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August 18, 1999

Bartenders' Pulmonary Function After Establishment of a Smoke-Free Workplace—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;282(7):629. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-7-jbk0818

In Reply: Among bartenders, pulmonary function improved after the establishment of smoke-free bars and taverns. Similarly, the prevalence of respiratory symptoms declined markedly after the smoking ban. Drs Bell and Urbach raise an important issue: is the improvement in pulmonary function clinically significant?

As we discussed in our article, we believe that the modest improvement in pulmonary function represents a clinically significant change. Importantly, the increase in FEV1 (1.2%) is similar to that observed after personal smoking cessation in previous studies (1.2% to 4.8%).1,2 Among bartenders with complete workplace ETS exposure cessation, we observed an even larger improvement in FEV1 (4.5%). Epidemiologic studies35 linking ETS exposure with decreased pulmonary function also support the clinical relevance of our findings.

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