Smoking ban works, doctor says
For a younger generation, it is hard to believe that at one time restaurants and bars like the Ginger Man Pub and the Firehouse Saloon would be as thick with cigarette smoke fog as a Louisiana bayou. Even harder to believe is that same fog of cigarette smoke existed in schools, offices and hospital waiting rooms.
Of course, smoking has been banned from most public indoor places for many years, and for Dr. Richard Castriotta, the ban couldn’t have come soon enough. Castriotta is a professor of internal medicine and the pulmonary division director at the University of Texas Health Science Center. He is also the chief of pulmonary medicine at Memorial Hermann Hospital in the Texas Medical Center.
Castriotta said a research paper recently in the journal Circulation: Journal of the American Heart Association, conclusively proves the benefits of limiting the use of cigarettes and exposure to second-hand smoke. The paper was authored by Stanton Glantz and Crystal Tan, both of the University of California San Francisco.
“That paper definitively demonstrates the effects of the reduction of smoke-related illnesses,” Castriotta said, such as a 90 percent drop in emphysema cases and chronic obstructive pulmonary disease, or COPD. “There is a 30-year latency period from the time someone starts smoking until they show signs of these conditions, but the data is fairly stable,” he said.
Lung cancer was almost unheard of before the mass production of cigarettes, Castriotta said, but became very common after people started smoking regularly. Now hospitals are seeing a reduction in the number of cases of lung cancer as well as other upper-respiratory cancers associated with smoking, such as cancers of the larynx and tongue.
“And smoking is a major cause of vascular disease,” he said, which leads to heart attacks, strokes and peripheral muscle problems like pain in the legs. There has been a marked reduction in those afflictions as well.
Those who suffer from second-hand smoke, such as asthmatics, are living a fuller and longer life because of the ban. “I had patients (before the ban) who couldn’t even go into a hospital waiting room because it was so full of smoke,” Castriotta said.
The benefits are not just on quality of life. They are economic, Castriotta said. Workplaces spend less cleaning their offices without smokers and, of course, they spend less on health care costs.
“If we still smoked like we did in the ’30s, ’40s or ’50s, we would not be able to afford our overloaded health care system,” he said. In fact, Castriotta lauded the U.S. for being a world leader in this area and said Europe is making similar measures. However, he predicted massive health care costs in Africa, Asia and especially China where smoking is very popular. “No health care system will be big enough to help all of those people when they will need care. I’m afraid people will just be left to die.”
Although concerned about smoking, Dr. Richard J. Castriotta’s most recent research interests have involved sleep disorders in traumatic brain injury, REM sleep behavior disorder in Parkinson’s disease, sleep-related hypoventilation in children, complex sleep apnea, methods of monitoring airflow during sleep, the diagnosis of sarcoidosis and medical ethics involving end-of-life decisions. His clinical interests include sleep disorders, interstitial lung disease, pulmonary hypertension, asthma and tuberculosis.
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