Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study

BMJ. 2004 Apr 24;328(7446):977-80. doi: 10.1136/bmj.38055.715683.55. Epub 2004 Apr 5.


Objective: To determine whether there was a change in hospital admissions for acute myocardial infarction while a local law banning smoking in public and in workplaces was in effect.

Design: Analysis of admissions from December 1997 through November 2003 using Poisson analysis.

Setting: Helena, Montana, a geographically isolated community with one hospital serving a population of 68 140.

Participants: All patients admitted for acute myocardial infarction.

Main outcome measures: Number of monthly admissions for acute myocardial infarction for people living in and outside Helena.

Results: During the six months the law was enforced the number of admissions fell significantly (- 16 admissions, 95% confidence interval - 31.7 to - 0.3), from an average of 40 admissions during the same months in the years before and after the law to a total of 24 admissions during the six months the law was effect. There was a non-significant increase of 5.6 (- 5.2 to 16.4) in the number of admissions from outside Helena during the same period, from 12.4 in the years before and after the law to 18 while the law was in effect.

Conclusions: Laws to enforce smoke-free workplaces and public places may be associated with an effect on morbidity from heart disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Hospitalization / statistics & numerical data*
  • Humans
  • Incidence
  • Middle Aged
  • Montana / epidemiology
  • Myocardial Infarction / epidemiology*
  • Poisson Distribution
  • Public Facilities / legislation & jurisprudence*
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / legislation & jurisprudence*
  • Smoking Prevention
  • Tobacco Smoke Pollution / adverse effects
  • Tobacco Smoke Pollution / legislation & jurisprudence
  • Tobacco Smoke Pollution / prevention & control*
  • Workplace / legislation & jurisprudence


  • Tobacco Smoke Pollution