Study Supports Health Benefits of Smoking Ban

By Cecilia Grefalda

A new study from Scotland is being touted by U.S. public health experts as the strongest evidence yet that public bans on smoking lead to improved health from reduced secondhand exposure. No Smoking

Since the end of March 2006, smoking has been prohibited by law in all enclosed public places throughout Scotland. The authors of this study collected data on smoking status and secondhand smoke exposure through questionnaires and biochemical findings from hospital patients with acute coronary syndrome. Nine hospitals were involved during the ten-month period preceding the passage of the legislation and during the same period the next year. Together, these institutions accounted for 64% of admissions for acute coronary syndrome in Scotland.

Previous studies have suggested a reduction in the total number of hospital admissions for acute coronary syndrome after the enactment of smoking bans in public places. However, it is unknown whether the reduction in admissions involved nonsmokers, smokers, or both.

According to this study, hospital admissions for heart attacks and acute coronary problems fell 17% overall, and even more for nonsmokers, in the year after Scotland banned smoking in public places.

The study found that nonsmokers accounted for 67% of the overall reduction in heart-disease hospitalizations. Nonsmokers saw a 20% reduction in their hospital admissions following the ban while smokers’ admissions were down 14%.

This isn’t the first study published regarding the health impact of smoking bans—the 17% decrease in hospitalizations among Scots was comparable to rates recorded in previous research. But these findings “should add considerable oomph to the pressure for smoking bans,” because of the study’s rigor and use of blood tests, said Edith Balback, director of the Community Health Program at Tufts University and president of Americans for Nonsmokers’ Rights.

Support for state and local smoke-free laws has grown in recent years; still, such bans face strong opposition in many areas, especially in the Midwest and South. Opponents typically include libertarian groups and small businesses and restaurant owners who say bans reduce their revenues.

According to Americans for Nonsmokers’ Rights, more than 60% of the U.S. population is covered by some type of smoking ban at the state or local level, usually restricting smoking in either public areas or workplaces. More comprehensive bans like Scotland’s—which prohibits smoking in all enclosed public areas and workplaces since March 2006—are now law in fourteen states, up from three in 2005, according to the Centers for Disease Control and Prevention.

The economic impact of smoking bans is still hotly debated in state and local governments. But, academic researchers are less divided. On the basis of numerous peer-reviewed studies, the Surgeon General’s Office issued a report in 2006 concluding that “smoke-free policies and regulations do not have an adverse economic impact on the hospitality industry”—a conclusion the tobacco industry disputes.

Source: Pell JP, Haw S, Cobbe S, Newby DE, Pell ACH, Fischbacher C, McConnachie A, Pringle S, Murdoch D, Dunn F, Oldroyd K, MacIntyre P, O'Rourke B, Borland W. 2008. Smoke-free Legislation and Hospitalizations for Acute Coronary Syndrome The New England Journal of Medicine 359: 482

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