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The Impact of the 2002 Delaware Smoking Ordinance on Heart Attack and Asthma
School of Public Health, University of Saskatchewan, 107 Wiggins Road, Saskatoon, Saskatchewan, S7N 5E5, Canada
Department of Biostatistics, University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA
* Author to whom correspondence should be addressed.
Received: 1 November 2010; in revised form: 23 November 2010 / Accepted: 29 November 2010 / Published: 2 December 2010
Abstract: In the United States, smoking is the leading cause of death - having a mortality rate of approximately 435,000 people in 2000—accounting for 8.1% of all US deaths recorded that year. Consequently, we analyzed the Delaware Hospital Discharge Database, and identified state and non-state residents discharged with AMI or asthma for the years 1999 to 2004. Statistical data analysis compared the incidence of AMI or asthma for each group before (1999–2002) and after (2003–2004) the amendment. As a result, we found that pre-ordinance and post-ordinance quarterly rates of AMI for Delaware residents were 451 (se = 21) and 430 (se = 21) respectively, representing a 4.7% reduction. Over the same time period, there was negligible change in the incidence of AMI for non-Delaware residents. After adjusting for population growth, the Risk Ratio (RR) for asthma in Delaware residents post-ordinance was 0.95 (95% CI, 0.90 to 0.999), which represented a significant reduction (P = 0.046). By comparison, non-Delaware residents had an increased RR for asthma post-ordinance of 1.62 (95% CI, 1.46 to 1.86; P < 0.0001).The results suggest that Delaware’s comprehensive non-smoking ordinance effectively was associated with a statistically significant decrease in the incidence of AMI and asthma in Delaware residents when compared to non-Delaware residents.
Keywords: acute myocardial infarction; asthma; smoking; secondhand smoke exposure; prevention; health promotion
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Moraros, J.; Bird, Y.; Chen, S.; Buckingham, R.; Meltzer, R.S.; Prapasiri, S.; Solis, L.H. The Impact of the 2002 Delaware Smoking Ordinance on Heart Attack and Asthma. Int. J. Environ. Res. Public Health 2010, 7, 4169-4178.
Moraros J, Bird Y, Chen S, Buckingham R, Meltzer RS, Prapasiri S, Solis LH. The Impact of the 2002 Delaware Smoking Ordinance on Heart Attack and Asthma. International Journal of Environmental Research and Public Health. 2010; 7(12):4169-4178.
Moraros, John; Bird, Yelena; Chen, Shande; Buckingham, Robert; Meltzer, Richard S.; Prapasiri, Surasri; Solis, Luis H. 2010. "The Impact of the 2002 Delaware Smoking Ordinance on Heart Attack and Asthma." Int. J. Environ. Res. Public Health 7, no. 12: 4169-4178.