Abstract 11973: Decrease In Mortality Rate And Hospital Admissions For Acute Myocardial Infarction After The Enactment Of The Smoking Ban Law In Sao Paulo City

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Introduction: Smoking restriction laws have been spread over the world in the last decade. Previous studies and meta-analyses showed a decline in the community rates of myocardial infarction and/or heart attack after enactment of these laws. However, there are few data about the Latin American population. In the first phase of this study, we reported a well succeed implementation of the law in Sao Paulo city, with decrease in carbon monoxide rates in places like restaurants, bars and night clubs. Hypothesis: To evaluate whether the 2009 implementation of a smoking ban law in Sao Paulo city was associated with reduction in rates of mortality and hospital admissions for myocardial infarction. Methods: We performed a time series study of monthly rates of mortality and hospital admissions for acute myocardial infarction from January 2005 to December 2010. The data derived from DATASUS, the main public health information system existent in Brazil and from SIM (Mortality Information System). Adjustments and analysis were done using Autoregressive Integrated Moving Average with exogenous variables (ARIMAX) method modeled by environmental variables and atmospheric pollutants to evaluate the tendency of mortality and hospital admissions before the law and forecast events after the law. We also used Interrupted Time Series Analysis (ITSA) associated to ARIMAX to compare the period before the law, the moment of implementation of the law and the period after the law. Results: We observed a reduction in the hospital admissions (-5,4% in the first 2 months after the law) and mortality rate (-11,9% in the first 17 months after the law) for myocardial infarction. Conclusions: Hospital admissions and mortality rate for myocardial infarction were reduced in the first months after smoking ban law. Graphic 1: Hospital admission rate for myocardial infarction, São Paulo city, 2005 to 2010. Graphic 2: Mortality rate for myocardial infarction, São Paulo city, 2005 to 2010.