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La proibizione del fumo nei luoghi pubblici è associata ad una riduzione dell'incidenza di infarto del miocardio

Con una revisione sistematica della letteratura ed una meta-analisi si portano nuove prove che l'abolizione del fumo nei luoghi pubblici comporta una riduzione del rischio cardiovascolare. I dati che sono stati ricavati in alcuni stati dell'America del Nord, in Italia ed in Scozia, cioè dove da alcuni anni sono in vigore leggi restrittive sul fumo nei locali pubblici, sono concordi nel dimostrare il declino dell'incidenza di infarto miocardico, declino che si rende evidente già entro pochi mesi dalla promulgazione delle leggi.

Cardiovascular effect of bans on smoking in public places: a systematic review and meta-analysis

Meyers DG, Neuberger JS, He J.

J Am Coll Cardiol 2009;54:1249-55

OBJECTIVES: A systematic review and a meta-analysis were performed to determine the association between public smoking bans and risk for hospital admission for acute myocardial infarction (AMI). BACKGROUND: Secondhand smoke (SHS) is associated with a 30% increase in risk of AMI, which might be reduced by prohibiting smoking in work and public places. METHODS: PubMed, EMBASE, and Google Scholar databases plus bibliographies of relevant studies and reviews were searched for peer-reviewed original articles published from January 1, 2004, through April 30, 2009, using the search terms "smoking ban" and "heart" or "myocardial infarct." Investigators supplied additional data. All published peer-reviewed original studies identified were included. Incidence rates of AMI per 100,000 person-years before and after implementation of the smoking bans and incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated. Random effects meta-analyses estimated the overall effect of the smoking bans. Funnel plot and meta-regression assessed heterogeneity among studies. RESULTS: Using 11 reports from 10 study locations, AMI risk decreased by 17% overall (IRR: 0.83, 95% CI: 0.75 to 0.92), with the greatest effect among younger individuals and nonsmokers. The IRR incrementally decreased 26% for each year of observation after ban implementation. CONCLUSIONS: Smoking bans in public places and workplaces are significantly associated with a reduction in AMI incidence, particularly if enforced over several years.

J Am Coll Cardiol 2009;54:1249-55