An abstract of the Mayo Clinic study was presented at a November meeting of the American Heart Association, and the full study is under consideration by the Journal of the American Medical Association, said Dr. Richard Hurt, the director of the Nicotine Dependence Center at Mayo Clinic and lead author of the study. The researchers looked at the 18 months before and 18 months after the enactment of smoke-free laws in Olmsted County, Minn., where Mayo is based. The number of heart attacks dropped by 45 percent after the laws took effect, which is similar to findings in other studies that have been published about other smoking bans. More important, the number of sudden cardiac deaths declined by 50 percent after the ban, Hurt said.
“This is the first time anyone has ever reported (on) sudden cardiac death” after a smoking ban, he said. “Sometimes sudden cardiac death is the first manifestation of coronary heart disease. The very first sign that a person had it, they just drop dead. Literally. So this reduction of 50 percent in sudden cardiac death is a rather amazing statistic.”
There could be a number of reasons why the two are connected. Even small exposure to second-hand smoke, as little as five minutes according to one study in Greece, caused dysfunction in the lining of the aorta, the main vessel feeding blood to the body. The smoke also affects platelets in the bloodstream, and stickier platelets are more prone to form clots that can cause heart attacks, Hurt said.
“For everyone, we should minimize the exposure to second-hand smoke,” Hurt said. “But for people with known heart disease, they should have no – literally no – exposure to second-hand smoke because the risk is too high.”
Augusta is operating under a statewide law that bans smoking in most public places such as restaurants but allows it in bars and places that do not admit anyone under age 18. Advocates are pushing for a ban in all public and many outdoor places, including construction sites and parks. For now, that ordinance is in committee but is not likely to come up again until at least January, said Augusta Commissioner Jerry Brigham, who is also a member of the Richmond County Board of Health.
Hurt said he has heard the arguments against the bans but believes secondhand smoke is like other public health hazards.
“It would be no different than if you had a problem with contaminated water in one of those establishments that was transmitting salmonella,” he said. “It just wouldn’t be something we would tolerate as a public health community. Nor would anyone else tolerate it, either.”
In fact, with all of the evidence of the hazards of secondhand smoke, now increased by his study, Hurt believes it is beyond arguing.
“There should be no more debate about this,” he said. “This is the most definitive study to date showing the relationship between smoke-free workplaces and reduction in heart attacks and for the first time showing reduction in sudden cardiac death. So if the public officials are interested in protecting the public health on the one hand and reducing medical costs on the other, then this is a no-brainer.”