Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/16659
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Smoke-free legislation and hospitalizations for acute coronary syndrome
Authors: Pell, Jill
Haw, Sally
Cobbe, Stuart M
Newby, David E
Pell, Alastair C H
Fischbacher, Colin
McConnachie, Alex
Pringle, Stuart D
Murdoch, David
Dunn, Frank
Oldroyd, Keith G
MacIntyre, Paul D
O'Rourke, Brian
Borland, William
Contact Email: s.j.haw@stir.ac.uk
Issue Date: 31-Jul-2008
Publisher: Massachusetts Medical Society
Citation: Pell J, Haw S, Cobbe SM, Newby DE, Pell ACH, Fischbacher C, McConnachie A, Pringle SD, Murdoch D, Dunn F, Oldroyd KG, MacIntyre PD, O'Rourke B & Borland W (2008) Smoke-free legislation and hospitalizations for acute coronary syndrome, New England Journal of Medicine, 359 (5), pp. 482-491.
Abstract: BACKGROUND Previous studies have suggested a reduction in the total number of hospital admissions for acute coronary syndrome after the enactment of legislation banning smoking in public places. However, it is unknown whether the reduction in admissions involved nonsmokers, smokers, or both. METHODS Since the end of March 2006, smoking has been prohibited by law in all enclosed public places throughout Scotland. We collected information prospectively on smoking status and exposure to secondhand smoke based on questionnaires and biochemical findings from all patients admitted with acute coronary syndrome to nine Scottish hospitals during the 10-month period preceding the passage of the legislation and during the same period the next year. These hospitals accounted for 64% of admissions for acute coronary syndrome in Scotland, which has a population of 5.1 million. RESULTS Overall, the number of admissions for acute coronary syndrome decreased from 3235 to 2684--a 17% reduction (95% confidence interval, 16 to 18)--as compared with a 4% reduction in England (which has no such legislation) during the same period and a mean annual decrease of 3% (maximum decrease, 9%) in Scotland during the decade preceding the study. The reduction in the number of admissions was not due to an increase in the number of deaths of patients with acute coronary syndrome who were not admitted to the hospital; this latter number decreased by 6%. There was a 14% reduction in the number of admissions for acute coronary syndrome among smokers, a 19% reduction among former smokers, and a 21% reduction among persons who had never smoked. Persons who had never smoked reported a decrease in the weekly duration of exposure to secondhand smoke (P<0.001 by the chi-square test for trend) that was confirmed by a decrease in their geometric mean concentration of serum cotinine from 0.68 to 0.56 ng per milliliter (P<0.001 by the t-test). CONCLUSIONS The number of admissions for acute coronary syndrome decreased after the implementation of smoke-free legislation. A total of 67% of the decrease involved nonsmokers. However, fewer admissions among smokers also contributed to the overall reduction.
Type: Journal Article
URI: http://hdl.handle.net/1893/16659
DOI Link: http://dx.doi.org/10.1056/NEJMsa0706740
Rights: From New England Journal of Medicine; Jill P. Pell, M.D., Sally Haw, B.Sc., Stuart Cobbe, M.D., David E. Newby, Ph.D., Alastair C.H. Pell, M.D., Colin Fischbacher, M.B., Ch.B., Alex McConnachie, Ph.D., Stuart Pringle, M.D., David Murdoch, M.B., Ch.B., Frank Dunn, M.D., Keith Oldroyd, M.D., Paul MacIntyre, M.D., Brian O'Rourke, M.D., and William Borland, B.Sc.; 'Special Article: Smoke-free Legislation and Hospitalizations for Acute Coronary Syndrome', 359:482-491; Copyright © 2008 Massachusetts Medical Society. Reprinted with permission.
Affiliation: University of Glasgow
HS Research - Stirling
Glasgow Royal Infirmary
University of Edinburgh
Monksland Hospital
Public Health Information Services Division
University of Glasgow
University of Dundee
Southern General Hospital
Stobhill Hospital
West of Scotland Heart and Lung Centre
Royal Alexandra Hospital
Hairmyres Hospital, East Kilbride
Western General Hospital

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