The concept of banning cigarettes in nearly all public places is still new to many Americans. Most of the country's largest urban areas have effectively banned smoking in bars, restaurants and nightlife venues, but these spaces remain smoke-friendly in many areas throughout the US.

The legislative tide is turning, however, and a dual report commissioned by the Centers for Disease Control will almost certainly benefit the anti-smoking movement in confirming two basic principles: secondhand smoke can cause cardiovascular disease and smoking bans can, at the very least, reduce its incidence.

A panel of experts from the Institute of Medicine reviewed a large swath of research on secondhand smoke and heart disease, noting that the likelihood of adverse events like heart attack and stroke rises considerably among subjects who spend a great deal of time around smokers. Even very brief exposure to smoke has been shown to constrict blood vessels and increase the likelihood of internal clotting. These are two major causes of heart disease, and the Surgeon General placed the number of yearly deaths that may be directly attributed to secondhand smoke at "tens of thousands".

Examining a series of eleven independent studies observing the efficiency of smoking bans, researchers noted a universal decline in heart disease rates in all data sets. The research remains imperfect as these declines varied widely from location to location and heart attacks dropped by as little as 4% in certain areas. Still, the average yearly drop in adverse events was 26%, a trend that continued for three consecutive years in the longest available studies. Many issues remain unresolved despite these definitive findings: the evidence reviewed by the panel was not specific enough to define the degree of risk posed by secondhand smoke exposure, though it made clear the fact that subjects who already suffer from heart disease face the greatest threats.

Some object to these bans for civil libertarian reasons, arguing that local and state governments cannot force private business owners to make their establishments smoke-free at risk of heavy fines or closure. One can follow the reasoning behind this argument: smoke-free spaces are common, and those who choose to allow their customers to smoke should, under this principle, be allowed to do so without fear of reprisal. Smoking can also become a legitimate revenue issue for some business owners, especially those who operate in the gaming resort & casino industries where smoking is especially common. Some libertarians and advocacy groups view current bans as precursors to the outright illegalization of tobacco products, calling them the latest step in an war intended to punish smokers themselves, rather than the corporations that manufacture their tobacco.

This ideological back-and-forth could go on indefinitely, but those who label smoking bans as ineffective examples of government overreach now stand on shakier ground. Abstainers who spend a lot of time in tobaccco-drenched spaces suffer many of the same ailments as those who actually smoke, and complete bans do, indeed, improve the health results of local populations to a surprising degree. Only 23 states currently enforce comprehensive smoking bans, but that number is sure to rise, and the debate will continue to intensify as legislators consider banning tobacco in increasingly public places like the park and yes, even the sidewalk.

Smoking advocates will continue to push against these bans, but they can no longer claim that evidence of their public health benefits is inconclusive.