Impact of stepwise introduction of smoke-free legislation on population rates of acute myocardial infarction deaths in Flanders, Belgium.
Identifieur interne : 000036 ( Main/Curation ); précédent : 000035; suivant : 000037Impact of stepwise introduction of smoke-free legislation on population rates of acute myocardial infarction deaths in Flanders, Belgium.
Auteurs : Bianca Cox [Belgique] ; Jaco Vangronsveld [Belgique] ; Tim S. Nawrot [Belgique]Source :
- Heart (British Cardiac Society) [ 1468-201X ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Belgique (épidémiologie), Dynamique non linéaire, Facteurs de l'âge, Facteurs de risque, Facteurs sexuels, Facteurs temps, Femelle, Humains, Infarctus du myocarde (), Infarctus du myocarde (mortalité), Modèles linéaires, Mâle, Politique anti-tabac (législation et jurisprudence), Programmes nationaux de santé (législation et jurisprudence), Prévalence, Sevrage tabagique (législation et jurisprudence), Sujet âgé, Sujet âgé de 80 ans ou plus, Tabagisme (effets indésirables), Tabagisme (législation et jurisprudence), Tabagisme (mortalité), Évaluation des risques.
- MESH :
- effets indésirables : Tabagisme.
- législation et jurisprudence : Politique anti-tabac, Programmes nationaux de santé, Sevrage tabagique, Tabagisme.
- mortalité : Infarctus du myocarde, Tabagisme.
- épidémiologie : Belgique.
- Adulte, Adulte d'âge moyen, Dynamique non linéaire, Facteurs de l'âge, Facteurs de risque, Facteurs sexuels, Facteurs temps, Femelle, Humains, Infarctus du myocarde, Modèles linéaires, Mâle, Prévalence, Sujet âgé, Sujet âgé de 80 ans ou plus, Évaluation des risques.
English descriptors
- KwdEn :
- Adult, Age Factors, Aged, Aged, 80 and over, Belgium (epidemiology), Female, Humans, Linear Models, Male, Middle Aged, Myocardial Infarction (mortality), Myocardial Infarction (prevention & control), National Health Programs (legislation & jurisprudence), Nonlinear Dynamics, Prevalence, Risk Assessment, Risk Factors, Sex Factors, Smoke-Free Policy (legislation & jurisprudence), Smoking (adverse effects), Smoking (legislation & jurisprudence), Smoking (mortality), Smoking Cessation (legislation & jurisprudence), Smoking Prevention, Time Factors.
- MESH :
- adverse effects : Smoking.
- epidemiology : Belgium.
- legislation & jurisprudence : National Health Programs, Smoke-Free Policy, Smoking, Smoking Cessation.
- mortality : Myocardial Infarction, Smoking.
- prevention & control : Myocardial Infarction.
- Adult, Age Factors, Aged, Aged, 80 and over, Female, Humans, Linear Models, Male, Middle Aged, Nonlinear Dynamics, Prevalence, Risk Assessment, Risk Factors, Sex Factors, Smoking Prevention, Time Factors.
Abstract
OBJECTIVE
Many studies demonstrated a decline in hospital admissions for cardiovascular diseases after the implementation of a smoking ban, but evidence for reductions in cardiovascular mortality is more limited. In Belgium, smoke-free legislation was implemented in different phases. Public places and most workplaces became smoke-free in January 2006, whereas the legislative ban on smoking in restaurants was introduced in January 2007. These successive steps in legislation provided us the opportunity to investigate possible stepwise changes in fatal acute myocardial infarction (AMI) rates.
METHODS
Data on all AMI deaths of 30 years of age or older in Flanders (Belgium) between 2000 and 2009 (n=38 992) were used. Age-standardised AMI death rates were analysed with segmented Poisson regression allowing for secular trends, seasonality, temperature, PM10 and influenza.
RESULTS
An immediate decrease in AMI mortality rates was observed in January 2006 (smoking ban at work). The effect was highest for women younger than 60 years of age (-33.8%; 95% CI -49.6 to -13.0), compared with an effect of -13.1% (95% CI -24.3 to -0.3) for male counterparts. Estimates for the elderly (≥60 years) were -9.0% (95% CI -14.1 to -3.7) for men and 7.9% (95% CI -13.5 to -2.0) for women. An additional effect of the smoking ban in restaurants was observed for elderly men, with an annual slope change of -3.8% (95% CI -6.5 to -1.0) after 1 January 2007.
CONCLUSIONS
Smoking ban interventions are associated with reductions in the population rate of myocardial mortality, with public health gains even before and during the middle-aged period of life.
DOI: 10.1136/heartjnl-2014-305613
PubMed: 25147283
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<term>Female</term>
<term>Humans</term>
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<term>Humans</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>Many studies demonstrated a decline in hospital admissions for cardiovascular diseases after the implementation of a smoking ban, but evidence for reductions in cardiovascular mortality is more limited. In Belgium, smoke-free legislation was implemented in different phases. Public places and most workplaces became smoke-free in January 2006, whereas the legislative ban on smoking in restaurants was introduced in January 2007. These successive steps in legislation provided us the opportunity to investigate possible stepwise changes in fatal acute myocardial infarction (AMI) rates.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>Data on all AMI deaths of 30 years of age or older in Flanders (Belgium) between 2000 and 2009 (n=38 992) were used. Age-standardised AMI death rates were analysed with segmented Poisson regression allowing for secular trends, seasonality, temperature, PM10 and influenza.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>An immediate decrease in AMI mortality rates was observed in January 2006 (smoking ban at work). The effect was highest for women younger than 60 years of age (-33.8%; 95% CI -49.6 to -13.0), compared with an effect of -13.1% (95% CI -24.3 to -0.3) for male counterparts. Estimates for the elderly (≥60 years) were -9.0% (95% CI -14.1 to -3.7) for men and 7.9% (95% CI -13.5 to -2.0) for women. An additional effect of the smoking ban in restaurants was observed for elderly men, with an annual slope change of -3.8% (95% CI -6.5 to -1.0) after 1 January 2007.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>Smoking ban interventions are associated with reductions in the population rate of myocardial mortality, with public health gains even before and during the middle-aged period of life.</p>
</div>
</front>
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<Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">Many studies demonstrated a decline in hospital admissions for cardiovascular diseases after the implementation of a smoking ban, but evidence for reductions in cardiovascular mortality is more limited. In Belgium, smoke-free legislation was implemented in different phases. Public places and most workplaces became smoke-free in January 2006, whereas the legislative ban on smoking in restaurants was introduced in January 2007. These successive steps in legislation provided us the opportunity to investigate possible stepwise changes in fatal acute myocardial infarction (AMI) rates.</AbstractText>
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<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Smoking ban interventions are associated with reductions in the population rate of myocardial mortality, with public health gains even before and during the middle-aged period of life.</AbstractText>
<CopyrightInformation>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</CopyrightInformation>
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