Photograph: Jonathan Brady/PA
Bans on lighting up in public and working spaces have reduced the harms from passive smoking, a review has concluded.
The Cochrane collaboration, a respected not-for-profit organisation of 14,000 academics, examined 77 studies from 21 countries with smoking bans and found a general reduction in hospital admissions for heart disease.
Among the evidence cited was a study showing that heart attack admissions in Liverpool fell by 42% in the first five years of the ban on smoking in enclosed public places and the workplace in England.
Another study found a 19% reduction in admissions for acute coronary syndrome among ex-smokers and a 21% reduction for nonsmokers (as well as a 14% reduction for smokers) in the first year after Scottish legislation came into effect. Scotland’s ban was introduced in 2006, a year before England’s.
The review’s author, Prof Cecily Kelleher, of University College Dublin, said: “The current evidence provides more robust support for the previous conclusions that the introduction of national legislative smoking bans does lead to improved health outcomes through a reduction in second-hand smoke exposure for countries and their populations.
“We now need research on the continued longer-term impact of smoking bans on the health outcomes of specific sub-groups of the population, such as young children, disadvantaged and minority groups.”
The team of Irish researchers found that 33 out of 44 studies on heart disease showed a “significant reduction” in admissions, with the remainder also showing a downward trend. They also found that the greatest reduction in admissions for heart disease following smoking legislation were identified in populations of non-smokers.
They did not come up with an overall figure for the reduced risk of heart disease as a consequence of legislation because the various studies analysed used different methodologies, they said.
Prof Peter Weissberg, medical director at the British Heart Foundation, said: “This review strengthens previous evidence that banning smoking in public places leads to fewer deaths from heart disease and that this effect is greatest in the non-smoking population. So, in public health terms, this has been a successful piece of legislation. Smoking is bad for smokers and for those around them.”
He cautioned that as they were observational studies, causality could not be conclusively established, but he added: “It would be hard to come up with an alternative, plausible explanation.”
