Objectives We examined the rate of acute myocardial infarction (AMI) deaths in Massachusetts before and after the implementation of a comprehensive smoke-free workplace law in July 2004. Methods We used Poisson regression models to examine the impact of the state law in cities and towns with and without previous local smoking bans and the effect of the local laws for the period of 1999 through 2006. Results The AMI mortality rate decreased by 7.4% (95% confidence interval [CI]=3.3%, 11.4%) after implementation of the state law. The state ban had an impact in cities and towns with no prior local smoking ban (9.2% decrease; P<.001) but not cities and towns with a prior local smoking ban. However, there was a nonsignificant 4.9% (95% CI=−5.0%, 13.9%) decrease associated with the local smoking ban that preceded the effect of the state ban. The effect of the state ban was modest (−1.6%) in the first 12 months after implementation but much larger after the first 12 months (−18.6%; P<.001). Conclusions Comprehensive statewide smoke-free workplace laws in Massachusetts were associated with an estimated 270 fewer AMI deaths per year. These results add to the evidence suggesting that smoke-free air laws are associated with lower rates of AMI.

Our results suggest that smoke-free laws reduce asthmatic symptoms, including persistent wheeze, chronic night cough, and wheeze-medication use in nonsmoking youth.

Objectives Women with longer, healthier pregnancies have more time to enroll in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), biasing associations between WIC and birth outcomes. We examined the association between WIC and preterm birth (PTB), low birth weight (LBW), and perinatal death (PND) using a fetuses-at-risk approach to address this bias, termed gestational age bias. Methods We linked California Medi-Cal recipients with a singleton live birth or fetal death from the 2010 Birth Cohort to WIC participant data (n = 236,564). We implemented a fetuses-at-risk approach using survival analysis, which compared, in each week of gestation, women whose pregnancies reached the same length and who had the same opportunity to utilize WIC. In each gestational week, we assessed WIC enrollment and the number of food packages redeemed thus far and computed hazard ratios (HR) using survival models with time-varying exposures and effects. Results Adjusting for maternal socio-demographic and health characteristics, WIC enrollment was associated with a lower risk of PTB from week 29-36 (HR = 0.71; HR = 0.52); LBW from week 26-40 (HR = 0.77; HR = 0.64); and PND from week 29-43 (HR = 0.78; HR = 0.69) (p < 0.05). The number of food packages redeemed was associated with a lower risk of PTB from week 27-36 (HR = 0.90; HR = 0.84); LBW from week 25-42 (HR = 0.93; HR = 0.88); and PND from week 27-46 (HR = 0.94; HR = 0.91) (p < 0.05). Conclusions for Practice To our knowledge this is the first study to examine the association between WIC and birth outcomes using this approach. We found that beginning from about 29 weeks, WIC enrollment was associated with a reduced risk of PTB by 29-48 %, LBW by 23-36 %, and PND by 22-31 %.

These results suggest that smoke-free laws are an effective strategy for reducing cotinine in youth without home SHS exposure; however, among youth with home SHS exposure, no benefit was detected.

Introduction:Little is known about how incentives may encourage low income smokers to call for quitline services. This study evaluates the impact of outreach through health channels on California Medicaid (Medi-Cal) quitline caller characteristics, trends, and reach.