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Abstract
Objective To evaluate a comprehensive tobacco control policy package on hospital admissions for acute myocardial infarction (AMI) and stroke in a global city.
Design Interrupted time series study.
Setting Beijing, China.
Population 31 707 AMI and 128 116 stroke hospital admissions recorded by the Beijing Medical Claim Data for Employees in 17.7 million residents from January 2013 to June 2017.
Intervention The policy package including all components of MPOWER has been implemented since June 2015.
Main outcome measures The immediate change of AMI and stroke hospital admissions and the annual change in the secular trend.
Results There was a secular increase trend for the crude hospital admission rates of AMI and stroke during the observational period. After implementation of the policy, immediate reductions were observed in the hospital admissions for both AMI (−5.4%, 95% CI −10.0% to −0.5%) and stroke (−5.6%, 95% CI −7.8% to −3.3%). In addition, the secular increase trend for stroke was slowed down by −15.3% (95% CI −16.7% to −13.9%) annually. Compared with the hypothetical scenario where the policy had not taken place, an estimated 18 137 (26.7%) stroke hospital admissions had been averted during the 25 months of postpolicy period.
Conclusions The results indicated significant health benefits on cardiovascular morbidity after the Beijing tobacco control policy package, which highlighted the importance for a comprehensive tobacco control policy at the national level in China. Similar tobacco control policy which consists of all components of MPOWER is urgently needed in other areas, especially in settings with high tobacco consumption, to achieve greater public health gains.
- public policy
- smoking caused disease
- low/middle income country
- prevention
- secondhand smoke
Data availability statement
Data are available upon reasonable request. Summarised hospital admission data can be accessed by contacting the National Insurance Claims for Epidemiological Research (NICER) Group, School of Public Health, Peking University. Contact email: 0016156078@bjmu.edu.cn. Air pollution data used in this study can be obtained from the China Environmental Monitoring Center (http://106.37.208.233:20035). Meteorological data can be accessed from the China Meteorological Data Sharing Service System (http://data.cma.cn/). Particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) concentrations can be obtained from the US Embassy report (http://www.stateair.net/web/post/1/1.html). The public holidays can be obtained from the General Office of the State Council of the People's Republic of China (http://english.www.gov.cn).
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Data availability statement
Data are available upon reasonable request. Summarised hospital admission data can be accessed by contacting the National Insurance Claims for Epidemiological Research (NICER) Group, School of Public Health, Peking University. Contact email: 0016156078@bjmu.edu.cn. Air pollution data used in this study can be obtained from the China Environmental Monitoring Center (http://106.37.208.233:20035). Meteorological data can be accessed from the China Meteorological Data Sharing Service System (http://data.cma.cn/). Particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) concentrations can be obtained from the US Embassy report (http://www.stateair.net/web/post/1/1.html). The public holidays can be obtained from the General Office of the State Council of the People's Republic of China (http://english.www.gov.cn).
Footnotes
YZ and YW are joint first authors.
YZ and YW contributed equally.
Contributors YH and CC contributed to the study concept and had full access to all the data in the study. WY and YZ take responsibility for the integrity of the data and interpreted the findings and drafted the article. MW, ZW and SW contributed to data analysis. JW and TW interpreted the data. All the authors contributed to the critical revision of the article for important intellectual content. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.