Regression results for AMI hospitalization rates are reported in . The main effect for comprehensive smoke-free laws was statistically significant in New York (b = −1.483, P < 0.05) and marginally significant at the 10% level in Florida (b = −4.377, P < 0.10). The interaction between the comprehensive smoke-free air law and time is significant for Florida (b = −2.514, P < 0.01) and New York (b = −0.251, P < 0.01), suggesting that hospitalization rates for AMI decrease steadily over time after implementation of a comprehensive smoke-free air law. Moderate smoke-free laws were in effect in communities in New York and Oregon before comprehensive laws were enacted in those states. The moderate law main effect was not significant in New York, but it was significant and positive in Oregon (b = 3.846, P < 0.05). The interaction between moderate laws and time was negative and significant in New York (b = −0.124, P < 0.05) and Oregon (b = −0.242, P < 0.01).
Single-state regression models, age-adjusted rate of hospital admissions for acute myocardial infarction (AMI).
Results for stroke hospitalization rates are reported in . Florida's statewide comprehensive smoke-free air law is associated with a significant reduction in stroke hospitalization rates, both immediately at the time of implementation (main effect b = −16.194, P < 0.01) and over time (interaction effect b = −2.105, P < 0.01). In New York, local moderate smoke-free laws are associated with a significant increase in stroke hospitalization rates for both the main effect (b = 1.848, P < 0.01) and the interaction with the monthly time trend (b = 0.098, P < 0.01). In Oregon, moderate smoke-free laws are significantly associated with a decrease in stroke hospitalization rates over time (b = −0.122, P < 0.01).
Single-state regression models, age-adjusted rate of hospital admissions for stroke.
Results from the counterfactual analysis are presented in . In Florida, the statewide law restricting smoking in all workplaces and restaurants is associated with reductions in AMI hospitalizations of 18.4% (95% CI: 8.8–28.0%) and stroke hospitalizations by 18.1% (95% CI: 9.3–30.0%) over the time period from Quarter 3 2003 through Quarter 4 2006, a span of just over 3 years. On an age-adjusted basis, this is equivalent to approximately 32,425 (95% CI, 15,478–49,373) averted AMI cases and 44,485 (95% CI: 22,745–66,224) averted stroke cases. Annually, this is a decline of approximately 5.3% for AMI and 5.2% for stroke hospitalizations in Florida.
Estimated total reductions in hospital admissions for acute myocardial infarction (AMI) and stroke attributed to implementation of comprehensive smoke-free air laws.
New York's comprehensive statewide smoke-free air law lowered AMI hospitalizations by 15.5% (95% CI: 11.0–20.1%) between March 2003 and December 2006, an average annual reduction of 4.4%. This is equivalent to 28,649 (95% CI: 20,292–37,006) averted hospitalizations on an age-adjusted basis. Other effects were not associated with significant reductions in hospitalizations.