Study of the impact of anti-tobacco legislation on public health in the Russian Federation

Abstract

Abstract Background Smoking increases the risk of developing many diseases, both non-infectious and infectious. On February 23, 2013, the Russian Federation adopted an anti-smoking law, which provided for a two-stage ban on smoking in public places. Since June 1, 2013, smoking has been banned in schools, hospitals, public transport, railway stations, workplaces, and since June 1, 2014 - in trains, hotels, bars, restaurants. Purpose To study the dynamics of monthly hospitalization rates for respiratory diseases and acute otitis media in three regions of the Russian Federation (Chuvash Republic, Samara and Arkhangelsk regions). Methods A retrospective analysis of the monthly hospital incidence of pneumonia of various etiologies (ICD-10 J12-J18), other acute lower respiratory infections (J20-J22), asthma (J45), status asthmaticus (J46) and acute otitis media (H65.0, H65.1, H66.0) from 2012 to 2017. The data were analyzed by the method of interrupted time series. The information was provided by the regional Fund of Medical Insurance. Results Two control points were identified - June 2013 and June 2014. We demonstrated the reduction of hospitalization rates for acute lower respiratory infections and pneumonia immediately after each of the two stages of the anti-smoking policy implementation in all regions studied. In the Arkhangelsk region, the decrease was 19% in 2013 and 22% in 2014, in the Samara region - 20% and 23%, and in the Chuvash Republic - 31% and 39%. The reduction of hospitalization for asthma, status asthmaticus and acute otitis media was observed only in Chuvash Republic: the decrease in the number of hospitalizations for asthma and status asthmaticus was 11% in 2013 and 12% in 2014, and for acute otitis media - 25% and 35%. In other regions the decline was non-significant. Conclusions Anti-tobacco legislation leads to an immediate and significant reduction in the number of hospitalizations for lower respiratory tract infections. Key messages The ban on smoking in public places reduces infections of the lower respiratory tract and acute otitis media. Anti-tobacco legislation has a positive impact on public health.