|
Amanda Jekowsky , American College of
Cardiology, 202-375-6645, ajekowsk@acc.org
September
21, 2009
Banning Smoking in Public Places and Workplaces is Good for
the Heart
Inhaling secondhand smoke greatly increases risk
of heart attack, even among young and nonsmokers
Public smoking bans appear to significantly reduce the risk
of heart attacks, particularly among younger individuals and
nonsmokers, according to a new study published in the September
29, 2009, issue of the Journal of the American College
of Cardiology. 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, M.D., M.P.H., professor of Cardiology and Preventive
Medicine, University of Kansas School of Medicine and 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 by 30 percent.
“Interestingly, 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,” 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.
“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,” said Steven
Schroeder, M.D., director, Smoking Cessation Leadership Center
University of California, San Francisco. “While cardiologists
routinely screen for lipid disorders and high blood pressure,
they also need to become vigilant about asking patients about
tobacco use and secondhand smoke exposure and provide counseling
as needed.”
Drs. Meyers and Schroeder encourage clinicians to support
community smoking bans and other tobacco control measures
including tax increases on cigarettes, expanded cessation
services including telephone quitlines and educational campaigns.
So far, bans on smoking in public places and workplaces have
been instituted in 32 states and many cities across the country.
As the United States increasingly institutes policies to protect
nonsmokers from second hand smoke, authors say these efforts
will yield great public health benefits in the form of reduced
disease, disability and deaths.
The researchers performed a systematic review and meta-analysis
of 10 reports from 11 geographic locations in the United States
(MT, CO, NY, IN, OH), Canada and Europe to compare the rates
of heart attacks before and after public smoking bans were
instituted. Collectively, the studies involved 24 million
people and observations of the effect of the bans ranged from
two months to three years.
Drs. Meyers and Schroeder report no conflicts of interest.
###
The American College of Cardiology is leading the way to optimal
cardiovascular care and disease prevention. The College is
a 36,000-member nonprofit medical society and bestows the
credential Fellow of the American College of Cardiology upon
physicians who meet its stringent qualifications. The College
is a leader in the formulation of health policy, standards
and guidelines, and is a staunch supporter of cardiovascular
research. The ACC provides professional education and operates
national registries for the measurement and improvement of
quality care. More information about the association is available
online at www.acc.org .
The American College of Cardiology (ACC) provides these news
reports of clinical studies published in the Journal of
the American College of Cardiology as a service to physicians,
the media, the public and other interested parties. However,
statements or opinions expressed in these reports reflect
the view of the author(s) and do not represent official policy
of the ACC unless stated so.
|
