Cut heart attacks in half! Ban smoking in bars and restaurants!

This is the latest come-on from the busybodies who want to banish smoking from private businesses. The claim, which has been credulously repeated by the news media, is based on a study of heart attacks in Helena, Montana, during the six months after a smoking ban took effect.

The unpublished study is the work of Richard Sargent and Robert Shepard, two local physicians who were leading advocates of Helena’s smoking ban, and Stanton Glantz, a well-known anti-smoking activist who directs the University of California at San Francisco’s Center for Tobacco Control Research and Education. Sargent says they discovered that the smoking ban “led to an immediate and dramatic decline in the number of heart attacks experienced in Helena.”

In truth, the study shows nothing of the kind. The fact that Sargent and his fellow tobaccophobes got away with this kind of prevarication shows how eager journalists are to accept any factoid that helps the anti-smoking cause.

According to data Sargent presented at a recent meeting of the American Academy of Cardiology, St. Peters Community Hospital in Helena saw an average of fewer than four heart attacks a month from June, when the smoking ban took effect, until December, when the ordinance was suspended because of a legal challenge. From 1998 through 2001, by contrast, the hospital recorded an average of about seven heart attacks a month during the same part of the year.

In a UCSF press release, Glantz declared, “This striking finding suggests that protecting people from the toxins in secondhand smoke not only makes life more pleasant; it immediately starts saving lives.”

To a more skeptical eye, this striking finding suggests the perils of drawing conclusions from a single study involving tiny, volatile numbers. As Richard Pasternak, an associate professor of medicine at Harvard, told UPI, “This is a small study, so we have to be cautious in how we interpret these results.”

Unless we work for the news service at Glantz’s university. The headline on the UCSF press release, which was echoed by news outlets, announced, “Public Smoking Ban Slashes Heart Attack Rate in Community.”

A little calculation shows how preposterous this claim is, even if you believe that secondhand smoke causes heart disease. The American Heart Association attributes 35,000 heart disease deaths a year, about 5 percent of the total, to secondhand smoke.

It seems reasonable to assume that the proportion would be similar for heart attacks, fatal or not. So even if a city completely eliminated secondhand smoke (which Helena’s ban did not do, since it did not apply to smoking at home), how could that possibly cut heart attacks in half?

Sargent and Glantz note that smoking bans also encourage smokers to cut back or quit. Inconveniently for them, that point suggests that any drop in heart attacks could be due to less smoking rather than less exposure to secondhand smoke.

In any case, the numbers still don’t add up. According to the U.S. Centers for Disease Control and Prevention, smoking accounts for about one-fifth of heart disease deaths. So even if every smoker in Helena quit (which no one claims happened), you would not get anything like the drop that Sargent, Shepard, and Glantz attribute to the ban.

If smoking bans cut heart attacks in half, it’s odd that no one has noticed it before, especially in big cities such as Los Angeles and San Francisco, where an effect of such magnitude should have been obvious. Indeed, why didn’t Glantz study hospital data in places within his own state where the samples would have been much bigger and the results more meaningful, instead of focusing on what Sargent calls “a tiny little community in the middle of nowhere”?

California’s ban on smoking in workplaces took effect in 1995; it was extended to bars in 1998. Yet according to CDC data, the number of heart disease deaths in California did not drop substantially in either year. If smoking bans cut heart attacks in half, surely the effect would have shown up in these numbers.

Likewise, Delaware should see a sharp drop in heart attacks now that it has banned smoking in all workplaces. So should New York City, where a smoking ban took effect this month, and New York state, which recently passed a ban that takes effect in July. Ditto Boston, Chicago, Dallas, and Florida. Or is there something special about hearts in Helena?

FOR JIM SEALY, A DALLAS ARCHITECT and expert witness in mold cases, die mold issue hit home hard.

Sealy owns a 47-year-old, 2,400-sq-ft ranch house in nearby Lancaster. The pier and beam ranch, which has a 30- in. crawlspace, in September 2001 developed a pinhole leak in the kitchen water line, causing a fine mist to be sprayed into the crawlspace. Oak flooring was set on a particle-board subfloor in a remodeling job in 1978 and the water and particle board played host to a very aggressive mold called trichoderma. It is not toxic to humans or animals, but very aggressively consumes cellulose. “The particle board became like wet shredded wheat in a matter of days,” says Sealy.

“We called a contractor friend and when he opened the crawl space and saw the mold, he closed it up and had us evacuate the house.”

Sealy discovered the mold problem after he noticed the floors were becoming spongy. “We couldn’t walk on the floors. It was like being on a roller coaster because we had elevation changes anywhere from 8 to 10 inches,” he says.

Sealy and his family ended up spending 357 nights in a motel while his house was condemned, remediated and reconstructed. Over 1,500 sq ft of flooring was removed, the wood frame sandblasted and drywall up to 4 ft high removed.

“The insurance company was the biggest problem,” Sealy says. “After four months, we had to sue to get them to remediate the mold.”

Sealy’s contractor estimated the job would cost $86,000, while State Farm Insurance Co. estimated $13,000. In the end, State Farm paid $78,000 for the work, plus another $24,000 for cleaning and storage and $90 per night for the motel. “They would not negotiate so we sued and a judge forced them into mediation,” says Sealy.

“What you see today is buildings being constructed improperly, without adequate flashing and built way too tight, “Sealy says.

A New York City restaurant has found a novel way to get round the city’s recent tough anti-smoking laws, by offering a menu of tobacco-flavoured delights.

The Serafina Sandro restaurant has unveiled its “Tobacco Special” menu to satisfy the cravings of some of the city’s estimated 1.3 million smokers.

They can no longer light up in the city’s restaurants, following Mayor Michael Bloomberg’s anti-smoking laws which came into effect last Sunday.

Delicacies such as filet mignon with a tobacco-wine sauce garnished with dried tobacco, gnocchi made with tobacco and even tobacco panna cotta desert are the result of two months’ strenuous testing by the restaurant’s chef, cigar-smoker Sandro Fioriti.

The city authorities are also to give smokers free nicotine patches in an attempt to help more people to quit smoking.

‘A new spice’

Under New York City’s new smoking laws, the city’s 13,000 bars and restaurants must now ban smoking on their premises.

As well as fines, owners of offending establishments could eventually have their business licences suspended under the new laws introduced by Mayor Bloomberg, himself a former smoker.

But co-owner of the Serafina Sandro restaurant, Vittorio Assaf, said that he was glad the city mayor had imposed the ban, saying it had encouraged the restaurant employees to produce more inventive dishes.

“It took Mayor Bloomberg to make us finally cook with tobacco in the kitchen,” he told Reuters news agency.

“It’s the invention of a new spice into the cuisine.”

‘Wasting funds’

New York City’s health department is also planning to give six-week supplies of nicotine patches to smokers who want to quit following the introduction of the smoking ban.

The patches will cost around $100 per person and are only available to the first 35,000 people who put in a call to a specially set up help line called 1-866-NY-QUITS.

City health officials say that they hope at least 7,000 people – one-fifth of the number patches will be offered to – will give up cigarettes, and say they intend to keep in regular contact with those attempting to quit in a bid to offer them support.

However BBC correspondent Jane Standley in New York says that the move has attracted criticism, with some arguing that the scheme – which will cost the city $2.5 million – is wasting funds while the city faces one of its most severe budgetary crises in years.