Posted on February 15, 2016

National smoking legislation reduces the harms of passive smoking and particularly risks from heart disease, according to the latest research review.

The Cochrane Review, led by Professor Cecily Kelleher from University College Dublin, examined 77 reports from across 21 countries. It found a general reduction in hospital admissions for heart disease in countries where smoking bans had been introduced.

“The current evidence provides more robust support for the previous conclusions that the introduction of national legislative smoking bans does lead to improved health outcomes through a reduction in second hand smoke exposure for countries and their populations,” said Professor Cecily Kelleher.

“We now need research on the continued longer-term impact of smoking bans on the health outcomes of specific sub-groups of the population, such as young children, disadvantaged and minority groups.”

The first national legislation banning indoor smoking in all public places was introduced in Ireland in 2004. Since then, many more countries, states and regions have adopted similar smoke-free legislation banning smoking in public places and work places.

The main reason for the introduction of the smoking bans is to protect non-smokers from the harmful health effects of exposure to second hand smoke. Another reason was to provide a supportive environment for people who want to stop smoking.

Tobacco is the second major cause of mortality in the world, and currently responsible for the death of about one in ten adults worldwide. Measures to control the demand for and supply of tobacco products, as well as to protect public health, have been demanded by the World Health Organization.

Cigarette smoking is identified as one the greatest public health disasters of the 20th century, with over 20 million attributable deaths.  The World Health Organization estimates that six million people die every year from tobacco-related diseases; 600,000 from the effects of passive smoking.

This latest review, funded by the Health Research Board in Ireland, is an update of the initial Cochrane Review published in 2010. The 2010 review examined how smoking legislation had reduced smoke in public places. The latest review included studies that examined evidence into the effects of passive smoking, and the associated health risks including heart disease.

The latest review identified that 33 of the 44 observational studies included, which specifically assessed cardiovascular disease, found evidence of a significant reduction in heart disease following the introduction of these bans. It also found that the greatest reduction in admissions for heart disease following smoking legislation were identified in populations of non-smokers.

Cochrane is a not-for profit organisation with collaborators from more than 120 countries working together to produce credible, accessible health information.

Full citation:

Frazer K, Callinan JE, McHugh J, van Baarsel S, Clarke A, Doherty K, Kelleher C. Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD005992. DOI: 10.1002/14651858.CD005992.pub3.

By: Dominic Martella, UCD University Relations

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