Montana Smoking Study
Subject: Secondhand smoke is more dangerous that we thought
The number of heart attacks fell by 40% in Helena, Montana in the six
months that an indoor smoking ban was in effect. Once the city repealed
the ban, heart attack rates jumped back to prior levels. All the arguments
our Honorable Mayor has put forth on the economic impact smoking bans
would have on the economics of downtown Denver, fade quickly when faced
with these numbers.
I expect we will hear about this study for years to come. Tobacco
company websites under the guise of promoting patriotic freedoms
are already astir trying to discredit this study.
Read the full text of the study published in the British Medical Journal:
Or start with a simple summary article from the Washington Post which
I will paste below.
Secondhand Smoke Poses Heart Attack Risk, CDC Warns
By Marc Kaufman
Washington Post Staff Writer
Friday, April 23, 2004; Page A01
For the first time, the Centers for Disease Control and Prevention is
warning people at risk of heart disease to avoid all buildings and gathering
places that allow indoor smoking.
The CDC disclosed its new advisory in a commentary to a study published
in the British Medical Journal yesterday, saying doctors need to warn
people with heart problems that secondhand smoke can significantly increase
their risk of a heart attack. The agency said that as little as 30 minutes'
exposure can have a serious and even lethal effect.
Link to BMJ article: http://bmj.bmjjournals.com/cgi/content/full/328/7446/980
The commentary accompanied a study showing that the number of heart attacks
in Helena, Mont., decreased substantially after the city banned indoor
smoking, then rose quickly to its former level after the law was struck
down in court.
That study found that during the six-month period in 2002 when the ban
was in effect, the number of heart attacks reported by Helena's heart
hospital fell by 40 percent.
In his commentary, Terry Pechacek, associate director of science at CDC's
Office on Smoking and Health, wrote that the research underscores evidence
that secondhand smoke rapidly increases the tendency of blood to clot,
which can restrict flow to the heart.
Pechacek said the new study strengthens the growing body of research pointing
to potentially fast and acute reactions to secondhand smoke, in addition
to the long-term damage done to nonsmokers who live with smokers. The
CDC has estimated that secondhand smoke causes 35,000 heart disease deaths
a year in the United States, but Pechacek said that estimate is likely
to be revised upward.
"We've said before that secondhand smoke increases the risk of heart disease
in nonsmokers, but this is our first recommendation that clinicians advise
their patients with heart disease to avoid indoor settings where smoking
is allowed," he said in a telephone interview.
"We don't make these kind of statements lightly," he said. "What we are
seeing in the data is a substantial biological change that occurs with
even 30 minutes of exposure to secondhand smoke."
The new CDC recommendation is bound to become part of the often acrimonious
national debate over whether smoking in public places should be banned.
Public health advocates say the bans will save many lives, while cigarette
makers and some businesspeople say the decision should be left to individual
Just yesterday, the Kentucky Supreme Court upheld a ban on smoking in
bars, restaurants and other public places in Lexington, ruling that the
city had acted within its authority to "promote and safeguard public health."
That ban has drawn national attention because Kentucky has the highest
smoking rate in the nation -- about one-third of adults there are smokers,
according to the CDC -- and is the second largest producer of tobacco.
As both the CDC and authors of the new study acknowledge, the Montana
data are limited by the relatively small number of people involved. Pechacek
said that similarly dramatic reductions in heart attacks are unlikely
to be found in larger populations, but he said the study is nonetheless
important because it offers the best real-world information to date on
the connection between indoor smoking and serious heart problems. He said
studies have been proposed or begun into how the indoor smoking bans in
California, New York City and Delaware have affected heart attack rates.
The study's authors, Richard P. Sargent and Robert M. Shepard of St. Peter's
Community Hospital in Helena, Mont., and Stanton A. Glantz of the University
of California at San Francisco, collected information about the number
of heart attacks from St. Peter's hospital records.
During the six-month period in 2002 when the indoor smoking ban was in
effect, 24 Helena residents suffered acute heart attacks. For the five
years before and after 2002, the average number of heart attacks reported
for Helena residents during the same six months was 40. The authors found
through St. Peter's records that the number of heart attacks suffered
by people living in the area outside Helena -- where there was no smoking
ban -- did not experience the same 2002 dip as Helena.
Of the patients followed in the study, 38 percent were current smokers,
29 percent were former smokers and 33 had never smoked.
Pechacek wrote: "If future studies replicate the positive results from
the Helena study, the public health implications would be dramatic: thousands
of acute [heart attacks] among non-smokers in countries around the world
could potentially be prevented each year."
© 2004 The Washington Post Company
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