Decrease in mortality rate and hospital admissions for acute myocardial infarction after the enactment of the smoking ban law in São Paulo city, Brazil

Abe, Tania M O; Scholz, Jaqueline; Masi, Eduardo de; Nobre, Moacyr Roberto Cucê; Filho, Roberto Kalil

doi:10.1136/tobaccocontrol-2016-053261

Cited by 14 publications

(13 citation statements)

References 39 publications

(10 reference statements)

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“…There were reductions in stroke and other CBDs of more than 20% and reductions in IHD of approximately 5%. Similar results were reported in other countries, although they mainly focused upon myocardial infarction and reported a range of reduction from 2 to 25% [23,25,26,36,45]. Based on previous studies from other countries, the effects on hospital admissions for stroke are limited, and the results are inconsistent [43,[46][47][48].…”

Section: Discussionsupporting

confidence: 76%

“…Cardiovascular diseases (CVDs) are the leading cause of smoking-related disease burden [14]. Decreased CVD hospital admissions have been reported following smoke-free legislation in many countries, but have mainly focused upon acute myocardial infarction [8,[23][24][25][26]. Health benefits after comprehensive tobacco control policies are usually evaluated in model studies [27].…”

Section: Introductionmentioning

confidence: 99%

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The impact of comprehensive tobacco control policies on cardiovascular diseases in Beijing, China

Wang

Zheng

et al. 2021

Addiction

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Background and Aims China has a high smoking prevalence, but lacks effective tobacco control interventions. In 2015, comprehensive policies that incorporated all six aspects of MPOWER were implemented in Beijing and were considered the strictest tobacco control policy implemented in China to date. Decreases in the prevalence of active smoking and secondhand smoke (SHS) exposure were observed thereafter. This study aimed to evaluate the impact of Beijing's 2015 tobacco control policy package on cardiovascular diseases (CVDs). Design Interrupted time–series study. Setting Beijing, China. Participants A total of 17.7 million employees enrolled in Urban Employee Basic Medical Insurance (UEBMI) between January 2013 to June 2017. Interventions Beijing's 2015 comprehensive tobacco policy package, combining a complete ban on smoking in indoor public places, cessation support, more comprehensive bans on advertising, and tax rises. Measurements The main outcome was hospital admissions for all CVDs and five major cause‐specific CVDs, including ischaemic heart disease (IHD), heart failure (HF), heart rhythm disturbances (HRDs), stroke and other cerebrovascular diseases (CBDs). The absolute number and proportion of reductions in the number of hospital admissions after the policies are reported. Findings A total of 419 875 hospital admissions for CVD were identified. In total, 13.4% [95% confidence interval (CI) = 11.5%, 15.3%] of hospital admissions for CVD were averted by the tobacco control policies. For major cause‐specific CVDs, significant hospital admission reductions occurred for IHD (5.4%, 95% CI = 2.6%, 8.3%), stroke (21.2%, 95% CI = 17.8%, 24.6%) and other CBDs (25.9%, 95% CI = 20.8%, 31.0%), but not for HF (4.7%, 95% CI = −4.2%, 13.5%) or HRDs (4.7%, 95% CI = −2.9%, 12.3%). Conclusions Beijing's 2015 tobacco control policy package appears to have been associated with a more than 10% reduction in all cardiovascular hospital admissions, including a more than 20% reduction in admissions for cerebrovascular diseases.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

The impact of comprehensive tobacco control policies on cardiovascular diseases in Beijing, China

Wang

Zheng

et al. 2021

Addiction

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“…29 30 33-52 As studies showed the decrease in the incidence of cardiovascular disease right after the smoking-free ban on public places was biologically plausible, [53][54][55] significant reductions in the hospital admissions for cardiovascular diseases were reported. 33 34 37-40 47-52 56 57 These studies were mostly from North America, Europe and Latin America, and showed consistent results for acute myocardial infarction (AMI), 33 34 37-40 47 51 52 while studies for stroke are limited and results were inconsistent. 37 48 49 Globally, the greatest estimated lifetime risk of stroke was in East Asia, especially the highest risk in men was in China.…”

Section: Original Researchmentioning

confidence: 99%

Impact of a comprehensive tobacco control policy package on acute myocardial infarction and stroke hospital admissions in Beijing, China: interrupted time series study

Zheng

Wang

et al. 2020

Tob Control

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ObjectiveTo evaluate a comprehensive tobacco control policy package on hospital admissions for acute myocardial infarction (AMI) and stroke in a global city.DesignInterrupted time series study.SettingBeijing, China.Population31 707 AMI and 128 116 stroke hospital admissions recorded by the Beijing Medical Claim Data for Employees in 17.7 million residents from January 2013 to June 2017.InterventionThe policy package including all components of MPOWER has been implemented since June 2015.Main outcome measuresThe immediate change of AMI and stroke hospital admissions and the annual change in the secular trend.ResultsThere was a secular increase trend for the crude hospital admission rates of AMI and stroke during the observational period. After implementation of the policy, immediate reductions were observed in the hospital admissions for both AMI (−5.4%, 95% CI −10.0% to −0.5%) and stroke (−5.6%, 95% CI −7.8% to −3.3%). In addition, the secular increase trend for stroke was slowed down by −15.3% (95% CI −16.7% to −13.9%) annually. Compared with the hypothetical scenario where the policy had not taken place, an estimated 18 137 (26.7%) stroke hospital admissions had been averted during the 25 months of postpolicy period.ConclusionsThe results indicated significant health benefits on cardiovascular morbidity after the Beijing tobacco control policy package, which highlighted the importance for a comprehensive tobacco control policy at the national level in China. Similar tobacco control policy which consists of all components of MPOWER is urgently needed in other areas, especially in settings with high tobacco consumption, to achieve greater public health gains.

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“…Comprehensive SFE result in a dramatic decrease in SHS exposure (27), which translates into positive health and economic outcomes. For example, studies conducted in South America showed benefits in cardiovascular (28)(29)(30) and respiratory health, and a decrease in neonatal and infant mortality (30). Studies of the economic impact in Latin American countries found high economic benefits (31).…”

Section: Generation Of Scientific Evidence To Support the Adoption An...mentioning

confidence: 99%

Towards a smoke-free world? South America became the first 100% smoke-free subregion in the Americas

Severini

Sandoval

Sonora

et al. 2022

Revista Panamericana De Salud Pública

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Almost 20 years after the launching by the Pan American Health Organization of its “Smoke-Free Americas” initiative in 2001, in December 2020, South America became the first subregion in the Americas to accomplish 100% smoke-free environments in line with Article 8 of the World Health Organization Framework Convention on Tobacco Control (FCTC). Some of these countries adopted legal measures that are more robust than others, including in their laws specific outdoor places in the smoking ban (like Argentina and Uruguay) and/or novel nicotine and tobacco products under their scope (like Ecuador and Paraguay). The 10 countries took different paths to adopt this public health measure, either through executive or legislative measures or a combination of both. A few countries, like Argentina, Brazil, and Venezuela, started at the subnational level and then moved on to the national level, similar to the rest of the countries. For achieving this milestone, an adequate context was crucial: the broad ratification of the FCTC and the relevance given to the human right to health, civil society efforts, commitments made by intergovernmental bodies, media and communication strategies, and the development of scientific evidence. Countries faced obstacles, including the well-known interference of the tobacco industry, which among other strategies used litigation; however, courts and judges upheld comprehensive legal measures on smoke-free environments. The process by which South America achieved this milestone represents a role model for other subregions of the Americas and the world.

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Decrease in mortality rate and hospital admissions for acute myocardial infarction after the enactment of the smoking ban law in São Paulo city, Brazil

Abstract: Hospital admissions and mortality rate for myocardial infarction were reduced in the first months after the comprehensive smoking ban law was implemented.

Cited by 14 publications

References 39 publications

The impact of comprehensive tobacco control policies on cardiovascular diseases in Beijing, China

The impact of comprehensive tobacco control policies on cardiovascular diseases in Beijing, China

Impact of a comprehensive tobacco control policy package on acute myocardial infarction and stroke hospital admissions in Beijing, China: interrupted time series study

Towards a smoke-free world? South America became the first 100% smoke-free subregion in the Americas

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