These and other findings are published in special report of this month’€™s The Lancet Oncology.

The report, authored by the International Agency for Cancer Research (IARC), also showed that smoke-free policies do not decrease the business activity of the restaurant and bar industry.

‘€œA reduction in the lung cancer burden is plausible, but relevant evidence will only become available in the future,’€ the authors said.

Dr John Pierce of the University of California and Dr María León from IARC’€™s Tobacco and Cancer Team prepared the Special Report in collaboration with scientists from around the world

 They assessed 11 proposals relating to causal effects of smoke-free policies and graded them into three categories.

Sufficient evidence meant that the association was judged to be causal; a lesser classification of strong suggested that the association is consistent but evidence of causality is limited; while the third category applied to proposals where there was insufficient data to come to a conclusion.

The working group comprehensively assessed peer-reviewed published work and accessible governmental reports on the effect of smoke-free policies to come to their conclusions.

The group found sufficient evidence that implementation of smoke-free policies substantially decrease second-hand smoke exposure; that smoke-free workplaces decrease cigarette consumption in continuing smokers; that smoke-free policies do not decrease the business activity of the restaurant and bar industry; that introduction of smoke-free policies decreases respiratory symptoms in workers; that voluntary smoke-free home policies decrease children’€™s second hand smoke-exposure; and that smoke-free home policies decrease adult smoking.

Strong evidence was found that smoke-free workplaces decrease the prevalence of adult smoking; that smoke-free policies decrease tobacco use in youths; that the introduction of smoke-free legislation decreases heart disease morbidity; and that smoke-free home policies decrease smoking in youths.

But, because the lead time for lung cancer to be diagnosed after exposure to a carcinogen such as cigarette smoke can be 20 or more years, the group concluded that ‘€œdata are not yet available regarding the expected decline in lung cancer after implementation of smoke-free policies.’€

The working group recommended that governments enact and implement smoke-free policies that conform to the WHO Framework Convention on Tobacco Control (FCTC).

 ‘€œImplementation of such policies can have a broader population effect of increasing smoke-free environments. Not only do these policies achieve their aim of protecting the health of non-smokers by decreasing exposure to second-hand smoke, they also have many effects on smoking behaviour, which compound the expected health benefits. These benefits will be greater if these policies are enacted as part of a comprehensive tobacco-control strategy that implements all of the provisions called for by the WHO-FCTC,’€ the authors said.

The authors pointed out that up to now, most research has been done in high resource countries. They recommended the establishment of a multinational surveillance system to allow assessment of the effect of these policies in low-resource and medium-resource countries.

Worldwide, over 5-million cigarettes are consumed annually with strong evidence that tobacco companies are targeting developing countries to make up for their losses in the developed world where smoking prevalence has dropped.

According to Dr Yussuf Saloojee of the National Council Against Smoking in South Africa, smoking related deaths worldwide stand at 5,2-million per year and it is expected to rise to 10-million by 2025 ‘€“ most of these deaths are projected to be in the developing world.

In 1993 there were 90 deaths annually from tobacco in Africa ‘€“ by 2050, this may increase to 500 000 deaths per annum, according to Saloojee.

Patricia Lambert, Director of the International Legal Consortium at The Campaign for Tobacco-Free Kids, said that in 2000 one in 10 deaths could be linked to tobacco use. ‘€œBy 2030 it is expected to be the leading cause of death with 70% of these deaths occurring in developing countries,’€ said Lambert, a former special advisor to South Africa’€™s health department.

‘€œThis (Tobacco) is the only legal product when used according to the manufacturer’€™s instructions kills or causes disease in more than half of the people who use it,’€ said Lambert. ‘€“ health-e news service