Boston's public heatlh commission is considering regulations that would partially ban smoking in Boston's bars and restaurants. Below is my testimony before the commission at its public hearing held last Thursday evening at Carney Hospital.

I am before you today in support of the Public Health Commission issuing regulations limiting smoking in Boston's restaurants and bars. However, I am also here to ask that you consider amending the proposed regulations so that the ban on restaurant and bar smoking is more complete — so that it covers all establishments, no matter what their size, no matter whether they are bars or restaurants.

It is probably not necessary for me to rehearse for you the compelling public health reasons that require your action. ETS — environmental tobacco smoke or secondhand smoke — is a major health risk to all who are exposed to it. It is a significant cause of disease and death. Researchers at the University of California at San Francisco report that second hand smoke is the third leading cause of preventable death in the country, causing, for example, 60,000 fatal heart attacks and 180,000 non-fatal heart attacks each year.

Thus, your actions here and in the future to limit smoking are easily justified as a public health measure. The issue, it seems to me, is not whether there should be such a limitation. The issue is how far-reaching that limitation should be.

For two reasons, I believe that the limitation should be complete.

First, a significant rationale for the proposal before you is that it is a measure designed to protect worker health and safety. Workers in bars and restaurants where there is smoking are exposed for the length of their shift — commonly eight hours a day — to secondhand smoke. Bartenders, to cite one estimate, effectively smoke two packs in one evening's work.

We have as a society made the policy decision that government should protect the health and safety of workers. Thus, to pick an example drawn from today's news, we do everything we can, often at enormous cost, to limit workers' exposure to asbestos, a carcinogen. Tobacco too is a carcinogen — indeed, its effects have been vastly more deadly than asbestos exposure.

How then can we have a ban on some establishments and not on others? How can we say that some workers are protected — say those working in a larger restaurant— but others must die? And let's not mince words here. We are talking about illness and death — not just smelly clothes, not just reddened eyes, not just wheezing and coughing. When we expose restaurant workers to tobacco, we kill them.

Second, a partial ban such as the one you are considering is, it seems to me, unfair to restaurants and bars themselves. If such a ban is to be imposed — and I firmly believe it should be — then it should be uniform and across the board. Thus, when smoking was banned on domestic airlines, it was done for all airlines, not just some.

This point, by the way, brings up the argument most commonly heard in opposition to a smoking ban: that it will hurt business.

One is tempted to note that, when it comes to issues of mortality and morbidity, we as a society are more than willing to bear enormous economic costs to save lives and reduce illness. These are costs we have imposed, for example, on utility companies when it comes to air pollution or on automobile companies when it comes to vehicle safety.

In this case however, it appears that claims about lost business are demonstrably untrue. Boston is not the first to have considered a smoking ban. The experience of literally hundreds of other municipalities is that business doesn't suffer. The reason is obvious: there are three times as many nonsmokers as smokers. To the extent that a ban deters some smokers from patronizing a bar or restaurant, there are others who, deterred now, will go out more.

I am aware, as you are, that the subject before you today is controversial. Indeed, a lobbyist for one of the affected groups told me yesterday, and I quote, "that it hasn't ever been proven that tobacco is a carcinogen...." These are the well worn arguments of the tobacco industry, arguments that have been exposed again and again as lies. I urge you. Seize the opportunity before you to take an action that will, perhaps more than any other single thing you might do, protect the health of our citizens and our workers.