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Canadian Journal of Public Health

, Volume 99, Issue 1, pp 62–65 | Cite as

Implications of a Public Smoking Ban

  • Mark Lemstra
  • Cory Neudorf
  • Johnmark Opondo
Article

Abstract

Objectives

Legislation to ban smoking in public places is currently a major area of interest across Canada. The main objectives of the study were to 1) determine the effect of the smoking ban on incidence of acute myocardial infarction, 2) determine if the new legislation altered population-based smoking prevalence, and 3) measure public support for the public smoking ban.

Methods

The city of Saskatoon initiated a public smoking ban on July 1, 2004. We retrospectively reviewed all hospital discharges for acute MI from July 2000 to June 2005. We reviewed CCHS survey information on smoking prevalence for Saskatoon, Saskatchewan and Canada from 2003 to 2005. We prospectively contacted 1,255 Saskatoon residents by telephone to determine support for the public smoking ban.

Results

The age-standardized incidence rate of acute MI fell from 176.1 (95% CI 165.3–186.8) cases per 100,000 population (July 1, 2000 to June 30, 2004) to 152.4 (95% CI 135.3–169.3) cases per 100,000 population (July 1, 2004 to June 30, 2005). Smoking prevalence in Saskatoon fell from 24.1% in 2003 (95% CI 20.4–27.7) to 18.2% in 2005 (95% CI 15.7–20.9) while smoking prevalence in Saskatchewan remained unchanged at 23.8% (95% CI 22.6–25.3) and Canada reduced from 22.9% (95% CI 22.5–23.3) to 21.3% (95% CI 20.8–21.8). Seventy-nine percent of Saskatoon residents believed the smoking ban was a good idea.

Interpretation

The public smoking ban in Saskatoon, Canada, is associated with reduced incidence rates of acute MI, lower smoking prevalence and high levels of public support.

Keywords

Tobacco smoke pollution myocardial infarction smoking cessation–legislation and jurisprudence prevalence studies 

Résumé

Objectifs

Les lois interdisant le tabagisme dans les lieux publics suscitent beaucoup d’intérêt au Canada. Notre étude visait principalement à: 1) déterminer l’effet de l’interdiction du tabagisme sur l’incidence des infarctus aigus du myocarde (IAM), 2) déterminer si les nouvelles lois ont modifié la prévalence du tabagisme dans la population et 3) mesurer l’appui à l’interdiction du tabagisme dans les lieux publics.

Méthode

La ville de Saskatoon interdit le tabagisme dans les lieux publics depuis le 1er juillet 2004. Nous avons examiné rétrospectivement toutes les sorties d’hôpitaux des patients ayant subi un IAM entre juillet 2000 et juin 2005. Nous avons examiné les données de l’Enquête sur la santé dans les collectivités canadiennes (ESCC) sur la prévalence du tabagisme à Saskatoon, en Saskatchewan et au Canada de 2003 à 2005. Prospectivement, nous avons contacté par téléphone 1 255 résidents de Saskatoon pour déterminer leur appui à l’interdiction du tabagisme dans les lieux publics.

Résultats

Le taux d’incidence des IAM, sans strate d’âges, a chuté. Il est passé de 176,1 cas pour 100 000 habitants (IC de 95 % = 165,3–186,8) du 1er juillet 2000 au 30 juin 2004 à 152,4 cas pour 100 000 habitants (IC de 95 % =135,3–169,3) du 1er juillet 2004 au 30 juin 2005. La prévalence du tabagisme à Saskatoon a également chuté, passant de 24,1 % en 2003 (IC de 95 % = 20,4–27,7) à 18,2 % en 2005 (IC de 95 % = 15,7–20,9), tandis que la prévalence du tabagisme en Saskatchewan est restée inchangée à 23,8 % (IC de 95 % = 22,6–25,3); à l’échelle du Canada, elle a diminué, passant de 22,9 % (IC de 95 % = 22,5–23,3) à 21,3 % (IC de 95 % = 20,8–21,8). Soixante-dix-neuf p. cent des résidents de Saskatoon considéraient l’interdiction du tabagisme comme une bonne idée.

Interprétation

L’interdiction du tabagisme dans les lieux publics à Saskatoon, au Canada, est associée à des taux d’incidence réduits d’IAM, à une moindre prévalence du tabagisme et à des niveaux élevés d’appui du public.

Motsclés

pollution par la fumée du tabac infarctus du myocarde renoncement au tabac–lois et jurisprudence études de prévalence 

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References

  1. 1.
    He J, Vupputuri S, Allen K, Prerost MR, Hughes J, Whelton PK. Passive smoking and the risk of coronary heart disease—A meta-analysis of epidemiologic studies. N Engl J Med 1999;340:920–26.CrossRefPubMedGoogle Scholar
  2. 2.
    Law MR, Morris JK, Wald NJ. Environmental tobacco smoke exposure and ischemic heart disease: An evaluation of the evidence. BMJ 1997;315:973–80.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Barnoya J, Glantz SA. Cardiovascular effects of second hand smoke nearly as large as smoking. Circulation 2005;111:2684–98.CrossRefPubMedGoogle Scholar
  4. 4.
    Pechacek TF, Babb S. How acute and reversible are the cardiovascular risks of second hand smoke? BMJ 2004;328:980–83.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Benowitz NL. Cigarette smoking and cardiovascular disease: Pathophysiology and implications for treatment. Prog Cardiovasc Dis 2003;46:91–111.CrossRefPubMedGoogle Scholar
  6. 6.
    Howard G, Thun MJ. Why is environmental tobacco smoke more strongly associated with coronary heart disease than expected? A review of potential biases and experimental data. Environ Health Perspect 1999;107(Suppl 6):853-58.Google Scholar
  7. 7.
    Law MR, Wald NJ. Environmental tobacco smoke and ischemic heart disease. Prog Cardiovasc Dis 2003;46:31–38.CrossRefPubMedGoogle Scholar
  8. 8.
    Sargent RP, Shepard RM, Glantz SA. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: Before and after study. BMJ 2004;328:977–80.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Kabat G. Effect of public smoking ban in Helena, Montana: When results look too good to be true, they probably are. BMJ 2004;328:1379; doi:10.1136/bmj.328.7452.1379-b.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Heloma A, Jaakkola MS. Four year follow-up of smoke exposure, attitudes and smoking behaviour following enactment of Finland’s national smoke free workplace law. Addiction 2003;98:1111–17.CrossRefPubMedGoogle Scholar
  11. 11.
    Borland R, Chapman S, Owen N, Hill D. Effects of workplace smoking bans on cigarette consumption. Am J Public Health 1990;80:178–80.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Chapman S, Borland R, Scollo M, Brownson RC, Dominello A, Woodward S. The impact of smoke-free workplaces on declining cigarette consumption in Australia and the United States. Am J Public Health 1999;89:1018–23.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Farrely MC, Evans WN, Sfekas AE. The impact of workplace smoking bans: Results from a national survey. Tobacco Control 1999;8:272–77.CrossRefGoogle Scholar
  14. 14.
    Fichtenberg CM, Glantz SA. Effect of smoke-free workplaces on smoking behaviour: Systematic review. BMJ 2002;325:1–7.CrossRefGoogle Scholar
  15. 15.
    Gallus S, Zuccaro P, Colombo P, Apolone G, Pacifici R, Garattini S, et al. Effects of new smoking regulations in Italy. Ann Oncol 2006;17:346–47.CrossRefPubMedGoogle Scholar
  16. 16.
    Fong GT, Hyland A, Borland R, Hammond D, Hastings G, McNeill A, et al. Reductions in tobacco smoke pollution and increases in support for smoke-free public places following the implementation of comprehensive smoke-free workplace legislation in the Republic of Ireland: Findings from the ITC Ireland/UK Survey. Tob Control 2006;15(Suppl 3):51–58.Google Scholar
  17. 17.
    Health Canada. Smoking in public places: Quebec, Ontario and Saskatchewan. Environics Research Group, Toronto, ON: PN5620, 2005.Google Scholar
  18. 18.
    Liu L, Reeder B, Shuaib A, Mazagri R. Validity of stroke diagnosis on hospital discharge records in Saskatchewan, Canada: Implications for stroke surveillance. Cerebrovascular Diseases 1999;9:224–30.CrossRefPubMedGoogle Scholar
  19. 19.
    Gurney JG. Brain cancer incidence in children: Time to look beyond the trends. Med Pediatr Oncol 1999;33:110–12.CrossRefPubMedGoogle Scholar
  20. 20.
    Smith MA, Freidlin B, Gloeckler Ries LA, Simon R. Trends in reported incidence of primary malignant brain tumors in children in the United States. J Natl Cancer Institute 1998;90(17):1269–77.CrossRefGoogle Scholar
  21. 21.
    Rothman KJ, Greenland S. Modern Epidemiology, 2nd Ed. Philadelphia, PA: Lippincott Williams and Wilkins, 1998.Google Scholar
  22. 22.
    Statistics Canada. Canadian Community Health Survey, cycle 2.1, 2003. Ottawa.Google Scholar
  23. 23.
    Statistics Canada. Canadian Community Health Survey, cycle 3.1, 2005. Ottawa.Google Scholar
  24. 24.
    SPSS. SPSS Version 13.0 (software). Chicago: SPSS, 2004.Google Scholar
  25. 25.
    World Health Organization. Combating the tobacco epidemic. World health report 1999; making a difference. Geneva: WHO, 1999;65–79.Google Scholar
  26. 26.
    Jamrozik K. Population strategies to prevent smoking. BMJ 2004;328:759–62.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© The Canadian Public Health Association 2008

Authors and Affiliations

  1. 1.Saskatoon Health RegionSaskatoonCanada

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