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Reductions in cardiovascular, cerebrovascular, and respiratory mortality following the national Irish smoking ban: interrupted time-series analysis.

Creator:

S Stallings-Smith, A Zeka, P Goodman, Zubair Kabir, Luke Clancy

Catalogue: Research and Evaluation
Report
Type: Report
Region: Republic of Ireland
Northern Ireland
Description:

Background: Previous studies have shown decreases in cardiovascular mortality following the implementation of comprehensive smoking bans. It is not known whether cerebrovascular or respiratory mortality decreases post ban. On March 29, 2004, the Republic of Ireland became the first country in the world to implement a national workplace smoking ban. The aim of this study was to assess the effect of this policy on all-cause and cause-specific, non-trauma mortality. Methods: A time-series epidemiologic assessment was conducted, utilizing Poisson regression to examine weekly age and gender-standardized rates for 215,878 non-trauma deaths in the Irish population, ages $35 years. The study period was from January 1, 2000, to December 31, 2007, with a post-ban follow-up of 3.75 years. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results: Following ban implementation, an immediate 13% decrease in all-cause mortality (RR: 0.87; 95% CI: 0.76 0.99), a 26% reduction in ischemic heart disease (IHD) (RR: 0.74; 95% CI: 0.63ââ,¬â?o0.88), a 32% reduction in stroke (RR: 0.68; 95% CI: 0.54ââ,¬â?o 0.85), and a 38% reduction in chronic obstructive pulmonary disease (COPD) (RR: 0.62; 95% CI: 0.46ââ,¬â?o0.83) mortality was observed. Post-ban reductions in IHD, stroke, and COPD mortalities were seen in ages $65 years, but not in ages 35 64 years. COPD mortality reductions were found only in females (RR: 0.47; 95% CI: 0.32ââ,¬â?o0.70). Post-ban annual trend reductions were not detected for any smoking-related causes of death. Unadjusted estimates indicate that 3,726 (95% CI: 2,305 4,629) smoking-related deaths were likely prevented post-ban. Mortality decreases were primarily due to reductions in passive smoking. Conclusions: The national Irish smoking ban was associated with immediate reductions in early mortality. Importantly, postban risk differences did not change with a longer follow-up period. This study corroborates previous evidence for cardiovascular causes, and is the first to demonstrate reductions in cerebrovascular and respiratory causes.

Date:

01/01/2013

Rights: Public
Suggested citation:

S Stallings-Smith, A Zeka, P Goodman, Zubair Kabir, Luke Clancy. (2013) Reductions in cardiovascular, cerebrovascular, and respiratory mortality following the national Irish smoking ban: interrupted time-series analysis. [Online]. Available from: http://publichealthwell.ie/node/484957 [Accessed: 22nd August 2019].

  

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National Drugs Library
 
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