Heart attack rates drop following national smoking bans in France

French researchers announced a striking 15% decrease in admissions of patients with myocardial infarction to emergency wards since the public ban on smoking came into effect in restaurants, hotels and casinos in France last January.

The announcement was made on 23 February by the National Sanitary Institute. Similar results were published in Italy on 12 February by the Environmental Health Authority: researchers in Rome found an 11.2 percent reduction of acute coronary events since the January 2005 smoking ban took effect in Italy.

The European Society of Cardiology (ESC) wishes to stress the positive impact of smoking bans in all European countries that have adopted laws banning tobacco use in public places.

“There is a wealth of data linking smoking and cardiovascular disease (CVD),” stated Prof Daniel Thomas, of the European Society of Cardiology and a Senior Cardiologist in the Centre Hospitalier Pitié- Salpêtrière in Paris. “Although further studies are needed all over France to confirm the strong decrease in smoking related deaths over time, these statistics show the same tendency professionals have already observed in Italy, Ireland and Scotland when these countries introduced their own bans on tobacco. To me, the most striking aspect in this study is the reduction of pollution inside cafés and restaurants by over 35%. Passive smoking has been shown to increase the risk of coronary heart disease and the recent smoking ban is obviously having a beneficial effect on both smokers and non-smokers.”

The European Society of Cardiology together with other health institutions has continuously informed the public of the overwhelming evidence of the adverse effect of smoking on cardiovascular health. The European Guidelines on CVD prevention warn that smoking is responsible for 50% of all avoidable deaths and that smoking causes heart attacks at any age. Data produced by Prof Pekka Jousilahti from Finland at the ESC's EuroPrevent Congress in 2006 showed that smoking releases over 4000 chemicals into the body affecting every organ.

“The swift reduction of heart attacks and strokes in France is very good news indeed!”states Prof Jean Pierre Bassand, Past President of the ESC and Head of the Cardiology Department at the University Hospital of Besançon . “Cardiologists do not need to be convinced that smoking and passive smoking have an important impact on the rate of heart attacks; they are also convinced that giving up cigarettes and eliminating passive smoking has a very favourable effect on the rate of heart attacks. Unfortunately the ban on smoking in public places has not led to a reduction in the number of smokers in France, confirming data observed elsewhere.”

Prof Daniel Thomas agrees: “Governments must learn from these findings and not give in to pressure from the tobacco lobby. In France people are actually still buying tobacco but just the fact that working and living environments are free from smoke pollution has made an enormous difference to public health, not only regarding cardiovascular disease, but also respiratory disease and other complaints such as headaches, as the INVS findings show. It is very important to stress the immediate results observed on cardiovascular disease when people live in smoke free environments.”

“Although cardiovascular diseases are very complex in nature and due to many causes, smoking bans most certainly have caused a reduction in coronary events. This is consistent with the pollution reduction observed in indoor public places” explains Roberto Ferrari, President Elect of the ESC.

The European Society of Cardiology would like to encourage smoke cessation across the continent through smoking bans and taxes on cigarettes. There is a consensus on the benefits of smoking cessation which are usually almost immediate and contribute to diminish the burden of cardiovascular disease.

The positive figures communicated last week in Italy and France should encourage other European countries to enforce similar measures to protect their citizens.

Smoking bans can save lives.