The Lie That Secondhand Smoke Causes Heart Disease

Corrupt Charlatans at the Institute of Medicine Based Their Fraudulent Report on Deliberate Concealment of the Evidence!

They performed no new studies, and merely uncritically regurgitated "published and unpublished data and testimony on the relationship between secondhand smoke and short-term and long-term heart problems." They ignored the CDC and other data on death rates which shows no discernable effect of smoking bans, and which furthermore reveals that the authors of the anti-smoking studies cynically cherry-picked their study periods and control populations. This data is freely accessible to the public, AND TO THE MEDIA, WHO UNQUESTIONINGLY PARROT THEIR FLAGRANT LIES AS TRUTH. (Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. National Academies Press, 2009.)

Secondhand Smoke Exposure and Cardiovascular Effects / NAP 2009 Press Release

These vermin are corrupt ideologues, not scientists, because they refuse to examine any evidence which does not support their preordained conclusions and their totalitarian social engineering agenda. In fact, they are the exact OPPOSITE of real scientists, and perfect examples of lying PROSTITUTES in the service of POLITICIANS.

Workplace Smoking Bans Don't Reduce Heart Disease Death Rates

The four states which banned smoking in most workplaces during 2002-2003 did not experience dramatic drops in the rate of death from acute myocardial infarction during the year after their smoking bans were implemented. They also have not experienced greater declines in death rates from acute myocardial infarction than the rest of the United States. Connecticut banned smoking in the workplace, including restaurants and bars, but exempting casinos and private clubs, as of Oct. 1, 2003. Delaware banned smoking in all public buildings and workplaces including bars, restaurants, and casinos, as of Nov. 27, 2003. Florida banned smoking in the workplace (including all restaurants), with stand-alone bars and smoking rooms in hotels exempt, as of July 1, 2003. South Dakota banned smoking in most workplaces, except bars and casinos, in July 2002.

US-4ami

CDC Data File, Acute Myocardial Infarction, State of Connecticut, 1999-2005
CDC Data File, Acute Myocardial Infarction, State of Delaware, 1999-2005
CDC Data File, Acute Myocardial Infarction, State of Florida, 1999-2005
CDC Data File, Acute Myocardial Infarction, State of South Dakota, 1999-2005
CDC Data File, Acute Myocardial Infarction, United States (minus 4), 1999-2005

The Massachusetts Smoking Ban Study

The anti-smokers claimed that, "The study, conducted by the state Department of Public Health and the Harvard School of Public Health, shows that a steep decline in heart attack deaths started as Boston and most of its neighbors adopted bans. Enforcement of the statewide law beginning in mid-2004 coincided with a further reduction, the study found. From 2003 to 2006, heart attack deaths in Massachusetts plummeted 30 percent, significantly accelerating what had been a more modest long-term decline." Dr. Michael Siegel, a phony critic of the anti-smokers who doesn't tell the rest of the story, claimed that "You can no longer argue that these declines would have occurred simply due to medical treatment." (Smoking ban tied to a gain in lives. By Stephen Smith. Boston Globe, Nov. 12, 2008.) Boston, Watertown, Saugus and Framingham banned smoking in May 2003. In Boston, it was banned everywhere but outdoors and in private homes, hotel rooms and some cigar bars. Cambridge banned smoking in all workplaces, including bars and restaurants, including all bars and restaurants, on June 9, 2003.

"'When we looked at the data, we saw a dramatic drop in heart attack deaths beginning in July, 2005 — a year after the workplace smoking ban went into effect. While there may be several factors that played a role in this decline, we believe the single most compelling reason was reduced exposure to secondhand smoke in workplaces across the state,' DPH Commissioner John Auerbach said." They promised that the study would be published early next year with estimates of the cost savings [sic] to the Massachusetts health care system. (Massachusetts Sees Fewer Heart Attack Deaths Since Implementation of Smoke-Free Workplace Law. Press Release, Massachusetts Department of Public Health, Nov. 12, 2008.)

In 1999, the age-adjusted death rate from acute myocardial infarction in the United States (minus four states which had statewide workplace bans prior to 2004) was 73.2 per 100k, and in 2005 it was 49.1. In Massachusetts. the respective rates were 60.8 and 41.2. Thus, in 2005, the death rate from AMI in the US (minus states that had statewide workplace bans) was at 67.1% of its former level, while in Massachusetts it was at 67.8% of its former level. So, the rate of decline in AMI death rates in Massachusetts since 1999 was no different from that of the rest of the United States as of 2005, the year after the smoking ban took effect.

CDC Data File, Acute Myocardial Infarction, State of Massachusetts, 1999-2005

The Pueblo, Colorado Smoking Ban Heart Attack Study

They don't even know if patients were exposed to either active or secondhand smoke, nor whether they even went to a bar. Furthermore:

"A critical piece of information is omitted from both the Pueblo Health Department press release and from the Campaign for Tobacco-Free Kids press release: that the expected number of heart attacks during the six-month period preceding the Pueblo smoking ban is substantially higher than the expected number of heart attacks during the six-month period after the Pueblo smoking ban. The reason for this is that the six-month period preceding the Pueblo smoking ban includes the winter months, while the six-month period following the Pueblo ban includes the summer months, and heart attack admissions during the winter have been shown to be substantially higher than during the summer. Since there were two winters and only one summer in the 18-month baseline period (before the smoking ban in Pueblo) and only one winter but two summers in the follow-up period (after the smoking ban), one would expect to see a decrease in the number of reported heart attacks, even in the absence of a smoking ban. In fact, there are 53% more cases of acute myocardial infarction (heart attacks) during the winter compared to the summer (see: Spencer FA, Goldberg RJ, Becker RC. Seasonal distribution of acute myocardial infarction in the Second National Registry of Myocardial Infarction. Journal of the American College of Cardiology 1998; 31:1226-1233). In the Mountain region of the country (which includes Colorado), there are 50.3% more heart attacks during the winter than the summer." (New Study Links Smoke-Free Ordinances to Fewer Heart Attacks. The Pueblo City-County Health Department. PR Newswire, Nov. 14, 2005; Premature Conclusions from Pueblo: More Information and More Research Needed Before Taking this to the Public. By Michael Siegel. Nov. 19, 2005.) This is a good reason to look at the data for twelve-month periods.

Pueblo City-County Health Department, Nov. 14, 2005 / PR Newswire

"Dr. Donald Lavan, a cardiologist at the University of Pennsylvania and a heart association spokesman, called the study preliminary but important. 'We know that when people stop smoking, we start to see improvements in six months for the individual,' but this study shows the benefit to the community as well, he said. 'It reaffirms the fact that secondhand smoke is deleterious to all people,' Lavan said." (Study: Heart Attacks Drop With Smoking Ban. Nov. 14, 2005 (AP).

The study was finally published in late 2006. (Reduction in the incidence of acute myocardial infarction associated with a citywide smoking ordinance. C Bartecchi, RN Alsever, C Nevin-Woods, WM Thomas, RO Estacio, BB Bartelson, MJ Krantz. Circulation 2006 Oct 3;114(14):1490-6.) The decitful title lies that the smoking ban reduced the incidence of acute myocardial infarctions, when they only determined there was a reduction in hospital admissions under that diagnosis. Hospital admissions in fact are a matter of hospital admission policies, which are entirely under the [anti-smoker] doctors' control. The only thing necessary to achieve a "reduction" in admissions (without compromising patient survival) is to deliberately admit patients too freely in the period before the ban, then go back to a more restrictive admission policy afterward. However, there is probable cause to suspect that patients' health was sacrificed, because the death rates from AMI rose during the period after the ban.

Bartecchi / Circulation 2006 full article

Heart Disease Death Rates in Pueblo County versus El Paso County

Death rates from acute myocardial infarction in Pueblo County increased the year after the ban.

The smoking ban in the city of Pueblo began in July 2003. The anti-smokers compared the rates of hospitalization for acute myocardial infarction during the 18-month period before the ban, beginning in January 2002, with the 18-month period after the ban began, ending in December 2004; and added a second follow-up from January 2005 to June 2006. They also compared it with the larger, ban-free neighboring county of El Paso, whose largest city is Colorado Springs. In contrast to their boasts of reduced hospitalizations for acute MI with false implications of a rapid improvement in public health, in Pueblo County the death rates from AMI rose from 36.9 in 2002 to 43.9 per 100,000 in 2004, while declining slightly in El Paso County, where there was no ban either in its largest city or anywhere within the county. About two-thirds of the approximately 150,000 people in Pueblo County live in the City of Pueblo.

Pueb-AMI

Pueb-IHD

Deaths from all ischemic heart disease are predominantly due to chronic IHD, with acute myocardial infarctions in second place. There were 831 deaths from chronic ischemic heart disease and 490 deaths from AMI in Pueblo County from 1999 to 2005; and 2159 deaths from chronic IHD and 848 from AMI in El Paso County during the same period. The seven-year average of death rates from all IHD of the two adjoining counties are remarkably similar, 110.9 and 113.9 (age-adjusted) respectively, despite 22.6% smokers in Pueblo County versus 17.7% smokers in El Paso County. (CDC Compressed Mortality File 1999-2005, http://wonder.cdc.gov/cmf-icd10.html.)

CDC Data File, Acute Myocardial Infarction, El Paso County CO, 1999-2005
CDC Data File, Acute Myocardial Infarction, Pueblo County CO, 1999-2005
CDC Data File, Acute Myocardial Infarction, State of Colorado, 1999-2005

On Jan. 2, 2009, the anti-smokers iniated a new barrage of propaganda with the extended analysis (Reduced Hospitalizations for Acute Myocardial Infarction After Implementation of a Smoke-Free Ordinance --- City of Pueblo, Colorado, 2002--2006. Reported by: RN Alsever, MD, Parkview Medical Center; WM Thomas, PhD, St. Mary-Corwin Medical Center; C Nevin-Woods, DO, R Beauvais, S Dennison, R Bueno, Pueblo City-County Health Dept; L Chang, PhD, Colorado State Univ-Pueblo; CE Bartecchi, MD, Univ of Colorado School of Medicine. S Babb, MPH, A Trosclair, MS, M Engstrom, MS, T Pechacek, PhD, R Kaufmann, PhD, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. MMWR Weekly 2009 Jan 2;57(51)1373-1377). An editorial proclaimed that "These findings provide support for considering smoke-free policies an important component of interventions to prevent heart disease morbidity and mortality." Obviously, this is a delieberate lie, because the CDC sits upon the pile of data which proves otherwise.

Alsever et al. / MMWR 2009 full article

No Net Reduction of Ischemic Heart Disease Deaths in Greeley, Either

The reporter from the Rocky Mountain News burbled that, "Like Pueblo, in 2003, Greeley banned smoking in restaurants, bars, businesses and other places where people gather. Several cities, including Greeley, found that heart attacks went down in the 18 months after a smoking ban began. The number of heart attacks in Greeley, for example, dropped by 16 percent in Greeley, according to the University of Colorado Health Sciences study." (Study links smoking bans, heart attack rate. By Bill Scanlon. Rocky Mountain News, Jan. 2, 2009.)

In Greeley, Weld County, Colorado, a smoking ban was enacted in December 2003. The age-adjusted death rates from all ischemic heart disease had declined since 1999 and reached a low of 115.9 per 100,000 in 2003, then rose slightly to 124.6 in 2005. The death rates of chronic ischemic heart disease and acute myocardial infarction both fell until 2002, then sharply diverged in 2003. AMI death rates remained stable, while CHD death rates rose. During 1999-2002, the death rates from AMI and CHD had been approximately equal, but by 2005 the death rates from CHD were more than twice those of AMI. So, there has been no miraculous reduction in heart disease deaths in Greeley after all. (Data source: Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1999-2005. CDC WONDER On-line Database, compiled from Compressed Mortality File 1999-2005 Series 20 No. 2K, 2008. Accessed at http://wonder.cdc.gov/cmf-icd10.html on Jan. 3, 2009.)

Greeley

CDC Data File, Acute Myocardial Infarction, Weld County CO, 1999-2005
CDC Data File, Chronic Ischemic Heart Disease, Weld County CO, 1999-2005

The Helena, Montana Smoking Ban Heart Attack Study

This study was recycled from over a year before, and it is garbage because they don't even know if patients were exposed to secondhand smoke, nor whether they even spent any appreciable time in a smoke-free workplace (most heart attack victims are over 65 years of age)

Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. Richard P. Sargent, Robert M. Shepard, Stanton A. Glantz. BMJ 2004 Apr 24;328:977-980. Glantz's two co-authors were attending physicians at St Peter's Community Hospital in Helena, Montana, "a geographically isolated community with one hospital serving a population of 68 140." "The attending physician made the diagnosis at the time of discharge, and the hospital billing staff assigned the codes. (Two of the authors (RPS and RMS) were attending physicians for 18 of the 304 admissions included in this study and so assigned the diagnosis." [So, two of the authors were in a position to directly influence the admission rates. And the isolation they cite as a study strength makes collusion with others likely -cast] They admit that "We did not make any direct observations to measure how much exposure to secondhand smoke was reduced during the months when the law was in force. We do not know the prevalence of smoking in venues covered by ban, though the city-county health department reported that all but two businesses complied."

Sargent - BMJ 2004 full article / PubMed Central

(Mont. Smoking Ban Cuts Heart Attacks. By Daniel Q. Haney, AP Medical Editor aka corrupt anti-smokers' whore. DATE: APRIL 1, 2003. [<= HINT: April Fool's Day.]) "Sargent, who with co-author Dr. Robert Shepard encouraged passage of the ordinance, presented the data Tuesday to applause at the annual scientific meeting in Chicago of the American College of Cardiology." They were presumably applauded for their willingness to commit fraud.

Mont. Smoking Ban Cuts Heart Attacks / CigOutlet.net

Even veteran anti-smokers such as G.C. Kabat reject this study. (Effect of Public Smoking Ban in Helena, Montana. Geoffrey C. Kabat. BMJ 2004 Jun 5;328(7452):1379.) "Firstly, the researchers had no information on whether exposure to second hand smoke changed as a result of the ban. They also did not present any information on whether smoking habits were affected by the ban. If the study was concerned to isolate an effect of second hand tobacco smoke, it should have been restricted to the 33% of the study population who were never smokers.... Finally, the "immediate effect" should make anyone stop and question the connection the authors are asserting. There are few interventions in public health that have such an immediate impact. Even if all active smokers in Helena had quit smoking for at least a year, one would not expect to see such a dramatic effect. The attempt to make claims about the effects of smoking bans based on this very weak ecological study raises disturbing questions about our ability to distinguish between sound science and wishful thinking." [This last is an understatement. The publication of a study such as this merely proves the willingness of anti-smokers in general and the British Medical Journal in particular to indulge in scientific fraud and misrepresentation, in order to push their political agenda -cast]

Kabat / BMJ 2004 full article

Heart Disease Death Rates in Lewis and Clark County, Montana

The Helena study "compared the number of admissions during the six months the law was in effect (in 2002) with the average number of admissions during the same six months in the years before (1998-2001) and after (2003) the law," with 304 cases altogether. They claimed that "During the six months the law was enforced the number of admissions fell significantly (- 16 admissions, 95% confidence interval - 31.7 to - 0.3), from an average of 40 admissions during the same months in the years before and after the law to a total of 24 admissions during the six months the law was effect." Smoking was banned in Helena, Montana, from June 5, 2002, to December 3, 2002. But, death rates from acute myocardial infarction were nearly identical in 2001 and 2002, and reached their lowest point in 2003, the year after the smoking ban was repealed.

Helena

Montana

CDC Data File, Acute Myocardial Infarction, Lewis and Clark County MT, 1999-2005
CDC Data File, Acute Myocardial Infarction, State of Montana, 1999-2005

The New York State Smoking Ban Study

"New York State enacted limited statewide smoking restrictions in 1989. The restrictions limited or prohibited smoking in many public places including schools, hospitals, public buildings, and retail stores. Employers were required to develop smoking policies and provide smoke-free work areas upon employee request. Larger restaurants were required to establish nonsmoking sections. Countywide smoking restrictions began in 1995 when Suffolk County and the 5 New York City counties implemented laws that restricted smoking in restaurants. By 2002, 75% of New Yorkers were subject to local smoking restrictions that were stronger than the state law. Many of these local laws completely banned smoking in workplaces and some expanded restrictions on smoking in restaurants. None limited smoking in bars. On July 24, 2003, New York implemented a statewide comprehensive smoking ban that prohibited smoking in all workplaces including restaurants and bars. After implementation of the statewide law, population exposure to environmental tobacco smoke declined nearly 50%. Cotinine levels in the saliva from a representative sample of New York State adults, declined from 0.078 ng/mL to 0.041 ng/mL. Nassau County and New York City implemented similar comprehensive bans in March 2003." They claimed that "In 2004, there were 3813 fewer hospital admissions for acute myocardial infarction than would have been expected in the absence of the comprehensive smoking ban. Direct health care cost savings of $56 million were realized in 2004." Specific details about patient smoking status or exposure to environmental tobacco smoke were not known. (Declines in Hospital Admissions for Acute Myocardial Infarction in New York State After Implementation of a Comprehensive Smoking Ban. HR Juster, BR Loomis, TM Hinman, MC Farrelly, A Hyland, UE Bauer, GS Birkhead. Am J Public Health 2007 Nov;97(11):2035-2039.)

Juster - Am J Public Health 2007 abstract / PubMed
Juster - Am J Public Health 2007 full article / Medscape

Heart Disease Death Rates in New York

Differences in the death rates from acute myocardial infarction between New York City and the rest of the state (minus the five boroughs of New York City, which are coextensive with five counties, and Suffolk and Nassau Counties) were smaller before the draconian ban on all indoor smoking was imposed on the entire state.

NY-AMI

New York City's death rates from chronic ischemic heart disease are much higher than those of the rest of the state (minus the seven counties), and chronic IHD deaths, not acute myocardial infarctions, are the largest component of all ischemic heart disease deaths.
NY-CHD

New York City's death rates from all ischemic heart disease have likewise been higher than those in the rest of the state; and, despite New York City's embrace of smoking bans, the gap has widened.

NY-IHD

The Indiana Smoking Ban Study

The anti-smokers exploited an anomalous spike in AMI death rates.

In all years from 1999 to 2005 except 2001, the death rates from acute myocardial infarction in Monroe County were somewhat lower than in Delaware County. In 2001, there was an anomalous spike in the AMI death rates in Monroe County. They rose from 58.7 to 77.9 per 100,000, then fell in 2002. The pre-ban study period was from Aug. 2001 to May 2003, and likely included extra admissions during the spike. These inflated heart attack admission rates in the pre-ban period were compared with the post-ban period from Aug. 2003 to May 2005. Delaware County and Monroe County have experienced nearly identical slight declines in their AMI death rates from 2003 to 2005.

Indiana

CDC Data File, Acute Myocardial Infarction, Delaware County IN, 1999-2005
CDC Data File, Acute Myocardial Infarction, Monroe County IN, 1999-2005
CDC Data File, Acute Myocardial Infarction, State of Indiana, 1999-2005

(Reduced admissions for acute myocardial infarction associated with a public smoking ban: matched controlled study. DC Seo, MR Torabi. J Drug Educ 2007;37(3):217-226.)

Seo & Torabi - J Drug Educ 2007 abstract / PubMed
Seo & Torabi - J Drug Educ 2007 full article / Tobacco Technical Assistance Consortium (pdf, 10 pp)

The Ohio Smoking Ban Study

The anti-smokers used a non-typical county for comparison.

The anti-smokers claimed that rates of hospitalization for angina, heart failure, atherosclerosis and acute myocardial infarction in Bowling Green, Ohio, significantly declined from 2002 to the first half of 2005, while those in Kent, Ohio did not significantly change. However, Portage County (Kent) had lower death rates from all ischemic heart disease to begin with, and the decline in Wood County (Bowling Green) was nearly identical to the decline in the state as a whole, which had no statewide ban. (The impact of a smoking ban on hospital admissions for coronary heart disease. SA Khuder, S Milz, T Jordan, J Price, K Silvestri, P Butler. Prev Med 2007 Jul;45(1):3-8.)

Khuder - Prev Med 2007 abstract / PubMed
Review of Khuder et al / ProCor

Ohio

CDC Data File, All Ischemic Heart Disease, Portage County OH, 1999-2005
CDC Data File, All Ischemic Heart Disease, Wood County OH, 1999-2005
CDC Data File, All Ischemic Heart Disease, State of Ohio, 1999-2005

The North Carolina Smoking Ban Study

Admission rates for heart attacks stopped declining after the ban.

"A team of researchers from the Division of Public Health and the University of North Carolina Department of Emergency Medicine used statewide emergency department data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NCDETECT) to examine rates of heart attacks before the law in 2008 and 2009 compared to rates after the law took effect in 2010. These results add to a growing number of studies documenting the health benefits of smoke-free legislation across the nation and the world. 'North Carolina’s experience in seeing reduced heart attack rates after implementation of smoke-free legislation is consistent with others that have taken this important step to enhance the population’s health,' Dr. David Goff of the Justus Warren Heart Disease and Stroke Task Force said. 'Informed by this strong evidence, we should now act to protect all workers in North Carolina, not just those working in restaurants and bars, from the hazards of second hand smoke.'" (N.C. Heart Attack Rates Down Since Passage of Smoke-Free Law. Press Release, Nov. 9, 2011.)

N.C. Heart Attack Rates Down / NC DHHS

In fact, the report says that "In North Carolina, the number of ED visits for AMI decreased from 2008 to 2010. This trend was consistent for the entire population of North Carolina (Table 1). Interestingly, the rates appear to have consistently declined between the year 2008 and 2009; after that period the rates leveled off at a consistently lower level in the year 2010 (Figure 1)." (The North Carolina Smoke Free Restaurants and Bars Law and Emergency Department Admissions for Acute Myocardial Infarction. The NC Tobacco and Prevention Contol Branch: Sally Herndon, Jim Martin, Ann Houston Staples, Molly Aldridge.) The rate of admissions for acute myocardial infarctions stopped declining in mid-2009, before the implementation of the smoking ban, as clearly shown by the graph on page 4.

The North Carolina Smoke Free Restaurants and Bars Law / NC DHHS (pdf, 8pp)
NCami

The Scottish Smoking Ban Acute Coronary Syndrome Study

The anti-smokers compared the number of hospital admissions for acute coronary syndrome during a ten-month period following the ban on indoor smoking in public places in Scotland, with the ten-month period preceding the ban. They crowed that "the number of admissions for acute coronary syndrome decreased from 3235 to 2684 — a 17% reduction (95% confidence interval, 16 to 18) — as compared with a 4% reduction in England (which has no such legislation) during the same period and a mean annual decrease of 3% (maximum decrease, 9%) in Scotland during the decade preceding the study." They and their media propaganda organs ballyhooed it as proof that smoking bans saved lives. (Smoke-free legislation and hospitalizations for acute coronary syndrome. JP Pell, S Haw, S Cobbe, DE Newby, AC Pell, C Fischbacher, A McConnachie, S Pringle, D Murdoch, F Dunn, K Oldroyd, P Macintyre, B O'Rourke, W Borland. N Engl J Med 2008 Jul 31;359(5):482-491.)

Pell - N Engl J Med 2008 abstract / PubMed

But a few months after the end of their study period, the number of hospital admissions for acute coronary syndrome sharply increased!

ScotBan

The increase in the number of admissions for acute coronary syndrome was not paralleled by increases in the numbers of admissions for acute myocardial infarction or stroke, which continued their long-term decline.


Seasonally identical 12-month periods
ACS
AMI
Stroke
All
Apr-05 to Mar-06 7899 8300 7896 24095
Apr-06 to Mar-07 7264
7764
7843
22871
Apr-07 to Mar-08
8926
7286
7569
23781

Hospital Activity. AC5 - Emergency admission: heart attack/angina/stroke, by NHS board, 2005-2008 (by month). Information Services, NHS National Services Scotland.

Emergency admission: heart attack/angina/stroke / ISD Scotland (xls)

Coronary Heart Disease. Full List of Tables. Information Services, NHS National Services Scotland. Page last updated: 25-NOV-2008.

Coronary Heart Disease / ISD Scotland

The Irish Smoking Ban Study

(Impact of a national smoking ban on the rate of admissions to hospital with acute coronary syndromes. E Cronin, P Kearney, P Sullivan. Presented at the annual scientific symposium of the European Society of Cardiology, 2007. Citation: European Heart Journal 2007;28(Abstract Supplement):585.)

Purpose: A ban on smoking in public places was introduced in Ireland on the 29th of March 2004. As both active and passive smoking are risk factors for coronary atherosclerosis, this might be expected to lead to a decrease in the number of patients presenting with acute coronary syndromes (ACS).

Methods: We analysed data collected in a continuous registry of all patients admitted to hospital with ACS in the south-western region, catchment population 620,525, to ascertain whether the ban has led to a decrease in the number of presentations to hospital with ACS.

Results: In the year ending 28th March 2004, there were 1277 admissions with ACS. In the year 29/03/2004 to 28/03/2005 there were 1092 admissions with ACS. This represents an absolute decline of 185, or 14.5%. The absolute decline was similar in males and females (15.6% and 12.0% respectively), but greater in smokers than in non-smokers (22.8% vs. 10.46%). The results are not accounted for by trends in hospital admissions with ACS in the preceding nine months.

Conclusions: A national ban on smoking in public places resulted in a decrease in admissions for ACS, especially in smokers. Our study provides evidence of the rapid effect of banning smoking in public places on decreasing the burden of ACS."

Search page / European Society of Cardiology

The lie-spewing media breathlessly proclaimed that "More than 17,000 heart attacks could be prevented in the UK after smoking in public places was banned, a conference heard yesterday. It could mean one in seven of the 123,000 heart attacks annually across the UK could be prevented if the results were replicated." Dr Edmond Cronin, of Cork University Hospital in Ireland, lied outright: "A national ban on smoking in public places resulted in a decrease in admissions for heart attack, especially in smokers. Our study provides evidence of the rapid effect of banning smoking in public places on decreasing the burden of heart attacks." (Smoking ban 'reduces heart attack rate'. By Rebecca Smith. The Telegraph, Sep. 5, 2007.)

These claims are a lie, because they used the admission rates of only nine months before as their baseline, and disregard the fact that a strong decline in heart disease deaths was already occurring, which began long before the smoking ban began on on March 29, 2004!

Cause of Death 1998
1999
2000
2001
2002
2003
2004
2005
2006
Ischaemic Heart Disease
7,240 7,059
6,589
6,163
6,107
5,583
5,485
5,064
4,860

(Deaths from principal causes registered in the years 1998 to 2006. Central Statistics Office Ireland, accessed 9-5-07.)

Deaths from principal causes registered in the years 1998 to 2006 / Central Statistics Office Ireland

The Reuters writer used the story as a pretext for a general spew-fest, but admitted that, "There was no significant change in heart attacks in the second year after the ban, indicating a possible step change in medical outcomes." (Heart attacks tumble after Irish smoking ban. By Ben Hirschler. Reuters, Sep 4, 2007.) Because actual heart disease deaths continued to decline during this period, the drop in admissions most likely reflects a "step change" in the admission policy, not the outcome! (For example, British doctors were historically less likely to admit patients for a heart attack than doctors in the U.S., with no difference in outcome.)

The Truth

Heart disease death rates have fallen steadily since 1961 to levels below those of the year 1900. (Fig. 1. In: Achievements in Public Health, 1900-1999: Decline in Deaths from Heart Disease and Stroke -- United States, 1900-1999. MMWR 1999 Aug 6;48(30):649-656.)

HDrates

The decline in death rates since 1970 has been as large among smokers as among non-smokers: When the sharp decline in heart disease death rates began in the United States in the 1960s, it was the same in smokers as in non-smokers: "Nonsudden CHD death decreased by 64% (95% CI 50% to 74%, Ptrend<0.001), and SCD rates decreased by 49% (95% CI 28% to 64%, Ptrend<0.001). These trends were seen in men and women, in subjects with and without a prior history of CHD, and in smokers and nonsmokers." (Temporal trends in coronary heart disease mortality and sudden cardiac death from 1950 to 1999: the Framingham Heart Study. CS Fox, JC Evans, MG Larson, WB Kannel, D Levy. Circulation 2004 Aug 3;110(5):522-527.) The decline in cigarette smoking has been much greater in middle-aged men than in middle-aged women, which is not at all in accord with the equivalence in the decline in mortality for the sexes. The decline in this study parallels the decline nationwide, and it began before there were any appreciable number of smoking bans. The quote is from the abstract.

Fox / Circulation 2004 full article
Fox / Circulation 2004 abstract

For political reasons, the anti-smokers have suppressed the hypothesis that smokers and non-smokers have merely been exposed at different rates to the real causal factor(s), and that their respective rates of heart disease have declined as population-wide exposure declines. This is the hypothesis which best fits the evidence!

For socioeconomic reasons, smokers and passive smokers are more likely to have been exposed to infectious causes of heart disease, such as cytomegalovirus. The anti-smokers' studies deliberately ignore the role of infection, in order to falsely blame active smoking and secondhand smoke for the excess. This is the reason that the pretended effects of secondhand smoke are so similar to the pretended effects of active smoking.

CMV & other infections cause heart disease

The "Heart Rate Variability" Scam

Effects of passive smoking on heart rate variability, heart rate and blood pressure: an observational study. D Felber Dietrich, J Schwartz, C Schindler, JM Gaspoz, JC Barthélémy, JM Tschopp, F Roche, A von Eckardstein, O Brändli, P Leuenberger, DR Gold, U Ackermann-Liebrich. Int J of Epidemiol 2007;36(4):834-840. [This is a Joel Schwartz/Harvard School of Public Health study, which means that they grind an ax promoting hysteria about particulates, and always ignore infection.] This study claimed to find lower LF power (~199 vs. ~234 ms²), higher heart rate (~75.3 vs. ~73.4 bpm), and higher diastolic blood pressure (~83.3 vs. ~81.8 mmHg) in ETS-exposed >2h/d vs. nonexposed subjects (estimated from Fig. 2). However, these are not the direct measurements of those values, they have all been jiggered by being "adjusted for study site, sex, age, education, BMI, diabetes and beta-blocker intake."

They claim that "Our study provides further evidence that ETS exposure is associated with cardiac autonomic dysregulation, which may be an intermediate step in the pathway to cardiac instability;" and that "LF, which is considered to represent both sympathetic and parasympathetic activities, was lower in subjects with higher ETS exposure. We also observed ETS-associated increases in heart rate and, more weakly, in DBP, consistent with increases in sympathetic stimulation." [Except that this claim that LF is associated with cardiac sympathetic innervation and function is bogus: "Several previous investigations have cast doubt on the validity of LF power as a measure of sympathetic activity, because of dissociations between LF power and cardiac norepinephrine spillover, directly recorded sympathetic nerve traffic, and plasma norepinephrine levels (4,6,23). Such dissociations are especially glaring in patients with congestive heart failure, which is characterized by decreased LF power (11) despite marked cardiac sympathetic activation." Moak, 2007].

This study admits that the small differences between ETS-exposed and non-exposed subjects were present 24 hours a day (i.e., when no exposure to ETS occurred): "Since few people are exposed to ETS during sleep, we restricted analyses to the sleep period, when acute exposure can be excluded and found results similar to those of the 24-h measures. Therefore, we think that our findings do not reflect acute responses." But, when the same differences are present during non-exposure as during acute exposure, the only conclusion that could legitimately be drawn is that ETS exposure does not produce those differences in the first place. However, rather than making the valid deduction that those differences were probably due to small pre-existing differences in health conditions between the exposed and the non-exposed subjects which were not accounted for in their analysis, these charlatans spout pseudo-scientific mumbo-jumbo:

"ETS may affect autonomic control of the heart through activation of neural receptors of the respiratory tract. On the other hand, gaseous components, soluble fractions of the particulate component and ultrafine particle components of ETS may be absorbed in the lung and have additional systemic effects. In the experimental setting, chronic ETS exposure has been shown to increase proinflammatory cytokines and arterial resistance, to decrease concentrations of antioxidants and to increase lipid peroxidation. We found no evidence of ETS-associated increases in inflammation as measured by CRP and other causal mechanisms may predominate with low-grade chronic exposure. Recent work by Bartoli and colleagues suggests that particle exposures alter barometric reflexes, a pathway through which ETS exposure might also influence HRV. Ultrafine particles are associated with oxidative stress, as well as with reduced HRV." This is nothing but a snow job! They are trying to make people believe in an effect which they could not demonstrate exists in the first place!

Felber Dietrich / Int J Epidemiol 2007 full article

Eating Causes Heart Rate Changes

Periprandial changes of the sympathetic-parasympathetic balance related to perceived satiety in humans. LF Harthoorn, E Dransfield. Eur J Appl Physiol 2008 Mar;102(5):601-608. "Subjects were exposed to a lunch-inducedhunger-satiety shift, while profiling diverse sensory, physiological, and biochemical characteristics at 15 min intervals.... Finally, neither chewing nor swallowing contributed to a heart rate increase at food consumption, but orosensory stimulation, as tested with modified sham feeding, caused a partial increase of heart rate."

Harthoorn - Eur J Appl Physiol 2008 abstract / PubMed

Heavy Drinking Causes Cardiovascular Changes

The alcohol hangover. JG Wiese, MG Shlipak, WS Browner. Ann Intern Med 2000 Jun 6;132(11):897-902. "Hangover may also be an independent risk factor for cardiac death. Symptoms of hangover seem to be caused by dehydration, hormonal alterations, dysregulated cytokine pathways, and toxic effects of alcohol. Physiologic characteristics include increased cardiac work with normal peripheral resistance, diffuse slowing on electroencephalography, and increased levels of antidiuretic hormone."

Wiese / Ann Intern Med 2000 full article

See Also:

The Surgeon General Lies That Smoking Causes Heart Disease
The EPA's ETS Lies
Infections in Peripheral Arterial Disease
The American Heart Association
How the Public Was Brainwashed About Heart Disease

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cast 04-06-12