Smoking ban linked to reduction in heart attacks

COLUMBUS — Enactment of Ohio’s strict ban on smoking in indoor public places was immediately followed by a sharp decline in the number of apparent heart attacks, a state study released Thursday showed.

The Ohio Department of Health also said the nearly 5-year-old law does not appear to have adversely affected the bottom lines of bars and restaurants.

“Symptoms of heart-related disorders, diseases that are clear diagnoses of heart attacks, and public attitudes are all reinforcing that this was a good decision,” said Dr. Ted Wymyslo, state health director.

“We were the first state in the Midwest and the first tobacco-growing state to move forward with this type of ban,” he said. “I want to tell you, it was a wise thing to do.”

The studies released Thursday are the first in a series to be released in coming months as the state attempts to gauge the impact of the indoor public smoking law passed by voters in November 2006 and implemented the following May. A study examining asthma rates is under way.

With few exceptions, the law prohibits smoking in offices, bars, restaurants, clubs, sports arenas, and any other enclosed place that has employees or is frequented by the general public. Business owners must remove ash trays and post no-smoking signs or face fines that increase in severity with multiple offenses.

Even as court battles continue over the fairness of how the law has been enforced, the state has begun to go after the liquor licenses of bars and restaurants that refuse to pay fines levied for violations of the ban.

Although state researchers can’t definitively tie it to the indoor smoking ban, researchers noted that an examination of hospital discharge data showed a sudden and dramatic dip in the number of heart attack-related discharges from hospitals after the state began to enforce the law in May 2007. The hospital data did not indicate whether the heart attack victims were smokers.

“However, it really is kind of remarkable to see this kind of drop,” said David Bruckman, of the Cleveland Department of Public Health and Case Western Reserve University. “We don’t really know why that occurred. We have to assume that it is coincident to the introduction of the first few months of the ban.”

Cresha Auck, director of government relations for the Ohio Heart Association, said a reduction in the number of heart attacks should have been expected as cigarette smoke disappeared from places frequented by the public.

“The cardiovascular system is impacted from tobacco smoke exposure within 20 minutes, so that’s why you see the heart attack rates come down,” she said.

The state used sales tax collections from businesses that sell alcohol for on-site consumption to examine the economic impact of the ban. Bars, some restaurants, bowling alleys, and other businesses that serve alcohol fought passage of the ban, arguing that it would result in many of their smoking customers to stop visiting their businesses or at least spend less time there.

“There was no statistically significant change in sales that was associated with the Ohio Smoke-Free Workplace Act that has hurt either bars or restaurants,” said Elizabeth Klein, of Ohio State University’s College of Public Health. “These findings are consistent with studies that have been conducted in cities, counties, states, and countries where there are no significant effects associated with policies that restricted smoking in workplaces.”

Much of the time period examined by the state funds coincided with when Ohio was spending in the neighborhood of $40 million a year in tobacco-settlement funds to help smokers quit and discourage non-smokers, particularly youths, from taking up the habit. The program was all but halted a couple of years ago when Ohio disbanded the anti-smoking foundation and confiscated its funding for other purposes.

Shelly Kaiser, spokesman for the American Lung Association in Ohio, noted that the state saw an up-tick in smoking rates in 2010 for the first time since the ban took effect. An estimated 22.5 percent of Ohioans said they smoked last year, up from 20.3 percent the year before.

Ohio this year will spend $1 million on enforcement of the law, using one-time federal funds that won’t be available next year. Dr. Wymyslo had just partial success in convincing lawmakers this spring to appropriate smoking cessation funds. He was not armed at the time with the graphs and statistics he presented yesterday.

“The fact that we don’t have a lot of readily available funding at this point won’t stop us from moving forward,” he said. “What we’ve developed is a tobacco collaborative where we’ve joined forces with private employers and insurers to see if we can find other ways to fund our tobacco cessation activities.

“Do not believe that our commitment to tobacco cessation has gone down,” Dr. Wymyslo said. “It’s the number-one best known risk factor for chronic disease. It causes one in five deaths that happen in Ohio, currently 18,000 a year.”


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