Association between the extension of smoke-free legislation and incident acute myocardial infarctions in Singapore from 2010 to 2019
An interrupted time-series analysis
Bibliographic Data
| ID | 21880558 |
|---|---|
| Authors | Jamie Sin Ying Ho (0000-0002-1180-6902, National University Hospital), Andrew Fu Wah Ho (0000-0003-4338-3876, SingHealth), Eric Jou (University of Cambridge), Nan Liu (0009-0003-4309-5513, Duke-NUS Medical School), Huili Zheng (0000-0002-3976-0088, Health Promotion Board), Joel Aik (0000-0002-2851-9424, National Environment Agency, corresponding author) |
| Year | 2023 |
| Volume | 8 |
| Issue | 10 |
| Pages | e012339 |
| Publication date | 2023-10-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMJ Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2059-7908 • E-ISSN: 2059-7908 |
| Publisher | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/bmjgh-2023-012339 |
| PMID | 37816537 |
| OpenAlex | W4387478103 |
| Language | EN |
| References cited | 40 |
BACKGROUND: We examined the association between smoke-free laws implemented in the outdoors and the common areas of residential apartment blocks and reported acute myocardial infarctions (AMI) in Singapore. METHODS: We used an interrupted time-series design and seasonal autoregressive integrated moving average models to examine the effect of the smoke-free law extensions in 2013 (common areas of residential blocks, covered pedestrian linkways, overhead bridges and within 5 m of bus stops), 2016 (parks) and 2017 (educational institutions, buses and taxis) on the monthly incidence rate of AMIs per 1 000 000 population. RESULTS: We included 133 868 AMI reports from January 2010 to December 2019. Post-2013, there was a decrease in the AMI incidence trend (β=-0.6 per month, 95%CI -1.0 to -0.29) and 2097 (95% CI 2094 to 2100) more AMIs may have occurred without the extension. There was a significant step-decline in male AMIs and a non-significant step-increase in female AMIs post-2013. Those 65 years and older experienced a greater decline to the postlegislation 2013 trend (β=-5.9, 95% CI -8.7 to -3.1) compared with those younger (β=-0.4, 95% CI -0.6 to -0.2), while an estimated 19 591 (15 711 to 23472) additional AMI cases in those 65 years and above may have occurred without the extension. We found a step-increase in monthly AMI incidence post-2016 (β=14.2, 95%CI 3.3 to 25.0). CONCLUSION: The 2013 smoke-free law extension to residential estates and other outdoor areas were associated with a decline in AMIs and those above the age of 65 years and men appeared to be major beneficiaries. Additional epidemiological evidence is required to support the expanded smoke-free legislation to parks, educational institutions, buses and taxis
Environmental health · Interrupted time series · Population · Rate ratio · Air Quality and Health Impacts · Demography · Injury Epidemiology and Prevention · Medicine · Smoking Behavior and Cessation
Reduced incidence of admissions for myocardial infarction associated with public smoking ban
Myocardial infarction and coronary deaths in the World Health Organization Monica Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents.
Worldwide burden of disease from exposure to second-hand smoke
Global burden of 87 risk factors in 204 countries and territories, 1990–2019
Smoking behaviors before and after implementation of a smoke-free legislation in Guangzhou, China
Hospital admissions for acute myocardial infarction before and after implementation of a comprehensive smoke-free policy in Uruguay
The smoke-free legislation in Hong Kong
The State of Tobacco Control in Asean
Declines in Hospital Admissions for Acute Myocardial Infarction in New York State After Implementation of a Comprehensive Smoking Ban
Implications of a Public Smoking Ban
| Citation velocity | historical |
|---|---|
| Highly cited | No |