Public health advocates are sometimes viewed as a bunch of overprotective nannies, trying to regulate people’s behavior and restricting their freedom in what foods they eat or how big their soft drinks are. Some of what they advocate, however, often has demonstrable benefits to the health of many individuals. One common public health measure is a ban on indoor smoking at public places like restaurants, bars and government offices. Research published in Health Affairs looks for an association between smoking bans and better community health outcomes. (Health Affairs Article) Several small studies have found an association between smoking bans and fewer heart attacks. The authors here undertook a larger study using Medicare beneficiaries, covering the period from 1991-2008 and looking specifically at links between the smoking prohibitions and hospitalizations for heart attack or COPD.
The researchers found 938 smoking bans. They tracked when they were instituted and looked at beneficiaries residing in various localities with the bans compared to those residing in locations without a smoking prohibition. While there obviously are factors that limit the results, like actual secondhand smoke exposure or level of enforcement of the bans, there appears to be a clear association between hospitalizations for the conditions at issue and a ban on public place smoking. Localities with a smoking ban showed relative reductions in heart attack admissions after passage of the ban. The more settings that were included in the ban, the more the rate dropped. There was also a reduction in hospitalizations for chronic obstructive pulmonary disease. While causation is difficult to show, the results of this and similar studies suggest that there is value in reducing the population’s exposure to second-hand smoke.