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HEALTH POLICY AND ETHICS: Jill A. Jarvie and Ruth E. Malone Children's Secondhand Smoke Exposure in Private Homes and Cars: An Ethical Analysis Am J Public Health 2008; 98: 2140-2145 [Abstract] [Full text] [PDF]

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Smoking inside cars should be globally banned

Ediriweera Desapriya, Kate Turkotte, Sayed Subzwari, Ian Pike   (16 January 2009)

Smoking inside cars should be globally banned 16 January 2009
Ediriweera Desapriya, Research Associate Department of Pediatrics, Kate Turkotte, Sayed Subzwari, Ian Pike Send letter to journal: Re: Smoking inside cars should be globally banned edesap{at}cw.bc.ca Ediriweera Desapriya, et al.	I read with interest the article by Jarvie and Malone (2008)(1) and certainly agree that smoking inside cars should be banned completely. Tobacco smoking has been identified as the second leading risk factor for death from any cause worldwide.(2) A recent Surgeon General's report shows that more than 126 million people are exposed to secondhand smoke. There were 50,000 deaths per year caused by secondhand smoke in US alone.(3, 4) Therefore there can be little argument against the rights of non-smokers to be protected from the adverse effects of passive smoking by every possible means. Among the many health policies adopted to discourage smoking, perhaps the most strategically important and effective has been the attention given to the effects of passive smoking.(5, 6) Many countries have created laws to ban smoking in workplaces, restaurants, bars and public transport, however private motor vehicles remain a place of intense and consistent exposure for children and non-smoking adults, especially women. The internal environment of a car is a potential site for significant second hand smoke exposure. People in the majority of motorized countries and rapidly motorizing countries spend considerable time in cars. Extensive scientific literature shows that passive smoking in a confined space such as inside the car is particularly harmful.(7, 8) Further studies demonstrate that the concentration of toxins in a smoke-filled car is 23 times greater than a smoky bar.(7, 8) Tobacco smoke contains 4,000 known chemicals, 69 of which are known or probable carcinogens, and when produced in enclosed spaces both smokers and nonsmokers are exposed to the harmful effects of smoke to a greater extent.6 The only effective way to reduce tobacco smoke exposure in cars is to bring effective global legislation that completely bans smoking inside cars. Traditionally cars have been produced with ash trays and cigarette lighters to support smoking while driving. Heavy smokers may not be deterred by simply enacting legislation. The other common criticism of such legislation is the technical difficulty of its implementation. Government policies should act to influence car manufactures to produce future cars without these bad influences to drivers and our children. They could even go so far as to install smoke interlocks (similar to alcohol interlocks),(9) as standard built-in equipment to discourage smoking and driving. It is important to note that distraction is a leading cause of traffic crashes and that the traffic safety community should be involved in the research regarding smoking as it relates to safe driving practices. References: (1). Jarvie JA, Malone RE. Children's secondhand smoke exposure in private homes and cars: an ethical analysis. Am J Public Health. 2008;98(12):2140-5. (2). Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006;367:1747-1757. (3). US Department of Health and Human Services. (USDHHS) The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Washington, DC: US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006 (4). US Department of Health and Human Services. (USDHHS) Children and Secondhand Smoke Exposure: Excerpts From the Health Consequences of Involuntary Exposure to Tobacco Smoke-A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2007 (5). Bryan-Jones K, Chapman S. Political dynamics promoting the incremental regulation of secondhand smoke: a case study of New South Wales, Australia. BMC Public Health. 2006; 6:192-8 (6). Desapriya EB, Iwase N, Shimizu S. Political economy of tobacco control policy on public health in Japan. Nihon Arukoru Yakubutsu Igakkai Zasshi. 2003; 38(1):15-33. (7). Edwards R, Wilson N, Pierse N. Highly hazardous air quality associated with smoking in cars: New Zealand pilot study. N Z Med J. 2006; 119:U2294 (8). Rees VW, Connolly GN. Measuring air quality to protect children from secondhand smoke in cars. Am J Prev Med. 2006; 31:363–8 (9). Desapriya E, Shimizu S, Pike I, Subzwari S, Scime G. Impact of lowering the legal blood alcohol concentration limit to 0.03 on male, female and teenage drivers involved alcohol-related crashes in Japan. Int J Inj Contr Saf Promot. 2007; 14(3):181-7.