Effect of the Italian smoking ban on population rates of acute coronary events
Effect of the Italian smoking ban on population rates of acute coronary events
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DOI：
10.1161/circulationaha.107.729889
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发表时间：
2008-03-04
期刊：
影响因子：
37.8
通讯作者：
Perucci, Carlo A.
中科院分区：
文献类型：
--
作者：
Cesaroni, Giulia;Forastiere, Francesco;Perucci, Carlo A.
背景——世界上有几个国家尚未禁止在公共场所吸烟。关于吸烟禁令对心脏健康影响的研究很少。我们评估了意大利罗马在 2005 年 1 月颁布禁止在所有室内公共场所吸烟的立法后急性冠脉事件发生频率的变化。方法和结果——我们分析了 2000 年至 2005 年间 35 至 84 岁城市居民的急性冠脉事件（院外死亡和入院）。我们通过比较立法前（2000-2004 年）和立法后（2005 年）期间的数据，计算了年度标准化利率和估计利率比率。我们考虑了几个与时间相关的潜在混杂因素，包括颗粒物 (PM(10)) 空气污染、温度、流感流行、时间趋势和总住院率。禁烟后，35至64岁人群（11.2%，95% CI 6.9%至15.3%）和65至74岁人群（7.9%，95% CI 3.4%至12.2%）急性冠脉事件的减少具有统计学意义。没有发现证据表明对老年人有影响。在男性和社会经济地位较低的群体中，这种减少往往更大。结论——我们发现，禁烟令后，成年人群中急性冠心病事件的统计显着减少。效果的大小与在室内公共场所观察到的污染减少以及被动吸烟对健康的已知影响一致。结果证实，禁止吸烟的公共干预措施可以产生巨大的公共卫生影响。
Background-Several countries in the world have not yet prohibited smoking in public places. Few studies have been conducted on the effects of smoking bans on cardiac health. We evaluated changes in the frequency of acute coronary events in Rome, Italy, after the introduction of legislation that banned smoking in all indoor public places in January 2005.Methods and Results-We analyzed acute coronary events (out-of-hospital deaths and hospital admissions) between 2000 and 2005 in city residents 35 to 84 years of age. We computed annual standardized rates and estimated rate ratios by comparing the data from prelegislation (2000-2004) and postlegislation (2005) periods. We took into account several time-related potential confounders, including particulate matter (PM(10)) air pollution, temperature, influenza epidemics, time trends, and total hospitalization rates. The reduction in acute coronary events was statistically significant in 35- to 64-year-olds (11.2%, 95% CI 6.9% to 15.3%) and in 65- to 74-year-olds (7.9%, 95% CI 3.4% to 12.2%) after the smoking ban. No evidence was found of an effect among the very elderly. The reduction tended to be greater in men and among lower socioeconomic groups.Conclusions-We found a statistically significant reduction in acute coronary events in the adult population after the smoking ban. The size of the effect was consistent with the pollution reduction observed in indoor public places and with the known health effects of passive smoking. The results affirm that public interventions that prohibit smoking can have enormous public health implications.