In the largest meta-analysis to date of studies examining the effect of smoking bans on heart attack admissions, a paper published this week in the journal Circulation concludes that smoking bans lead to an immediate 15% decline in heart attack admissions or deaths. The typical follow-up period in the reviewed studies was approximately one year. Thus, the paper is concluding that smoking bans produce a 15% decline in heart attacks in the first year following implementation of these bans. Furthermore, the paper argues that the observed decline is due to a reduction in secondhand smoke exposure. Most of the policies were bans on smoking in restaurants and/or bars.
The basic method of the study was as follows: "We included studies examining the association between smokefree laws and hospitalizations or deaths due to cardiovascular or respiratory disease with sufficient data to calculate the relative risk and confidence interval before and after... ."
The article concludes: "Consistent with 3 prior meta-analyses that concluded that smoke-free laws are associated with significant decreases in AMI and other cardiac hospital admissions, we found that comprehensive smoke-free laws (covering workplaces, restaurants, and bars) were associated with a
15% decrease in AMI hospitalizations."
The Rest of the Story
Unfortunately, this article doesn't do what it purports to do.
What the Study Does: The study examines changes in the rates of heart attack admissions or deaths from before to after the implementation of smoking bans in a large number of localities. It provides convincing data to conclude that in these localities, there was an overall 15% decline in heart attack admissions or deaths during the time period when smoking bans were implemented in these localities. There is no question that the implementation of smoking bans has been associated with a decline in heart attacks, and the best estimate for the magnitude of that decline is about 15%.
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