How about a little good news on a lousy day? A new study confirms previous research, which showed public smoking bans reduce hospitalizations for heart attacks and other life-threatening problems. The Iowa Smokefree Air Act, which went into effect in July 2008, has likely prevented many premature deaths.
UPDATE: The smoking ban was controversial while it was debated in 2008. Below I’ve listed all of the state legislators who had the courage to send that bill to Governor Chet Culver’s desk.
The new study appears in the latest issue of Health Affairs, a peer-reviewed journal. Here’s the abstract of "Smoking Bans Linked To Lower Hospitalizations For Heart Attacks And Lung Disease Among Medicare Beneficiaries," by Mark W. Vander Weg, Gary E. Rosenthal, and Mary Vaughan Sarrazin.
Policies limiting exposure to cigarette smoke have been associated with reduced hospitalizations for heart attacks, but little is known about the impact of smoking bans on other health conditions and whether findings from individual communities generalize to other areas. We investigated the association between smoking bans targeting workplaces, restaurants, and bars passed throughout the United States during 1991-2008 and hospital admissions for smoking-related illnesses-acute myocardial infarction and chronic obstructive pulmonary disease-among Medicare beneficiaries age sixty-five or older. Risk-adjusted hospital admission rates for acute myocardial infarction fell 20-21 percent thirty-six months following implementation of new restaurant, bar, and workplace smoking bans. Admission rates for chronic obstructive pulmonary disease fell 11 percent where workplace smoking bans were in place and 15 percent where bar smoking bans were present. By contrast, very little effect was found for hospitalization for gastrointestinal hemorrhage and hip fracture-two conditions largely unrelated to smoking and examined as points of comparison. These findings provide further support for the public health benefits of laws that limit exposure to tobacco smoke.
That’s a big drop in hospitalizations for heart attacks and serious lung ailments in communities with public smoking bans. In Iowa, the smoking rate dropped noticeably even in the first year after the Smokefree Air Act passed, and has continued to decline since. That trend benefits both people who quit smoking and those who no longer are exposed to their loved ones’ or co-workers’ secondhand smoke.
Lead author Mark Vander Weg is an associate professor in the University of Iowa Carver College of Medicine. He spoke to the Iowa City Press-Citizen:
Hospitalization for heart attack rates is on the decline in general, Vander Weg said, which could be a result of advancing medical care resulting in better identification and treatment of coronary artery disease. It also could be because fewer people are smoking, he said. COPD, on the other hand, has been increasing across the country, Vander Weg said.
Within the first three months of smoking bans being enacted, the increase in COPD admission rates was 5 percent lower in communities with bans than those without. After three years, that difference had grown to 17 percent.
Communities that had smoking bans in all three possible locations – bars, restaurants and offices – saw greater relative reductions than counties that banned smoking only in a single setting, the study found.
Areas with bans in two or three settings saw decreases in heart attack admissions of between 14 percent and 16 percent, while those with a single ban did not see as significant of decreases, Vander Weg said.
“The bottom line for that is that the more bans that there were, the greater reduction that we saw, at least in heart attacks,” he said.
The admissions were only for patients age 65 and older because the study relied on Medicare data. Although research has shown that smoking is declining nationwide, it’s declining at a lower rate among people age 65 and older.
Because of the many health risks associated with secondhand smoke, Bleeding Heartland strongly supported the Iowa Smokefree Air Act and the Iowa Department of Public Health’s decision to enforce that ban in all restaurants. I had no sympathy for smokers who whined about “Big Brother Democrats and Turncoat Republicans” and called the public smoking ban “Soviet” or “fascist.”
Former Governor Chet Culver deserves credit for supporting this bill through the legislative process and signing it into law. The lawmakers who had the guts to vote for this controversial bill should feel proud too.
Here is the full list of 54 House members who voted yes on the final version of House File 2212 in 2008. I’ve put an asterisk next to those who still serve in the Iowa legislature. Note that while Democrats provided most of the yes votes, the bill would not have passed without some support from House Republicans.
Pam Jochum* (now in Iowa Senate)
Janet Petersen* (now in Iowa Senate)
Art Staed (defeated in 2008 but just re-elected)
Special credit goes to Iowa senators who resisted House Democrats’ attempt to weaken the bill and got a fairly strong smoking ban through the conference committee. Here’s the full list of the 28 state senators who voted for the final version of the Iowa Smokefree Air Act. Again, most of the yes votes came from Democrats, but at least one Republican vote was needed for final passage. I put asterisks next to the names of those who still serve.
Frank Wood (defeated in 2008, just elected to Iowa House)
One major loophole remains in Iowa’s public smoking ban: casino floors are exempt. Democrat state senator Bill Heckroth voted for an earlier version of the smoking ban but against the final bill, I think because of the casino exemption. An Iowa Smoke-Free Gaming group is trying to rescind that loophole, but they face long odds, given the gambling industry’s influence at the statehouse.