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Cardiorespiratory hospitalisation and mortality reductions after smoking bans in Switzerland

机译：瑞士禁烟后的心肺住院率和死亡率降低

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Smoking bans are considered one of the most effective policies to reduce population exposure to tobacco smoke and prevent adverse health outcomes. However, evidence on the effect of contextual variables on the effectiveness of smoking bans is still lacking.; The patchwork of cantonal smoke-free laws in Switzerland was used as a quasi-experimental setting to assess changes after their introduction in: hospitalisations and mortality due to cardiorespiratory diseases in adults; total hospitalisations and hospitalisations due to respiratory disorders in children; and the modifying effects of contextual factors and the effectiveness of the laws.; Using hospital and mortality registry data for residents in Switzerland (2005-2012), we conducted canton-specific interrupted time-series analyses followed by random effects meta-analyses to obtain nationwide smoking ban estimates by subgroups of age, sex and causes of hospitalisation or death. Heterogeneity of the impact caused by strictness of the ban and other smoking-related characteristics of the cantons was explored through meta-regression.; Total hospitalisation rates due to cardiovascular and respiratory diseases did not significantly change after the introduction of the ban. Post-ban changes were detected in ischaemic heart disease hospitalisations, with a 2.5% reduction (95% confidence interval [CI)] -6.2 to 1.3%) for all ages and 5.5% (95% CI -10.8 to -0.2%) in adults 35-64 years old. Total mortality due to respiratory diseases decreased by 8.2% (95% CI -15.2 to -0.6%) over all ages, and chronic obstructive pulmonary disease mortality decreased by 14.0% (95% CI -22.3 to -4.5%) in adults ≥65 years old. Cardiovascular mortality did not change after the introduction of the ban, but there was an indication of post-ban reductions in mortality due to hypertensive disorders (-5.4%, 95% CI -12.6 to 2.3%), and congestive heart failure (-6.0%, 95% CI -14.5 to 3.4%). No benefits were observed for hospitalisations due to respiratory diseases in children or for infant mortality. The type of smoking ban implemented explained the heterogeneity of benefits across cantons for some outcomes.; Smoking bans in Switzerland were associated with overall reductions in cardiovascular and respiratory hospitalisation and mortality in adults.
机译：禁烟被认为是减少人口接触烟草烟雾并防止不良健康后果的最有效政策之一。但是，仍然缺乏有关上下文变量对禁烟效果的影响的证据。瑞士各州无烟法律的拼凑被用作准实验环境，以评估其引入后的变化：成人心肺疾病的住院和死亡率；儿童总住院和因呼吸系统疾病而住院；以及上下文因素和法律效力的修改效果；利用瑞士居民的住院和死亡登记数据（2005-2012年），我们进行了针对各州的间断时间序列分析，然后进行随机效应荟萃分析，以按年龄，性别和住院原因或死亡。通过元回归分析了禁令的严格性和各州与吸烟相关的其他特征所造成的影响的异质性。禁令实施后，由于心血管和呼吸系统疾病引起的总住院率没有明显变化。在缺血性心脏病住院患者中发现禁令后变化，所有年龄段的患者均降低2.5％（95％置信区间[CI] -6.2至1.3％），5.5％（95％CI -10.8至-0.2％）降低。 35-64岁的成人。 ≥65岁的成年人，呼吸系统疾病导致的总死亡率下降了8.2％（95％CI -15.2至-0.6％），慢性阻塞性肺疾病死亡率下降了14.0％（95％CI -22.3至-4.5％）。岁。禁令实施后，心血管疾病死亡率没有改变，但有迹象表明，由于高血压疾病（-5.4％，95％CI -12.6至2.3％）和充血性心力衰竭（-6.0），导致禁令后死亡率降低％，95％CI -14.5至3.4％）。没有观察到因儿童呼吸系统疾病而住院或婴儿死亡的益处。实施的禁烟令解释了各州在某些结果上利益的异质性。瑞士的禁烟令与成年人心血管和呼吸系统住院以及死亡率的总体下降有关。

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