Anti-smoking legislation has significant health benefits

In many European countries it is no longer allowed to smoke in public places, such as restaurants or bars. That means smokers need to find designated areas for their unhealthy habits, away from non-smokers. This means that not only is smoking discouraged by such laws, non-smokers also benefit because they are no longer covered by second hand smoke when visiting public places. German research has pointed out that this latter group benefits the most in terms of health from such anti-smoking regulations.

Myocardial infarction
German researchers looked at the number of reported myocardial infarctions, or heart attacks, in the two years before and after the anti-smoking laws were passed. Their research was performed in the area around the German city of Bremen, which has about 800.000 inhabitants. It is known that smoking can cause cardiovascular problems, meaning that it is a good benchmark to see whether the anti-smoking regulations resulted in health improvements.

Effect
By counting the number of reported myocardial infarctions per month, the scientists noted a significant drop after the 1st of January 2008, the date at which the anti-smoking regulations came into effect. In fact, the drop in the number of myocardial infarctions in the non-smokers group had dropped 26 percent, when comparing the two years before and after the onset of the aforementioned law. Although they did not directly measure whether this was due to decreased levels of smoke in public places, it is a rather dramatic drop. By comparison, the number of myocardial infarctions in the smokers group increased by 4 percent. Taking all people together, the average drop was 16 percent.

The number of myocardial infarctions (STEM) per month in Bremen and surroundings. There is a clear decrease in the non-smokers group. The absolute number of infarctions is higher in the non-smokers group because there were more non-smokers than smokers admitted to the study.

Outlook
Although it was already known that non-smokers can be harmed by so-called second hand smoking, the German study is a clear sign that there are actual health benefits that result from removing smoke from public places. Although the measurement was fairly indirect, there is no apparent confounding factor that could possibly explain such a dramatic decrease in incidence, especially because the smokers group is unaffected. It is therefore interesting to find out whether research groups will find the same effects in other cities or countries. The findings in Bremen call for a larger study carried out in a large number of big cities, perhaps also involving other known health effects caused by smoking.