Second-hand smoke, public smoking ban and acute myocardial infarction. A brief review of the literature with emphasis on the Swiss experience

Summary Tobacco use is one of the most important avoidable causes of cardiovascular diseases worldwide and is one of the most important causes of acute myocardial infarction globally, especially in men. Active and passive smoking increase the risk of coronary artery disease and the risk of acute myocardial infarction. There is substantial evidence that the cardiovascular system is exquisitely sensitive to the toxins produced by secondhand smoke through different mechanisms (increased platelet activation, endothelial dysfunction, oxidative stress, inflammation among others). Multiple studies in various countries indicated that reducing the exposure to second-hand smoke by implementation of regulations to ban smoking in public buildings is followed by a rapid reduction in the number of hospital admissions for acute coronary syndromes. Insofar as the smoke-free policies can offer a simple and inexpensive intervention for the prevention of cardiovascular diseases they should be included in prevention programmes worldwide. In this review we summarise several pathophysiological aspects of second-hand smoke, and refer to the epidemiological data of the literature also alluding to the peculiar federal Swiss situation including our own experience in Southern Switzerland, at a time when an animated public debate on nationwide smoke ban legislation is very hot.