Study Affirms Health Benefits of Smoking Bans

A study in this week's New England Journal of Medicine suggests that public smoking bans can significantly reduce hospital admissions for acute coronary syndrome (ACS), particularly among nonsmokers, the Wall Street Journal reports. To determine how such bans affect public health, a team of Scottish researchers collected information on smoking status and exposure from patients admitted to any of nine Scottish hospitals for ACS in the 10 months preceding the March 2006 enactment of a law that banned smoking in all enclosed public spaces throughout the country. They then compared those results against information collected during the same period the next year. Between the two study periods, the number of hospitalizations for ACS decreased by 17 percent, from 3,235 patients to 2,684 patients, with 67 percent of the reduction attributed to nonsmokers. In comparison, hospital admissions for ACS in Scotland had fallen by an average of only 3 percent annually during the decade preceding the study. Examining the study results by smoking status, the researchers found that ACS admissions following the smoking ban decreased by 14 percent among smokers, 19 percent among former smokers and 21 percent among people who had never smoked. In addition, people who had never smoked reported a decrease in exposure to secondhand smoke following the ban's enactment. Researchers then confirmed those reports through blood and saliva tests for cotinine, a metabolic product of nicotine. Based on their findings, the researchers conclude that public smoking bans improve health, particularly in terms of ACS risk. U.S. public health experts, meanwhile, called the results the strongest evidence to date of this benefit, and the director of the Community Health Program at Tufts University and the president of Americans for Nonsmokers Rights said the study "should add considerable oomph to the pressure for smoking bans" elsewhere (Singer-Vine, Wall Street Journal, 7/31/08 [subscription required]; Pell et al., New England Journal of Medicine, 7/31/08 [subscription required]).