• Research Review
• Journal Review

Authors: SA Khuder, S Milz, T Jordan, et al.
 
Reference: Preventive Medicine 2007; 45: 3-8, http://www.sciencedirect.com/science/journal/00917435.

Reviewer: Joaquin Barnoya, MD, MPH, ProCor contributing editor, Director, Research and Education, Unidad de Cirugia Cardiovascular de Guatemala, Guatemala.
 
Problem addressed: Smoke-free environments as a tobacco control tool.
 
Purpose of study: Bowling Green, Ohio, implemented a smoke-free ordinance in March 2002. A matched control city, Kent, Ohio, was used to examine the effect of the ordinance on hospital admission for smoking-related diseases.
 
Study design: This is a quasi-experimental design where the intervention city is Bowling Green and the control is Kent. Hospital discharge data were for the residents of the two cities. A six-year period was covered (1999-2004) and the first half of 2005. Primary diagnosis included angina, heart failure, atherosclerosis and acute myocardial infarction. Age-standardized rates were calculated using the combined population of the two cities as the standard population. They hypothesized that at least six months were needed to allow for a potential health effect of the ordinancy.
 
Results: In the intervention city, admissions for CHD showed a significant reduction starting in 2003. Rates were significantly reduced from 36 per 10,000 populations in 2002 to 22 per 10,000 populations in 2003 (39% decrease) and to 19 per 10,000 populations in the first half of 2005 (47% decrease). Admissions in Kent were not significantly changed.  Monthly admissions were also significantly decreased in Bowling Green as opposed to Kent were they appeared to be constant. 
 
Comment: This interesting analysis adds to the mounting evidence supporting the benefits of smoke-free environments on heart disease admissions. Noteworthy of this study, compared to the Pueblo and Piedmont, Italy studies, is that it included a wider range of heart diseases. In addition, the study is accompanied by a commentary by Dinno and Glantz (Prev Med 2007; 45: 9-11) in which they estimate, based on the available studies, that smoke-free laws are associated with a 27% reduction in heart disease hospital admissions.

Citations:

1. Dinno A, Glantz S. Clean indoor air laws immediately reduce heart attacks. Preventive Medicine 2007; 45: 9-11.