In Indianapolis, the smoking ban enacted in 2006 has unexpectedly caused an increase in heart attack deaths:
The ban, which affected all workplaces, including restaurants but excluding bars, went into effect on March 1, 2006. Had the smoking ban resulted in an immediate decline in heart attacks, as claimed by a number of anti-smoking groups and researchers and by a special Institute of Medicine committee, one would have expected the heart disease death rate in Marion County to have decreased in 2006, compared to 2005.
Data from the Marion County Health Department, however, show that the age-adjusted heart disease death rate for Marion County actually increased by 16% from 2005 to 2006, going from 171.0 to 197.6 deaths per 100,000 population.
This reversed a trend of declining heart disease death rates prior to the smoking ban. The rate had declined by 4.4% from 2002 to 2003, by 6.0% from 2003 to 2004, and by 5.8% from 2004 to 2005. Thus, the increase of 16% observed from 2005 to 2006 was a striking increase that coincided precisely with the implementation of the workplace and restaurant smoking ban.
Of course the ban didn’t actually cause the increase any more than bans in other cities caused the decreases so often hyped by anti-smoking advocates. And if the death rate can fluctuate this much in Indianapolis, a city of nearly 800,000, then the odds of getting meaningful data out of towns like Starkville, MS, Pueblo, CO, and Helena, MT are pretty damn low.* The fact that ban advocates cling so tightly to those success stories is an indication of just how the weak the association between bans and decreases in AMI really is.
*Those studies used overall rates of AMI rather than the rate of AMI deaths, but the two rates should move in tandem.
Previously:
What really happened in Starkville?
Lazy reporting and the Pueblo ban study
Jacob Grier is a freelance writer, barista, mixologist, and magician in Portland, OR. He writes, eats, and drinks a lot. His articles have appeared in The Washington Post, Reason Online, The Oregonian, and other publications.
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According to ASH, The rate should have started declining a half hour after the ban took effect.
http://www.pr-inside.com/smoking-bans-saving-many-lives-r1488584.htm
Why should the two move in tandem? Seems to me that as technology and emergency health care techniques improve, the death rate per case would decrease. So if the disease rate increases, the death rate would certainly increase more slowly, could remain constant, or decrease.
Which, of course, bolsters your argument, since an increase in death rate can only mean an increase in disease rate if we assume improving care.
Of course, improving care might be a faulty assumption in a down economy, as less people can afford to get preventive care for heart disease…
@Jeff: The study period was 2005-06, so I don’t think you have to worry about recession effects.
Anti-smoking organisations will never believe this after all the bull they spread about Smoking Bans saving lives by reducing Heart attacks. Of course that reduced rate of Attacks has been put to sleep in at least three countries. This may help bring to light that Bans do not reduce attacks. Some sanity would be a breath of fresh air.
Analysis by Dr. Michael Siegel today, December 2, 2009, at http://tobaccoanalysis.blogspot.com/
The heart disease death rate in Marion County, Indiana, increased by 16% in the first year following implementation of the Indianapolis smoking ban.
The ban, which affected all workplaces, including restaurants but excluding bars, went into effect on March 1, 2006. The heart disease death rate in Marion County was expected to decrease in 2006, compared to 2005.
Data from the Marion County Health Department, however, show that the age-adjusted heart disease death rate for Marion County actually increased by 16% from 2005 to 2006, going from 171.0 to 197.6 deaths per 100,000 population.
This reversed a trend of declining heart disease death rates prior to the smoking ban. The rate had declined by 4.4% from 2002 to 2003, by 6.0% from 2003 to 2004, and by 5,8% from 2004 to 2005. The increase of 16% observed from 2005 to 2006 was a striking increase that coincided precisely with the implementation of the workplace and restaurant smoking ban.
Data from Health & Hospital Corporation Datamart at http://hhcdatamart.com/mica/death/DeathCounty.html