Declines in hospital admissions for acute myocardial infarction in New York state after implementation of a comprehensive smoking ban
Declines in hospital admissions for acute myocardial infarction in New York state after implementation of a comprehensive smoking ban
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DOI：
10.2105/ajph.2006.099994
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发表时间：
2007-11-01
影响因子：
12.7
通讯作者：
Birkhead, Guthrie S.
中科院分区：
文献类型：
--
作者：
Juster, Harlan R.;Loomis, Brett R.;Birkhead, Guthrie S.
目标。减少对环境烟草烟雾的暴露已被证明可以降低心血管疾病的风险。我们研究了2003年纽约州实施全面禁烟是否与急性心肌梗死和中风住院人数的减少有关，超出了适度、局部和全州范围的吸烟限制的影响，并与长期趋势无关。我们分析了1995-2004年间县级、年龄调整后的急性心肌梗死和中风的月度住院率的趋势，以确定入院率与禁烟令实施之间的任何联系。我们使用回归模型对预先存在的吸烟限制、入院人数的季节性趋势、不同县之间的差异和长期趋势的影响进行了调整。2004年，在没有全面禁烟的情况下，因急性心肌梗塞入院的人数比预期少3813人。2004年实现了5600万美元的直接保健费用节约。因中风入院的人数并没有减少。由于纽约州全面禁烟，在我们控制了其他相关因素后，急性心肌梗死的住院率降低了8%。全面禁烟构成了一种简单而有效的干预措施，大大改善了公众的健康。
Objectives. Reductions in exposure to environmental tobacco smoke have been shown to attenuate the risk of cardiovascular disease. We examined whether the 2003 implementation of a comprehensive smoking ban in New York State was associated with reduced hospital admissions for acute myocardial infarction and stroke, beyond the effect of moderate, local and statewide smoking restrictions, and independent of secular trends.Methods. We analyzed trends in county-level, age-adjusted, monthly hospital admission rates for acute myocardial infarction and stroke from 1995 to 2004 to identify any association between admission rates and implementation of the smoking ban. We used regression models to adjust for the effects of pre-existing smoking restrictions, seasonal trends in admissions, differences across counties, and secular trends.Results. In 2004, there were 3813 fewer hospital admissions for acute myocardial infarction than would have been expected in the absence of the comprehensive smoking ban. Direct health care cost savings of $56 million were realized in 2004. There was no reduction in the number of admissions for stroke.Conclusions. Hospital admission rates for acute myocardial infarction were reduced by 8% as a result of a comprehensive smoking ban in New York State after we controlled for other relevant factors. Comprehensive smoking bans constitute a simple, effective intervention to substantially improve the public's health.