According to a systematic review and meta-analysis of 10 reports from 11 geographic locations in the United State, Canada and Europe to compare the rates of heart attack before and after public smoking bans were instituted, public smoking bans appear to significantly reduce the risk of heart attack, particularly among younger individuals and nonsmokers.
Collectively, the studies involved 24 million people and observations of the effect of the bans ranged from two months to three years. Researchers find that smoking bans can reduce the number of heart attacks by as much as 26 percent per year.
“Even breathing in low doses of cigarette smoke can increase one’s risk of heart attack,” said David Meyers, lead investigator of the study, which is the most comprehensive analysis of related studies to date. “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. The cardiac benefits increased with longer ban duration.”
According to projections by the authors, a nationwide ban on public smoking could prevent as many as 154,000 heart attacks each year. These findings are particularly important in light of mounting evidence that second-hand smoke exposure is nearly as harmful to the heart as chronic active smoking. Direct smoking doubles the risk of heart attack. Second hand smoke increases the risk of heart attack by 30 percent.
“Interestingly, public smoking bans had a stronger effect in reducing heart attack 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,” said Dr. Meyers. “Heavily exposed people like those working in the entertainment or hospitality industries are likely to accrue the greatest benefit from smoking bans.”
Dr. Meyers adds that smoking remains the leading preventable risk factor for heart attack. Secondhand smoke is thought to increase the likelihood of a heart attack by making the blood “sticky” and more prone to clotting, reducing the amount of “good” (HDL) cholesterol in the body, and putting individuals at greater risk for dangerous heart rhythms, among other factors.
The good news is that the beneficial effects of smoking bans appear to be fairly immediate, with declines in reported heart attack cases within 3 months. The impact of bans was strengthened if compliance was good, if baseline smoking prevalence was low and if air quality was good.
References:
1. David Meyers, et al. Cardiovascular Effect of Bans on Smoking in Public Places. J Am Coll Cardiol, 2009; 54:1249-1255, doi:10.1016/j.jacc.2009.07.022.
