Big Decline in Heart Attacks, Cardiac Deaths in
County After Smoke-Free Workplace Laws
Heart attacks drop by 33 percent, sudden cardiac
deaths by 17 percent after protection from secondhand smoke; seniors
should take note > In a second study released today a world-wide look finds
hospitalizations drop with restrictions on public smoking; see below
Oct. 29, 2012 – There was a substantial drop in
heart attacks and sudden cardiac deaths in a Minnesota county after it
implemented laws to ban smoking in restaurants, bars and all workplaces,
according to an evaluation from the Mayo Clinic in Rochester. Senior
citizens are the most common victims of these coronary problems and may
benefit most from laws to restrict public smoking.
Exposure to secondhand smoke (SHS) has been
associated with coronary heart disease (CHD) in nonsmokers, and earlier
research suggests that the cardiovascular effects of SHS are about as
large as those with active smoking, according to the study published
Online First by Archives of Internal Medicine, a JAMA Network
The theory has been that elimination of smoking in
public places, such as by smoke-free laws and policies, has the
potential for reducing smoking and perhaps cardiovascular problems.
The Mayo researchers, led by Richard D. Hurt, M.D.,
evaluated the incidence of myocardial infarction (MI, heart attack) and
sudden cardiac death (SCD) in Olmsted County, Minn., during the 18-month
period before and after implementation of smoke-free ordinances.
People Should Avoid Secondhand Smoke
don't have to be a smoker for
smoking to harm you. You can also have health problems from
breathing in other people's smoke. Secondhand smoke is the
combination of smoke that comes from the burning end of a
cigarette, cigar or pipe and the smoke exhaled by the smoker.
Secondhand smoke contains
more than 50 substances that can cause cancer.
Health effects of exposure
to secondhand smoke include lung cancer, nasal sinus cancer,
respiratory tract infections and heart disease.
There is no safe amount of
secondhand smoke. Children, pregnant women, older people and
people with heart or breathing problems should be especially
2002, a smoke-free restaurant ordinance was implemented and, in 2007,
all workplaces, including bars, became smoke free.
“We report a substantial decline in the incidence
of MI from 18 months before the smoke-free restaurant law was
implemented to 18 months after the comprehensive smoke-free workplace
law was implemented five years later,” the authors comment.
When comparing the 18 months before implementation
of the smoke-free restaurant ordinance with the 18 months after
implementation of the smoke-free workplace law, the number of heart
attacks declined by 33 percent from about 150.8 to 100.7 per 100,000
And, the incidence of sudden cardiac deaths
declined by 17 percent from 109.1 to 92 per 100,000 population.
“All people should avoid SHS exposure as much as
possible, and those with CHD (coronary heart disease) should have no
exposure to SHS (secondhand smoke),” the authors conclude.
The study highlights the “potential benefits of 100
percent smoke-free policies in workplaces, restaurants and bars:
significantly decreased incidence of myocardial infarction and a trend
toward decreased sudden cardiac death,” according to a commentary by
Sara Kalkhoran, M.D., and Pamela M. Ling, M.D., M.P.H., of the
University of California, San Francisco.
“Moving forward, we should prioritize the
enforcement of smoke-free policies, eliminating loopholes in existing
policies as well as encouraging expansion of smoke-free policies to
include multiunit housing, motor vehicles, casinos and outdoor
locations,” they continue.
“Exposure to SHS should not be a condition of
employment and all workers, including those of lower income and those in
the service and hospitality industries, should have equal protection
from SHS exposure,” they conclude.
The study was supported in part by a grant from
ClearWay Minnesota, a grant from the National Heart, Lung and Blood
Institute of the National Institutes of Health and a grant from the
National Institute on Aging of the National Institutes of Health.
Commentary: Extending the Health Benefits of Clean Indoor Air Policies
Second study on secondhand smoke
Smoke-Free Laws Led Quickly to Fewer Hospitalizations
45 studies covered 33 smoke-free laws around U.S., world
Oct. 29, 2012 - Smoke-free legislation was associated with substantially
fewer hospitalizations and deaths from heart and respiratory diseases,
according to research in the American Heart Association journal
Researchers reviewed 45 studies covering 33 smoke-free laws at the local
and state levels around the United States and from countries as varied
as Uruguay, New Zealand and Germany and found:
● Comprehensive smoke-free laws were associated with a rapid 15
percent decrease in heart attack hospitalizations and 16 percent
decrease in stroke hospitalizations.
● Smoke-free laws were also rapidly followed by a 24 percent decrease
in hospitalizations for respiratory diseases, including asthma and
chronic obstructive pulmonary disease.
● The most comprehensive laws — those covering workplaces,
restaurants and bars — resulted in the highest health benefits.
"The public, health professionals and policy makers need to understand
that including exemptions and loopholes in legislation – such as
exempting casinos – condemns more people to end up in emergency rooms,"
said Stanton Glantz, Ph.D., senior study author and director of the
Center for Tobacco Control Research and Education at the University of
California, San Francisco.
"These unnecessary hospitalizations are the real cost of failing to
enact comprehensive smoke-free legislation."
The findings support the American Heart Association's position that
smoke-free laws should be comprehensive and apply to all workplaces and
public environments, including restaurants, bars and casinos. The
analysis also is consistent with other studies that have found
smoke-free laws were followed by significant decreases in acute heart
attack and other cardiac-related hospital admissions.
"Stronger legislation means immediate reductions in secondhand
smoke-related health problems as a byproduct of reductions in secondhand
smoke exposure and increases in smoking cessation that accompany these
laws," Glantz said. "Passage of these laws formalize and accelerate
social change and the associated immediate health benefits."
The National Cancer Institute funded the study.
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