Acute Myocardial Infarction Mortality Before and After State-wide Smoking Bans
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Rapid declines in hospital admissions for acute myocardial infarction (AMI) following smoke-free ordinances have been reported in smaller communities. The AMI mortality rate among persons age 45 + years (deaths per 100,000 persons, age-standardized to the 2000 US population) in the 3 years before adoption of the smoke-free ordinance (the expected rate) was compared with the rate observed in the first full year after the ban (the target year) in six US states. Target-year declines were also compared to those in states without smoking bans. Target-year declines in AMI mortality in California (2.0%), Utah (7.7%) and Delaware (8.1%) were not significantly different from the expected declines (P = 0.16, 0.43 and 0.89, respectively). In South Dakota AMI mortality increased 8.9% in the target year (P = 0.007). Both a 9% decline in Florida and a 12% decline in New York in the 2004 target year exceeded the expected declines (P = 0.04 and P < 0.0002, respectively) but were not significantly different (P = 0.55 and 0.08, respectively) from the 9.8% decline that year in the 44 states without bans. Smoke-free ordinances provide a healthy indoor environment, but their implementation in six states had little or no immediate measurable effect on AMI mortality.
KeywordsMyocardial infarction Secondhand smoke Smoke-free ordinances
Dr. Rodu’s research is supported by unrestricted grants from tobacco manufacturers (Swedish Match AB, Reynolds American Inc. Services Company Altria Client Services, and British American Tobacco) to the University of Louisville, and by the Kentucky Research Challenge Trust Fund. The terms of the grants assure that the sponsors are unaware of this study, and thus had no scientific input or other influence with respect to its design, analysis, interpretation or preparation of the manuscript. None of the authors has any financial or other personal relationship with regard to the sponsors.
- 8.Lemstra, M., Neudorf, C., & Opondo, J. (2008). Implications of a public smoking ban. Canadian Journal of Public Health, 99, 62–65.Google Scholar
- 9.Centers for Disease Control and Prevention. (2007). National center for health statistics (NCHS), office of analysis and epidemiology(OAE), compressed mortality file (CMF) on CDC WONDER On-line database. Available at http://wonder.cdc.gov/mortSQL.html. Accessed 1 Aug 2011.
- 10.Lowry, R. (2009). VassarStats: Website for statistical computation, available at http://faculty.vassar.edu/lowry/VassarStats.html. Accessed 1 Aug 2011.
- 13.Rodu, B., & Cole, P. (2004). Helena study random variation confirmed. Rapid response to Sargent RP, Shepard RM, Glantz SA: Reduced incidence of admissions for myocardial infarction with public smoking: before and after study. BMJ, 328, 977–980. Available at: http://www.bmj.com/cgi/eletters/328/7446/977#125959. Accessed 1 Aug 2011.
- 15.US Department of Health and Human Services. (1993). Major local tobacco control ordinances in the United States. Smoking and tobacco control monograph 3. Bethesda, MD: National Cancer Institute.Google Scholar
- 16.RTI International. (2004). First annual independent evaluation of New York’s Tobacco control program. North Carolina: Research Triangle Park. Available at: http://www.health.state.ny.us/nysdoh/tobacco/reports/docs/nytcp_eval_report_final_11-19-04.pdf. Accessed 1 Aug 2011.