smoking ban essay conclusion

Should Smoking Be Illegal?

Should smoking be banned? What are the pros and cons of banning cigarettes in public places? If you’re writing an argumentative essay or persuasive speech on why smoking should be banned, check out this sample.

Smoking Should Be Banned: Essay Introduction

Reasons why smoking should be banned, why smoking should not be banned: essay arguments, why smoking should be banned essay conclusion.

Smoking involves burning a substance to take in its smoke into the lungs. These substances are commonly tobacco or cannabis. Combustion releases the active substances in them, like nicotine, which are absorbed through the lungs.

A widespread technique through which this is done is via smoking manufactured cigarettes or hand-rolling the tobacco ready for smoking. Almost 1 billion people in the majority of all human societies practice smoking. Complications directly associated with smoking claim the lives of half of all the persons involved in smoking tobacco or marijuana for a long time.

Smoking is an addiction because tobacco contains nicotine, which is very addictive. The nicotine makes it difficult for a smoker to quit. Therefore, a person will become used to nicotine such that he/she has to smoke to feel normal. Consequently, I think smoking should be banned for some reason.

One reason why smoking should be banned is that it has got several health effects. It harms almost every organ of the body. Cigarette smoking causes 87% of lung cancer deaths and is also responsible for many other cancer and health problems. 

Apart from this, infant deaths that occur in pregnant women are attributed to smoking. Similarly, people who stay near smokers become secondary smokers, who may breathe in the smoke and get the same health problems as smokers. Although not widely smoked, cannabis also has health problems, and withdrawal symptoms include depression, insomnia, frustration, anger, anxiety, concentration difficulties, and restlessness.

Besides causing emphysema, smoking also affects the digestive organs and the blood circulatory systems, especially heart arteries. Women have a higher risk of heart attack than men, exacerbating with time as one smokes. Smoking also affects the mouth, whereby the teeth become discolored, the lips blacken and always stay dry, and the breath smells bad.

Cigarette and tobacco products are costly. People who smoke are therefore forced to spend their money on these products, which badly wastes the income they would have otherwise spent on other things. Therefore, I think that smoking should be forbidden to reduce the costs of treating diseases related to smoking and the number of deaths caused by smoking-related illnesses.

However, tobacco and cigarette manufacturing nations would lose a lot if smoking was to be banned. I, therefore, think that it should not be banned. Some nations largely depend on exporting cigarettes and tobacco products to get revenue.

This revenue typically boosts the economy of such nations. If smoking were banned, they would incur significant losses since tobacco companies are multi-billion organizations. Apart from these, millions of people will be jobless due to the ban.

The process by which tobacco and cigarette products reach consumers is very complex, and it involves a chain process with several people involved in it. Banning smoking, therefore, means these people will lose their jobs, which most may depend on for their livelihoods.

In conclusion, the ban on smoking is a tough step to be undertaken, especially when the number of worldwide users is billions. Although it burdens nations enormously in treating smoking-related diseases, it may take a long time before a ban can work. Attempts by some nations to do this have often been met with failures.

Cite this paper

• Chicago (N-B)
• Chicago (A-D)

StudyCorgi. (2020, January 12). Should Smoking Be Illegal? https://studycorgi.com/should-smoking-be-banned/

"Should Smoking Be Illegal?" StudyCorgi , 12 Jan. 2020, studycorgi.com/should-smoking-be-banned/.

StudyCorgi . (2020) 'Should Smoking Be Illegal'. 12 January.

1. StudyCorgi . "Should Smoking Be Illegal?" January 12, 2020. https://studycorgi.com/should-smoking-be-banned/.

Bibliography

StudyCorgi . "Should Smoking Be Illegal?" January 12, 2020. https://studycorgi.com/should-smoking-be-banned/.

StudyCorgi . 2020. "Should Smoking Be Illegal?" January 12, 2020. https://studycorgi.com/should-smoking-be-banned/.

This paper, “Should Smoking Be Illegal?”, was written and voluntary submitted to our free essay database by a straight-A student. Please ensure you properly reference the paper if you're using it to write your assignment.

Before publication, the StudyCorgi editorial team proofread and checked the paper to make sure it meets the highest standards in terms of grammar, punctuation, style, fact accuracy, copyright issues, and inclusive language. Last updated: November 8, 2023 .

If you are the author of this paper and no longer wish to have it published on StudyCorgi, request the removal . Please use the “ Donate your paper ” form to submit an essay.

Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence (2010)

Chapter: 8 conclusions and recommendations, 8 conclusions and recommendations.

In this report, the committee has examined three relationships in response to its charge (see Box 8-1 for specific questions):

The association between secondhand-smoke exposure and cardiovascular disease, especially coronary heart disease and not stroke (Question 1).

The association between secondhand-smoke exposure and acute coronary events (Questions 2, 3, and 5).

The association between smoking bans and acute coronary events (Questions 4, 5, 6, 7, and 8).

This chapter summarizes the committee’s review of information relevant to those relationships; presents its findings, conclusions, and recommendations on the basis of the weight of evidence; and presents its responses to the specific questions that it was asked in its task.

SUMMARY OF REPORT

Exposure assessment.

To determine the effect of changes in exposure to secondhand smoke it is necessary to quantify changes in epidemiologic studies. Airborne measures and biomarkers of exposure to secondhand smoke are available; they are complementary and provide different information (see Chapter 2 ). Biomarkers (such as cotinine, the major proximate metabolite of nicotine) in-

tegrate all sources of exposure and inhalation rates, but cannot identify the place where secondhand-smoke exposure occurred and, because of a short half-life they reflect only recent exposures. Airborne measures of exposure can demonstrate the contribution of different sources or venues of exposure and can be used to measure changes in secondhand-smoke concentrations at individual venues, but they do not reflect the true dose. Airborne concentration of nicotine is a specific tracer for secondhand smoke. Particulate matter (PM) can also be used as an indicator of secondhand-smoke exposure, but because there are other sources of PM it is a less specific tracer than nicotine. The concentration of cotinine in serum, saliva, or urine is a specific indicator of integrated exposure to secondhand smoke.

Although in most of the smoking-ban studies the magnitude, frequency, and duration of exposures that occurred before a ban are not known, monitoring studies demonstrate that exposure to secondhand smoke is dramatically reduced in places that are covered by bans. Airborne nicotine

and PM concentrations in regulated venues such as workplaces, bars, and restaurants decreased by more than 80% in most studies; serum, salivary, or urinary cotinine concentrations decreased by 50% or more in most studies, probably reflecting continuing exposures in unregulated venues (for example, in homes and cars).

Pathophysiology

The pathophysiology of the induction of cardiovascular disease by cigarette-smoking and secondhand-smoke exposure is complex and undoubtedly involves multiple agents. Many chemicals in secondhand smoke have been shown to exert cardiovascular toxicity (see Table 3-1 ), and both acute and chronic effects of these chemicals have been identified. Experimental studies in humans, animals, and cell cultures have demonstrated effects of secondhand smoke, its components (such as PM, acrolein, polycyclic

aromatic hydrocarbons [PAHs], and metals), or both on the cardiovascular system (see Figure 3-1 for summary). Those studies have yielded sufficient evidence to support an inference that acute exposure to secondhand smoke induces endothelial dysfunction, increases thrombosis, causes inflammation, and potentially affects plaque stability adversely. Those effects appear at concentrations expected to be experienced by people exposed to secondhand smoke.

Data from animal studies also support a dose–response relationship between secondhand-smoke exposure and cardiovascular effects (see Chapter 3 ). The relationship is consistent with the understanding of the pathophysiology of coronary heart disease and the effects of secondhand smoke on humans, including chamber studies. The association comports with known associations between PM, a major constituent of secondhand smoke, and coronary heart disease.

Overall, the pathophysiologic data indicate that it is biologically plausible for secondhand-smoke exposure to have cardiovascular effects, such as effects that lead to cardiovascular disease and acute myocardial infarction (MI). The exact mechanisms by which such effects occur, however, remain to be elucidated.

Smoking-Ban Background

Characteristics of smoking bans can heavily influence their consequences. Interpretation of the results of epidemiologic studies that involve smoking bans must account for information on the bans and their enforcement.

Secondhand smoke should have been measured before and after implementation of a ban, and locations with and without bans should have been compared. Studies that include self-reported assessments of exposure to secondhand smoke cannot necessarily be compared with each other unless the survey instruments (such as interviews) were similar.

The comparability of the time and length of followup of the studies should be assessed. For example, the impact of a ban in one area may differ from the impact of a ban in another solely because the observation times were different and other activities may have occurred during the same periods. In comparing studies, it may be impossible to separate contextual factors associated with ban legislation—such as public comment periods, information announcing the ban, and notices about the impending changes—from the impact of the ban itself. The committee therefore included such contextual factors in drawing conclusions about the effects of a ban.

Interpretation needs to consider the timeframes in the epidemiologic evidence, for example, the time from onset of a smoking ban to the mea-

surement of incidence of a disease, the timing and nature of enforcement, and the time until changes in cardiovascular-event rates were observed in people who had various baseline risks. Interpretation should account for the extent to which studies assessed possible alternative causes of decreases in hospitalizations for coronary events, including changes in health-care availability and in the standard of practice in cardiac care, such as new diagnostic criteria for acute MI during the period of study. The latter is especially important in making before–after comparisons in the absence of a comparison geographic area in which no ban has been implemented.

When designing and analyzing future studies, researchers should examine the time between the implementation of a smoking ban and changes in rates of hospital admission or cardiac death. Future studies could evaluate whether decreases in admissions are transitory, sustained, or increasing, and ideally they would include information on individual subjects, including prior history of cardiac disease, to answer the questions posed to the committee.

Epidemiologic Studies

Cardiovascular disease is a major public-health concern. The results of dozens of epidemiologic studies of both case–control and cohort design carried out in multiple populations consistently indicate about a 25–30% increase in risk of coronary heart disease from exposure to secondhand smoke (see Chapter 4 ). Epidemiologic studies using serum cotinine concentration as a biomarker of overall exposure to secondhand smoke indicated that the relative risk (RR) of coronary heart disease associated with secondhand smoke is even greater than those estimates. The excess risk is unlikely to be explained by misclassification bias, uncontrolled-for confounding effects, or publication bias. Although few studies have addressed the risk of coronary heart disease posed by secondhand-smoke exposure in the workplace, there is no biologically plausible reason to suppose that the effect of secondhand-smoke exposure at work or in a public building differs from the effect of exposure in the home environment. Epidemiologic studies demonstrate a dose–response relationship between chronic secondhand-smoke exposure as assessed by self-reports of exposure (He et al., 1999) and as assessed by biomarkers (cotinine) and long-term risk of coronary heart disease (Whincup et al., 2004). Dose–response curves show a steep initial rise in risk when going from negligible to low exposure followed by a gradual increase with increasing exposure.

The INTERHEART study, a large case–control study of cases of first acute MI, showed that exposure to secondhand smoke increased the risk of nonfatal acute MI in a graded manner (Teo et al., 2006).

Eleven key epidemiologic studies evaluated the effects of eight smok-

ing bans on the incidence of acute coronary events (see Table 8-1 and Chapter 6 ). The results of those studies show remarkable consistency: all showed decreases in the rate of acute MIs after the implementation of smoking bans (Barone-Adesi et al., 2006; Bartecchi et al., 2006; CDC, 2009; Cesaroni et al., 2008; Juster et al., 2007; Khuder et al., 2007; Lemstra et al., 2008; Pell et al., 2008; Sargent et al., 2004; Seo and Torabi, 2007; Vasselli et al., 2008). Two of the studies (Pell et al., 2008; Seo and Torabi, 2007) examined rates of hospitalization for acute coronary events after the implementation of smoking bans and provided direct evidence of the relationship of secondhand-smoke exposure to acute coronary events by presenting results in nonsmokers.

The decreases in acute MIs in the 11 studies ranged from about 6 to 47%, depending on characteristics of the study, including the method of statistical analysis. The consistency in the direction of change gave the committee confidence that smoking bans result in a decrease in the rate of acute MI. The studies took advantage of bans as “natural experiments” to look at questions about the effects of bans, and indirectly of a decrease in secondhand-smoke exposure, on the incidence of acute cardiac events. As discussed in Assessing the Health Impact of Air Quality Regulations: Concepts and Methods for Accountability Research (HEI Accountability Working Group, 2003) in the context of air-pollution regulations, studies of interventions constitute a more definitive approach than other epidemiologic studies to determining whether regulations result in health benefits. All the studies are relevant and informative with respect to the questions posed to the committee, and overall they support an association between smoking bans and a decrease in acute cardiovascular events. The studies have inherent limitations related to their nature, but they directly evaluated the effects of an intervention (a smoking ban, including any concomitant activities) on a health outcome of interest (acute coronary events).

The committee could not determine the magnitude of effect with any reasonable degree of certainty on the basis of those studies. The variability in study design, implementation, and analysis was so large that the committee concluded that it could not conduct a meta-analysis or combine the information from the studies to calculate a point estimate of the effect. In particular, the committee was unable to determine the overall portion of the effect attributable to decreased smoking by smokers as opposed to decreased exposure of nonsmokers to secondhand smoke because of a lack of information on smoking status in nine of the studies (Barone-Adesi et al., 2006; Bartecchi et al., 2006; CDC, 2009; Cesaroni et al., 2008; Juster et al., 2007; Khuder et al., 2007; Lemstra et al., 2008; Sargent et al., 2004; Seo and Torabi, 2007; Vasselli et al., 2008). The results of the studies are consistent with the findings of the pathophysiologic studies discussed in Chapter 3 and the data on PM discussed in Chapters 3 and 7 . At the population level,

results of the key intervention studies reviewed by the committee are for the most part consistent with a decrease in risk as early as a month following reductions in secondhand-smoke exposure; however, given the variability in the studies and the lack of data on the precise timing of interventions, the smoking-ban studies do not provide adequate information on the time it takes to see decreases in acute MIs.

Plausibility of Effect

The committee considered both the biologic plausibility of a causal relationship between a decrease in secondhand-smoke exposure and a decrease in the incidence of acute MI and the plausibility of the magnitude of the effect seen in the key epidemiologic studies after implementation of smoking bans.

The experimental data reviewed in Chapter 3 demonstrate that several components of secondhand smoke, as well as secondhand smoke itself, exert substantial cardiovascular toxicity. The toxic effects include the induction of endothelial dysfunction, an increase in thrombosis, increased inflammation, and possible reductions in plaque stability. The data provide evidence that it is biologically plausible for secondhand smoke to be a potential causative trigger of acute coronary events. The risk of acute coronary events is likely to be increased if a person has preexisting heart disease. The association comports with findings on air-pollution components, such as diesel exhaust (Mills et al., 2007) and PM (Bhatnagar, 2006).

As a “reality check” on the potential effects of changes in secondhand-smoke exposure, the committee estimated the decrease in risk of cardiovascular disease and specifically heart failure that would be expected on the basis of the risk effects of changes in airborne PM concentrations after implementation of smoking bans seen in the PM literature. The PM in cigarette smoke is not identical with that in air pollution, and the committee did not attempt to estimate the risk attributable to secondhand-smoke exposure through the PM risk estimates but rather found this a useful exercise to see whether the decreases seen in the epidemiologic literature are reasonable, given data on other air pollutants that have some common characteristics. The committee’s estimates on the basis of the PM literature support the possibility that changes in secondhand-smoke exposure after implementation of a smoking ban can have a substantial effect on hospital admissions for heart failure and cardiovascular disease.

SUMMARY OF OVERALL WEIGHT OF EVIDENCE

The committee examined three relationships—of secondhand-smoke exposure and cardiovascular disease, of secondhand-smoke exposure and

TABLE 8-1 Summary of Key Studies (Studies Listed by Smoking-Ban Region in Order of Publication)

acute coronary events, and of smoking bans and acute coronary events. The committee used the criteria of causation described in Smoking and Health: Report of the Advisory Committee of the Surgeon General of the Public Health Service (U.S. Public Health Service, 1964) in drawing conclusions regarding those relationships. The criteria are often referred to as the Bradford Hill criteria because they were, as stated by Hamill (1997), “later expanded and refined by A. B. Hill” (Hill, 1965). Table 8-2 summarizes the available evidence on secondhand-smoke exposure and coronary events in terms of the Bradford Hill criteria.

Secondhand-Smoke Exposure and Cardiovascular Disease

The results of both case–control and cohort studies carried out in multiple populations consistently indicate exposure to secondhand smoke causes about a 25–30% increase in the risk of coronary heart disease; results of some studies indicate a dose–response relationship. Data from animal studies support the dose–response relationship (see Chapter 3 ). Data from experimental studies of animals and cells and from intentional human-dosing studies indicate that a relationship between secondhand-smoke exposure and coronary heart disease is biologically plausible and consistent with understanding of the pathophysiology of coronary heart disease.

Taking all that evidence together, the committee concurs with the conclusions in the 2006 surgeon general’s report (HHS, 2006) that “the evidence is sufficient to infer a causal relationship between exposure to secondhand smoke and increased risks of coronary heart disease morbidity and mortality among both men and women.” Although the committee found strong and consistent evidence of the existence of a positive association between chronic exposure to secondhand smoke and coronary heart disease, determining the magnitude of the risk (the number of cases that are attributable to secondhand-smoke exposure) proved challenging, and the committee has not done it.

Secondhand-Smoke Exposure and Acute Coronary Events

Two of the epidemiologic studies reviewed by the committee that examine rates of hospitalization for acute coronary events after implementation of smoking bans provide direct evidence related to secondhand smoke exposures. The studies either reported events in nonsmokers only (Monroe, Indiana) (Seo and Torabi, 2007) or analyzed nonsmokers and smokers separately on the basis of serum cotinine concentration (Scotland) (Pell et al., 2008). Both studies showed reductions in the RR of acute coronary events in nonsmokers when secondhand-smoke exposure was decreased after implementation of the bans; this indicates an association between a

decrease in exposure to secondhand smoke and a decrease in risk of acute coronary events. Because of differences between and limitations of the two studies (such as in population, population size, and analysis), they do not provide strong sufficient evidence to determine the magnitude of the decrease in RR.

The effect seen after implementation of smoking bans is consistent with data from the INTERHEART study, a case–control study of 15,152 cases of first acute MI in 262 centers in 52 countries (Teo et al., 2006). Increased exposure to secondhand smoke increased the risk of nonfatal acute MI in a graded manner, with adjusted odds ratios of 1.24 (95% confidence interval [CI], 1.17–1.32) and 1.62 (95% CI, 1.45–1.81) in the least exposed people (1–7 hours of exposure per week) and the most exposed (at least 22 hours of exposure per week), respectively. In contrast, a study using data from the Western New York Health Study collected from 1995 to 2001 found that secondhand smoke was not significantly associated with higher risk of MI (Stranges et al., 2007). That study, however, looked at lifetime cumulative exposure to secondhand smoke, a different exposure metric from that in the other studies and one that does not take into account how recent the exposure is.

The other key epidemiologic studies that looked at smoking bans provide indirect evidence of an association between secondhand-smoke exposure and acute coronary events (Barone-Adesi et al., 2006; Bartecchi et al., 2006; CDC, 2009; Cesaroni et al., 2008; Juster et al., 2007; Khuder et al., 2007; Lemstra et al., 2008; Sargent et al., 2004; Vasselli et al., 2008). Although it is not possible to separate the effect of smoking bans in reducing exposure to secondhand smoke and their effect in reducing active smoking in those studies, because they did not report individual smoking status or secondhand-smoke exposure concentrations, monitoring studies of airborne tracers 1 and biomarkers 2 of exposure to secondhand smoke have demonstrated that exposure to secondhand smoke is dramatically reduced after implementation of smoking bans. Those studies therefore provide indirect evidence that at least part of the decrease in acute coronary events seen after implementation of smoking bans could be mediated by a decrease in exposure to secondhand smoke. It is not possible to determine the differential magnitude of the effect that is attributable to changes in nonsmokers and smokers.

Experimental data show that an association between secondhand-

TABLE 8-2 Evaluation of Available Data in Terms of Bradford-Hill Criteria

smoke exposure and acute coronary events is biologically plausible (see Chapter 3 ). Experimental studies in humans, animals, and cell cultures have demonstrated short-term effects of secondhand smoke as a complex mixture or its components individually (such as oxidants, PM, acrolein, PAHs, benzene, and metals) on the cardiovascular system. There is sufficient evidence from such studies to infer that acute exposure to secondhand smoke at concentrations relevant to population exposures induces endothelial dysfunction, increases inflammation, increases thrombosis, and potentially adversely affects plaque stability. Those effects occur at magnitudes relevant to the pathogenesis of acute coronary events. Furthermore, indirect evidence obtained from studies of ambient PM supports the notion that exposure to PM present in secondhand smoke could trigger acute coronary events or induce arrhythmogenesis in a person with a vulnerable myocardium.

Taking all that evidence together, the committee concludes that there is sufficient evidence of a causal relationship between a decrease in secondhand-smoke exposure and a decrease in the risk of acute MI. Given the variability among studies and their limitations, the committee did not provide a quantitative estimate of the magnitude of the effect.

Smoking Bans and Acute Coronary Events

Nine key studies looked at the overall effect of smoking bans on the incidence of acute coronary events in the overall populations—smokers and nonsmokers—studied (Barone-Adesi et al., 2006; Bartecchi et al., 2006; CDC, 2009; Cesaroni et al., 2008; Juster et al., 2007; Khuder et al., 2007; Lemstra et al., 2008; Sargent et al., 2004; Vasselli et al., 2008). Those studies consistently show a decrease in acute MIs after implementation of smoking bans. The combination of experimental data on secondhand-smoke effects discussed above and exposure data that indicate that secondhand-smoke concentrations decrease substantially after implementation of a smoking ban provides evidence that it is biologically plausible for smoking bans to decrease the rate of acute MIs. The committee concludes that there is an association between smoking bans and a reduction in acute coronary events and, given the temporality and biologic plausibility of the effect, that the evidence is consistent with a causal relationship. Although all the studies demonstrated a positive effect of bans in reducing acute MIs, differences among the studies, including the components of the bans and other interventions that promote smoke-free environments that took place during the bans, limited the committee’s confidence in estimating the overall magnitude of the effect. There is little information on how long it would take for such an effect to be seen inasmuch as the studies have not evaluated periods shorter than a month.

DATA GAPS AND RESEARCH RECOMMENDATIONS

Studies of the effect of indoor smoking bans and secondhand-smoke exposure on acute coronary events should be designed to examine the time between an intervention and changes in the effect and to measure the magnitude of the effect. No time to effect can be postulated for individuals on the basis of the available data, and evaluation of population-based effectiveness of a smoking ban depends on societal actions that implement and enforce the ban and on actions that include smoke reduction in homes, cars, and elsewhere. The decrease in secondhand-smoke exposure does not necessarily occur suddenly—it might decline gradually or by steps. In a likely scenario, once a ban is put into place and enforced, a sharp drop in secondhand-smoke exposure might be seen immediately and followed by a slower decrease in exposure as the population becomes more educated about the health consequences of secondhand smoke and exposure becomes less socially acceptable. Future studies that examine the time from initiation of a ban to observation of an effect and that include followup after initiation of enforcement, taking the social aspects into account, would provide better information on how long it takes to see an effect of a ban. Statistical models should clearly articulate a set of assumptions and include sensitivity analyses. Studies that examine whether decreases in hospital admissions for acute coronary events are transitory or sustained would also be informative.

Many factors are likely to influence the effect of a smoking ban on the incidence and prevalence of acute coronary events in a population. They include age, sex, diet, background risk factors and environmental factors for cardiovascular disease, prevalence of smokers in the community, the underlying rate of heart disease in the community (for example, the rate in Italy versus the United States), and the social environment. Future studies should include direct observations on individuals—including their history of cardiac disease, exposure to other environmental agents, and other risk factors for cardiac events—to assess the impact of those factors on study results. Assessment of smoking status is also needed to distinguish between the effects of secondhand smoke in nonsmokers and the effects of a ban that decreases cigarette consumption or promotes smoking cessation in smokers.

Few constituents of secondhand smoke have been adequately studied for cardiotoxicity. Future research should examine the cardiotoxicity of environmental chemicals, including those in secondhand smoke, to define cardiovascular toxicity end points and establish consistent definitions and measurement standards for cardiotoxicity of environmental contaminants. Specifically, information is lacking on the cardiotoxicity of highly reactive smoke constituents, such as acrolein and other oxidants; on techniques for

quantitating those reactive components; and on the toxicity of low concentrations of benzo[ a ]pyrene, of PAHs other than benzo[a]pyrene, and of mixtures of tobacco-smoke toxicants.

Many questions remain with respect to the pathogenesis of cardiovascular disease and acute coronary events and how secondhand-smoke constituents perturb the pathophysiologic mechanisms and result in disease and death. For example, a better understanding of the factors that promote plaque rupture and how they are influenced by tobacco smoke and PM would provide insight into the mechanisms underlying the cardiovascular effects of secondhand smoke and might lead to better methods of detecting preclinical disease and preventing events.

The committee found only sparse data on the prevalence and incidence of cardiovascular disease and acute coronary events at the national level in general compared with other health end points for which there are central data registries and surveillance of all events, such as the Surveillance, Epidemiology, and End Results (SEER) Program for cancer. Although there are national databases that include acute MI patients—such as the National Registry of Myocardial Infarction (Morrow et al., 2001; Rogers et al., 1994), the Health Care Financing Administration database, and the Cooperative Cardiovascular Project (Ellerbeck et al., 1995)—and the Centers for Disease Control and Prevention’s annual National Hospital Discharge Survey and National Health Interview Survey provide some information on cardiovascular end points, these are not comprehensive or inclusive with respect to hospital participation, patient inclusion, or data capture. A national database that captures all cardiovascular end points would facilitate future epidemiologic studies by allowing the tracking of trends and identification of high-risk populations at a more granular level.

A large prospective cohort study could be very helpful in more accurately estimating the magnitude of the risk of cardiovascular disease and acute coronary events posed by secondhand-smoke exposure. It could be a new study specifically designed to assess effects of secondhand smoke or, as was done with the INTERHEART study, take advantage of existing studies—such as the Framingham Heart Study, the Multi-Ethnic Study of Atherosclerosis, the American Cancer Society’s Cancer Prevention Study-3, the European Prospective Investigation into Cancer and Nutrition study, and the Jackson Heart Study—provided that they have adequate information on individual smoking status and secondhand-smoke exposure (or the ability to measure it, for example, in adequate blood samples). If properly designed, such a study could identify subpopulations at highest risk for acute coronary events from secondhand-smoke exposure in relation to such characteristics as age and sex, and concomitant risk factors, such as obesity.

COMMITTEE RESPONSES TO SPECIFIC QUESTIONS

The committee was tasked with responding to eight specific questions. The questions and the committee’s responses are presented below.

What is the current scientific consensus on the relationship between exposure to secondhand smoke and cardiovascular disease? What is the pathophysiology? What is the strength of the relationship?

On the basis of the available studies of chronic exposure to secondhand smoke and cardiovascular disease, the committee concludes that there is scientific consensus that there is a causal relationship between secondhand-smoke exposure and cardiovascular disease. The results of a number of meta-analyses of the epidemiologic studies showed increases of 25–30% in the risk of cardiovascular disease caused by various exposures. The studies include some that use serum cotinine concentration as a biomarker of exposure and show a dose–response relationship. The pathophysiologic data are consistent with that relationship, as are the data from studies of air pollution and PM. The data in support of the relationship are consistent, but the committee could not calculate a point estimate of the magnitude of the effect (that is, the effect size) given the variable strength of the relationship, differences among studies, poor assessment of secondhand-smoke exposure, and variation in concomitant underlying risk factors.

Is there sufficient evidence to support the plausibility of a causal relation between secondhand smoke exposure and acute coronary events such as acute myocardial infarction and unstable angina? If yes, what is the pathophysiology? And what is the strength of the relationship?

The evidence reviewed by the committee is consistent with a causal relationship between secondhand-smoke exposure and acute coronary events, such as acute MI. It is unknown whether acute exposure, chronic exposure, or a combination of the two underlies the occurrence of acute coronary events, inasmuch as the duration or pattern of exposure in individuals is not known. The evidence includes the results of two key studies that have information on individual smoking status and that showed decreases in risks of acute coronary events in nonsmokers after implementation of a smoking ban. Those studies are supported by information from other smoking-ban studies (although these do not have information on individual smoking status, other exposure-assessment studies have demonstrated that secondhand-smoke exposure decreases after implementation of a smoking ban) and by the large body of literature on PM, especially PM 2.5 , a

constituent of secondhand smoke. The evidence is not yet comprehensive enough to determine a detailed mode of action for the relationship between secondhand-smoke exposure and a variety of intervening and preexisting conditions in predisposing to cardiac events. However, experimental studies have shown effects that are consistent with pathogenic factors in acute coronary events. Although the committee has confidence in the evidence of an association between chronic secondhand-smoke exposure and acute coronary events, the evidence on the magnitude of the association is less convincing, so the committee did not estimate that magnitude (that is, the effect size).

Is it biologically plausible that a relatively brief (e.g., under 1 hour) secondhand smoke exposure incident could precipitate an acute coronary event? If yes, what is known or suspected about how this risk may vary based upon absence or presence (and extent) of preexisting coronary artery disease?

There is no direct evidence that a relatively brief exposure to secondhand smoke can precipitate an acute coronary event; few published studies have addressed that question. The circumstantial evidence of such a relationship, however, is compelling. The strongest evidence comes from airpollution research, especially research on PM. Although the source of the PM can affect its toxicity, particle size in secondhand smoke is comparable with that in air pollution, and research has demonstrated a similarity between cardiovascular effects of PM and of secondhand smoke. Some studies have demonstrated rapid effects of brief secondhand-smoke exposure (for example, on platelet aggregation and endothelial function), but more research is necessary to delineate how secondhand smoke produces cardiovascular effects and the role of underlying preexisting coronary arterial disease in determining susceptibility to the effects. Given the data on PM, especially those from time-series studies, which indicate that a relatively brief exposure can precipitate an acute coronary event, and the fact that PM is a major component of secondhand smoke, the committee concludes that it is biologically plausible for a relatively brief exposure to secondhand smoke to precipitate an acute coronary event.

With respect to how the risk might vary in the presence or absence of preexisting coronary arterial disease, it is generally assumed that acute coronary events are more likely to occur in people who have some level of preexisting disease, although that underlying disease is often subclinical. There are not enough data on the presence of pre-existing coronary arterial disease in the populations studied to assess the extent to which the absence or presence of such preexisting disease affects the cardiovascular risk posed by secondhand-smoke exposure.

What is the strength of the evidence for a causal relationship between indoor smoking bans and decreased risk of acute myocardial infarction?

The key intervention studies that have evaluated the effects of indoor smoking bans consistently have shown a decreased risk of heart attack. Research has also indicated that secondhand-smoke exposure is causally related to heart attacks, that smoking bans decrease secondhand-smoke exposure, and that a relationship between secondhand-smoke exposure and acute coronary events is biologically plausible. All the relevant studies have shown an association in a direction consistent with a causal relationship (although the committee was unable to estimate the magnitude of the association), and the committee therefore concludes that the evidence is sufficient to infer a causal relationship.

What is a reasonable latency period between a decrease in secondhand smoke exposure and a decrease in risk of an acute myocardial infarction for an individual? What is a reasonable latency period between a decrease in population secondhand smoke exposure and a measurable decrease in acute myocardial infarction rates for a population?

No direct information is available on the time between a decrease in secondhand-smoke exposure and a decrease in the risk of a heart attack in an individual. Data on PM, however, have shown effects on the heart within 24 hours, and this supports a period of less than 24 hours. At the population level, results of the key intervention studies reviewed by the committee are for the most part consistent with a decrease in risk as early as a month following reductions in secondhand-smoke exposure; however, given the variability in the studies and the lack of data on the precise timing of interventions, the smoking-ban studies do not provide adequate information on the time it takes to see decreases in heart attacks.

What are the strengths and weaknesses of published population-based studies on the risk of acute myocardial infarction following the institution of comprehensive indoor smoking bans? In light of published studies’ strengths and weaknesses, how much confidence is warranted in reported effect size estimates?

Some of the weaknesses of the published population-based studies of the risk of MI after implementation of smoking bans are

Limitations associated with an open study population and, in some cases, with the use of a small sample.

Concurrent interventions that reduce the observed effect of a smoking ban.

Lack of exposure-assessment criteria and measurements.

Lack of information collected on the time between the cessation of exposure to secondhand smoke and changes in disease rates.

Differences between control and intervention groups.

Nonexperimental design of studies (by necessity).

Lack of assessment of the sensitivity of results to the assumptions made in the statistical analysis.

The different studies had different strengths and weaknesses in relation to the assessment of the effects of smoking bans. For example, the Scottish study had such strengths as prospective design and serum cotinine measurements. The Saskatoon study had the advantage of comprehensive hospital records, and the Monroe County study excluded smokers. The population-based studies of the risk of heart attack after the institution of comprehensive smoking bans were consistent in showing an association between the smoking bans and a decrease in the risk of acute coronary events, and this strengthened the committee’s confidence in the existence of the association. However, because of the weaknesses discussed above and the variability among the studies, the committee has little confidence in the magnitude of the effects and, therefore, thought it inappropriate to attempt to estimate an effect size from such disparate designs and measures.

What factors would be expected to influence the effect size? For example, population age distribution, baseline level of secondhand smoke protection among nonsmokers, and level of secondhand smoke protection provided by the smoke-free law .

A number of factors that vary among the key studies can influence effect size. Although some of the studies found different effects in different age groups, these were not consistently identified. One major factor is the size of the difference in secondhand-smoke exposure before and after implementation of a ban, which would vary and depends on: the magnitude of exposure before the ban, which is influenced by the baseline level of smoking and preexisting smoking bans or restrictions; and the magnitude of exposure after implementation of the ban, which is influenced by the extent of the ban, enforcement of and compliance with the ban, changes in social norms of smoking behaviors, and remaining exposure in areas not covered by the ban (for example, in private vehicles and homes). The baseline rate of acute coronary events or cardiovascular disease could influence the effect

size, as would the prevalence of other risk factors for acute coronary events, such as obesity, diabetes, and age.

What are the most critical research gaps that should be addressed to improve our understanding of the impact of indoor air policies on acute coronary events? What studies should be performed to address these gaps?

The committee identified the following gaps and research needs as those most critical for improving understanding of the effect of indoor-air policies on acute coronary events:

The committee found a relative paucity of data on environmental cardiotoxicity of secondhand smoke compared with other disease end points related to secondhand smoke, such as carcinogenicity and reproductive toxicity. Research should develop standard definitions of cardiotoxic end points in pathophysiologic studies (for example, specific results on standard assays) and a classification system for cardiotoxic agents (similar to the International Agency for Research on Cancer classification of carcinogens). Established cardiotoxicity assays for environmental exposures and consistent definitions of adverse outcomes of such tests would improve investigations of the cardiotoxicity of secondhand smoke and its components and identify potential end points for the investigation of the effects of indoor-air policies on acute coronary events.

The committee found a lack of a system for surveillance of the prevalence of cardiovascular disease and of the incidence of acute coronary events in the United States. Surveillance of incidence and prevalence trends would allow secular trends to be taken into account better and to be compared among different populations to establish the effects of indoor-air policies. Although some national databases and surveys include cardiovascular end points, a national database that tracks hospital admission rates and deaths from acute coronary events, similar to the SEER database for cancer, would improve epidemiologic studies.

The committee found a lack of understanding of a mechanism that leads to plaque rupture and from that to an acute coronary event and of how secondhand smoke affects that process. Additional research is necessary to develop reliable biomarkers of early effects on plaque vulnerability to rupture and to improve the design of pathophysiologic studies of secondhand smoke that examine effects of exposure on plaque stability.

All 11 key studies reviewed by the committee have strengths and limitations due to their study design, and none was designed to test the hypothesis that secondhand-smoke exposure causes cardiovascular disease or acute coronary events. Because of those limitations and the consequent variability in results, the committee did not have enough information to estimate the magnitude of the decrease in cardiovascular risk due to smoking bans or to a decrease in secondhand-smoke exposure. A large, well-designed study could permit estimation of the magnitude of the effect. An ideal study would be prospective; would have individual-level data on smoking status; would account for potential confounders, including other risk factors for cardiovascular events (such as obesity and age), would have biomarkers of mainstream and secondhand-smoke exposures (such as blood cotinine concentrations); and would have enough cases to allow separate analyses of smokers and nonsmokers or, ideally, stratification of cases by cotinine concentrations to examine the dose–response relationship. Such a study could be specifically designed for secondhand smoke or potentially could take advantage of existing cohort studies that might have data available or attainable for investigating secondhand-smoke exposure and its cardiovascular effects, such as was done with the INTERHEART study. Existing studies that could be explored to determine their utility and applicability to questions related to secondhand smoke include the Multi-Ethnic Study of Atherosclerosis (MESA) study, the American Cancer Society’s CPS-3, the European Prospective Investigation of Cancer (EPIC), the Framingham Heart Study, and the Jackson Heart Study. Researchers should clearly articulate the assumptions used in their statistical models and include analysis of the sensitivity of results to model choice and assumptions.

Barone-Adesi, F., L. Vizzini, F. Merletti, and L. Richiardi. 2006. Short-term effects of Italian smoking regulation on rates of hospital admission for acute myocardial infarction. European Heart Journal 27(20):2468-2472.

Bartecchi, C., R. N. Alsever, C. Nevin-Woods, W. M. Thomas, R. O. Estacio, B. B. Bartelson, and M. J. Krantz. 2006. Reduction in the incidence of acute myocardial infarction associated with a citywide smoking ordinance. Circulation 114(14):1490-1496.

Bhatnagar, A. 2006. Environmental cardiology: Studying mechanistic links between pollution and heart disease. Circulation Research 99(7):692-705.

CDC (Centers for Disease Control and Prevention). 2009. Reduced hospitalizations for acute myocardial infarction after implementation of a smoke-free ordinance—city of Pueblo, Colorado, 2002–2006. MMWR—Morbidity & Mortality Weekly Report 57(51):1373-1377.

Cesaroni, G., F. Forastiere, N. Agabiti, P. Valente, P. Zuccaro, and C. A. Perucci. 2008. Effect of the Italian smoking ban on population rates of acute coronary events. Circulation 117(9):1183-1188.

Ellerbeck, E. F., S. F. Jencks, M. J. Radford, T. F. Kresowik, A. S. Craig, J. A. Gold, H. M. Krumholz, and R. A. Vogel. 1995. Quality of care for Medicare patients with acute myocardial infarction. A four-state pilot study from the cooperative cardiovascular project. JAMA 273(19):1509-1514.

Hamill, P. V. 1997. Re: “Invited commentary: Response to Science article, ‘Epidemiology faces its limits.’” American Journal of Epidemiology 146(6):527-528.

He, J., S. Vupputuri, K. Allen, M. R. Prerost, J. Hughes, and P. K. Whelton. 1999. Passive smoking and the risk of coronary heart disease--a meta-analysis of epidemiologic studies. New England Journal of Medicine 340(12):920-926.

HEI (Health Effects Institute) Accountability Working Group. 2003. Assessing the health impact of air quality regulations: Concepts and methods for accountability research. Communication 11. Boston, MA: Health Effects Institute.

HHS (U.S. Department of Health and Human Services). 2006. The health consequences of involuntary exposure to tobacco smoke: A report of the surgeon general. Atlanta, GA: U.S. 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.

Hill, A. B. 1965. The environment and disease: Association or causation? Proceedings of the Royal Society of Medicine 58:295-300.

Juster, H. R., B. R. Loomis, T. M. Hinman, M. C. Farrelly, A. Hyland, U. E. Bauer, and G. S. Birkhead. 2007. Declines in hospital admissions for acute myocardial infarction in New York state after implementation of a comprehensive smoking ban. American Journal of Public Health 97(11):2035-2039.

Khuder, S. A., S. Milz, T. Jordan, J. Price, K. Silvestri, and P. Butler. 2007. The impact of a smoking ban on hospital admissions for coronary heart disease. Preventive Medicine 45(1):3-8.

Lemstra, M., C. Neudorf, and J. Opondo. 2008. Implications of a public smoking ban. Canadian Journal of Public Health 99(1):62-65.

Mills, N. L., H. Tornqvist, M. C. Gonzalez, E. Vink, S. D. Robinson, S. Soderberg, N. A. Boon, K. Donaldson, T. Sandstrom, A. Blomberg, and D. E. Newby. 2007. Ischemic and thrombotic effects of dilute diesel-exhaust inhalation in men with coronary heart disease. New England Journal of Medicine 357(11):1075-1082.

Morrow, D. A., E. M. Antman, L. Parsons, J. A. de Lemos, C. P. Cannon, R. P. Giugliano, C. H. McCabe, H. V. Barron, and E. Braunwald. 2001. Application of the TIMI risk score for ST-elevation MI in the National Registry of Myocardial Infarction 3. JAMA 286(11):1356-1359.

Pell, J. P., S. Haw, S. Cobbe, D. E. Newby, A. C. H. Pell, C. Fischbacher, A. McConnachie, S. Pringle, D. Murdoch, F. Dunn, K. Oldroyd, P. Macintyre, B. O’Rourke, and W. Borland. 2008. Smoke-free legislation and hospitalizations for acute coronary syndrome. New England Journal of Medicine 359(5):482-491.

Rogers, W. J., L. J. Bowlby, N. C. Chandra, W. J. French, J. M. Gore, C. T. Lambrew, R. M. Rubison, A. J. Tiefenbrunn, and W. D. Weaver. 1994. Treatment of myocardial infarction in the United States (1990 to 1993). Observations from the National Registry of Myocardial Infarction. Circulation 90(4):2103-2114.

Sargent, R. P., R. M. Shepard, and S. A. Glantz. 2004. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: Before and after study. BMJ 328(7446):977-980.

Seo, D.-C., and M. R. Torabi. 2007. Reduced admissions for acute myocardial infarction associated with a public smoking ban: Matched controlled study. Journal of Drug Education 37(3):217-226.

Stranges, S., M. Cummings, F. P. Cappuccio, and M. Travisan. 2007. Secondhand smoke exposure and cardiovascular disease. Current Cardiovascular Risk Reports 1(5):373-378.

Teo, K. K., S. Ounpuu, S. Hawken, M. R. Pandey, V. Valentin, D. Hunt, R. Diaz, W. Rashed, R. Freeman, L. Jiang, X. Zhang, S. Yusuf, and I. S. Investigators. 2006. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: A case-control study. Lancet 368(9536):647-658.

U.S. Public Health Service. 1964. Smoking and health: Report of the Advisory Committee of the Surgeon General of the Public Health Service . PHS Publication No. 1103. Washington, DC.

Vasselli, S., P. Papini, D. Gaelone, L. Spizzichino, E. De Campora, R. Gnavi, C. Saitto, N. Binkin, and G. Laurendi. 2008. Reduction incidence of myocardial infarction associated with a national legislative ban on smoking. Minerva Cardioangiologica 56(2):197-203.

Whincup, P. H., J. A. Gilg, J. R. Emberson, M. J. Jarvis, C. Feyerabend, A. Bryant, M. Walker, and D. G. Cook. 2004. Passive smoking and risk of coronary heart disease and stroke: Prospective study with cotinine measurement. BMJ 329(7459):200-205.

Data suggest that exposure to secondhand smoke can result in heart disease in nonsmoking adults. Recently, progress has been made in reducing involuntary exposure to secondhand smoke through legislation banning smoking in workplaces, restaurants, and other public places. The effect of legislation to ban smoking and its effects on the cardiovascular health of nonsmoking adults, however, remains a question.

Secondhand Smoke Exposure and Cardiovascular Effects reviews available scientific literature to assess the relationship between secondhand smoke exposure and acute coronary events. The authors, experts in secondhand smoke exposure and toxicology, clinical cardiology, epidemiology, and statistics, find that there is about a 25 to 30 percent increase in the risk of coronary heart disease from exposure to secondhand smoke. Their findings agree with the 2006 Surgeon General's Report conclusion that there are increased risks of coronary heart disease morbidity and mortality among men and women exposed to secondhand smoke. However, the authors note that the evidence for determining the magnitude of the relationship between chronic secondhand smoke exposure and coronary heart disease is not very strong.

Public health professionals will rely upon Secondhand Smoke Exposure and Cardiovascular Effects for its survey of critical epidemiological studies on the effects of smoking bans and evidence of links between secondhand smoke exposure and cardiovascular events, as well as its findings and recommendations.

READ FREE ONLINE

Welcome to OpenBook!

You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

Do you want to take a quick tour of the OpenBook's features?

Show this book's table of contents , where you can jump to any chapter by name.

...or use these buttons to go back to the previous chapter or skip to the next one.

Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

Switch between the Original Pages , where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

To search the entire text of this book, type in your search term here and press Enter .

Share a link to this book page on your preferred social network or via email.

View our suggested citation for this chapter.

Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

Get Email Updates

Do you enjoy reading reports from the Academies online for free ? Sign up for email notifications and we'll let you know about new publications in your areas of interest when they're released.

• IELTS Scores
• Life Skills Test
• Find a Test Centre
• Alternatives to IELTS
• Find Student Housing
• General Training
• Academic Word List
• Topic Vocabulary
• Collocation
• Phrasal Verbs
• Writing eBooks
• Reading eBook
• All eBooks & Courses
• Sample Essays
• Ban Smoking Essay

Ban Smoking in Public Places Essay

This is a  ban smoking in public places  essay. It is an example of an essay where you have to give your opinion as to whether you agree or disagree.

The sample answer shows you how you can present the opposing argument first, that is not your opinion, and then present your opinion in the following paragraph.

It is always a good idea to present a balanced essay which presents both sides of the argument, but you must always make it very clear what your opinion is and which side of the argument you support.

You should spend about 40 minutes on this task.

Write about the following topic:

Smoking not only harms the smoker, but also those who are nearby. Therefore, smoking should be banned in public places.

To what extent do you agree or disagree?

Give reasons for your answer and include any relevant examples from your own experience or knowledge.

Write at least 250 words.

Model Answer:

Medical studies have shown that smoking not only leads to health problems for the smoker, but also for people close by. As a result of this, many believe that smoking should not be allowed in public places. Although there are arguments on both sides, I strongly agree that a ban is the most appropriate course of action.

Opponents of such a ban argue against it for several reasons. Firstly, they say that passive smokers make the choice to breathe in other people’s smoke by going to places where it is allowed. If they would prefer not to smoke passively, then they do not need to visit places where smoking is permitted. In addition, they believe a ban would possibly drive many bars and pubs out of business as smokers would not go there anymore. They also argue it is a matter of freedom of choice. Smoking is not against the law, so individuals should have the freedom to smoke where they wish.

However, there are more convincing arguments in favour of a ban. First and foremost, it has been proven that tobacco consists of carcinogenic compounds which cause serious harm to a person’s health, not only the smoker. Anyone around them can develop cancers of the lungs, mouth and throat, and other sites in the body. It is simply not fair to impose this upon another person. It is also the case that people’s health is more important than businesses. In any case, pubs and restaurants could adapt to a ban by, for example, allowing smoking areas.

In conclusion, it is clear that it should be made illegal to smoke in public places. This would improve the health of thousands of people, and that is most definitely a positive development.

(290 words)

This essay is well organized and presented.

The introduction is clear - note how it follows the ban smoking in public places essay question - it paraphrases the information in order to introduce the topic and the argument.

The argument against a ban on smoking in public places is presented first. It is made clear that it is not the authors opinion by the topic sentence:

• "Opponents of such a ban argue against it for several reasons".

And also by the use of the word 'they' to refer to the opponents.

The writer then clearly shows they are moving on to the other argument which is their own (and it has clearly been stated in the thesis that this is their argument):

• "However, there are more convincing arguments in favour of a ban".

In this paragraph, 'they' is dropped because it is now the writers opinion.

<<< Back

Next >>>

More Agree / Disagree Essays:

Extinction of Animals Essay: Should we prevent this from happening?

In this extinction of animals essay for IELTS you have to decide whether you think humans should do what they can to prevent the extinction of animal species.

Airline Tax Essay: Would taxing air travel reduce pollution?

Airline Tax Essay for IELTS. Practice an agree and disagree essay on the topic of taxing airlines to reduce low-cost air traffic. You are asked to decide if you agree or disagree with taxing airlines in order to reduce the problems caused.

Technology Development Essay: Are earlier developments the best?

This technology development essay shows you a complex IELTS essay question that is easily misunderstood. There are tips on how to approach IELTS essay questions

IELTS Sample Essay: Is alternative medicine ineffective & dangerous?

IELTS sample essay about alternative and conventional medicine - this shows you how to present a well-balanced argument. When you are asked whether you agree (or disagree), you can look at both sides of the argument if you want.

Employing Older People Essay: Is the modern workplace suitable?

Employing Older People Essay. Examine model essays for IELTS Task 2 to improve your score. This essay tackles the issue of whether it it better for employers to hire younger staff rather than those who are older.

Essay for IELTS: Are some advertising methods unethical?

This is an agree / disagree type question. Your options are: 1. Agree 100% 2. Disagree 100% 3. Partly agree. In the answer below, the writer agrees 100% with the opinion. There is an analysis of the answer.

Human Cloning Essay: Should we be scared of cloning humans?

Human cloning essay - this is on the topic of cloning humans to use their body parts. You are asked if you agree with human cloning to use their body parts, and what reservations (concerns) you have.

Multinational Organisations and Culture Essay

Multinational Organisations and Culture Essay: Improve you score for IELTS Essay writing by studying model essays. This Essay is about the extent to which working for a multinational organisation help you to understand other cultures.

IELTS Vegetarianism Essay: Should we all be vegetarian to be healthy?

Vegetarianism Essay for IELTS: In this vegetarianism essay, the candidate disagrees with the statement, and is thus arguing that everyone does not need to be a vegetarian.

Paying Taxes Essay: Should people keep all the money they earn?

Paying Taxes Essay: Read model essays to help you improve your IELTS Writing Score for Task 2. In this essay you have to decide whether you agree or disagree with the opinion that everyone should be able to keep their money rather than paying money to the government.

Dying Languages Essay: Is a world with fewer languages a good thing?

Dying languages essays have appeared in IELTS on several occasions, an issue related to the spread of globalisation. Check out a sample question and model answer.

Truthfulness in Relationships Essay: How important is it?

This truthfulness in relationships essay for IELTS is an agree / disagree type essay. You need to decide if it's the most important factor.

Return of Historical Objects and Artefacts Essay

This essay discusses the topic of returning historical objects and artefacts to their country of origin. It's an agree/disagree type IELTS question.

Free University Education Essay: Should it be paid for or free?

Free university education Model IELTS essay. Learn how to write high-scoring IELTS essays. The issue of free university education is an essay topic that comes up in the IELTS test. This essay therefore provides you with some of the key arguments about this topic.

Examinations Essay: Formal Examinations or Continual Assessment?

Examinations Essay: This IELTS model essay deals with the issue of whether it is better to have formal examinations to assess student’s performance or continual assessment during term time such as course work and projects.

IELTS Internet Essay: Is the internet damaging social interaction?

Internet Essay for IELTS on the topic of the Internet and social interaction. Included is a model answer. The IELTS test usually focuses on topical issues. You have to discuss if you think that the Internet is damaging social interaction.

Scientific Research Essay: Who should be responsible for its funding?

Scientific research essay model answer for Task 2 of the test. For this essay, you need to discuss whether the funding and controlling of scientific research should be the responsibility of the government or private organizations.

Role of Schools Essay: How should schools help children develop?

This role of schools essay for IELTS is an agree disagree type essay where you have to discuss how schools should help children to develop.

Sample IELTS Writing: Is spending on the Arts a waste of money?

Sample IELTS Writing: A common topic in IELTS is whether you think it is a good idea for government money to be spent on the arts. i.e. the visual arts, literary and the performing arts, or whether it should be spent elsewhere, usually on other public services.

Internet vs Newspaper Essay: Which will be the best source of news?

A recent topic to write about in the IELTS exam was an Internet vs Newspaper Essay. The question was: Although more and more people read news on the internet, newspapers will remain the most important source of news. To what extent do you agree or disagree?

Any comments or questions about this page or about IELTS? Post them here. Your email will not be published or shared.

Before you go...

Check out the ielts buddy band 7+ ebooks & courses.

Would you prefer to share this page with others by linking to it?

• Click on the HTML link code below.
• Copy and paste it, adding a note of your own, into your blog, a Web page, forums, a blog comment, your Facebook account, or anywhere that someone would find this page valuable.

Band 7+ eBooks

"I think these eBooks are FANTASTIC!!! I know that's not academic language, but it's the truth!"

Linda, from Italy, Scored Band 7.5

IELTS Modules:

Other resources:.

• All Lessons
• Band Score Calculator
• Writing Feedback
• Speaking Feedback
• Teacher Resources
• Free Downloads
• Recent Essay Exam Questions
• Books for IELTS Prep
• Student Housing
• Useful Links

Recent Articles

Decreasing House Sizes Essay

Apr 06, 24 10:22 AM

Latest IELTS Writing Topics - Recent Exam Questions

Apr 04, 24 02:36 AM

IELTS Essay: English as a Global Language

Apr 03, 24 03:49 PM

Important pages

IELTS Writing IELTS Speaking IELTS Listening   IELTS Reading All Lessons Vocabulary Academic Task 1 Academic Task 2 Practice Tests

Connect with us

Copyright © 2022- IELTSbuddy All Rights Reserved

IELTS is a registered trademark of University of Cambridge, the British Council, and IDP Education Australia. This site and its owners are not affiliated, approved or endorsed by the University of Cambridge ESOL, the British Council, and IDP Education Australia.

Home — Essay Samples — Law, Crime & Punishment — Laws & Regulations — Smoking Ban

Essays on Smoking Ban

Smoking ban essay topics are important because they cover a wide range of issues related to public health, individual rights, and government regulation. Smoking bans have been implemented in many countries and cities around the world in an effort to reduce the harmful effects of secondhand smoke and to encourage smokers to quit. The debate over smoking bans is a contentious one, with arguments on both sides about the impact of such bans on businesses, personal freedom, and public health. Choosing a smoking ban essay topic can be a challenging task, as there are many different aspects to consider. This list of smoking ban essay topics aims to provide a wide range of options for students and researchers to explore.

The Importance of the Topic

Smoking bans are important because they have a direct impact on public health. Secondhand smoke has been proven to cause a wide range of health problems, including respiratory issues, heart disease, and cancer. By implementing smoking bans in public places, governments can help to protect non-smokers from the harmful effects of secondhand smoke. Additionally, smoking bans can also encourage smokers to quit, as they may find it more difficult to smoke in public places. This can lead to improved health outcomes for individuals and reduce the burden on healthcare systems.

Furthermore, smoking bans can also have economic implications. Businesses that rely on customers who smoke may see a decline in revenue as a result of smoking bans, while others may benefit from a healthier, smoke-free environment. The impact of smoking bans on businesses and the economy is a topic of great interest to researchers and policymakers.

Choosing a Topic

When choosing a smoking ban essay topic, it is important to consider the different perspectives on the issue. Some potential topics to consider include the impact of smoking bans on public health, the economic effects of smoking bans on businesses, the legal and ethical considerations of smoking bans, and the effectiveness of smoking bans in reducing smoking rates. Students and researchers should also consider the geographical and cultural context of their chosen topic, as smoking bans can vary widely from one place to another.

Another important consideration when choosing a smoking ban essay topic is the availability of research and data. Some topics may have more data and evidence available than others, making them easier to research and write about. It is also important to consider the potential implications of the chosen topic, both in terms of its relevance and its potential impact on public policy and public health.

Smoking ban essay topics cover a wide range of important issues related to public health, individual rights, and government regulation. Choosing a topic can be a challenging task, as there are many different aspects to consider. This list of smoking ban essay topics aims to provide a wide range of options for students and researchers to explore. By considering the different perspectives on the issue and the availability of research and data, students and researchers can choose a topic that is both interesting and relevant. Ultimately, the goal of exploring smoking ban essay topics is to contribute to a better understanding of the impact of smoking bans on public health, individual rights, and society as a whole.

The Hazards of Smoking: Effects, Bans, and Prevention

Rhetorical analysis of anti-smoking quotes, made-to-order essay as fast as you need it.

Each essay is customized to cater to your unique preferences

+ experts online

Smoking Informative Speech

Reducing the risk of cad: why smoking should be banned, should smoking be made illegal: argumentative, the effects of smoking ban, let us write you an essay from scratch.

• 450+ experts on 30 subjects ready to help
• Custom essay delivered in as few as 3 hours

Political and Social Determinants of The Introduction of The Smoking Ban Act in The UK

Effect of tobacco: why cigarette smoking should be banned, smoking and vaping ban in australia, e-cigarettes and vaping epidemic across the united states, get a personalized essay in under 3 hours.

Expert-written essays crafted with your exact needs in mind

Discussion on Whether Cigarette Smoking Should Be Banned in Public Places

Young, wild, and free: the increasing number of underage cigarette users, a research paper on smoking cigarettes: should society ban it, nevada's smoking freedom at stake as joelle babula argues that local government should enforce strict laws, california smoking ban of 1998: a closer look, nicotine addiction: should smoking be banned in public places, relevant topics.

• Constitution
• Business Law
• Contract Law
• Consumer Protection
• Restorative Justice
• Legal Drinking Age

By clicking “Check Writers’ Offers”, you agree to our terms of service and privacy policy . We’ll occasionally send you promo and account related email

No need to pay just yet!

We use cookies to personalyze your web-site experience. By continuing we’ll assume you board with our cookie policy .

• Instructions Followed To The Letter
• Deadlines Met At Every Stage
• Unique And Plagiarism Free

Essay on Nationwide Smoking Ban

Students are often asked to write an essay on Nationwide Smoking Ban in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Nationwide Smoking Ban

What is a nationwide smoking ban.

A nationwide smoking ban is a law that stops people from smoking in public areas across a whole country. It means no one can smoke in places like restaurants, parks, and offices. This rule is made to protect everyone from the bad effects of smoking.

Benefits of the Ban

This ban is good for health. It reduces diseases caused by smoking, like lung cancer. It also helps people who don’t smoke stay healthy because they don’t breathe in smoke from others.

Impact on Smokers and Society

The ban encourages smokers to quit, which can be tough. But it makes the air cleaner for all, and that’s a big win for the health of the people and the country.

250 Words Essay on Nationwide Smoking Ban

A nationwide smoking ban is a law that stops people from smoking in public places all over a country. This means no one can smoke in places like restaurants, offices, or parks. The main goal is to protect people from the smoke that comes from cigarettes, which can be harmful to everyone’s health.

Why is Smoking Harmful?

Smoking is bad for health because it can cause diseases like cancer, heart problems, and breathing issues. Not just smokers, but also people around them can get sick from the smoke. This is called secondhand smoke and it is especially dangerous for children and people who are already sick.

A smoking ban can make the air cleaner and healthier for everyone. It can also encourage smokers to smoke less or quit altogether. This can save lives and reduce the number of people getting sick because of smoking. Hospitals might also have fewer patients with smoking-related problems, which saves money and resources.

Challenges of the Ban

Making a smoking ban work is not always easy. Some people who smoke might find it hard to change their habits. Businesses like bars and clubs might worry about losing customers. The government needs to help people understand why the ban is important and offer support to those who want to stop smoking.

A nationwide smoking ban is important for keeping everyone healthy. It helps protect people from the dangers of smoking and secondhand smoke. While it can be tough to get used to at first, the benefits of having clean air and healthier lives are worth it.

500 Words Essay on Nationwide Smoking Ban

A nationwide smoking ban is a law that stops people from smoking tobacco in public places across a whole country. This means no one can smoke in places like restaurants, offices, and parks. The idea is to protect everyone’s health, including those who do not smoke. This kind of ban is also known as a smoke-free law.

Why Do We Need a Smoking Ban?

Smoking is bad for health. It can cause sickness like cancer and heart disease not just in people who smoke but also in those who breathe in the smoke, known as secondhand smoke. Children and people who are sick are especially at risk. By banning smoking in public, everyone can breathe cleaner air, stay healthier, and sick people can get better without breathing smoke.

The Benefits of a Smoking Ban

When smoking is not allowed, there are many good things that happen. First, the air is cleaner, which is better for our lungs. Second, fewer people get sick from smoking-related diseases, which means they live longer and healthier lives. Third, when people see less smoking around them, they are less likely to start smoking, especially young people. This means fewer smokers in the future.

How Does a Smoking Ban Work?

A smoking ban works by making rules that say where people can and cannot smoke. Signs are put up to tell people about the rules. Police and other officials help make sure people follow the rules. If someone breaks the rule, they might have to pay money as a fine.

Challenges of a Smoking Ban

Even though a smoking ban is good for health, it can be hard to put in place. Some people who smoke feel it is not fair to tell them where they can smoke. Businesses that sell cigarettes might make less money. Also, it takes time and effort to teach people about the new rules and why they are important.

What People Think About Smoking Bans

People have different thoughts about smoking bans. Some people are very happy because they want clean air and good health. Others might not like the ban because they enjoy smoking or because they make money from selling cigarettes. It is important to listen to everyone and try to find a way that helps the most people.

A nationwide smoking ban is a big step towards better health for everyone. It helps make sure that the air we all breathe is clean and safe. It can also help people live longer and healthier lives by preventing diseases caused by smoking. Even though it might be tough to start, a smoking ban is a good idea for the health of all people in a country. It’s like making a rule that helps protect everyone, just like wearing seatbelts in cars. It is important for everyone to understand why a smoking ban is good and to help each other follow the rules.

That’s it! I hope the essay helped you.

If you’re looking for more, here are essays on other interesting topics:

• Essay on Nationalism And Patriotism
• Essay on Graffiti
• Essay on National Heroes Day

Apart from these, you can look at all the essays by clicking here .

Happy studying!

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

Top Streams

• Data Science Courses in USA
• Business Analytics Courses in USA
• Engineering Courses in USA
• Tax Courses in USA
• Healthcare Courses in USA
• Language Courses in USA
• Insurance Courses in USA
• Digital Marketing Courses in USA

Top Specialization

• Masters in Data Analytics in USA
• Masters in Mechanical Engineering in USA
• Masters in Supply Chain Management in USA
• Masters in Computer Science in USA
• MBA in Finance in USA
• Masters in Architecture in USA

Top Universities

• Cornell University
• Yale University
• Princeton University
• University of California Los Angeles
• University of Harvard
• Stanford University
• Arizona State University
• Northeastern University

ACCEL PROGRAMS

• Master of Business Administration
• MS in Data Analytics
• MS in Computer Science
• Project Management Courses in Australia
• Accounting Courses in Australia
• Medical Courses in Australia
• Psychology Courses in Australia
• Interior Designing Courses in Australia
• Pharmacy Courses in Australia
• Social Work Courses in Australia
• MBA in Australia
• Masters in Education in Australia
• Masters in Pharmacy in Australia
• Masters in Information Technology in Australia
• BBA in Australia
• Masters in Teaching in Australia
• Masters in Psychology in Australia
• University of Melbourne
• Deakin University
• Carnegie Mellon University
• Monash University
• University of Sydney
• University of Queensland
• RMIT University
• Macquarie University
• Bachelor of Business Administration
• Bachelor of Computer Applications
• Data Science Courses in Canada
• Business Management Courses in Canada
• Supply Chain Management Courses in Canada
• Project Management Courses in Canada
• Business Analytics Courses in Canada
• Hotel Management Courses in Canada
• MBA in Canada
• MS in Canada
• Masters in Computer Science in Canada
• Masters in Management in Canada
• Masters in Psychology in Canada
• Masters in Education in Canada
• MBA in Finance in Canada
• Masters in Business Analytics in Canada
• University of Toronto
• University of British Columbia
• McGill University
• University of Alberta
• York University
• University of Calgary
• Algoma University
• University Canada West
• BBA in Canada, Trinity Western University
• BBA in Canada, Yorkville University
• Project Management Courses in UK
• Data Science Courses in UK
• Public Health Courses in UK
• Digital Marketing Courses in UK
• Hotel Management Courses in UK
• Nursing Courses in UK
• Medicine Courses in UK
• Interior Designing Courses in UK
• Masters in Computer Science in UK
• Masters in Psychology in UK
• MBA in Finance in UK

MBA in Healthcare Management in UK

• Masters in Education in UK
• Masters in Marketing in UK
• MBA in HR in UK
• University of Oxford
• University of Cambridge
• Coventry University
• University of East London
• University of Hertfordshire
• University of Birmingham
• Imperial College London
• University of Glasgow
• MBA with Work Placement
• MSc Data Science with Work Placement

Top Resources

• Universities in Germany
• Study in Germany
• Masters in Germany
• Courses in Germany
• Bachelors in Germany
• Germany Job Seeker Visa
• Cost of Living in Germany

Best Universities in Germany

Top courses.

• Masters in Data Science in Germany
• MS in Computer Science in Germany
• Marine Engineering in Germany
• MS Courses in Germany
• Masters in Psychology in Germany
• Hotel Management Courses in Germany
• Masters in Economics in Germany
• Paramedical Courses in Germany
• Karlsruhe Institute of Technology
• University of Bonn
• University of Freiburg
• University of Hamburg
• University of Stuttgart
• Saarland University
• Mannheim University
• Master of Business Administration (90 ECTS)
• MS Data Science 60 ECTS
• Master in Computer Science (120 ECTS)
• MBA in Ireland
• Phd in Ireland
• Masters in Computer Science Ireland
• Cyber Security in Ireland
• Masters in Data Analytics Ireland
• Ms in Data Science in Ireland
• Pharmacy courses in ireland
• Business Analytics Course in Ireland
• Universities in Ireland
• Study in Ireland
• Masters in Ireland
• Courses in Ireland
• Bachelors in Ireland
• Cost of Living in Ireland
• Ireland Student Visa
• Part Time Jobs in Ireland
• Trinity College Dublin
• University College Dublin
• Dublin City University
• University of Limerick
• Dublin Business School
• Maynooth University
• University College Cork
• National College of Ireland

Colleges & Courses

• Masters in France
• Phd in France
• Study Medicine in France
• Best Universities in Frankfurt
• Best Architecture Colleges in France
• ESIGELEC France
• Study in France for Indian Students
• Intakes in France
• SOP for France Visa
• Study in France from India
• Reasons to Study in France
• How to Settle in France

More About France

• Cost of Living in France
• France Study Visa
• Cost of Living in Frankfurt
• France Scholarship for Indian Students
• Part Time Jobs in France
• Stay Back in France After Masters

About Finland

• Universities in Finland
• Study in Finland
• Courses in Finland
• Bachelor Courses in Finland
• Masters Courses in Finland
• Cost of Living in Finland
• MS in Finland
• Average Fees in Finland Universities
• PhD in Finland
• MBA Leading Business Transformation
• MBA Business Technologies
• Bachelor Degree in Medicine & Surgery
• MBBS Courses in Georgia
• MBBS Courses in Russia
• Alte University
• Caucasus University
• Georgian National University SEU
• David Tvildiani Medical University
• Caspian International School Of Medicine
• Asfendiyarov Kazakh National Medical University
• Kyrgyz State Medical Academy
• Cremeia Federal University
• Bashkir State Medical University
• Kursk State Medical University
• Andijan State Medical Institute
• IELTS Syllabus
• IELTS Prepration
• IELTS Eligibility
• IELTS Test Format
• IELTS Band Descriptors
• IELTS Speaking test
• IELTS Writing Task 1
• IELTS score validity
• IELTS Cue Card

IELTS Reading Answers Sample

• Animal Camouflage
• Types Of Societies
• Australia Convict Colonies
• A Spark A Flint
• Emigration To The Us
• The History Of Salt
• Zoo Conservation Programmes
• The Robots Are Coming
• The Development Of Plastic

IELTS Speaking Cue Card Sample

• Describe A Puzzle You Have Played
• Describe A Long Walk You Ever Had
• Describe Your Favourite Movie
• Describe A Difficult Thing You did
• Describe A Businessman You Admire
• Memorable Day in My Life
• Describe Your Dream House
• Describe A Bag You Want to Own
• Describe a Famous Athlete You Know
• Aquatic Animal

IELTS Essay Sample Sample

• Best Education System
• IELTS Opinion Essay
• Agree or Disagree Essay
• Problem Solution Essays
• Essay on Space Exploration
• Essay On Historical Places
• Essay Writing Samples
• Tourism Essay
• Global Warming Essay
• GRE Exam Fees
• GRE Exam Syllabus
• GRE Exam Eligibility
• Sections in GRE Exam
• GRE Exam Benefits
• GRE Exam Results
• GRE Cutoff for US Universities
• GRE Preparation
• Send GRE scores to Universities

GRE Exam Study Material

• GRE Verbal Preparation
• GRE Study Material
• GRE AWA Essays
• GRE Sample Issue Essays
• Stanford University GRE Cutoff
• Harvard University GRE Cutoff
• GRE Quantitative Reasoning
• GRE Verbal Reasoning
• GRE Reading Comprehension
• Prepare for GRE in 2 months

Other Resources

• Documents Required For Gre Exam
• GRE Exam Duration
• GRE at Home
• GRE vs GMAT
• Improve GRE Verbal Scores

Free GRE Ebooks

• GRE Preparation Guide (Free PDF)
• GRE Syllabus (Free PDF)
• GMAT Eligibility
• GMAT Syllabus
• GMAT Exam Dates
• GMAT Registration
• GMAT Exam Fees
• GMAT Sections
• GMAT Purpose

GMAT Exam Study Material

• How to prepare for GMAT?
• GMAT Score Validity
• GMAT Preparation Books
• GMAT Preparation
• GMAT Exam Duration
• GMAT Score for Harvard
• GMAT Reading Comprehension
• GMAT Retake Strategy

Free GMAT Ebooks

• GMAT Guide PDF
• Download GMAT Syllabus PDF
• TOEFL Exam Registration
• TOEFL Exam Eligibility
• TOEFL Exam Pattern
• TOEFL Exam Preparation
• TOEFL Exam Tips
• TOEFL Exam Dates
• Documents for TOEFL Exam
• TOEFL Exam Fee

TOEFL Exam Study Material

• TOEFL Preparation Books
• TOEFL Speaking Section
• TOEFL Score and Results
• TOEFL Writing Section
• TOEFL Reading Section
• TOEFL Listening Section
• TOEFL Vocabulary
• Types of Essays in TOEFL

Free TOEFL Ebooks

• TOEFL Exam Guide (Free PDF)
• PTE Exam Dates
• PTE Exam Syllabus
• PTE Exam Eligibility Criteria
• PTE Test Centers in India
• PTE Exam Pattern
• PTE Exam Fees
• PTE Exam Duration
• PTE Exam Registration

PTE Exam Study Material

• PTE Exam Preparation
• PTE Speaking Test
• PTE Reading Test
• PTE Listening Test
• PTE Writing Test
• PTE Essay Writing
• PTE exam for Australia

Free PTE Ebooks

• PTE Syllabus (Free PDF)
• Duolingo Exam
• Duolingo Test Eligibility
• Duolingo Exam Pattern
• Duolingo Exam Fees
• Duolingo Test Validity
• Duolingo Syllabus
• Duolingo Preparation

Duolingo Exam Study Material

• Duolingo Exam Dates
• Duolingo Test Score
• Duolingo Test Results
• Duolingo Test Booking

Free Duolingo Ebooks

• Duolingo Guide (Free PDF)
• Duolingo Test Pattern (Free PDF)

NEET & MCAT Exam

• NEET Study Material
• NEET Preparation
• MCAT Eligibility
• MCAT Preparation

SAT & ACT Exam

• ACT Eligibility
• ACT Exam Dates
• SAT Syllabus
• SAT Exam Pattern
• SAT Exam Eligibility

USMLE & OET Exam

• USMLE Syllabus
• USMLE Preparation
• USMLE Step 1
• OET Syllabus
• OET Eligibility
• OET Prepration

PLAB & LSAT Exam

• PLAB Exam Syllabus
• PLAB Exam Fees
• LSAT Eligibility
• LSAT Registration
• TOEIC Result
• Study Guide

Application Process

• LOR for Masters
• SOP Samples for MS
• LOR for Phd
• SOP for Internship
• SOP for Phd
• Check Visa Status
• Motivation Letter Format
• Motivation Letter for Internship
• F1 Visa Documents Checklist

Career Prospects

• Popular Courses after Bcom in Abroad
• Part Time Jobs in Australia
• Part Time Jobs in USA
• Salary after MS in Germany
• Salary after MBA in Canada
• Average Salary in Singapore
• Higher Studies after MBA in Abroad
• Study in Canada after 12th

Trending Topics

• Best Education System in World
• Best Flying Schools in World
• Top Free Education Countries
• Best Countries to Migrate from India
• 1 Year PG Diploma Courses in Canada
• Canada Vs India
• Germany Post Study Work Visa
• Post Study Visa in USA
• Data Science Vs Data Analytics
• Public Vs Private Universities in Germany
• Universities Vs Colleges
• Difference Between GPA and CGPA
• Undergraduate Vs Graduate
• MBA in UK Vs MBA in USA
• Degree Vs Diploma in Canada
• IELTS vs TOEFL
• Duolingo English Test vs. IELTS
• Why Study in Canada
• Cost of Living in Canada
• Education System in Canada
• SOP for Canada
• Summer Intake in Canada
• Spring Intake in Canada
• Winter Intake in Canada
• Accommodation in Canada for Students
• Average Salary in Canada
• Fully Funded Scholarships in Canada
• Why Study in USA
• Cost of Studying in USA
• Spring Intake in USA
• Winter Intake in USA
• Summer Intake in USA
• STEM Courses in USA
• Scholarships for MS in USA
• Acceptable Study Gap in USA
• Interesting Facts about USA
• Free USA course
• Why Study in UK
• Cost of Living in UK
• Cost of Studying in UK
• Education System in UK
• Summer Intake in UK
• Spring Intake in UK
• Student Visa for UK
• Accommodation in UK for Students
• Scholarships in UK
• Why Study in Germany
• Cost of Studying in Germany
• Education System in Germany
• SOP for Germany
• Summer Intake in Germany
• Winter Intake in Germany
• Study Visa for Germany
• Accommodation in Germany for Students
• Free Education in Germany

Country Guides

• Study in UK
• Study in Canada
• Study in USA
• Study in Australia
• SOP Samples for Canada Student Visa
• US F1 Visa Guide for Aspirants

Exams Guides

• Duolingo Test Pattern

Recommended Reads

• Fully Funded Masters Guide
• SOP Samples For Australia
• Scholarships for Canada
• Data Science Guide
• SOP for MS in Computer Science
• Study Abroad Exams
• Alumni Connect
• Booster Program

GPA CALCULATOR Convert percentage marks to GPA effortlessly with our calculator!

Expense calculator plan your study abroad expenses with our comprehensive calculator, ielts band calculator estimate your ielts band score with our accurate calculator, education loan calculator discover your eligible loan amount limit with our education calculator, university partner explore growth and opportunities with our university partnership, accommodation discover your perfect study abroad accommodation here, experience-center discover our offline centers for a personalized experience, our offices visit us for expert study abroad counseling..

• 18002102030
• Study Abroad

Should Smoking Be Banned In Public Places Essay - Samples and Tips for IELTS

• IELTS Preparation
• IELTS E-Books
• IELTS Registration
• IELTS Exam Fee
• IELTS Exam Dates 2024
• Documents Required
• IELTS Test Centers
• Test Format
• Band Descriptors
• IELTS Speaking Test
• General Reading Test
• General Writing Task
• IELTS Coaching
• Types of Essays
• IELTS for Australia
• IELTS Results
• Generation Gap Essay
• GPA Calculator
• Study Abroad Consultant In India
• Study Visa Consultants in India

Updated on 27 January, 2024

Anupriya Mukherjee

Sr. content writer.

IELTS or the International English language Testing System is one of the most popular and standardized tests to measure the English language proficiency of non-native English speakers. The IELTS writing section has two tasks, and task 2 is an essay writing question. Here, an essay topic will be given and you need to write an essay in response to it. The should smoking be banned in public places essay has been asked multiple times in the IELTS writing test over the years.

The test-takers need to practice common topics related to general and controversial issues. The relevant essay questions may change, but the main topic often remains the same. 

Applicants must develop ideas and provide relevant examples to write a winning essay on topics related to questions like should smoking be banned in public places? The essay writing module is a challenging task and needs thorough preparation. Let us take a look at some of the  smoking should be banned in public places IELTS essay samples and some tips to ace the task.

Table of Contents

Sample essay:, download e-books for ielts preparation, download ielts sample papers.

• Tips to write a winning IELTS essay on ' should smoking be banned in public places

Frequently Asked Questions

Learn more about study abroad, popular study abroad destinations, sample 1 on s hould smoking be banned in public places essay.

Some say 'smoking in public areas should be banned' while others go against the ban. Discuss both sides and give your opinion. 

Tip: It is an opinion-based topic. Here, both sides need to be discussed, and finally, the opinion of the test-taker should be discussed. 

Smoking is quite common among the younger generations today. But it has detrimental health impacts on both the smoker and any other person that inhales the smoke. The idea that 'smoking in public should be banned, is supported as well as opposed by many people. I believe smoking in public cannot be completely banned but there can be a middle path. 

There are convincing arguments in favor of the ban because smoking ultimately leads to serious health crises. Supporters of the ban have various reasons to state. 

Firstly, smoking is injurious to health. The main cause of lung cancer is smoking tobacco. Active smokers also suffer from other diseases like tuberculosis and heart problems. The symptoms may take time to show up but it eventually leads to a major crisis. It does not affect only the smoker, but also the people around the smoker. Both active and passive smokers can fall ill, and this calls for huge support for a blanket ban on smoking in public places. 

Secondly, smoking is an addiction that influences non-smokers too. Anything that becomes an addiction is not at all safe and it tends to spread quickly. Peer and colleague group influences are very common in forming smoking habits. It is very easy to pick up smoking when one stays among smokers for long. People spend plenty of time in public areas, hence, smoking should be banned in public areas to avoid such negative influences. 

Lastly, non-smokers feel very stressed when among smokers. It becomes difficult for pregnant women, senior citizens, and children, to adjust to an environment that is filled with cigarette smoke. It irritates non-smokers of various age groups. Smoking in public should be banned as it leads to annoyance to a large extent.  

Nevertheless, some people oppose this ban too.

Firstly, they are unhappy about giving away their rights to smoke. They believe that such a ban would make them feel deprived of their individual rights. 

Secondly, people against the ban on smoking in public areas say that cigarettes are sold and advertised publicly, and banning them will not make any difference. “Why can’t the government ban cigarettes completely if smoking in public is not allowed?”

Thirdly, they argue on terms like it becomes difficult to give up due to addiction. There are many incidents where severe health conditions are reported by active smokers, due to nicotine withdrawal. It is not easy to give up on smoking if someone does it regularly. 

Fourthly, it will be an expensive affair to ban public smoking and impose new rules. Hence, they feel that the best solution is to keep active smokers separated from the general public. 

Considering both sides of the argument, I feel there should be designated smoking zones in public areas. The bus stands, shopping malls, restaurants, and offices must have separate smoking zones so that addicted smokers are not affected or deprived. 

Important Resources to Read:

Sample 2 on  ‘smoking should be banned in public places IELTS essay’

Some businesses restrict smoking inside office spaces. Do you agree or disagree with this step taken by the businesses? Give reasons for your opinion.

Sample essay: 

Corporate offices often see groups of individuals discussing issues while smoking. Is it a habit or does smoking actually help you brainstorm? Well, for non-smokers it should be banned, and for smokers, it is almost office culture.

Many companies, firms, and government offices have imposed restrictions on smoking inside office spaces. I feel it can be addressed with some other effective measures. 

There are certain seemingly positive sides to smoking during work hours. It is believed that smoking improves concentration and helps the employees relax after long meetings or completion of projects. There is constant stress regarding deadlines, appraisal, and targets at work. In such a scenario, smoking is supposed to reduce stress.

Nicotine is a stimulant and smoking during office hours might keep employees in an active and elevated mood. Some projects may demand employees to stay awake late at night and work. In such a situation, employees don't feel drowsy and sleepy due to the nicotine boost. 

Despite all these positive sides, there are alarming negative aspects too. 

Firstly, smoking is harmful to health. It is one of the main reasons behind the increasing number of lung cancer cases globally. Diseases like tuberculosis and various cardiovascular health issues are caused by prolonged smoking habits. It does not only affect the smoker but also the people who spend time around smokers. Passive smokers face detrimental impacts too when they come in contact with smokers. 

Secondly, the non-smokers feel uncomfortable in public spaces filled with cigarette smoke. It causes them stress. It is also very annoying, particularly for pregnant women and senior citizens in the office areas.

The debate between smokers and non-smokers can stop only when the authorities plan something fruitful. A strict ban on smoking will do no good. It will instill a sense of anger and disappointment among smokers if their rights are taken away suddenly. Similarly, the health impact of passive smokers cannot be ignored. In my opinion, office spaces and public areas should have separate smoking zones. This way, non-smokers will not have any problems and smokers can also relax.

You Can Also Read Sample Questions and Answers For The IELTS Passage: G reen Wave Washes Over Mainstream Shopping

Recommended Reads:

Tips to write a winning IELTS essay on ' should smoking be banned in public places

• The time allotted for the task 2 essay is 40 minutes and no extra time is allowed.
• The minimum word limit for an essay is 250 words but there is no upper word limit. It is recommended to write a little more than the prescribed limit. 
• Organize the entire essay in 3 parts, introduction, body, and conclusion. In the introduction is a clear overview of the entire topic. The body is an analysis of facts and the conclusion should contain the opinion and summing up points.
• Paraphrasing is important. It increases the readability of the essay.
• Write short, crisp, and to-the-point sentences. Do not write complicated and lengthy sentences. 
• Answer all the parts of the questions. Refer to the first sample below, which has three parts - 1. agree in favor of why smoking should be banned 2. disagree in context to why smoking should not be banned 3. your own opinion.
• If you are using any facts or statistical data, you need to be sure about them.
• Idioms make your write-up colorful and accurate. You need to know them well before you use them.
• Use collocations wherever needed. Use connectors and linking words but do not stuff them unnecessarily. 
• Be careful about the punctuation.
• Present all your ideas in the right flow. The ideas, concepts, and experiences should be relevant to the topic.
• Maintain a semi-formal tone. Do not use any informal and personal phrases.
• Proofread your essay once you are done with the writing. This will help you scan mistakes in your essay.
• When you practice a particular topic you must focus on learning all the relevant vocabulary related to it.
• Check spellings, you should not make spelling errors. Use only those words that you are 100% sure of. 
• Practice all kinds of essays. You can get pattern questions like advantages, disadvantages, opinions, causes and effects, causes and solutions, and direct questions. 
• The conclusion is very important. The way you sum up your opinion will matter in boosting your IELTS band. 
• Get your practice essays checked by an expert or any IELTS experienced professional you might know.

It is important to practice and prepare for a winning IELTS essay. The IELTS writing task is very important as it measures the writing skills of non-native English speakers. Go through all the samples and tips on  should smoking be banned in public places essay to write well. For any assistance regarding the IELTS essays, applicants can get in touch with academic counselors of upGrad Abroad.

Also Reads:

How does smoking in public places affect the environment?

Smoking cigarettes or other tobacco products in public has an adverse effect upon the environment. It leads to pollution and releases toxic air and polluting agents into the atmosphere. The cigarette butts also pile up, littering several areas and the chemicals contained in the same are toxic. When they leach into water and soil, they end up contaminating the entire ecosystem, leading to pollution of the water and soil alike. Smoking is also an irritant for others if done in public.

How does smoking affect the society & community?

Smoking has a widespread impact on the community and society at large. Smoking in public releases toxic and harmful air into the atmosphere while also contributing towards increasing the pollutant counts in the air. It also leads to contamination of the soil and water through the littering of cigarette butts. 

Exposure to second-hand smoke is also physically harmful for others in public. Smoking contributes towards respiratory disorders and air pollution as well. It also enhances the risks of various ailments and fatalities in society at large.

What are the arguments for and against banning smoking in all public places?

The arguments for banning smoking in public places are the following: 

• Smoking leads to air pollution and releases toxic air into the atmosphere. 
• Littering of cigarette butts leads to widespread soil and water contamination. 
• Smoking leads to serious diseases and respiratory illnesses for others owing to their exposure to second-hand smoke. 
• Smoking leads to a higher incidence of heart attacks, lung cancer and other disease which de-stabilize major chunks of communities, leading to higher healthcare costs for Governments and more strain on healthcare resources. 

The arguments against banning smoking in public places are the following: 

• Smoking bans do not usually have the intended effect, i.e. getting people to cut down or give up smoking. 
• It may be perceived as an infringement of the freedom and rights of citizens. 
• It will lead to lower tax revenues for Governments, limiting their public spending as a result. 
• It will not be good for several businesses as well, especially in the food and beverages sector.

Why smoking should be banned in public places ielts essay?

Smoking is a social evil that is greatly impacting the society and community at large. At the individual and organizational levels, much more needs to be done for combating the harmful incidence of rising smoking levels amongst people in multiple age groups. Smoking causes innumerable ailments and diseases, while exposing people to harmful passive smoke and pollutes the air considerably. It also contributes towards soil and air pollution. I feel that smoking should be banned in public places owing to its negative effects on entire communities.

Smoking should be banned in public places because of the pollution it creates. Firstly, it leads to the release of toxic smoke and other pollutants into the atmosphere. Secondly, littering of cigarette butts leads to soil and water contamination alike. Thirdly, people who are non-smokers, are exposed to passive smoke for no fault of theirs and contract respiratory ailments in turn. Fourthly, banning public smoking will lower the incidence of fatalities and serious disease, lowering the strain on Governmental healthcare resources and costs of the same. 

Banning public smoking will also set a more positive example for the younger generations who will be less likely to pick up the habit. Hence, I firmly believe that Governments should set examples by banning public smoking and setting the tone for a healthier tomorrow.

Here are few of the trending IELTS Reading Answers:

• The Life And Work Of Marie Curie Reading Answers
• Why Pagodas Don't Fall Down
• Spoken Corpus Comes To Life Reading Answers
• Striking Back At Lightning With Lasers IELTS Reading Answers
• The Context Meaning And Scope Of Tourism Reading Answers
• A Spark A Flint IELTS Reading Answers
• The Concept Of Role Theory Reading Answers
• Micro Enterprise Credit For Street Youth Reading Answers
• When Evolution Runs Backwards IELTS
• The Impact Of Wilderness Tourism IELTS Reading Answers
• The Truth About The Environment Reading Answers
• The Politics Of Pessimism Reading Answer
• The Rocket From East To West Reading Answers
• Glass Capturing The Dance Of Light
• Population Movements And Genetics Reading Answers
• The Megafires Of California Reading Answers

What is Scholarship

Learn all about the scholarships like types of scholarships and how to get a one

Provincial Nominee Program Canada

Learn all about Provincial Nominee Program (PNP) Canada

Fulbright Scholarship

Learn about the eligibility, benefits, procedure etc about Fulbright Scholarships

Education Loan for Study Abroad

Learn about educational loans, types, amount, eligibility & more in this article.

Best Universities in Australia

Learn about best universities in Australia along with other information

SEVIS Fees for F1 Visa

Learn about SEVIS fees amount & how to pay SEVIS fee here.

Learn more about the best universities in Germany for higher education

Learn all about USMLE exam here including USMLE steps, process & more

Letter of Recommendation (LOR)

Find our all about an LOR and also how to effectively write an LOR

Best Courses After 12th Commerce in USA

Know about the best courses to study in the USA after 12th commerce.

MBA Jobs in Australia for Indians

Know about the best-paying jobs after an MBA in Australia

Best Courses After 12th Arts in USA

Know the study options in USA for Indian students after completing 12th from Arts

Narotam Sekhsaria Scholarship

Narotam Sekhsaria scholarships are available for Indian students to apply for

What is SDS and Non SDS Visa

Difference between SDS and Non-SDS visa applications, their requirements & more.

MBA in healthcare management in the UK and the scope of work after graduating.

PR in Canada

How to get Canada PR from India along with the key factors, process and cost

CRS Score Calculator

Learn more about CRS of Canada’s Express Entry program.

MBA Fees in Canada

Learn about all the costs involved in pursuing an MBA in Canada.

What to Do After BCom

Popular courses after BCom abroad that you can opt for. Read to know!

Vidya Lakshmi Education Loan

Study abroad by applying for a student loan at the Vidya Lakshmi Portal.

Study in Canada & Save up to 20 Lakhs with upGrad Abroad

Study in Australia & Save up to 20 Lakhs with upGrad Abroad

Study in the USA & Save up to 20 Lakhs with upGrad Abroad

Study in Germany & Save up to 20 Lakhs with upGrad Abroad

Study in Ireland & Save up to 20 Lakhs with upGrad Abroad

Study in UK & Save up to 20 Lakhs with upGrad Abroad

Anupriya Mukherjee is a passion-driven professional working as a Content Marketer and earlier worked as a Digital Marketeer. With around 6 years of work experience, she has experience creating high-quality, engaging content for websites, blogs, news articles, video scripts, brochures, and ebooks.

Important Exams

Important resources for ielts, free study abroad counselling, trending searches, editor's pick, other countries.

• BSc in Nursing
• MA in Communication
• Bachelors in Aviation
• Masters in Accounting
• Masters in Public Health in Australia
• Nursing Courses in Australia
• University of Melbourne Courses
• MS in Australia
• Masters in Business Analytics in Australia
• Universities in Australia
• La Trobe University
• Courses in Australia
• Masters in Australia
• University of Adelaide
• Universities in Canada
• Masters in Data Science in Canada
• University of Saskatchewan
• University of Victoria
• Thompson Rivers University
• Courses in Canada
• Masters in Canada
• University of Manitoba
• University of Windsor
• Trent University
• Concordia University
• Masters in UK
• University of Strathclyde Ranking
• University of Leicester
• Queen Mary University of London
• Liverpool John Moores University Ranking
• Courses in UK
• University of Leicester Ranking
• Manchester Metropolitan University Ranking
• University of Oxford Courses
• University of Bristol
• Bachelors in UK
• University of West London Ranking
• University of Sussex Ranking
• De Montfort University
• University of Cambridge Courses
• Universities in UK
• Northumbria University Ranking
• Kings College London
• Queen Mary University of London Ranking
• Birmingham City University
• Northeastern University ranking
• New York University
• Saint Louis University
• Bachelors in USA
• George Mason University
• Northeastern University acceptance rate
• Columbia University Ranking
• University of Texas at Dallas ranking
• Courses in USA
• University of South Florida ranking
• Universities in USA
• Pace University
• University of Texas at Arlington ranking
• Masters in USA
• Saint Louis University Ranking
• University of Dayton ranking
• Purdue University
• University at Buffalo
• George Mason University ranking
• Purdue University ranking
• DePaul University
• masters in computer science in usa
• Columbia University Acceptance Rate
• New York University Ranking
• DePaul University Ranking
• Drexel University Ranking
• How to download IELTS Scorecard
• IELTS Band Score Chart
• Duolingo Accepted Universities In Canada
• GRE Waived University In Usa
• Duolingo Accepted Universities In Australia
• Duolingo Certificate
• Universities in Canada Without IELTS
• SAT Exam Syllabus
• Duolingo Exam Fee
• Minimum IELTS Score For Canada
• Gmat Syllabus
• IELTS Common Speaking Topics
• Duolingo vs IELTS
• Usmle Test Centers In India
• Top Phrases for IELTS Speaking Test
• IELTS Introduction Sample
• IELTS Speaking Scores
• MBA In UK Without Gmat
• Gre Exam Fee in India
• 22 July IELTS Exam
• IELTS Writing Task 2 Topics
• CEFR Level in IELTS
• Masters Courses in Netherlands
• Study in Netherlands
• Technological University Dublin
• University of Europe for Applied Sciences Acceptance Rate
• Dundalk Institute of Technology
• Maynooth University Courses
• Dublin City University Courses
• National University of Ireland Galway Courses
• University of Limerick Courses
• Business Courses in Ireland
• Courses in Netherlands
• Universities in Netherlands
• Technological University Dublin Courses
• Dundalk Institute of Technology Courses

The above tips are the Author's experiences. upGrad does not guarantee scores or admissions.

Call us to clear your doubts at:

Download our App

• Grievance Redressal
• Experience Centers
• Terms of Use
• Privacy Policy
• University Partner
• Accommodation
• IELTS Band Calculator
• Download Study Abroad App
• Education Loan Calculator
• upGrad Abroad Office
• Expense Calculator
• Knowledge Base
• Business Partner

Top Destinations

Masters programs.

• MBA in Germany, IU
• MIM in Germany, IU
• MS in CS in Germany, IU
• MS in Data Analytics in USA, Clark University
• MS in Project Management in USA, Clark University
• MS in IT in USA, Clark University
• MS in Data Analytics & Visualization in USA, Yeshiva University
• MS in Artificial Intelligence in USA, Yeshiva University
• MS in Cybersecurity, Yeshiva University

Study Abroad Important Blogs

• Cost of Study:
• Cost of Studying in Canada
• Cost of Studying in Ireland
• Cost of Studying in Australia
• Cost of living:
• Cost of living in UK
• Cost of living in Australia
• Cost of living in Germany
• Cost of living in Ireland
• Cost of living in Canada
• Career Opportunities:
• Career Opportunities in Australia
• Career Opportunities in Germany
• Job Opportunities in After MS in Canada
• Job Opportunities After MBA in Australia
• Job Opportunities After MS in UK
• IELTS Exam Resources:
• Academic IELTS
• IELTS Band Score
• IELTS Writing Task 2
• IELTS Slot Booking
• IELTS Score for UK
• IELTS Score for USA
• Validity of IELTS Score
• IELTS Speaking Topics
• IELTS Reading Tips
• How to Prepare for IELTS at Home Without Coaching
• IELTS Preparation Books
• Types of IELTS Exam
• IELTS Academic vs General
• IELTS Exam Pattern
• IELTS Essay
• IELTS Exam Dates
• Top Streams:
• Fashion Designing Courses in Australia
• Accounting Courses in Canada
• Management Courses in Canada

Persuasive Essay Guide

Persuasive Essay About Smoking

Persuasive Essay About Smoking - Making a Powerful Argument with Examples

People also read

A Comprehensive Guide to Writing an Effective Persuasive Essay

200+ Persuasive Essay Topics to Help You Out

Learn How to Create a Persuasive Essay Outline

30+ Free Persuasive Essay Examples To Get You Started

Read Excellent Examples of Persuasive Essay About Gun Control

How to Write a Persuasive Essay About Covid19 | Examples & Tips

Crafting a Convincing Persuasive Essay About Abortion

Learn to Write Persuasive Essay About Business With Examples and Tips

Check Out 12 Persuasive Essay About Online Education Examples

Are you wondering how to write your next persuasive essay about smoking?

Smoking has been one of the most controversial topics in our society for years. It is associated with many health risks and can be seen as a danger to both individuals and communities.

Writing an effective persuasive essay about smoking can help sway public opinion. It can also encourage people to make healthier choices and stop smoking. 

But where do you begin?

In this blog, we’ll provide some examples to get you started. So read on to get inspired!

• 1. What You Need To Know About Persuasive Essay
• 2. Persuasive Essay Examples About Smoking
• 3. Argumentative Essay About Smoking Examples
• 4. Tips for Writing a Persuasive Essay About Smoking

What You Need To Know About Persuasive Essay

A persuasive essay is a type of writing that aims to convince its readers to take a certain stance or action. It often uses logical arguments and evidence to back up its argument in order to persuade readers.

It also utilizes rhetorical techniques such as ethos, pathos, and logos to make the argument more convincing. In other words, persuasive essays use facts and evidence as well as emotion to make their points.

A persuasive essay about smoking would use these techniques to convince its readers about any point about smoking. Check out an example below:

Simple persuasive essay about smoking

Tough Essay Due? Hire Tough Writers!

Persuasive Essay Examples About Smoking

Smoking is one of the leading causes of preventable death in the world. It leads to adverse health effects, including lung cancer, heart disease, and damage to the respiratory tract. However, the number of people who smoke cigarettes has been on the rise globally.

A lot has been written on topics related to the effects of smoking. Reading essays about it can help you get an idea of what makes a good persuasive essay.

Here are some sample persuasive essays about smoking that you can use as inspiration for your own writing:

Persuasive speech on smoking outline

Persuasive essay about smoking should be banned

Persuasive essay about smoking pdf

Persuasive essay about smoking cannot relieve stress

Persuasive essay about smoking in public places

Speech about smoking is dangerous

Persuasive Essay About Smoking Introduction

Persuasive Essay About Stop Smoking

Short Persuasive Essay About Smoking

Stop Smoking Persuasive Speech

Check out some more persuasive essay examples on various other topics.

Argumentative Essay About Smoking Examples

An argumentative essay is a type of essay that uses facts and logical arguments to back up a point. It is similar to a persuasive essay but differs in that it utilizes more evidence than emotion.

If you’re looking to write an argumentative essay about smoking, here are some examples to get you started on the arguments of why you should not smoke.

Argumentative essay about smoking pdf

Argumentative essay about smoking in public places

Argumentative essay about smoking introduction

Check out the video below to find useful arguments against smoking:

Tips for Writing a Persuasive Essay About Smoking

You have read some examples of persuasive and argumentative essays about smoking. Now here are some tips that will help you craft a powerful essay on this topic.

Choose a Specific Angle

Select a particular perspective on the issue that you can use to form your argument. When talking about smoking, you can focus on any aspect such as the health risks, economic costs, or environmental impact.

Think about how you want to approach the topic. For instance, you could write about why smoking should be banned. 

Check out the list of persuasive essay topics to help you while you are thinking of an angle to choose!

Research the Facts

Before writing your essay, make sure to research the facts about smoking. This will give you reliable information to use in your arguments and evidence for why people should avoid smoking.

You can find and use credible data and information from reputable sources such as government websites, health organizations, and scientific studies. 

For instance, you should gather facts about health issues and negative effects of tobacco if arguing against smoking. Moreover, you should use and cite sources carefully.

Paper Due? Why Suffer? That's our Job!

Make an Outline

The next step is to create an outline for your essay. This will help you organize your thoughts and make sure that all the points in your essay flow together logically.

Your outline should include the introduction, body paragraphs, and conclusion. This will help ensure that your essay has a clear structure and argument.

Use Persuasive Language

When writing your essay, make sure to use persuasive language such as “it is necessary” or “people must be aware”. This will help you convey your message more effectively and emphasize the importance of your point.

Also, don’t forget to use rhetorical devices such as ethos, pathos, and logos to make your arguments more convincing. That is, you should incorporate emotion, personal experience, and logic into your arguments.

Introduce Opposing Arguments

Another important tip when writing a persuasive essay on smoking is to introduce opposing arguments. It will show that you are aware of the counterarguments and can provide evidence to refute them. This will help you strengthen your argument.

By doing this, your essay will come off as more balanced and objective, making it more convincing.

Finish Strong

Finally, make sure to finish your essay with a powerful conclusion. This will help you leave a lasting impression on your readers and reinforce the main points of your argument. You can end by summarizing the key points or giving some advice to the reader.

A powerful conclusion could either include food for thought or a call to action. So be sure to use persuasive language and make your conclusion strong.

To conclude,

By following these tips, you can write an effective and persuasive essay on smoking. Remember to research the facts, make an outline, and use persuasive language.

However, don't stress if you need expert help to write your essay! We're the best essay writing service for you!

Our persuasive essay writing service is fast, affordable, and trustworthy. 

Try it out today!

Write Essay Within 60 Seconds!

Caleb S. has been providing writing services for over five years and has a Masters degree from Oxford University. He is an expert in his craft and takes great pride in helping students achieve their academic goals. Caleb is a dedicated professional who always puts his clients first.

Paper Due? Why Suffer? That’s our Job!

Keep reading

An official website of the United States government

The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings
• Browse Titles

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Institute of Medicine (US) Committee on Secondhand Smoke Exposure and Acute Coronary Events. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington (DC): National Academies Press (US); 2010.

Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence.

• Hardcopy Version at National Academies Press

8 Conclusions and Recommendations

In this report, the committee has examined three relationships in response to its charge (see Box 8-1 for specific questions):

Specific Questions to the Committee. The Centers for Disease Control and Prevention requested that the IOM convene an expert committee to assess the state of the science on the relationship between secondhand smoke exposure and acute coronary events. (more...)

• The association between secondhand-smoke exposure and cardiovascular disease, especially coronary heart disease and not stroke (Question 1).
• The association between secondhand-smoke exposure and acute coronary events (Questions 2, 3, and 5).
• The association between smoking bans and acute coronary events (Questions 4, 5, 6, 7, and 8).

This chapter summarizes the committee’s review of information relevant to those relationships; presents its findings, conclusions, and recommendations on the basis of the weight of evidence; and presents its responses to the specific questions that it was asked in its task.

• SUMMARY OF REPORT

Exposure Assessment

To determine the effect of changes in exposure to secondhand smoke it is necessary to quantify changes in epidemiologic studies. Airborne measures and biomarkers of exposure to secondhand smoke are available; they are complementary and provide different information (see Chapter 2 ). Biomarkers (such as cotinine, the major proximate metabolite of nicotine) in tegrate all sources of exposure and inhalation rates, but cannot identify the place where secondhand-smoke exposure occurred and, because of a short half-life they reflect only recent exposures. Airborne measures of exposure can demonstrate the contribution of different sources or venues of exposure and can be used to measure changes in secondhand-smoke concentrations at individual venues, but they do not reflect the true dose. Airborne concentration of nicotine is a specific tracer for secondhand smoke. Particulate matter (PM) can also be used as an indicator of secondhand-smoke exposure, but because there are other sources of PM it is a less specific tracer than nicotine. The concentration of cotinine in serum, saliva, or urine is a specific indicator of integrated exposure to secondhand smoke.

Although in most of the smoking-ban studies the magnitude, frequency, and duration of exposures that occurred before a ban are not known, monitoring studies demonstrate that exposure to secondhand smoke is dramatically reduced in places that are covered by bans. Airborne nicotine and PM concentrations in regulated venues such as workplaces, bars, and restaurants decreased by more than 80% in most studies; serum, salivary, or urinary cotinine concentrations decreased by 50% or more in most studies, probably reflecting continuing exposures in unregulated venues (for example, in homes and cars).

Pathophysiology

The pathophysiology of the induction of cardiovascular disease by cigarette-smoking and secondhand-smoke exposure is complex and undoubtedly involves multiple agents. Many chemicals in secondhand smoke have been shown to exert cardiovascular toxicity (see Table 3-1 ), and both acute and chronic effects of these chemicals have been identified. Experimental studies in humans, animals, and cell cultures have demonstrated effects of secondhand smoke, its components (such as PM, acrolein, polycyclic aromatic hydrocarbons [PAHs], and metals), or both on the cardiovascular system (see Figure 3-1 for summary). Those studies have yielded sufficient evidence to support an inference that acute exposure to secondhand smoke induces endothelial dysfunction, increases thrombosis, causes inflammation, and potentially affects plaque stability adversely. Those effects appear at concentrations expected to be experienced by people exposed to secondhand smoke.

Data from animal studies also support a dose–response relationship between secondhand-smoke exposure and cardiovascular effects (see Chapter 3 ). The relationship is consistent with the understanding of the pathophysiology of coronary heart disease and the effects of secondhand smoke on humans, including chamber studies. The association comports with known associations between PM, a major constituent of secondhand smoke, and coronary heart disease.

Overall, the pathophysiologic data indicate that it is biologically plausible for secondhand-smoke exposure to have cardiovascular effects, such as effects that lead to cardiovascular disease and acute myocardial infarction (MI). The exact mechanisms by which such effects occur, however, remain to be elucidated.

Smoking-Ban Background

Characteristics of smoking bans can heavily influence their consequences. Interpretation of the results of epidemiologic studies that involve smoking bans must account for information on the bans and their enforcement.

Secondhand smoke should have been measured before and after implementation of a ban, and locations with and without bans should have been compared. Studies that include self-reported assessments of exposure to secondhand smoke cannot necessarily be compared with each other unless the survey instruments (such as interviews) were similar.

The comparability of the time and length of followup of the studies should be assessed. For example, the impact of a ban in one area may differ from the impact of a ban in another solely because the observation times were different and other activities may have occurred during the same periods. In comparing studies, it may be impossible to separate contextual factors associated with ban legislation—such as public comment periods, information announcing the ban, and notices about the impending changes—from the impact of the ban itself. The committee therefore included such contextual factors in drawing conclusions about the effects of a ban.

Interpretation needs to consider the timeframes in the epidemiologic evidence, for example, the time from onset of a smoking ban to the mea surement of incidence of a disease, the timing and nature of enforcement, and the time until changes in cardiovascular-event rates were observed in people who had various baseline risks. Interpretation should account for the extent to which studies assessed possible alternative causes of decreases in hospitalizations for coronary events, including changes in health-care availability and in the standard of practice in cardiac care, such as new diagnostic criteria for acute MI during the period of study. The latter is especially important in making before–after comparisons in the absence of a comparison geographic area in which no ban has been implemented.

When designing and analyzing future studies, researchers should examine the time between the implementation of a smoking ban and changes in rates of hospital admission or cardiac death. Future studies could evaluate whether decreases in admissions are transitory, sustained, or increasing, and ideally they would include information on individual subjects, including prior history of cardiac disease, to answer the questions posed to the committee.

Epidemiologic Studies

Cardiovascular disease is a major public-health concern. The results of dozens of epidemiologic studies of both case–control and cohort design carried out in multiple populations consistently indicate about a 25–30% increase in risk of coronary heart disease from exposure to secondhand smoke (see Chapter 4 ). Epidemiologic studies using serum cotinine concentration as a biomarker of overall exposure to secondhand smoke indicated that the relative risk (RR) of coronary heart disease associated with secondhand smoke is even greater than those estimates. The excess risk is unlikely to be explained by misclassification bias, uncontrolled-for confounding effects, or publication bias. Although few studies have addressed the risk of coronary heart disease posed by secondhand-smoke exposure in the workplace, there is no biologically plausible reason to suppose that the effect of secondhand-smoke exposure at work or in a public building differs from the effect of exposure in the home environment. Epidemiologic studies demonstrate a dose–response relationship between chronic secondhand-smoke exposure as assessed by self-reports of exposure (He et al., 1999) and as assessed by biomarkers (cotinine) and long-term risk of coronary heart disease (Whincup et al., 2004). Dose–response curves show a steep initial rise in risk when going from negligible to low exposure followed by a gradual increase with increasing exposure.

The INTERHEART study, a large case–control study of cases of first acute MI, showed that exposure to secondhand smoke increased the risk of nonfatal acute MI in a graded manner (Teo et al., 2006).

Eleven key epidemiologic studies evaluated the effects of eight smok ing bans on the incidence of acute coronary events (see Table 8-1 and Chapter 6 ). The results of those studies show remarkable consistency: all showed decreases in the rate of acute MIs after the implementation of smoking bans (Barone-Adesi et al., 2006; Bartecchi et al., 2006; CDC, 2009; Cesaroni et al., 2008; Juster et al., 2007; Khuder et al., 2007; Lemstra et al., 2008; Pell et al., 2008; Sargent et al., 2004; Seo and Torabi, 2007; Vasselli et al., 2008). Two of the studies (Pell et al., 2008; Seo and Torabi, 2007) examined rates of hospitalization for acute coronary events after the implementation of smoking bans and provided direct evidence of the relationship of secondhand-smoke exposure to acute coronary events by presenting results in nonsmokers.

Summary of Key Studies (Studies Listed by Smoking-Ban Region in Order of Publication).

The decreases in acute MIs in the 11 studies ranged from about 6 to 47%, depending on characteristics of the study, including the method of statistical analysis. The consistency in the direction of change gave the committee confidence that smoking bans result in a decrease in the rate of acute MI. The studies took advantage of bans as “natural experiments” to look at questions about the effects of bans, and indirectly of a decrease in secondhand-smoke exposure, on the incidence of acute cardiac events. As discussed in Assessing the Health Impact of Air Quality Regulations: Concepts and Methods for Accountability Research (HEI Accountability Working Group, 2003) in the context of air-pollution regulations, studies of interventions constitute a more definitive approach than other epidemiologic studies to determining whether regulations result in health benefits. All the studies are relevant and informative with respect to the questions posed to the committee, and overall they support an association between smoking bans and a decrease in acute cardiovascular events. The studies have inherent limitations related to their nature, but they directly evaluated the effects of an intervention (a smoking ban, including any concomitant activities) on a health outcome of interest (acute coronary events).

The committee could not determine the magnitude of effect with any reasonable degree of certainty on the basis of those studies. The variability in study design, implementation, and analysis was so large that the committee concluded that it could not conduct a meta-analysis or combine the information from the studies to calculate a point estimate of the effect. In particular, the committee was unable to determine the overall portion of the effect attributable to decreased smoking by smokers as opposed to decreased exposure of nonsmokers to secondhand smoke because of a lack of information on smoking status in nine of the studies (Barone-Adesi et al., 2006; Bartecchi et al., 2006; CDC, 2009; Cesaroni et al., 2008; Juster et al., 2007; Khuder et al., 2007; Lemstra et al., 2008; Sargent et al., 2004; Seo and Torabi, 2007; Vasselli et al., 2008). The results of the studies are consistent with the findings of the pathophysiologic studies discussed in Chapter 3 and the data on PM discussed in Chapters 3 and 7 . At the population level, results of the key intervention studies reviewed by the committee are for the most part consistent with a decrease in risk as early as a month following reductions in secondhand-smoke exposure; however, given the variability in the studies and the lack of data on the precise timing of interventions, the smoking-ban studies do not provide adequate information on the time it takes to see decreases in acute MIs.

Plausibility of Effect

The committee considered both the biologic plausibility of a causal relationship between a decrease in secondhand-smoke exposure and a decrease in the incidence of acute MI and the plausibility of the magnitude of the effect seen in the key epidemiologic studies after implementation of smoking bans.

The experimental data reviewed in Chapter 3 demonstrate that several components of secondhand smoke, as well as secondhand smoke itself, exert substantial cardiovascular toxicity. The toxic effects include the induction of endothelial dysfunction, an increase in thrombosis, increased inflammation, and possible reductions in plaque stability. The data provide evidence that it is biologically plausible for secondhand smoke to be a potential causative trigger of acute coronary events. The risk of acute coronary events is likely to be increased if a person has preexisting heart disease. The association comports with findings on air-pollution components, such as diesel exhaust (Mills et al., 2007) and PM (Bhatnagar, 2006).

As a “reality check” on the potential effects of changes in secondhand-smoke exposure, the committee estimated the decrease in risk of cardiovascular disease and specifically heart failure that would be expected on the basis of the risk effects of changes in airborne PM concentrations after implementation of smoking bans seen in the PM literature. The PM in cigarette smoke is not identical with that in air pollution, and the committee did not attempt to estimate the risk attributable to secondhand-smoke exposure through the PM risk estimates but rather found this a useful exercise to see whether the decreases seen in the epidemiologic literature are reasonable, given data on other air pollutants that have some common characteristics. The committee’s estimates on the basis of the PM literature support the possibility that changes in secondhand-smoke exposure after implementation of a smoking ban can have a substantial effect on hospital admissions for heart failure and cardiovascular disease.

• SUMMARY OF OVERALL WEIGHT OF EVIDENCE

The committee examined three relationships—of secondhand-smoke exposure and cardiovascular disease, of secondhand-smoke exposure and acute coronary events, and of smoking bans and acute coronary events. The committee used the criteria of causation described in Smoking and Health: Report of the Advisory Committee of the Surgeon General of the Public Health Service (U.S. Public Health Service, 1964) in drawing conclusions regarding those relationships. The criteria are often referred to as the Bradford Hill criteria because they were, as stated by Hamill (1997), “later expanded and refined by A. B. Hill” (Hill, 1965). Table 8-2 summarizes the available evidence on secondhand-smoke exposure and coronary events in terms of the Bradford Hill criteria.

Evaluation of Available Data in Terms of Bradford-Hill Criteria.

Secondhand-Smoke Exposure and Cardiovascular Disease

The results of both case–control and cohort studies carried out in multiple populations consistently indicate exposure to secondhand smoke causes about a 25–30% increase in the risk of coronary heart disease; results of some studies indicate a dose–response relationship. Data from animal studies support the dose–response relationship (see Chapter 3 ). Data from experimental studies of animals and cells and from intentional human-dosing studies indicate that a relationship between secondhand-smoke exposure and coronary heart disease is biologically plausible and consistent with understanding of the pathophysiology of coronary heart disease.

Taking all that evidence together, the committee concurs with the conclusions in the 2006 surgeon general’s report (HHS, 2006) that “the evidence is sufficient to infer a causal relationship between exposure to secondhand smoke and increased risks of coronary heart disease morbidity and mortality among both men and women.” Although the committee found strong and consistent evidence of the existence of a positive association between chronic exposure to secondhand smoke and coronary heart disease, determining the magnitude of the risk (the number of cases that are attributable to secondhand-smoke exposure) proved challenging, and the committee has not done it.

Secondhand-Smoke Exposure and Acute Coronary Events

Two of the epidemiologic studies reviewed by the committee that examine rates of hospitalization for acute coronary events after implementation of smoking bans provide direct evidence related to secondhand smoke exposures. The studies either reported events in nonsmokers only (Monroe, Indiana) (Seo and Torabi, 2007) or analyzed nonsmokers and smokers separately on the basis of serum cotinine concentration (Scotland) (Pell et al., 2008). Both studies showed reductions in the RR of acute coronary events in nonsmokers when secondhand-smoke exposure was decreased after implementation of the bans; this indicates an association between a decrease in exposure to secondhand smoke and a decrease in risk of acute coronary events. Because of differences between and limitations of the two studies (such as in population, population size, and analysis), they do not provide strong sufficient evidence to determine the magnitude of the decrease in RR.

The effect seen after implementation of smoking bans is consistent with data from the INTERHEART study, a case–control study of 15,152 cases of first acute MI in 262 centers in 52 countries (Teo et al., 2006). Increased exposure to secondhand smoke increased the risk of nonfatal acute MI in a graded manner, with adjusted odds ratios of 1.24 (95% confidence interval [CI], 1.17–1.32) and 1.62 (95% CI, 1.45–1.81) in the least exposed people (1–7 hours of exposure per week) and the most exposed (at least 22 hours of exposure per week), respectively. In contrast, a study using data from the Western New York Health Study collected from 1995 to 2001 found that secondhand smoke was not significantly associated with higher risk of MI (Stranges et al., 2007). That study, however, looked at lifetime cumulative exposure to secondhand smoke, a different exposure metric from that in the other studies and one that does not take into account how recent the exposure is.

The other key epidemiologic studies that looked at smoking bans provide indirect evidence of an association between secondhand-smoke exposure and acute coronary events (Barone-Adesi et al., 2006; Bartecchi et al., 2006; CDC, 2009; Cesaroni et al., 2008; Juster et al., 2007; Khuder et al., 2007; Lemstra et al., 2008; Sargent et al., 2004; Vasselli et al., 2008). Although it is not possible to separate the effect of smoking bans in reducing exposure to secondhand smoke and their effect in reducing active smoking in those studies, because they did not report individual smoking status or secondhand-smoke exposure concentrations, monitoring studies of airborne tracers 1 and biomarkers 2 of exposure to secondhand smoke have demonstrated that exposure to secondhand smoke is dramatically reduced after implementation of smoking bans. Those studies therefore provide indirect evidence that at least part of the decrease in acute coronary events seen after implementation of smoking bans could be mediated by a decrease in exposure to secondhand smoke. It is not possible to determine the differential magnitude of the effect that is attributable to changes in nonsmokers and smokers.

Experimental data show that an association between secondhand- smoke exposure and acute coronary events is biologically plausible (see Chapter 3 ). Experimental studies in humans, animals, and cell cultures have demonstrated short-term effects of secondhand smoke as a complex mixture or its components individually (such as oxidants, PM, acrolein, PAHs, benzene, and metals) on the cardiovascular system. There is sufficient evidence from such studies to infer that acute exposure to secondhand smoke at concentrations relevant to population exposures induces endothelial dysfunction, increases inflammation, increases thrombosis, and potentially adversely affects plaque stability. Those effects occur at magnitudes relevant to the pathogenesis of acute coronary events. Furthermore, indirect evidence obtained from studies of ambient PM supports the notion that exposure to PM present in secondhand smoke could trigger acute coronary events or induce arrhythmogenesis in a person with a vulnerable myocardium.

Taking all that evidence together, the committee concludes that there is sufficient evidence of a causal relationship between a decrease in secondhand-smoke exposure and a decrease in the risk of acute MI. Given the variability among studies and their limitations, the committee did not provide a quantitative estimate of the magnitude of the effect.

Smoking Bans and Acute Coronary Events

Nine key studies looked at the overall effect of smoking bans on the incidence of acute coronary events in the overall populations—smokers and nonsmokers—studied (Barone-Adesi et al., 2006; Bartecchi et al., 2006; CDC, 2009; Cesaroni et al., 2008; Juster et al., 2007; Khuder et al., 2007; Lemstra et al., 2008; Sargent et al., 2004; Vasselli et al., 2008). Those studies consistently show a decrease in acute MIs after implementation of smoking bans. The combination of experimental data on secondhand-smoke effects discussed above and exposure data that indicate that secondhand-smoke concentrations decrease substantially after implementation of a smoking ban provides evidence that it is biologically plausible for smoking bans to decrease the rate of acute MIs. The committee concludes that there is an association between smoking bans and a reduction in acute coronary events and, given the temporality and biologic plausibility of the effect, that the evidence is consistent with a causal relationship. Although all the studies demonstrated a positive effect of bans in reducing acute MIs, differences among the studies, including the components of the bans and other interventions that promote smoke-free environments that took place during the bans, limited the committee’s confidence in estimating the overall magnitude of the effect. There is little information on how long it would take for such an effect to be seen inasmuch as the studies have not evaluated periods shorter than a month.

• DATA GAPS AND RESEARCH RECOMMENDATIONS

Studies of the effect of indoor smoking bans and secondhand-smoke exposure on acute coronary events should be designed to examine the time between an intervention and changes in the effect and to measure the magnitude of the effect. No time to effect can be postulated for individuals on the basis of the available data, and evaluation of population-based effectiveness of a smoking ban depends on societal actions that implement and enforce the ban and on actions that include smoke reduction in homes, cars, and elsewhere. The decrease in secondhand-smoke exposure does not necessarily occur suddenly—it might decline gradually or by steps. In a likely scenario, once a ban is put into place and enforced, a sharp drop in secondhand-smoke exposure might be seen immediately and followed by a slower decrease in exposure as the population becomes more educated about the health consequences of secondhand smoke and exposure becomes less socially acceptable. Future studies that examine the time from initiation of a ban to observation of an effect and that include followup after initiation of enforcement, taking the social aspects into account, would provide better information on how long it takes to see an effect of a ban. Statistical models should clearly articulate a set of assumptions and include sensitivity analyses. Studies that examine whether decreases in hospital admissions for acute coronary events are transitory or sustained would also be informative.

Many factors are likely to influence the effect of a smoking ban on the incidence and prevalence of acute coronary events in a population. They include age, sex, diet, background risk factors and environmental factors for cardiovascular disease, prevalence of smokers in the community, the underlying rate of heart disease in the community (for example, the rate in Italy versus the United States), and the social environment. Future studies should include direct observations on individuals—including their history of cardiac disease, exposure to other environmental agents, and other risk factors for cardiac events—to assess the impact of those factors on study results. Assessment of smoking status is also needed to distinguish between the effects of secondhand smoke in nonsmokers and the effects of a ban that decreases cigarette consumption or promotes smoking cessation in smokers.

Few constituents of secondhand smoke have been adequately studied for cardiotoxicity. Future research should examine the cardiotoxicity of environmental chemicals, including those in secondhand smoke, to define cardiovascular toxicity end points and establish consistent definitions and measurement standards for cardiotoxicity of environmental contaminants. Specifically, information is lacking on the cardiotoxicity of highly reactive smoke constituents, such as acrolein and other oxidants; on techniques for quantitating those reactive components; and on the toxicity of low concentrations of benzo[ a ]pyrene, of PAHs other than benzo[a]pyrene, and of mixtures of tobacco-smoke toxicants.

Many questions remain with respect to the pathogenesis of cardiovascular disease and acute coronary events and how secondhand-smoke constituents perturb the pathophysiologic mechanisms and result in disease and death. For example, a better understanding of the factors that promote plaque rupture and how they are influenced by tobacco smoke and PM would provide insight into the mechanisms underlying the cardiovascular effects of secondhand smoke and might lead to better methods of detecting preclinical disease and preventing events.

The committee found only sparse data on the prevalence and incidence of cardiovascular disease and acute coronary events at the national level in general compared with other health end points for which there are central data registries and surveillance of all events, such as the Surveillance, Epidemiology, and End Results (SEER) Program for cancer. Although there are national databases that include acute MI patients—such as the National Registry of Myocardial Infarction (Morrow et al., 2001; Rogers et al., 1994), the Health Care Financing Administration database, and the Cooperative Cardiovascular Project (Ellerbeck et al., 1995)—and the Centers for Disease Control and Prevention’s annual National Hospital Discharge Survey and National Health Interview Survey provide some information on cardiovascular end points, these are not comprehensive or inclusive with respect to hospital participation, patient inclusion, or data capture. A national database that captures all cardiovascular end points would facilitate future epidemiologic studies by allowing the tracking of trends and identification of high-risk populations at a more granular level.

A large prospective cohort study could be very helpful in more accurately estimating the magnitude of the risk of cardiovascular disease and acute coronary events posed by secondhand-smoke exposure. It could be a new study specifically designed to assess effects of secondhand smoke or, as was done with the INTERHEART study, take advantage of existing studies—such as the Framingham Heart Study, the Multi-Ethnic Study of Atherosclerosis, the American Cancer Society’s Cancer Prevention Study-3, the European Prospective Investigation into Cancer and Nutrition study, and the Jackson Heart Study—provided that they have adequate information on individual smoking status and secondhand-smoke exposure (or the ability to measure it, for example, in adequate blood samples). If properly designed, such a study could identify subpopulations at highest risk for acute coronary events from secondhand-smoke exposure in relation to such characteristics as age and sex, and concomitant risk factors, such as obesity.

• COMMITTEE RESPONSES TO SPECIFIC QUESTIONS

The committee was tasked with responding to eight specific questions. The questions and the committee’s responses are presented below.

What is the current scientific consensus on the relationship between exposure to secondhand smoke and cardiovascular disease? What is the pathophysiology? What is the strength of the relationship?

On the basis of the available studies of chronic exposure to secondhand smoke and cardiovascular disease, the committee concludes that there is scientific consensus that there is a causal relationship between secondhand-smoke exposure and cardiovascular disease. The results of a number of meta-analyses of the epidemiologic studies showed increases of 25–30% in the risk of cardiovascular disease caused by various exposures. The studies include some that use serum cotinine concentration as a biomarker of exposure and show a dose–response relationship. The pathophysiologic data are consistent with that relationship, as are the data from studies of air pollution and PM. The data in support of the relationship are consistent, but the committee could not calculate a point estimate of the magnitude of the effect (that is, the effect size) given the variable strength of the relationship, differences among studies, poor assessment of secondhand-smoke exposure, and variation in concomitant underlying risk factors.

Is there sufficient evidence to support the plausibility of a causal relation between secondhand smoke exposure and acute coronary events such as acute myocardial infarction and unstable angina? If yes, what is the pathophysiology? And what is the strength of the relationship?

The evidence reviewed by the committee is consistent with a causal relationship between secondhand-smoke exposure and acute coronary events, such as acute MI. It is unknown whether acute exposure, chronic exposure, or a combination of the two underlies the occurrence of acute coronary events, inasmuch as the duration or pattern of exposure in individuals is not known. The evidence includes the results of two key studies that have information on individual smoking status and that showed decreases in risks of acute coronary events in nonsmokers after implementation of a smoking ban. Those studies are supported by information from other smoking-ban studies (although these do not have information on individual smoking status, other exposure-assessment studies have demonstrated that secondhand-smoke exposure decreases after implementation of a smoking ban) and by the large body of literature on PM, especially PM 2.5 , a constituent of secondhand smoke. The evidence is not yet comprehensive enough to determine a detailed mode of action for the relationship between secondhand-smoke exposure and a variety of intervening and preexisting conditions in predisposing to cardiac events. However, experimental studies have shown effects that are consistent with pathogenic factors in acute coronary events. Although the committee has confidence in the evidence of an association between chronic secondhand-smoke exposure and acute coronary events, the evidence on the magnitude of the association is less convincing, so the committee did not estimate that magnitude (that is, the effect size).

Is it biologically plausible that a relatively brief (e.g., under 1 hour) secondhand smoke exposure incident could precipitate an acute coronary event? If yes, what is known or suspected about how this risk may vary based upon absence or presence (and extent) of preexisting coronary artery disease?

There is no direct evidence that a relatively brief exposure to secondhand smoke can precipitate an acute coronary event; few published studies have addressed that question. The circumstantial evidence of such a relationship, however, is compelling. The strongest evidence comes from airpollution research, especially research on PM. Although the source of the PM can affect its toxicity, particle size in secondhand smoke is comparable with that in air pollution, and research has demonstrated a similarity between cardiovascular effects of PM and of secondhand smoke. Some studies have demonstrated rapid effects of brief secondhand-smoke exposure (for example, on platelet aggregation and endothelial function), but more research is necessary to delineate how secondhand smoke produces cardiovascular effects and the role of underlying preexisting coronary arterial disease in determining susceptibility to the effects. Given the data on PM, especially those from time-series studies, which indicate that a relatively brief exposure can precipitate an acute coronary event, and the fact that PM is a major component of secondhand smoke, the committee concludes that it is biologically plausible for a relatively brief exposure to secondhand smoke to precipitate an acute coronary event.

With respect to how the risk might vary in the presence or absence of preexisting coronary arterial disease, it is generally assumed that acute coronary events are more likely to occur in people who have some level of preexisting disease, although that underlying disease is often subclinical. There are not enough data on the presence of pre-existing coronary arterial disease in the populations studied to assess the extent to which the absence or presence of such preexisting disease affects the cardiovascular risk posed by secondhand-smoke exposure.

What is the strength of the evidence for a causal relationship be tween indoor smoking bans and decreased risk of acute myocardial infarction?

The key intervention studies that have evaluated the effects of indoor smoking bans consistently have shown a decreased risk of heart attack. Research has also indicated that secondhand-smoke exposure is causally related to heart attacks, that smoking bans decrease secondhand-smoke exposure, and that a relationship between secondhand-smoke exposure and acute coronary events is biologically plausible. All the relevant studies have shown an association in a direction consistent with a causal relationship (although the committee was unable to estimate the magnitude of the association), and the committee therefore concludes that the evidence is sufficient to infer a causal relationship.

What is a reasonable latency period between a decrease in second hand smoke exposure and a decrease in risk of an acute myocardial infarction for an individual? What is a reasonable latency period between a decrease in population secondhand smoke exposure and a measurable decrease in acute myocardial infarction rates for a population?

No direct information is available on the time between a decrease in secondhand-smoke exposure and a decrease in the risk of a heart attack in an individual. Data on PM, however, have shown effects on the heart within 24 hours, and this supports a period of less than 24 hours. At the population level, results of the key intervention studies reviewed by the committee are for the most part consistent with a decrease in risk as early as a month following reductions in secondhand-smoke exposure; however, given the variability in the studies and the lack of data on the precise timing of interventions, the smoking-ban studies do not provide adequate information on the time it takes to see decreases in heart attacks.

What are the strengths and weaknesses of published population- based studies on the risk of acute myocardial infarction following the institution of comprehensive indoor smoking bans? In light of published studies’ strengths and weaknesses, how much confidence is warranted in reported effect size estimates?

Some of the weaknesses of the published population-based studies of the risk of MI after implementation of smoking bans are

• Limitations associated with an open study population and, in some cases, with the use of a small sample.
• Concurrent interventions that reduce the observed effect of a smoking ban.
• Lack of exposure-assessment criteria and measurements.
• Lack of information collected on the time between the cessation of exposure to secondhand smoke and changes in disease rates.
• Differences between control and intervention groups.
• Nonexperimental design of studies (by necessity).
• Lack of assessment of the sensitivity of results to the assumptions made in the statistical analysis.

The different studies had different strengths and weaknesses in relation to the assessment of the effects of smoking bans. For example, the Scottish study had such strengths as prospective design and serum cotinine measurements. The Saskatoon study had the advantage of comprehensive hospital records, and the Monroe County study excluded smokers. The population-based studies of the risk of heart attack after the institution of comprehensive smoking bans were consistent in showing an association between the smoking bans and a decrease in the risk of acute coronary events, and this strengthened the committee’s confidence in the existence of the association. However, because of the weaknesses discussed above and the variability among the studies, the committee has little confidence in the magnitude of the effects and, therefore, thought it inappropriate to attempt to estimate an effect size from such disparate designs and measures.

What factors would be expected to influence the effect size? For example, population age distribution, baseline level of secondhand smoke protection among nonsmokers, and level of secondhand smoke protection provided by the smoke-free law .

A number of factors that vary among the key studies can influence effect size. Although some of the studies found different effects in different age groups, these were not consistently identified. One major factor is the size of the difference in secondhand-smoke exposure before and after implementation of a ban, which would vary and depends on: the magnitude of exposure before the ban, which is influenced by the baseline level of smoking and preexisting smoking bans or restrictions; and the magnitude of exposure after implementation of the ban, which is influenced by the extent of the ban, enforcement of and compliance with the ban, changes in social norms of smoking behaviors, and remaining exposure in areas not covered by the ban (for example, in private vehicles and homes). The baseline rate of acute coronary events or cardiovascular disease could influence the effect size, as would the prevalence of other risk factors for acute coronary events, such as obesity, diabetes, and age.

What are the most critical research gaps that should be addressed to improve our understanding of the impact of indoor air policies on acute coronary events? What studies should be performed to address these gaps?

The committee identified the following gaps and research needs as those most critical for improving understanding of the effect of indoor-air policies on acute coronary events:

• The committee found a relative paucity of data on environmental cardiotoxicity of secondhand smoke compared with other disease end points related to secondhand smoke, such as carcinogenicity and reproductive toxicity. Research should develop standard definitions of cardiotoxic end points in pathophysiologic studies (for example, specific results on standard assays) and a classification system for cardiotoxic agents (similar to the International Agency for Research on Cancer classification of carcinogens). Established cardiotoxicity assays for environmental exposures and consistent definitions of adverse outcomes of such tests would improve investigations of the cardiotoxicity of secondhand smoke and its components and identify potential end points for the investigation of the effects of indoor-air policies on acute coronary events.
• The committee found a lack of a system for surveillance of the prevalence of cardiovascular disease and of the incidence of acute coronary events in the United States. Surveillance of incidence and prevalence trends would allow secular trends to be taken into account better and to be compared among different populations to establish the effects of indoor-air policies. Although some national databases and surveys include cardiovascular end points, a national database that tracks hospital admission rates and deaths from acute coronary events, similar to the SEER database for cancer, would improve epidemiologic studies.
• The committee found a lack of understanding of a mechanism that leads to plaque rupture and from that to an acute coronary event and of how secondhand smoke affects that process. Additional research is necessary to develop reliable biomarkers of early effects on plaque vulnerability to rupture and to improve the design of pathophysiologic studies of secondhand smoke that examine effects of exposure on plaque stability.
• All 11 key studies reviewed by the committee have strengths and limitations due to their study design, and none was designed to test the hypothesis that secondhand-smoke exposure causes cardiovascular disease or acute coronary events. Because of those limitations and the consequent variability in results, the committee did not have enough information to estimate the magnitude of the decrease in cardiovascular risk due to smoking bans or to a decrease in secondhand-smoke exposure. A large, well-designed study could permit estimation of the magnitude of the effect. An ideal study would be prospective; would have individual-level data on smoking status; would account for potential confounders, including other risk factors for cardiovascular events (such as obesity and age), would have biomarkers of mainstream and secondhand-smoke exposures (such as blood cotinine concentrations); and would have enough cases to allow separate analyses of smokers and nonsmokers or, ideally, stratification of cases by cotinine concentrations to examine the dose–response relationship. Such a study could be specifically designed for secondhand smoke or potentially could take advantage of existing cohort studies that might have data available or attainable for investigating secondhand-smoke exposure and its cardiovascular effects, such as was done with the INTERHEART study. Existing studies that could be explored to determine their utility and applicability to questions related to secondhand smoke include the Multi-Ethnic Study of Atherosclerosis (MESA) study, the American Cancer Society’s CPS-3, the European Prospective Investigation of Cancer (EPIC), the Framingham Heart Study, and the Jackson Heart Study. Researchers should clearly articulate the assumptions used in their statistical models and include analysis of the sensitivity of results to model choice and assumptions.
• Barone-Adesi, F., L. Vizzini, F. Merletti, and L. Richiardi. 2006. Short-term effects of Italian smoking regulation on rates of hospital admission for acute myocardial infarction . Eu ropean Heart Journal 27(20):2468-2472. [ PubMed : 16940340 ]
• Bartecchi, C., R. N. Alsever, C. Nevin-Woods, W. M. Thomas, R. O. Estacio, B. B. Bartelson, and M. J. Krantz. 2006. Reduction in the incidence of acute myocardial infarction associated with a citywide smoking ordinance . Circulation 114(14):1490-1496. [ PubMed : 17000911 ]
• Bhatnagar, A. 2006. Environmental cardiology: Studying mechanistic links between pollution and heart disease . Circulation Research 99(7):692-705. [ PubMed : 17008598 ]
• CDC (Centers for Disease Control and Prevention). 2009. Reduced hospitalizations for acute myocardial infarction after implementation of a smoke-free ordinance—city of Pueblo, Colorado, 2002–2006 . MMWR—Morbidity & Mortality Weekly Report 57(51):1373-1377. [ PubMed : 19116606 ]
• Cesaroni, G., F. Forastiere, N. Agabiti, P. Valente, P. Zuccaro, and C. A. Perucci. 2008. Effect of the Italian smoking ban on population rates of acute coronary events . Circulation 117(9):1183-1188. [ PubMed : 18268149 ]
• Ellerbeck, E. F., S. F. Jencks, M. J. Radford, T. F. Kresowik, A. S. Craig, J. A. Gold, H. M. Krumholz, and R. A. Vogel. 1995. Quality of care for Medicare patients with acute myocardial infarction. A four-state pilot study from the cooperative cardiovascular project . JAMA 273(19):1509-1514. [ PubMed : 7739077 ]
• Hamill, P. V. 1997. Re: “Invited commentary: Response to Science article, ‘Epidemiology faces its limits.’” American Journal of Epidemiology 146(6):527-528. [ PubMed : 9290514 ]
• He, J., S. Vupputuri, K. Allen, M. R. Prerost, J. Hughes, and P. K. Whelton. 1999. Passive smoking and the risk of coronary heart disease--a meta-analysis of epidemiologic studies . New England Journal of Medicine 340(12):920-926. [ PubMed : 10089185 ]
• HEI (Health Effects Institute) Accountability Working Group. 2003. Assessing the health impact of air quality regulations: Concepts and methods for accountability research. Communication 11 . Boston, MA: Health Effects Institute.
• HHS (U.S. Department of Health and Human Services). 2006. The health consequences of involuntary exposure to tobacco smoke: A report of the surgeon general . Atlanta, GA: U.S. 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. [ PubMed : 20669524 ]
• Hill, A. B. 1965. The environment and disease: Association or causation? Proceedings of the Royal Society of Medicine 58:295-300. [ PMC free article : PMC1898525 ] [ PubMed : 14283879 ]
• Juster, H. R., B. R. Loomis, T. M. Hinman, M. C. Farrelly, A. Hyland, U. E. Bauer, and G. S. Birkhead. 2007. Declines in hospital admissions for acute myocardial infarction in New York state after implementation of a comprehensive smoking ban . American Journal of Public Health 97(11):2035-2039. [ PMC free article : PMC2040364 ] [ PubMed : 17901438 ]
• Khuder, S. A., S. Milz, T. Jordan, J. Price, K. Silvestri, and P. Butler. 2007. The impact of a smoking ban on hospital admissions for coronary heart disease . Preventive Medicine 45(1):3-8. [ PubMed : 17482249 ]
• Lemstra, M., C. Neudorf, and J. Opondo. 2008. Implications of a public smoking ban . Ca nadian Journal of Public Health 99(1):62-65. [ PMC free article : PMC6975881 ] [ PubMed : 18435394 ]
• Mills, N. L., H. Tornqvist, M. C. Gonzalez, E. Vink, S. D. Robinson, S. Soderberg, N. A. Boon, K. Donaldson, T. Sandstrom, A. Blomberg, and D. E. Newby. 2007. Ischemic and thrombotic effects of dilute diesel-exhaust inhalation in men with coronary heart disease . New England Journal of Medicine 357(11):1075-1082. [ PubMed : 17855668 ]
• Morrow, D. A., E. M. Antman, L. Parsons, J. A. de Lemos, C. P. Cannon, R. P. Giugliano, C. H. McCabe, H. V. Barron, and E. Braunwald. 2001. Application of the TIMI risk score for ST-elevation MI in the National Registry of Myocardial Infarction 3 . JAMA 286(11):1356-1359. [ PubMed : 11560541 ]
• Pell, J. P., S. Haw, S. Cobbe, D. E. Newby, A. C. H. Pell, C. Fischbacher, A. McConnachie, S. Pringle, D. Murdoch, F. Dunn, K. Oldroyd, P. Macintyre, B. O’Rourke, and W. Borland. 2008. Smoke-free legislation and hospitalizations for acute coronary syndrome . New England Journal of Medicine 359(5):482-491. [ PubMed : 18669427 ]
• Rogers, W. J., L. J. Bowlby, N. C. Chandra, W. J. French, J. M. Gore, C. T. Lambrew, R. M. Rubison, A. J. Tiefenbrunn, and W. D. Weaver. 1994. Treatment of myocardial infarction in the United States (1990 to 1993). Observations from the National Registry of Myocardial Infarction . Circulation 90(4):2103-2114. [ PubMed : 7923698 ]
• Sargent, R. P., R. M. Shepard, and S. A. Glantz. 2004. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: Before and after study . BMJ 328(7446):977-980. [ PMC free article : PMC404491 ] [ PubMed : 15066887 ]
• Seo, D.-C., and M. R. Torabi. 2007. Reduced admissions for acute myocardial infarction associated with a public smoking ban: Matched controlled study . Journal of Drug Educa tion 37(3):217-226. [ PubMed : 18047180 ]
• Stranges, S., M. Cummings, F. P. Cappuccio, and M. Travisan. 2007. Secondhand smoke exposure and cardiovascular disease . Current Cardiovascular Risk Reports 1(5):373-378.
• Teo, K. K., S. Ounpuu, S. Hawken, M. R. Pandey, V. Valentin, D. Hunt, R. Diaz, W. Rashed, R. Freeman, L. Jiang, X. Zhang, S. Yusuf, and I. S. Investigators. 2006. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: A case-control study . Lancet 368(9536):647-658. [ PubMed : 16920470 ]
• U.S. Public Health Service. 1964. Smoking and health: Report of the Advisory Committee of the Surgeon General of the Public Health Service . PHS Publication No. 1103. Washington, DC.
• Vasselli, S., P. Papini, D. Gaelone, L. Spizzichino, E. De Campora, R. Gnavi, C. Saitto, N. Binkin, and G. Laurendi. 2008. Reduction incidence of myocardial infarction associated with a national legislative ban on smoking . Minerva Cardioangiologica 56(2):197-203. [ PubMed : 18319698 ]
• Whincup, P. H., J. A. Gilg, J. R. Emberson, M. J. Jarvis, C. Feyerabend, A. Bryant, M. Walker, and D. G. Cook. 2004. Passive smoking and risk of coronary heart disease and stroke: Prospective study with cotinine measurement . BMJ 329(7459):200-205. [ PMC free article : PMC487731 ] [ PubMed : 15229131 ]

Airborne measures of exposure, such as the unique tracer nicotine or the less specific tracer PM, can demonstrate the contribution of different sources or venues of an exposure but do not reflect true dose.

Biomarkers of exposure to tobacco smoke, such as serum or salivary cotinine concentrations, integrate all sources of exposure and inhalation rates but, because of a short half-life, reflect only recent exposures.

• Cite this Page Institute of Medicine (US) Committee on Secondhand Smoke Exposure and Acute Coronary Events. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington (DC): National Academies Press (US); 2010. 8, Conclusions and Recommendations.
• PDF version of this title (1.8M)

In this Page

Related information.

• PMC PubMed Central citations
• PubMed Links to PubMed

Recent Activity

• Conclusions and Recommendations - Secondhand Smoke Exposure and Cardiovascular E... Conclusions and Recommendations - Secondhand Smoke Exposure and Cardiovascular Effects

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

Connect with NLM

National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894

Web Policies FOIA HHS Vulnerability Disclosure

Help Accessibility Careers

• Share full article

Advertisement

Supported by

EUROPEAN PILOTS JOIN BAN ON MOSCOW

By Jon Nordheimer

• Sept. 8, 1983

Thousands of commercial pilots in western Europe said today that they would join a 60-day boycott of scheduled flights to Moscow in retaliation for the Soviet Union's downing of a Korean Air Lines 747 jumbo jet.

British, Scandinavian, Dutch and French pilots heeded the call issued Tuesday by the governing board of the International Federation of Air Line Pilots Associations that its 61,000 members join the boycott.

Federation officials in London said they had also been given assurances that Italian pilots will shortly announce their intention to join the boycott. And they said West German and Swiss pilots had expressed a desire to take part but were uncertain whether they had the legal right to refuse to fly if their governments opposed the move.

Pilots for Air France said they would drop plans to join the protest if their Government entered into negotiations with the Soviet Union to win new guarantees of safety for airliners flying in Soviet airspace. Heartened by Swift Response

Officials of the pilots federation said they were heartened by the swift response of the European pilots and expected to know by the weekend whether commercial pilots in other parts of the world would join.

The officials said they hoped the boycott could be firmly in place by Monday.

Five thousand British pilots were the first to announce support of the boycott, and it was anticipated that service on four weekly British Airways flights to Moscow might be interrupted as early as Friday.

The pilots federation represents professional associations in 63 countries. Seventeen of these associations have members who work for airlines that operate routes to Moscow.

Capt. Robert Tweedy of Ireland, president of the federation, acknowledged that complete participation was not expected. A few member associations are in Communist bloc nations and others, like India, have close ties to Moscow that they might not wish to jeopardize.

''We're not pretending this is going to be easy,'' Captain Tweedy said. ''There are a lot of legal and political problems for some of our associations. But we hope that the different states and airlines will see the benefit of taking this action to demonstrate our determination that in the future this must never happen again.'' Puzzlement About Flight Path

At a news conference, several of the federation's top officials, all of whom are professional pilots, expressed puzzlement over the conditions that sent the Korean jetliner off course last week and into highly sensitive Soviet airspace. It was shot down by a Soviet fighter with the loss of 269 lives.

Individually, the federation officials rejected the Soviet contention that the passenger plane was on a secret espionage mission for the United States.

''Absurd,'' said Capt. John LeRoy, an American who is deputy president of the federation. ''It's very difficult to equip a commercial 747 for a covert mission. The Russians on the ground knew exactly what it was: a commercial airliner on a routine flight. I have no doubt that they knew what it was.''

At the same time, the officials suggested that a review should be made of the airline industry's growing dependence on computer guidance systems and other technological innovations that increasingly have taken over control of jetliners on most long-distance flights. Speculation over the departure of the Korean jet from its scheduled flight path has centered on a possible misprogramming of the 747's navigational systems.

Accidents aboard flights of a new generation of airliners this year has raised concern that such a dependence may lead to tragic errors in feeding data into a plane's computer systems. In addition, because several systems in a modern jetliner are interdependent, there have been instances when the malfunction of one system has caused the shutdown of others.

''Certain things are worrying,'' Captain Tweedy said. ''We welcome the improvements, they make the planes more efficient. But we want to make sure the whole system glues together.'' Might Never Be Explained

Captain Tweedy, a pilot for British Airways who has flown 747's, said the mystery surrounding the Korean jet's deviation from its flight path might never be fully explained. Even if the Russians recover the plane's flight recorders, he said, it is unlikely that they would share the information contained in them.

But the federation will be studying flying procedures now observed by commercial airliners on the 2,400- nautical-mile route from Anchorage to the Far East, he said, to see whether new safety measures might be recommended.

Federation officials said that in the course of thousands of flights each year there are probably fewer than a dozen reported ''serious'' wanderings from scheduled flight paths because of computer error.

''It's a very, very unusual circumstance,'' said Captain LeRoy, a United Air Lines pilot, who was the most outspoken of the federation officers in his condemnation of Soviet culpability in last week's disaster.

''But no one ever thought that a 747 filled with people would be shot down,'' he said. ''No one thought anyone would be that inhuman.''

He said the pilots federation had heard numerous accounts of how Soviet passenger airliners had ''wandered'' into restricted American airspace and been escorted out of the areas by United States military planes.

''The Soviet pilot may be followed, fined or face the possibility of being thrown in jail once he lands, but he wouldn't be shot down,'' he said.

Friday, Late City Final Edition

How we handle corrections

On Why One Should Stop Smoking Essay (Speech)

Introduction.

Credibility material: how do you really feel when some of the problems you or your relative or even friends face due to smoking? And is it possible to stop smoking after you have been told that smoking will definitely give you serious health problems? Well, I had a friend who became a chain smoker. He used to wake and the first thing that went into his mouth was a cigarette stick, then any other thing will follow thereafter. My friend had been experiencing persistent coughs that made him suspect he might have contracted HIV virus yet he had not yet spent with a woman. But he went for HIV test which proved negative. He continued smoking as he sought out the cough issue in his own ways. One day he became very ill and the cough became even worse. As a friend I accompanied him to a local hospital where he was diagnosed with cancer. The doctor’s advice was that he should stop smoking; however, he never adhered to the doctor’s advice and later died of serious cancer. That was a sad event caused by what could be avoided.

• Link to the audience: one of the people who have suffered health complications or death as a result of smoking may be somebody close to you or someone you know.
• Thesis and preview: today I am privileged to have your audience and I intend to talk to you about the effects of smoking, and also I propose to give a talk on how to solve the problem of smoking.

Shift into the main section of the speech: I will begin by telling you how smoking affects us.

So many people around the world have suffered the effects of smoking. I will talk about these effects in terms of health and financial effects.

• Research has found out that non-smokers are also exposed to dangers related to smoking. It can lead to increased effects of asthma on those who already have asthma, especially children. Taking for instance, available statistics indicate that in the United States of America alone, 53,000 non-smokers are killed by issues related to smoking (San Francisco Tobacco Free Project para1).
• To those who have coronary diseases, second hand smoking increases the risk of the disease and can make it severe. Moreover, those who have high risk factors of the disease can easily be attacked when exposed to smoking environment for long.
• Imagine that being exposed to second hand smoke for only thirty minutes is enough to cause damages to your heart and the damages are just similar to those of an actual or habitual smoker.
• Smoking also affects the unborn: the fetus is affected by secondary smoke inhaled by the mother.
• In women who are young and have not reached menopause, secondary smoke increases the risk of breast cancer.
• Other effects are impaired learning ability of children, increased risk of experiencing spinal pain, and reduced median cotinine levels (Bonnie pp.5-21).Transition: I believe that you can now realize that smoking does not only affect the smoker, but even the non-smokers and the unborn. The problems related to smoking affects all of us, but the smokers are more exposed than non-smokers even though in some of the problems both groups suffer are just the same. Now I will tell you about the risks smokers directly face.

Habitual smokers are exposed to:

• Habitual smokers are at a very high risk of cancer. It has been known that smoking is one of the leading causes of cancer. Taking the case of United Kingdom alone, approximately 106, 000 individuals die annually due to smoke related cancer.
• Some of the diseases caused and or worsened by smoking include, lung cancer, diseases of the heart, chronic obstructive pulmonary diseases and also circulation problems.
• To pregnant women, smoking is highly likely to cause miscarriages, complications, poor development of the child which may continue after birth and it may also result into still birth or death of the child in the first one week of birth (Litt 29).
• Smoking also has economic and other effects on smokers. Smokers, especially heavy chain smokers, use a lot of money as cigarette expenditures. Some of other effects of smoking include, bad breath, clothes and home environment smell stale tobacco, reduces sense of taste, life insurance of smokers are damn expensive and potential employers may not like smokers due to the possibility of constant seek leave.Transition: you can see how much risk smokers are exposed to. It is important to note that these risks can potentially result into deaths. However, it is possible to avoid all these smoking related problems. Now, my last discussion will be on how to solve the problem of smoking.

The only effective way in solving the problem is to stop smoking. But the question somebody may be asking is, “How do I stop smoking?” I will give some ways on how to do so:

• Will power is one of the ways to use in solving the problems but the most difficult of all other ways. One should have the courage and have undying persistence on quitting smoking.
• Use nicotine-based chewing gum; even though they still contain nicotine, however, the victim under treatment is not getting the tar into the body system.
• Use anti-depressants under a medical doctor’s guide.
• It is important to stop smoking once diagnosed with problems related with smoking
• Another way to stop smoking is to seek the intervention of a counselor who will guide you on gradual processes of stopping smoking.
• Non-smokers, especially with risky diseases, should avoid smoking environments (Acts 50).

Brakelight/intention to stop: as you can realize, stopping smoking and campaigning against it will be beneficial to all of us.

Summary: I have talked to you about the effects of smoking on both habitual smokers and non-smokers and also on how the problems can be stopped or avoided. All of us must rise up and campaign against smokers or else we will gradually be affected and infected.

Link back to the audience: now that you know the effects of smoking and how to solve it will you help somebody stop smoking? How happy will you be or satisfied will you feel if someone is to come to thank you for helping him or her stop smoking? Let us take the challenge.

Concluding remark: I am going to stop here, but not before I give you a quote by somebody known as Dr. Gro Harlem Brundtland. “A cigarette is the only consumer product which when used as directed kills its consumer.”

Acts, Humbler. How to Stop Smoking in 50 Days . New York: Bookway International Services, 2001.

Bonnie, Richard. Ending the Tobacco Problem: A Blueprint for the Nation . New York: National Academies Press, 2007.

Litt, Iris. Taking our pulse: The health of America’s women . New York: Stanford University Press, 1997.

San Francisco Tobacco Free Project. “Untitled.” 2010.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2022, August 25). On Why One Should Stop Smoking. https://ivypanda.com/essays/no-smoking-persuasive-speech/

"On Why One Should Stop Smoking." IvyPanda , 25 Aug. 2022, ivypanda.com/essays/no-smoking-persuasive-speech/.

IvyPanda . (2022) 'On Why One Should Stop Smoking'. 25 August.

IvyPanda . 2022. "On Why One Should Stop Smoking." August 25, 2022. https://ivypanda.com/essays/no-smoking-persuasive-speech/.

1. IvyPanda . "On Why One Should Stop Smoking." August 25, 2022. https://ivypanda.com/essays/no-smoking-persuasive-speech/.

Bibliography

IvyPanda . "On Why One Should Stop Smoking." August 25, 2022. https://ivypanda.com/essays/no-smoking-persuasive-speech/.

• Health Care Costs for Smokers
• Ethical Problem of Smoking
• Smoking Ban in the United States of America
• Should Smoking Be Banned in Public Places?
• Causes and Effects of Smoking
• Conclusion of Smoking Should Be Banned on College Campuses Essay
• Legislation Reform of Public Smoking
• Ban Smoking in Cars
• Business Ethics: Smoking Issue
• Cigarette Smoking in Public Places
• Online Discussion and Violence Program Evaluation
• Rhetorical Analysis: Elements and Concepts
• Rhetorical Analysis of Academic Communities
• Che Guevara: The Speech Before the General Assembly of the UN
• The Public Speeches by Kennedy, Mac Arthur and King