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Smoke-free legislation and hospitalizations for acute coronary syndrome

Environmental Health Economic Analysis Annotated Bibliography

Details

Research article Cost-benefit analysis (CBA)
Authors
Pell JP, Haw S, Cobbe S, Newby DE, Pell AC, Fischbacher C, McConnachie A, Pringle S, Murdoch D, Dunn F, Oldroyd K, MacIntyre P, O'Rourke B, and Borland W
Journal
New England Journal of Medicine
Summary
This cost-benefit analysis performed in Scotland, Europe found that the number of hospital admissions for acute coronary syndrome decreased 17% overall and 21% among persons who had never smoked after enactment of smoke-free legislation. Study findings supported the legal treaty for improving public health outlined in the World Health Organization's Framework Convention on Tobacco Control.
Population
Acute coronary syndrome patients — adults (men ≤ 55 years, women ≤ 65 years)

Health Outcomes

  • Cardiovascular outcomes (acute coronary syndrome)

Environmental Agents

List of Environmental Agents:

  • Air pollutants (tobacco smoke)

Source of Environmental Agents:

  • Cigarette smoke (secondhand)

Economic Evaluation / Methods and Source

Type:

  • Cost-benefit analysis (CBA)

Cost Measured: (Not available)

Potential Cost Measures: (Not available)

Benefits Measures:

  • Reduction in acute coronary syndrome
  • related hospital admissions following smoke-free legislation

Potential Benefits: (Not available)

Location:

  • Scotland

Models Used: (Not available)

Methods Used:

  • The authors compared the number of admissions for acute coronary syndrome (ACS) before and after implementation of national legislation, overall, and according to smoking status. The authors — 1) collected data prospectively on all patients with ACS admitted to nine hospitals during the 10 months before implementation of the smoke-free legislation and during the same 10 months thereafter; 2) obtained case ascertainment for individuals with ACS by performing troponin assays for all patients admitted with chest pain; 3) obtained smoking status and exposure to secondhand smoke by self-reports and confirmed using cotinine assays; and 4) analyzed percentage reduction in the number of admissions, including subgroup analyses according to patients' sex and age group.

Sources Used:

  • Acute myocardial infarction: trends in incidence 1996-2005 (NHS National Services Scotland, 2007); Hospital Episodes Statistics (Department of Health, 2007); Deaths: information and statistics (General Register for Scotland, 2007); additional sources cited in publication

Economic Evaluation / Methods and Source

Citation:

  • Pell JP, Haw S, Cobbe S, Newby DE, Pell AC, Fischbacher C, McConnachie A, Pringle S, Murdoch D, Dunn F, Oldroyd K, MacIntyre P, O'Rourke B, and Borland W. 2008. Smoke-free legislation and hospitalizations for acute coronary syndrome. New England Journal of Medicine.

Pubmed:

DOI:

NIEHS Funding: (Not available)

Other Funding: (Not available)