Smoking bans have heart benefits

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% every year, particularly among younger individuals and non-smokers, 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 many cities across the US.

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

Their study appears in 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.

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

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 five locations in the United States, one in Canada, three in Italy and one in Scotland.

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

Benefits evident immediately
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."

Experts agree
Dr Steven Schroeder, director of the Smoking Cessation Leadership Centre at the University of California, San Francisco, US, 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 in the American Heart Association's (AHA) journal Circulation also shows that smoke-free 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.

Drop in heart attack rates
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% after one year. Rates then continued to decline over time, with about a 36% 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, US, 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. - (Reuters Health)

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

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Smoking and heart disease