The Morbidity and Mortality Weekly Report has a new study online, reporting on the results of a municipal smoke-free ordinance in Pueblo, CO. The report says that in the 36 months since the ordinance took effect, "the rate of acute myocardial infarction (AMIs) hospitalizations for city residents decreased from 257 per 100,000 person-years during the 18 months before the ordinance's implementation to 152 per 100,000 person-years."

The report, entitled, Reduced Hospitalizations for Acute Myocardial Infarction After Implementation of a Smoke-Free Ordinance City of Pueblo, Colorado, 2002-2006, says exposure to secondhand smoke has immediate adverse cardiovascular effects, and prolonged exposure can cause coronary heart disease. The report says the study findings suggest that smoke-free policies can result in reductions in AMI hospitalizations, and that such reductions are sustained over a 3-year period. The report says such smoke-free policies are important "in preventing morbidity and mortality associated with heart disease. This effect likely is mediated through reduced second hand smoke (SHS) exposure among nonsmokers and reduced smoking, with the former making the larger contribution."

The study further examined if the change in AMI rates could be attributed to pre-existing secular trends. AMI rates were reviewed for the three 18-month periods immediately preceding the pre-implementation phase. No statistically significant secular trend was found. To ensure that the change in the Pueblo AMI rates was not attributable to undercounting fatal AMIs post-implementation, the number of AMI deaths for the city of Pueblo were obtained from the Health Statistics Section of the Colorado Department of Public Health and Environment. After accounting for AMI deaths in a conservative manner and adding these numbers to the hospital AMI admission data, the rate for the city of Pueblo remained statistically significant through the study period.
An editorial note in the report states that evidence indicates that SHS exposure can have adverse effects on the functioning of the heart, blood, and vascular systems that increase the risk for a cardiac event. In addition, evidence suggests acute effects of SHS exposure might be rapidly reversible. The editorial note points out eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from SHS, and that previous studies have found that the implementation of smoke-free laws leads to decreased SHS exposure among nonsmoking employees of restaurants and bars and among nonsmoking adults in the general public.

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