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(Circulation. 2006;114:1450-1451.)
© 2006 American Heart Association, Inc.

Editorial

Smoking Bans Prevent Heart Attacks

Jonathan M. Samet, MD, MS

From the Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology and The Institute for Global Tobacco Control, Baltimore, Md.

Correspondence to Jonathan M. Samet, MD, MS, Professor and Chairman, Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, 615 N Wolfe St, Suite W6041, Baltimore, MD 21205. E-mail jsamet@jhsph.edu

Key Words: Editorials • epidemiology • myocardial infarction • prevention • smoking

An extract of the first 250 words of the full text is provided, because this article has no abstract.

In this issue of Circulation, Bartecchi and colleagues¹ describe a reduction in hospitalizations for acute myocardial infarction in Pueblo, Colo, after the implementation of a city-wide smoking ordinance. The ordinance, which was strictly enforced, prohibited smoking in all workplaces, including bars and restaurants, and in all buildings open to the public. The findings in Pueblo confirm a similar assessment of the consequences of a public smoking ban in Helena, Mont, which was the first such assessment reported.² In the Montana study, the law was in force for 6 months before a challenge led to a court order suspending it. Admissions for acute myocardial infarction declined by 40% during the 6 months of the ban and then rose after it was lifted.

Article p 1490

Replication is critical in inferring causality.³ The drop in hospitalizations for acute myocardial infarction after the ban in Pueblo provides clear confirmation of the results in Helena. The new report¹ has several strengths. The number of hospitalizations (855) is large, so the impact of the ban can be precisely estimated; the statistical analysis indicates that the findings are highly unlikely to have arisen by chance. The design incorporated 2 comparison populations: residents of Pueblo County outside of the city of Pueblo and residents of El Paso County, which includes Colorado Springs. By including these comparison populations, Bartecchi et al¹ were able to account for temporal trends of a decline in hospitalizations for acute myocardial infarction that might have mistakenly been attributed to the ordinance. Their . . . [Full Text of this Article]

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