England smoking ban cut heart attacks, health cost

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A ban on smoking in public places in England led to a swift and significant drop in the number of heart attacks, saving the health service 8.4 million pounds ($13 million) in the first year, scientists said on Wednesday.

The findings of a large British study suggest that anti-smoking legislation has the potential to save millions of lives in both the short and longer term by reducing the amount of smoking and the exposure to second-hand smoke.

“These benefits are just a fraction of the total benefits of the legislation, because we looked only at the effect on heart attacks in the immediate period,” Anna Gilmore, director of the Bath University tobacco control research group, told reporters at a briefing.

"In the current (economic) climate, this study underlines the importance of public health interventions such as this. They’re cheap, they’re easy to implement, they have important health benefits and they save health service money.”

Gilmore’s study, published in the British Medical Journal, showed that in the year after July 2007, when a law banning smoking in public places in England took effect, there were 1,200 fewer hospital admissions for heart attacks than the annual average in the previous 5 years, a fall of 2.4 percent.

A separate study by the London Health Observatory (LHO), also published on Wednesday, found this 2.4 percent drop produced estimated savings of 8.4 million pounds in emergency hospital care in the first 12 months.

“The message is clear: investment in prevention pays,” said Bobbie Jackson, director of the LHO, which collects and spreads public health information.

Worldwide, some 5 million people die every year from smoking-related heart attacks, strokes and cancers, according to the World Health Organisation (WHO). A further 430,000 adults die annually from exposure to second-hand smoke.

Exposure to second-hand smoke increases the risk of heart disease, the biggest killer of men and women in industrialised nations. It also has an “acute” effect, posing an immediate risk of heart attack in some people exposed to it.

Previous smaller studies in parts of Europe, the United States and Canada also found that smoking bans reduce the rate of heart attacks, but Gilmore said the British study was the largest of its kind, covering a population of 49 million.

Experts commenting on Gilmore’s work said it underlined the need for governments to push further to cut rates of smoking.

“Banning smoking in public places was a bold step and now we have evidence showing that was absolutely right,” said Betty McBride of the British Heart Foundation charity.

“What’s more, we’ll see more benefits in future because heart attacks aren’t the only way that tobacco smoke harms the heart. Government should see this as a green light for further life-saving measures.”

A WHO treaty in 2003, ratified by 160 countries, recommended imposing a complete ban on advertising, promotion and marketing of tobacco products, but only 26 countries have imposed such a ban.

SOURCE:  BMJ, online June 8, 2010.

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