One year after a public smoking ban went into effect in Italy, heart attacks and other acute coronary events were reduced. Researchers collected data on acute coronary events in residents of Rome for five years before the ban on smoking in all public indoor places went into effect on January 10, 2005, and one year after. Episodes of acute coronary events dropped 11% in people 35 to 64 years old and 8% in those 65 to 74 years old. Exposure to second-hand smoke was also reduced. Cigarette sales fell by 5.5%. "Because coronary heart diseases are the leading causes of death in Italy and elsewhere, even the small reduction we observed could have enormous public health implications," wrote Cesaroni and colleagues in the March 4 issue of Circulation.
In India smoking is epidemic and will cause 1 million deaths per year by 2010, according to a report published online in the New England Journal of Medicine on February 13. Jha and colleagues conducted the first national survey of smoking in rural and urban India using 900 field workers to cover 1.1 million homes. It has been estimated that about 120 million people smoke in India. Among those ages 30 to 69 years, these researchers found that smoking doubles women's risk of death from a medical cause and raises that risk by 70% in men, over nonsmokers' risk. Female smokers die an average of eight years sooner and male smokers six years sooner than nonsmokers. Indian health officials may face an uphill battle: smoking cessation is uncommon in India, and smokers usually quit only after becoming ill.
In the United States, state tobacco control programs reduce the prevalence of smoking among adults. Smoking prevalence declined from 29.5% in 1985 to 18.6% in 2003, largely the result of state tobacco-control programs that employ media campaigns and higher taxes on cigarettes, among other measures. According to a study by Farrelly and colleagues in the February issue of the American Journal of Public Health, increasing the price of cigarettes resulted in the greatest decline in smoking among adults ages 18 to 24, and overall funding of state tobacco-control programs had a greater effect on those 25 years old and older. But state funding for such comprehensive programs fell by 28% from 2002 to 2005, and some states have cut funding by up to 75%. Only four states (Maine, Colorado, Delaware, and Mississippi) had funded such programs at the recommended level as of 2005. The researchers note that if all states had funded such programs at the recommended minimum to optimum levels from 1995 to 2003, 2.2 million to 7.1 million fewer adults would have been smokers in 2003. States appear to be missing an opportunity to save both lives and money, they say.