Effects of Italian Smoking Regulation on Rates of Hospital Admission for Acute Coronary Events: A Country-Wide Study
Effects of Italian Smoking Regulation on Rates of Hospital Admission for Acute Coronary Events: A Country-Wide Study
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DOI：
10.1371/journal.pone.0017419
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发表时间：
2011-03-02
期刊：
影响因子：
3.7
通讯作者：
Richiardi, Lorenzo
中科院分区：
文献类型：
--
作者：
Barone-Adesi, Francesco;Gasparrini, Antonio;Richiardi, Lorenzo
背景资料：一些研究报告说，在实施吸烟法规后，普通人群中的急性冠状动脉事件（ACE）减少，尽管这种干预措施的影响程度尚不确定。我们使用2005年1月实施国家吸烟法规后意大利人口中ACE住院的数据，对在公共场所实施禁烟对健康的影响进行了全国范围的评估。方法和结果：使用混合效应回归模型分析了2002年1月至2006年11月意大利20个地区ACE的入院率，长期趋势和季节性。采用中断时间序列的标准方法来评估禁烟的即时和渐进影响。调查了年龄对影响的影响，假设年轻人在公共场所接触被动吸烟的机会更大。在研究期间，意大利人群中共有936，519例因ACE住院。在引入禁令后，年龄小于70岁的人群中因ACE住院的人数明显减少了4%（率比[RR]，0.96; 95%置信区间[CI]，0.95-0.98）。在年龄≥ 70岁的人群中未发现影响（RR 1.00; 95% CI 0.99-1.02）。通过使用较窄的年龄categoris.Conclusions：无烟政策可以构成一个简单而廉价的干预措施，预防心血管疾病，因此应包括在预防计划的分析，进一步建议修改年龄的影响。
Background: Several 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 Findings: Rates 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.Conclusions: Smoke-free policies can constitute a simple and inexpensive intervention for the prevention of cardiovascular diseases and thus should be included in prevention programmes.