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Bans on smoking in public are good for the heart

Last Updated: 2009-09-21 17:01:20 -0400 (Reuters Health)

NEW YORK (Reuters Health) - It's not just easier to breathe in public places where smoking has been banned: It turns out that your heart benefits from such bans too.

Smoking in public places can cut the number of heart attacks by as much as 26 percent every year, particularly among younger individuals and nonsmokers, according to research released Monday.

The findings suggest that the harms of secondhand smoking are no longer theoretical, say heart specialists. To date, bans on smoking in public places and workplaces have been instituted in 32 US states and many cities across the country.

The researchers, led by Dr. David G. Meyers of University of Kansas School of Medicine, Kansas City, Kansas, project that a nationwide ban on public smoking could prevent as many as 154,000 heart attacks each year.

Their study appears in the September 29 issue of the Journal of the American College of Cardiology.

"Even breathing in low doses of cigarette smoke can increase one's risk of heart attack," Meyers noted in a statement issued by the journal.

"Public smoking bans seem to be tremendously effective in reducing heart attack and, theoretically, might also help to prevent lung cancer and emphysema, diseases that develop much more slowly than heart attacks," Meyers added.

According to the study, smoking doubles the risk of heart attack, while "passive" smoke - aka secondhand smoking -- increases the risk by 30 percent.

To gauge the impact of public smoking bans on the heart, Meyers and colleagues compared the rates of heart attacks before and 2 months to 3 years after public smoking bans were instituted in 5 locations in the United States, 1 in Canada, 3 in Italy and 1 in Scotland.

Overall, the heart attack rate fell by a healthy 17 percent after bans on smoking in public places went into effect, they report. After that first year, the rate fell by 26 percent per year.

The benefits of public smoking bans were evident fairly quickly, with declines in reported heart attacks seen within 3 months.

"Interestingly," Meyers said, "public smoking bans had a stronger effect in reducing heart attacks among women and younger individuals, which may be explained, in part, because younger people tend to frequent clubs, restaurants and bars where smoking is a likely part of the social scene. Heavily exposed people like those working in the entertainment or hospitality industries are likely to accrue the greatest benefit from smoking bans."

Dr. Steven Schroeder, director of the Smoking Cessation Leadership Center at the University of California, San Francisco, who was not involved in the study noted: "Several years ago, the idea that secondhand smoke was harmful to the heart was a theory and one with some controversy attached, but this article moves us from the theoretical to fact and to practice."

"The reduction in heart attacks associated with public smoking bans is a big deal," Schroeder said.

A related study published today in the American Heart Association's (AHA) journal Circulation also shows that smokefree legislation yields "rapid and substantial" reductions in heart attack rates and that these benefits grow with time.

Drs. James M. Lightwood and Stanton Glantz of University of California, San Francisco, pooled data from 13 studies that looked at changes in heart attack rates after smoking bans were enacted in communities in the US, Canada and Europe.

Mirroring Meyers study, Lightwood and Glantz found that heart attack rates started to fall immediately after bans on smoking in public places went into effect, reaching 17 percent after one year. Rates then continued to decline over time, with about a 36 percent drop 3 years after the bans were enacted.

In an AHA-issued statement, Dr. David Goff, of Wake Forest University School of Medicine in Winston-Salem, North Carolina, said: "It is important to move forward now with widespread implementation of smoke-free laws."

"At a time of great concern over the financial sustainability of our healthcare system, smoke free laws represent an inexpensive approach to reducing heart attacks, and, probably, other cardiovascular conditions," Goff added.

SOURCE: Journal of the American College of Cardiology, 2009 / Circulation: Journal of the American Heart Association, 2009.

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