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Report: Smoking bans protect nonsmokers' hearts

WASHINGTON (AP) - A major report confirms 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 Thursday's report from the prestigious Institute of
Medicine.

More than 126 million nonsmoking people in the U.S. 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 smoking customers or employees.

Thursday's hard-hitting report promises to influence that debate
here and abroad.

"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, 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.

Since New York led the way in 2003, 21 states plus the District
of Columbia now have what the CDC calls comprehensive laws banning
smoking in both public and private workplaces, restaurants and bars
- with no exception for ventilated smoking areas. Some other states
have less restrictive laws.

That means 41 percent of people in the country are as protected
in public from secondhand smoke as possible, Frieden said. The
report found just 5 percent of the world's population was covered
by comprehensive smoke-free laws.

While the public mostly connects smoking with lung cancer, heart
disease is a more immediate consequence. About a third of all heart
attacks in the U.S. are related to smoking, Frieden said.

How much do bans help? That depends on how existing bans were
studied and how much secondhand smoke exposure different
populations have. Some heavily exposed nonsmokers have the same
risk of heart damage as people who smoke up to nine cigarettes a
day, said Dr. Lynn Goldman, an environmental health specialist at
Johns Hopkins University who led the Institute of Medicine
committee.

Her team reviewed 11 key studies of smoking bans in parts of the
U.S., Canada, Italy and Scotland. Those studies found drops in the
number of heart attacks that ranged from 6 percent to 47 percent.

Some of the benefit may be to smokers who at least cut back
because of public or workplace smoking bans, and may even quit at
home, too. But two studies - one in Monroe, Ind., and another in
Scotland - as well as a 52-country study of secondhand smoke's
heart effects focused particularly on nonsmokers, to reassure that
the bans do help them, Goldman said.

The impact can be quick.

Helena, Mont., for example, recorded 16 percent fewer heart
attack hospitalizations in the six months after its ban went into
effect than in the same months during previous years, while nearby
areas that had no smoking ban saw heart attacks rise. More
dramatically, heart attack hospitalizations dropped 41 percent in
the three years after Pueblo, Colo., banned workplace smoking.

The institute is part of the National Academies, an independent
organization chartered by Congress to advise the government on
scientific matters.
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On the Net:
Institute of Medicine: http://www.iom.edu

(Copyright 2009 by The Associated Press. All Rights Reserved.)


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