兩份獨(dú)立報(bào)告顯示,在公共場所實(shí)行禁煙令的國家,在禁煙一年心臟病發(fā)作減少17%,3年下降36%.
The number of heart attacks has fallen steeply in countries where bans on smoking in public places have been introduced, according to two independent reviews
Smoking bans were introduced in pubs and other public places in England and Wales in 2007. Photograph: Danny Lawson/PA
The ban on smoking in public places could reduce heart attacks by more than a third in some parts of the world, say researchers.
Two independent health reviews have found that heart attack rates dropped steeply in areas where bans have been introduced, with one reporting 36% fewer cases three years after smoke-free legislation came in.
Smoking in pubs, restaurants and other public spaces was banned in England and Wales in July 2007, a year after similar laws were introduced in Scotland. The Scottish ban led to a 14% fall in the number of people being admitted to hospital with a heart attack the following year.
A Department of Health study of heart attack rates in England and Wales is not due to report until next year, but experts believe the number of cases in the regions has already fallen by around 10% as a result of the smoking ban.
The latest reviews, which draw on published studies from the US, Canada, France, Italy, Ireland and Scotland, suggest heart attacks in Britain will fall even further over the next two years.
"While we obviously won't bring heart attack rates to zero, these findings give us evidence that in the short to medium term, smoking bans will prevent a lot of heart attacks," said James Lightwood, a health economist at the University of California in San Francisco and co-author of one of the reviews, published in the US journal Circulation.
Dr Lightwood analysed 13 published reports on heart attacks in countries or states where smoking bans have been introduced. A year after the bans were brought in, heart attacks had fallen by an average of 17%. After three years, the number of heart attacks had dropped by 36%.
"This study adds to the already strong evidence that secondhand smoke causes heart attacks, and that passing 100% smoke-free laws in all work places and public places is something we can do to protect the public," Dr Lightwood said.
Heart attacks may fall more modestly in Britain than other European countries because many workplaces imposed smoking bans before nationwide laws were passed.
A second review, by David Meyers at the University of Kansas, drew on 10 studies from the same regions. His report, which is published in the Journal of the American College of Cardiology, found heart attacks had fallen by 17% on average a year after smoking bans were imposed. Most of the benefit was seen among young people and non-smokers.
Smoking doubles the risk of heart attack by making blood clots form more easily and, in the longer term, by hardening the arteries. Passive smokers, who regularly inhale tobacco fumes from others, have around a 30% greater risk of heart attack.
Nearly 10m people in Britain smoke and around 114,000 die each year of smoking-related diseases. According to figures released by the Department of Health today, the NHS has saved 70,000 lives by supporting those who want to quit.
"The public smoking ban is the single most important and cost-effective health policy we have. The amount of money it will save the NHS is enormous," said John Britton, director of the UK Centre for Tobacco Control Studies at Nottingham University.
2007年在英國和威爾士的酒吧和其它公共場所推行禁煙令。照片:Danny Lawson/PA
研究者說在世界某些地區(qū)公共場所實(shí)行禁煙令能減少心臟病發(fā)作1/3以上。
兩個(gè)獨(dú)立的健康評論發(fā)現(xiàn),在實(shí)行禁煙令的地區(qū)心臟病發(fā)作率急劇下降,在無煙立法之后3年報(bào)告病例少于36%.
2007年在英國和威爾士禁止在酒吧、餐館和其它公共場所吸煙,一年之后類似法規(guī)在蘇格蘭實(shí)行。蘇格蘭人禁令導(dǎo)致在隨后一年心臟病發(fā)作住院人數(shù)下降14%.
在英國和威爾士衛(wèi)生部心臟病發(fā)作率研究一直到下一年才做出報(bào)告,但專家認(rèn)為區(qū)域病例數(shù)由于禁煙令的結(jié)果早已下降到10%.
最新的評論,是根據(jù)美國、加拿大、法國、意大利、愛爾蘭和蘇格蘭公布的研究,提出在英國心臟病發(fā)作,甚至在未來兩年會進(jìn)一步減少。
舊金山加利福尼亞大學(xué)的衛(wèi)生經(jīng)濟(jì)學(xué)家和美國循環(huán)(Circulation)雜志公布一個(gè)評論的作者之一James Lightwood說:"顯然我們不能把心臟病發(fā)作率下降到零,這些發(fā)現(xiàn)帶給我們的證據(jù),短到中期之內(nèi),禁煙能防止許多心臟病發(fā)作".
Lightwood博士分析了施行禁煙法的一些國家或州區(qū)心臟病發(fā)作公布的13個(gè)報(bào)告。禁煙令實(shí)行一年之后,心臟病發(fā)作平均下降17%.3年之后心臟病發(fā)作數(shù)字下降36%.
"這研究增加了先前的強(qiáng)有力證據(jù),吸二手煙引起心臟病發(fā)作,在所有工作區(qū)和公共場所我們能為保護(hù)公眾做些事情,100%通過禁煙令。" Lightwood博士說。
在英國心臟病發(fā)作降低比歐洲其它國家更明顯,因?yàn)楹芏喙ぷ鲌鏊趪彝ㄟ^立法之前就已經(jīng)強(qiáng)行禁煙了。
第二個(gè)評論是由堪薩斯大學(xué)的David Meyers從同區(qū)的10個(gè)研究得出的。他的報(bào)告在美國心臟病學(xué)會雜志公布,發(fā)現(xiàn)在實(shí)行禁煙令一年之后心臟病發(fā)作平均下降17%.在青年人和非吸煙者看到更大效益。
因?yàn)楦菀仔纬赡扉L日久,形成動脈硬化使吸煙者心臟病發(fā)作的危險(xiǎn)成倍增加。被動吸煙,規(guī)律地吸入他人排放的煙氣,心臟病發(fā)作的危險(xiǎn)會提升30%.
在英國有近1000萬人吸煙,每年約有114,000人因吸煙相關(guān)疾病斃命。按衛(wèi)生部今天發(fā)表的數(shù)字,英國國民健康保險(xiǎn)制度(NHS)支持戒煙者拯救70,000人的生命。
諾丁漢大學(xué)英國煙草控制研究中心主管John Britton說:"公共禁煙令是我們的最重要和低成本高效健康政策。"