This study examined the impact of Arizona's smokefree air law on hospital admissions for heart attacks, angina, stroke, and asthma. The study found that the smokefree law resulted in a statistically significant decrease in all four conditions. The reductions were larger for counties without pre-existing smokefree ordinances than for counties with pre-existing smokefree laws. The authors wrote that, "...there is evidence that the following reductions (and percentage reductions) in hospital admission cases in the nonban counties from May 1, 2007, to May 31, 2008, are attributable to the statewide ban: 159 (13%) fewer AMI cases, 63 (33%) fewer angina cases, 198 (14%) fewer stroke cases, and 249 (22%) fewer asthma cases. The estimated savings in hospital costs from these reductions is $16.8 million."

In March 2002, the city of Bowling Green, Ohio, implemented a smokefree ordinance in workplaces and public places.

The study examined the effect of the ordinance on hospital admissions for smoking-related diseases and concluded that, "A reduction in admission rates for smoking-related diseases was achieved in Bowling Green compared to the control city. The largest reduction was for coronary heart disease, where rates were decreased significantly by 39% after 1 year and by 47% after 3 years following the implementation of the ordinance."

The city of Helena, Montana, enacted a smokefree air law in June 2001, bringing smokefree air to all indoor workplaces, including restaurants and bars. The law was in effect for six months starting in June 2002 before it was suspended due to a legal challenge. During those six months, a significant trend was observed at the regional hospital. The rate of heart attacks in the Helena area declined by 40% while the smokefree air law was in effect, and then increased once the law was suspended.

Dr. Richard P. Sargent announced these findings on April 1, 2003 at the American Conference of Cardiology. Dr. Sargent , Dr. Robert Shepard and Dr. Stanton Glantz conducted a study to compare the number of hospital admissions in Helena for acute myocardial infarctions (heart attacks) during the sixth month period the smokefree workplace law was in effect, and compared those numbers to the same time period in the previous four years, and looked at figures for the surrounding area not affected by the smokefree law.

The Helena study, "Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study," was published in the April 2004 issue of the British Medical Journal. The doctors found a 40% drop in admissions for heart attacks from people living or working in Helena - where a smokefree ordinance was in effect - and no change for people living further away. The study shows that the health benefits of a comprehensive smokefree workplace law may be much more immediate than previously thought.

In response to the findings of the Helena study, the CDC has issued a warning that people at risk of heart disease should avoid exposure to secondhand smoke due to the immediate affects secondhand smoke can have in indoor places that allow smoking. The CDC warning is very significant because it is the first time a government agency has taken action to publicize the acute affects of secondhand smoke and its imminent harm to the public.

Dr. Sargent and Dr. Shepard were the recipients of the first annual Americans for Nonsmokers' Rights Smokefree Advocate of the Year Award in recognition of their leadership in protecting nonsmokers from secondhand smoke, and their work conducting the landmark cardiology study in Helena. The awards were presented on December 10, 2003 at the National Conference on Tobacco or Health in Boston, MA.

The Helena Heart Study demonstrates that even a little exposure to secondhand smoke can be deadly. The study is powerful, and demonstrated the urgent need for smokefree laws to protect the public. So it comes as no surprise that the Helena Heart study has unfairly come under attack by the opposition. The opposition has used unsubstantiated claims to argue the validity of this study. These claims are hogwash. If the study is challenged in your community, this Helena heart study fact sheet from the American Heart Association may be an helpful resource.

Related Material:

Talking Points on the Helena Heart Study

American Heart Association Press Release (misdated)

A study by Indiana University researchers found that comprehensive smokefree workplace laws result in immediate and significant improvements in heart health, particularly in nonsmokers.

The study found a 59% net decrease in hospital admissions for heart attacks, also known as acute myocardial infarctions (AMIs), in nonsmokers with no prior cardiac history in Monroe County, Indiana versus the control county during the study period which tracked 22 months prior to and following the implementation of a comprehensive smokefree workplace law.

The study, "Reduced Admission for Acute Myocardial Infarction Associated with a Public Smoking Ban: Matched Controlled Study," conducted by Dong-Chul Seo, Ph.D. and Mohammad Torabi, Ph.D. is published in Journal of Drug Education Vol. 37 No. 3, 2007.

ANR Press Release

On January 14, 2010, the American Cancer Society announced the completion of a study into the effect of the 2008 Iowa Smokefree Air Act on hospital admissions for tobacco related conditions.

The study examined data submitted to the Iowa Department of Public Health summarizing the number of monthly hospitalizations between July 2005 and June 2009 for cardiovascular diseases caused or made worse by smoking and exposure to tobacco smoke.

“We found a 24 percent reduction in hospital admissions due to coronary heart disease in the year after the Smokefree Air Act was passed compared with the previous three years,” said Dr. Christopher Squier of the Department of Oral Pathology at the College of Dentistry, University of Iowa. “This represents 2,324 fewer Iowans dealing with this condition, a result that no one can ignore. In less than two years, we are already seeing the public health benefits of this landmark piece of legislation, and for that our legislators and the governor should be commended.”

Hospital admissions due to heart attacks and strokes were also down during this same period.

According to a November 12, 2008 Boston Globe article, a study conducted by the state Department of Public Health and the Harvard School of Public Health has found that the state's smokefree air law had resulted in a decrease heart attacks.

The article stated that, "the number of heart attacks began dropping in communities with strong antismoking laws years before the 2004 statewide law and that similar reductions were achieved in other cities and towns only after the state ban. By the end of 2006, the rate of decline in all cities and towns had nearly converged. The authors said this pattern showed that advances in treatment of heart attacks were not responsible for the smaller number of deaths."

A 2008 study conducted by the Henry Ford Hospital concluded that the number of heart attacks in Michigan could be significantly reduced if a statewide smokefree air law were passed.

Mouaz Al-Mallah, M.D., Henry Ford's director of Cardiac Imaging Research and lead author of the study, stated, "If Michigan were to implement a comprehensive smoking ban tomorrow, we would see a 12 percent drop in heart attack admissions after the first year."

A study published in the American Journal of Public Health found that the state's smokefree air law resulted in 3,813 fewer hosptial admissions for heart attacks in 2004, as well as a savings of $56 million in direct health care costs.

On November 14, 2005, a new study was presented at the American Heart Association's Scientific Sessions conference, which found that heart attack rates in Pueblo, Colorado, dropped by nearly 30 percent after the city passed a smokefree ordinance in 2003. According to a press release issued by the Pueblo City-County Health Department, "The Pueblo study affirmed that such laws can cause a dramatic improvement in public health, within even the first few months."

In October 2006, the study was published in the journal Circuation.

On January 2, 2009, a follow-up study was published in the journal Morbidity and Mortality Weekly Report. The study found that heart attack rates in Pueblo continued to decline.

Related Material:

Smoking Bans Prevent Heart Attacks (Editorial)
Jonathan M. Samet, MD, MS
Circulation, October 2006

Pueblo Heart Study Fact Sheet (2005)