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.
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