Smoking bans and heart attack rates

Anybody who has followed the debate over whether or not smoking should be allowed in workplaces (including restaurants and bars) has likely heard about the infamous “Helena study.” According to three researchers, a smoking ban in Helena, Montana, was associated with a substantial drop in heart attacks; when the ban was repealed six months later on legal grounds, the heart attack rate increased. The media loved the story, passing on the study’s claims virtually unchallenged. However, lots of people (example 1, example 2) are skeptical of the study’s findings.

In my opinion the study’s findings are a little too perfect, and thus deserve an extra dose of skeptical inquiry. I come to you, my fellow Dopers, for your wisdom and BS-identification skills. I have two main questions:

  1. Is the original Helena study legit? I have read the paper, but I don’t know standard medical methodologies so I don’t feel qualified to critique it in the same way I would, say, a social science paper. Did the authors use accepted methodologies, case selection techniques, statistical analyses, etc?

  2. Have any other communities with smoking bans experienced changes in heart attack rates in the months/years since their ban implementation?

You will note, my fine Dopers, that we are in GQ. 'Nuff said, right?

I’m not going to crunch numbers, but I’d say that Helena, Montana, is statistically insignificant, much less its population of smokers and heart attack victims. Their statement that the change is statistically significant seems to fly in the face of the customary statistical usage of the word. I’d be interested in seeing the actual annual statistics for the area’s MI patients.

I am a vigorous supported of smoking bans, but not because of questionable health benefits or trumped up “research.”