Introduction
Implementation of smokefree laws is followed by drops in hospital admissions for cardiovascular
diseases and asthma. The impact of smokefree laws on use of non-hospital medical services
has not been assessed. The purpose of this study is to evaluate the impact of Uruguay’s
national 100% smokefree legislation on non-hospital emergency care visits, hospitalizations
for bronchospasm, and bronchodilator use.
Methods
The monthly number of non-hospital emergency care visits and hospitalizations for
bronchospasm, as well as monthly puffs of bronchodilators (total and per person),
from 3 years prior to the adoption of the 100% smokefree policy on March 1, 2006,
through 5 years after the policy were assessed using interrupted time series negative
binomial regression. Data analysis was conducted in 2014.
Results
The incidence of non-hospital emergency visits for bronchospasm decreased by 15% (incidence
rate ratio [IRR]=0.85, 95% CI=0.76, 0.94) following implementation of the law. Hospitalizations
for bronchospasm did not change significantly (IRR=0.89, 95% CI=0.66, 1.21). Total
monthly puffs of salbutamol and ipratropium administered in the non-hospital emergency
setting decreased by 224 (95% CI=–372, –76) and 179 (95% CI=–340, –18.6), respectively,
from means of 1,222 and 1,007 before the law.
Conclusions
Uruguay’s 100% smokefree law was followed by fewer emergency visits for bronchospasm
and less need for treatment, supporting adoption of such policies in low- and middle-income
countries to reduce the disease burden and healthcare costs associated with smoking.
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References
- Association between smoke-free legislation and hospitalizations for cardiac, cerebrovascular, and respiratory diseases: a meta-analysis.Circulation. 2012; 126: 2177-2183
- Smokefree policies in Latin America and the Caribbean: making progress.Int J Environ Res Public Health. 2012; 9: 1954-1970
- Hospital admissions for acute myocardial infarction before and after implementation of a comprehensive smoke-free policy in Uruguay.Tob Control. 2013; 22: e16-e20
- Hospital admissions for acute myocardial infarction before and after implementation of a comprehensive smoke-free policy in Uruguay: experience through 2010.Tob Control. 2014; 23: 471-472
- Declines in acute myocardial infarction after smoke-free laws and individual risk attributable to secondhand smoke.Circulation. 2009; 120: 1373-1379
National Statistics Institute. National Statistics Institute Household Survey 2011; 2011.
- A cross-country comparison of secondhand smoke exposure among adults: findings from the Global Adult Tobacco Survey (GATS).Tob Control. 2013; 22: e5
- The global burden of asthma.Chest. 2006; 130: 4S-12S
- Hospital admissions for childhood asthma after smoke-free legislation in England.Pediatrics. 2013; 131: e495-e501
- Smoke-free legislation and hospitalizations for childhood asthma.N Engl J Med. 2010; 363: 1139-1145
- Acute pulmonary admissions following implementation of a national workplace smoking ban.Chest. 2012; 142: 673-679
- Short-term impact of the smokefree legislation in England on emergency hospital admissions for asthma among adults: a population-based study.Thorax. 2013; 68: 619-624
- Reduction in asthma-related emergency department visits after implementation of a smoke-free law.J Allergy Clin Immunol. 2008; 122: 537-541
- Bartenders’ respiratory health after establishment of smoke-free bars and taverns.JAMA. 1998; 280: 1909-1914
- The impact of a 100% smoke-free law on the health of hospitality workers from the city of Neuquen, Argentina.Tob Control. 2010; 19: 134-137
- Respiratory symptoms, pulmonary function, and markers of inflammation among bar workers before and after a legislative ban on smoking in public places.JAMA. 2006; 296: 1742-1748
- Association between smokefree laws and voluntary smokefree-home rules.Am J Prev Med. 2011; 41: 566-572
- Association between being employed in a smoke-free workplace and living in a smoke-free home: Evidence from 15 low and middle income countries.Prev Med. 2014; 59: 47-53
- Smoking ban policies and their influence on smoking behaviors among current California smokers: A population-based study.Prev Med. 2014; 59: 73-78
- Population effectiveness of pharmaceutical aids for smoking cessation: what is associated with increased success?.Nicotine Tob Res. 2006; 8: 661-669
- Tobacco control campaign in Uruguay: a population-based trend analysis.Lancet. 2012; 380: 1575-1582
ITC Project. ITC Uruguay National Report. Findings from the Wave 1 to 3 Surveys (2006-2011). University of Waterloo, Waterloo, Ontario, Canada; Centro de Investigación para la Epidemia del Tabaquismo (CIET Uruguay); Universidad de la Republica, Facultad de Ciencias Sociales; 2012.
- Reduction of secondhand tobacco smoke in public places following national smoke-free legislation in Uruguay.Tob Control. 2010; 19: 231-234
- Fewer hospitalizations for chronic obstructive pulmonary disease in communities with smoke-free public policies.Am J Public Health. 2014; 104: 1059-1065
- Association of anti-smoking legislation with rates of hospital admission for cardiovascular and respiratory conditions.CMAJ. 2010; 182: 761-767
Article Info
Publication History
Published online: May 18, 2015
Identification
Copyright
© 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
