The smoking ban approved by South Dakota voters last November appears to have had immediate effects on the state's public health.
Among the most direct effects of the ban is less smoking, because smokers have fewer places to light up.
Cigarette sales have plummeted almost 10 percent since the ban took effect, falling from 39 million packs in 2010 to 35 million in 2011. That is 75 million fewer cigarettes smoked.
But whether smokers are quitting or just cutting back isn't clear. Calls to the state's QuitLine, where smokers can receive help to stop smoking, are actually down in 2011.
The big spike in QuitLine calls came not when the smoking ban took effect last year, but in 2009, after the Legislature passed the ban.
"We feel like those who were affected most immediately accessed some help to do that," said Linda Ahrendt, administrator of the Office of Health Promotion for the South Dakota Department of Health.
Slightly more than 6,650 people called the QuitLine in 2011, down from 7,450 in 2010 and 10,500 in 2009. According to state data, just under half of all people who call the QuitLine end up permanently ditching cigarettes.
South Dakota's adult smoking rate is now 15 percent, the lowest it has ever been. But it remains high in some parts of the population, including high school students (23 percent), pregnant women (17 percent) and Native Americans (49 percent).
Fewer cigarettes smoked means good news for smokers' health. But advocates of the smoking ban say an even bigger impact could come through the reduction in secondhand smoke.
"Secondhand smoke is way more dangerous than most people think," said Dr. Allen Nord, a Rapid City physician who was a key proponent of the smoking ban. "It's the third-leading cause of preventable deaths in the United States -- not (smoking) cigarettes, but secondhand smoke. In other words, other peoples' smoke can kill you."
Some of those effects won't be known for a long time.
"The diseases that are drivers of cost are things that are years out," said Jennifer Stalley, government relations director for the American Cancer Society. "Cancer is generally a very slow-going disease."
But medical experts say there are immediate health benefits to cleaner air in bars, restaurants and casinos, including fewer incidences of asthma, respiratory infections and heart attacks.
Dr. David Meyers, a professor at the University of Kansas, studied the effect on heart attacks as cities, states and countries worldwide have banned smoking. He found that within a year of enacting a smoking ban, heart-attack rates dropped by 10 percent to 15 percent. (Though most of the about 25 studies on the subject have found significant decreases in heart attacks of 10 to 15 percent after a smoking ban, Meyers noted that one peer-reviewed study found a much smaller decrease of about 3 percent.)
Smoking doesn't cause heart attacks by itself, but it does exacerbate other risk factors, such as hardened arteries, Meyers said.
With the entire population seeing 15 percent fewer heart attacks, Meyers said the benefit to people at risk of a heart attack alone should be much larger.
"There are some people who are destined to have greater benefits from a public smoking ban than others," he said. "The 55-year-old bartender ought to get a huge effect."
Contact David Montgomery at 394-8329 ordavid.montgomery@rapidcityjournal.com
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