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Acute Coronary Events Drop After Italy's Public Smoking Ban

Analysis shows young people in low socioeconomic areas had greatest reduction

THURSDAY, Feb. 14 (HealthDay News) -- The number of acute coronary events dropped significantly among adults in Rome after Italy banned smoking in public places in 2005, a new report shows.

Researchers in the Italian capital found an 11.2 percent reduction of acute coronary events in persons aged 35 to 64 years and a 7.9 percent reduction in those aged 65 to 74, according to the findings in the Feb. 12 issue of Circulation.

Cigarette sales and the frequency of people smoking also dropped.

"Since coronary heart disease is a leading cause of death in Italy, the reduction observed had enormous public health implications," study co-author Francesco Forastiere, head of the environmental and occupational epidemiology unit of the Rome E. Health Authority, said in a prepared statement. "It will be interesting to see if the effect of the ban is stable over time, and if similar positive health effects can be detected in other places."

The study was the first in Europe to show long-term health benefits of smoking bans in public places.

Researchers looked at city statistics for the five years preceding a 2005 public smoking ban with those from one year after. They identified acute coronary events from hospital discharge reports with a diagnosis of myocardial infarction or unstable angina and from the regional register of causes of deaths with diagnosis of out-of-hospital coronary deaths.

The January 2005 comprehensive smoking ban in Italy included all indoor public places such as offices, retail shops, restaurants, pubs and discos.

Young people living in low socioeconomic areas seemed to have the greatest reduction in acute coronary events after the smoking ban, researchers reported. Those living in lower socioeconomic areas have worse health conditions with more risk factors for heart attack such as obesity, hypertension, diabetes and a higher rate of smoking.

"This implies that a disadvantaged person has a higher probability of being surrounded by smokers at work and in public places unless a smoking ban is in place," Giulia Cesaroni, senior researcher at the Department of Epidemiology in Rome, said in a prepared statement.

The ban also appeared to have changed people's smoking habits. According to the report, the frequency of smoking decreased from 34.9 percent to 30.5 percent in men and from 20.6 percent to 20.4 percent in women. Cigarette sales also decreased 5.5 percent.

However, the smoking ban did not appear to reduce coronary events in those aged 75 to 84.

"The older age group spends more time at home than in the workplace or public businesses," Cesaroni said. "The smoking ban has a greater effect on those of working age and those who spend a lot of their time in public places."

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-- Kevin McKeever

SOURCE: American Heart Association, news release, Feb. 11, 2008

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