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New Study: Ohio Town Shows Sharp Drop in Heart Attacks Following Smoking Ban [08/19-1]

Excerpts from: Study looks at smoking ban's effect on health Bowling Green focus of research

By TAD VEZNER and LUKE SHOCKMAN Toledo Blade [08/19/04]

A study released today by an anti-smoking group on the effects of smoking bans in Toledo and Bowling Green showed a sharp drop in heart attacks in Bowling Green following implementation of its ban.

The heart-attack study — done by public health researchers at the Medical College of Ohio and funded by the Ohio Tobacco Use Prevention and Control Foundation — did not analyze heart attack rates in Toledo because its ban has been fully enforced only since January and 2004 health data are not yet available.

The Bowling Green heart-attack study, spearheaded by Sadik Khuder, associate professor of public health and medicine at MCO, found that heart attacks in the Wood County city fell by 45 percent in the first half of 2003 from the second half of 2002 — after the city's smoking ban was fully implemented.

The study used Kent, Ohio — a city in northeast Ohio without a smoking ban but with similar demographics to Bowling Green — as a control model.

Heart attacks in the same period also fell in Kent, but by only 26 percent.

“The findings are preliminary, but they do indicate a major change in heart attacks,” said James Price, a public health professor at the University of Toledo who was the principal investigator in the overall study. “The question is, is it due to the Clean Indoor Air Act? We think it may be.”

Some scientists who were involved in the study remain cautious about the findings.

“There's definitely a [decrease], but it's only for six months. We don't know if it will continue,” said Sheryl Milz, an assistant professor of public health at MCO, who helped conduct the Bowling Green research. “It might have nothing to do with the clean indoor air ordinance.”

One of the area's leading health officials, however, said he's sure the ban is improving public health.

“The decrease doesn't surprise me. I have little doubt,” there's a relationship between the ban and reduced heart attack cases, said Dr. David Grossman, health commissioner for the Toledo-Lucas County health department and an early supporter of Toledo's smoking ban.

The study — which also looked at air quality in bars and restaurants with smoking lounges and the economic impact of smoking bans on bars and restaurants — was coordinated by the Northwest Ohio Strategic Alliance for Tobacco Control.

Bowling Green voters passed a ban on smoking in most bars and restaurants in November, 2002.

In the study, Ms. Milz and her colleagues examined patient records for Bowling Green residents who were treated for heart attacks at area hospitals before and after the passage of the ban.

Some of the data show what researchers refer to as a “statistically significant” drop in the number of heart attacks after the ban, meaning the decrease is unlikely to be due to chance.

For example, from July, 2002, to December, 2002, there were 33 heart attack patients. From January, 2003, to June, 2003, there were 18, translating into a 45 percent drop.

However, the rest of the data show why it's difficult at this point to draw any strong conclusions, Ms. Milz said.

One unusual finding: The number of heart attacks went from 30 in the first six months of 2002 [the ban was implemented in February, 2002] to 33 in the second six months. In addition, in some of the previous years of Bowling Green data, there were relatively sharp drops for short periods of time, though not as much as last year.

Smoking ban supporters say the findings suggest smoking bans can reduce the harmful effects of secondhand smoke.

Dr. Gopinath Upamaka, a cardiologist and director of coronary care at Toledo Hospital, said there's little doubt secondhand smoke is linked to heart problems, and he tells his patients to avoid secondhand smoke.

He said carbon monoxide in smoke can prevent enough oxygen from getting to the heart, and smoke can make arteries more prone to rupturing.

MCO researchers also found that contaminants from secondhand smoke are still showing up in nonsmoking areas adjacent to enclosed smoking lounges in bars and restaurants they tested in Bowling Green and Toledo.

The levels are low, but MCO researchers said there isn't a known “safe” level of tobacco smoke exposure, so it's possible even the small levels could be harmful.

Farhang Akbar-Khanzadeh, a public health professor at MCO who did that portion of the study, said his findings parallel those done elsewhere, as well as some of his own previous research.

He said the problem appears to be that the entrances to the separate lounges are frequently opened and closed, allowing secondhand smoke to escape into nonsmoking areas.

The study also looked at the economic impact of smoking bans on area bars, restaurants, and bowling alleys.

Mr. Price, the University of Toledo public health professor who headed the economic portion of the study, said he used information from Dun & Bradstreet — a Short Hills, N.J.,-based consulting firm that compiles financial data on both large and small businesses — to conclude that there was nearly no difference in the financial health of restaurants in Toledo and Bowling Green after the smoking ban took effect compared to other similar-sized cities in Ohio without bans and compared to the suburban cities of Maumee, Perrysburg, and Sylvania.

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