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Invited Commentary |

Extending the Health Benefits of Clean Indoor Air Policies:  Comment on “Myocardial Infarction and Sudden Cardiac Death in Olmsted County, Minnesota, Before and After Smoke-Free Workplace Laws”

Sara Kalkhoran, MD; Pamela M. Ling, MD, MPH
Arch Intern Med. 2012;172(21):1642-1643. doi:10.1001/2013.jamainternmed.269.
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Tobacco smoke endangers the health of both active smokers and nonsmokers exposed to secondhand smoke (SHS). The 2006 Surgeon General's report1 found that adult exposure to SHS has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer, and that children exposed to SHS have an increased risk of sudden infant death syndrome and respiratory problems, such as asthma.

The results of the study by Hurt et al2 highlight some of the potential benefits of 100% smoke-free policies in workplaces, restaurants, and bars: significantly decreased incidence of myocardial infarction and a trend toward decreased sudden cardiac death. The authors used comprehensive access to medical records in a single system, a substantial follow-up period, and rigorous epidemiologic criteria to record and validate diagnoses of myocardial infarction and sudden cardiac death in Olmstead County, Minnesota. They found that, after implementation of smoke-free workplace laws, the incidence of myocardial infarction declined significantly (33%) and there was a trend of decreased incidence of sudden cardiac death, while the prevalence of other risk factors for cardiac disease remained unchanged or increased.

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