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By DR. RICHARD ROSEN

The editorial, "Start planning now to launch controversial smoking rules" (Nov. 12), properly advises proprietors of restaurants and bars to become familiar with how a new law that eliminates smoking in these venues starting on Jan. 2, 2010, will affect them.

It is important to recognize Greensboro, Guilford County and North Carolina have a 20-year, unblemished record of successful implementation of incremental restrictions on smoking in public places. The first compilation of voluntary smoke-free restaurants in Guilford County listed six establishments; that number reached 450 by 2008. The first ordinance was in Greensboro, narrowly enacted by a referendum 20 years ago this month, which made large stores smoke-free and required restaurants to establish nonsmoking sections.

Proof of the regulation's popularity came 15 months later when voters rebuffed a repeal effort by more than 10,000 votes. Since then, many air-quality studies, including some in Greensboro, have shown the damaging particles of secondhand smoke diffuse across any demarcation that attempts to separate smokers from nonsmokers, so having nonsmoking sections does not provide adequate protection.

Progress in eliminating the hazard of secondhand smoke was retarded in 1993 with passage of HB 957, which mandated that state government buildings permit smoking in 20 percent of their space and which pre-empted local governments from passing measures with stricter restrictions. Guilford County circumvented pre-emption and over several years made all of its government buildings smoke-free uneventfully.

In 2003 state Rep. Alma Adams of Greensboro introduced a rule making the North Carolina House floor smoke-free. In subsequent years the General Assembly chipped away at pre-emption in stages by making the entire General Assembly, schools, prisons, community colleges, the state university system, state government buildings and vehicles smoke-free and permitting local governments to make their government buildings smoke-free.

Each change occurred with equanimity, providing optimism that the latest law will be well-received.

Underpinning the progressive restrictions on secondhand smoke have been scientific advances in delineating its dangers. By the time of the publication of the first Surgeon General's report on the threat in 1986, conclusive proof existed that children raised in homes in which parents smoked had more ear infections, emergency room visits, asthma attacks and bronchitis than those from smoke-free homes. The rates of heart attacks and lung cancer were higher among nonsmokers who had spouses who smoked than nonsmokers who had spouses who didn't smoke.

More recently, we have learned that secondhand smoke causes activation of the cells lining blood vessels in 30 minutes, making them more likely to clot. Because of this, the Centers for Disease Control and Prevention warns people with heart disease and at risk for heart disease to avoid even brief exposure to smoke.

The rate of hospital admissions for heart attacks in Helena, Mont., and many other cities dropped after a comprehensive ban on smoking in public places took effect, and in the case of Helena, rose again when the ban was rescinded.

Recent metanalysis concluded that bans on smoking in public places reduce admissions for heart attacks by 17 percent. If a strong national strong ban were in place, America would have 156,400 fewer heart attacks annually.

The 2006 Surgeon General's report concluded that secondhand smoke is a health hazard and should be banned from all public places. Now 23 states have comprehensive bans, covering the majority of Americans.

Buttressed by our history; successful city, county and state limitations of secondhand smoke; and evidence of its profound dangers, I envision Jan. 2, 2010, as a day of major advancement in the health of North Carolinians.

The new law also repeals the odious pre-emption that paralyzed local governments from acting on exposure to secondhand smoke. Starting Jan. 2, local boards of health (with concurrence by county commissioners) and city and town councils, will be free to pass health-promoting bans in their communities.

I look forward to helping this happen here.

The writer lives in Greensboro and is the chairman of Smokefree Guilford.