Impact of the smoke-free legislation on the incidence and mortality of AMI and stroke in Tianjin China: analysis of routinely collected data
Background Comprehensive smoke-free legislation is an effective way to protect the population from the harms of secondhand smoke (SHS) and has been implemented in many countries. Tianjin is one of the few cities in China that have passed smoke-free legislation. We investigated the impact of smoke-fr...
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doaj-9ec494a4bf4248f9bf9875caf2caee992020-11-25T00:30:16ZengEuropean PublishingTobacco Induced Diseases1617-96252018-03-0116110.18332/tid/8397183971Impact of the smoke-free legislation on the incidence and mortality of AMI and stroke in Tianjin China: analysis of routinely collected dataHong Xiao0Gonghuan Yang1Xia Wan2Yang Liu3Mohsen Naghavi4University of Washington, Global Health Department, United States of AmericaInstitute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, ChinaInstitute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, ChinaInstitute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, ChinaInstitute for Health Metrics and Evaluation, United States of AmericaBackground Comprehensive smoke-free legislation is an effective way to protect the population from the harms of secondhand smoke (SHS) and has been implemented in many countries. Tianjin is one of the few cities in China that have passed smoke-free legislation. We investigated the impact of smoke-free legislation on acute myocardial infarction (AMI) and stroke in Tianjin. Methods An interrupted time series design adjusting for underlying secular trend, seasonal pattern, population size changes and meteorology factors was conducted to analyze the impact of the smoking free law on the weekly incidence and mortality of AMI and stroke. The study period was from January 1, 2007, to December 31, 2015, with a post-ban follow-up of 3.5 years. Results Following the smoke-free law implementation, there was a decline in the annual proportional change for AMI and stroke mortality. A gradual 16% (RR:0.84; 95% CI: 0.83-0.85) decrease per year in AMI mortality among in population ages ≥ 35 years and a gradual 4% (RR:0.96; 95% CI: 0.95-0.98) decrease per year in stroke mortality among 35-64 age group in Tianjin was observed. Post-ban stroke incidence immediate reductions were found in in stroke in 35-64 age group (RR:0.96; 95% CI: 0.95-0.98). AMI incidence immediate reductions were only found in females aged 35-64 (RR:0.71; 95% CI: 0.65-0.78). Conclusions The smoke-free law in Tianjin was associated with gradual reductions in AMI and stroke mortality and immediate reductions in AMI and stroke incidence. The considerably modest and inconsistent effect on AMI and stroke incidence probably reflects the weak law enforcement and limitation of incidence surveillance data in Tianjin. This study reinforces the need for large-scale, effective and comprehensive smoke-free law in China. Funding: This research was supported by China Medical Board (15-208)http://www.journalssystem.com/tid/Impact-of-the-smoke-free-legislation-on-the-incidence-and-mortality-of-AMI-and-stroke,83971,0,2.htmlWCTOH |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hong Xiao Gonghuan Yang Xia Wan Yang Liu Mohsen Naghavi |
spellingShingle |
Hong Xiao Gonghuan Yang Xia Wan Yang Liu Mohsen Naghavi Impact of the smoke-free legislation on the incidence and mortality of AMI and stroke in Tianjin China: analysis of routinely collected data Tobacco Induced Diseases WCTOH |
author_facet |
Hong Xiao Gonghuan Yang Xia Wan Yang Liu Mohsen Naghavi |
author_sort |
Hong Xiao |
title |
Impact of the smoke-free legislation on the incidence and mortality of AMI and stroke in Tianjin China: analysis of routinely collected data |
title_short |
Impact of the smoke-free legislation on the incidence and mortality of AMI and stroke in Tianjin China: analysis of routinely collected data |
title_full |
Impact of the smoke-free legislation on the incidence and mortality of AMI and stroke in Tianjin China: analysis of routinely collected data |
title_fullStr |
Impact of the smoke-free legislation on the incidence and mortality of AMI and stroke in Tianjin China: analysis of routinely collected data |
title_full_unstemmed |
Impact of the smoke-free legislation on the incidence and mortality of AMI and stroke in Tianjin China: analysis of routinely collected data |
title_sort |
impact of the smoke-free legislation on the incidence and mortality of ami and stroke in tianjin china: analysis of routinely collected data |
publisher |
European Publishing |
series |
Tobacco Induced Diseases |
issn |
1617-9625 |
publishDate |
2018-03-01 |
description |
Background
Comprehensive smoke-free legislation is an effective way to protect the population from the harms of secondhand smoke (SHS) and has been implemented in many countries. Tianjin is one of the few cities in China that have passed smoke-free legislation. We investigated the impact of smoke-free legislation on acute myocardial infarction (AMI) and stroke in Tianjin.
Methods
An interrupted time series design adjusting for underlying secular trend, seasonal pattern, population size changes and meteorology factors was conducted to analyze the impact of the smoking free law on the weekly incidence and mortality of AMI and stroke. The study period was from January 1, 2007, to December 31, 2015, with a post-ban follow-up of 3.5 years.
Results
Following the smoke-free law implementation, there was a decline in the annual proportional change for AMI and stroke mortality. A gradual 16% (RR:0.84; 95% CI: 0.83-0.85) decrease per year in AMI mortality among in population ages ≥ 35 years and a gradual 4% (RR:0.96; 95% CI: 0.95-0.98) decrease per year in stroke mortality among 35-64 age group in Tianjin was observed. Post-ban stroke incidence immediate reductions were found in in stroke in 35-64 age group (RR:0.96; 95% CI: 0.95-0.98). AMI incidence immediate reductions were only found in females aged 35-64 (RR:0.71; 95% CI: 0.65-0.78).
Conclusions
The smoke-free law in Tianjin was associated with gradual reductions in AMI and stroke mortality and immediate reductions in AMI and stroke incidence. The considerably modest and inconsistent effect on AMI and stroke incidence probably reflects the weak law enforcement and limitation of incidence surveillance data in Tianjin. This study reinforces the need for large-scale, effective and comprehensive smoke-free law in China. Funding: This research was supported by China Medical Board (15-208) |
topic |
WCTOH |
url |
http://www.journalssystem.com/tid/Impact-of-the-smoke-free-legislation-on-the-incidence-and-mortality-of-AMI-and-stroke,83971,0,2.html |
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