The number of heart attacks has fallen since England imposed a smoking ban

Doing unto others

JOHN STUART MILL argued in the 19th century that an individual should be free to do as he pleased, so long as he did not harm anyone else. The ban on smoking in pubs, bars and company cars—in effect, in all enclosed public spaces—that came into effect in England in 2007 was informed by such thinking. Brought in to protect the health of non-smokers who worked in or frequented such places, it seems to have worked. Research published on June 9th shows that, since the ban, fewer people have been admitted to hospital with symptoms of a heart attack.

Second-hand smoke from a smouldering cigarette is far more noxious than the nicotine-infused fumes inhaled by the smoker. In the minutes after a neighbour has lit a cigarette, a passive smoker’s chances of suffering an immediate heart attack rise rapidly as toxins in the fug make his blood stickier. His long-term risk also rises, as narrowing arteries threaten him with heart disease and his chances of developing lung cancer and numerous other nasties also increase.

Anna Gilmore of the University of Bath and her colleagues looked at how many people were admitted to hospital with a heart attack in England between 2002 and 2008. About 110,000 people are struck down each year; almost a fifth of them die before they reach hospital, and a further tenth within a month of going into one. Ms Gilmore and her team found that, in the 12 months after the smoking ban came into force, some 1,200 fewer people were admitted to hospital with heart attacks than even the prevailing downward trend had suggested was likely. That drop of 2.4% saved £8.4m in emergency hospital care.

When the ban took effect, England was the largest jurisdiction to forbid smoking in enclosed public spaces. Studying a large population tends to give a more accurate result than studies of smaller places such as Scotland, parts of Italy and New York state, where more impressive reductions have been claimed. When the town of Helena, in Montana, banned smoking for six months, for example, hospital admissions for heart attacks almost halved from seven to less than four a month. Ms Gilmore reckons her figure, which covers far more people, is more robust.

Because heart disease is the most common cause of death in wealthy countries, even a relatively small reduction in heart attacks is good news for a great many people. In Britain, the freedom to smoke remains, but not at the expense of others.