Wednesday 9 November 2011

The North Carolina smoking ban/heart attack hoax

Stop me if you think you've heard this one before.

From the University of San Francisco (note the byline)...

Heart attacks down 21 percent in the first year after the North Carolina smokefree restuarant and bar law took effect

Submitted by sglantz on Wed, 2011-11-09 11:54

The evidence that strong smokefree laws provide large and immediate health benefits just keeps piling up.

The latest study, released today, found a 21 percent drop in emergency room admission for heart attacks during the first year of the law, saving an estimated $3.4 to $4.3 million in heath care costs. This is serious money, particularly as both government and the private sector struggle to keep health costs down.

These real documented and rapid benefits not just in terms of health, but the economy, show that the economic argument on smokefree policies has clearly shifted away from the tobacco industry and its allies to the health side.

Real and documented, you say? So we can assume, at the very least, that there were 21% fewer heart attacks after the smoking ban?

Not even that, I'm afraid. Not even close. As the study shows, there were 9,066 heart attacks in 2008. This fell by 10.5% to 8,113 in 2009. The smoking ban came in at the start of 2010. In that year, there were 7,669 heart attacks—a decline of 5.5%.

The researchers have even helpfully included a graph in which you can clearly see the heart attack rate falling before the ban and then leveling off somewhat after the ban.

As if to rub our noses in it, the researchers spell out exactly what the trend was.

Interestingly, the rates appear to have consistently declined between the year 2008 and 2009; after that period the rates leveled off at a consistently lower level in the year 2010.

Er, yeah. So where on earth does this claim that there was "a 21 percent drop in emergency room admission for heart attacks during the first year of the law" come from?

The answer is that they did a Gilmore. They made a computer model. You may recall Anna Gilmore and her band of merry women reinterpreting the no-change-there-then English heart attack data and declaring that 2.4% of the 4.2% drop was attributable to the smoking ban. Unprovable (she made no attempt to prove it) but also unfalsifiable.

This new study takes that approach to absurd new depths. Whereas Gilmore claimed that a portion of the drop in heart attacks was due to the smoking ban, this model says that the smoking ban reduced the heart attack rate by 21%, despite the actual heart attack rate only falling by 5.5%.

You almost have to admire the sheer audacity of these people. Every time I think there is no way they can keep flogging this dead horse, they come up with another ruse.

Here is a study which unequivocally shows that the smoking ban had absolutely no effect on the heart attack rate. If anything, the year after the smoking ban saw rather more heart attacks that would be predicted based on the preceding years. The study provides all the data you need to see that the heart attack rate fell by 5.5% after the smoking ban and yet it concludes—based on a demonstrably ludicrous computer model—that the smoking ban reduced the heart attack rate by 21%. When your computer gives you information like that it's time to turn it off and turn it on again.

And yet you can be sure that when this study is inevitably reported, the facts will not be allowed to stand in the way. The number of people who actually went to hospital with a heart attack will become irrelevant (although it's fitting that bans based on imaginary deaths are saving imaginary lives). The fiction has become the reality. The model has spoken. "There were 21% fewer heart attacks after the smoking ban. Here's Tom with the weather..."


Anonymous said...


I just got off the phone with the N.C. dept of health and human services and asked if they were going to print a retraction of this junk study.......after reading them the flaws in their study and all the absurdity surrounding all the other junk studies he said we stand behind our study! I told him,you do realise how stupid this study makes you look and your dept! then the line went dead!


Anonymous said...

.C. Heart Attack Rates Down Since Passage of Smoke-Free Law
For release: Immediate November 9, 2011
Contact: Mark Van Sciver (919) 707-5059

RALEIGH – Emergency room visits by North Carolinians experiencing heart attacks have declined by 21 percent since the January 2010 start of the state’s Smoke-Free Restaurants and Bars Law. State Health Director Dr. Jeffrey Engel reported the results to the Justus-Warren Heart Disease and Stroke Prevention Task Force this morning.

Anonymous said...

I notice you have included Glantz's blog in your blogs of note. He wrote something about this. I posted a comment including a link to your article. I haven't bothered looking to see whether it was published.

Carl V Phillips said...

Chris, I know you asked me in a tweet about they could have possibly justified this. Sorry I did not have a chance to respond -- I had a very busy week. I think you pretty well sum it up. I believe there is an interesting additional bit that I will add. It will require a full EP-ology post, rather than fitting in a comment, though, so I will put it there within the next day or two.

Antipholus Papps said...

Well, by looking at that graph, it seems to me that there is a sharp drop-off in heart attacks around Christmas and New Year's Day! Which can only be interpreted to mean that turkey, sherry and cigars are good for you! Hurrah!