Tuesday, September 22, 2009


One of the " easiest " thing that giovernments can do to save healthcare dollar is to stop public smoking. Of course, that raises important economic issues of big cigarette company endorsements and lost of tax revenue. I suppose this is not a perfect world and we cannot please everyone. However, it is very true that banning public smoking saves lives and saves money.
The latest issue of the Journal of the American College of Cardiology 54:1249, 2009 carried an article by Dr D Meyers and group from the University of Kansas School of Medicine entitled " Cardiovascular Effect of Bans on Smoking in Public Places. A Systematic Review and Meta-Analysis ". They did internet research ( the trend nowadays ), and put in keywords to research the effects of a public ban on smoking and cardiovascular benefits. They were able to trace 11 studies at 10 locations which fitted their protocol. They found that overall there was a 17% reduction in heart attack rates in the first year with a 26% incremental gain over subsequent years. Meaning that we can save one third of our population from heart attacks if we decide to ban public smoking, thereby reducing primary and secondary smoke. Unfortunately, few studies study the overall economic benefit ( or loss ), should we ban public smoking. I suppose the impression must be that it will be an overall gain, as the smoking related heart attacks can strike young adults at the prime of their career.
This is however not the only study for this month. There is another study by a group from University of California San Francisco, under Dr James Lightwood, that also study the effects of banning public smoking in UK from July 2007, and they found almost similar finndings. That banning smoking reduced the heart attack rates by 17% in the first year and 36% in the next.
These are very large numbers of heart attacks prevented. There is no doubt in my mind that stopping smoking saves lives, saves money.
I am sure that if the government is sincere about stretching the healthcare dollar, banning smoking in public places is the way to go. There again, there is the issue of enforcement. At this moment, if I am not wrong, smoking advertisement, and smoking has been banned in certain public places like hospitals, government buildings and restaurants. Go to any common restaurants, and see the many still puffing away. Oneday, I decided to raise the attention of the smoker to the no smoking sign. I nearly had my head bitten off. He just told me, in not so polite terms, to mind my own business. Of course the restaurant owner is not interested in my complaint. It is business and all about money. Who cares about heart attack rates, and who cares about saving healthcare cost, until they need healthcare. Our enforcement agencies are legendary. What then are we talking about?

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