Smoking bans linked to cut in heart risk

In Pennsylvania, it’s been more than a year since a smoking ban took effect in most businesses and public places and the law’s supporters welcome evidence that it will result in better health conditions.

A major report, released by the Institute of Medicine last month, confirmed what health officials long have believed: Bans on smoking in restaurants, bars and other gathering spots reduce the risk of heart attacks among nonsmokers.

“If you have heart disease, you really need to stay away from secondhand smoke. It’s an immediate threat to your life,” declared Dr. Neal Benowitz of the University of California, San Francisco, who co-wrote the report.

More than 126 million nonsmoking people in the United States are regularly exposed to someone else’s tobacco smoke. The surgeon general in 2006 cited “overwhelming scientific evidence” that tens of thousands die each year as a result, from heart disease, lung cancer and a list of other illnesses.

Yet smoking bans have remained a hard sell, as lawmakers and business owners debate whether such prohibitions are worth the anger of lm cigarettes customers or employees.

“The evidence is clear,” said Dr. Thomas Frieden, head of the federal Centers for Disease Control and Prevention, which requested the study. “Smoke-free laws don’t hurt business … but they prevent heart attacks in nonsmokers.”

Among the report’s conclusions: While heavier exposure to secondhand smoke is worse, there’s no safe level. It also cited “compelling” if circumstantial evidence that even less than an hour’s exposure might be enough to push someone already at risk of a heart attack over the edge.

That’s because within minutes, the smoke’s pollution-like small particles and other substances can start constricting blood vessels and increasing blood’s propensity to clot — key heart attack factors. Yet many people don’t know they have heart disease until their first heart attack, making it important for everyone to avoid secondhand smoke, Dr. Benowitz said.

“Even if you think you’re perfectly healthy, secondhand smoke could be a potential threat to you,” he said.

Many of the IOM committee members initially were skeptical they’d find much benefit from the bans, said statistician Stephen Feinberg of Carnegie Mellon University. He proclaimed himself “the resident skeptic” who changed his mind. “There was a clear and consistent effect of smoking bans,” he said.

Pennsylvania’s Clean Indoor Air Act went into effect Sept. 11, 2008, and monitoring its effect on people is one local group, Tobacco Free Allegheny. The group’s executive director, Cindy Thomas, commented on the IOM report:

“I’m not surprised by the report because it actually validates what we’ve been hearing from other sources, because there’ve been studies from the U.S., from Canada and Europe, that have demonstrated that the heart attack rate declines when a smoking ban is put in place.

“We know the air quality improves when there’s a smoking ban. In Pennsylvania, the result of air quality tests after our recent smoking ban showed that indoor air pollution dropped an average of 87 percent in the first six months after the smoking ban took effect.

“The health risks for nonsmokers decreased because the air quality improved, but a collateral benefit to smoking bans is more smokers are motivated to quit, so their heart attack risk declines as well.”
Post-Gazette staff writer Pohla Smith contributed to this report.


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