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ESC: Heart Attacks Decline Following Irish Smoking Ban

Article

VIENNA -- In the 12 months following implementation of a nationwide smoking ban in Ireland, the number of hospital admissions for acute coronary syndrome decreased by 11%.

VIENNA, Sept. 5 -- In the 12 months following implementation of a nationwide smoking ban in Ireland, the number of hospital admissions for acute coronary syndrome decreased by 11%.

While the decrease was impressive, Edward Cronin, M.D., of Cork University Hospital in Wilton, said the report was based on hospital records in just two counties-Cork and Kerry. Moreover, he said "this is an observational study so we cannot prove an association between the smoking ban and the decline in [acute coronary syndrome] admissions."

Nonetheless, Dr. Cronin said that these results follow a similar pattern reported in other nations and regions where smoking bans have been enacted.

Dr. Cronin presented his findings at the European Society of Cardiology meeting here.

Ireland, which banned smoking in workplaces including restaurants and pubs on March 29, 2004, was the first European Union nation to enact a smoking ban. That action was particularly compelling given the fact that Ireland had the second highest rate of cardiovascular deaths among western European nations-only Finland posted higher cardiovascular mortality.

Dr. Cronin and colleagues analyzed acute coronary syndrome admissions data collected by the Coronary Heart Attack Ireland Register, which included all such admissions in southwestern Ireland.

During the 12 months before the smoking ban, there were about 1,200 admissions for acute coronary syndrome, Dr. Cronin said. In the following year, March 29, 2004 through March 29, 2005, the number of admissions declined by 11%. "Most of the reduction occurred in admissions for non-ST elevation MI," he said.

Dr. Cronin said he was gratified but not particularly surprised by the observed decrease in events.

Unlike lung cancer in which the risk of cigarette smoking continues for years after smoking is stopped, the benefit to the heart is fairly quick, he said.

"Within 30 seconds of inhaling smoke platelets get stickier and endothelial function is impaired. When smoking stops, those effects also stop," he said.

Asked about the smoking rate in Ireland, Dr. Cronin said he thinks that smoking is declining, but he had no data to confirm that speculation.

He said, too, that he had not analyzed the data to determine the economic impact of fewer acute coronary syndrome hospitalizations.

Dr. Cronin's study follows one published in April that reported an 83% reduction in indoor air pollution and an 80% drop in airborne carcinogens in Dublin restaurants and pubs in the 12 months following the ban. That reduction in secondhand smoke exposure was accompanied by significant reductions in respiratory illness among bar and restaurant workers.

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