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Smoking bans protect nonsmokers, report says

By Lauran Neergaard
Associated Press / October 16, 2009

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WASHINGTON - A major report confirms what health officials have long believed: Bans on smoking in restaurants, bars, and other gathering spots reduce the risk of heart attacks among nonsmokers.

“If you have heart disease, you really need to stay away from secondhand smoke. It’s an immediate threat to your life,’’ said Dr. Neal Benowitz of the University of California at San Francisco, who cowrote yesterday’s report from the Institute of Medicine.

More than 126 million nonsmoking people in the United States are regularly exposed to someone else’s tobacco smoke. The surgeon general in 2006 cited overwhelming scientific evidence that tens of thousands die each year as a result, from heart disease, lung cancer, and other illnesses.

Yet smoking bans have remained a hard sell, as lawmakers and business owners debate whether such prohibitions are worth the anger from smoking customers and employees.

“The evidence is clear,’’ said Dr. Thomas Frieden, head of the US Centers for Disease Control and Prevention, which requested the study. “Smoke-free laws don’t hurt business . . . but they prevent heart attacks in nonsmokers.’’

Among the report’s conclusions: While heavier exposure to secondhand smoke is worse, there is no safe level. It also cited compelling if circumstantial evidence that even less than an hour’s exposure might be enough to push someone already at risk of a heart attack over the edge.

That’s because within minutes, the smoke’s pollutionlike small particles and other substances can start constricting blood vessels and increasing blood’s propensity to clot, both key heart attack factors. Yet many people do not know they have heart disease until their first heart attack, making it important for everyone to avoid secondhand smoke, Benowitz said.

Many of the institute’s committee members were skeptical they would find much benefit from the bans, said statistician Stephen Feinberg of Carnegie Mellon University. He called himself “the resident skeptic’’ who changed his mind.

“There was a clear and consistent effect of smoking bans,’’ Feinberg said.

Twenty-one states and the District of Columbia have what the CDC calls comprehensive laws banning smoking. That means 41 percent of Americans are as protected in public from secondhand smoke as possible, Frieden said. Just 5 percent of the world’s population is covered by comprehensive laws.

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