Most of you know I am no stranger to the food and wine world and living in New York I have access to a lot of great establishments where I can indulge in these two passions of mine.  I got word a few weeks ago that a new wine bar was going to open in Greenwich Village and it sounded perfect, but I was skeptical based on the man who owns it.

While Roberto Passon is an established restaurateur here in Manhattan, I personally think he did the most cowardly thing he could have done with Aria Wine Bar: he played it safe (and boring) and completely didn’t live up to the concept he had UrbanDaddy and food writer Gael Greene promulgate on the internet, that of having Aria be like a slice of Venetian life.   Passon is respected for his pastas and he was wise to not rely on them here at Aria, but at his original restaurant the pasta was the only thing he got right.

With its communal tables, hanging prosciuttos, and large chalkboards with parts of the bar’s offerings written in a rustic manner, that’s about as Venetian as it got.  In every write-up about Aria before and right after its opening two weeks ago, each person mentioning this new spot obsessed over the fact that Passon was bringing traditional cicchetti, or Venetian-style tapas, to New York.  While I am the product of proud immigrant Italians, I am not Venetian, but I know cicchetti when I see it and cicchetti was not to be found here.

Forgetting the small offering of salumi and some cheeses, there were roughly twenty dishes on the menu and an overwhelming reliance on goat cheese, a/k/a not something you’ll find widely in Venice (if at all).  You don’t have to be card-carrying member of MENSA to deduce that if Venice is built on a series of canals then its residents must eat a lot of seafood, but seafood was virtually non-existent on the menu.  The most traditional cicchette of them all is cod on a piece of crusty bread: not only was no cod to be found, but there was not one instance of fish on bread.   I did have the anchovies with marinated peppers and the anchovies were lackluster and the peppers didn’t have that acidic quality they should have if marinated.  The polenta with sauteed mushrooms was good, but the mushrooms were loaded with butter and even overpowered the shaved parmigiano on top. The polpettini were a nice presentation and had decent flavour, but the pomodoro sauce that dressed them was not as fresh as it should have been.  It seemed like the only thing that worked was the bufala mozzarella with heirloom tomato and basil, but as long as the core ingredients are good no one can screw that up.

Sadly, I was expecting a lot more from the wine list, which was small in comparison to the hype that was built around it.  I had been informed through multiple sources that the list was comprised of wines chosen entirely by women, which in and of itself it a great marketing tool. There were a few whites, two rosés (only one listed on the menu — I had to ask about the other), five reds and a couple of dessert wines. While I commend Mr. Passon for going this route, the wine list was confusing and I honestly didn’t care that next to every wine there was a woman’s name because it’s not like all of these women were present and accounted for so you could choose to commend or scold them for what they selected. While I enjoyed a couple glasses of the Familia Cassone ’08 Malbec, I could have cared less that someone named Florencia felt it belonged there.

All-in-all Aria Wine Bar is not a home run: the atmosphere was fun, but the food failed to deliver on its promise and the wine list was nothing spectacular.  I was really hoping Aria would be one of those unique spots here in New York that actually educated Americans about what true regional Italian cuisine is, but it instead went on stereotypes and placated a society that thinks real Italian food is this homogenized existence where your meatballs actually belong on your pasta.  I think the most fun part of the wine bar was its bathroom where a basket of chalk encouraged patrons to sketch on its walls. If you are reading this Roberto Passon, I left you a note in Italian at the centre of the wall facing the mirror by the sink: leggerlo e magari puoi dirmi dove è il baccalà.

Check out my monthly wine review for my lovely friends over at Life In Abruzzo.  This review was originally published on their website on 18 May 2010.

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If you have experience with Abruzzese vintners then you know that the name Farnese is associated with bargain wine. Do not be alarmed by the moniker of “bargain” because inexpensive wines these days rarely mean poorly made, but rather affordable and ready to drink.

In 1582 Princess Marguerite Farnese fell in love with the town of Ortona. Sandwiched between the Adriatic and the Maiella Massif, the Princess adored the landscape so much she did what any royal would have done: she purchased the entire town. Farnese commissioned a palazzo and lived there happily in her own slice of paradise, but thanks to her and her family’s cosmopolitan nature, Farnese wine became respected and was found on banquet tables of European high courts. Although the Farnese family has not owned the label for generations, their successors in pure gratitude have kept the name and adapted the old world traditions to modern day.

As a wine lover I found this 100% Montepulciano d’Abruzzo to be more medium in body, but while sharing two bottles with my family over dinner some argued it approached the low-end of the full body scale. To the nose there is that mark of any good Abruzzo wine – ripe raspberries – and along to follow were definite hints of dark raisin and a distinct creaminess that prevents the fruit from seeming too sharp. To the palate the berry permeates almost throughout but as it fades there is the slightest hint of licorice before giving way to the unique infusion of French Oak.  (Farnese wines are cured in French and American oak barrels.)

This particular wine seems to be made with meat in mind because it pairs extremely well with salamis, as well red meats. My family and I enjoyed the first bottle over some antipasti plus polpettini in a fresh tomato sauce with shavings of parmigiano and my brother’s favourite, arancini. As we continued onto the secondi piatti the Farnese transitioned nicely to compliment osso buco and veal chop alike.

While being a delightful wine for its stability, I will warn those of you with a honed palate that this Montepulciano will bore you if you are looking for sophistication.  It is still a great bottle and a terrific buy, so if you are looking for a wine everyone would love for an event or are new to the wine world, this is a great place to start. With a price tag of roughly $8 — $10 (£6-£8) per bottle in stores ($30/£15 in a restaurant), the Farnese Montepulciano is an easy win and one of those labels that should always be on your wine rack.

I have to admit that the older I get, the more adventurous I become in my food choices.  Until I was nearly 21 years-old I was a vegetarian (and vegan for three years in there, too!) and I was a boring person with boring food tastes.  It wasn’t until I met my best friend who happens to be from La Paz, Bolivia, that I was exposed to some rather unique foods and preparations.  Thanks to Nico I also got very interested in cooking and I think the weekend he and a few of our good friends made something like five dozen salteñas from scratch that I got the ethnic gourmet bug.

Thanks to the violin I’ve had the opportunity to see a lot more of the world than many people my age, and in that time I’ve tried some weird things. I’ve eaten sheep eyeballs, cow brains, pork cheeks, chocolate-covered grasshoppers, spleen sandwiches, head cheese, etc., and with the exception that I have to stay away from shellfish due to my one food allergy, I’ll try anything at least once since I usually wind up liking it.   I’m the quintessential “When in Rome” person: if I’m visiting your home or your country and you tell me what is on my plate is traditional, I would never dream of insulting you by not partaking.  Now with that being said, even I come across things that make me shake my head, so I ask you when you take a look below, would you eat this??

• Monkey Toes: apparently in Indonesia they break apart the toes of a monkey and deep fry them.  I know people who firmly believe that frying anything makes it good, but would you give this a shot?
• Bull Penis: this is popular in many Asian countries and I can’t say I would be too excited to try it.  I know that the translation into Chinese (for example) is something along the lines of “bull pizzler” and it’s not uncommon in stews, but like most of you will be, I’m not interested.
• Breast Milk: I know you don’t “eat” this, but c’mon! I don’t drink regular cow’s milk, so I doubt I would want this when in China.  There is a restaurant in the Hunan province that serves dishes cooked in breast milk as part of their “Milk Banquet” menu.
• Tarantula: This arachnid is not uncommon in some parts of the world but it rather popular in Cambodia.  Legend has it that during the days of the Khmer Rouge and a scarce food supply, locals hunted them and prepared them in ways that today they are sold throughout markets both as snack food and to take home for a meal.

• Kopi Luwak: Sounds exotic, right?  Well if you ever find yourself in Indonesia don’t say I didn’t warn you if someone offers you this specialty coffee since it’s made from the excrement of a cat-like creature called the Luwak.  Luwaks eat only the most ripe coffee berries that the stomach cannot digest, so they come out whole.  Combine that with the enzymes and stomach acid and you have what is actually the world’s most expensive coffee of upwards of USD $300 per pound.
• Lardo: This comes from my Italian people and it’s good, albeit a bit weird! Take off the ending vowel and you have the word “lard,” and this is pure animal fat. It’s made by taking pure pig fat and curing it in a large marble basin with salt, pepper, and rosemary. Lardo is sliced so thin you can basically see through is and can be served on a piece of warm bread or over some salumi like prosciutto, but it’s actually really good on its own. Since it’s so thin it literally melts on your tongue, but I think if you have cholesterol issues you might want to forgo this one!

Have you ever eaten anything strange or supremely removed from your comfort zone?  Please leave comments and share below!

A very interesting and rather humourous look at what fast-food companies are doing as they expand into markets rather unfamiliar with their original, seemingly American products.  I don’t know about you, but despite not eating fast-food in the US, I almost want to go to Israel just to try a McKebab….

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Fast-food chains adapt to local tastes

(CNN) — After thousands of years of civilization, finally India has Crunchwraps.

In March, a Taco Bell opened in Bangalore, the first Indian outpost of the chain.

About 2,500 people a day have been lining up to try burritos and quesadillas, helped out by employees hired to explain what, exactly, burritos and quesadillas are, according to reports.

But Indian customers aren’t just ordering the Tex-Mex treats known in the U.S. Yum Foods, Taco Bell’s parent company, came up with a bunch of special menu items designed for local palates: crunchy potato tacos and extra-spicy burritos filled with paneer, the rubbery, fresh Indian cheese.

This move is what people in the trade call product localization: customizing what you’re selling to the people you’re selling it to. It’s a crucial strategy in the global fast-food business. American chains are bringing burgers and pizza and chimichangas to Asia, but they are also adapting to their new homes, coming up with hybrid foods that the folks back home don’t hear about.

This is nothing new, of course. McDonald’s, which has branches in more than 119 countries, has been customizing its menus for years.

Anyone who’s seen “Pulp Fiction” knows that a McDonald’s Quarter Pounder is called a Royal in France, but it’s not just the names that are different. French visitors to the golden arches can get Le P’tit Moutarde, a smaller-size burger with mustard sauce, and they can pair it with a banana caramel shake.

In the Netherlands, McDonald’s serves a McKroket (a fried beef croquette on a bun); in Germany, it offers shrimp with cocktail sauce. The 280 Gr. is an Italy-only burger, designed for sophisticated palates — you can get one with real Parmigiano-Reggiano cheese.

There’s a burger on pita bread for the Greek market (the Greek Mac, of course), and a McKebab for Israel. Naturally, you can get guacamole on your burger in Mexico; you can also order McMolletes — refried beans and salsa on an English muffin.

Asia is the fastest-growing market for American fast food though, and all the chains trying to find a place there are scrambling to come up with new dishes to please local tastes.

Here’s some of what Americans may be missing:

India

As the Taco Bell honchos undoubtedly know, India is a tricky market for food chains. Hindus don’t eat beef, Muslims don’t eat pork, and a sizable percentage of the country doesn’t eat meat at all.

Fried chicken is a relatively safe bet, and KFC — another Yum Foods-owned brand — does a good business in buckets of Colonel Sanders’ original recipe. But it also caters to vegetarians with a veg thali, a vegetable-and-rice mixed plate, and the Chana Snacker, a chickpea burger with Thousand Island dressing.

The Indian Subway menu has the same turkey and tuna sandwiches as in U.S. stores, but roast beef is nowhere to be found, and the ham is made of chicken. And at franchises from Chandigarh to Chennai, you can order a chicken tikka sub or one made from roast lamb.

When McDonald’s set up shop in India in 1996, it ditched beef and introduced the Maharaja Mac, originally made with lamb. Chicken patties are used on the sandwich now, but even more popular is the vegetarian McAloo Tikki, a burger made from potatoes and peas. To allay strict dietary concerns, the carnivorous and vegetarian cooking is done separately, by different sets of workers: Those cooking the veggie meals wear green aprons; people handling meat wear red.

The big fast-food success story is Domino’s Pizza, which recently opened its 300th branch in India. It manages to please all tastes and honor all restrictions: There’s a corn and black olive pizza for the vegetarians (the “Gourmet”) and keema do pyaaza topping — ground lamb and onions — for meat eaters. For a true exotic taste, there’s pepperoni: “100 percent pork pepperoni,” the online menu promises, rather scandalously.

China

The leading American chain in the Chinese market, KFC, offers plenty of dishes that cater to local tastes. Instead of coleslaw, you can order seasonal vegetables with your chicken: bamboo shoots in spring, lotus root in summer. It also offers a traditional breakfast menu featuring congee — rice porridge — served with fried crullers or sesame flatbread for dipping.

McDonald’s, on the other hand, sticks mostly with classic sandwiches. After introducing regionally specific items, such as the rice burgers it serves in other Asian countries, and trying to compete with KFC on the chicken front, it found that its Chinese customers preferred to order Western foods. So it played up the burgers, rolling out a suggestive ad campaign with the slogan “Feel the beef.”

But not everything is exactly the same as it is in the States. A version of the Quarter Pounder (called the Big N’ Beefy) is served with cucumbers rather than pickles and comes with a spicier sauce. If you don’t want fries, you can order a corn cup, a side dish that has caught on at other Asian branches. For dessert, you can choose between pineapple or taro root pies.

Japan

For its Japanese stores, McDonald’s has found that novelty is the way to go, and the company has introduced lots of special menu items. You can pair your Teriyaki McBurger, made from pork, with a bag of Seaweed Shaker fries (add the seaweed powder yourself). You can get a Croquette Burger or a Bacon Potato Pie. Probably the most distinctively Japanese dish is the Ebi Filet-O, a fried shrimp patty on a bun (“ebi” means shrimp in Japanese). McDonald’s helped popularize the dish by signing up model Yuri Ebihara — nicknamed “Ebi-chan” — to do a series of print ads and commercials.

A few years back, Pizza Hut Japan introduced the Double Roll, an over-the-top pizza to make all other over-the-top pizzas run away and cower in fear. One half (the “gourmet half”) was topped with ham, bacon, sausage, tomatoes and garlic. The other half was covered with miniature hamburger patties, soybeans and corn. Sadly, the Double Roll is no longer sold, but that doesn’t mean Pizza Hut is boring. Your topping choices include tuna, fried squid and spicy Korean-style beef. You also can get the “Idaho Special” with potato, corn, bacon and mayonnaise.

South Korea

Dunkin’ Donuts has made a big splash in South Korea, popularizing bagels and doughnuts as breakfast treats. Besides the standard American glazed and filled versions, it offers red bean and glutinous rice doughnuts as well as sweet potato muffins and a sesame tofu ring. There are savory fried croquettes filled with lentil curry or kimchi, spicy pickled cabbage. To drink, you can get a hot 12-grain latte, made from roasted barley, brown rice and other grains.

Today one year ago at 3:32a, L’Aquila and its surrounding areas were rattled by a devastating earthquake. The 6.3 magnitude quake is considered one of the largest post-war natural disasters in Europe’s history and it left 60,000 people homeless.  The bells rung today at a candlelit vigil in downtown L’Aquila 308 times: once for each life lost.

While at first the efforts by the government and emergency crews were praised worldwide, most people still remain in temporary housing and are not able to stay terribly close to where their homes once were. Medieval architecture is still in a state of great disrepair and downtown remains essentially off-limits since the structures are still labeled as unstable.  It has been one year, yet some estimate it may take ten years for life to return to normal in this quaint and gorgeous southern Italian provincial area.

Although political slogans were banned from being broadcast during the somber vigil, it is even more of a reminder that as nearly 25,000 people gathered in front of the cathedral, many of the streets they traveled today are still littered with rubble.  Silvio Berlusconi offered his condolences once more and praised the efforts of his government in aiding the injured, the sick, the homeless, and the dead, but as expected many more whistled rather than applauded.  The so-called “Wheelbarrow People”–those displaced residents who have protested with wheelbarrows by picking up the rubble in the quartered off downtown areas–still stage regular protests because corruption has once again taken centre stage in Italy.

I was lucky since none of my extended family or friends were in their homes in L’Aquila at the time, but I know I am in the minority here.  If you wish you can still donate to the Red Cross or through the National Italian American Foundation (NIAF) or any other venues listed on my friend Sammy Dunham’s website, Life in Abruzzo. Also on her site is a heart-breaking letter from the extremely articulate Sofia Lawrence, who at 12 years old wrote a letter to her friend Davide in his memory. In addition, one great way to help any area ravaged by disaster is to patronize its industry(ies), so please find some businesses below that I personally support and will help L’Aquila get back on its feet:

• Marcelli Formaggi : a family owned and operated business right in Abruzzo importing some of the finest cheeses, honey, and olive oil.  The Marcelli family’s cheeses can be found in some of New York’s top restaurants and through their sister site, Abruzzo Pantry, you can place an order and enjoy fine, farm-fresh foods.
• La Porta dei Parchi : this happens to be the Marcelli’s farm where if you’re looking for a unique experience, you can take part in Italy’s burgeoning agriturismo movement.  You can stay on the grounds, help the family, and experience what life is like in the L’Aquila province–one of the most beautiful spots in all of Italy. If this seems a bit out-of-character for you, you can participate in their “Adopt a Sheep” program & your contributions will help fund the farm and you can get fresh wool and cheese sent to you from your sheep.  It’s adorable and a wonderful concept.
• Breaking Bread in L’Aquila: Maria Filice’s first book–Breaking Bread in L’Aquila–pays homage to the region’s food and traditions and today is actually the book’s official launch.  You can learn about it on Maria’s website, Food and Fate, and all net profits will be going towards the rebuilding efforts.

Video: L\’Aquila Marks One Year Anniversary

You don’t have to be Italian to love cheeses as much as I do, but if you were raised around a family like mine, then chances are you have a great appreciation for it.  I’ve said this many times–and it is the total truth–I could live happily until the day I die with some good red wine, cheese, and some salumi (not to be confused with the term salami). Now what my cholesterol levels might be come that day when I do die is a totally different story…!

My darling Grandfather comes from a very small town called Castel di Ieri in the province of L’Aquila in Abruzzo and the province itself is known for sheep, strong meats, and great cheeses. There is a family located in an equally small town called Anversa and the Marcellis are heralded for their formaggi. Outside of their bioagriturismo business where you can go to La Porta dei Parchi  and see what life is like there, they also import their cheeses to New York City where they are served in some of the best restaurants in town.  On top of it all they have this wonderful program known as Adotta una pecora or “Adopt a Sheep” where your contributions can help keep this dying industry alive. (In return you can reap some excellent benefits like a partially paid tribute to La Porta, fresh cheese, and amazing wool products.)

If you love great, farm fresh products made by real people preserving tradition, then I urge you to visit the Marcelli’s website where whether in the US or the EU you can see which restaurants carry their cheeses and place orders of your own.  Go visit them here to learn their story, philosophy and order some great goodies: http://www.marcelliformaggi.com/

If you are an animal lover like me and are interested in adopting the most adorable sheep to ever roam Italy, then please visit http://www.laportadeiparchi.it/help_usa.htm

For more information on the bioagriturismo movement in L’Aquila and Abruzzo go to:  http://www.laportadeiparchi.it/index.htm

All the information provided on these websites come in a variety of languages, so no matter what you prefer you will be able to better understand what makes this part of Italy so wonderful and hopefully enjoy some of the delicious things I got to have growing up!

As if I couldn’t be any more proud to be Abruzzese via my maternal Grandfather, the owner of a wonderful website–Life in Abruzzo–contacted me recently and asked me to be a guest writer for the webzine and travel guide.  Once a month I will be providing wine reviews of various bottles from the region and below you will find my first which was published earlier today.

In between my monthly reviews please go and check out Life in Abruzzo both on the website and follow them on Twitter for the latest updates on all things Abruzzo!

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With multiple estates mostly concentrated in Teramo and Chieti, this specific Montepulciano d’Abruzzo was first produced in 1981 when Gianni Masciarelli decided to enter the wine business and follow his passion. Containing grapes from his estates in Teramo and Pescara, this wine is deep ruby red in colour and was rather surprising to me in how it delivered.

To the nose this wine seems intensely fruit-forward with discernable notes of raspberry and cherry, yet in its early delivery the expected bouquet was not what I got, but rather I tasted more tobacco and earth than the berries I smelled moments before.  This wine is somewhat deceiving in that respect. Another unexpected occurrence here was how long it took this wine to open up: I always let red wines breathe but this one took an exceptionally long time to reach its full potential.  It seemed so light and once it finally opened up after about twenty minutes I finally started to taste some of the plum and berry notes I figured I would be tasting from start to finish.  Other notes present besides the aforementioned are red currant, which along with the smoky tobacco hints made for a nice balance overall.

This is a great wine to keep around as something to enjoy a glass of while relaxing at home, but I do not think it has a lot of pairing options.  Since this wine is in the light-medium range in body, it is best enjoyed with cheeses such as Fontina Val d’Aosta, a young Pecorino (no older than 8-14 months aged), or one of my personal favourites, scamorza.  Each of these cheeses will bring out the earthier notes in this wine that are faint in comparison to the fruity notes and will balance well with the wine overall.

If you would like to pair this with a meal, lightly seasoned pork or lamb will be most suited and if they are grilled even better.  I myself prepared some pork and once the wine opened up the two worked together brilliantly.

This wine is actually meant to be enjoyed young according to its maker, and I can see why: since I only had access to a 2006 one can tell that its individual essences become very blurred over time and therefore lose their respective intensities.  A great bargain, this wine retails anywhere between USD $8 — $13 per bottle (depending on the vintage), so buy plenty and drink often!

Yesterday I made a quick posting on Twitter and my Facebook about how Pizzeria Uno had filed for Chapter 11 and as is my nature, made a snappy comment along the lines of “I’m glad the world finally realised that Chicago-style is NOT pizza.”  While many of my fellow east coasters agreed with me and laughed a bit, as always I ruffled some feathers & some defended their favourite pie. One of those defenders was a good friend from college who is so obsessed by pizza that he has spent so many man hours working on his own pizza dough and sauce that he is a self-titled pizza master. (I love you dearly, Stephen, but until I get samples you’re still a coffee-loving bassoon player in my heart.)

Just like there are with many foods that are beloved around the world, there will always be this debate about authenticity, history, style, etc, and pizza is no exception.  It’s always funny to me to think of how pizza-obsessed we’ve become as a culture since my 90 year-old Italian immigrant Grandfather has told me stories about the rise of pizza culture in the US numerous times.  Up until a few decades ago pizza was only found in Italian communities in various cities like Brooklyn, where he moved to as a child from Abruzzo.  Brooklyn style (which is basically what most NY pizza is today) was a modification from the original Neapolitan pie, which is considered to be the original pizza.

For those of you unfamiliar with the story behind pizza, like any cherished food today it started out as food for the poor. While bakers used it as a means to gauge oven temperature as far back as the 16th century in Naples, the cooked dough was covered in a white sauce and often topped with olive oil, fish, and/or  tomatoes and sold out in the streets like the busy Spaccanapoli  for pennies.  Forward to June 1889, where Neapolitan chef Raffaele Esposito wished to honour Queen Margherita of Savoy and created what is known today as the traditional Neapolitan pie: thin crust garnished with fresh tomato, mozzarella and basil. The red, white and green in the food as you may have guessed was meant to represent the Italian flag.  **Random fact: Esposito was the first to add cheese to pizza; and while other chefs created food for the Queen’s visit, she strongly preferred his pizza because of the taste and its representation of the flag’s colours.

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Obviously we now have all these different styles of pizza and everyone has their favourite, but Naples took it one step further in 1984 with the creation of the Associazione Verace Pizza Napoletana, which only recognizes the margherita and the marinara and compiled a specific set of rules for those that which to call their pizza “Neapolitan.” Such rules include that the pizza must be made in a wood-fired, domed oven at 485 C for no more than 60 — 90 seconds; the dough must be needed by hand and no rolling pins or mechanical devices are to be used, with the dough’s diameter being no more than 35 centimetres.  Just like we have here in the US, even parts of Italy have regional styles like Sicily (square slices with thicker crust) and Rome, where pizza is a snack food that’s folded like a sandwich and only the dough is exposed.

Here in New York we fight Chicago in two aspects: hot dogs and pizza. Chicago-style pizza is also known as “deep-dish” because it’s prepared in a special pan that allots for a much thicker crust and allows for greater amounts of cheese, sauce, and toppings.  Just like when I order coffee and tell the person behind the counter I want a bit of milk with my coffee and not a bit of coffee with my milk, I feel the exact same way about pizza: I don’t want mounds of greasy dough in my way.  (I also don’t want to eat a slice and feel like I’m carrying dead weight in my intestines, either.) I always wondered why Chicago has to add so much to their versions of popular East Coast foods, but I’m guessing their ridiculous Winter weather patterns have something to do with it.

I don’t think I have to spell out what I prefer and grew up with, but what do you like and why?  Is there any merit at all to the great pizza debate??

A very interesting article from Dr. Michael Siegal’s blog that was brought to my attention by Jorge Armenteros of Tobacconist University. Keep in mind this is not the first commentary about showing the world that governments’ lofty claims about the benefits of not smoking are often unfounded….

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Published Study Finds No Effect of Smoking Ban on Heart Attacks in Tuscany, Italy in First Year After Ban

This is the first published study to report no significant effect of a smoking ban on heart attacks.

The smoking ban in Italy went into effect on January 10, 2005. The investigators compared incident cases of acute myocardial infarction (heart attacks) among the Tuscany population (which is about 3.6 million) during the five-year period before the ban (2000-2004) with the number of cases during the first year after the ban (2005).

Monthly, age-standardized rates for acute myocardial infarction were determined for the entire study period and a Poisson regression model was used to assess the significance of any changes in heart attack incidence during 2005 compared to the baseline period. The analysis controlled for seasonality, long-term trends, and changes in the age distribution of the population.

Two models were tested: a linear model and a non-linear model. In the linear model, the authors found that the smoking ban was associated with a non-significant 5.4% reduction in the heart attack rate in 2005. In the non-linear model, the authors found that the smoking ban was associated with no effect whatsoever on heart attack rates (a non-significant 1% increase).

The article concludes: “Differently from the results published to date, this study did not find a comparable effect of the smoke-free law on the incidence of AMI [acute myocardial infarction] during the first year after the implementation of the ban. Our estimate and the related uncertainty suggest that the expected reduction is likely to be lower. … The estimate of the effect of the ban seems to be highly sensitive to the model specification and to the effects of unaccounted factors which could modify the trend of AMI incidence, such as changes in the prevalence of other risk factors or the modification of diagnostic criteria. Several arguments which are put forward to inspect the causal relation between smoking bans and AMI indicate that the plausible effects could be lower than the estimates reported so far.”

The authors close by stating: “The implementation of smoking bans in public places represents a milestone in the history of public health. The relationship with a decrease of both active and passive smoke is unquestionable, with conclusive evidences on the reductions of a number of health outcomes after the enforcement. In particular, a decrease of cardiovascular events in the long run is expected, given the conclusive association with chronic SHS exposure. On the other hand, the estimate of the short-term effect of smoking bans on cardiovascular diseases is still uncertain, and the range of reduction showed by some of the studies published to date is likely to be an overestimate, not consistent with previous knowledge about the burden of cardiovascular diseases attributable to SHS. Moreover, several other factors, like changes in diagnostic criteria, have a strong influence on the trend of cardiovascular diseases, and it seems very problematic to properly control for their effects with this study design. Nonetheless, as this study has shown, the resulting bias could be substantial.”

The Rest of the Story

This study has a number of important strengths compared to the previous literature on this research question. First, it covers a large population of about 5.6 million people. The results are based on a total of 13,456 new cases of myocardial infarction. This compares with only 304 heart attacks in the Helena study.

A second advantage of this study is that the identification of heart attack cases is based on a registry (the Acute Myocardial Infarction Registry of Tuscany), which provides consistent surveillance for heart attacks occurring throughout the study period. This differs from studies such as the one in Scotland, where different methods were used to identify heart attacks occurring pre-ban and post-ban.

Perhaps the most important strength of the study is that it included a reasonable baseline period of five years, rather than just one or two years prior to the implementation of the smoking ban, which was the case in many of the previous studies.

A final strength of this study is that it considered both linear and non-linear trends in heart attacks to model the results. But it is important to note that even with a linear trend assumption, the study found no significant effect of the smoking ban and the estimated magnitude of the association was quite small (just 5.4%).

Importantly, this published study was not considered by the Institute of Medicine committee which reviewed this issue and released its report in October of last year. It was also not considered in published meta-analyses on this topic. Because of the high sample size of this study, it is likely that inclusion of this study in the previous meta-analyses would have negated their results.

While one study does not prove or disprove a hypothesis (one always needs to look at the totality of the evidence), this study is important because it is not consistent with the conclusions that have been widely disseminated by anti-smoking groups. The interesting thing to observe will be whether or not these findings are even reported by these groups.

Based on my experience in the anti-smoking movement, I am willing to bet that not a single group which previously reported the results of studies “favorable” to their cause will now report the results of this negative study. In fact, I’m so sure that no group will do this that I am putting up a $100 reward for the first group that does. I will contribute $100 to the first anti-smoking organization that previously reported the results of one of the positive studies and which now reports the results of this negative study.

I’m not worried about losing my money because as I’ve recently learned, it’s not the quality of the science or the truth that is important. It’s the favorability of the findings. Anti-smoking groups have largely lost their scientific base and scientific integrity and they are now turning into propaganda machines which are only interested in disseminating findings that are favorable to their cause. They will not share unfavorable findings because the ultimate goal is not the truth and the scientific facts, but the supporting of the agenda.

I’d love to be proven wrong. It can be done simply by emailing me the link to an anti-smoking group’s dissemination of the results of the Tuscany study. I’ll be waiting.