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Cited by 21Smoking Behavior and CessationAcute Myocardial Infarction ResearchCardiac Health and Mental Health

The effect of smoke-free legislation on the mortality rate of acute myocardial infarction: a meta-analysis

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Gao, Min, Li, Yanyu, Wang, Fugang, Zhang, Shengfa, Qu, Zhiyong, Wan, Xia, Wang, Xiaohua, Yang, Jie +2 more·2019·BMC Public Health
DOI 10.1186/s12889-019-7408-7PMC PMC6749716
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Abstract

Background: Several studies have demonstrated that smoke-free legislation is associated with a reduced risk of mortality from acute myocardial infarction (AMI). This study aimed to examine and quantify the potential effect of smoke-free legislation on AMI mortality rate in different countries. Methods: Studies were identified using a systematic search of the scientific literature from electronic databases, including PubMed, Web of Science, ScienceDirect, Embase, Google Scholar, and China National Knowledge Infrastructure (CNKI), from their inception through September 30, 2017. A random effects model was employed to estimate the overall effects of smoke-free legislation on the AMI mortality rate. Subgroup analysis was performed to explore the possible causes of heterogeneity in risk estimates based on sex and age. The results of meta-analysis after excluding the studies with a high risk of bias were reported in this study. Results: A total of 10 eligible studies with 16 estimates of effect size were included in this meta-analysis. Significant heterogeneity in the risk estimates was identified (overall I 2 = 94.6%, p < 0.001). Therefore, a random effects model was utilized to estimate the overall effect of smoke-free legislation. There was an 8% decline in AMI mortality after introducing smoke-free legislation (RR = 0.92, 95% confidence interval (CI): 0.90–0.94). The results of subgroup analyses showed that smoke-free legislation was significantly associated with lower rates of mortality for the following 5 diagnostic subgroups: smoke-free in workplaces, restaurants and bars (RR = 0.92, 95% CI: 0.90–0.95), smaller sample size (RR = 0.92, 95% CI: 0.89–0.95), study location in Europe (RR = 0.90, 95% CI: 0.85–0.94), regional study area (RR = 0.92, 95% CI: 0.89–0.94), and no previous local smoke-free legislation (RR = 0.91, 95% CI: 0.90–0.93). However, there was not much difference in AMI mortality rates after the legislation between the longer (RR = 0.92, 95% CI: 0.86–0.98) and shorter follow-up duration subgroups (RR = 0.92, 95% CI: 0.89–0.94). Conclusion: Smoke-free legislation could significantly reduce the AMI mortality rate by 8%. The reduction in the AMI mortality rate was more significant in studies with more comprehensive laws, without prior smoke-free bans, with a smaller sample size, at the regional level, and with a location in Europe.

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  • Studies of the effects of smoke-free laws found that hospital admission and mortality rates for cardiovascular and respiratory conditions decreased after implementation of smoking bans.

    “Studies of the effects of smoke-free laws found that hospital admission and mortality rates for cardiovascular and respiratory conditions decreased after the implementation of smoking bans455–459.”

    From Health effects associated with exposure to secondhand smoke: a Burden of Proof study (2024) · cites this paper as [459]

    The Conclusion (page unavailable) reports a decline in acute myocardial infarction mortality after smoke-free legislation, supporting the cardiovascular-mortality part of the claim. The paper does not report findings for hospital admissions or respiratory conditions; those outcomes appear in titles in its References (page unavailable). (LLM, conf=0.86)

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Authors
Gao, M., Li, Y., Wang, F., Zhang, S., Qu, Z., Wan, X., Wang, X., Yang, J., Tian, D., & Zhang, W.
Affiliations
  • Beijing Normal University (CN)
  • North China Electric Power University (CN)
  • People's Bank of China (CN)
  • Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
  • Chinese Center For Disease Control and Prevention (CN)
Corresponding author
Zhang, Weijun
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2019-09-18
Volume
19
Issue
1
Pages
1269-1269
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-019-7408-7
PMC
PMC6749716
OpenAlex
W2974721251
Cited by
21
References
7
Citations by year
2026: 1 · 2025: 2 · 2024: 6 · 2023: 7 · 2022: 1 · 2021: 2 · 2020: 2
FWCI
0.15
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Fundamental Research Funds for the Central Universities (SKZZX2013053)
  • Key Laboratory on Development and Application of Rural Renewable Energy (2012BAJ18B00)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
smoking bans, acute myocardial infarction, mortality, tobacco control, passive smoking, workplace smoking bans, cardiovascular risk reduction, age and sex differences, follow-up duration, research location, China
MeSH terms
China, Female, Humans, Male, Myocardial Infarction, Public Facilities, Public Health, Restaurants, Smoking, Time Factors, Workplace, Smoke-Free Policy

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