Nigel Hawkes, Health Editor, and Melanie Reid
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The ban on smoking in public places in Scotland is already beginning to have an impact on the nation’s health, a conference in Edinburgh heard yesterday.
The number of nonsmokers admitted to hospital after heart attacks fell by 20 per cent in the ten months after the ban came into force in March 2006, compared with the same ten months in the year before, Jill Pell, of Glasgow University, said.
Other studies have shown that children’s exposure to secondhand smoke has fallen, except among children whose mothers smoke, or those with two parents who smoke.
Professor Pell’s study covered nine hospitals, which between them account for two thirds of all hospital admissions for heart attacks in Scotland. In the ten months of the year leading up to the ban, there were 3,235 admissions, while in the matching period after the ban, the figure was 2,684.
Patients were asked if they were smokers or nonsmokers, and their answers double-checked through blood tests to detect levels of cotinine, the product into which nicotine is converted by the body. In nonsmokers, the fall in heart attack admissions was higher, at 20 per cent.
Professor Pell said that the reduction among nonsmokers was biologically plausible, because smoke contained a lot of toxins that could trigger heart attacks in people with coronary heart disease. “The difference between our study and earlier ones is that we have been able to show an effect in people who have never smoked. That can only be due to lower levels of passive smoke,” she said.
Rates of heart disease are falling everywhere, but not as fast as this. Over the same period of ten months after the ban, admissions in England fell by 4 per cent, and the reduction rate in Scotland over the decade before the ban was 3 per cent per year.
Sally Haw, principal public health adviser to NHS Scotland, who collaborated in the study, said she was confident that the figures were reliable.
“It’s a large study, we have confirmed people’s smoking status, and we have used a robust definition to count admissions” she said.
Sir Richard Peto, of Oxford University, an expert in the epidemiology of smoking, said many things could affect admissions for heart attacks, including the weather. Fewer people suffer heart attacks when the weather is mild. “I’d be surprised if this drop were due solely to the smoking ban,” he said. “I would like to see cigarette sales figures, to see if there has been any fall.”
Jon Ayres, head of the University of Aberdeen environmental and occupational medicine department, said: “It’s very difficult to believe there is anything fundamentally wrong with the results. I think the 20 per cent figure is good. If you look at the figures month to month, the effect seems to creep up since last year. This also suggests that the important thing was the smoking ban.”
The study has yet to be published, but the conference coincided with the publication online by the British Medical Journal of three other studies. One found a reduction of 39 per cent in exposure to secondhand smoke in 11-year-olds and a similar decrease among adult nonsmokers.
Cotinine levels in blood were used to measure exposure, and showed that most children have benefited. But in those with two parents who smoke, or with a mother who is a smoker, the drop was not statistically significant.
A study by Aberdeen University of nearly 400 staff at 72 pubs in Aberdeen, Glasgow and Edinburgh also found health improvements in bar staff. The two-day conference at the Edinburgh International Conference Centre has attracted an international audience of health experts and policymakers.
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It's now November 16th. The full heart attack data is now available and Michael Blastland has shown the claim to be nonsense in a BBC website magazine article two days ago. Of course nobody is reading this and the anti-tobacco industry has moved on to its next lie. Jill Pell has gone to ground and Peter Donnelly and Shona Robison are still collecting their fat salaries. Nobody has ever seen the "study". What a disgrace. I'm not surprised people don't trust scientists any more. I hope the Times devotes some space to this correction. These people are beneath contempt.
Jonathan Bagley, manchester, uk
Remind that those nonsmoking Talibans from USA have
a urgent need of succes. They know very well her campaign
will break down in a moment if people realise : It is only a
campaign for to sell Pills instead of cigarettes.They will
help you quit smoking for their own benefits.-not yours!
And now all over Europe they face a growing resistance
of people who are used to use their own brain-what a tread
for them, so they have to fake succes for the public
Michael Weber, Heidelberg, Germany
Though the smoking ban will save lives and improve health
I find it difficult to belive, that in such a short space of time, a dramatic drop in heart attacks in non-smokers can be attributed to it (except when you need a headline).
In science we trust but in claims that are "biologically plausable" we suspect the well meaning have an agenda of their own beyond the disipline of their studies.
robert everitt , wolverhampton,
I take it from these 'supposedly' concrete findings that funding/grants into other causes of heart attacks and other diseases are to be stopped and research discontinued. I ask this because almost every doctor/researcher/sci attributes whatever illness they are treating/researching on smoking or SHS.
I used to have a very healthy respect for scientists/doctors and researchers, but I'm afraid that respect no longer applies to the vast majority of these professions. Integrity and honesty used to be the top priority, now it's securing funding/grants from pharmacuetical companies and government but reading ones name in the newspapers to further careers appears to be the number one priority.
SHS is a baffling subject really. Why is that not one of these rabid anti smoking paragons haven't called for tobacco to be made illegal, a ban on selling it, instead they come out with issue licences to sell it, which the government will fall all over itself to comply with, more money for them.
Lucy , london,
At last a study to show the benifits to health following the smoking ban in Scotland. This is great news and fully justifies the ban. I and other non smoker now suffer a large smoke intake as we walk along the road, with all the associated and proved health problems. So come on all you MPs and ban smoking completely everywhere except in peoples homes. You know this will happen later so why not make it sooner so we nonsmokers can enjoy even better health and longer life.
John, Richmond, North Yorks
There are over 100 hospitals in Scotland but the NHS only took results from 9 of them...
Tony, Hull,
I agree with Derek James. Yes, there is a link between smoking and heart disease, but there's going to be a substantial lag between the start of the smoking ban and any improvement in cardiac health. Maybe in 20 years the ban will have made a difference, but this year's improvement is just coincidence. Anyone trying to pretend there's a link is flat-out lying.
Of particular interest is Professor Pell's interpretation of the data. He acknowledges that heart attacks are down in non-smokers too, but rather than draw the obvious conclusion that smoking has nothing to do with the reduction, he mysteriously deduces that "That can only be due to lower levels of passive smoke". To me, this suggests that he'd made up his mind what the conclusions would be before he even looked at the data.
Neil Turner, London / Cape Town, UK / South Africa
This is the worst, and most biased scientific report I have ever read, and Profesor Pell knows this perfectly well. One assumes therefore that he must be an anti-smoking extremeist. Perhaps, before preparing this report he should have read the latest unbiased, and detailed report on the effects of passive smoking!
Desmond, Barnstaple, Devon
yeah right ho, yet all of the science in support of so called passive smoking was said to be junk as the no smoking bill passed through the house of lords. incidentially smoking is said to kill roughly 30,000 people a year. incompenent docs and nurses kill 40,000 people a year-perhaps we should ban them to!!!
junk science, uk,
Could it be that, because of the smoking ban, there are less visits to pubs, so drinking levels are down. Alcohol and heart problems are supposedly related, so maybe less booze equals less heart attacks? Were the alcohol consumption figures included in these statistics?
Alan Nicholls, Nottingham, England
Derek James:
I assume you have hard evidence to back your claim that it's too short a time to see an effect, especially in light of published evidence that the endothelial and nitric oxide effects of second-hand smoke are much more acute than directly inhaled smoke; also that platelet stickiness is a huge part of tobacco smoke-related acute coronary disease.
People who support smoking should just come out and say that they want smoking to continue in preference to a regard for their own or other's health. Just don't try to discredit evidence because there's 'no way this can be right'.
Avril, Edinburgh,
The higher incidence of heart attacks in cold weather has been well documented. The study by Pell covered ten months (why ten months?) which means that winter (i.e. colder) conditions are under-represented post-ban.
Every study that deals with statistics should present confidence levels (e.g. 90 %) and statements such as 'reliable' are political not scientific. The above studies seem light in providing any levels of statistical significance. That apart, any statistical study is significant only if: the data can be demonstrated to be representative (i.e. all studies and data are represented and the significant ones are not cherry-picked); alternative variables are taken into account (e.g. weather) and most importantly, there is a scientific reason behind the observation.
The problem with sensationalising speculative results is that it distracts from identifying the real causes of disease. It might be good news for the political paymasters, but it is irresponsible.
Ken Nicholson, Swindon, UK
If this study is true then should we not completely ban cigarette manufacturing in this country?
The study has proven that the chemicals added to tobacco have an almost immediate effect on the health of the smoker and also the non smoker so why has the government not issues an immediate ban on health grounds.
Alternatively if you take the statistics and interpolate them for China where smoking is heavy and endemic then surely with 1.3 billion people heart attacked should be fairly common on the street.
Remember statistics are just that and there could be a lot of other factors like people who recently give up exercise more, eat different foods as they can taste the difference.
joseph Kellie, Edinburgh, Scotland
Blimey!
No one dared to claim that smokers giving up would reduce their risks by this much!
What unbelievable rubbish! (Not the figures, but the conclusion)
"When the smoke ban takes effect in England, we'll all be immortal" says Professor
Nigel Hall, Cardiff,
Rubbish propaganda. In such a short time no way can this be right.
Derek James, Stourbridge,