Lessons from N.C.ís Smoking Ban
By David Goff
The writer, is a doctor and professor at the Wake Forest School of Medicine and the president of the Mid-Atlantic Affiliate of the American Heart Association.

Researchers from North Carolina have just revealed heart-warming statistics showing a decline in emergency room visits for acute myocardial infarctions (AMIs or heart attack) since the stateís Smoke-Free Restaurants and Bars Law went into effect. The North Carolina Division of Public Health and the University of North Carolina Department of Emergency Medicine compared rates of heart attacks in 2008 and 2009 to rates since the law was enacted in January of 2010. Their results corroborate a growing body of evidence that shows the positive effects of smoke-free legislation on heart attack rates. Horry County would do well to heed the message.

According to the report, The North Carolina Smoke Free Restaurants and Bars Law and Emergency Department Admissions for Acute Myocardial Infarction, visits to North Carolina emergency rooms by North Carolinians experiencing heart attacks declined 21 percent since their smoke-free law went into effect. The significance of this is far-reaching. Applying the 21 percent reduction rate to North Carolinaís historical AMI statistics, the law helped lower AMI hospital discharges by over 4,000 a year, AMI deaths by over 1,500 a year, and probably lowered out-of-hospital cardiac deaths by over 2,500 a year. Thatís a lot of lives impacted so far by one life-saving law.

The fallout is even bigger than that, though. Thereís money at stake, a lot of it. The average cost of an AMI is at least $14,000. The reduction in AMI since the smoke-free law started is saving North Carolina over $56 million per year, not including the cost of out-of-hospital cardiac deaths and other related diseases, including strokes.

Itís no longer a secret. Secondhand smoke is a known cause of heart attacks, particularly for those with existing heart disease, family history of heart disease or with risk factors such as high blood pressure and high cholesterol. The surgeon general, as far back as 2006, reported evidence of the causal relationship between secondhand smoke exposure and health problems, as well as biological evidence of the plausibility of the association between smoke-free legislation and decreased incidence of AMI. The language became even stronger in the 2010 Surgeon Generalís Report, stating unequivocally that even brief exposure to secondhand smoke can cause heart attacks especially in individuals with underlying cardiovascular conditions.

As a general internist and heart disease prevention researcher, I have seen the toll of heart disease and stroke on families in North Carolina. Having grown up in eastern North Carolina, I have spent many wonderful vacations at Myrtle Beach and have the highest regard for your citizenry. I would love to see Horry County residents benefit from the same smoke-free law that has helped so many people in my home state and many other places in South Carolina.

The South Carolina Department of Health and Environmental Control has shared 2010 data that illuminates a huge opportunity for Horry County from similar health policy: one out of every five adults in South Carolina smokes, with smoking contributing to 25 percent of heart disease conditions every year. Heart disease accounted for 57,794 hospitalizations in South Carolina that year with a total hospitalization cost of more than $286 billion.

According to County Health Rankings, Horry County ranks number 40 out of 46 counties for smoking prevalence. That makes Horry County one of the worst counties to have to breathe in, in spaces shared with smokers. A growing number of South Carolina localities have already taken measures to protect their citizens from secondhand smoke, with over 40 local smoke-free ordinances passed and in effect or soon-to-be-in effect. Horryís high smoking prevalence makes such policy even more vital there.
Smoke-free laws canít come soon enough. Horry County residents deserve the same opportunity for long lives free of cardiovascular disease that North Carolina residents now have. I urge the citizens of Horry County to act now to improve air quality.

Reprinted from the Myrtle Beach Sun News
Saturday, Dec. 10, 2011