1. Tobacco smoke contains at least 67 known human or animal carcinogens [Repace, 2006]. This is true whether tobacco smoke is inhaled in the act of smoking, or exposed to nonsmokers indoors or outdoors. Meaning: Inhaling tobacco smoke can cause cancer even when inhaled outdoor.

2. In a study measuring the levels of nicotine inhaled by nonsmoking workers in indoor smoking places versus indoor nonsmoking places [Agbenyikey et al 2010], the mean concentration in nonsmoking workers after adjusting for exposures from other sources was 25 fold higher than their counterparts in nonsmoking venues. Meaning:. If you do not smoke and you work at a place that allows smoking, you are just as a smoker. Therefore you can get all the diseases a smoker can get from smoking tobacco. Our lawmakers are not protecting our employees from carcinogens

3. The age adjusted prevalence rate of smoking among the 13-15 age group is in the double digits (13%) and increasing.[GYTS 2000, GYTS 2006, GYTS 2009] Meaning: Regardless of any other prevalence studies, if this situation is not reversed, the prevalence rate in Ghana would skyrocket in a decade.

4. A fifth of Ghanaian youth are likely to start smoking within the next year[GYTS 2009] Meaning: Unless they do not care, the onus lies on the adults, government, lawmakers in Ghana to halt this menace.

5. The mean public places indoor air pollution caused by tobacco smoke in Ghana, as of 2008, was higher than all 32 countries that participated in the global indoor air pollution study [Hyland et al, 2008]. Meaning: The average indoor public place in Ghana is extremely polluted. Although a few number of people may be smoking.

6. In another global study of 28 countries [Shahrir et al 2011] more than 50% of Ghanaian bars & nightclubs receive promotional items from the tobacco companies and 80% of these bars & nightclubs sell cigarettes. Meaning: Tobacco industry’s illicit activities are high in Ghana and also cigarettes are easily accessible.

7. In Agbenyikey et al 2010, the levels of ambient nicotine, a specific carcinogen of tobacco, was extremely high in smoking places (1.83 ?g/m3) and almost nonexistent in nonsmoking venues (0.03?g/m3). Meaning: Patrons at venues where smoking is allowed are exposed to high levels of nicotine whereas patrons at nonsmoking places are safer.

8. An exposure assessment of another pollutant and marker for tobacco, PM2.5, in over 90 smoking and nonsmoking venues (each venue measured at least 9 times & controlled for other sources of PM2.5) revealed that smoking places have a median concentration of 553 ?g/m3 compared to 16 ?g/m3 nonsmoking places.[Agbenyikey et al 2010] Meaning: The level of pollution at smoking places are categorized as hazardous to health by WHO and USA EPA

9. Studies and controlled experiments demonstrate that, irrespective of the direction of the wind, an individual in an outdoor bar, park, stadium, patios, and sidewalks or otherwise standing by a smoker is exposed to the smoke. It also shows that outdoor levels of tobacco smoke can be as high as indoor levels. Even though indoor air dissipates faster, it could trigger a cardiovascular event. [Klepeis, et al. 2007, CARB, 2006, Boffi et al. 2006]. Meaning: Outdoor tobacco smoke can also cause cancer. Many countries have passed this smoke-free law.

10. Conclusion: Defiant smokers, the tobacco industry and their shameless campaigners argue that

a. What about the right of the smoker?

b. What about the bad engine emissions from rickety vehicles?

c. Why not concentrate on serious and acute health problems?

d. Smoke-free law will kill entertainment business, etc

These arguments are lame! Could someone remind them that smoking is a privilege that cannot supersede the nonsmokers’ right to a cancer free air? Regulating tobacco and implementing emission standards are not mutually exclusive. Also, regulating tobacco and concentrating on other seemingly more serious health issues can be done simultaneously. There is no objective study supporting the claim that regulating tobacco leads to loss of revenue in the hospitality industry. It is actually the contrary. [Bartosch et al 2002. Scollo et al 2003]

Wil Agbenyikey, MPH, Sc.D Candidate & The smokefreeghana.com Syndicate