Health benefits of smoke-free legislation
Respiratory health benefits
There is considerable experience and knowledge of the beneficial effects of comprehensive smoke-free legislation. Early studies from the USA showed that there were immediate respiratory health benefits in bar workers. The introduction of the Irish smoke-free legislation, and subsequently the Scottish and other national legislation, has created an opportunity to measure health benefits at the level of individuals and populations. Various studies have confirmed the US results, showing significantly reduced respiratory symptoms and improved spirometry. In Irish studies, this was accompanied by a reduction in cotinine and exhaled breath carbon monoxide. The Irish research also found a significant improvement in gas exchange in the lung. These significant effects were seen in nonsmokers and ex-smokers but did not reach statistical significance in current smokers. It is also important to note that the subjects were not patients: they were in full-time employment with normal pulmonary function, yet they saw significant health benefits 1 year after the ban.
Cardiovascular health benefits
Studies on patients in the USA, Italy and Scotland have shown definite reductions in acute myocardial infarctions, varying from 17% in Scotland to 11% in Italy. Similar effects were seen in a small Irish regional study. More recently, an English study has shown a smaller, but nonetheless definite, reduction of 2.5%.
It is expected that the effects of smoke-free policies on lung cancer rates will take some time to be seen and reliably analysed.
There have been several recent reports of the beneficial effects of Irish and Scottish smoke-free legislation in pregnancy and in children.