CASE News

March 3, 2007
Columbia Missourian
Will less smoke make Columbia more heart-healthy
By Aaron T. Ancel

Helena, Mont., was several years ahead of Columbia when its lawmakers outlawed smoking in most public places.

Its 2002 ordinance banned smoking in places of employment, indoor public places and created a smoke-free buffer surrounding entries into smoke-free buildings.

For six months after the smoking ban took effect, hospitals in the city of 28,000 saw a 40 percent decline in heart attack admissions.

That was the evidence shared by Richard Sargent, a private physician in Helena and one of the study's authors, during a recent presentation at MU's Department of Family and Community Medicine.

The number of heart attack admissions bounced back almost as quickly after the Montana State Legislature rescinded the ban six months after it became law. The Montana Supreme Court overturned the legislative action on a technicality relating to the wording of the law.

Sargent acknowledged that the link between the smoking ban and the number of heart attack patients is a correlation but not necessarily a cause-and-effect situation. To illustrate the point, he cited another study that found 43 percent of people who had suffered from a heart attack had eaten a dill pickle within a week before their attack.

On the other hand, he said, it was unlikely that the entire town started eating better, exercising more or suddenly aged. The only known change that affected everyone in Helena at the same time was the smoking ban, he said. Also, there was no change in rates for patients that lived outside Helena city limits.

A similar study in Pueblo, Colo., after the town implemented a smoking ban, found a 30 percent decrease in the rate of hospital admissions for heart attacks in an 18-month period, Sargent said.

David Sohl, a management analyst for MU Health Care, proposed a similar study in Columbia that will compare heart attack admissions in hospitals serving Columbia residents before and after the smoking ban. He will work for the Boone County/Columbia Department of Health, independent of MU, and is still in the process of looking for funding.

Because the smoking ban in Columbia took effect in January, the study may not begin for a year in order to generate adequate data, Sohl said. He said the demographics of Columbia are similar to that of Pueblo, and he expects that "similar trends will be seen here."

Both Boone Hospital Center and University Hospital will be included in the study. Both serve people from outside of Columbia, and the study may use customer billing information to weed out patients that are not affected by the ban, Sohl said.

Kevin Everett, an assistant professor in MU's Department of Family and Community Medicine, helped bring Sargent to Columbia through a grant designed to provide community education on secondhand smoke.

"There are short-term health consequences," Everett said. "The policies do what they are intended to do. They clean up the air."

According to the U.S. Surgeon General, the risk of developing heart disease increases by 25 to 30 percent for nonsmokers who are exposed to secondhand smoke at work or at home.

The Missouri Department of Health and Human Services states that, less than 2 percent of Missourians live in communities with legislation protecting employees and the public from secondhand smoke while more than half the U.S. population is protected by some form of smoking ban legislation.