Smoking Bans Cut Down On Heart Attacks For Everyone, Study Finds

Bans on smoking in public and in workplaces can sharply reduce the number of heart attacks among both smokers and nonsmokers, according to a report issued Thursday by the Institute of Medicine. The report provides strong support for the anti-smoking laws in effect in 21 states and the District of Columbia and is likely to bolster efforts to pass such laws elsewhere.

“It’s clear that smoking bans work,” said Dr. Lynn R. Goldman of the Johns Hopkins Bloomberg School of Public Health, who led the panel that produced the report. “Bans reduce the risk of heart attacks in nonsmokers as well as smokers.”

“There’s no question that secondhand smoke has an adverse health impact in workplaces and public environments,” said Dr. Clyde Yancy, president of the American Heart Association. “We must continue to enact comprehensive smoke-free laws across the country to save lives and reduce the number of new smokers.”

Nearly 440,000 Americans die each year from smoking-related illnesses — more than one-third from heart disease — according to the heart association. About 38,000 of those deaths are related to secondhand smoke, which has many characteristics of other types of air pollution linked to heart disease. The association between illness and secondhand smoke was reinforced by a 2006 report by the U.S. surgeon general on the consequences of exposure to environmental smoke.

Among the report’s conclusions: While heavier exposure to secondhand smoke is worse, there’s no safe level. It also cited “compelling” if circumstantial evidence that even less than an hour’s exposure might be enough to push someone already at risk of a heart attack over the edge.

That’s because within minutes, the smoke’s pollution-like small particles and other substances can constrict blood vessels and increase blood’s propensity to clot — key heart attack factors. Yet many people don’t know they have heart disease until their first heart attack, making it important for everyone to avoid secondhand smoke, said Dr. Neal Benowitz of the University of California, San Francisco, who co-wrote Thursday’s report.

“Even if you think you’re perfectly healthy, secondhand smoke could be a potential threat to you,” he said.

Still, bans on smoking have remained controversial, in part because of fears that they might keep customers away from bars and restaurants. Last year, the Centers for Disease Control and Prevention commissioned the Institute of Medicine to study the evidence. Some of the members of the panel initially were skeptical about the benefits of such bans, according to statistician Stephen E. Fienberg of Carnegie Mellon University in Pittsburgh, but they quickly changed their minds when they began reviewing the evidence.

The panel examined 11 studies of heart attacks in areas where bans were implemented and found a decrease in heart attacks in every study, ranging from a low of 6 percent to a high of 47 percent, depending on how the study was conducted.

“Such consistent data confirms for the committee that smoking bans do, in fact, decrease the rate of heart attacks,” they wrote. One study, for example, found that hospitalizations for heart attacks in Pueblo dropped 41 percent in the three years after the city banned smoking in the workplace.

In most of the studies, it was difficult to isolate the benefits for nonsmokers from those for smokers, but two of the studies showed a very clear benefit for nonsmokers.

The committee also surveyed the evidence from laboratory studies in animals and concluded that these results supported bans. By Thomas H. Maugh II, Denver Post.

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