In Amy Ann Moore's recent letter to the editor, "Smoking ban would increase health of public" (SN 6/20), she makes the statement, "I appreciate the fact that we all have opinions. With privilege, however, comes responsibility." I concur, and thus was dismayed when Moore went on to make the blanket statement that "passive smoke exposure among women before their first pregnancy is the only known cause of pre-menopausal breast cancer." While there is some scientific evidence that supports this claim, Moore left out critical information.

First, the evidence exists only in cases where there has been repeated, long-term exposure to secondhand smoke, and second, the relationship between long-term exposure to secondhand smoke and breast cancer is not causal.

When it comes right down to it, what we know through the rigors of scientific inquiry about the long-term effects of prolonged exposure to secondhand smoke is limited, and what we know of the health risks of short-term, episodic exposure is substantially less.

Does this mean it shouldn't concern us? No, it simply means we ought to proceed thoughtfully before making knee-jerk health policy decisions and committing our limited resources.

Certainly Kentucky, which Moore applauds for having 13 smoke-free communities, exemplifies this well. In considering Kentucky's epidemiology data, the increased tobacco controls have done nothing to reduce the smoking rate.

There also have been no improvements in health outcomes associated with exposure to passive smoke. On the other hand, tobacco remains Kentucky's primary cash crop.

There is a very strong correlation between tobacco growing communities, smoking rates and associated health risks. Perhaps the resources used to establish those 13 smoke-free communities would have been far more effective had they helped move Kentucky away from its economic dependency on tobacco.

Unfortunately, we will never know because it was never considered. Indeed, the very mistake Moore is accusing The State News of committing is committed by tobacco-control proponents daily.

The only real difference is the ramifications are far more serious - and our forgiveness should not be granted quite so freely.

Rebecca Allen
alcohol, tobacco and other drugs health educator for Olin Health Center