Smoking ban miracle in Germany

Readers of this story recognise the holes in it. Researchers found a city where heart attack admissions have dropped following the introduction of a smoking ban, and quickly decided that it would help in building the case for a smoking ban, regardless of any other factors, such as the comprehensiveness of the ban and whether or not it did actually result in a reduction of so-called passive smoke exposure (rather than simply ensuring that people were exposed at home rather than in recreational venues).

The story says that the drop in heart attacks in Bremen was a 25 per cent drop and compares it to the drop of 2.4 per cent that the Department of Health found in England. A ten-fold disparity (as well as the huge disparities in population) in the figures must surely tell them something! but the figures of various heart attack drops are rattled off as if they proved, rather than cast a heavy shadow over the theory that smoking bans stop heart attack admissions.

A more accurate measure would have involved a larger population, across the whole of Germany. Why pick Bremen anyway – simply because the figures could be made to show a large drop? Small populations are more likely to produce startling variances for a wide variety of reasons.

An example of a study seeking to cover a wider population base is here. No statistically significant drops in heart attacks were found when studies were conducted over wider population bases using publicly available data on admissions, and employing appropriate controls.