Thursday 26 January 2012

Sheer heart attacks

Long time readers will have seen quite a few graphs like the one below over the years (for example here and here). They show the number of people admitted to hospital with heart attacks in a country. In this case, the country in England. I have previously used NHS hospital data to show that the English smoking ban had no effect on England's heart attack rate, contrary to a claim made by Anna "pants on fire" Gilmore. (In fact, the data in that graph came from her study; she just chose not to show it in a chart.)

You can see the non-effect of the ban (started July 2007) in the graph below. Clearly, there is a consistent, gradual downward trend, but no big dips. There are slight increases in the downward trend in 2005 and 2010, but these can hardly be attributed to a ban that started in 2007.

You knew this already, right? I only mention it again because this graph comes from a new study in the British Medical Journal which looks at the the heart attack rate in England between 2002 and 2010. So, just in case you think I've been making up the data these past two years, let this assure you that I have not.

The six page study does not mention the smoking ban at all and its data clearly do not support the notion that the ban had any observable effect on heart attack admissions. The big story is that deaths from heart attack have halved since the turn of the century. This is great news, but it has obviously been a steady process which has come about for a multitude of reasons.

If someone tells you that the heart attack rate fell after the smoking ban, they are not lying, but they are not being entirely truthful either. Pick any event of the last decade and the heart attack rate fell afterwards. Pathetic as this post hoc logic is, it has been the basis of one of the biggest scientific scams of recent years.


George Speller said...

ITN perpetuated the myth only this evening.

Xopher said...

Why tell us again when this report appeared in October
The best source I found was from the BHF -
Lots of data to hang themselves by.

timbone said...

I was waiting for a blog on this. They just can't leave it out can they. Best example was, I think, Telegraph. This is an Oxford Uni research since 2002, and yet, para 5 just had to mention the fall since 1st July 2007, then shooting themselves in the foot by saying that this was other studies, which we know were spurious to say the least.

timbone said...

Here is the article. Journalists and television reporters seem to have a brief that they must mention smoking, even if like paragraph five in this article, it just seems to have crept in to the party uninvited.

Leg-iron said...

The decline seems to have accelerated slightly after Labour left office.

Michael J. McFadden said...

Beautifully clear example Chris! Many thanks for digging it out and sharing! As you may have seen in the last day or so of postings on MP Stephen Williams' blog at:

the information is quite useful!


Michael J. McFadden said...

Xopher, thank you for your VERY useful data reference! The source is impeccable, and that makes it all the better!

Just a quick observation from a quick look at a single set of graphs in it: If you go to pages 27 and 28 you'll see the "death by disease figures for all the UK. The Antis will of course enjoy pointing to a drop (Just in England ... not bothering trying to add multi-#s in my head right now) in cardio deaths from check deaths from 245 thousand in 1991 to 198k in '01 and 149k in '09. BUT... take a look at something you'd expect smoking to have a much GREATER effect on: Respiratory disease deaths: from 59k in '91, to 63k in '01 and staying at 63k in '09! The smoking bans have had no observable effect!

The change in whole milk consumption is interesting also: Very steady at about 2.4L/person/week from 1960 to '75, then an incredible and steady drop off of over 80% to about .4L in '08! What the Q happened over there? .4 liters per WEEK? I drink double that on an average DAY!

P.S. Of course I dilute it a bit with chocolate...

Ken said...

The latest line (as heard from a heart specialist on C4 News last night) is to say nothing about the 2007 smoking ban or secondhand smoke but to say that the decreasing number of places where you can legally smoke over the whole period accounts for some of the reduction in heart attacks.

Anonymous said...

The curious case of the vanishing killer

"It's a good news story that has medical researchers baffled: in the past decade, deaths from heart disease in the UK have fallen spectacularly, and no one knows why."

"But smoking peaked in the 1940s and then began to decline, just as the heart disease epidemic was taking off."

"The Oxford researchers conclude that just under half the decline in heart attack death rates in England over the last decade is due to better hospital treatment; the rest is due to changes in lifestyle and the widespread use of pills to lower cholesterol and blood pressure."

"But the greatest rates of decline occurred in men and women aged 65-74 and the lowest in those aged 30-54 and 85 and older."


"Statins are thought to be taken by one in three people over 40. Up to seven million people in England take them, costing the NHS at least £450 million a year. A large proportion of these are at a low risk of heart problems and take the drugs to ward off future disease.

Experts who advocate the use of statins say they have helped prolong thousands of lives by preventing heart attacks and other cardiovascular events."


The Apiarist said...

The myth was heavily promoted on R4's 6 o'clock news, namely "The smoking ban had an immediate effect."

If you believe that there was a sudden reduction within days of the ban then you deserve all the ridicule that is your due.

JJ said...

It was Romilly Weeks that mentioned smoking in pubs on the ITN news.

Anonymous said...

Brilliant demolition job Chris.

Page bookmarked for ease of future reference when posting elsewhere re this topic.

dearieme said...

"If someone tells you that the heart attack rate fell after the smoking ban, they are not lying,...": oh yes they are - suppressio veri.

Tomrat said...

Sorry but am I missing something core here?

If there was no dip this is surely evidence that smoking has little or nothing to do with cardiac arrest; assume atleast a drop in the number of smokers correlating to the ban and you would expect at least a similar drop in cardiac events.

Unless of course it is offset by several years of course; possible but it would really bake some folks' noodles if you plotted this graph against population who smoke (watching the troughs have little or no effect).

In any case kudos Chris.