An estimated one billion people are expected to die this century as a result of tobacco-related disease. (CBC)

Public smoking bans seem to have paid off in fewer hospital admissions for heart and lung problems, a Canadian study suggests.

The study looked for any effects of Toronto's 2001 ban on smoking in restaurants, aimed at reducing exposure to second-hand smoke, which the researchers say is a major factor in preventable poor health and premature death.

In Monday's issue of the Canadian Medical Association Journal, the researchers reported the following changes since the ban took effect:

• 17 per cent decrease in the heart attack hospitalization rate.
• 33 per cent decrease in rates of admission for respiratory conditions such as asthma, pneumonia and bronchitis.
• 39 per cent decrease in admissions because of cardiovascular conditions such as angina and stroke.

"Research delineating the impact of smoke-free legislation on cardiovascular and respiratory outcomes could have an immense impact on public health, given that an estimated one billion people are expected to die during the 21st century as a result of tobacco-related disease," study author Dr. Alisa Naiman of the Institute for Clinical Evaluative Sciences in Toronto and her co-authors wrote.

The study concluded that the findings are consistent with evidence that exposure to second-hand smoke is detrimental to health "and legitimizes legislative efforts to further reduce exposure."

'Immediate and dramatic' benefit

"These results show an immediate and dramatic decrease in these conditions and offers further evidence that anti-smoking legislation is an integral component of reducing exposure to tobacco smoke and for those who quit, reaping the rewards of a healthier lifestyle," study co-author Rick Glazier, a senior scientist at ICES, said in a release.

The model suggests that eliminating smoking in restaurants contributed to the substantial decline in hospital admissions for the conditions studied in Toronto, but the study can't credit the ban alone for the decline.

The decline in hospital admissions occurred in combination with the decline in the number of smokers, greater efforts to tighten restrictions on tobacco sales, and general improvements in preventive care, the researchers said.

Smoke-free demands

Public health campaigns and demand for smoke-free environments have also played a role, said Pippa Beck, a policy analyst with the Canadian Non-Smokers Rights Association.

"It's amazing when you see major hotel chains that have voluntarily gone 100 per cent smoke-free," Beck said.

"They are not doing that because the government is telling them to. They're doing that because they're responding to the market demand of their customers and in fact it helps the bottom line as well. It's less cost for cleaning and upkeep."

The study's authors called for more research to determine where smoking bans work best.

The ban hasn't resulted in fewer smokers in Toronto, according to federal statistics.

The city's smoking ban has made it tougher to be a smoker, said Michelle Cameron as she sipped a coffee and smoked a cigarette outside a cafe in the city's east end.

Cameron has changed where she lights up since the ban, which she supports. She is also trying to quit. "I've had the patch, I've had the gum, I've had the puffer. Slowly but surely, I'm coming around to it."

So far in Canada, Vancouver is contemplating expanding smoking bans to include outdoor public places such as parks and beaches.

In a commentary that accompanies the study, Prof. Alan Maryon-Davis of Kings College London, United Kingdom, argued for comprehensive cost-benefit analyses to weigh the potential health benefits of anti-smoking legislation against infringements on personal liberty and effects on jobs and livelihoods.