Whose Life Is a Smoking Ban Saving?

In 2004, a report was released which claimed that a smoking ban in Montana had resulted in an almost immediate 40 percent reduction of admissions to hospital for acute heart attacks. The report led to a surge in research on the impact of smoking bans in a selection of countries and communities. It’s thought that this effect on hospital admissions and deaths, from heart attacks, range from 47 percent to 6 percent, with larger studies showing a smaller effect. Smoking bans could be reducing heart attacks and heart disease in two major ways – either by inducing current smokers to give up entirely or by reducing the exposure of non-smokers to passive smoking. Over 40 years of research on heart disease has shown that giving up has an incredibly strong effect, but there is very little effect on the latter in terms of how it affects people. With this in mind it is strange that so many advertisers play up the fact that eliminating exposure to environmental smoking in public places could save lives.

 

Heart disease has been the leading cause of death in the US for more than 70 years, with researchers constantly trying to find new ways to combat the various risk factors for the disease. What all of these studies show is that the most common risk factors for heart disease include smoking, obesity, high blood pressure, level of physical activity, alcohol intake and psychological factors. Those who currently smoke have roughly a two-fold risk of developing heart disease, compared to those who never smoke. This shows that giving up smoking could significantly affect how low your risk is with regards to this disease, not to mention the effect it has on other areas of your health as well.

 

In contrast to research which previously looked at the causes of heart disease, studies of smoking bans usually compare hospital admissions for heart attacks before and after a smoking ban. But these studies don’t take into account the defined populations nor do they look at information on individuals. Most of these studies are limited to short-term periods preceding and following the ban. Because of this, they are unable to highlight whether a reduction of hospital admissions can be connected to measurable reductions in the exposure to tobacco smoke, or other factors. For this reason, there is a lack of connection between the best research on predicting heart disease and the much weaker body of evidence which looks at the effect of smoking bans on our health. The latter of these is suggested by health authorities that there is a substantial effect of a ban on the health of the public, but this simply isn’t founded in research. Of course, this isn’t to say there is no benefit to a smoking ban – it does, at the very least, limit the amount of smoke each smoker inhales. But it would be difficult to gauge the magnitude of the effect and the mechanism responsible for the reduction of heart disease rates.

 

Anything which discourages smoking is great news, but health authorities should be careful in how they word their so-called evidence – furthermore, people should be better educated on the effects of bans on their health, so as not to be bought into by clever wording and unsubstantiated evidence. Smoking is a dangerous activity and takes it’s toll on your health in a variety of ways, from cancers to stroke, so giving up is always the better option. But to what extent it helps those around you is yet to be discovered, and will be difficult to decipher.

Categories: ban, environment, health, health authorities, heart, heart attacks, heart disease, hospital admissions, risk factors, Smoking, smoking ban, smoking bans

HIV Prevention v/s Pain: The Pros and Cons of Circumcision

Over the years, parents have been faced with a sexual health issue right in the early stages of their child’s infancy; circumcision. While proponents tout the wellness benefits of circumcision, opponents argue that the barbaric nature of the procedure does no good to a boy’s wellbeing. Now, the latest to join the fray is an anti-circumcision group in San Francisco, who are pushing for a ban on the practice. Unsurprisingly, those in favour of the procedure disagree with the proposal, citing the procedure’s history as a religious ritual, as well as its sexual health benefits, as some research suggests that circumcision helps prevent the spread of HIV. The debate that rages on is, therefore, “Is circumcision a good idea or not?”

 

We can date the process of circumcision as far back as to the Ancient Egyptians in 2,500BC, but the ritual later became more associated with Jewish people. Reasons for this included marking a boy’s passage into manhood, marking to distinguish those of higher social status, male “menstruation” or sign of the onset of puberty, and a way to discourage masturbation. Now, however, circumcision is not just a Jewish ritual but the most common surgery performed on males in the United States. According to a recent survey by the Centres for Disease Control and Prevention (CDC), between the years of 1999 and 2004, 79% of men reported that they were circumcised.

 

The main health reason to be circumcised is that the process is believed to prevent diseases, such as HIV, and some research suggests that circumcision reduces the risk of male-to-female HIV transfer. This is possibly due to the fact that, when you are circumcised, the Langerhans cells in your foreskin are removed, and these cells are more susceptible to HIV infection. Langerhans cells are equipped with special receptors that may allow HIV access into the body. In 2009, three studies published in the Cochrane Database of Systematic Reviews – which included data from more than 11,000 men in South Africa, Uganda and Kenya between 2002 and 2006 – showed that circumcised men were 54% less likely to get HIV than their uncircumcised counterparts.

 

However, while HIV prevention is becoming a well-supported argument for circumcision in developing countries, it is not as strong of an argument for the United States or for us here in Britain. A report from the CDC notes, ‘A number of important differences from sub-Saharan African settings where the three male circumcision trials were conducted must be considered in determining the possible role for male circumcision in HIV prevention in the United States.’ It continues, ‘Studies to date have demonstrated efficacy only for penile-vaginal sex, the predominant mode of HIV transmission in Africa, whereas the predominant mode of sexual HIV transmission in the United States is by penile-anal sex among [men who have sex with men].’

 

Still, is that a reason to ban the practise, especially considering the fact that there’s a lack of strong evidence showing negative side effects? Proponents of the San Francisco ban have now delivered more than 12,000 signatures to the Department of Elections, and, if enough signatures are deemed to be valid, this ban will appear on the ballot in the November election. Under the ban, circumcision of any male under the age of 18 would carry a fine of up to $1,000 and jail time of up to one year. Lloyd Schofield, the leader of the proposal, comments that circumcision is ‘excruciatingly painful and permanently damaging surgery that’s forced on men when they’re at their weakest and most vulnerable.’ However, Scott Bryan, a spokesperson for the CDC, argues, ‘Data has shown that with anaesthesia, the majority of infants have no objective pain reaction.’

Categories: ban, circumcision, HIV, HIV prevention, hiv transmission, langerhans cells, male circumcision, predominant mode, research suggests, san francisco, sexual health, united states