No heart miracle in any Australian state

Yesterday I discussed Australia's hospital admissions data which show that a series of smoking bans have done nothing to reduce that nation's heart attack rate. Far from resulting in a 40% fall - as claimed by the infamous Helena study - rates of acute myocardial infarction have continued to rise. 

Since each Australian state acted independently, it is useful to look at them individually. The graphs below show rates of heart attack admissions in Australian public hospitals between 2000 and 2008. The date of the smoking ban is shown with an arrow in each case.

Of most interest is the data from Western Australia, Tasmania and Queensland. These three states were the first to introduce comprehensive smoking bans (in January 2005, January 2006 and July 2006 respectively) and so have the longest follow-up time in which a fall in heart attack incidence could manifest itself. As you can see from the graphs below, that did not happen.

Western Australia

Tasmania

Queensland

In every case, heart attack admissions rose over time and there was no positive effect from each state's smoking ban. If one adopted the post hoc ergo proptor hoc rationale of Stanton Glantz and the other "smoking bans slash heart attacks" advocates, one might even say that the smoking bans of Western Australia and Queensland resulted in even more lives being lost. This would be abject nonsense, but no more so than the conclusions of studies from out-of-the-way places like Helena, Pueblo and Bowling Green (which, incidentally, have far fewer people living in them).

Hospital admissions statistics from the other Australian regions follow much the same pattern. Again, there is a long-term rise and, again, the introduction of smoking bans had no discernible effect on the year-on-year fluctuations that are inevitable in such data. In fact, if one were feeling uncharitable, it would (again) be technically true to say that 3 of these 4 regions saw the heart attack rate rise more sharply after the ban than before it. Of all the Australian states, only South Australia saw a fall in the rate, albeit by only 1.5%.

Australian Capital Territory

New South Wales

Victoria

South Australia

These figures, I think, speak for themselves. The arrows might as well have been placed there in a game of pin the tail on the donkey for all the relevance they have to the number of people suffering heart attacks. There is no correlation whatsoever. In this respect they are entirely in keeping with the data from England, Scotland and Wales. 

It is not inconceivable that in the next few months we shall see some researcher come forth clutching a study showing that heart attacks fell by 30 or 40 per cent in Eucla or Katoomba or God knows where after the smoking ban. It is even conceivable that news of this miracle would sweep around the world like the notorious Helena and Scotland studies did. 

It would, however, be nice to think that journalists might ask themselves whether data collected by professional tobacco control advocates from obscure towns really trumps genuine hospital admissions data collected by professional statisticians from entire nations.

But that, I fear, may be too much to hope for.

[All figures come from the Australian government's 'Australian hospital statistics' series]