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Hospital admissions for acute myocardial infarction before and after implementation of a comprehensive smoke-free policy in Uruguay: experience through 2010
  1. Ernesto Marcelo Sebrié1,
  2. Edgardo Sandoya2,
  3. Eduardo Bianco2,
  4. Andrew Hyland1,
  5. K Michael Cummings3,
  6. Stanton A Glantz4
  1. 1Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
  2. 2Cetro de Investigación para la Epidemia del Tabaquismo, Montevideo, Uruguay
  3. 3Departments of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
  4. 4Department of Medicine (Cardiology), Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Professor Stanton A Glantz, Department of Medicine (Cardiology), Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA 94143-1390, USA; glantz{at}medicine.ucsf.edu

Abstract

Background Comprehensive smoke-free laws have been followed by drops in hospitalisations for acute myocardial infarction (AMI), including in a study with 2 years follow-up for such a law in Uruguay.

Methods Multiple linear and negative binomial regressions for AMI admissions (ICD-10 code 121) from 37 hospitals for 2 years before and 4 years after Uruguay implemented a 100% nationwide smoke-free law.

Results Based on 11 135 cases, there was a significant drop of −30.9 AMI admissions/month (95% CI −49.8 to −11.8, p=0.002) following implementation of the smoke-free law. The effect of the law did not increase or decrease over time following implementation (p=0.234). This drop represented a 17% drop in AMI admissions following the law (IRR=0.829, 95% CI 0.743 to 0.925, p=0.001).

Conclusions Adding two more years of follow-up data confirmed that Uruguay's smoke-free law was followed by a substantial and sustained reduction in AMI hospitalisations.

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