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Systematic review with meta-analysis
Meta-analysis of before and after studies shows a 10% reduction in acute coronary events after introduction of comprehensive smoke-free legislation
  1. Joaquin Barnoya1,2,
  2. Graham A Colditz1
  1. 1The Cardiovascular Unit of Guatemala, Guatemala
  2. 2Washington University School of Medicine, St Louis, Missouri, USA
  1. Correspondence to Joaquin Barnoya
    Campus Box 8100, 660 S. Euclid Avenue, St Louis, MO 63110, USA; barnoyaj{at}

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That tobacco (active and passive smoking) is the leading cause of cardiovascular disease (CVD) is no longer subject to debate. However, as opposed to some other CVD risk factors, we do know what works for tobacco control. From an individual and societal perspective, smoke-free environments have proven to be one of the most effective measures to prevent CVD (and other chronic diseases). Smoke-free environments decrease smoking prevalence, heart disease mortality and lung cancer incidence.1 Globally, as of November 2010, 169 nations had signed the World Health Organization Framework Convention on Tobacco Control and, partially stimulated by it, as of January 2011, 55 countries had some sort of smoke-free law, 37 of which include both bars and restaurants. …

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  • Competing interests JB is partially supported by an unrestricted grant from the American Cancer Society. GAC is supported by an American Cancer Society Clinical Research Professorship.