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Those two studies, therefore, are designed to assess the association between secondhand smoke exposure and heart attacks.
The committee also conducted an extensive literature search and reviewed relevant publications.
To ensure that it was aware of all relevant studies, the committee searched medical-literature databases from 1997 to the present with keywords that included .
The speed and magnitude of risk reduction after smoking cessation, however, have been debated (Critchley and Capewell, 2003; Dobson et al., 1991; Doll and Peto, 1976; Gordon et al., 1974; Negri et al., 1994).
Some studies found that risk could decline to that of a lifelong nonsmoker (Dobson et al., 1991; Gordon et al., 1974; Lightwood and Glantz, 1997), and others have suggested that some residual excess risk remains (Negri et al., 1994; Teo et al., 2006).
On the basis of a systematic review of 20 cohort studies, Critchley and Capewell (2003) estimated that there was a 36% reduction in mortality in patients with coronary heart disease who quit smoking compared with those who continued smoking.
Their data provide evidence that limitation of secondhand-smoke exposure should reduce risk of mortality from coronary heart disease substantially. In response to CDC’s request, IOM convened an 11-member committee to assess the state of the science on the relationship between secondhand-smoke exposure and acute coronary events. The committee included experts in secondhand-smoke exposure, the pharmacology and pathophysiology of secondhand smoke, clinical cardiology, epidemiology (including cardiovascular epidemiology), and statistics. The committee met three times, including two open information-gathering sessions at which the members heard from stakeholders and researchers. The appendix presents the agendas of the public meetings. The committee evaluated in great detail 11 publications that specifically assessed the effect of smoking bans on the incidence of acute coronary events (see Chapter 5). Those publications looked at the effects of eight smoking bans in different locations: three publications on overlapping regions of Italy after implementation of a national smoking ban (Barone-Adesi et al., 2006; Cesaroni et al., 2008; Vasselli et al., 2008); two publications on the effects of a smoking ban in Pueblo, Colorado—one with 18 months of data (Bartecchi et al., 2006) and one with 3 years of data (CDC, 2009); and one publication each on the effects of smoking bans in Helena, Montana (Sargent et al., 2004), Monroe County, Indiana (Seo and Torabi, 2007), Bowling Green, Ohio (Khuder et al., 2007), New York state (Juster et al., 2007), Saskatoon, Canada (Lemstra et al., 2008), and Scotland (Pell et al., 2008). Exposure of the US population to environmental tobacco smoke: The third National Health and Nutrition Examination Survey, 1988 to 1991. The Centers for Disease Control and Prevention (CDC) asked the Institute of Medicine (IOM) to convene an expert committee to assess the state of the science on the relationship between secondhand-smoke exposure and acute coronary events. Specifically, the committee reviewed available scientific literature on secondhand-smoke exposure (including short-term exposure) and acute coronary events, with emphasis on evidence of causality and on knowledge gaps that future research should address. To accomplish its task, the committee was asked to address a series of specific questions, which are presented in Box 1-1. Despite the improvement, some 126 million nonsmokers living in the United States in 2000 were still being exposed to secondhand smoke. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: A case-control study. Data reviewed in the surgeon general’s 2006 report indicate that smoke-free policies are the most economical and effective way to reduce secondhand-smoke exposure (HHS, 2006); the effect of legislation to ban smoking in public places and workplaces on cardiovascular health of nonsmoking adults, however, remains a question.