Hospital admissions drop since city introduced anti-smoking laws

Toronto hospitals have seen a one-third drop in the number of patients with heart and respiratory problems since the city introduced harsh anti-smoking laws nearly a decade ago, according to a study released on Monday.

“I really don’t think we can entertain more of a discussion that second hand smoke doesn’t really have an effect,” said lead author Alisa Naiman, from the University of Toronto. “I think it’s pretty conclusive.”

The results of a 10-year study by Dr. Naiman and co-authors were released in the Canadian Medical Association Journal, outlining the effects of banning smoking in city restaurants and bars.

The study found hospital admissions for cardiovascular and respiratory conditions — ailments commonly linked to smoking — dropped 39% and 33% respectively since 2001. The study also found a 17% decrease in hospitalization stemming from heart attacks.

The study also examined cases unrelated to the effects of smoking — cholecystitis, bowel obstructions and appendicitis — and found no change, suggesting other health trends were not a factor in the cardiovascular and respiratory results.

“Smoking bans are intended to protect people from the health hazards of both second hand smoke and, indirectly, by creating an environment that encourages smokers to quit,’’ said Dr. David McKeown, Toronto’s Medical Officer of Health. “˜”˜The health outcomes that the study measures … are exactly the health problems we are trying to address through smoking bans.’’

In 2001, Toronto banned smoking in restaurants and dinner theatres. The ban extended to bars and bingo halls in 2004. More recently, city hall has moved to ban smoking in public parks and playgrounds, as well as cars containing young children.

Dr. Naiman said those bans will likely lead to better personal health, but would likely not lead to further benefits in terms of similar reductions at hospitals because they are smaller in scope, and the majority of the benefit has already been gleaned from the larger bans.

Tobacco is considered the leading cause of preventable death in the world, and second-hand smoke is among the leading causes of preventable poor health and premature death in developing worlds.

Dr. Naiman estimated one billion people are expected to die during the 21st century, as a result of tobacco-related disease.

The study also noted its findings were “consistent with the evidence that exposure to second-hand smoke is detrimental to health and legitimizes legislative efforts to further reduce exposure.”

Dr. Naiman said other factors influencing the results include better prevention of smoking-related diseases and increased awareness of second hand smoke concerns.

“This is part of a body of evidence now which is supporting the idea that smoking bans, as part of a comprehensive approach to tackle the harms of smoking, actually do have health benefits,” Dr. McKeown said.