Institute of Medicine Report Concludes Smoke-Free Laws Prevent Heart Attacks; It's Time to Make All Workplaces and Public Places Smoke-Free

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids

Oct. 15 2009

Washington, D.C. — A landmark report released today by the Institute of Medicine provides powerful new evidence that elected officials have no excuse for failing to enact comprehensive smoke-free workplace laws. The IOM report concludes smoke-free laws reduce the number of heart attacks and save lives. The report also confirms that there is conclusive scientific evidence that secondhand smoke causes heart disease, including heart attacks, and finds there is compelling evidence that even relatively brief exposure to secondhand smoke can lead to a heart attack.

These powerful conclusions, reached by one of the most prestigious scientific authorities in the United States, send a loud and clear message to elected officials across the U.S. and worldwide: No excuses, no half-measures. It's time to protect everyone's right to breathe clean air by enacting comprehensive smoke-free laws that include all workplaces and public places, including restaurants and bars. There should be no exceptions or loopholes. No one should have to put themselves at risk of a heart attack, lung cancer or the other serious diseases caused by secondhand smoke in order to earn a paycheck or enjoy a night out.

In the United States, 27 states, the District of Columbia and Puerto Rico have enacted smoke-free laws that include restaurants and bars. The new report should spur the remaining 23 states to enact comprehensive laws that include all workplaces, restaurants and bars (and all states to eliminate any exceptions that remain in their laws). This report should also spur countries around the world to enact comprehensive smoke-free laws in compliance with the Framework Convention on Tobacco Control, the international tobacco control treaty ratified by 167 countries.

Even before this IOM report, there was already conclusive evidence that secondhand smoke causes death and disease, while smoke-free laws protect health and save lives. As the U.S. Surgeon General stated in issuing a groundbreaking report on secondhand smoke in June 2006, "The debate is over. The science is clear: Secondhand smoke is not a mere annoyance but a serious health hazard that causes premature death and disease in children and nonsmoking adults."

Secondhand smoke contains more than 4,000 chemicals, including at least 69 carcinogens. The Surgeon General found that secondhand smoke is a proven cause of lung cancer, heart disease, serious respiratory illnesses such as bronchitis, low birth weight and sudden infant death syndrome. The Surgeon General also found that secondhand smoke is responsible for tens of thousands of deaths in the U.S. each year, there is no safe level of exposure and smoke-free laws protect health without harming business.

The IOM's conclusions that smoke-free laws prevent heart attacks and that even short-term exposure to secondhand smoke can lead to a heart attack add significantly to the Surgeon General's report. The IOM report was requested by the Centers for Disease Control and Prevention (CDC) in the wake of a growing number of studies in smoke-free localities, states and countries that found reductions in heart attack rates after smoke-free laws are implemented. After reviewing 11 such studies in the United States, Canada, Scotland and Italy and a multitude of other scientific studies examining the relationship between secondhand smoke and cardiovascular disease, an IOM committee of scientific experts reached the following conclusions:

  • "The committee concludes that there is a causal relationship between smoking bans and decreases in acute coronary events."
  • "The evidence reviewed by the committee is consistent with a causal relationship between secondhand-smoke exposure and acute coronary events, such as acute MI (myocardial infarction)."
  • "The committee concludes that it is biologically plausible for a relatively brief exposure to secondhand smoke to precipitate an acute coronary event." According to the report, experimental studies have found that secondhand smoke exposure causes adverse changes in the cardiovascular system that increase the risk of a heart attack.

In the U.S., 27 states, Washington, D.C., and Puerto Rico have passed smoke-free laws that cover restaurants and bars. The states are: Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina (Jan. 2, 2010), Ohio, Oregon, Rhode Island, South Dakota (on hold pending resolution of litigation), Utah, Vermont, Washington, and Wisconsin (July 5, 2010).

Internationally, a growing number of countries have enacted strong, nationwide smoke-free laws. These include Bermuda, Bhutan, Colombia, Djibouti, Iceland, Ireland, Lithuania, New Zealand, Norway, Panama, Turkey, the United Kingdom, and Uruguay. Most Canadian provinces/territories and Australian states/territories have also enacted such laws.

The Institute of Medicine is part of the U.S. National Academy of Sciences. The report and related materials can be found at www.iom.edu.