Italian smoking ban leads to drop in heart attacks

Brussels, 03 Oct 2006

Following the introduction of the Italian smoking ban, hospital admissions for heart attacks in the under 60s have fallen significantly, according to new research. The scientists suggest that most of the reduction is due to a fall in the levels of passive smoking. Their findings are published online by the European Heart Journal.

Since 10 January 2005, smoking has been banned in all indoor public places in Italy, including cafés, bars, restaurants and discos. Compliance is generally good. The researchers looked at the numbers of hospital admissions due to heart attacks (acute myocardial infarction, or AMI) in the Piedmont region in the months following the ban and compared the figures to the same period of the previous year.

'From February 2005 to June 2005, the immediate period following the ban, we found a significant drop in admissions for AMI among both men and women under the age of 60, with 832 cases compared to 922 for the same months in the previous year,' said Dr Francesco Barone-Adesi of the Cancer Epidemiology Unit at the University of Turin. 'Moreover, the rates of AMI had, if anything, been increasing between 2001 and 2004, so the reduction we saw in the first half of 2005 was not attributable to long-term trends. In fact, as there was evidence that AMI was increasing over time, it's possible that our estimate of an 11 per cent decrease after the introduction of the ban is even an underestimate.'

An analysis of the effects of the ban on the habits of active smokers suggests that reductions in active smoking can only account for a small fraction of the observed 11 per cent fall in heart attacks. According to the researchers, most of the fall can be accounted for by a reduction in exposure to passive smoking.

'The argument of the 'victimless crime', however, clearly and finally has to leave the discussion based on accumulating data,' write Peter Radke and Heribert Schunkert of the University Hospital of Schleswig-Holstein in an accompanying article.

Other data supports the idea that smoking bans reduce both active and passive smoking. Cigarette sales fell by 8.9 per cent in 2005, the year when the ban came into force. Surveys also show that cigarette consumption fell by 7.6 per cent after the ban, due to a fall in the number of smokers and a reduction in the number of cigarettes smoked per day. With regard to passive smoking, tests showed that the nicotine vapour phase concentration in pubs and discos fell by 90 to 95 per cent after the ban.

Smoking bans are becoming increasingly common both in Europe and around the world. In March 2004, Ireland became the first EU country to ban smoking in all enclosed places. Since then, a number of other countries have followed suit and more are expected to join the smoke-free club in the coming years.

A Eurobarometer survey published earlier this year reveals that 80 per cent of Europeans would like to see a ban on smoking in public places, and support for smoking restrictions is highest in countries where these are already in place. Later this year the European Commission plans to carry out a consultation to determine the best ways to tackle the problem of environmental tobacco smoke.

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