Areas that have adopted smoke-free policies in their restaurants, bars, and workplaces have seen a corresponding drop in systolic blood pressure, according to data from the Coronary Artery Risk Development in Young Adults (CARDIA) study.

Dr. Stephanie Mayne

Dr. Stephanie Mayne

“Among a geographically diverse cohort of black and white nonsmoking adults followed for 15 years, we found that participants living in areas with smoke-free policies in restaurants, bars, and workplaces had lower systolic blood pressure at the end of follow-up, compared with participants living in areas without smoke-free policies,” wrote Stephanie L. Mayne, PhD, of the department of preventative medicine at Northwestern University, Chicago, and her coauthors in the Journal of the American Heart Association.

The study analyzed data from 2,606 CARDIA participants, all of whom enrolled in 1985-1986 and underwent follow-up exams after 2, 5, 7, 10, 15, 20, 25, and 30 years. Smoke-free policies were obtained from the American Non-Smokers’ Rights Foundation’s Local Ordinance Database and linked to participants based on their census tract and examination date. Systolic and diastolic blood pressure (SBP, DBP), along with physical activity and dietary quality, were measured at each examination.

By year 25, participants in areas with smoke-free restaurants had SBP values that were 1.14 mm Hg lower than participants who lived in areas with smoke-friendly restaurants (95% confidence interval, 2.15-0.12). Participants in areas with smoke-free bars returned similar results, with a SBP difference of 1.52 mm Hg (95% CI, 2.48-0.57). The data were less conclusive for DBP, though CARDIA indicated that SBP was more associated with cardiovascular disease risk than DBP and “even small reductions in SBP may result in meaningful reductions in CVD risk.”

The coauthors shared the study’s potential limitations, including an inability to control for antismoking campaigns and the possibility that participants did not report any infrequent smoking habits. However, they highlighted previous associations between smoke-free policies and reduced risk of hospitalization for CVD, noting the relation and suggesting “BP reduction as a potential mechanism through which smoke-free policies may reduce rates of CVD at the population level.”

This study was supported by the National Heart, Lung, and Blood Institute, in collaboration with the University of Alabama at Birmingham, Northwestern University, the University of Minnesota, Kaiser Foundation Research Institute, and Johns Hopkins University School of Medicine. It was partially supported by the Intramural Research Program of the National Institute on Aging. No conflicts of interest were reported.

SOURCE: Mayne SL et al. J Am Heart Assoc. 2018 Nov 21. doi: 10.1161/JAHA.118.009829.