Smoking ban leads to major drop in heart attacks

[RyanX]

_http://www.usatoday.com/news/health/2008-12-31-smoking-heart_N.htm?csp=34

ATLANTA (AP) — A smoking ban in one Colorado city led to a dramatic drop in heart attack hospitalizations within three years, a sign of just how serious a health threat secondhand smoke is, government researchers said Wednesday. The study, the longest-running of its kind, showed the rate of hospitalized cases dropped 41% in the three years after the ban of workplace smoking in Pueblo, Colo., took effect. There was no such drop in two neighboring areas, and researchers believe it's a clear sign the ban was responsible.

The study suggests that secondhand smoke may be a terrible and under-recognized cause of heart attack deaths in this country, said one of its authors, Terry Pechacek of the U.S. Centers for Disease Control and Prevention.

BETTER LIFE: More on smoking, alcohol and drug addiction

At least eight earlier studies have linked smoking bans to decreased heart attacks, but none ran as long as three years. The new study looked at heart attack hospitalizations for three years following the July 1, 2003 enactment of Pueblo's ban, and found declines as great or greater than those in earlier research.

"This study is very dramatic," said Dr. Michael Thun, a researcher with the American Cancer Society.

"This is now the ninth study, so it is clear that smoke-free laws are one of the most effective and cost-effective to reduce heart attacks," said Thun, who was not involved in the CDC study released Thursday.

Smoking bans are designed not only to cut smoking rates but also to reduce secondhand tobacco smoke. It is a widely recognized cause of lung cancer, but its effect on heart disease can be more immediate. It not only damages the lining of blood vessels, but also increases the kind of blood clotting that leads to heart attacks. Reducing exposure to smoke can quickly cut the risk of clotting, some experts said.

"You remove the final one or two links in the chain" of events leading to a heart attack, Thun said.

Secondhand smoke causes an estimated 46,000 heart disease deaths and about 3,000 lung cancer deaths among nonsmokers each year, according to statistics cited by the CDC.

In the new study, researchers reviewed hospital admissions for heart attacks in Pueblo. Patients were classified by ZIP codes. They then looked at the same data for two nearby areas that did not have bans — the area of Pueblo County outside the city and for El Paso County.

In Pueblo, the rate of heart attacks dropped from 257 per 100,000 people before the ban to 152 per 100,000 in the three years afterward. There were no significant changes in the two other areas.

"The need for protection from secondhand smoke in all workplaces and public places has never been clearer," said Matthew Myers of the Campaign for Tobacco-Free Kids, in a prepared statement. He is president of the Washington, D.C.-based advocacy organization.

But the study had limitations: It assumed declines in the amount of secondhand smoke in Pueblo buildings after the ban, but did not try to measure that. The researchers also did not sort out which heart attack patients were smokers and which were not, so it's unclear how much of the decline can be attributed to reduced secondhand smoke.

One academic argued there's not enough evidence to conclude the smoking ban was the cause of Pueblo's heart attack decline.

The decline could have had more to do with a general decline in smoking in Pueblo County, from about 26% in 2002-2003 to less than 21% in 2004-2005. If there were stepped-up efforts to treat or prevent heart disease in the Pueblo area, that too could have played a role, said Dr. Michael Siegel, a professor of social and behavioral sciences at the Boston University School of Public Health.

"I don't think it's as clear as they're making it out to be," Siegel said.

 

[henry]

Whenever a study on smoking comes from the U.S. Centers for Disease Control and Prevention, run the other way. The highlighted section is a good example. Note also this statement:

"Secondhand smoke causes an estimated 46,000 heart disease deaths and about 3,000 lung cancer deaths among nonsmokers each year, according to statistics cited by the CDC."

One might be tempted to think that the statistics they cite are numbers of actual deaths based upon death certificates. But as Don Oakley shows in his book Slow Burn, these are "statistics" generated by computer models.

But how does the CDC arrive at its calculations from those state reports? At least one enterprising reporter, Nickie McWhirter of The Detroit News, tried to find out. Her article was posted on the Internet by the American Smokers Alliance. She wrote:

I recently read that 435,000 Americans die every year from smoking-related illnesses. That sounds like a rock-hard, irrefutable fact, and pretty scary. How are such statistics determined? I phoned the American Lung Association’s Southfield office to find out.

No one there seemed to know. However, a friendly voice said most such numbers come from the National Center for Health Statistics. That’s a branch of the National Centers for Disease Control. The friendly voice provided a phone number in New York City. Wrong number. The New York office collects only morbidity [the rate of occurrence of a disease] data, I was told. I needed mortality data [the death rate].

Several bureaucratically misdirected calls later, I spoke with someone in Statistical Resources at NCHS. He said his office collects mortality based on death certificates. Progress! Data is categorized by race, sex, age, geographic location, he said, but not smoking. Never. No progress.

He suggested I phone the Office of Smoking and Health, Rockville, Md., and provided a number. That phone had been disconnected.

Was I discouraged? No! Ultimately, and several unfruitful phone calls later, I found a government information officer in Washington, D.C., with a relatively new phone directory and a helpful attitude. She found a listing for the elusive Office on Smoking and Health in Atlanta.

Bingo! Noel Barith, public information officer, said the 435,000 figure probably came from its computers. S&H generates lots of statistics concerning “smoking-related” stuff, he said. It’s all done according to a formula programmed into the computers.

Really? Since I had already determined that no lifestyle data on individual patients and their medical histories is ever collected, how can the computer possibly decide deaths are smoking related? Barith didn’t know. Maybe the person who devised this computer program knows. Barith promised to have a computer expert return my call. The next day, SAMMEC Operations Manager, Richard Lawton, phoned. SAMMEC, I learned, is the name of the computer program. Its initials stand for Smoking Attributed Morbidity, Mortality and Economic Cost.

The computer is fed raw data and SAMMEC employs various complex mathematical formulas to determine how many people in various age groups, locations, and heaven knows what other categories are likely to get sick or die from what diseases and how many of these can be assumed to be smoking related.

Assumed? This is all guesswork? Sort of. Lawton confirmed that no real people, living or dead, are studied, no doctors consulted, no environmental factors considered.

Lawton was absolutely lyrical about SAMMEC and its capabilities, however, provided one can feed it appropriate SAFs. What are SAFs?

“That’s the smoking attributable fraction for each disease or group of people studied,” he said. It sounded like handicapping horses. Lawton began to explain how to arrive at an SAF, using an equation that reminded me of Miss Foster’s algebra class.

“Wait a minute!” I commanded. “I don’t need to know that. I need to know if the SAFs and all the rest of this procedure yield valid, factual information. To know that we must know if sometime, somewhere, some human being or human beings actually looked at records of other human beings, smokers and nonsmokers, talked to their doctors, gathered enough information from reality to BEGIN to devise a mathematical formula that MIGHT be applied to large groups of people much later, without ever needing to study those people, and could be expected to yield TRUE FACTS within a reasonable margin of error. Who did that? Can you tell me, Mr. SAMMEC expert?” [Caps in original.]

Nice guy, Mr. Lawton, but he didn’t have a clue. He said he thought the original work concerning real people, their deaths and evidence of smoking involvement was part of work done by a couple of epidemiologists, A.M. and D.E. Lilienfield. It’s all in a book titled Foundations of Epidemiology, published about 1980 by Oxford University Press, he said. SAMMEC came later, based on the Lilienfield’s [sic] work. Maybe. He wasn’t sure.

I was unable to find the book, or the Lilienfields.

So there you have it. Research shall continue, but so far it has only revealed that no one churning out statistics knows anything about smoking and its relationship, if any, to diseases and death. A computer knows everything, based on mystical formulas of unknown origin, content and reliability. Raw data in, startling statistics out. SAMMEC speaks, truth is revealed! Oh, brave new world. Are there 435,000 smoking-related deaths per year in America? Maybe. I can tell you this with absolute certainty, however: No human beings are ever studied to find out. 32

[32. Nickie McWhirter, “Computer blows out smoking-related death figures with no real human facts.” The Detroit News, October 18, 1992. Cited in Don Oakley, Slow Burn, pp 240-42.]

 

[dant]

Haha. It reminds me of the `Man behind the curtain', and when ToTo
pulled the veil way - and I loved this part - the Whiz was pulling levers,
turning gears, and screaming threats into the Mic.

Seems this is what is going on - fudging the data to twist the facts.

Thanks for the info - it was really interesting!

Dan

 

[RyanX]

Thanks Henry for the excerpt.

The piece from USAToday originally struck me as a propaganda piece with cherry picked data. I'm sure if one looks around at all of the cities across the US who have implemented smoking bans (and there are a lot of them!), one can find some city where heart disease, cancer or something has decreased within a given period of time.

 

[Al Today]

Should one be amazed, amused, angry, or fearful of the number of people on this planet who do not know how to think critically? Many do not have the interest or possibly the energy to do a little work and research any given subject that is used in this apparent brainwashing of the masses project. Are they lazy or do they just not care? I dunno... Seems to me too many people just blindly accept whatever is written/spoken that references an impressive organizational name or some person that displays so-called "impressive" educational/profession credentials. So many on this planet appear to be completely programmed zombies, ready to march and possibly put themselves into jeopardy for what I see as "D" called the `Man behind the 'curtain'.

 

[dant]

Al:

Have your read this link:
http://www.cassiopaea.org/forum/index.php?topic=11376.0;topicseen

Dan

 

[Al Today]

Al:

Have your read this link:
http://www.cassiopaea.org/forum/index.php?topic=11376.0;topicseen

Dan

Yep, good stuff. It's always nice to see the same ideas/view written by different people. When I see the same ideas/view from a multitude of sundry sources, that kinda lends more and more credence to that view. Think I'll go and have a smoke.!.!.!