LETTERS TO THE EDITOR: SMOKING CAUSES GREAT HARM, AND LAWS CONCERNING IT SHOULD BE ENFORCED

To the Editor:

As nurses, we witness the detrimental effects of smoking each time we work. Recently, research has determined that smoking is the number one contributory cause of death in our society. More deaths are related to smoking than to deaths caused by drugs, guns and accidents combined. In Missouri alone, 26 percent of our population smokes, and one in every five deaths is directly linked to smoking. In 1990, this represented 10,000 deaths and $1.3 billion in costs to our state. These figures only take into account the deaths caused directly from smoking, including cardiovascular disease, cancer and emphysema. The numbers would be staggering if all deaths in which smoking was the underlying cause were included.

In addition to the affects of smoking on the smoker, there is growing concern for the affects of passive, or "second-hand" smoke one can be exposed to by being in the presence of a smoker. Second-hand smoke is a mixture of more than 4,000 substances, 40 of which are known to cause cancer. It has been classified by the U.S. Environmental Protection Agency (EPA) as a known cause of lung cancer, and estimated to cause approximately 3,000 lung cancer deaths in nonsmokers each year (60 per year for Missourians). Additionally, it is estimated to be responsible for between 130,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age annually, causing up to 15,000 hospitalizations per year, and may cause thousands of non-asthmatic children to develop asthma annually. Additionally, exposure to secondhand smoke leads to irritation of the eye, nose and throat, irritation of the lungs, and cardiovascular symptoms.

In an effort to promote health and improve the quality as well as quantity of life, the State of Missouri passed the Clean Indoor Air Law, which took effect in August of 1992. Healthcare Reform has brought our nation's health status to the forefront of discussion, and the nurses of District 8 of the Missouri Nurses' Association are committed to promoting and advocating legislation and practices that will improve the health of our Missouri residents. For this reason, we want to share the following excerpts from the law:

-- The law states that a person shall not smoke in a public place or public meeting except in a designated smoking area. If a business, agency or meeting falls under the definition of a public place or public meeting, smoking is prohibited.

-- It is not mandatory to establish a smoking area -- the entire business/agency may be non-smoking at the owner's discretion. However, if they choose to provide a smoking area, proprietors of businesses or agencies may not have more than 30 percent of their area as a smoking area. Most importantly, if a smoking area is established, seating arrangements, available ventilation systems, and physical barriers are to be used to isolate the smoking areas from nonsmokers.

-- Proprietors must prominently post non-smoking or smoking signs. Bars, taverns, and restaurants with 50 or less seats are exempted from the law, but if they choose not to have smoking areas, very visible signs must be posted that say, "Non-smoking areas are unavailable." Enclosed arenas or stadiums with seating capacities of more than 15,000 are also exempted from the law.

-- Any proprietor who permits smoking in a non-smoking area or does not provide non-smoking areas that meet the above qualifications is subject to fines and penalties. Complaints against violators can be made to local law enforcement agencies.

-- Pamphlets reviewing this information are available by calling 314-876-3247 or writing to: Clean Indoor Air, Missouri Department of Health, 201 Business Loop 70 West, Columbia, MO 65203

We appreciate the local businesses and proprietors who have designated their businesses as nonsmoking, and the efforts the State Of Missouri has put forth in recognizing the impact that smoking has on the health of our residents. We hope this letter will increase your awareness, as the nurses of District 8 join with you to chart a course for a healthy nation.

Cheryl A. Mothes, R.N., M.N.

District 8, Missouri Nurses' Association Board Member

Cape Girardeau

Sharon Stinson, M.S.A, B.S.N., R.N., C.N.A

District 8, Missouri Nurses' Association President

Jackson