Effects of separately ventilated smoking lounges on the health of smokers: is this an appropriate public health policy?

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Correspondence to : Dr Michael Siegel, Office on Smoking and Health, Centers for Disease Control and Prevention, Mailstop K50, 4770 Buford Highway, NE, Atlanta, Georgia 30341, USA Abstract Background There is some evidence that smokers may face an increased risk of lung cancer from environmental tobacco smoke (ETS) exposure. We con sidered the possibility that policies ex posing smokers to high ETS levels in smoking lounges may have an adverse effect on the health of smokers. Objective To compare the potential im pact of a separately ventilated smoking lounge (SVSL) policy and a smoke-free workplace policy on lung cancer mor tality among smokers. Methods-We modelled the change in lung cancer mortality among smokers currently employed at workplaces that do not regulate smoking after implemen tation of a SVSL policy and a smoke-free policy. Outcomes of each policy were determined for a wide range of possible assumptions. Threshold analyses were performed to define the levels of key parameters at which the basic results of the model would change. Results Under a wide range of plausible assumptions, a SVSL policy was pre dicted to result in substantial lung cancer mortality among smokers, while a smoke-free policy was predicted to pre vent many lung cancer deaths among smokers. The finding that the effects of a smoke-free policy were favourable was robust, holding true unless it was as sumed that ETS exposure has no effect on lung cancer risk among smokers. Conclusion The potential adverse health effects of ETS on smokers should be considered in regulating smoking in the workplace.