The study concluded that the extent of the decline could not be explained by "community cointerventions or changes in cardiovascular risk factors with the exception of smoking prevalence. As trends in other risk factors do not appear explanatory, smoke-free workplace laws seem to be ecologically related to these favorable trends. Secondhand smoke exposure should be considered a modifiable risk factor for MI. All people should avoid secondhand smoke to the extent possible, and people with coronary heart disease should have no exposure to secondhand smoke."
Also this month, a separate study in the American Heart Association's Circulation magazine examines the relationship between smoke-free legislation and hospital admission or death from cardiac, cerebrovascular, and respiratory diseases.
Examining dozens of previous studies and using a dizzying methodology, the Circulation report determined that "smoke-free legislation was associated with a lower risk of smoking-related cardiac, cerebrovascular, and respiratory diseases, with more comprehensive laws associated with greater changes in risk."
Barbara Yawn, MD, a family physician and director of research at the 66-bed Olmsted Medical Center in Rochester, MN, calls the findings, particularly those in JAMA, "really very impressive."