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Smoke-Free Laws Tied to Lowered Blood Pressures

— Modest effects seen across tobacco policy types

Last Updated November 30, 2018
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Reductions in secondhand smoke exposure due to smoke-free policies appear to have modestly reduced blood pressure on a population level, a multicenter cohort study found.

Nonsmokers in communities with smoke-free policies had significantly lower systolic blood pressures compared with those in areas without smoke-free policies, with an adjusted predicted mean reduction of 1.14 mm Hg for policies against smoking in restaurants, 1.52 mm Hg for policies on smoking in bars, and 1.41 mm Hg for policies against smoking in the workplace, reported Stephanie Mayne, PhD, of The Children's Hospital of Philadelphia, and colleagues in the .

Previous research has found that smoke-free policies have contributed to fewer cardiovascular disease, and particularly acute myocardial infarction related hospital admissions. These laws have also reduced secondhand smoke exposure. However, prior investigations have not assessed reductions in BP as a result of smoke-free laws, the researchers noted.

This paper "supports the potential benefits of a smoke-free environment on overall cardiovascular health, which are numerous in addition to potential effects on BP," commented Carl "Chip" Lavie, MD, of the Ochsner Heart and Vascular Institute in New Orleans, who was not involved in the study.

The researchers gathered data on 2,606 (mean age 35.1 years) nonsmoking adults. The researchers connected longitudinal information from the CARDIA (Coronary Artery Risk Development in Young Adults) study to data regarding smoke-free legislation on the local, county and state levels in restaurants, bars, and workplaces with hopes of assessing connections to BP, the investigators noted.

The data from mixed-effects models estimated relationships of policies with blood pressure and hypertension during the course of a 15-year follow-up, while findings from a fixed-effects regression model approximated relationships of smoke-free laws for within-person changes in systolic and diastolic BP and hypertension, the researchers highlighted.

Smoke-free laws in restaurants and bars were linked with significant mean within-person declines in systolic BP of 0.85 and 1.08 mm Hg, respectively.

But only restaurant regulations were linked with a significant within-person reduction in diastolic BP (-0.58 mm Hg, 95% CI -1.15 to -0.01).

"The effects on BP, however, although statistically significant, are only very modest. Also, there is also the possibility that these slight effects were due to other unmeasured factors in the particular environment and not necessarily due to the smoke-free status entirely," Lavie told 51˶.

In the end, the findings "underscore the potential benefit at a population level of smoke-free policies as a prevention measure for high SBP," the researchers concluded.

Disclosures

The study was supported by the National Heart, Lung, and Blood Institute (NHLBI), University of Alabama at Birmingham, Northwestern University, University of Minnesota, Kaiser Foundation Research Institute, and Johns Hopkins University School of Medicine, and Intramural Research Program of the National Institute on Aging (NIA).

Mayne did not report any disclosures.

Primary Source

Journal of the American Heart Association

Mayne S, et al "Associations of smoke-free policies in restaurants, bars, and workplaces with blood pressure changes in the (CARDIA) study" Am Heart J 2018; DOI: 10.1161/JAHA.118.009829.