Smoking Ban Boosted Health of Bartenders, Study Reports

San Francisco bartenders showed dramatic improvements in lung health within two months after the January implementation of California’s indoor smoking ban, UC San Francisco researchers report today.

Bartenders were exposed to unusually high levels of secondhand smoke before the ban--about four to six times the level found in other workplaces.

Examining 53 bartenders before and after the ban was implemented, Dr. Mark D. Eisner and his colleagues at UC San Francisco found that 59% of those reporting respiratory problems, such as wheezing, shortness of breath and morning coughing, were symptom-free less than two months after the ban began.

Moreover, they report in today’s Journal of the American Medical Assn., 78% of those with eye, nose or throat irritation were also symptom-free.

“That’s a pretty big change over a short period of time,” Eisner said. Although the number of people studied is relatively small, the results are considered statistically significant.

“We’ve never had a study like this that tracked health changes following the creation of a smoke-free workplace,” said UC San Francisco epidemiologist Stanton A. Glantz, an anti-smoking activist who did not participate in the study.

“The results show that this law is really achieving its stated aim of protecting people who go into bars and who work in bars,” he said. “This will make it much more difficult for the tobacco industry to get the law repealed.”

Tobacco industry spokesmen contacted by The Times said they had not yet seen the study and could not comment on it.

Surprisingly, even among bartenders who smoked cigarettes, the reduced exposure to secondhand smoke led to improved respiratory symptoms and function, the researchers said.

“Even smokers are being made ill in a smoke-filled room,” Eisner said.

The health effects of secondhand smoke, often called environmental tobacco smoke or ETS, have long been controversial. But the consensus now is that long-term exposure causes lung cancer and heart disease. Exposure to secondhand smoke is considered the third leading cause of preventable deaths, trailing only active smoking and alcohol consumption.

But the short-term health effects have been much less thoroughly studied, especially in adults. The imminent onset of the indoor smoking ban at the beginning of this year provided a unique opportunity to explore such effects, Eisner said.

The team randomly selected more than 100 free-standing bars and taverns--those not located in restaurants--in the San Francisco area, but identified only 30 that would cooperate in the study. Subsequent analysis showed that these 30 were representative of the group as a whole, the researchers said.

The researchers interviewed 53 bartenders at the 30 establishments before the end of 1997, questioning them about respiratory symptoms and measuring lung function with a device called a spirometer.

Thirty-nine of the bartenders (74%) reported respiratory symptoms and 41 (77%) reported eye, nose and throat irritation.

The team then returned in February, asking the same questions and again measuring lung function. The bartenders’ median exposure to smoke had declined from 28 hours per week to two hours.

Of those who reported respiratory symptoms initially, 23 no longer had such symptoms. And of those who had initially reported sensory irritations, 32 were symptom-free. The subjects’ lung functions also had improved significantly.

“This is a very important study because it shows that reduction of exposure to secondhand smoke can result in immediate benefits in adults’ respiratory symptoms,” said Dr. Gail Weinmann of the National Heart, Lung and Blood Institute.

There were not a huge number of people covered in the study, she cautioned. “But to get statistically significant results from only 53, I think, is pretty impressive.”

“This is the first study that shows that when you put [smoking] restrictions in place, it has a measurable health benefit,” Glantz said.

“This will increase the pressure that health groups will be able to mount against cities, like Los Angeles, that have not been actively enforcing the ban,” he said.

In an editorial in the same issue of the journal, Dr. Ronald M. Davis of the Henry Ford Health System in Detroit called for further smoking bans across the country.

“Because of the risk of passive smoking, nonsmokers’ exposure to secondhand smoke needs to be eliminated,” he wrote.

“That goal can be accomplished through two different approaches: prohibiting smoking indoors or limiting smoking to rooms that have been specially designed to prevent smoke from escaping to other areas of the building. The former approach is the preferred option, as it ensures maximum protection of nonsmokers, is easier and less expensive to implement, and avoids exposing smokers to the added risk of concentrated ETS in designated smoking areas.”