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• Reduced Hospitalizations for Acute Myocardial Infarction After Implementation of a Smoke-Free Ordinance --- City of Pueblo, Colorado, 2002--2006 

The Pueblo Heart Study examined the impact of a municipal smoke-free ordinance in the city of Pueblo, Colorado, that took effect on July 1, 2003 (3). The rate of AMI hospitalizations for city residents decreased 27%, from 257 per 100,000 person-years during the 18 months before the ordinance's implementation to 187 during the 18 months after it (the Phase I post-implementation period).* This report extends that analysis for an additional 18 months through June 30, 2006 (the Phase II post-implementation period). The rate of AMI hospitalizations among city residents continued to decrease to 152 per 100,000 person-years, a decline of 19% and 41% from the Phase I post-implementation and pre-implementation period, respectively. No significant changes were observed in two comparison areas. These findings suggest that smoke-free policies can result in reductions in AMI hospitalizations that are sustained over a 3-year period and that these policies are important in preventing morbidity and mortality associated with heart disease. This effect likely is mediated through reduced SHS exposure among nonsmokers and reduced smoking, with the former making the larger contribution (4,6,7). . . .

Editorial Note:

Evidence from animal and human studies indicates that SHS exposure can produce rapid adverse effects on the functioning of the heart, blood, and vascular systems that increase the risk for a cardiac event (1). Relevant mechanisms include effects on platelet function, endothelial function, and inflammation. Epidemiologic and laboratory data indicate that the risk for heart disease and AMI increase rapidly with relatively small doses of tobacco smoke, such as those received from SHS, and then continue to increase more slowly with larger doses (1,8,9). Evidence also suggests that the acute effects of SHS exposure might be rapidly reversible (8,9).

Eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from SHS

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