According to the Centers for Disease Control and Prevention, exposure to secondhand smoke results in approximately 3,000 lung cancer deaths and 35,000 heart disease deaths in the United States each year.
Fortunately, policies establishing smoke-free public places are a very effective method for reducing exposure to secondhand smoke. For example, restricting smoking in public places decreases per capita cigarette consumption and increases smoking cessation rates.
It also increases the health of the public. One famous example occurred in Helena, Mont. This town prohibited smoking in all workplaces and public places in 2002.
Six months after this ordinance, the number of hospital admissions for heart attacks declined 40 percent, but then rebounded when the ordinance was suspended.
Though strict local laws are the most effective in reducing smoking in public places, an increasing number of states, possibly influenced by tobacco companies, have enacted "pre-emptive" smoking laws that forbid local laws from being more stringent than the lax statewide no-smoking laws.
Panagiotakos and colleagues acknowledge that their study was limited by the reliance on patients' recollection of exposure to secondhand smoke, as well as by the fact that the researchers did not chemically verify if the patients had actually been exposed.
Nonetheless, the authors conclude: "Our findings add to the current scientific knowledge by showing that the exposure to secondhand smoke substantially increases the risk of short-term recurrent events in hospitalized patients for acute coronary syndrome."
Dr. John Spangler is director of tobacco intervention programs and professor of family medicine at Wake Forest University School of Medicine.