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Changes in hospitalizations for chronic respiratory diseases after two successive smoking bans in Spain
- Source :
- PLoS ONE, Vol 12, Iss 5, p e0177979 (2017), Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid, Consejería de Sanidad de la Comunidad de Madrid, Repisalud, Instituto de Salud Carlos III (ISCIII), Biblos-e Archivo. Repositorio Institucional de la UAM, instname, PLoS ONE
- Publication Year :
- 2017
- Publisher :
- Public Library of Science (PLoS), 2017.
-
Abstract
- This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Existing evidence on the effects of smoke-free policies on respiratory diseases is scarce and inconclusive. Spain enacted two consecutive smoke-free regulations: a partial ban in 2006 and a comprehensive ban in 2011. We estimated their impact on hospital admissions via emergency departments for chronic obstructive pulmonary disease (COPD) and asthma. Methods Data for COPD (ICD-9 490-492, 494-496) came from 2003-2012 hospital admission records from the fourteen largest provinces of Spain and from five provinces for asthma (ICD-9 493). We estimated changes in hospital admission rates within provinces using Poisson additive models adjusted for long-term linear trends and seasonality, day of the week, temperature, influenza, acute respiratory infections, and pollen counts (asthma models). We estimated immediate and gradual effects through segmented-linear models. The coefficients within each province were combined through random-effects multivariate meta-analytic models. Results The partial ban was associated with a strong significant pooled immediate decline in COPDrelated admission rates (14.7%, 95%CI: 5.0, 23.4), sustained over time with a one-year decrease of 13.6% (95%CI: 2.9, 23.1). The association was consistent across age and sex groups but stronger in less economically developed Spanish provinces. Asthma-related admission rates decreased by 7.4% (95%CI: 0.2, 14.2) immediately after the comprehensive ban was implemented, although the one-year decrease was sustained only among men (9.9%, 95%CI: 3.9, 15.6). Conclusions The partial ban was associated with an immediate and sustained strong decline in COPDrelated admissions, especially in less economically developed provinces. The comprehensive ban was related to an immediate decrease in asthma, sustained for the medium-term only among men<br />This work was supported by Grant FIS PI11/01276 from the Institute of Health Carlos III, Ministry of Economy and Competitiveness
- Subjects :
- Male
Viral Diseases
Respiratory diseases
Pulmonology
Social Sciences
lcsh:Medicine
Plant Science
Smoke-Free Policy
Pulmonary Disease, Chronic Obstructive
0302 clinical medicine
Medicine and Health Sciences
Decrease in asthma
Public and Occupational Health
030212 general & internal medicine
lcsh:Science
health care economics and organizations
Multidisciplinary
Plant Anatomy
Smoking
Poisson
Hospitals
humanities
Hospitalization
Infectious Diseases
Work (electrical)
Pollen
Christian ministry
Female
Medical emergency
Emergency Service, Hospital
Research Article
Tobacco Control
Medicina
Chronic Obstructive Pulmonary Disease
Smoke-free policies
03 medical and health sciences
medicine
Humans
Regulations
Asthma
business.industry
lcsh:R
Biology and Life Sciences
medicine.disease
Influenza
Health Care
030228 respiratory system
Health Care Facilities
Spain
Respiratory Infections
Law and Legal Sciences
Changes in hospitalizations
lcsh:Q
business
Smoking Legislation
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 12
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....e39563f9d811977cd5c4ad09528ab7b5