Abstract
BackgroundSeveral studies have reported a reduction in acute coronary events (ACEs) in the general population after the enforcement of smoking regulations, although there is uncertainty concerning the magnitude of the effect of such interventions. We conducted a country-wide evaluation of the health effects of the introduction of a smoking ban in public places, using data on hospital admissions for ACEs from the Italian population after the implementation of a national smoking regulation in January 2005.Methods and FindingsRates of admission for ACEs in the 20 Italian regions from January 2002 to November 2006 were analysed using mixed-effect regression models that allowed for long-term trends and seasonality. Standard methods for interrupted time-series were adopted to assess the immediate and gradual effects of the smoking ban. Effect modification by age was investigated, with the assumption that exposure to passive smoking in public places would be greater among young people. In total, 936,519 hospital admissions for ACEs occurred in the Italian population during the study period. A 4% reduction in hospital admissions for ACEs among persons aged less than 70 years was evident after the introduction of the ban (Rate Ratio [RR], 0.96; 95% Confidence Interval [CI], 0.95–0.98). No effect was found among persons aged at least 70 years (RR 1.00; 95% CI 0.99–1.02). Effect modification by age was further suggested by analyses using narrower age categories.ConclusionsSmoke-free policies can constitute a simple and inexpensive intervention for the prevention of cardiovascular diseases and thus should be included in prevention programmes.
Highlights
Second hand smoke causes several diseases, including lung cancer and cardiovascular and respiratory diseases [1]
Several studies found a reduction in rates of hospital admissions for acute cardiovascular diseases in the general population after the enforcement of smoking bans in indoor public places
We identified hospital admissions for acute coronary events (ACEs) selecting all records with a primary discharge diagnosis of either acute myocardial infarction (ICD-9-CM code: 410 [16]) or other acute and sub-acute forms of ischemic heart disease (ICD-9-CM code: 411[16])
Summary
Second hand smoke causes several diseases, including lung cancer and cardiovascular and respiratory diseases [1]. The mounting evidence about the adverse effects of second hand smoke prompted several countries to introduce smoking bans in indoor public places such as public venues and workplaces. Several studies found a reduction in rates of hospital admissions for acute cardiovascular diseases in the general population after the enforcement of smoking bans in indoor public places. Several studies have reported a reduction in acute coronary events (ACEs) in the general population after the enforcement of smoking regulations, there is uncertainty concerning the magnitude of the effect of such interventions. We conducted a country-wide evaluation of the health effects of the introduction of a smoking ban in public places, using data on hospital admissions for ACEs from the Italian population after the implementation of a national smoking regulation in January 2005
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