We are all aware of the dangers of secondhand smoke. This topic has been on my mind lately because the city in which I live just passed a fairly comprehensive smoking ban. Over a year ago, the city council passed a law banning smoking in many establishments but had several loopholes. The more comprehensive ban takes effect next year-plenty of time for people, groups, and businesses to file lawsuits. This new law bans smoking indoors in public buildings with very few exceptions.

Now, I know many of you live in communities where this issue is not an issue at all. Many cities (both large and small) have passed various antismoking ordinances over the past few years. Many of you are probably thinking that this is an old topic. But let me remind you that I live in Kentucky. It is a huge issue in this state.

Although I am very glad that we will have a fairly comprehensive smoking ban here in Louisville, Ky, soon (I hope), I was shocked at the opposition to its passing. There was much lobbying against it, and there may still be lawsuits or restraining orders. I was amazed at the number of people and groups who opposed this legislation for a myriad reasons, including the following: (1) It will hurt my business; (2) my customers will not like it; (3) it is unfair; and (4) I have a right to smoke when and where I choose.

When the council was discussing this issue, there were more people who opposed it in the room. However, there were more people in the room who favored the bill. But the group of people who favored the bill was not as loud as the group who opposed the bill. The group who favored the bill was persistent and kept discussing the point that this is a public health issue affecting both smokers and nonsmokers. The groups in favor of the legislation were occasionally drowned out by the opposition. However, the "silent majority" kept pushing and pushing this issue until the council passed a more comprehensive smoking ban.

This reminded me that nurses are a silent majority. We make up the largest group of healthcare providers. We are instrumental in providing healthcare, but often, our voices are not heard. We are drowned out by smaller groups who can be very loud. Imagine what we could accomplish as a group to positively impact healthcare if we were not so silent. We must become a vocal majority. Just like the larger group of people who favored the smoking ban, we must make our voices heard. Imagine what would happen if we all spoke up and pushed for universal health coverage, affordable healthcare, easy access to healthcare, or any health issue.

Working as a group, we can become the vocal majority. We need to work as a group in our communities and work with legislators to improve healthcare for all. Contact your legislator to offer an opinion on healthcare issues. Attend meetings and actually discuss healthcare topics with your representatives. We can become the vocal majority on healthcare issues.

On a side note, I feel I must get back on my soapbox and remind you of the dangers of secondhand smoke. After all, it was the impetus for this column. So indulge me. The effects of secondhand smoke include, but are not limited to, the following:

1. Causes lung cancer and chronic lung disease in nonsmokers

2. Contributes to sudden infant death syndrome

3. Exposes one to thousands of chemicals and known carcinogens

4. Linked to low birth weight, asthma, otitis media in children, cognitive deficits among children, bronchitis, and cervical cancer

5. Causes irritation to the eyes and mucous membranes

Let us work together to move nurses from the silent majority to the vocal, loud, and impossible-to-ignore majority. Just imagine what we can accomplish.

Vickie A. Miracle, RN, EdD, CCRN, CCNS, CCRC

Editor, DCCN and Lecturer

Bellarmine University

School of Nursing

Louisville, KY

[email protected]