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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction
Author(s): Sims, Michelle
Maxwell, Roy
Bauld, Linda
Gilmore, Anna
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Keywords: adult
age distribution
controlled study
heart infarction
hospital admission
hospital readmission
major clinical study
passive smoking
population size
priority journal
retrospective study
seasonal variation
sex difference
time series analysis
United Kingdom
Smoking England
Smoking cessation programmes
Issue Date: 19-Jun-2010
Date Deposited: 25-Mar-2013
Citation: Sims M, Maxwell R, Bauld L & Gilmore A (2010) Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction. BMJ, 340 (c2161).
Abstract: Objective: To measure the short term impact on hospital admissions for myocardial infarction of the introduction of smoke-free legislation in England on 1 July 2007. Design: An interrupted time series design with routinely collected hospital episode statistics data. Analysis of admissions from July 2002 to September 2008 (providing five years' data from before the legislation and 15 months' data from after) using segmented Poisson regression. Setting: England. Population: All patients aged 18 or older living in England with an emergency admission coded with a primary diagnosis of myocardial infarction. Main outcome measures: Weekly number of completed hospital admissions. Results: After adjustment for secular and seasonal trends and variation in population size, there was a small but significant reduction in the number of emergency admissions for myocardial infarction after the implementation of smoke-free legislation (-2.4%, 95% confidence interval -4.06% to -0.66%, P=0.007). This equates to 1200 fewer emergency admissions for myocardial infarction (1600 including readmissions) in the first year after legislation. The reduction in admissions was significant in men (3.1%, P=0.001) and women (3.8%, P=0.007) aged 60 and over, and men (3.5%, P less than 0.01) but not women (2.5% P=0.38) aged under 60. Conclusion: This study adds to a growing body of evidence that smoke-free legislation leads to reductions in myocardial infarctions. It builds on previous work by showing that such declines are observed even when underlying reductions in admissions and potential confounders are controlled for. The considerably smaller decline in admissions observed in England compared with many other jurisdictions probably reflects aspects of the study design and the relatively low levels of exposure to secondhand smoke in England before the legislation.
DOI Link: 10.1136/bmj.c2161
Rights: Publisher policy allows this work to be made available in this repository. Published in BMJ 2010; 340 doi: by BMJ Publishing Group with the following policy: authors may use their own articles for the following non commercial purposes without asking our permission (and subject only to acknowledging first publication in the BMJ and giving a full reference or web link, as appropriate).

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