Dr. Ellen Hahn: Strong Smoking Bans in Communities Help Lower Rates of Lung Cancer

Posted: November 29, 2017

Written by Linda Blackford
Photography by University Photographer Mark Cornelison 
This article originally appeared in the Kentucky Herald-Leader on November 28, 2017

Communities with strong laws against workplace smoking have lower rates of lung cancer, a new study from the University of Kentucky found.

That conclusion might seem obvious, but the study by anti-smoking advocate Ellen Hahn of the UK College of Nursing is the first to show that lung cancer rates go down when smoke-free laws cover workers and the general public from the dangers of second-hand smoke. That’s important in Kentucky, which has the highest rate of lung cancer in the country and one of the highest adult smoking rates.

Lung cancer mortality rates here are 50 percent higher than the national average.

Hahn’s team looked at 20 years of lung cancer data for more than 80,000 Kentuckians over age 50 in communities with strong, moderate and weak smoke-free laws. Strong laws cover all workplaces, including restaurants and bars. Moderate laws covers indoor public places, but not all workplaces, while weak laws are defined by having major exemptions, such as bars or bowling alleys.

The lung cancer incidence was eight percent lower in places with strong smoke-free laws compared to those without the laws. There was not a difference between places with moderate and weak laws and those without any bans.

Put another way, Hahn said, there are 4,000 new cases of lung cancer diagnosed every year in Kentucky. Comprehensive smoke-free laws across the state could prevent 325 of them.

The study was published Tuesday in “Cancer,” a journal of the American Cancer Society.

When the study started in 2014, 33 Kentucky municipalities had one or more smoke-free laws.

But Hahn said only about one-third of Kentuckians are protected by comprehensive smoke-free laws. That includes Lexington, which became tobacco-rich Kentucky’s first city to enact a smoking ban in 2003, partly due to Hahn’s advocacy. The ban was challenged in court, but the Kentucky Supreme Court ruled that it was government’s duty to protect the public’s health. Lexington’s ban includes most indoor public spaces.

Hahn’s work through UK’s BREATHE (Bridging Research Efforts and Advocacy Toward Healthy Environments) has documented other benefits of Lexington’s ban. In 2005, she found a 22 percent decline in asthma-related visits to Fayette County emergency rooms, along with a dramatic reduction in nicotine exposure. Twenty months after the ban, there were 16,500 fewer smokers in Fayette County.

Studies in other states have also found a dramatic decrease in heart attacks after bans are enacted.

Despite the bans in numerous Kentucky cities, many rural communities, where tobacco was once a major crop and many people still smoke, have held out. Hahn said she hopes the latest study will convince rural communities to enact tougher laws against public smoking.

“Local government can play a critical role in preventing lung cancer,” Hahn said. “Elected officials can ensure that all workers and the public are protected from secondhand smoke by passing strong smoke-free laws with few or no exceptions.”

Hahn said tobacco’s legacy “haunts us,” but that “we know what works, we just have to do it.

“With smoke-free laws, 325 lung cancer cases would be prevented every year. That’s a lot of loved ones who are in pain and who suffer. If a smoke-free law can save 325 lives a year, why not?”