Scots smoke ban 'improved health'

[AnnaKarpik]

I'm not an expert but surely a diagnosis of a heart attack is a pretty clear one?

As neither of us is an expert this could well be a pointless argument but....

I don't think that an internal event (within a human body) that has occurred without any monitoring and cannot be verified by direct examination - such as, an episode of acute chest pain, say - is likely to have a 100% accurate diagnosis rate. How many diagnoses are actually checked out anyway? is there a government body paying for post-mortem examinations to confirm a previous diagnosis?

Personally I have had 3 incorrect diagnoses of a problem that was not a difficult or obscure one and have undergone tests on my heart which is perfectly healthy. Why should heart attacks - which seldom happen in hospitals anyway - be so easy to diagnose?

 

[chymaera]

Why should heart attacks - which seldom happen in hospitals anyway - be so easy to diagnose?

A heart attack causes a very specific enzime to be in the blood which is easily detectable.

 

[WouldBe]

and quite often produces a change in the electrical signals that can be picked up on an ecg.

 

[mr steev]

I can't believe that this is cause and effect. The sort of conditions caused by smoking are built up over time, not the course of one year.

Indeed
You could just as easily put it down to the 'eating 5 fruit and veg a day' campaign.
Or that cos it's been a shite summer, less people have excerted themselves out and about (although this is in Scotland, so they're probably used to the weather )

 

[AnnaKarpik]

A heart attack causes a very specific enzime to be in the blood which is easily detectable.

I find that this is true although I do not find (possibly through superficial searching) over what period blood testing has been used to diagnose heart attack in the UK or whether any diagnostic criteria have changed in the recent past. Or even whether there have been any changes to data collection in the recent past.

The point that I have tried to make is that almost any set of data can be incomplete or biased and moreover is open to interpretation depending on the person or group producing the report. If any of us were told authoritativelythat applying leeches improved your enjoyment of sex we might be a little sceptical. Why not be equally sceptical of extraordinary claims about a smoking ban?

 

[justuname]

I can't believe that this is cause and effect. The sort of conditions caused by smoking are built up over time, not the course of one year. Come back in 10 year's time, with data gathered from multiple locations that have banned smoking in public places, and then we can start talking cause and effect.

I agree. But why has no one thought of thr obvious cause of this improvement, the reorganisation of the NHS? The greater use of market discipline within health provision, the increased involvement of the private sector, with its expertise, lack of bureaucracy and entrepreneurial spirit - these processes have been at work for over a decade and have had an enormous impact on the NHS.

I'm sure it would be possible to find funding for a study looking at the interaction between the reorganisation of managerial and clinical service provision systems in the NHS and clinical outputs such as heart attack rates that would show a strong correlation between the two.

 

[_angel_]

Seeing as the press release was only released yesterday and it was only on the BBC the same day, could you reveal your source that got the story several days earlier than everyone else, please?

Are you trying to start an argument or what? I heard/ read this a couple of days before you posted this thread. And I'm not starting on anyone about it either!

 

[_angel_]

As neither of us is an expert this could well be a pointless argument but....

I don't think that an internal event (within a human body) that has occurred without any monitoring and cannot be verified by direct examination - such as, an episode of acute chest pain, say - is likely to have a 100% accurate diagnosis rate. How many diagnoses are actually checked out anyway? is there a government body paying for post-mortem examinations to confirm a previous diagnosis?

Personally I have had 3 incorrect diagnoses of a problem that was not a difficult or obscure one and have undergone tests on my heart which is perfectly healthy. Why should heart attacks - which seldom happen in hospitals anyway - be so easy to diagnose?

They can test quite accurately, the attacks do not have to occur in hospital, they can do a test afterwards to see if the person suffered a heart attack or not. My dad had one such test when he was in hospital with angina. They wanted to know if he had suffered a mild heart attack, fortunately it wasn't.

I'm puzzled at the scepticism regarding these figures tbh.

 

[chymaera]

I'm puzzled at the scepticism regarding these figures tbh.

So am I given every country that has introduced a smoking ban had a dramatic drop in heart attacks in the following year.

 

[Fullyplumped]

So am I given every country that has introduced a smoking ban had a dramatic drop in heart attacks in the following year.

Do you have a source for that, or did you "read it somewhere"?

 

[chymaera]

Do you have a source for that, or did you "read it somewhere"?

Just for you I will log off from here, go over to another forum where I posted a number of references and be back in a few minutes.

 

[chymaera]

Do you have a source for that, or did you "read it somewhere"?

http://www.newscientist.com/article/dn3557.html
http://www.bmj.com/cgi/content/abstract/bmj.38055.715683.55v1
http://www.independent.ie/national-...as-smoking-ban-takes-full-effect-1071344.html
http://student.bmj.com/issues/04/06/papers/244.php
http://www.eurekalert.org/pub_releases/2006-10/esoc-ips100106.php
http://sciam.com/article.cfm?alias=heart-attacks-tumble-afte&chanID=sa003&modsrc=reuters

 

[Fullyplumped]

http://www.newscientist.com/article/dn3557.html
http://www.bmj.com/cgi/content/abstract/bmj.38055.715683.55v1
http://www.independent.ie/national-...as-smoking-ban-takes-full-effect-1071344.html
http://student.bmj.com/issues/04/06/papers/244.php
http://www.eurekalert.org/pub_releases/2006-10/esoc-ips100106.php
http://sciam.com/article.cfm?alias=heart-attacks-tumble-afte&chanID=sa003&modsrc=reuters

Thank you for that. The articles you cited certainly show that a smoking ban in public places had that effect in Ireland, Piedmont in Italy, and Helena, Montana, just as it did in the hospitals in Scotland. Those aren't all the locations in which smoking in public places have been banned, as you originally suggested, but the studies emphasise the validity of the conclusion in the study reported at the recent conference in Edinburgh.

 

[chymaera]

Those aren't all the locations in which smoking in public places have been banned, .

What do you want blood. They are the first ones I came across, it is a very long list otherwise.

 

[Fullyplumped]

What do you want blood. They are the first ones I came across, it is a very long list otherwise.

We might as well be rigorous with the facts, as not.

Are you the Artist Formerly Known as Tobyjug, as others have suggested? If so, you threatened to have your missus beat me up.

 

[Redmist]

I would like to see the total number of scottish heart attacks including non-admissions for the same period before I draw conclusions because if more people are having heart attack private and dying as opposed to having heart attacks in public and being admitted to hospital it would be a bad thing for public health.

 

[Alan G]

I find that this is true although I do not find (possibly through superficial searching) over what period blood testing has been used to diagnose heart attack in the UK or whether any diagnostic criteria have changed in the recent past. Or even whether there have been any changes to data collection in the recent past.

Using blood tests and ECG you can tell if someone has had a heart attack or an angina attack. My mum had her first heart attack 13 years ago and they were using this technique back then, and every subsequent heart attack she has had since.

[anecde]
for the period she stopped smoking her health improved and the number of angina attacks she was having reduced, once she started again it returned to its previous level of angina attacks.
[anectode]

So I have no problem with the idea that the smoking ban could have an affect this quickly albeit based on 1 anecdotal account. As I said before, more data for the next few years will be needed to draw a definite causational rather than correlational link but it is not unreasonable to think that one will be found.

 

[Cobbles]

I wasn't joking when I said that. The smoking ban seems to have brought home to people that smoking cigarettes is lethal in ways that other measures haven't. It is extremely likely that the public health message is being complemented very effectively by messages at home. It is probable, I think, that most of those who would have avoided heart attacks are not single and have families that are on at them all the time to stop smoking and pack in the filthy habit.

Indeed, and people who have been going to smoke filled pubs for decades have discovered that the touted "long term effects" have reversed themselves instantaneously...........

It's probably more to do with guaranteed surgical waiting lists leading to damaged hearts getting a bypass operation in time for the patient not to have a heart attack.

 

[_angel_]

A lot of people on here desperate for the effects of the smoking ban not to be positive, it seems, even in light of the evidence. Is it a bit inconvenient for them?

 

[chymaera]

A lot of people on here desperate for the effects of the smoking ban not to be positive, it seems, even in light of the evidence. Is it a bit inconvenient for them?

Give the one off large drop drop in heart attack rates in the year after bans elswhere. (Referenced in an earlier message) I really think the evidence overwhelming.