France: Smoking ban lowers cardiac emergency admissions by 15%

The French Health Authorities announced in February that the smoking ban — which began in February 2007 for communal buildings and work places, and was implemented in January 2008 with effect on bars, restaurants and hotels — has produced striking results.

Professor Bertrand Dautzenberg a thoracic specialist at the Pitié-Salpêtrière Hospital in Paris has followed the effects of the new smoking laws for the French Ministry of Health since November 2006. The project ImETS* measures the effects of passive smoking on health every month. They use 12 parameters, four for each section, to measure changes in the exposure to smoke (E), the evolution of tobacco use (T) and the effects of smoking on health (S). This results in an overall global score known as the ETS12 index.
In collaboration with occupational safety and health (médecin de santé du travail) figures have been compiled on the number of workplaces where smoking has been banned effectively from the premises. Since January 2007 the number of workplaces with no smoking has risen from 43 to 86%, interestingly only 75% of hospitals seem able to comply with this law while 98% of offices have succeeded.
The amount of air pollution from fine particles in different public areas is measured every month in exactly the same place. In January 2008 the amount of pollution in bars and restaurants was 75% less than that measured in January 2007.
The effects of passive smoking are calculated from the number of patients seen by the emergency services for myocardial infarction (heart attack) and the number of strokes in people aged 65 or under. The statistics are based on 100,000 admissions from a national panel of 32 large hospitals. Normally the number of admissions for heart attack and stroke in the under 65’s follows a seasonal pattern. A clear reduction in the number of myocardial infarction of approximately 15% and for stroke 12% is seen when comparing the numbers in January and February 2008 with those from the two previous years.
That this effect is really due to the introduction of the smoking ban in bars and restaurants will need to be confirmed by follow-up over coming months. Further studies will be carried out all over France to confirm the strong decrease in smoking related deaths over time. However, these figures show a similar tendency to those observed in Italy, Ireland and Scotland when these countries introduced bans on tobacco.
The European Society of Cardiology together with other health institutions continuously informs 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. The fact that such a rapid improvement in public health can be seen following a smoking ban should encourage other countries to implement their own bans as soon as possible.
However as a note of caution: the overall sales for cigarettes in France have remained stable since 2005, the new precautions put in place are to protect non-smokers from the effects of passive smoking and have had no affect on the number of smokers. The figures for sales in January 2008 are no different from those in any other year.
The French are still smoking, but outdoors!
* indices mensuels tabagism passif: Exposition Tabagisme Santé


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