236645 Impact of the 2002 Delaware Smoking Ordinance on Heart Attack and Asthma

Tuesday, November 1, 2011

John Moraros, MD, PhD, MPH , School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
Yelena Bird, MD, PhD, MPH , School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
Shande Chen, PhD , Department of Biostatistics, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX
Robert Buckingham, DrPH , School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
Richard Meltzer, MD, PhD , Department of Health Science, MSC 3HLS, New Mexico State University, Las Cruces, NM
Surasri Prapasiri, MPH , Department of Health Science, Las Cruces, NM
Luis Solis, MPH , Department of Health Science, MSC 3HLS, New Mexico State University, Las Cruces, NM
Xiaolei Tao, MD , School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
Introduction: In the United States, smoking is the leading cause of death-having a mortality rate of approximately 435,000 people in 2000-accounting for 8.1% of all US deaths recorded that year. Methods: This study aimed to analyze the Delaware Hospital Discharge Database and identify state and non-state residents discharged with AMI or asthma for the years 1999 to 2004. Statistical data analysis compared the incidence of AMI or asthma for each group before (1999-2002) and after (2003-2004) the comprehensive amendment of the The Delaware Clean Indoor Air Act of 1994. 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. Over the same time period, there was negligible change in the incidence of AMI for non-Delaware residents. After adjusting for population growth, the Risk Ratio (RR) for asthma in Delaware residents post-ordinance was 0.95 (95% CI, 0.90 to 0.999), which represented a significant reduction (p = 0.046). 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). Conclusion: Delaware's comprehensive non-smoking ordinance effectively was associated with a statistically significant decrease in the incidence of AMI and asthma in Delaware residents when compared to non-Delaware residents.

Learning Areas:
Administer health education strategies, interventions and programs
Advocacy for health and health education
Epidemiology
Occupational health and safety
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
Introduction: In the United States, smoking is the leading cause of death-having a mortality rate of approximately 435,000 people in 2000-accounting for 8.1% of all US deaths recorded that year. Methods: This study aimed to analyze the Delaware Hospital Discharge Database and identify state and non-state residents discharged with AMI or asthma for the years 1999 to 2004. Statistical data analysis compared the incidence of AMI or asthma for each group before (1999-2002) and after (2003-2004) the comprehensive amendment of the The Delaware Clean Indoor Air Act of 1994. 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. Over the same time period, there was negligible change in the incidence of AMI for non-Delaware residents. After adjusting for population growth, the Risk Ratio (RR) for asthma in Delaware residents post-ordinance was 0.95 (95% CI, 0.90 to 0.999), which represented a significant reduction (p = 0.046). 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). Conclusion: Delaware’s comprehensive non-smoking ordinance effectively was associated with a statistically significant decrease in the incidence of AMI and asthma in Delaware residents when compared to non-Delaware residents. Learning Objectives: 1. Determine the impact of the 2002 Delaware smoking ordinance on heart attack and asthma rate; and 2.Compare the difference between pre-ordinance and post-ordinance quarterly rates on heart attack and asthma.

Keywords: Tobacco Policy, Asthma

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a faculty member in the School of Public Health, University of Saskatchewan. I designed and conducted this study in the Delaware, United States.
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.

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