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Impact of the smoke-free legislation on the incidence and mortality of AMI and stroke in Tianjin China: analysis of routinely collected data
- Source :
- Tobacco Induced Diseases, Vol 16, Iss 1 (2018)
- Publication Year :
- 2018
- Publisher :
- European Publishing, 2018.
-
Abstract
- Background Comprehensive smoke-free legislation is an effective way to protect the population from the harms of secondhand smoke (SHS) and has been implemented in many countries. Tianjin is one of the few cities in China that have passed smoke-free legislation. We investigated the impact of smoke-free legislation on acute myocardial infarction (AMI) and stroke in Tianjin. Methods An interrupted time series design adjusting for underlying secular trend, seasonal pattern, population size changes and meteorology factors was conducted to analyze the impact of the smoking free law on the weekly incidence and mortality of AMI and stroke. The study period was from January 1, 2007, to December 31, 2015, with a post-ban follow-up of 3.5 years. Results Following the smoke-free law implementation, there was a decline in the annual proportional change for AMI and stroke mortality. A gradual 16% (RR:0.84; 95% CI: 0.83-0.85) decrease per year in AMI mortality among in population ages ≥ 35 years and a gradual 4% (RR:0.96; 95% CI: 0.95-0.98) decrease per year in stroke mortality among 35-64 age group in Tianjin was observed. Post-ban stroke incidence immediate reductions were found in in stroke in 35-64 age group (RR:0.96; 95% CI: 0.95-0.98). AMI incidence immediate reductions were only found in females aged 35-64 (RR:0.71; 95% CI: 0.65-0.78). Conclusions The smoke-free law in Tianjin was associated with gradual reductions in AMI and stroke mortality and immediate reductions in AMI and stroke incidence. The considerably modest and inconsistent effect on AMI and stroke incidence probably reflects the weak law enforcement and limitation of incidence surveillance data in Tianjin. This study reinforces the need for large-scale, effective and comprehensive smoke-free law in China. Funding: This research was supported by China Medical Board (15-208)
- Subjects :
- lcsh:RC705-779
Health (social science)
business.industry
Incidence (epidemiology)
Public Health, Environmental and Occupational Health
030508 substance abuse
Medicine (miscellaneous)
lcsh:Diseases of the respiratory system
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
lcsh:RC254-282
WCTOH
03 medical and health sciences
0302 clinical medicine
Environmental health
Medicine
030212 general & internal medicine
cardiovascular diseases
0305 other medical science
business
China
Stroke
Smoke free legislation
health care economics and organizations
Subjects
Details
- Language :
- English
- ISSN :
- 16179625
- Volume :
- 16
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Tobacco Induced Diseases
- Accession number :
- edsair.doi.dedup.....22b0c079befe350c7f07da7bf2da025c