Clean air and good health, along with freedom and liberty, are Montana values. And they all go together.
Twenty years ago, our state took the lead in highlighting the benefits of smoke-free air in our indoor public spaces, including restaurants, bars and casinos.
Those benefits include reduced risk for heart attacks, lung cancer and asthma attacks. They also include the freedom not to breathe toxic chemicals, and the liberty to do an honest day’s work as a casino employee, waitperson, bartender or dishwasher without putting your life on the line through exposure to deadly smoke.
Not only did we talk about the benefits of smoke-free policies, we also demonstrated them — not just to Montana, but to the entire world.
In 2003, we co-authored “The Helena Heart Attack Study,” a paper published in the British Medical Journal that showed how smoke-free protections have an amazingly rapid effect on preventing heart attacks. This was the first study of its kind and it happened because of Montanans’ fight for clean indoor air.
In Helena, a comprehensive smoke-free ordinance went into effect after a strong “yes for smokefree” vote in June 2002, but was suspended six months later due to a legal challenge from the tavern and casino industries. While we were unhappy about the suspension, this turning off-and-on of the smoke “faucet” provided an unique opportunity to compare local health data from before and after the ordinance went into effect.
What we found was remarkable. Local health records showed that during an average six-month period, the number of hospital admissions for heart attacks in Helena was just under seven per month. However, during the six months that the ordinance was in place, the number dipped to under four per month — a drop of nearly 60 percent. This was a huge improvement in just a short period, and demonstrated how significant smoke-free protections are to preventing death and disease.
Reinstating Helena’s protections and expanding them statewide took several years of outreach and education to Montana citizens, decision makers and businesses. The Montana Legislature finally passed the Montana Clean Indoor Air Act in 2005, making indoor public spaces smoke-free, apart from bars and casinos, which had until 2009 to comply. In that time, the Helena study was replicated in Ireland, Scotland, France, Germany, Italy, Greece and Canada as well as in numerous communities in the United States.
We are proud to be a part of this history. Yet we are concerned about the future.
Where Montana once led on clean air, there are now signs of retreat. This legislative session saw three bills aimed at doing away with our smoke-free protections. Thankfully, due to the hard work of health advocates and wiser heads in the Legislature, all three of these bills failed.
However, our state leaders also missed a tremendous opportunity by tabling a good bill by Sen. Willis Curdy that would’ve added e-cigarettes into our smoke-free protections.
Studies show that e-cigarette aerosol contains ultrafine particles linked to cancer, lung and heart disease. E-cigarette aerosol also contains nicotine, which is harmful to adolescent brain development. Contrary to claims otherwise, e-cigarettes do not benefit users by helping them quit. The majority become “dual users” of both e-cigarettes and conventional cigarettes.
Using recreational marijuana in our public spaces is prohibited, the same should be true of e-cigarettes.
A 2021 poll by the American Heart Association and American Cancer Society Cancer Action Network showed that 89% of Montana Democratic and Republican voters support our Clean Indoor Air Act and 81% (four in five) support including electronic smoking devices into it.
We urge our elected officials to protect Montanans’ freedom to breathe healthy air by strengthening our Clean Indoor Air Act to include ALL types of smoking.
Richard Sargent, M.D., and Robert Shepard, M.D., of Helena, are co-authors of the Helena Heart Attack Study.