Secondhand smoke and ischaemic heart disease: demographic characteristic of a worldwide healthcare problem

The importance of extinguishing secondhand smoke is now universally acknowledged.1 Among the many unfavourable effects of passive smoke exposure those on the cardiovascular system are especially concerning. In a large meta-analysis of the literature, Lightwood and Glantz estimated that public and workplace smoking restriction laws may be effective to reduce by approximately 20% (effect size 0.83, 95% confidence interval (CI) 0.80–0.87) the number of acute hospitalisations for ischaemic heart disease (IHD).2 Similar conclusions emerged from a recent Cochrane systematic review,3 which highlighted that convincing evidence exists in support of a temporal association between the implementation of smoke-free prohibitions and the subsequent decline of cardiovascular morbidity and mortality. In spite of this evidence, the adoption of strict policies has recently been...