Tobacco Research

The latest updates from the University of Bath's Tobacco Control Research Group

Tagged: England

Smoking ban linked to drop in adults’ second-hand smoke exposure

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📥  Public policy

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Levels of second-hand smoke  exposure among non-smoking adults fell by almost 30 per cent after smoke free legislation was introduced in England in 2007.

The most comprehensive study to date of second-hand smoke exposure among non-smoking adults in England, which was funded by the Department of Health, was published on 13 December 2011 in the journal Environmental Health Perspectives.

Researchers analysed data from seven national surveys conducted between 1998 and 2008. These surveys measured cotinine, an indicator of tobacco smoke exposure, in saliva samples from over 30,000 people aged 16 and over.

They showed that levels of exposure to second-hand smoke in non-smokers had been declining in the ten years leading up to smoke free legislation. But even when this decline was taken into account, the introduction of smoke free public places led to significant, additional reductions in exposure. Average exposure fell by 27 per cent immediately following the legislation.

The results further revealed that while there was a marked reduction in the levels of second-hand smoke exposure among those who lived in a smoke free home, those who lived in a home where there was smoking inside showed no significant change in exposure following the implementation of smoke free public places.

Dr Michelle Sims, the first author of the paper, said: “Smoke exposure fell after the introduction of England’s smoke free legislation above and beyond the underlying long-term decline, demonstrating the positive effect of the legislation.

“Nevertheless, some population subgroups appear not to have benefited significantly from the legislation, suggesting that these groups should receive more support to reduce their exposure.

“There is now a large body of evidence documenting the adverse effects of second-hand smoke exposure.  In adults it is now known to be linked with coronary heart disease, lung and various other cancers, stroke, chronic respiratory symptoms and adverse pregnancy outcomes.”

Other research has shown that smoke free legislation is also associated with reductions in hospital admissions for heart attacks and asthma in the UK and other countries.

Professor Anna Gilmore, who directed the study, said: “The importance of this study is that it examines the impacts of smoke free policies on adults’ exposure using a specific biological-marker of smoke exposure (rather than self-reported exposure) while simultaneously controlling for underlying declines in exposure.

“To our knowledge it is the first study to do this. The fact it shows marked declines in adult exposure provides further evidence of the important public health benefits of smoke-free policies.”

Smoke-free legislation was implemented in England on the 1st July 2007, making virtually all enclosed public places and workspaces smoke-free. The aim of the legislation was to protect non-smokers and children from the negative consequences of second-hand smoke exposure.

The full text of this article can be accessed here:

http://ehp03.niehs.nih.gov/article/info%3Adoi%2F10.1289%2Fehp.1103680

 

Smoking ban linked to drop in admissions for heart attacks

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📥  Public policy

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We have observed a 2.4 per cent drop in the number of emergency admissions to hospital for a heart attack  following the implementation of smokefree legislation in England.

The legislation was introduced on 1 July 2007 and this study was the first to evaluate its impact on heart attacks.

The team, led by Dr Anna Gilmore, Director of the Tobacco Control Research Group, part of the UK Centre for Tobacco Control Studies, found there were 1200 fewer emergency hospital admissions for myocardial infarction, commonly known as heart attacks, in the year after the legislation was introduced.

First author of the paper Dr Michelle Sims said: “After the implementation of smokefree legislation there was a statistically significant drop of 2.4 percent in the number of emergency admissions for myocardial infarction. This implies that just over 1200 emergency admissions for myocardial infarction were prevented over a 12 month period.”

Numerous studies show that passive smoking increases the risk of coronary heart disease, with recent evidence suggesting that the risk may be increased by as much as 60 per cent, similar to that observed in light active smokers. Exposure to other people’s tobacco smoke also appears to have an acute impact on the heart, within minutes of exposure, and thus trigger acute coronary events.

Measures that reduce exposure to second hand smoke, such as smokefree legislation, are therefore likely to reduce the occurrence of acute coronary events, including myocardial infarction, with almost immediate effect.

This study builds on a growing body of evidence linking the introduction of smokefree legislation with a reduction in hospital admissions for acute coronary events.  It finds a smaller reduction in admissions than many other studies and the authors propose two reasons for this. First, levels of exposure to other people’s smoke in England were already quite low before the legislation was introduced and thus the potential for health benefits following the legislation will be lower. Second, the analysis helped eliminate other reasons for a decline in admissions including accounting for the fact that admissions for heart attacks have been reducing anyway.

Dr Gilmore said: “Given the large number of heart attacks in this country each year, even a relatively small reduction has important public health benefits. This study provides further evidence of the benefits of smokefree legislation.”

The study was funded by the Department of Health and published in June 2010 in the British Medical Journal.