Abstract
BackgroundThis is the first study to have examined the effect of smoking bans on hospitalizations in the Atlantic Canadian socio-economic, cultural and climatic context. On June 1, 2003 Prince Edward Island (PEI) enacted a province-wide smoking ban in public places and workplaces. Changes in hospital admission rates for cardiovascular (acute myocardial infarction, angina, and stroke) and respiratory (chronic obstructive pulmonary disease and asthma) conditions were examined before and after the smoking ban.MethodsCrude annual and monthly admission rates for the above conditions were calculated from April 1, 1995 to December 31, 2008 in all PEI acute care hospitals. Autoregressive Integrated Moving Average time series models were used to test for changes in mean and trend of monthly admission rates for study conditions, control conditions and a control province after the comprehensive smoking ban. Age- and sex-based analyses were completed.ResultsThe mean rate of acute myocardial infarctions was reduced by 5.92 cases per 100,000 person-months (P = 0.04) immediately after the smoking ban. The trend of monthly angina admissions in men was reduced by −0.44 cases per 100,000 person-months (P = 0.01) in the 67 months after the smoking ban. All other cardiovascular and respiratory admission changes were non-significant.ConclusionsA comprehensive smoking ban in PEI reduced the overall mean number of acute myocardial infarction admissions and the trend of angina hospital admissions.
Highlights
The use of and exposure to tobacco products is a leading cause of preventable death and disability worldwide [1]
The risk of Acute Myocardial Infarction (AMI) increases in a dose-response relationship with exposure to Second-Hand Smoke (SHS) [4,5].Exposure to SHS at home has been associated with stroke [6,7], a metaanalysis failed to find a significant relationship [3]
SHS exposure has been associated with the onset and severity of pediatric asthma and has been weakly associated with the onset and severity of adult asthma and Chronic Obstructive Pulmonary Disease (COPD) [8,9]
Summary
The use of and exposure to tobacco products is a leading cause of preventable death and disability worldwide [1]. The daily smoking rate dropped from 24.5% (95% Confidence Interval (CI) 22.5 to 26.5%) in 2001 to 17.1% (95% CI 15.1 to 19.3%) in 2007–2008 and daily exposure to SHS in public places in the previous month dropped from 13.0% (95% CI 10.9 to 15.4%) in 2003 to 6.4% (95% CI 5.1 to 7.8%) in 2007–2008 according to data supplied by the Canadian Community Health Survey [17] This is the first study to have examined the effect of smoking bans on hospitalizations in the Atlantic Canadian socio-economic, cultural and climatic context. Changes in hospital admission rates for cardiovascular (acute myocardial infarction, angina, and stroke) and respiratory (chronic obstructive pulmonary disease and asthma) conditions were examined before and after the smoking ban
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