177449 Determine the correlation between comprehensive non-smoking ordinances and incidence rates of AMI and asthma

Monday, October 27, 2008: 8:48 AM

Yelena Bird, MD, PhD, MPH , Fred Hutchinson Cancer Research Center, Las Cruces, NM
Richard Meltzer, MD, PhD , Department of Health Science, MSC 3HLS, New Mexico State University, Las Cruces, NM
John Moraros, MD, PhD, MPH, CHES , Fred Hutchinson Cancer Research Center, Las Cruces, NM
Kiran Sapkota, MS , Department of Health Science, MSC 3HLS, New Mexico State University, Las Cruces, NM
Shande Chen, PhD , Department of Biostatistics, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX
Melissa Gomez, MD , School of Medicine, University of New Mexico, Albuquerque, NM
Surasri Prapasiri, MPH , Department of Health Science, MSC 3HLS, New Mexico State University, Las Cruces, NM
Luis Solis, MPH , Department of Health Science, MSC 3HLS, New Mexico State University, Las Cruces, NM
     
Background: Comprehensive non-smoking ordinances have been linked to decreases in the incidence of acute myocardial infarction (AMI). In 2002 the Delaware Clean Indoor Air Act was amended to restrict smoking in bars, restaurants, and casinos.

Methods: In an analysis of Delaware Hospital Discharge Database we identified Delaware and non-Delaware residents discharged with AMI or asthma for the years 1999-2004. Data analysis compared the incidence of AMI or asthma before (1999-2002) and after (2003-2004) the amendment of Delaware's non-smoking ordinance for each group.

Results: Pre-ordinance and post-ordinance quarterly rates of AMI for Delaware residents were 451 (se = 21) and 430 (se = 21) respectively, representing a 4.7% reduction and 169 fewer AMI over the two-year period after implementation of the comprehensive smoke-free ordinance (2003-2004). The risk ratio (RR) for post vs. pre-ordinance quarterly rate of AMI showed a statistically significant decrease of 0.95 (95% CI, 0.91 to 0.99; P=0.022) and a population adjusted RR of 0.91 (95% CI, 0.87 to 0.95; P<0.001). Over the same time period, there was negligible change in the incidence of AMI for non-Delaware residents. After adjusting for population growth, the RR for asthma in Delaware residents post-ordinance was 0.95 (95% CI, 0.90 to 0.997), a significant reduction (P=0.038). By comparison, non-Delaware residents had an increased RR for asthma post-ordinance of 1.62 (95% CI, 1.46 to 1.86; P<0.0001).

Conclusions: Delaware's comprehensive non-smoking ordinance led to a statistically significant decrease in the incidence of AMI and asthma in Delaware residents but not in non-Delaware residents.

Learning Objectives:
Determine the correlation between comprehensive non-smoking ordinances and incidence rates of AMI and asthma. Compare the level of AMI and asthma between Delaware residents and non-Delaware residents before (1999-2002) and after (2003-2004) the amendment of Delaware’s non-smoking ordinance. Describe the effects of the pre and post non-smoking ordinances to the rates of incidence of AMI and asthma.

Keywords: Tobacco Policy, Smoking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Primary investigator
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Global Trends and Health Benefits of Smoke Free Air
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