# Smoking bans reduce cardiac deaths by 50%? **URL:** \ **Category:** Factual Questions\ **Created:** [November 15, 2011, 2:33pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003 "2011-11-15T14:33:16Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Hbns](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hbns](https://boards.straightdope.com/u/Hbns)\ **Post date:** [November 15, 2011, 2:33pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/1 "2011-11-15T14:33:16Z")
**[Mayo Clinic study credits smoking bans for dramatic decrease in heart attacks](http://blogs.citypages.com/blotter/2011/11/mayo_clinic_study_credits_smoking_bans_for_dramatic_decrease_in_heart_attacks.php)** > [@](#): > > In 2000, the incidence of heart attack was 212.3 cases per 100,000 residents, and by 2009, the numbers showed only 102.9 cases. The incidents of sudden cardiac arrest death also fell, from 152.5 to 76.6 cases. That’s a 45 percent reduction in heart attacks overall, and a 50 percent reduction in death due to cardiac arrest. Can someone shed some light on this for me? Is it a scientifically sound study? Given what I know about co-wokers that smoke who now rush out at break to hurridly smoke down 2 or 3 cigarettes in a row, I am actually a bit surprised that cardiac incidence aren’t actually up. I guess what I really want to know, is this just a conclusion drawn from statistical analysis, or is there an underlying medical theory to this? ---
**Author:** ![mcgato](https://avatars.discourse-cdn.com/v4/letter/m/ac8455/32.png) [@mcgato](https://boards.straightdope.com/u/mcgato)\ **Post date:** [November 15, 2011, 3:34pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/2 "2011-11-15T15:34:34Z")
[Similar findings in Montana.](http://www.davehitt.com/facts/helena.html) It looks real. ---
**Author:** ![thatguyjeff](https://avatars.discourse-cdn.com/v4/letter/t/6de8d8/32.png) [@thatguyjeff](https://boards.straightdope.com/u/thatguyjeff)\ **Post date:** [November 15, 2011, 3:49pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/3 "2011-11-15T15:49:20Z")
I wonder… No mention if the cases counted were even smokers to begin with. Looks like an overall sample. And if so (being that non-smokers were included in the numbers) then how could a ban attribute? I think it’s about 15-20% of the population who still smokes. What about all the new heart drugs and whatnot? Those had no affect then I suppose. Everyone should just quit smoking and all heart problems will be completely eradicated? ---
**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\ **Post date:** [November 15, 2011, 3:55pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/4 "2011-11-15T15:55:32Z")
> [@thatguyjeff](#): > > No mention if the cases counted were even smokers to begin with. Looks like an overall sample. And if so (being that non-smokers were included in the numbers) then how could a ban attribute? There is some thought that exposure to second-hand smoke can lead to MI in people with heart conditions. > [@](#): > > What about all the new heart drugs and whatnot? Those had no affect then I suppose. Everyone should just quit smoking and all heart problems will be completely eradicated? I don’t think anyone believes that all heart problems will be solved, but there is at least some evidence that quitting smoking greatly reduces the risk of heart attack. In fact, I have seen numbers that say pack-a-day smokers have more that twice the risk of heart attack as non-smokers. ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [November 15, 2011, 4:01pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/5 "2011-11-15T16:01:16Z")
Scientific studies control for these variables. For example, the public health effects of new cardiac drugs are well known, and it’s easy to figure out what part of the gap is still unaccounted for. They can also run control groups in similar areas that do not have the smoking bans. It’s safe to say that the effects they are talking about are, to the best of our scientific knowledge, real. The article mentions that second hand smoke is a factor. Anyway, it’s well known that the two most cost-effective ways of reducing chronic disease are smoking bans and raising taxes on cigarettes. If you are interested in creating a healthier public that lives longer and suffers less disease, these are the best “bang for your buck” measures you can take. ---
**Author:** ![Hbns](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hbns](https://boards.straightdope.com/u/Hbns)\ **Post date:** [November 15, 2011, 6:44pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/6 "2011-11-15T18:44:08Z")
I know that reducing smoking is a posititve health benefit. I would rather not have this turn into a thread about the merits of anti-smoking regulations. I am most interested in the scientific validity of the claim. **mcgato** was kind enough to link to similar findings in Montana. I had vaguely remembered this report. If you follow that link it takes you to a page debunking the report on numerous accounts that certainly seem plausible. Essentially boiling it down to a statistical anomaly that is being given more attention than it deserves. I’m curious if this latest report is something similar? Does anyone know of a link or cite to the article in a peer reviewed journal? ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [November 15, 2011, 7:10pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/7 "2011-11-15T19:10:23Z")
Do you really think the Mayo clinic isn’t very careful with their sources before making major announcements? We aren’t talking about Parade Magazine here. Here is a [list](http://www.rochesterproject.org/publication-search/top10.php) of their top ten most cited articles. This is a HUGE research project, and findings on smoking are just a small part of it. The idea that this is based on spurious data to further some political cause is approaching conspiracy-theory levels of unlikeliness. ---
**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\ **Post date:** [November 15, 2011, 7:19pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/8 "2011-11-15T19:19:22Z")
Well, there is at least one caveat - the study was funded by an advocacy group that pushed for the ban: [http://www.clearwaymn.org/](http://www.clearwaymn.org/) That said, the study was based on the very respected Rochester Epidemiology Project and backs up previous findings (both the Montana one and [one in Scotland](http://www.nejm.org/doi/full/10.1056/NEJMsa0706740)). As to this particular study, I don’t believe the results have been published. They were presented at a meeting of the American Heart Association. ---
**Author:** ![Hbns](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hbns](https://boards.straightdope.com/u/Hbns)\ **Post date:** [November 15, 2011, 7:51pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/9 "2011-11-15T19:51:51Z")
> [@even\_sven](#): > > Do you really think the Mayo clinic isn’t very careful with their sources before making major announcements? We aren’t talking about Parade Magazine here. > > Here is a [list](http://www.rochesterproject.org/publication-search/top10.php) of their top ten most cited articles. This is a HUGE research project, and findings on smoking are just a small part of it. The idea that this is based on spurious data to further some political cause is approaching conspiracy-theory levels of unlikeliness. Thank you **even sven** for assuming my motives to be nefarious. Being a native Minnesotan I am well aware of the prestige and reputation the [Mayo Clinic enjoys.](http://www.startribune.com/lifestyle/wellness/133853703.html) > [@](#): > > Mayo pushed for a smoke-free ordinance in Olmsted County, the first county in Minnesota to pass a ban and among the first in the nation. Mayo also helped write statewide legislation, known as the Freedom to Breathe Act. Smoking rates dropped 23% but cardiac events fell 45%. Not being a one to one corollary it piqued my curiosity. Thank you **Jas09** for the additional links and pointing out what should have become obvious. That the similar findings reinforce each other. I am intrigued by this lever effect and will have to read more on the subject. I do note that Citypages states > [@](#): > > The numbers come from the Rochester Epidemiology Project… So the conclusions as well? Or was this presented by Mayo Clinic’s Nicotine Dependence Center? Does anyone know if the results will be published? Or of a link to the AHA presentation? ---
**Author:** ![JoelUpchurch](https://avatars.discourse-cdn.com/v4/letter/j/f05b48/32.png) [@JoelUpchurch](https://boards.straightdope.com/u/JoelUpchurch)\ **Post date:** [November 15, 2011, 9:21pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/10 "2011-11-15T21:21:45Z")
Anyone that thinks that because of a mere ban on public smoking that the cardiac death rate will drop 50% in a short period of time is rather gullible. [[URL=“http://newsblog.mayoclinic.org/”]http://newsblog.mayoclinic.org/](http://newsblog.mayoclinic.org/2011/11/14/research-findings-show-smoke-free-workplaces-reduce-heart-attacks/) > [@](#): > > The population-based study showed that during the 18 months before Olmsted County’s first smoke-free law for restaurants was passed in 2002, the regional incidence of heart attack was 212.3 cases per 100,000 residents. In the 18 months following a comprehensive smoke-free ordinance in 2007, in which restaurants and workplaces became smoke-free, that rate dropped to 102.9 per 100,000 residents — a decrease of about 45 percent. **Additionally, during these two time periods, the incidence of sudden cardiac death fell from 152.5 to 76.6 per 100,000 residents — a 50 percent reduction.** This wouldn’t be plausible even if actual smoking decreased 50% during the time interval, which it didn’t. When the study is actually published, it will turn out that is doesn’t say anything like what is published in the study. There is also no mention of any control studies in areas that didn’t change their law. It isn’t even clear that the study was peer reviewed. ---
**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\ **Post date:** [November 15, 2011, 9:35pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/11 "2011-11-15T21:35:22Z")
> [@JoelUpchurch](#): > > Anyone that thinks that because of a mere ban on public smoking that the cardiac death rate will drop 50% in a short period of time is rather gullible. Perhaps. Time will tell, of course, whether these lower rates continue post-ban. Could you explain why you think it is impossible for the MI event rate or heart-related death rate to fall by a greater amount than the smoking rate? Do you completely deny that second-hand smoke can exacerbate heart conditions and lead to MI? How many studies are required before you are convinced it is at least _possible_? ---
**Author:** ![JoelUpchurch](https://avatars.discourse-cdn.com/v4/letter/j/f05b48/32.png) [@JoelUpchurch](https://boards.straightdope.com/u/JoelUpchurch)\ **Post date:** [November 15, 2011, 10:46pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/12 "2011-11-15T22:46:21Z")
> [@Jas09](#): > > Perhaps. Time will tell, of course, whether these lower rates continue post-ban. > > Could you explain why you think it is impossible for the MI event rate or heart-related death rate to fall by a greater amount than the smoking rate? Do you completely deny that second-hand smoke can exacerbate heart conditions and lead to MI? How many studies are required before you are convinced it is at least _possible_? You are taking me out of context. What I’m saying is that a 50% decrease in sudden cardiac death in a short period of time is unlikely. There are previous studies that support decreases, but on a much lower order of magnitude. Most studies weren’t even able prove a connection between second hand smoke bans and a decrease in mortality. Would the fact that none of the previous studies showed such a dramatic result renders it less than credible. Also sudden cardiac death is mostly in people over 65. Changes in workplace smoking would have minimal impact on people who are retired. [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5106a3.htm](http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5106a3.htm) ---
**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\ **Post date:** [November 15, 2011, 11:15pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/13 "2011-11-15T23:15:30Z")
I agree that it seems high. But just because something seems unlikely doesn’t make it impossible or incorrect. As I said, time will tell whether these results bear out or not. I’m interested in your statement that most studies weren’t able to prove a connection between bans and decreased mortality (specifically heart-related incidents since that is what this study claims to have found). Could you cite some of these studies? The Scotland study found a 17% reduction (compared to 4% in England with no such ban) - is that more in line with what you consider plausible? As to the 65-and-older comment, the ban was not just workplaces but also restaurants and other public places. Older people are still exposed to second-hand smoke even if they are retired. ---
**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\ **Post date:** [November 15, 2011, 11:28pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/14 "2011-11-15T23:28:41Z")
I think I found the study you are referring to here: [http://www.springerlink.com/content/prr81661082w4447/](http://www.springerlink.com/content/prr81661082w4447/) Haven’t had time to look at it in detail yet. ---
**Author:** ![JoelUpchurch](https://avatars.discourse-cdn.com/v4/letter/j/f05b48/32.png) [@JoelUpchurch](https://boards.straightdope.com/u/JoelUpchurch)\ **Post date:** [November 16, 2011, 3:42am UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/15 "2011-11-16T03:42:38Z")
> [@Jas09](#): > > I agree that it seems high. But just because something seems unlikely doesn’t make it impossible or incorrect. As I said, time will tell whether these results bear out or not. > > I’m interested in your statement that most studies weren’t able to prove a connection between bans and decreased mortality (specifically heart-related incidents since that is what this study claims to have found). Could you cite some of these studies? > > The Scotland study found a 17% reduction (compared to 4% in England with no such ban) - is that more in line with what you consider plausible? > > As to the 65-and-older comment, the ban was not just workplaces but also restaurants and other public places. Older people are still exposed to second-hand smoke even if they are retired. I can’t really do comparisons of Europe with the United States. Europe has been way been behind the curve compared to the United States in terms of banning smoking. The thing is that over 65 people don’t work in restaurants and other places, so their exposure would already be drastically reduced compared to the people who actually work there. The trouble is I started working in the 70s and even then people couldn’t smoke at their desks. In the later eighties they wouldn’t people let people smoke indoors. By the time they were outright forbidding smoking during the 21st century, you have already eliminated 90% of the exposure to second hand smoking. Now they are coming after third hand smoking. They want to fire people if they can even smell cigarette smoke on their clothing and give them nicotine tests to determine if they smoke at home. The don’t even claim to be able measure any harm and are using the Linear No Threshold hypotheses to claim that there is no safe level of exposure to tobacco products. I spent a fair part of the day reading "Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence (2010) " [http://www.nap.edu/openbook.php?record\_id=12649&page=15](http://www.nap.edu/openbook.php?record_id=12649&page=15) They cited just about study on the subject but managed to avoid anything that resembled a simple declarative sentence or including any numerical data. ---
**Author:** ![Lust4Life](https://avatars.discourse-cdn.com/v4/letter/l/ecc23a/32.png) [@Lust4Life](https://boards.straightdope.com/u/Lust4Life)\ **Post date:** [November 17, 2011, 3:06pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/16 "2011-11-17T15:06:23Z")
I’ve always wondered if cases of obesity have risen due to smokers giving up. Obesity itself being bad for the heart. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [November 17, 2011, 8:54pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/17 "2011-11-17T20:54:56Z")
> [@Lust4Life](#): > > I’ve always wondered if cases of obesity have risen due to smokers giving up. If diabetes risk is an acceptable proxy estimate for obesity, then it seems that obesity levels do rise in smokers after they quit, at least in the [short term](http://www.medicinenet.com/script/main/art.asp?articlekey=109837): > [@](#): > > Researchers say people who quit smoking typically gain weight, which may explain the temporary period of increased risk for developing type 2 diabetes, which is closely linked to obesity. > > The findings are reported in the Jan. 5 [2010] issue of Annals of Internal Medicine. […] > > Researchers in 1987-1989 enrolled 10,892 middle-aged adults who did not have diabetes and followed them for nine years. The study found that overall, people who smoked had a 42% higher risk of developing diabetes during the follow-up period than nonsmokers. However, smokers who quit had a 70% higher risk of developing type 2 diabetes in the first six years after quitting than people who had never smoked. > > The risks of developing type 2 diabetes were highest in the first three years after quitting smoking, then returned to normal after 10 years, the researchers say. > > Among those who continued smoking over that period, the chance of developing diabetes was 30% higher than in people who had never smoked. ---
**Author:** ![Rachellelogram](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rachellelogram/32/8689_2.png) [@Rachellelogram](https://boards.straightdope.com/u/Rachellelogram)\ **Post date:** [November 17, 2011, 8:55pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/18 "2011-11-17T20:55:10Z")
Is there maybe a third variable afoot? Like smokers moving to towns without smoking bans, or something else? ---
**Author:** ![Hbns](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hbns](https://boards.straightdope.com/u/Hbns)\ **Post date:** [November 17, 2011, 9:48pm UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/19 "2011-11-17T21:48:51Z")
Hard to say what is entirely afoot with the Montana and Minnesota reports. Just ban effect, trend + ban effect, demographic changes + ban effect, all of the above, none of the above. The most interesting reading for me has been the study from Scotland linked to originally by **Jas09** it compares numbers pre and post ban in Scotland to the numbers for the same time period in England (no ban implemented). Giving us something that appears to be a pretty good control group (England). The magnitude of the reduction is less than these other reports by a large margin, but I did find it interesting the former smokers and non-smokers had a greater reduction of incidence than smokers. Further substantiated the premise that second hand smoke can be a trigger for these coronary events. ---
**Author:** ![dtilque](https://avatars.discourse-cdn.com/v4/letter/d/d6d6ee/32.png) [@dtilque](https://boards.straightdope.com/u/dtilque)\ **Post date:** [November 18, 2011, 1:14am UTC](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003/20 "2011-11-18T01:14:44Z")
The effect in the UK is probably reduced because they have more sources of second-hand smoke outside of work. [Next page](https://boards.straightdope.com/t/smoking-bans-reduce-cardiac-deaths-by-50/603003.md?page=2)