By Ed Susman
UPI Science News
From the Science & Technology Desk
Published 4/1/2003 4:20 PM
View printer-friendly version

CHICAGO, April 1 (UPI) -- A six-month ban on smoking in public places in Helena, Mont., resulted in a 60 percent reduction in heart attack admissions to the local hospital, researchers said Tuesday.

"This striking finding suggests that protecting people from the toxins in secondhand smoke not only makes life more pleasant -- it immediately starts saving lives," said Stanton Glantz, professor of medicine at the University of California, San Francisco cardiovascular research institute and a statistics authority. "This work substantially raises the stakes in debates over enacting and protecting smoke-free ordinances," he added.

"What surprised us was how quickly there was an impact from this ordinance," said Dr. Richard Sargent, who presented the study Tuesday at the annual meeting of the American College of Cardiology.

From June 2002 until December 2002, an ordinance in the city of Helena, Montana's state capital, banned smoking in bars, restaurants, casinos and workplaces in the city. Within a couple of months, Sargent said, heart attacks became rare.

"Helena represents a unique situation," said Glantz. The city of 65,000 people is relatively isolated and is served by one general hospital.

"Also interesting, we found that people from the surrounding area around Helena where smoking was permitted still had similar heart attack levels," Sargent said. "I liken it to a doughnut. In the hole is smoke-free Helena. In the dough is the high-smoke, high-heart attack surrounding area."

Researchers at St. Peter's Community Hospital reviewed records for the past four years and determined that about 6.8 admission for heart attacks occurred each month. During the time of the smoking ban there were three admissions a month, Glantz told United Press International.

"That represents a 60 percent decline in admissions and is highly statistically significant," he said. "The possibility that the finding occurring by chance would be two in a thousand."

Sargent said he and a colleague were chatting about lack of heart attacks in the hospital since the passing of the ordinance. They decided to see if their observations were correct. "You aren't going to believe these numbers," his colleague told Sargent after checking the heart attack admission records.

Sargent said the records were meticulously scrutinized to make sure the findings were real. "We believe this is the first time we have been able to show that a smoking ban has resulted in such a reduction in heart attacks," he said.

"This is a small study so we have to be cautious in how we interpret these results," Richard Pasternak, associate professor of medicine at the Harvard Medical School in Boston, told UPI. "However, the direction of the impact is correct. We know that the smoke from one cigarette can rupture a plaque in blood vessels."

The rupture of blockages in coronary arteries creates a cascade of events in which clots can form, choking of blood to arteries of the heart, and causing chest pain or a heart attack. Pasternak said second-hand smoke also is known to have similar impact on people with heart disease.

"So when we have less people exposed to smoke as was the case in Helena it makes sense that the hospital admission rate will be decreased," Pasternak said.

Dr. Robert Shepard of St. Peter's Community Hospital, a co-author, said a court challenge to the smoking ordinance has resulted in the law being suspended. "We are seeing an increase in heart attacks again since December," he said.

In December 2002, there were six heart attacks. Eight occurred in January 2003, five in February and nine in March. Shepard said in a couple of more months he will be able to confirm that the suspension of the ban can be blamed on causing 14 to 16 extra heart attacks in the city.

Sargent said the results of the Montana study could help other communities fighting to implement smoking bans, such as Chicago and the states of Delaware and Florida.