“Even a small amount of exposure to secondhand smoke can increase in blood clotting, constrict blood vessels and can cause a heart attack,” said Dr. Neal L. Benowitz, a professor of medicine, psychiatry, and biopharmaceutical sciences at the University of California, San Francisco, and a member of the panel. “Short-term exposure can make a big difference.”
“For places in the country that don’t have smoking bans,” Dr. Benowitz added, “smoking bans need to be put in place as quickly as possible. The longer we wait, the more disease we are accepting.”
For the report, commissioned by the Centers for Disease Control and Prevention, the scientific panel did not conduct its own study. It instead extensively examined the published and unpublished data on the connection between secondhand smoke and heart problems, focusing particularly on 11 studies from different communities in Canada, Italy, Scotland and the United States that had imposed bans on smoking.
Although the degree of heart attack reduction in those communities varied widely, from 6 percent to 47 percent, every study showed a decline in heart attacks after a ban was imposed.
“I don’t think there’s any question that the evidence is now overwhelming,” said Dr. Richard D. Hurt, director of nicotine dependence center at the Mayo Clinic, who was not involved in the report. “It is absolutely clear to me that secondhand smoke kills a lot of people, and one of the mechanisms by which it does is through exposure and the effect on the cardiovascular system.”
Members of the committee said that, because of differences in the kinds of data collected in the various studies, they were not able to specify what level of secondhand smoke exposure was linked to specific types of heart disease or heart attack.
“Evidence was not strong enough to say the degree,” said Dr. Lynn R. Goldman, a professor of environmental health sciences at Johns Hopkins University, who was the chairwoman of the panel.
Furthermore, the panel could not assess the degree to which “individual lifestyle, community and societal factors can also influence the magnitude” of heart disease reduction. Smoking bans, for example, may be accompanied by public health messages or social inconveniences that prompt more people in a community to stop smoking and reduce their heart attack risk that way.
But, Dr. Goldman said, evidence was sufficient to “conclude a cause-and-effect relationship exist between heart disease generally and secondhand smoke exposure.”
“It increased the risk of coronary heart disease by about 25 to 30 percent, a pretty significant increase,” she continued.
And she said, “we found a cause and effect relationship between smoking bans and decreases in heart attack and acute coronary events. It showed remarkable consistency. All of the studies showed decreases in the rate of acute myocardial infarctions after implementation of smoking bans.”
Smoking bans have been growing in states and municipalities across the United States. Seventeen states, Puerto Rico and the District of Columbia ban smoking in bars, restaurants and workplaces, while another 14 states prohibit smoking in one or two of those types of establishments, according to Americans for Nonsmokers’ Rights, an advocacy group. More than 350 cities and towns have similar bans. Nineteen states do not have bans on smoking in at least one type of public place.
And while the Institute of Medicine report is among the most comprehensive analyses of the link between smoking bans and drops in heart disease, the state of the science in this area appears to be swaying even the public pronouncements of tobacco companies.
David Sutton, a spokesman for Philip Morris U.S.A., said he could not comment on the institute report until the company had had a chance to review it. But Mr. Sutton said the company supported smoking bans in public areas.
“The company believes that the public should be guided by the conclusions of public health officials when deciding whether to be present in a situation where there is secondhand smoke,” he said, “and that those conclusions are sufficient to warrant regulations that limit smoking in public places.”
Mr. Sutton added that private business owners “should have the flexibility to determine policy for their establishments, to cater to smokers and nonsmokers alike.” [rc]
Copyright 2009 The New York Times Company
October 15, 2009
USA: Report Links Smoking Bans and Heart Health
.
NEW YORK, NY / The New York Times / Health / October 15, 2009
By Pam Belleuck
Smoking bans in places like restaurants, offices and public buildings reduce cases of heart attacks and heart disease, according to a report released Thursday by a federally commissioned panel of scientists.
The report, issued by the Institute of Medicine, concluded that exposure to secondhand smoke significantly increased the risk of having a heart attack among both smokers and nonsmokers. The panel also said it found that a reduction in heart problems began to take effect fairly quickly after a smoking ban was instituted and that exposure to low or fleeting levels of secondhand smoke could cause cardiovascular problems.
“Even a small amount of exposure to secondhand smoke can increase in blood clotting, constrict blood vessels and can cause a heart attack,” said Dr. Neal L. Benowitz, a professor of medicine, psychiatry, and biopharmaceutical sciences at the University of California, San Francisco, and a member of the panel. “Short-term exposure can make a big difference.”
“For places in the country that don’t have smoking bans,” Dr. Benowitz added, “smoking bans need to be put in place as quickly as possible. The longer we wait, the more disease we are accepting.”
For the report, commissioned by the Centers for Disease Control and Prevention, the scientific panel did not conduct its own study. It instead extensively examined the published and unpublished data on the connection between secondhand smoke and heart problems, focusing particularly on 11 studies from different communities in Canada, Italy, Scotland and the United States that had imposed bans on smoking.
Although the degree of heart attack reduction in those communities varied widely, from 6 percent to 47 percent, every study showed a decline in heart attacks after a ban was imposed.
“I don’t think there’s any question that the evidence is now overwhelming,” said Dr. Richard D. Hurt, director of nicotine dependence center at the Mayo Clinic, who was not involved in the report. “It is absolutely clear to me that secondhand smoke kills a lot of people, and one of the mechanisms by which it does is through exposure and the effect on the cardiovascular system.”
Members of the committee said that, because of differences in the kinds of data collected in the various studies, they were not able to specify what level of secondhand smoke exposure was linked to specific types of heart disease or heart attack.
“Evidence was not strong enough to say the degree,” said Dr. Lynn R. Goldman, a professor of environmental health sciences at Johns Hopkins University, who was the chairwoman of the panel.
Furthermore, the panel could not assess the degree to which “individual lifestyle, community and societal factors can also influence the magnitude” of heart disease reduction. Smoking bans, for example, may be accompanied by public health messages or social inconveniences that prompt more people in a community to stop smoking and reduce their heart attack risk that way.
But, Dr. Goldman said, evidence was sufficient to “conclude a cause-and-effect relationship exist between heart disease generally and secondhand smoke exposure.”
“It increased the risk of coronary heart disease by about 25 to 30 percent, a pretty significant increase,” she continued.
And she said, “we found a cause and effect relationship between smoking bans and decreases in heart attack and acute coronary events. It showed remarkable consistency. All of the studies showed decreases in the rate of acute myocardial infarctions after implementation of smoking bans.”
Smoking bans have been growing in states and municipalities across the United States. Seventeen states, Puerto Rico and the District of Columbia ban smoking in bars, restaurants and workplaces, while another 14 states prohibit smoking in one or two of those types of establishments, according to Americans for Nonsmokers’ Rights, an advocacy group. More than 350 cities and towns have similar bans. Nineteen states do not have bans on smoking in at least one type of public place.
And while the Institute of Medicine report is among the most comprehensive analyses of the link between smoking bans and drops in heart disease, the state of the science in this area appears to be swaying even the public pronouncements of tobacco companies.
David Sutton, a spokesman for Philip Morris U.S.A., said he could not comment on the institute report until the company had had a chance to review it. But Mr. Sutton said the company supported smoking bans in public areas.
“The company believes that the public should be guided by the conclusions of public health officials when deciding whether to be present in a situation where there is secondhand smoke,” he said, “and that those conclusions are sufficient to warrant regulations that limit smoking in public places.”
Mr. Sutton added that private business owners “should have the flexibility to determine policy for their establishments, to cater to smokers and nonsmokers alike.” [rc]
Copyright 2009 The New York Times Company
“Even a small amount of exposure to secondhand smoke can increase in blood clotting, constrict blood vessels and can cause a heart attack,” said Dr. Neal L. Benowitz, a professor of medicine, psychiatry, and biopharmaceutical sciences at the University of California, San Francisco, and a member of the panel. “Short-term exposure can make a big difference.”
“For places in the country that don’t have smoking bans,” Dr. Benowitz added, “smoking bans need to be put in place as quickly as possible. The longer we wait, the more disease we are accepting.”
For the report, commissioned by the Centers for Disease Control and Prevention, the scientific panel did not conduct its own study. It instead extensively examined the published and unpublished data on the connection between secondhand smoke and heart problems, focusing particularly on 11 studies from different communities in Canada, Italy, Scotland and the United States that had imposed bans on smoking.
Although the degree of heart attack reduction in those communities varied widely, from 6 percent to 47 percent, every study showed a decline in heart attacks after a ban was imposed.
“I don’t think there’s any question that the evidence is now overwhelming,” said Dr. Richard D. Hurt, director of nicotine dependence center at the Mayo Clinic, who was not involved in the report. “It is absolutely clear to me that secondhand smoke kills a lot of people, and one of the mechanisms by which it does is through exposure and the effect on the cardiovascular system.”
Members of the committee said that, because of differences in the kinds of data collected in the various studies, they were not able to specify what level of secondhand smoke exposure was linked to specific types of heart disease or heart attack.
“Evidence was not strong enough to say the degree,” said Dr. Lynn R. Goldman, a professor of environmental health sciences at Johns Hopkins University, who was the chairwoman of the panel.
Furthermore, the panel could not assess the degree to which “individual lifestyle, community and societal factors can also influence the magnitude” of heart disease reduction. Smoking bans, for example, may be accompanied by public health messages or social inconveniences that prompt more people in a community to stop smoking and reduce their heart attack risk that way.
But, Dr. Goldman said, evidence was sufficient to “conclude a cause-and-effect relationship exist between heart disease generally and secondhand smoke exposure.”
“It increased the risk of coronary heart disease by about 25 to 30 percent, a pretty significant increase,” she continued.
And she said, “we found a cause and effect relationship between smoking bans and decreases in heart attack and acute coronary events. It showed remarkable consistency. All of the studies showed decreases in the rate of acute myocardial infarctions after implementation of smoking bans.”
Smoking bans have been growing in states and municipalities across the United States. Seventeen states, Puerto Rico and the District of Columbia ban smoking in bars, restaurants and workplaces, while another 14 states prohibit smoking in one or two of those types of establishments, according to Americans for Nonsmokers’ Rights, an advocacy group. More than 350 cities and towns have similar bans. Nineteen states do not have bans on smoking in at least one type of public place.
And while the Institute of Medicine report is among the most comprehensive analyses of the link between smoking bans and drops in heart disease, the state of the science in this area appears to be swaying even the public pronouncements of tobacco companies.
David Sutton, a spokesman for Philip Morris U.S.A., said he could not comment on the institute report until the company had had a chance to review it. But Mr. Sutton said the company supported smoking bans in public areas.
“The company believes that the public should be guided by the conclusions of public health officials when deciding whether to be present in a situation where there is secondhand smoke,” he said, “and that those conclusions are sufficient to warrant regulations that limit smoking in public places.”
Mr. Sutton added that private business owners “should have the flexibility to determine policy for their establishments, to cater to smokers and nonsmokers alike.” [rc]
Copyright 2009 The New York Times Company
