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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.

Posted in: Public policy