Oct. 15, 2009
"It's clear that smoking bans work," said Lynn Goldman, professor of environmental health sciences, Johns Hopkins Bloomberg School of Public Health,
About 43 percent of nonsmoking children and 37 percent of nonsmoking adults are exposed to secondhand smoke in the
A 2006 report from the U.S. Surgeon General's office, The Health Consequences of Involuntary Exposure to Tobacco Smoke, concluded that exposure to secondhand smoke causes heart disease and indicated that smoke-free policies are the most economical and effective way to reduce exposure. However, the effectiveness of smoking bans in reducing heart problems has continued to be a source of debate.
The IOM committee conducted a comprehensive review of published and unpublished data and testimony on the relationship between secondhand smoke and short-term and long-term heart problems. Eleven key studies that evaluated the effects of smoking bans on heart attack rates informed the committee's conclusions about the positive effects of smoke-free policies. The studies calculated that reductions in the incidence of heart attacks range from 6 percent to 47 percent. Given the variations in how the studies were conducted and what they measured, the committee could not determine more precisely how great the effect is. Only two of the studies distinguished between reductions in heart attacks suffered by smokers versus nonsmokers. However, the repeated finding of decreased heart attack rates overall after bans were implemented conclusively demonstrates that smoke-free policies help protect people from the cardiovascular effects of tobacco smoke, the committee said.
The report also provides a detailed discussion of the evidence from animal research and epidemiological studies showing a cause-and-effect relationship between secondhand smoke exposure and heart problems. The committee was not able to determine the exact magnitude of the increased risk presented by breathing environmental tobacco smoke, but noted that studies consistently indicate it increases the risks by 25 percent to 30 percent. Although there is no direct evidence that a relatively brief exposure to secondhand smoke could precipitate a heart attack, the committee found the indirect evidence compelling. Data on particulate matter in smoke from other pollution sources suggest that a relatively brief exposure to such substances can initiate a heart attack, and particulate matter is a major component of secondhand smoke.
The report was sponsored by the U.S. Centers for Disease Control and Prevention. Established in 1970 under the charter of the National Academy of Sciences, the
[ This news release and report are available at http://national-academies.org ]
Board on Population Health and Public Health Practice
Committee on Secondhand Smoke Exposure and Acute Coronary Events
Lynn R. Goldman, M.D. (chair)
Professor of Environmental Health Sciences
Neal L. Benowitz, M.D.
Professor of Medicine, Psychiatry, and Biopharmaceutical Sciences, and
Aruni Bhatnagar, Ph.D.
Professor of Medicine and Distinguished University Scholar
Department of Environmental Cardiology
Francesca Dominici, Ph.D.
Professor of Biostatistics
Stephen E. Fienberg, Ph.D.
Department of Statistics and Machine Learning Department
Gary D. Friedman, M.D., M.S.
Research Scientist Emeritus
Division of Medical Methods Research
S. Katharine Hammond, Ph.D.
Division of Environmental Health Sciences
Jiang He, M.D., Ph.D.
Joseph S. Copes Chair and Professor
Department of Epidemiology
Suzanne Oparil, M.D.
Vascular Biology and Hypertension Program
Division of Cardiovascular Disease, and
Professor of Medicine, Physiology, and Biophysics
Eric D. Peterson, M.D.
Professor of Medicine, and
Associate Vice Chair for Quality
Division of Cardiology
Edward Trapido, Sc.D.
Professor and Acting Division Director
Department of Epidemiology and Public Health
Michelle Catlin, Ph.D.