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Bans best for non-smokers

Non-smokers gain the most from public smoking bans, while smokers will likely see few health benefits, a new study suggests.

Researchers found that heart attacks among non-smokers dropped by 70 percent after one county enacted such a ban, but the number of heart attacks among smokers didn't change. Moreover, in a matched county used as a control that didn't ban smoking, heart attacks among non-smokers declined just 11 percent over the same time period.

Reduced exposure
"The benefit of the ban appears to come from reduced exposure to second hand smoke among non-smokers," Dr Dong-Chul Seo, who was involved in the research, said in an interview with Reuters Health.

Past studies of the health effects of smoking bans have had a number of flaws, Seo and co-investigator Dr Mohammad R. Torabi, both of Indiana University in Bloomington note in the Journal of Drug Education. Many compare neighbouring municipalities in which one enacted a ban but the other did not, but because people may spend time in both places, such comparisons won't provide an accurate picture of the ban's effects.

Also, researchers often didn't omit people who've had heart surgery or have high blood pressure or high cholesterol, which increase the likelihood of having a heart attack regardless of whether or not a person is exposed to second hand smoke.

To avoid these problems, Seo and Torabi used a county more than 50 miles away as a control, which was closely matched demographically to the county where the smoking ban was enacted. They also excluded heart attack patients with high cholesterol, high blood pressure and other heart attack risk factors.

70% reduction
The researchers found that there were just five non-smokers admitted to the hospital with heart attacks in the 22 months after Monroe County enacted its smoking ban, compared to 17 in the 22-month period before the ban, representing a 70 percent reduction.

Over the same time periods, there were 18 and 16 heart attacks among non-smokers in Delaware County, which did not enact a smoking ban - a statistically insignificant difference of 11 percent.

These observations provide evidence that any health effects of smoking bans are due to non-smokers being exposed to less second-hand smoke, rather than smokers cutting down on cigarettes or quitting, the researchers say.

"Smokers would continue to smoke regardless of a public smoking ban," Seo pointed out. "For the non-smokers, it's a totally different situation."

SOURCE: Journal of Drug Education, 2007. – (Reuters Health)

Read more:
Stop Smoking Centre

December 2007

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