RT Journal Article
SR Electronic
T1 Impact of smoke-free legislation on acute myocardial infarction and stroke mortality: Tianjin, China, 2007–2015
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP 61
OP 67
DO 10.1136/tobaccocontrol-2018-054477
VO 29
IS 1
A1 Hong Xiao
A1 Hui Zhang
A1 Dezheng Wang
A1 Chengfeng Shen
A1 Zhongliang Xu
A1 Ying Zhang
A1 Guohong Jiang
A1 Gonghuan Yang
A1 Xia Wan
A1 Mohsen Naghavi
YR 2020
UL http://tobaccocontrol.bmj.com/content/29/1/61.abstract
AB Background Smoke-free legislation is an effective way to protect the population from the harms of secondhand smoke and has been implemented in many countries. On 31 May 2012, Tianjin became one of the few cities in China to implement smoke-free legislation. We investigated the impact of smoke-free legislation on mortality due to acute myocardial infarction (AMI) and stroke in Tianjin.Methods An interrupted time series design adjusting for underlying secular trends, seasonal patterns, population size changes and meteorological factors was conducted to analyse the impact of the smoke-free law on the weekly mortality due to AMI and stroke. The study period was from 1 January 2007 to 31 December 2015, with a 3.5-year postlegislation follow-up.Results Following the implementation of the smoke-free law, there was a decline in the annual trends of AMI and stroke mortality. An incremental 16% (rate ratio (RR): 0.84; 95% CI: 0.83 to 0.85) decrease per year in AMI mortality and a 2% (RR: 0.98; 95% CI: 0.97 to 0.99) annual decrease in stroke mortality among the population aged ≥35 years in Tianjin was observed. Immediate postlegislation reductions in mortality were not statistically significant. An estimated 10 000 (22%) AMI deaths were prevented within 3.5 years of the implementation of the law.Conclusion The smoke-free law in Tianjin was associated with reductions in AMI mortality. This study reinforces the need for large-scale, effective and comprehensive smoke-free laws at the national level in China.