Fewer Hospitalizations for Chronic Obstructive Pulmonary Disease in Communities With Smoke-Free Public Policies

Hahn, Ellen J.; Rayens, Mary Kay; Adkins, Sarah; Simpson, Nick; Frazier, Susan K.; Mannino, David M.

doi:10.2105/ajph.2014.301887

Cited by 33 publications

(33 citation statements)

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“…We compiled information about each law or Board of Health regulation implemented over time, including the date and strength of the policy (ie, comprehensive [or 100%] 30 vs moderate/ weak 12,31 ) from the Smoke-free Ordinance database at the Kentucky Center for Smoke-free Policy. We compiled information about each law or Board of Health regulation implemented over time, including the date and strength of the policy (ie, comprehensive [or 100%] 30 vs moderate/ weak 12,31 ) from the Smoke-free Ordinance database at the Kentucky Center for Smoke-free Policy.…”

Section: Methodsmentioning

confidence: 99%

“…Smoking causes 82% of lung cancer deaths, and SHS is the cause of an additional 5% of these deaths. 10,11 Comprehensive smoke-free laws are known to reduce the prevalence of chronic obstructive pulmonary disease, 12 myocardial infarction, [13][14][15][16] coronary heart disease, 16,17 stroke, 16 asthma, 16,18 and ambulance calls. 3 Thousands of lung cancer deaths could be prevented each year if smoking and exposure to SHS and radon were reduced.…”

Section: Introductionmentioning

confidence: 99%

“…3 Thousands of lung cancer deaths could be prevented each year if smoking and exposure to SHS and radon were reduced. 12 Diseases like lung cancer take longer to develop, and longitudinal data are required to accurately assess how smoke-free laws impact lung cancer incidence. 10,11 Comprehensive smoke-free laws are known to reduce the prevalence of chronic obstructive pulmonary disease, 12 myocardial infarction, [13][14][15][16] coronary heart disease, 16,17 stroke, 16 asthma, 16,18 and ambulance calls.…”

Section: Introductionmentioning

confidence: 99%

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Lung cancer incidence and the strength of municipal smoke‐free ordinances

Hahn

Rayens

Wiggins

et al. 2017

Cancer

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lung cancer incidence and the strength of municipal smoke‐free ordinances

Hahn

Rayens

Wiggins

et al. 2017

Cancer

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“…Studies on smokefree laws and COPD hospitalizations have had varied findings, with one study showing no significant difference 11 and two showing reduced hospitalizations. 24,25 …”

Section: Discussionmentioning

confidence: 99%

Effect of Uruguay’s National 100% Smokefree Law on Emergency Visits for Bronchospasm

Kalkhoran¹,

Sebrié²,

Sandoya³

et al. 2015

American Journal of Preventive Medicine

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Introduction Implementation of smokefree laws is followed by drops in hospital admissions for cardiovascular diseases and asthma. The impact of smokefree laws on use of non-hospital medical services has not been assessed. The purpose of this study is to evaluate the impact of Uruguay’s national 100% smokefree legislation on non-hospital emergency care visits and hospitalizations for bronchospasm and bronchodilator use. Methods The monthly number of non-hospital emergency care visits and hospitalizations for bronchospasm, as well as monthly puffs of bronchodilators (total and per person), from 3 years prior to the adoption of the 100% smokefree policy on March 1, 2006 through 5 years after the policy were assessed using interrupted time series negative binomial regression. Data analysis was conducted in 2014. Results The incidence of non-hospital emergency visits for bronchospasm decreased by 15% (incidence rate ratio [IRR]=0.85, 95% CI=0.76, 0.94) following implementation of the law. Hospitalizations for bronchospasm did not change significantly (IRR=0.89, 95% CI=0.66, 1.21). Total monthly puffs of salbutamol and ipratropium administered in the non-hospital emergency setting decreased by 224 (95% CI= −372, −76) and 179 (95% CI= −340, −18.6), respectively, from means of 1,222 and 1,007 before the law. Conclusions Uruguay’s 100% smokefree law was followed by fewer emergency visits for bronchospasm and less need for treatment, supporting adoption of such policies in low- and middle-income countries to reduce the disease burden and healthcare costs associated with smoking.

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“…More comprehensive laws were associated with greater reduction of risk. Further evidence on effectiveness, particularly on respiratory admissions, was added by subsequent publications [28,29].…”

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confidence: 99%

Protecting children from second-hand smoke

Kuehni

Barben²

2015

Eur Respir J

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@ERSpublicationsEffects of smoke-free legislation on paediatric RTIs: more evidence that child health can be easily improved http://ow.ly/OPcWdSince the 1970s, we have known that second-hand smoke (SHS) makes children sick, but we have only recently begun to quantify tobacco-related ill health, and to monitor the effects of public health interventions. In this issue of the European Respiratory Journal, BEEN et al.[1] quantify, for the first time, the effects of smoke-free legislation on hospitalisations for paediatric respiratory infections.In 1974, two Lancet papers found that infants with smoking parents had higher hospital admission rates and higher risks of pneumonia and bronchitis [2,3]. Since then, an accumulating body of evidence has confirmed a higher incidence of cough, wheeze, asthma, upper and lower respiratory tract infections (RTIs), preterm birth, and sudden infant death [4][5][6]. Globally, ∼40% of children are exposed to SHS [7]. OBERG et al. [7] conservatively attributed 603 000 deaths (1% of all deaths) and 10.9 million disability-adjusted life years (DALYs) (0.7% of all DALYs) to SHS, based on area-specific prevalence of those exposed, and on disease-specific risk estimates for lower respiratory infections, otitis media, asthma, lung cancer and ischaemic heart disease. For this assessment, the authors considered only the listed outcomes with level "A" evidence; real numbers will be higher. Children accounted for 166 000 (28%) deaths and for 6.6 million (40%) DALYs caused by SHS; and within childhood disease, lower respiratory infections were most relevant. SHS is a group 1 carcinogen with no safe levels, and children with their immature immune system and developing lungs are particularly vulnerable [8].Parents, who smoke at home or in the car, are responsible for children's exposure to SHS [9]. To improve child health, we therefore need interventions targeted at adults: preventing them from taking up smoking, or helping them quit. One approach is that of individual prevention, which attempts to change parents' attitudes and educate them through individual counselling, education or smoking cessation programmes. A second approach is structural, which depends on changing the environment and organisational structures by methods such as economic incentives, reducing the availability of cigarettes, tobacco-free advertising, or smoke-free public spaces [10].Individual prevention remains important in clinical practice. Combining medication and counselling by a physician doubles the chance that individual smokers will quit, and is more cost-effective than other clinical interventions [10]. However, absolute rates of quitting remain low and smoking cessation programmes, including nicotine replacement therapy, electronic cigarettes and nicotine vaccines have small effects [11][12][13]. Even when patients are severely ill with COPD [14], or are offered financial rewards for successful quitting [15], quit rates hardly exceed 15%. Families of lower socioeconomic status (SES), who have a higher prevalence of...

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Fewer Hospitalizations for Chronic Obstructive Pulmonary Disease in Communities With Smoke-Free Public Policies

Abstract: Strong smoke-free public policies may provide protection against COPD hospitalizations, particularly after 12 months, with the potential to save lives and decrease health care costs.

Cited by 33 publications

References 31 publications

Lung cancer incidence and the strength of municipal smoke‐free ordinances

Lung cancer incidence and the strength of municipal smoke‐free ordinances

Effect of Uruguay’s National 100% Smokefree Law on Emergency Visits for Bronchospasm

Protecting children from second-hand smoke

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