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Effects of Italian smoking regulation on rates of hospital admission for acute coronary events: a country-wide study.

Barone-Adesi, F; Gasparrini, A; Vizzini, L; Merletti, F; Richiardi, L (2011) Effects of Italian smoking regulation on rates of hospital admission for acute coronary events: a country-wide study. PLOS ONE, 6 (3). e17419. ISSN 1932-6203
SGUL Authors: Barone-Adesi, Francesco

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BACKGROUND: Several studies have reported a reduction in acute coronary events (ACEs) in the general population after the enforcement of smoking regulations, although there is uncertainty concerning the magnitude of the effect of such interventions. We conducted a country-wide evaluation of the health effects of the introduction of a smoking ban in public places, using data on hospital admissions for ACEs from the Italian population after the implementation of a national smoking regulation in January 2005. METHODS AND FINDINGS: Rates of admission for ACEs in the 20 Italian regions from January 2002 to November 2006 were analysed using mixed-effect regression models that allowed for long-term trends and seasonality. Standard methods for interrupted time-series were adopted to assess the immediate and gradual effects of the smoking ban. Effect modification by age was investigated, with the assumption that exposure to passive smoking in public places would be greater among young people. In total, 936,519 hospital admissions for ACEs occurred in the Italian population during the study period. A 4% reduction in hospital admissions for ACEs among persons aged less than 70 years was evident after the introduction of the ban (Rate Ratio [RR], 0.96; 95% Confidence Interval [CI], 0.95-0.98). No effect was found among persons aged at least 70 years (RR 1.00; 95% CI 0.99-1.02). Effect modification by age was further suggested by analyses using narrower age categories. CONCLUSIONS: Smoke-free policies can constitute a simple and inexpensive intervention for the prevention of cardiovascular diseases and thus should be included in prevention programmes.

Item Type: Article
Additional Information: ©2011 Barone-Adesi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Acute Disease, Age Distribution, Aged, Cardiovascular Diseases, Female, Hospitalization, Humans, Italy, Male, Myocardial Infarction, Smoking, Social Control, Formal
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: PLOS ONE
ISSN: 1932-6203
2 March 2011Published
PubMed ID: 21399685
Web of Science ID: 21399685
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