WHEELING - A new study suggests heart attack hospitalizations have decreased 41 percent in a Colorado city because of a smoking ban there.
The rate of hospitalized cases dropped 41 percent three years after the ban of workplace smoking in Pueblo took effect. There was no such drop in two neighboring areas, and researchers believe it's a clear sign the ban was responsible.
The study suggests that secondhand smoke may be a terrible and under-recognized cause of heart attack deaths in this country, said one of its authors, Terry Pechacek of the U.S. Centers for Disease Control and Prevention.
At least eight earlier studies have linked smoking bans to decreased heart attacks, but none ran as long as three years. Some critics had questioned whether a ban could have such an immediate impact, and suggested other factors could have driven the declines.
Dr. Edward Chiu, a cardiologist at Wheeling Hospital, said he had not yet read the study, but found its results to be interesting and intriguing.
"Smoking has always been a factor when considering risk factors for coronary artery disease and heart attack," Chiu said.
Fact Box
HELP KICKING THE HABIT
Wheeling Hospital is kicking off 2009 with Freedom From Smoking, an eight-session program designed to help adults conquer their smoking addiction.
FFS, an American Lung Association of West Virginia program, begins Monday. The group will meet each Monday and Wednesday through Jan. 28.
Sessions begin at 7 p.m. and will take place in Auditorium A of the hospital.
There is a fee for the program. More information is available by calling Wheeling Hospital's Respiratory Care Department at 304-243-3289. Those interested in participating should also talk with their physician about using nicotine replacement therapies during the program.
The FFS clinic program's behavior modification approach to quitting smoking offers committed quitters a step-by-step method for changing behavior and quitting smoking.
The program uses positive thinking and alternative behaviors; it includes rewards to motivate the smoker to quit.
He noted he did not know of any studies related to the impact of Ohio County's smoking ban on people's health. Though most patients, he said, quit smoking when they begin having heart problems, others do not.
"A lot of people think, 'It's not going to happen to me,'" he said.
Chiu said it would be interesting to discover how many people have quit smoking because of Ohio County's smoking ban, imposed in 2005 by the Wheeling-Ohio County Board of Health.
Ohio County's ban makes exceptions for video gambling parlors, bars with video gambling rooms and video gambling areas at Wheeling Island Hotel-Casino-Racetrack.
The Colorado study looked at heart attack hospitalizations for three years following the July 1, 2003, enactment of Pueblo's ban and found declines as great or greater than what was seen in the other research.
"This study is very dramatic," said Dr. Michael Thun, an American Cancer Society researcher.
"This is now the ninth study, so it is clear that smoke-free laws are one of the most effective and cost-effective ways to reduce heart attacks," said Thun, who was not involved in the CDC study released Thursday.
Marshall County's smoking ban began in July 2002, but it includes exceptions for bars, said Ronda Francis, administrator at the Marshall County Health Department.
"Something similar happened in Washington state. The smoking ban regulation was rescinded and (heart attack hospitalizations) shot up again," Francis said in comparing results of the Pueblo study.
Francis said she did not know of a similar study in Marshall County. But since smoking still is allowed in bars there, the results of such a study may not show an accurate picture of heart attack numbers, she noted.
When Marshall County's ban first began, Francis said a couple people told her the law helped them quit smoking.
"But they already wanted to stop," Francis added. "They were not allowed to smoke in their workplace anymore. I haven't heard of anyone recently."
Smoking bans are designed not only to cut smoking rates but also to reduce secondhand tobacco smoke. It is a widely recognized cause of lung cancer, but its effect on heart disease can be more immediate. It not only damages the lining of blood vessels, but also increases the kind of blood clotting that leads to heart attacks. Reducing exposure to smoke can quickly cut the risk of clotting, some experts said.
"You remove the final one or two links in the chain" of events leading to a heart attack, Thun said.
Secondhand smoke causes an estimated 46,000 heart disease deaths and about 3,000 lung cancer deaths among nonsmokers each year, according to statistics cited by the CDC.
In the new study, researchers reviewed hospital admissions for heart attacks in Pueblo. Patients were classified by ZIP codes. They then looked at the same data for two nearby areas that did not have bans - the area of Pueblo County outside the city and for El Paso County.
In Pueblo, the rate of heart attacks dropped from 257 per 100,000 people before the ban to 152 per 100,000 in the three years afterward. There were no significant changes in the two other areas.
The study assumed declines in the amount of secondhand smoke in Pueblo buildings after the ban, but did not try to measure that. The researchers also did not sort out which heart attack patients were smokers and which were not, so it's unclear how much of the decline can be attributed to reduced secondhand smoke.
"It's not just unhealthy for the smoker, but anyone breathing secondhand smoke as well," Francis said.
She noted in the past, people have attempted to argue that secondhand smoke doesn't hurt nonsmokers. They only think in terms of cancer, she said, and not the other life-threatening illnesses - such as heart attacks and asthma attacks - that secondhand smoke can cause.