a new review published in the April issue of The Cochrane Library suggests that restrictions on smoking in public reduce secondhand smoke exposure, heart attacks, and improve a number health indicators.

Researchers searched for studies of situations where a legislative ban had been introduced, or restrictions on smoking had been applied to populations. They considered data from 50 studies that monitored at least the first six months after a policy change had been implemented.

"Taken together, the benefits for workers and the reduction of hospital-related morbidity are impressive," says Professor Cecily Kelleher, School of Public Health, Physiotherapy and Population Science at University College Dublin, Ireland.

"The balance of evidence suggests that legislative smoking bans have achieved their primary objective of reducing exposure to secondhand smoke. The impact on active smoking is not yet conclusively demonstrated," Kelleher says.

Around the world, many countries are introducing policies that restrict where people can smoke. This follows findings that tobacco smoke is the second major cause of death in the world and, according to the World Health Organization (WHO), is currently responsible for the death of around one in ten adults.

Smoking, however, is a complex personal and social activity, so there is an ongoing need to monitor the effect of legislation to see if it is benefiting people.

While there is often a fear that people will react badly to any restrictive policy, the researchers found that approval of the bans, and compliance with them, increased once the bans had been implemented.

Citation: Callinan et al., 'Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption', Cochrane Database of Systematic Reviews, 2010; doi: 10.1002/14651858.CD005992.pub2