Nevada Easing smoking Ban? -"What happens in Vegas Stays in Vegas"- We Can Only Hope

  According to the April 18th New York Times, the Nevada state  senate voted 16-5 to advance a measure that would soften the status of the statewide public smoking ban.  Legislators are hoping to pass  a measure that resembles that of  our neighboring state of Tennessee.  The Volunteer state doesn't quite understand that adults "are people too" as they only restrict smoking in places that patronize human beings under the age of 21.(Hey, you do have to give them credit for learning that children exposed to 2nd hand smoke have a 3x increased risk of lung cancer as adults.)  Nevada, blaming their decrease in casino revenue on the ban passed in 2007 obviously hasn't come away from the roulette wheel long enough to read the newspaper.  Excuse me, but has anyone in Nevada noticed that the US is now in a depress......recess.......I mean economic slow down? 

  FIVE Nevada legislators  understand the economics of tobacco use and voted against the measure.  They are obviously among the few individuals voting who cared enough to actually study the economics of their state's health care plan at all. Earlier in the day, the New York Times reported that the Nevada State assembly passed legislation ensuring outpatient cancer treatment for indigents.  Democrat Sen. John Lee who supports retaining the ban was incredulous at the turn of events and stated "if you are over 21 , it's oK to go ahead and kill yourself and everyone around you but the other house says 'wait a minute, my gosh.......if they have cancer, we've gotta take care of them'."

  From 1999 to 2007, medicaid expenditures for the state tripled while average expenditures for  the remainder of the country merely doubled.  Nevada spent 1.2 billion medicaid dollars in large part due to heart disease death rates of 242/100,000 as compared with the 211/100,000 for the rest of the country.  The smoking prevalence of 21% is higher than the US average of 19%.  If anyone needs a smoking ban, it's a state who triples its medicaid expenditures over the course of 8 years.  The Nevada FIVE are to be commended but  probably feel a lot like Lot and his family just prior to their infamous city's final firework's display. Having FIVE " righteous"  legislators just  might save them. ( After all, Sodom and Gomorrah only had four.) .... OK, OK,......don't get your Cirque tickets in a twist.....I'm only kidding!

I'm not the brightest bulb on the casino marquee, but I'd suggest that the legislators look at the health benefits reaped by other cities who've passed REAL smoking bans (not fake ones like Tennessee) prior to voting.  Pueblo Colorado's heart attack rate fell by 27% in just 18 months and by 41% by the end of the study period after passing a comprehensive public smoking ban. Surrounding cities who still allowed good clean air to be poisoned by the largely inconsiderate smokers saw no such decrease.    New York City produced a greater than 50% reduction in teen smoking resulting in 24,000 fewer nicotine addicts who WON't have to take the subway to their chemo and radiation therapies in the future.  Lexington, Ky. saw a 24% decrease in ER visits for acute asthma visits following their ban. From my viewpoint, smoking bans aren't much of a gamble.  It's a sure bet for LONG TERM decreases in health care  expenditures that will offset any supposed decrease in revenue from such concerns as losing the Tobacco Plus Expo convention.  (a real "plus" anyway you smoke it in my book).

The finger pointing in Nevada reminds me of a story a patient told me last week.  A very elderly gentleman said to me:   "Yeah,.....I remember when you were a very little girl (about 5 years old I'd say), your mom and dad took you and your brother out to eat.  A saucer was knocked off the end of the table and your dad had to pay for it.  He thought your brother did it, but I saw who really did it", pointing to me.  I vaguely remember eating there at all, much less the rest of the story, but it's the same situation as Nevada. Like my unsuspecting little brother, the Nevada Clean air act  is getting the blame for slumping casino revenues when it fact, the entire country is in a slump period. On the other hand, it's interesting that the increase in lung cancer rates prior to the ban going into effect didn't get  any attention at all from those who are now crying foul over the clean air act.   Not a single casino or bar owner in support of softening the ban seems  the least bit concerned that their patrons, co workers and family members will be  dying at an alarmingly high rate.   Maybe their penchant for rolling the dice extends to gambling with the  health and human life of others as well.

Of course, The solution to the entire mess is obvious.   OUR NATION MUST become a SMOKE FREE nation!!!! (Washington, are you listening??) That way, none of this whining about losing business could be blamed on patrons running to places where they can sniff carcinogens freely and enjoy increasing the cancer rates of their friends and neighbors without pesky bans.  If the entire country were smoke free, we'd be "  healthier and wealthier "  and even "wiser" with all the money we could put toward education instead of toward chemo, radiation, home oxygen and primary PCI's.   

So back to Nevada.  I only hope for the sake of the rest of our country that "What Happens in Vegas Stays in Vegas".  If this state softens its smoking ban, I would hope that the rest of the country would stay OUT of Vegas, at least until someone else gets to deal the cards. If the state legislature votes to protect the public, lessen health care expenditures and prolong quality of life, then Nevada will have really hit the BIG Jack Pot!! 

Melissa

Your comments

	Nevada Easing smoking Ban? -"What happens in Vegas Stays in Vegas"- We Can Only Hope
	# 1 of 10	April 26, 2009 10:15 (EDT)
	San Man	You forget that the folks in Washington DC. have the same problem as those in Nevada.  A greed for cash.  There is a huge amount of revenue tied to tobacco tax.  A nationwide smoking ban means higher taxes elsewhere to make up the difference.  And in these ...economic slow times... that is a bitter pill to swallow!
	# 2 of 10	April 27, 2009 08:45 (EDT)
	Melissa	San, You are correct.  Greed is the absolute best descriptor for this entire argument in Nevada. This is the only argument in the history of American politics where it's perfectly acceptable to promote the death of innocents.  If a sniper's bullet killed as many who will die of 2nd hand smoke exposure in Nevada in the next decade( if this legislation passes), we'd be up in arms.  TV camera crews would be reporting on the spot.  Swat teams would be deployed.  Money would be funneled into the state to help locate and contain the culprit. Iinstead, it's cigarette smoke and because we can see through it, it doesn't count.  How many folks in Nevada became indignant at the peanut butter contamination scandle?  I'm certain some were asking "How could that gentleman  know that peanut butter  left his facility with ANY POTENTIAL capacity for being tainted with salmonella?"   Any one of those folks in Nevada who are promoting easing the restriction are no better than that gentleman who knowingly put Americans in harm's way.  It's hypocrisy at it's finest.    One final question however.  WHERE IS THE NEVADA HEART ASSOCIATION ON THIS??? Where is the Nevada MEDICAL ASSOCIATION?  Where are the physicians? Perhaps it's because we are not privy to their local news coverage on a daily basis, but  I SINCERELY  hope they are making an organized concerted effort to combat this issue.  Melissa
	# 3 of 10	May 20, 2009 03:17 (EDT)
	Angelina	Dr. Walton-Shirley: Where did you get your statistics for medicare expenditures for NV vs the rest of the US from 2000-2007? That is a very telling statistic, but I'd like to see the source if possible. Thank you for you help and information! Angelina
	# 4 of 10	May 21, 2009 06:11 (EDT)
	Melissa	Angelina, I checked with the Medicare expenditures by state. There is a website for it, but I did not keep that information and I apologize for it.   I believe you can just google it if you do not have someone at your local hospital in administration who could get that for you!   Good luck.  Hope that helps. Melissa
	# 5 of 10	May 26, 2009 09:34 (EDT)
	Melissa	Angelina, I found one of the sites where I was able to obtain the information.  It's statehealthfacts.org.  I'll keep trying to find more for you from time to time. Melissa
	# 6 of 10	June 27, 2009 06:34 (EDT)
	Jake	I guess we're all agreed on this subject. Ban smoking!!!! It leads to nothing but cancer, slight of breath, heart disease, or any other kind of illness. If we make it illegal to smoke in public it gives smokers less of a reason to smoke period. Banning smoking will save lives you wait and see. <a href="http://www.ecommunity.com/cardiovascular/">heart surgery</a>
	# 7 of 10	June 30, 2009 06:40 (EDT)
	Melissa	The world continues to "mint" several thousand new smokers per year.  Culture change is a must, especially in a world economy that cannot provide care to those with "no fault" diseases, not to mention those that we as human beings bring upon ourselves.  The catalyst of personal responsibility is paramount to the success of any over hauled healthcare system.  Without it, any effort is destined to fail.
	# 8 of 10	July 13, 2009 09:54 (EDT)
	Bingos	This brings me to an idea:...
	# 9 of 10	September 2, 2009 08:08 (EDT)
	Bill Bartmann	Excellent site, keep up the good work
	# 10 of 10	September 10, 2009 06:59 (EDT)
	Melissa	Thanks Bill, Hope you continue to enjoy it. Melissa

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