Doctors say, "Smoking Ban is a Health-Rights Issue"
Secondhand smoke is involuntary exposure. If you work in the bar, you breathe it, and if you need that job, you breathe it. And the argument is, 'Yeah, but they need the job and they get money.' I heard that same argument out of W.R. Grace. Anaconda Copper made the same argument: if you want the job, you put up with the poison.


According to two Helena physicians pushing hard for passage of the city's clean indoor air ordinance, the overriding issue is public health, and whether people have the right to harm others. Dr. Robert Shepard, 54, and Dr. Richard Sargent, 44, both practice at Helena HealthCare's Family Health Clinic on North Montana Avenue. Between them, they've practiced medicine in the area for more than 30 years.

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In addition, Shepard, who chaired former Gov. Racicot's Tobacco Use Prevention Council, fought in vain for a tobacco tax increase as far back as 1990. Sargent, who sits on the American Cancer Society's Lewis and Clark Advisory Committee, also helped develop the Nicotine Dependency Center that opened last year through the county health department.

In separate interviews last week, the doctors made their case for the ordinance, which is up for a vote of the citizens of Helena on June 4.

"This is entirely a health issue," Shepard said. "I wouldn't be here doing this if I didn't see the impact on my patients every day. It's an addictive behavior. It kills people. It kills my patients. It kills people that I like. It's a dangerous, dangerous product, and anything we can do to restrict its use is justified."

Sargent said that in some ways, secondhand tobacco smoke is worse than first-hand smoke breathed by the smoker. "What you've got to understand about secondhand smoke is, it's all the chemicals without the pesky filter," he said. "The stuff coming off the burning end is much worse than what the smoker gets. Working in a smoke-filled bar, that's the equivalent of smoking somewhere between 15 and 20 cigarettes per day in terms of health effect. When you start looking at the health effects, it's a pack a day."

While both doctors regularly implore their patients to stop smoking, they recognize that the proposed ordinance isn't about making people quit, but about forbidding people from smoking around others in public buildings.

"Secondhand smoke is involuntary exposure," Sargent said. "If you work in the bar, you breathe it, and if you need that job, you breathe it. And the argument is, 'Yeah, but they need the job and they get money.' I heard that same argument out of W.R. Grace. Anaconda Copper made the same argument: if you want the job, you put up with the poison.

"Traditionally, we have held in American society that if your activity harms somebody else, you have to stop," he continued. "I can swing my hands through the air -- until they connect with your nose, and then I have violated you. I can operate a business as long as I don't poison my employees."

"We still have the opinion that people can choose what they want to do to themselves," Shepard said. "But we no longer take the position that anyone is allowed to do any activity which is harmful to somebody else. We don't tell people they can't drink, we tell them they can't drink and drive. Even though you have free speech, you do not have the right to slander somebody. We need to take this broadly accepted human principal in the United States that you can't do anything that harms someone else, and we need to apply that to tobacco."

At times the doctors seem incredulous that anyone could believe secondhand smoke isn't that dangerous, based on a growing body of studies that proves otherwise.

"People make decisions based on emotion, then they look for data that backs up their side," Sargent said.

(Opponents) have to refute the data to be able to say 'We're not harming anybody,' and yet that's their weakest point, because the data is rock solid," Shepard said. "There is no way that they are going to be able to refute that data. It's accepted by every major scientific body, not just in the United States, but in Europe, Australia, New Zealand, and around the world. They've got their heads in the sand if they think the data is incorrect.

"If you accept the data, and there's nothing that a thinking person can do (but accept it), then where do you come up with the concept that there is a right for businesses to harm somebody by exposing them to that substance?" he asked. "My challenge is, name any substance other than tobacco which is as harmful as tobacco is and is unrestricted."

Much of the argument against the ordinance focuses on the threat of economic impact, but the doctors maintain that the threat is more imagined than real.

"The hypothesis is that 'My tips are going to go down and that business will go down,'" Shepard said. "If you look at the data, there are tons of studies which show that business doesn't go down. People continue to come in and frequent those establishments despite their inability to smoke there. I understand the fear, but the reality is that that isn't what's going to happen. There's a lot of information that would suggest that the exact opposite is true."

"For the last seven years, Philip Morris has bought into the tavern industry, telling them what a disaster this was going to be for them, in spite of all of the evidence to the contrary," Sargent said. Citing dozens of scientific studies that say the hospitality industry isn't harmed by smoking bans, he said, "The tobacco industry has used their four studies to show horrible economic impact, and there are major critiques against all of them."

Both doctors believe that the smoking ordinance will make Helena more attractive to tourists and conventioneers. "We're going to be able to market this as a completely smoke-free environment," Shepard said. "There are scientific studies of the impact both on tourism and convention business, and typically there is no impact or a positive impact on the communities that enact these ordinances. Once again, (ban opponents) are speaking from emotion rather than speaking from the data."

Added Sargent: "I envision billboards north of Great Falls, south of Butte and east of Bozeman that say 'Come to smoke-free Helena.' You've got to remember, four out of five Americans don't smoke, and four out of five Montanans don't smoke. So you can tailor the business to 20 percent of the people, or you can tailor the business to 80 percent of your potential customers."

"There isn't any new ground here, and the dire predictions that businesses have had all around the United States that this is going to be terrible for business simply have not come true," Shepard said. "One of the quotes from (a tobacco company marketing director in 1994) says exactly that: 'People don't believe it because it has never been true.' And the fact is, that's right. It has never come true. So they're repeating the same tired, worn arguments that people don't buy."

While believing there's "probably some truth" to the notion that people more prone to addiction are similarly drawn to smoking, drinking and gambling, Shepard said eliminating one of those elements from casinos wouldn't necessarily harm the others.

"Let's assume you smoke five cigarettes less a day (if the ordinance passes). That's a quarter of a pack, that's around 75 cents," he said. "Are you going to put that 75 cents in the bank? No, that's going to be 75 cents that's burning a hole in your pocket. They may sell fewer cigarettes within the casino, but their profit margin on the gaming is so much higher. That's going to go up because people are going to gamble away the money they save by not smoking cigarettes. That hypothesis is at least as plausible as (the ban opponents'), which is that people won't show up to do what they enjoy doing in the future."

Shepard said the perceived threat to business makes people downplay the real health risks. "It's that money that makes people turn the blind eye to the ethical issue of what they're doing," Shepard said. "In a way, the local opposition is simply recapitulating that argument. They're saying ŽNo matter what, our profits are worth more than people's health,' and I just can't believe that any responsible, ethical business would take a position like that."

"You can't kill your employees for a profit," Sargent said. "It's just wrong. You can't sicken them for a profit. Everybody else has to provide workplace protection."

Shepard resents the implication that money from the national tobacco settlement is being used to push for passage of the ordinance. "That's totally and absolutely bogus," he said. "That tobacco settlement money goes directly into the general fund of the state of Montana and not one penny of it comes out of that fund to support the campaign. In fact, Governor Martz, much to my chagrin, has used much of that money to balance the budget of the state of Montana. This project receives absolutely no funding in any way from that."

Both doctors expect the ordinance to face additional legal challenges if it passes, and believe the issue may come up in the next session of the Legislature. "It will surface in the next session," Shepard said. "And I think we need to say to our legislators, 'We don't like this idea of the state coming in and taking away local control,' and that's what this issue is. The states don't like it when the federal government takes away their control, why should they expect us to like it when they take away our control?"

While he doesn't agree with business owners who believe the ordinance will threaten their livelihood, Shepard does understand some of the reluctance to embrace the proposed law.

"When you have something that has been working for you for a long time, you trust that you can predict the future off of that," he said. "And when somebody comes in and says, 'Trust me, you can depend on this other system; it will work for you going forward too,' people are less likely to do that.

"But medicine changes, life changes, our culture changes," he continued. "What wasn't important 20 years ago is important now. And what is important right now is this changing concept about anybody's right to harm somebody else. When improvements can be made in the way we live our lives, the way we run our society, the way we do our culture, then I think we need to embrace those improvements and move forward."

Montana Forum
Sunday, May 5, 2002
Helena IR Staff