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IMPACT OF SMOKING BAN ON CARDIOVASCULAR MORBIDITY AND MORTALITY: LESSONS TO LEARN FROM MICHIGAN
A1429 JACC April 1, 2014 Volume 63, Issue 12
Prevention Impact of Smoking Ban on Cardiovascular Morbidity and Mortality: Lessons to Learn from Michigan Poster Contributions Hall C Sunday, March 30, 2014, 3:45 p.m.-4:30 p.m.
Session Title: Prevention: Gender, Race/Ethnicity, and Preventive Interventions Abstract Category: 20. Prevention: Clinical Presentation Number: 1219-151 Authors: Sourabh Aggarwal, Amy Attaway, Ravikanth Papani, Shrey Velani, Thomas Melgar, Western Michigan University School of Medicine, Kalamazoo, MI, USA Background: Cigarette smoking is well known to increase mortality and morbidity. Smoking bans/smoke-free laws are public policies prohibiting tobacco smoking in workplaces and/or public spaces. Michigan State’s “Smoke Free Air Law” restricting indoor public smoking came into effect in May 2010. However, its clinical impact on acute cardiovascular morbidity and mortality events is unknown. Methods: We queried Nationwide Inpatient Sample (NIS) for hospitalizations from acute myocardial infarction (MI), congestive heart failure (CHF) exacerbations and acute ischemic thrombotic stroke (AITS) before and after the ban implementation for the state of Michigan. The NIS represents 20% of all hospitals data in US. Data for 2009 was compared with 2011 to analyze the clinical impact of smoking ban. Results: There was a statistically significant reduction in cardiovascular morbidity and mortality with total hospitalizations for above-mentioned parameters decreasing from 65,329 to 64,002 (51.77 per 1000 total hospitalizations to 49.54 per 1000 total hospitalizations, p value <0.001) and in-hospital mortality decreasing from 3.91 per 100-events to 3.53 per 100 events (p value <0.05). There was also a significant reduction in hospitalizations from CHF exacerbations (p value <0.001) and non-significant reduction in AITS and MIs. There was also significant reduction in inhospital mortality for MI (p value <0.001) and non-significant reduction in in-hospital mortality from CHF exacerbation and AITS. Conclusion: This is the first ever reported study determining acute clinical impact of state-wide public smoking ban on cardiovascular outcomes. There is no nation-wide federal policy for public indoor smoking ban. Our study highlights the acute clinical benefit of smoking ban on cardiovascular morbidity and mortality and provides a concrete evidence of clinical benefit of public policy and lays the foundation where in implementation of similar policy at federal level can be initiated.
Prevention Impact of Smoking Ban on Cardiovascular Morbidity and Mortality: Lessons to Learn from Michigan Poster Contributions Hall C Sunday, March 30, 2014, 3:45 p.m.-4:30 p.m.
Session Title: Prevention: Gender, Race/Ethnicity, and Preventive Interventions Abstract Category: 20. Prevention: Clinical Presentation Number: 1219-151 Authors: Sourabh Aggarwal, Amy Attaway, Ravikanth Papani, Shrey Velani, Thomas Melgar, Western Michigan University School of Medicine, Kalamazoo, MI, USA Background: Cigarette smoking is well known to increase mortality and morbidity. Smoking bans/smoke-free laws are public policies prohibiting tobacco smoking in workplaces and/or public spaces. Michigan State’s “Smoke Free Air Law” restricting indoor public smoking came into effect in May 2010. However, its clinical impact on acute cardiovascular morbidity and mortality events is unknown. Methods: We queried Nationwide Inpatient Sample (NIS) for hospitalizations from acute myocardial infarction (MI), congestive heart failure (CHF) exacerbations and acute ischemic thrombotic stroke (AITS) before and after the ban implementation for the state of Michigan. The NIS represents 20% of all hospitals data in US. Data for 2009 was compared with 2011 to analyze the clinical impact of smoking ban. Results: There was a statistically significant reduction in cardiovascular morbidity and mortality with total hospitalizations for above-mentioned parameters decreasing from 65,329 to 64,002 (51.77 per 1000 total hospitalizations to 49.54 per 1000 total hospitalizations, p value <0.001) and in-hospital mortality decreasing from 3.91 per 100-events to 3.53 per 100 events (p value <0.05). There was also a significant reduction in hospitalizations from CHF exacerbations (p value <0.001) and non-significant reduction in AITS and MIs. There was also significant reduction in inhospital mortality for MI (p value <0.001) and non-significant reduction in in-hospital mortality from CHF exacerbation and AITS. Conclusion: This is the first ever reported study determining acute clinical impact of state-wide public smoking ban on cardiovascular outcomes. There is no nation-wide federal policy for public indoor smoking ban. Our study highlights the acute clinical benefit of smoking ban on cardiovascular morbidity and mortality and provides a concrete evidence of clinical benefit of public policy and lays the foundation where in implementation of similar policy at federal level can be initiated.