smoke. This information is readily available through scientific studies in peer-reviewed literature. Secondhand smoke, also known as environmental tobacco smoke, is defined as “a mixture of the smoke given off by the burning end of a cigarette, pipe or cigar and the smoke exhaled from the lungs of smokers. It is involuntarily inhaled by nonsmokers, lingers in the air hours after cigarettes have been extinguished and can cause or exacerbates a wide range of adverse health effects, including cancer, respiratory infections, and asthma.” [1] You already have the facts: all available, reputable data strongly indicate that exposure to secondhand smoke is a significant cause of disease and death. Data further indicate that employees and patrons of establishments where secondhand smoke is present, often have significant biological markers indicating exposure to that smoke. Further, elegant data from Montana and San Francisco reveal significant decreases in respiratory symptoms, including cough and sputum production following enactment of smoke-free legislation. My submitted written testimony lists many facts about the effects of secondhand smoke. The bottom line is that secondhand smoke is a classified carcinogen that causes disease, exacerbates a number of conditions including cardiac disease and asthma and is the third leading preventable cause of death in the U.S. killing 38,000 to 65,000 nonsmokers every year.
"Additional facts from the American Lung Association:
• Secondhand smoke causes lung cancer, other types of cancer, and heart disease in nonsmokers.
• Exposure to secondhand smoke can cause children to develop asthma, bronchitis, pneumonia, other respiratory infections, and ear infections. Exposure to secondhand smoke also increase the risk that infants will die of Sudden Infant Death Syndrome (SIDS).
• Food service workers appear to be 50% more likely than the general population to develop lung cancer, largely because many of them are exposed to secondhand smoke on the job.
• Besides causing disease, secondhand smoke also exacerbates a number of pre-existing health conditions, including some allergies, asthma, bronchitis, other respiratory ailments, and heart disease.
• The Environmental Protection Agency has classified environmental tobacco smoke as a "Group A" Carcinogen – a substance known to cause cancer in humans. (U.S. Environmental Protection Agency, Respiratory Health Effects of Involuntary Smoking, 1993.)
• Waiters and waitresses have almost twice the risk of lung cancer due to involuntary exposure to environmental tobacco smoke (ETS). (Siegel, Michael, "Involuntary Smoking in the Restaurant Workplace," Journal of the American Medical Association, July 28, 1993; 270: 490-493.)
• A study of hospital admissions for acute myocardial infarction in Helena, Montana before, during, and after a local law eliminating smoking in workplaces and public places was in effect, has determined that laws to enforce smokefree workplaces and public places may be associated with a reduction in morbidity from heart disease. [2]
"So does second hand smoke cause disease and death? Yes it does. Do persons working or visiting public places in our City have significant exposure to that smoke? Yes they do.
"The next area for consideration is whether requiring smoke-free environments in all public places as named in the proposed legislation will exert a negative impact on the revenue base in our wonderful City. As you heard from experts throughout the day, particularly from our neighbors in New York City, experience to date indicates that clean air does not negatively impact on the bar, nor restaurant industry. No negative impact, and in fact, a recent review of the New York experience reveals an increase in the amount of money spent in bars and restaurants, an increase in the total number of such establishments and a concomitant increase in employment. These facts appear to indicate that clean air has appealed greatly to New York restaurant and bar patrons and the industry continues to thrive.
"What else needs to be considered? Certainly it is important to know if such legislation has the support of Philadelphians. Various polls indicate that a majority of people who live here, want to breathe clean air here. What about the impact on personal freedom? I have heard and read the debate concerning whether mandating a smoke-free environment is akin to taking away personal liberty. Recall that in public health, we work to ensure conditions in which people can be healthy. Secondhand smoke is demonstrably dangerous to the public’s health and without solid, smoke-free legislation, countless persons will remain at risk of acute and chronic illness. Smoke-free public spaces are supported by the American Lung Association, the American Cancer Association, the Environmental Protection Agency and the Centers for Disease Control, to name a few.
"Healthy People 2010, the nation’s blueprint for the public’s health, contains an objective “to establish laws on smoke-free indoor air that prohibit smoking in public places and worksites.” Under that objective, it is noted that “policy, educational, and clinical interventions can reduce secondhand smoke exposure among the population.” This is about protecting the public’s health and doing so without in any way jeopardizing the bar and restaurant industry so vital to our City. Through policy, you have the opportunity to protect the public’s health, and make our wonderful City, a healthier City. Thank you."
1. California Environmental Protection Agency. Health Effects of Exposure to Environmental Tobacco Smoke. September 1997.
2. Sargent, Richard P.; Shepard, Robert M.; Glantz, Stanton A., "Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study," British Medical Journal, 328: 977-980, April 24, 2004.