In the year after smoke-free legislation was introduced in England, there were 1,200 fewer emergency heart attack hospital admissions - a 2.4 percent decrease, a recent study shows.
The smoke-free law, enacted on July 1, 2007, prohibits smoking Winston and other discount smoking brands in all public places and enclosed workplaces. The researchers analyzed emergency department admissions for patients aged 18 and older from July 2002 to September 2008.
While the decrease may seem small, many public places and workplaces were already smoke-free when the legislation was introduced, the researchers noted.
The study appears online June 9 in the BMJ.
The findings show that banning smoking in public places can reduce hospital admissions for heart attacks even in countries that already have other anti-smoking regulations. This can have an important public health benefit given the high rates of heart disease worldwide, said Dr. Anna Gilmore, University of Bath, and colleagues, in a BMJ news release.
The nation’s three big tobacco companies, and trade associations representing hundreds of New York City bodegas and convenience stores, are challenging the city’s latest salvo in the antismoking wars: graphic images of diseased brains, lungs and teeth that are posted where Marlboro, Eva, Red & White cigarettes are sold.
The tobacco companies — Philip Morris, Lorillard and R. J. Reynolds — joined with the New York State Association of Convenience Stores and retailers in filing a federal lawsuit against the city in an effort to remove the gruesome placards from about 11,500 establishments. Since late last year, the city has required the retailers to post them within three inches of cash registers or in each place where tobacco products are displayed.
The suit, filed on Wednesday in United States District Court in Manhattan, contends that the placard rule infringes on the federal government’s authority to regulate cigarette advertising and warnings and violates the First Amendment rights of store owners who disagree with their message, and that the placards are so disgusting that they hurt business by discouraging people from buying not only cigarettes but also more-wholesome merchandise like milk and sandwiches.
“This is not the city taking out a billboard, which it would have every right to do,” Floyd Abrams, a First Amendment lawyer who is representing the convenience stores, said Friday. “What it doesn’t have the right to do is to force other people to adopt its expression.”
The suit also complains that because of heavy restrictions on cigarette advertising, advertising space near the cash register is one of the last places where companies can promote their brands.
By putting ugly posters there instead, the suit says, the city is blocking tobacco companies from communicating with consumers, depriving retailers of coveted advertising revenue and pushing restrictions on tobacco-related speech “past the constitutional tipping point.”
In a statement, the city’s health department said that putting warnings where cigarettes were sold was one of the most effective ways to deter people from smoking and to discourage a new generation of smokers. “By trying to suppress this educational campaign,” the statement said, “the tobacco industry is signaling its desire to keep kids in the dark.”
The city has spent $80,000 to print and distribute the signs in the eight months since the law was adopted. They are based on research that shows pictures are much more effective at conveying the hazards of smoking than written text, according to the health department.
The suit received a mixed reception on Friday at the Corner News convenience store at 40th Street and Eighth Avenue in Manhattan.
Maria Roman, 35, a customer-service representative, barely glanced at the poster of a bloody tooth, stuck to the cash register, as she paid for a package of candy. To her, she said, the poster seemed perfectly factual. “It’s the truth,” she said, shrugging. “It’s just a visualization of what’s actually happening.”
John Pae, 58, a chef, said he generally resented government intrusions into his life but was even angrier about high cigarette taxes and a proposed soda tax, because they affected his wallet.
He said that he had called the city’s 311 hotline to help him quit smoking about two and a half months ago, but that the nicotine patches the city provided were so cheap that they had to be held on with duct tape. He has since bought patches at a drugstore.
“Everything pushed me to quit — taxes, getting older, the effect on my health,” Mr. Pae said. But he conceded that the city’s 311 smoking-cessation program, which he saw advertised on television, “made it easier.”
A clerk at the store, Saiful Islam, said a photograph on the cash register, of a diseased tooth, was so upsetting that some customers had switched from buying cigarettes to buying candy or gum. Many of them were spending as much on soda, candy and lottery tickets as they had on cigarettes, he said, so the store had not lost business.
He said the taxes that had pushed the price of a pack of cigarettes to $10 were worse for business than the posters, because they led people to buy cigarettes on the black market — which he said thrived on the sidewalk right outside the store.
In the year after smoke-free legislation was introduced in England, there were 1,200 fewer emergency heart attack hospital admissions - a 2.4 percent decrease, a recent study shows. 
