Cardiovascular benefits of smoking regulations: The effect of decreased exposure to passive smoking.
OBJECTIVE
Decreases in population rates of acute myocardial infarction (AMI) have been repeatedly seen in the first months after the introduction of regulations banning smoking in public places. By decreasing the exposure to passive smoking and its acute cardiovascular effects, smoking regulations may cause an immediate drop in AMI incidence, beginning from the initial days after their introduction. Using simulations, we quantified this expected decrease.


METHODS
Expected AMI decreases were estimated using several parameters, including prevalence of exposure to passive and active smoking, relative risks of AMI associated with active and passive smoking, decrease in exposure to passive smoking after the introduction of the regulation, and level of susceptibility of active smokers to exposure to passive smoking.


RESULTS
After evaluating several possible combinations of these parameters, we found that AMI reductions of 5-15% seem likely. For example, a scenario with a population average of 5 hours per week of overall exposure to passive smoking, a 50% reduction in this exposure after the introduction of the regulation, an acute relative risk (RR) of AMI of 4.5 in the first hour after passive smoking exposure, and similar susceptibility to passive smoking among both active and passive smokers translates into a 8.6% decrease in AMI.


CONCLUSIONS
Smoking regulations can cause immediate and relevant decreases in AMI through the prevention of exposure to passive smoking.
Richiardi
Lorenzo
L
Cancer Epidemiology Unit, CeRMS and CPO Piemonte, University of Turin, Italy. lorenzo.richiardi@unito.it
Vizzini
Loredana
L
Merletti
Franco
F
Barone-Adesi
Francesco
F
D016902:Air Pollution, Indoor / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003198:Computer Simulation; D006291:Health Policy; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000517:prevention & control*; D012306:Risk; D018570:Risk Assessment / Q000379:methods; D012907:Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence*; D016540:Smoking Cessation; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
D014028:Tobacco Smoke Pollution