Study Finds Smoke-Free Laws Improve Health, Reduce Heart Attacks

WASHINGTON, D.C. – A study published online July 31 in the prestigious New England Journal of Medicine provides new, strong evidence that laws requiring smoke-free workplaces and public places have a rapid and significant impact on health.

The study found that after Scotland implemented a comprehensive smoke-free law, there was a decrease of 17 percent in hospital admissions for acute coronary syndrome, and 67 percent of the decrease was among non-smokers.

The 17 percent decrease was significantly greater than the 4 percent decrease over the same time period in England, which at the time was not smoke-free. It was also significantly greater than the average 3 percent annual decline in Scotland in the decade prior to the smoke-free law.

This research adds to a growing body of scientific evidence that shows two things: 1) Secondhand smoke is a proven cause of serious disease and premature death. 2) Smoke-free air laws provide significant and immediate benefits to health.

Public health authorities around the world have concluded that secondhand smoke has been proven to cause lung cancer, heart disease, sudden infant death syndrome (SIDS), low birth weight and serious respiratory conditions.
This study should serve as an impetus for governments to take urgent action to protect citizens from secondhand smoke.

The World Health Organization international tobacco control treaty, the Framework Convention on Tobacco Control, commits nations to taking effective action to protect nonsmokers from secondhand smoke.
Standards adopted by the treaty’s governing body make it clear that only 100-percent smoke-free laws, that apply to all workplaces and public places, meet the treaty’s requirements. Currently, 157 countries have ratified the treaty.

The treaty standards also state that other approaches, such as separate smoking sections and rooms or ventilation systems, are not effective as there is no safe level of exposure to secondhand smoke. Additionally, all people, including workers, should be protected from secondhand smoke.
A growing number of countries, regions and cities around the world are adopting strong smoke-free laws.

For example the countries of France, Thailand, and Turkey, and cities including Mexico City and Abuja have adopted or implemented smoke-free laws so far this year.
Other countries to adopt strong smoke-free laws include Ireland, Italy, Norway, the United Kingdom, and Uruguay.

In Australia, Canada and the United States, a growing number of states, provinces and territories have adopted such laws.
The study, conducted by a team of researchers in the United Kingdom, collected data from patients with acute coronary syndrome during the 10 months before implementation of the Scottish law, and during the same 10 months after implementation.

The researchers took biochemical findings from all patients and analyzed the levels of cotinine, a marker for nicotine exposure. There was a 14 percent reduction in the number of admissions for acute coronary syndrome among smokers, a 19 percent reduction among former smokers, and a 21 percent reduction among persons who had never smoked.

The study was funded by the National Health Service Health Scotland and the British Heart Foundation.
Several other studies have demonstrated reductions in coronary events in the wake of smoke-free laws.

However, the Scottish study is particularly strong because it utilized larger samples, examined the effect among non-smokers and smokers, included measures of exposure to secondhand smoke, and included a strong geographic control.