Association of restaurant smoking ban and the incidence of acute myocardial infarction in Finland

Sipilä, Jussi; Gunn, Jarmo; Kauko, Tommi; Rautava, Päivi; Kytö, Ville

doi:10.1136/bmjopen-2015-009320

Cited by 14 publications

(11 citation statements)

References 29 publications

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“… 40 Despite the contradictory results, smoking is still a well-known risk factor for developing CVD. 41 Overall, body weight reduction, tobacco cessation, and BP control in prehypertensive patients are important ways to prevent hypertension, diabetes, and dyslipidaemia, thus lowering their risk of developing CVD.…”

Section: Discussionmentioning

confidence: 99%

Association of prehypertension and cardiovascular risk factor clustering in Inner Mongolia: a cross-sectional study

Guo

Wang

et al. 2017

BMJ Open

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ObjectivesTo assess the clustering of cardiovascular disease (CVD) risk factors in Han and Mongolian adults with prehypertension or hypertension in Northern China.MethodsWe selected 3227 Han and Mongolian participants (20–80 years old) using a multistage cluster sampling method in 2014. The participants were interviewed by standard questionnaires and underwent anthropometric measurement and biochemical testing. Han and Mongolian participants were divided into optimal, prehypertension, and hypertension groups based on blood pressure. A multinomial logit analysis was performed to explore relationships between CVD risk factor clustering and prehypertension or hypertension, and the heterogeneity between Han and Mongolian was evaluated by the Cochran Q test. The differences between the ethnic groups in the proportions of risk factors was tested with the χ2 test.ResultsThe clustering of two or three CVD risk factors in the prehypertension or hypertension groups was consistently higher than in the optimal group (Bonferroni, p<0.0167). The odds ratios (ORs) of prehypertension and hypertension increased with the number of CVD risk factors (ptrend <0.0001). In multivariate modelling, the adjusted ORs of one, two, and ≥3 CVD risk factors versus no risk factors was, respectively, 1.95, 2.25, and 2.28 in Han prehypertensive participants, and 1.73, 2.83, and 3.69 in Mongolian prehypertensive participants. In addition, the adjusted ORs were 3.15, 4.75, and 6.49 in Han hypertensive participants, and 1.90, 5.29, and 8.13 in Mongolian hypertensive participants (all p<0.05). There was no significant heterogeneity between Han and Mongolian participants in the prehypertension or hypertension groups. The age-standardised prevalence of ≥3 risk factors was 38.30% in Han men and 39.79% in Mongolian men. The rate was significantly lower in Han women than Mongolian women (9.18% vs 14.55%, p=0.002).ConclusionsThese findings showed clustering of CVD risk factors in prehypertensive Han and Mongolian adults, and showed prehypertension may be a useful target for intervention.

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Section: Discussionmentioning

confidence: 99%

Association of prehypertension and cardiovascular risk factor clustering in Inner Mongolia: a cross-sectional study

Guo

Wang

et al. 2017

BMJ Open

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“…Primary care-based health checks have been shown to improve the management of cardiovascular risk factors such as hypertension, hypercholesterolemia and high body mass index 33 . However, smokers are less likely to participate in such health checks 34 spaces has led to significant reduction in hospital admissions with acute coronary syndrome [36][37][38] .…”

Section: Discussionmentioning

confidence: 99%

Smoking status and mortality outcomes following percutaneous coronary intervention

Parasuraman

Zaman

Egred

et al. 2020

European Journal of Preventive Cardiology

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Objective The aim of this study was to assess the impact of smoking on short (30-day) and intermediate (30-day to 6-month) mortality following percutaneous coronary intervention (PCI). Background The effect of smoking on mortality post-PCI is lacking in the modern PCI era. Methods This was a retrospective analysis of prospectively collected data comparing short- and intermediate-term mortality amongst smokers, ex-smokers and non-smokers. Results The study cohort consisted of 12,656 patients: never-smokers ( n = 4288), ex-smokers ( n = 4806) and current smokers ( n = 3562). The mean age (±standard deviation) was 57 (±11) years in current smokers compared with 67 (±11) in ex-smokers and 67 (±12) in never-smokers; p < 0.0001. PCI was performed for acute coronary syndrome (ACS) in 84.1% of current smokers, 57% of ex-smokers and 62.9% in never-smokers; p < 0.0001. In a logistic regression model, the adjusted odds ratios (95% confidence intervals (CIs)) for 30-day mortality were 1.60 (1.10–2.32) in current smokers and 0.98 (0.70–1.38) in ex-smokers compared with never-smokers. In the Cox proportional hazard model, the adjusted hazard ratios (95% CI) for mortality between 30 days and 6 months were 1.03 (0.65–1.65) in current smokers and 1.19 (0.84–1.67) in ex-smokers compared with never-smokers. Conclusion This large observational study of non-selected patients demonstrates that ex-smokers and never-smokers are of similar age at first presentation to PCI, and there is no short- or intermediate-term mortality difference between them following PCI. Current smokers undergo PCI at a younger age, more often for ACS, and have higher short-term mortality. These findings underscore the public message on the benefits of smoking cessation and the harmful effects of smoking.

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“…These findings complement an existing body of literature that has generally indicated that smoke-free policy implementation is associated with lower rates of hospital admissions or mortality for cardiovascular disease. 16,17,[19][20][21][22][27][28][29][30][31][32][33][34][35] Prior studies have typically been ecological in nature [14][15][16][17][18][19][20][22][23][24][25][26][27][28][29][30][31][34][35][36] and have not had access to detailed individual-level information on sociodemographic characteristics and cardiovascular disease risk factors. Our findings that patterns were largely similar after controlling for a large number of potential confounders suggest that differences in cardiovascular disease risk among those in areas with and without smoke-free policies are not explained by differences in individual sociodemographics or traditional cardiovascular disease risk factors.…”

Section: Original Research Articlementioning

confidence: 99%

“…Several prior ecological studies in the United States and European countries reported stronger relative risks of smoke-free policies with lower rates of hospital admissions among younger people. [26][27][28][29]34,35 For example, Cox et al 29 found smoke-free policy implementation in Belgium to be associated with a 34% lower rate of deaths from acute myocardial infarction among women under 60 years compared to only 7.9% among women 60 years or older. Similarly, Barone-Adesi et al 28 found smoke-free policy implementation in northern Italy to be associated with a 25% lower rate of hospital admission for acute myocardial infarction among women <60 years of age and no association among those >60 years of age.…”

Section: Original Research Articlementioning

confidence: 99%

“…Prior studies have used primarily ecological designs, [14][15][16][17][18][19][20][22][23][24][25][26][27][28][29][30][31][34][35][36] and have lacked access to detailed individual-level data on sociodemographic characteristics and cardiovascular disease risk factors. Interpretation of results from ecological studies is limited by the potential for unmeasured confounding by individuallevel characteristics, a drawback that could be reduced by using data from ongoing cohort studies.…”

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confidence: 99%

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Longitudinal Associations of Smoke-Free Policies and Incident Cardiovascular Disease

et al. 2018

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Editorial, see p 567BACKGROUND: Smoke-free legislation has been associated with lower rates of cardiovascular disease hospital admissions in ecological studies. However, prior studies lacked detailed information on individuallevel factors (eg, sociodemographic and clinical characteristics) that could potentially confound associations. Our objective was to estimate associations of smoke-free policies with incident cardiovascular disease in a longitudinal cohort after controlling for sociodemographics, cardiovascular disease risk factors, and policy covariates. METHODS:Longitudinal data from 3783 black and white adults in the CARDIA study (Coronary Artery Risk Development in Young Adults; 1995 were linked to state, county, and local 100% smoke-free policies in bars, restaurants, and nonhospitality workplaces by Census tract. Extended Cox regression estimated hazard ratios (HRs) of incident cardiovascular disease associated with time-dependent smoke-free policy exposures. Models were adjusted for sociodemographic characteristics, cardiovascular disease risk factors, state cigarette tax, participantreported presence of a smoking ban at their workplace, field center, and metropolitan statistical area poverty. RESULTS:During a median follow-up of 20 years (68 332 total personyears), 172 participants had an incident cardiovascular disease event (2.5 per 1000 person-years). Over the follow-up period, 80% of participants lived in areas with smoke-free policies in restaurants, 67% in bars, and 65% in nonhospitality workplaces. In fully adjusted models, participants living in an area with a restaurant, bar, or workplace smoke-free policy had a lower risk of incident cardiovascular disease compared with those in areas without smoke-free policies (HR, 0.75, 95% confidence interval, HR, 0.76, 95% confidence interval, HR, 0.54, 95% confidence interval, respectively; HR, 0.58, 95% confidence interval, for living in an area with all 3 types of policies compared with none). The estimated preventive fraction was 25% for restaurant policies, 24% for bar policies, and 46% for workplace policies. CONCLUSIONS:Consistent with prior ecological studies, these individualbased data add to the evidence that 100% smoke-free policies are associated with lower risk of cardiovascular disease among middle-aged adults.

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Association of restaurant smoking ban and the incidence of acute myocardial infarction in Finland

Cited by 14 publications

References 29 publications

Association of prehypertension and cardiovascular risk factor clustering in Inner Mongolia: a cross-sectional study

Association of prehypertension and cardiovascular risk factor clustering in Inner Mongolia: a cross-sectional study

Smoking status and mortality outcomes following percutaneous coronary intervention

Longitudinal Associations of Smoke-Free Policies and Incident Cardiovascular Disease

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