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Cited by 11Smoking Behavior and CessationAcute Ischemic Stroke ManagementAir Quality and Health Impacts

Effects of a Smoke-Free Policy in Xi'an, China: Impact on Hospital Admissions for Acute Ischemic Heart Disease and Stroke

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Chu, Meng, Liu, Zhiyan, Fang, Xinzhu, Wu, Yajun, Liu, Huannan, Zhao, Xuan, Zhang, Tianxiao, Wu, Qian +1 more·2022·Frontiers in Public Health
DOI 10.3389/fpubh.2022.898461PMC PMC9253815
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Abstract

Background: Smoking and secondhand smoke (SHS) exposure rates are much higher in China than in other countries. A smoke-free policy was implemented in Xi'an, a city in Shaanxi Province, China, on November 1, 2018. This study aimed to evaluate the effect of the smoke-free policy on changes in hospital admissions for acute ischemic heart disease (AIHD) and stroke in Xi'an. Methods: All subjects had been hospitalized for AIHD or stroke from February 9, 2017 to December 25, 2019 (study period: 150 weeks) in six randomly selected public hospitals out of 36 tertiary hospitals in Xi'an. A generalized additive model developed using an interrupted time series design was used to compare immediate and annual percent changes in hospital admissions before and after policy implementation. Results: The study included 31,400 cases (16,656 cases of AIHD and 14,744 cases of stroke) from 6 hospitals in Xi'an. Immediately after implementation of the smoke-free policy, AIHD admissions were reduced significantly (−31.66%, 95% CI: – 39.45 to −22.86%), but stroke admissions were not (−4.94%, 95% CI: −13.26 to 4.17%). The annual reduction in stroke-related admissions (−14.54%, 95% CI: −23.53 to −4.49%) and the annual increase in AIHD-related admissions (40.58%, 95% CI: 22.08 to 61.87%) were significant. Although there was no significant reduction in AIHD admissions, stroke admissions were significantly reduced by −15.73% (from 7,350 to 6,194) after implementation of the smoke-free policy in Xi'an. Conclusion: The smoke-free policy had different effects on hospital admissions for AIHD and stroke in Xi'an. Xi'an should improve its smoke-free legislation and expand the measures to maintain or achieve additional significant health benefits. These findings can guide the formulation and implementation of regional and national smoke-free policies.

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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 [457]

    The Introduction reports reductions in cardiovascular mortality after some smoking bans, and the Results report reduced stroke admissions in Xi’an. But the paper’s findings are mixed for cardiovascular admissions, and its text does not report a reduction in respiratory admissions or mortality; respiratory outcomes appear only in cited reference titles. No page numbers are available in our copy. (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Chu, M., Liu, Z., Fang, X., Wu, Y., Liu, H., Zhao, X., Zhang, T., Wu, Q., & Tan, F.
Affiliations
  • Xi'an Jiaotong University (CN)
  • Northwest University (CN)
Corresponding author
Wu, Qian
ORCID
Venue
Frontiers in Public Health
Publisher
Frontiers Media SA
Published
2022-06-21
Volume
10
Pages
898461-898461
ISSN
2296-2565 (ISSN-L)
DOI
10.3389/fpubh.2022.898461
PMC
PMC9253815
OpenAlex
W4283257382
Cited by
11
References
4
Citations by year
2026: 1 · 2025: 6 · 2024: 3 · 2023: 1
FWCI
1.55
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
Keywords
smoke-free policies, passive smoking, acute ischemic heart disease, stroke, hospitalization, tobacco control, public health policy evaluation, Xi'an
MeSH terms
China, Hospitals, Humans, Tobacco Smoke Pollution, Myocardial Ischemia, Stroke, Smoke-Free Policy

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