Posted on 10/02/2006 9:27:24 PM PDT by mc6809e
Hospital admissions for acute heart attack in people under 60 fell by 11% in the Piedmont region of Italy in the five months after the introduction of a ban on smoking in indoor public places, compared with admissions for the same period in the previous year.
Importantly, nearly all of the fall was probably due to reductions in exposure to passive smoking, the researchers, from the University of Turin, concluded.
Their results, published in the latest on line edition of European Heart Journal[1] (Tuesday 3 October) add more evidence to studies supporting the effectiveness of smoking regulations, according t[2].
"The argument of the 'victimless crime' clearly and finally has to leave the discussion based on accumulating data, including this new research," said editorial co-author Dr Peter Radke, consultant cardiologist at the Department of Cardiology and Angiology at the University Hospital of Schleswig-Holstein in Lübeck, Germany.
The Italian Government banned smoking in all indoor public places on 10 January 2005. The researchers, led by Dr Francesco Barone-Adesi, analysed all hospital admissions with discharge diagnoses of acute myocardial infarction (AMI), and AMI deaths, between January 2001 and June 2005 for residents throughout the region of Piedmont (population 4.3 million).
"From February 2005 to June 2005, the immediate period following the ban, we found a significant drop in admissions for AMI among both men and women under the age of 60, with 832 cases compared to 922 for the same months in the previous year. Moreover, the rates of AMI had, if anything, been increasing between 2001 and 2004, so the reduction we saw in the first half of 2005 was not attributable to long-term trends. In fact, as there was evidence that AMI was increasing over time, it's possible that our estimate of an 11% decrease after the introduction of the ban is even an underestimate," said Dr Barone-Adesi, who is a cancer researcher at the Cancer Epidemiology Unit at the University of Turin.
He said that both active and passive smoking contributed to the fall, but that only around 1% was likely to be due to active smoking, a conclusion reached after studying the effects of the ban on the habits of active smokers. "We found that the observed reduction in active smoking after the ban could account for only a 0.7% decrease in admissions and that about a 10% decrease is due to the sharp reduction of exposure to passive smoking."
The decrease in admissions was confined to under 60s. Dr Barone-Adesi said several studies had found that the relative risk and attributable risk of AMI for smoking decreases with age. The reason was still a matter of debate, but a probable explanation was that other risk factors become more important as people age. It was also the case that younger people tend to spend more time in public places exposed to smoke, so a different effect was not unexpected.
He said that smoking acts on the aggregation of platelets in the blood and was most likely to increase acutely the risk of AMI. "This may explain our finding of an 11% decrease in the first five months after the ban began. It suggests that smoking regulations may have important short-term effects on health. The long-term effects on respiratory and cardiovascular diseases and cancer will have to be evaluated over the years to come."
Co-author of the editorial, Professor Heribert Schunkert, Director of the Department of Cardiology and Angiology at University Hospital of Schleswig-Holstein, said that Dr Barone-Adesi and his team provided further evidence from national registries and surveys – an 8.9% fall in cigarette sales, 7.6% reduction in cigarette consumption and a more than 90% reduction in nicotine vapour phase concentration in pubs and discos – suggesting that the smoking ban in Italy did reduce overall smoking, which was likely leading to the observed effect on AMI admissions.
"The implications of the study for public measures of health are important. While there are some limitations to the Barone-Adesi study, in our view these findings are an important addition to the growing body of research indicating that tightening the regulations on public smoking will play a vital role in improving public health and reducing deaths from smoking."
Dr Radke said that in October 2000 South Africa was the first country in the world to ban smoking in public areas and some US states and cities instituted smoking-free regulations before the European Union. Ireland was the first northern hemisphere country to ban smoking in enclosed places from March 2004 and has become the leading model for Europe. Norway, Sweden, Italy and Scotland have instituted countrywide legislation and more EU countries are due to follow suit.
"It took quite a long time to implement smoking-free policies in the 'old world', but Europe is on the move," he concluded. (ends)
### [1] Short-term effects of Italian smoking regulation on rates of hospital admission for acute myocardial infarction. European Heart Journal. doi:10.1093/eurheartj/ehl201. [2] Public smoking ban: Europe on the move. European Heart Journal. doi:10.1093/eurheartj/ehl266.
A PDF of the full reports are available on request from Margaret Willson or is available on:
http://www.oxfordjournals.org/our_journals/eurheartj/press_releases/freepdf/ehl201.pdf (research paper)
http://www.oxfordjournals.org/our_journals/eurheartj/press_releases/freepdf/ehl266.pdf (editorial)
The European Heart Journal is an official journal of the European Society of Cardiology. Please acknowledge the journal as a source in any articles.
ESC Press & PR Office (for independent comment): Tel: +33 (0)4 92 94 86 27 Fax: +33 (0)4 92 94 86 69 Email: press@escardio.org
probably???
come on! I'm sure they didn't spend one second looking at any other reason.
Puff
FMCDH(BITS)
I'll drink to that.
"come on! I'm sure they didn't spend one second looking at any other reason."
And what other reasons could there be?
To any legitimate statistician, ''probably'' is no valid conclusion at all, under any set of conditions. Either one can establish a correlation between event X and event Y, with other variables controlled within reasonable limits, or one cannot. If neither of these conditions obtain, and one still wants to pronounce some sort of ''conclusion'', then ...
...one is full of shjt, and is nothing other than a bogosopher passing oneself off as a statistician.
The fact that this ersatz ''study'' was published in Austin is, frankly, also a tipoff to its incompetent execution and ''conclusion''.
Don't flame me here, Texas FReepers. There's been more ''statistical'' BS emanating from UT @Austin in my adult life than from any other institution west of the Hudson and east of San Bernadino.
I'll give you half a dozen more any time you like.
Doesn't matter if one is studying secondhand smoke, secondhand pianos, or Second Hand Rose. Assuming only that the article has no actual errors of fact (a dangerous assumption, I grant you), this ''study'' is crapola on its face and would be dismissed out of hand by any honest and competent statistician (i.e. one with no agenda regarding the results).
The reproductive rate is so low and dropping so fast that there are fewer Italians to die of heart attacks. I would like to see the statistics for the same period before the ban.
They've also used the same study template in Montana and Colorado. Always people admitted to the hospital, not total heart attacks and always for some rather arbitrary local area. In tje Colorado case you can show that total deaths from heart attacks have fluctuated in the past more than they did over the study period.
Not especially convincing but they want very much to find scientific backing for their preconceived notion. The tortured data are screaming.
Nearly all of your reasons are based on an assumed bias, which I don't think is a legitimate criticism. That is only conjecture on your part. I must disagree that the study would be rejected out of hand by a statistician. Again, that is unsubstantiated conjecture. If anything, the results are likely to lean toward more of a measured effect with added controls, not less of a measured effect.
The famous Framingham studies were all done on a local population and formed the basis for a deeper understanding of many diseases. Thousands of research studies cite the Framingham data.
If the study had been done on a diverse population, you would have criticized it for being too diverse and when it is done on a tightly controlled population, you criticize it for not being diverse enough.
I handed in a paper once -- just once -- with some of the same formal errors as are evinced here, and had it bounced back at me with some nasty comments on the side. A lesson well learned, I assure you. These days, quite evidently, academic standards are much more lax, as long as the ''study'' ''proves'' (probably, hahahahahahaha) what its sponsors and researchers want to ''prove''.
Flawed methodology does not have to be based on ''assumed bias''. An honest statistician -- and these lot aren't, which sentiment I will put in writing and sign in front of any judge in the land -- can and will make errors in sampling, both in size and randomness, in failing to detect or account for related variables and events, in not accounting for random, presumably unknown, exogenous factors, any number of ways.
The bias in the study is perfectly obvious to any competent person in the field who hasn't any personal agenda. Once more, studying ANYTHING for 5 months, in ONE region of ONE nation, cannot yield anything at all resembling a statistically valid result. Is there vulcanism in the region, for instance, and was there more or less of it during the study period? Did they control for diet? Did they control for heredity, and btw what IS the historical incidence of heart attack in the subgroup of the population they studied, and over how many years? AND, did they control for reliability (which question is only relevant if bothered to control for historical biological factors, which they almost assuredly did not, given the idiotic ''conclusion'' published)? Was their data any good to start with, or was it collated from incompetent (i.e. the Italian gov't) or biased sources?
Until one answers these and quite a few more questions along the same lines, AND INCLUDES the answers in the publication, one is nothing other than a would-be BS artist.
Bah. You appear to be one of those people who will defend such ''studies'' to the death, because the result agrees with your particular viewpoint. Never mind this specific topic, volitive statistical blinders such as yours here, or any number of others on any number of other subjects, end up costing absolutely everyone in the medium run and in the long run.
You don't know sod-all about proper (and valid) statistical method, m'friend. Cherish your viewpoint, fine with me, but don't call such drivel as this a valid statistical study.
Anyone who would listen to my opinion about, say, open-wheel racing, would be a fool because I don't know what I'm talking about on that subject -- and I'm fortunate, because I know that I don't know what I'm talking about on that subject.
Regarding statistics, you're in the same boat, but considerably less fortunate.
Ta-ta.
One would intuit that, contrary to the thrust of the article, the decline in active smoking induced by the ban - as evinced by the falloff in cigarette sales and consumption - would be a much more important factor in the reduction in acute MI admissions than a decline in passive smoking, since active smoking is much more of a risk factor than passive. Then again, other risk factors aren't even mentioned, nor are possible changes in the demographics between the newer and older populations in the area.
My guess is that the study design was flawed to a large degree and that the conclusions as to the huge contribution of reduced second hand smoke inhalation to the observed MI admissions decline had more to do with political correctness than statistical correctness.
Please scroll down this page to yesterday's entry.
To my experience, when an abstract or an article mentions just one specific population segment (and that one pretty amorphous, ''under-60s'') prominently, the authors of the ''study'' were generally fishing for a pre-desired result. There are doubtless exceptions to this, in the big, wide world. However, I'll stick with the Damon Runyon viewpoint:
''The race is not always to the swift, nor the battle to the strong ... but that's the way to bet.''
Talk about using bogus stats, these folks are either math challenged or out right liars.
Surely you can think of a couple yourself?
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