Published in Journal of Policy Analysis and Management, the study looked at more than two million heart attack deaths over the course of 16 years, making it by far the largest exercise of its kind ever conducted. The researchers found a great deal of fluctuation in heart attack rates but concluded that:
...large short-term increases in myocardial infarction incidence following a smoking ban are as common as the large decreases reported in the published literature.
The crucial four little words here are 'in the published literature'. The large increases get ignored while the large decreases get studied, written up, published and press released. The widely-reported studies that have found drops in heart attacks after smoking bans are—as regular readers already know—the result of straightforward cherry-picking and publication bias. We know that in most Western countries there is a long-term trend of declining heart attack rates. We also know that there is substantial variation in heart attack rates and that smaller communities (like the Isle of Man or Helena) are more likely to see bigger fluctuations because the average number of cases is already very small (single digits per month, in those instances).
As such, it is child's play to mine the hospital data and find places which have seen large drops in heart attack admissions following a smoking ban. It's not a coincidence that such studies usually rely on obscure towns in Montana or Ohio, and not the huge populations of Wales, Australia or New Zealand, where we know smoking bans have had zero effect on the number of heart attacks. And on the odd occasion when researchers get carried away and agree to do a heart miracle study for an entire nation before they've had a chance to look at the data, they can always ignore the actual hospital records and cook the books to create the illusion of a large drop in heart attacks, even though the real data show nothing of the sort.
What this latest study shows is that if you look at vast populations, there is far less chance of a fluke result and, if the findings are honestly reported, there can only be one conclusion:
"In contrast with smaller regional studies, we find that smoking bans are not associated with statistically significant short-term declines in mortality or hospital admissions for myocardial infarction or other diseases."
For more comment on this, see Michael Siegel, Jacob Sullum and Mr Puddlecote. The latter also has the news about regular commenter Junican winning a year's subscription to Tobacco Control after entering a competition to come up with new terminology for the anti-smoking movement to employ. His spoof suggestion turned out to be less risible than the real submissions. Junican is currently buying pornographic magazines to wrap around his issues of the world's foremost anti-smoking journal so he can read them in public without embarrassment.
