Impact of Total Indoor Smoking Ban on Cardiovascular Disease Hospitalizations and Mortality: The Case of Chile.

Autor:	Montes de Oca D; Universidad Adolfo Ibáñez, Peñalolén, Santiago de Chile, Chile., Paraje G; Business School, Universidad Adolfo Ibáñez, Peñalolén, Santiago de Chile, Chile.; Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Peñalolén, Santiago de Chile, Chile., Cuadrado C; Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Peñalolén, Santiago de Chile, Chile.; School of Public Health, Universidad de Chile, Santiago de Chile, Chile.
Jazyk:	angličtina
Zdroj:	Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco [Nicotine Tob Res] 2024 Aug 22; Vol. 26 (9), pp. 1166-1174.
DOI:	10.1093/ntr/ntae045
Abstrakt:	Introduction: The harmful effects of first and secondhand smoking are well-established. Smoke-free laws aim at protecting nonsmokers. This study aimed to assess the impact of the 2013 total ban on indoor smoking in Chile on hospitalizations and deaths of major cardiovascular events. Aims and Methods: The logarithm of the monthly hospitalization and death rates, standardized by age for every 100 000 inhabitants, were estimated for ischemic heart disease, acute myocardial infarction, strokes, and a composite outcome of ischemic heart diseases (which includes acute myocardial infarction) and strokes. In addition, interrupted time series with synthetic control groups were used to assess changes in levels and trends after the intervention. Results: The total ban on indoor smoking caused significant reductions in death rates for the three diseases studied for age groups above 20 years old. In addition, there were substantial decreases in the post-intervention hospitalization rates for ischemic heart disease: for the 20-44 age group, the decrease was 8.7% compared to the pre-intervention period (p < .01). In comparison, such a reduction was 4% (p < .01) for the ≥65 age group. For acute myocardial infarction, the decrease was 11.5% (p < .01) for the 20-44 age group, while for stroke, it was a 1.2% (p < .01) decrease for the total population. It is estimated that the smoking ban averted 15.6% of the deaths compared with the synthetic control groups. Conclusions: The implementation of total smoke-free environments in Chile contributed to the reduction of mortality for main cardiovascular diseases. This study provides additional evidence of causality linking the policy to health outcomes. Implications: The total indoor smoking ban significantly affected age-standardized hospitalization and deaths. The number of deaths averted by this policy is estimated at approximately 4758 and 5256 for IHD and stroke, respectively, during the 2013-2017 period (15.6% fewer deaths than predicted by the synthetic control groups). The study contributes to the body of evidence that supports total indoor smoking bans. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.)
Databáze:	MEDLINE
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