The Impact Of Smoke-Free Legislation On Coronary Heart Disease

Coronaries And Controversy - 

06 Feb 2009   

A number of studies have been published recently showing a decline in admissions to hospital for heart attack following the implementation of smokefree laws in various countries. Many of these studies, including one on the impact of the Scottish smoking ban [1] have also been the subject of criticism by so-called "dissidents" who claim that the research is nothing more than 'junk' science. In a recently published review [2] ASH's Director of Policy and Research, Martin Dockrell, looks behind the scenes to see what has prompted this criticism and to what extent it is justified. The analysis finds parallels with those who were in denial about the causes of AIDS long after the scientific debate was over. 

The focus of the analysis was a study by Pell and colleagues of the impact of the Scottish smoke-free legislation which found that there was a 17% reduction in hospitalizations for acute coronary syndrome compared with a 4% reduction in England (which had not enacted smokefree legislation). 

The ASH review acknowledges that many of the studies have differing strengths and that no single study can ever demonstrate causation. However, even before the Scottish study was published, the headline figures attracted criticism for being "over-hasty" and constituting "junk science". 

So who was behind the protest and was it justified? Dockrell's review reveals that the strongest critics - Blastland and Dilnot [3] had in fact rejected the research before they had had the opportunity to examine it. Furthermore, ASH believes that all of their criticisms are unfounded and bear close resemblance to the views put forward by tobacco industry proponents. [4] 

Commenting on the dissidents, Martin Dockrell said: 

"While careful analytical critiques of research are welcome, the recent unwarranted attacks on the authors of the smokefree research suggest an ulterior motive. We found an unholy alliance of conspiracy theorists, tobacco industry lobbyists and journalists impatient for a good story." /.../