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I am pleased to see that December 31st has been set for the smoke-free legislation to be enacted here. Smoke-free legislation aims to protect nonsmokers from secondhand smoke, but it may also reduce the risk among smokers because of reduced smoking or increased smoking cessation. A study published in the New England Journal of Medicine in July 2008 looked at what happened in Scotland comparing the year after smoking in public places was banned to England where there was no change in smoking legislation. Before the ban there had been a year on year 3% drop in acute heart attacks per year. The year after the ban was in place acute admissions for heart attacks dropped by 17% this compared to England there was a drop of 4% in the same year. About 2/3 rds of this drop was in non-smokers and 1/3rd smokers. This is a considerable difference and even in a small country like Cayman would represent a considerable number of people who would not have a heart attack. If the statistics in cayman mirror this it would be a powerful improvement in health.
However such a drop in the Scottish study might have been related to a reduction in smoking because of the publicity of the ban. There also might have been a number of people who perhaps were about to have a heart attack when they walked into a smoky room and the nicotine caused the artery to clog off ( as nicotine in cigarettes causes arteries to spasm). Such patients might be expected to live a little longer before the inevitable took place. If that was the case this improvement might be seen only in the first year or so and then admissions would increase back to where they had been before the ban had come into place. In order to be sure there was consistent improvement research would need to look at what happened after the first year.
Such a study was recently reported by the CDC who looked at what happened in after the first eighteen months after a ban in Pueblo Colorado and compared it the following eighteen months. With comparisons with another city that had no such legislation and another area outside the city limits.
In the first 18 months the number for acute heart attack diminished by an impressive 27% however in following eighteen month period heart attacks were reduced by a further 17% to make an incredible 41% reduction in acute heart attacks.
The enactment of this legislation in the Cayman Islands is likely to make a considerable impact on the health of its citizens considerably more than any medication or catheter laboratory could hope to do at little or no cost.
A recent article in the Journal “Heart” has called the worldwide enactments of similar legislations a “triumph”. However, it is hardly something worth boasting about when the first paper linking smoking to heart attacks occurred in the 1920′s. Unfortunately, rather it is testament to the power of money, vested interests and political inertia that it has taken almost a century for the world to wake-up to the toxicity of tobacco smoking.
However the good news is that it may increase the appetite for looking at reducing consumption of trans-fats, sodium and fructose corn syrup which hopefully won’t take another century. I will be looking at some of the research pertaining to these issues over the next few weeks.
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I can’t WAIT for this legislation to be enacted. I am not a smoker, but I have friends that are. They always tell me that this legislation is interfering with their right to smoke. I always tell them that their right to smoke is all fine and good, but that their smoking is directly affecting MY HEALTH.
A co-worker of mine’s aunt died from second-hand smoke. She never smoked a day in her life, but her husband did. He always thought it wouldn’t hurt her and she is the one who ended up dying. He is fine! No evidence of lung cancer what so ever.
If you want to smoke fine, but don’t exhale in my general vicinity….EVER!
Ann, I think many of us, doctors included, underestimated the immediate effects of inhaling a single cigarette on ours and others vascular system. I hope we will be looking at our statistics in the next 2-3 years so we can see how much this legislation has benefited us all.
I am a smoker but I really don’t care either way if they want to enact the law or not…..I don’t visit most bars or clubs anymore for fear of being shot or stabbed, so i do most of my entertaining at home where no law can prevent me from smoking. Banning it in restaurants is no issue to me either as I prefer to cook at home instead of going to restaurants and have strangers cooking for me that I don’t know where there hands have been.
Only thing that has me a little boggled about this non-smoking thing is not too long after the discussion of the smoking ban out came the Cayman Lights, very nice…..make them with our name on it then ban it, is someone confused or not thinking straight?
Denise thanks for your comment. Its interesting to me how changing the law in other jurisdictions appears to have considerably helped smokers as well as non-smokers in terms of reduced heart attacks – like you say all smokers are still able to smoke at home so why such a change?
Hi Dr. Pickering! You can pat yourself on the back for helping this ban finally come to pass!! Your tongue-in-cheek Reasons to not stop smoking book was mentioned on talk radio the other morning too! Well done and thank you for all your efforts to help Cayman be healthier!
Thanks Jeanette for your nice comments. I still have a few of the books left too! I hope we will look at the changeover to get an idea for how effective its been here, because we are a smallish place it should be easy to review the figures.
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