British Columbia has taken some positive steps to reduce people's exposure to secondhand smoke. But according to the provincial health officer, B.C. needs to do more. Dr. Perry Kendall also says the government should step up public-education programs about the benefits of quitting smoking.

Kendall's call to eliminate secondhand smoke falls on the heels of newly proposed legislation in Ontario that, if enacted, would bring about aggressive smoke-free laws. He made the recommendations in his annual report, released in mid-December, which this year focused on air quality.

Ontario's bill to make all workplaces and public spaces 100-percent smoke-free by May 2006 was introduced on December 15, the same day Kendall issued his report. Besides prohibiting smoking in all restaurants, bars, banquet halls, health-care facilities, schools, casinos, bingo halls, and offices and government buildings, as well as in private clubs (including Royal Canadian Legions), common areas in residential buildings (including hotels and apartment and condominium buildings), and work vehicles, the proposed legislation would also eliminate all designated smoking areas and enclosed ventilated rooms in such public places. The new law would restrict the display of tobacco products in stores, banning the walls of cigarette packs and cartons behind convenience-store counters.

Kendall's office would welcome similar rules here.

"A number of provinces are moving toward major bans on smoking," said deputy provincial health officer Dr. Eric Young in a phone interview with the Straight . "We're hoping that there will be some impetus for such changes based on this report now that Ontario has introduced its proposal.

"We approach things from a public-health perspective," Young added. "In B.C., there are over 5,500 deaths per year related to smoking. We've known for a long time that smoking leads to lung cancer, heart disease, breast cancer, leukemia, asthma, premature birth, low birth weight, SIDS... It's an extremely important issue, one individuals and society have a lot of control over."

According to the Ottawa-based Physicians for a Smoke-Free Canada, 1,107 nonsmoking adults died in 1998 as a result of tobacco-related causes, as did 96 infants under the age of one year. The organization's Web site ( www .smoke-free.ca/ ) lists illnesses known to be caused by secondhand smoke, including nasal-sinus cancer and nonmalignant respiratory disease in adults, and bronchitis, asthma, pneumonia, and middle-ear disease in children. It describes other conditions thought to be caused by secondhand smoke, like stroke, cervical cancer, and miscarriages in adults and decreased lung function and the exacerbation of cystic fibrosis in children.

Kids are especially vulnerable when it comes to secondhand smoke, because they have weaker immune systems and breathe more air relative to body weight than adults. According to the PSFC, exposure to cigarette smoke causes up to about 220,000 ear infections in Canadian children annually, 2,100 tonsillectomies and adenoidectomies, and 270 sudden-infant-death-syndrome fatalities. Maternal smoking can negatively affect the fetus, since it deprives the baby of oxygen and other nutrients.

Also known as environmental tobacco smoke, secondhand smoke contains at least 40 carcinogens, the PSFC says, and some of them are in stronger concentrations in secondhand smoke than they are in the smoke that goes directly into smokers' lungs. Among the toxic substances are arsenic, cadmium, formaldehyde, benzene, vinyl chloride, and lead.

"Even if smoking is restricted to a single room, the harmful constituents of cigarette smoke can be dispersed throughout the house," the PSFC Web site states. "Many of these highly dangerous chemicals are in invisible gas form."

Sixty-eight percent of British Columbians have no real protection from secondhand smoke, the group alleges.

Antitobacco organizations support any efforts to enforce stricter smoke-free laws. Take Airspace, a Burnaby-based group that maintains on its Web site that nonsmokers have a right to breathe air that is not polluted with carcinogenic secondhand tobacco smoke; that smokers and passive smokers have the right to hold the tobacco industry accountable for smoking-related illnesses and death; and that smokers have a right to publicly funded smoking-cessation services.

That last is a critical point, because no one denies how hard it is for some people to quit smoking. Young said that smokers trying to stop need a lot of support.

"It's difficult to change habits, especially highly addictive habits," he said. "People need to get from the thinking-about-it stage to actually taking steps to making it a reality. And they need to recognize there will be setbacks but not beat themselves up. If they have a setback, they need to say, 'All right, I'll just try again.'

"We encourage those who are smoking to make every attempt to quit; it's a very, very addictive substance and it's difficult to quit. But keep trying to quit. Use every available means. They might want their doctor's advice. They might need medication in the form of patches or gum. There are other aids; there are a variety of methods.

"If people are committed to smoking, they have a personal responsibility not to expose other people to secondhand smoke," he added. "They shouldn't smoke at home if there are children in the home. They shouldn't smoke in the car if other people use that car."

Not surprisingly, the smoke-free movement has its opponents. Last September, the Canadian Tobacco Manufacturers' Council funded an on-line smoker's association called mychoice.ca. The group says it is committed to "restoring common sense, balance and civility" to the way Canadian adult smokers are treated by their federal, provincial, and municipal governments.

"Research shows Canada's adult smokers are tired of feeling powerless and voiceless as they are hit time and again with increasing taxes, more severe restrictions, and social stigmatization," the Web site states.

Smokers and nonsmokers will obviously never see eye to eye, but tougher secondhand-smoke laws would at least help clear the air.