Longitudinal Impact of the Smoking Ban Legislation in Acute Coronary Syndrome Admissions

Abstract

Background and Purpose. The association between smoking and CV has been proved; however smoking is still the first preventable cause of death in the EU. We aim to evaluate the potential impact of the smoke ban on the number of ACS events in the Portuguese population. In addition, we evaluate the longitudinal effects of the smoking ban several years after its implementation. Methods. We analyzed the admission rate for ACS before and after the ban using data from hospital admission. Monthly crude rate was computed, using the Portuguese population as the denominator. Data concerning the proportion of smokers among ACS patients were obtained from the NRACS. Interrupted time series were used to assess changes over time. Results. A decline of −5.8% was found for ACS crude rate after the smoking ban. The decreasing trend was observed even after years since the law. The effect of the ban was higher in men and for people over 65 years. The most significant reduction of ACS rate was found in Lisbon. Conclusions. Our results suggest that smoking ban is related to a decline in ACS admissions, supporting the importance of smoke legislation as a public health measure, contributing to the reduction of ACS rate.

Cardiovascular disease and high blood pressure trend analyses from 2002 to 2016: after the implementation of a salt reduction strategy

“…direct association between the initiatives to reduce salt implement in the country the reduction observed in the proportion of hypertensives ACS patients. However, our methodology was applied, using the same data to analyse the effects of the smoking ban legislation on ACS trends, and a significant reduction was found right after the ban [ 39 ].…”

Smoking ban in public places and myocardial infarction hospitalizations in high cardiovascular risk European country – insights from the Polish nationwide AMI-PL database

“…11,18 In Portugal, a reduction in the rates of AMI admissions was still observed even after 7 years, which was also attributed to the introduction of a smoking ban. 19 Notably, Sargent et al 20 reported an increase in the rate of AMI admissions following the revoking of the ban. In general, total smoking bans were shown to be more effective than partial restrictions.…”

“…26 In Portugal, the effect of the smoking ban was greater in men and in people aged 65 years or older. 19 In England, after the introduction of smoke -free laws, the rate of AMI hospitalizations was significantly reduced in individuals aged 60 years or older (both men and women) as well as in men, but not women, younger than 60 years. 14 In a mathematical model, Richiardi et al 27 also showed that the impact of smoke -free laws on the rate of AMI hospitalizations was lower in women (2.4%-7.2%) than in men (3.6%-10.9%).…”

Adult vaccination as part of a healthy lifestyle: moving from medical intervention to health promotion

“…Improving vaccination coverage requires encouraging an audience to take an action, or alter their existing habits and may, therefore, be more comparable to campaigns designed to promote positive attitudes towards the subject behaviour, such as exercise, or seeking screening for cancer (see Box 1). In addition, many of the most successful public health campaigns have incorporated legislative action such as bans on the sale of alcohol or cigarettes to minors, restriction on alcohol blood levels for drivers or restricting areas where smoking is permitted [85][86][87][88]. However, legislative action to reduce defined behaviours is intrinsically easier than legislative action to reduce non-compliance with a behaviour.…”