Statewide smoking bans have “little or no measurable immediate effect” on the number of persons who die from heart attacks, according to a new report by medical researchers at two universities.
In “Acute Myocardial Infarction Mortality Before and After State-wide Smoking Bans,” researchers Brad Rodu and Nicholas Peiper of the University of Louisville and Phillip Cole of the University of Alabama write, “Our results are consistent with a recent analysis finding that smoking bans were not associated with short-term declines in mortality or hospital admissions for myocardial infarction or other diseases.”
They add, “This study’s results are consistent with the fact that even the decline in active smoking has played only a minor role in reducing heart disease.” According to another recent study, titled “Explaining the decrease in US deaths from coronary disease, 1980–2000,” published in the New England Journal of Medicine, the decline in smoking accounted for only about 12 percent of the total decline in heart disease mortality.
Testing Benefits Claims
Rodu, Peiper, and Cole conducted the study after noting several published reports have claimed smoking bans result in almost immediate reductions in heart attack mortality rates. To test the observations, they compared the acute myocardial infarction mortality rate among persons 45 years old or older (deaths per 100,000 persons, age-standardized to the 2000 U.S. population) in the three years before adoption of the smoke-free ordinance (the expected rate) with the rate observed in the first full year after the ban (the target year) in six U.S. states.
Target-year declines were also compared to those in states without smoking bans. Target-year declines in California, Utah, and Delaware were not statistically different from expected declines based on the prior three years. In South Dakota, heart attack mortality increased 8.9 percent in the target year. Florida and New York saw bigger declines than expected but not statistically different from the 9.8 percent decline in the 44 states without a statewide smoking ban.
They conclude, “Smoke-free ordinances may serve public health objectives by providing non-smokers with indoor environments that are free from irritating and potentially harmful pollutants. However, this study does not provide evidence that these ordinances result in a measurable immediate reduction in AMI mortality of the magnitude claimed by reports based on very small incident numbers.”