Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2015

Open Access 01-12-2015 | Research article

Impact of a countywide smoke-free workplace law on emergency department visits for respiratory diseases: a retrospective cohort study

Authors: Ivana T Croghan, Jon O Ebbert, J Taylor Hays, Darrell R Schroeder, Alanna M Chamberlain, Véronique L Roger, Richard D Hurt

Published in: BMC Pulmonary Medicine | Issue 1/2015

Login to get access

Abstract

Background

With the goal of reducing exposure to secondhand smoke, the state of Minnesota (MN), enacted a smoke-free law (i.e., Freedom to Breathe Act) in all workplaces, restaurants, and bars in 2007. This retrospective cohort study analyzes emergency department (ED) visits in Olmsted County, MN, for chronic obstructive pulmonary disease (COPD) and asthma over a five-year period to assess changes after enactment of the smoke-free law.

Methods

We calculated the rates of ED visits in Olmsted County, MN, with a primary diagnosis of COPD and asthma in the five-year period from January 1, 2005 to December 31, 2009. Analyses were performed using segmented Poisson regression to assess whether ED visit rates declined following enactment of the smoke free law after adjusting for potential underlying temporal trends in ED visit rates during this time period.

Results

Using segmented Poisson regression analyses, a significant reduction was detected in asthma-related ED visits (RR 0.814, p < 0.001) but not for COPD-related ED visits following the enactment of the smoke-free law. The reduction in asthma related ED visits was observed in both adults (RR 0.840, p = 0.015) and children (RR 0.751, p = 0.015).

Conclusions

In Olmsted County, MN, asthma-related ED visits declined significantly after enactment of a smoke-free law. These results add to the body of literature supporting community health benefits of smoke-free policies in public environments and their potential to reduce health care costs.
Literature
2.
go back to reference Centers for Disease Control and Prevention (CDC): Cigarette Smoking Attributable Morbidity - United States.MMWR Morb Mortal Rep 2003 2000,52(35):842–844. Centers for Disease Control and Prevention (CDC): Cigarette Smoking Attributable Morbidity - United States.MMWR Morb Mortal Rep 2003 2000,52(35):842–844.
4.
go back to reference Centers for Disease Control and Prevention: Chronic obstructive pulmonary disease among adults–United States.MMWR Morb Mortal Wkly Rep 2012 2011,61(46):938–943. Centers for Disease Control and Prevention: Chronic obstructive pulmonary disease among adults–United States.MMWR Morb Mortal Wkly Rep 2012 2011,61(46):938–943.
5.
go back to reference U.S. Department of Health and Human Services: How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Bethesda, MD: US Department of Health and Human Services, Center for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010. U.S. Department of Health and Human Services: How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Bethesda, MD: US Department of Health and Human Services, Center for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.
7.
go back to reference U.S. Department of Health and Human Services: The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Bethesda, MD: US Department of Health and Human Services, Center for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006. U.S. Department of Health and Human Services: The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Bethesda, MD: US Department of Health and Human Services, Center for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006.
8.
go back to reference World Health Organization: WHO Framework Convention on Tobacco Control. Geneva: WHO Press; 2003. World Health Organization: WHO Framework Convention on Tobacco Control. Geneva: WHO Press; 2003.
9.
go back to reference Institute of Medicine: Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Chapter 5: Background of Smoking Bans. Washington, DC: The National Academies Press; 2010. Institute of Medicine: Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Chapter 5: Background of Smoking Bans. Washington, DC: The National Academies Press; 2010.
10.
go back to reference Hyland A, Barnoya J, Corral JE: Smoke-free air policies: past, present and future.Tob Control 2012,21(2):154–161. 10.1136/tobaccocontrol-2011-050389CrossRefPubMed Hyland A, Barnoya J, Corral JE: Smoke-free air policies: past, present and future.Tob Control 2012,21(2):154–161. 10.1136/tobaccocontrol-2011-050389CrossRefPubMed
14.
15.
go back to reference Hahn EJ: Smokefree legislation: a review of health and economic outcomes research.Am J Prev Med 2010,39(6 Suppl 1):S66–76.CrossRefPubMed Hahn EJ: Smokefree legislation: a review of health and economic outcomes research.Am J Prev Med 2010,39(6 Suppl 1):S66–76.CrossRefPubMed
16.
go back to reference Callinan JE, Clarke A, Doherty K, Kelleher C: Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption.Cochrane Database Syst Rev 2010, 4:CD005992. Callinan JE, Clarke A, Doherty K, Kelleher C: Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption.Cochrane Database Syst Rev 2010, 4:CD005992.
18.
go back to reference Moraros J, Bird Y, Chen S, Buckingham R, Meltzer RS, Prapasiri S, et al.: The impact of the 2002 Delaware smoking ordinance on heart attack and asthma.Int J Environ Res Public Health 2010,7(12):4169–4178. 10.3390/ijerph7124169CrossRefPubMedPubMedCentral Moraros J, Bird Y, Chen S, Buckingham R, Meltzer RS, Prapasiri S, et al.: The impact of the 2002 Delaware smoking ordinance on heart attack and asthma.Int J Environ Res Public Health 2010,7(12):4169–4178. 10.3390/ijerph7124169CrossRefPubMedPubMedCentral
20.
go back to reference Moorman JE, Akinbami LJ, Bailey CM, Zahran HS, King ME, Johnson CA, et al.: National surveillance of asthma: United States, 2001–2010.Vital Health Stat 3 2012, (35):1–67. Moorman JE, Akinbami LJ, Bailey CM, Zahran HS, King ME, Johnson CA, et al.: National surveillance of asthma: United States, 2001–2010.Vital Health Stat 3 2012, (35):1–67.
21.
go back to reference Ford ES, Croft JB, Mannino DM, Wheaton AG, Zhang X, Giles WH: COPD surveillance–United States, 1999–2011.Chest 2013,144(1):284–305. 10.1378/chest.13-0809CrossRefPubMedPubMedCentral Ford ES, Croft JB, Mannino DM, Wheaton AG, Zhang X, Giles WH: COPD surveillance–United States, 1999–2011.Chest 2013,144(1):284–305. 10.1378/chest.13-0809CrossRefPubMedPubMedCentral
23.
go back to reference Melton LJ 3rd: History of the Rochester Epidemiology Project.Mayo Clin Proc 1996,71(3):266–274. 10.4065/71.3.266CrossRefPubMed Melton LJ 3rd: History of the Rochester Epidemiology Project.Mayo Clin Proc 1996,71(3):266–274. 10.4065/71.3.266CrossRefPubMed
24.
go back to reference St Sauver JL, Grossardt BR, Yawn BP, Melton LJ 3rd, Rocca WA: Use of a medical records linkage system to enumerate a dynamic population over time: the Rochester epidemiology project.Am J Epidemiol 2011,173(9):1059–1068. 10.1093/aje/kwq482CrossRefPubMedPubMedCentral St Sauver JL, Grossardt BR, Yawn BP, Melton LJ 3rd, Rocca WA: Use of a medical records linkage system to enumerate a dynamic population over time: the Rochester epidemiology project.Am J Epidemiol 2011,173(9):1059–1068. 10.1093/aje/kwq482CrossRefPubMedPubMedCentral
25.
go back to reference Wagner AK, Soumerai SB, Zhang F, Ross-Degnan D: Segmented regression analysis of interrupted time series studies in medication use research.J Clin Pharm Ther 2002,27(4):299–309. 10.1046/j.1365-2710.2002.00430.xCrossRefPubMed Wagner AK, Soumerai SB, Zhang F, Ross-Degnan D: Segmented regression analysis of interrupted time series studies in medication use research.J Clin Pharm Ther 2002,27(4):299–309. 10.1046/j.1365-2710.2002.00430.xCrossRefPubMed
26.
go back to reference Rayens MK, Burkhart PV, Zhang M, Lee S, Moser DK, Mannino D, et al.: Reduction in asthma-related emergency department visits after implementation of a smoke-free law.J Allergy Clin Immunol 2008,122(3):537–541. e533 10.1016/j.jaci.2008.06.029CrossRefPubMed Rayens MK, Burkhart PV, Zhang M, Lee S, Moser DK, Mannino D, et al.: Reduction in asthma-related emergency department visits after implementation of a smoke-free law.J Allergy Clin Immunol 2008,122(3):537–541. e533 10.1016/j.jaci.2008.06.029CrossRefPubMed
27.
go back to reference Millett C, Lee JT, Laverty AA, Glantz SA, Majeed A: Hospital admissions for childhood asthma after smoke-free legislation in England.Pediatrics 2013,131(2):e495–501. 10.1542/peds.2012-2592CrossRefPubMedPubMedCentral Millett C, Lee JT, Laverty AA, Glantz SA, Majeed A: Hospital admissions for childhood asthma after smoke-free legislation in England.Pediatrics 2013,131(2):e495–501. 10.1542/peds.2012-2592CrossRefPubMedPubMedCentral
28.
go back to reference Sims M, Maxwell R, Gilmore A: Short-term impact of the smokefree legislation in England on emergency hospital admissions for asthma among adults: a population-based study.Thorax 2013,68(7):619–624. 10.1136/thoraxjnl-2012-202841CrossRefPubMed Sims M, Maxwell R, Gilmore A: Short-term impact of the smokefree legislation in England on emergency hospital admissions for asthma among adults: a population-based study.Thorax 2013,68(7):619–624. 10.1136/thoraxjnl-2012-202841CrossRefPubMed
29.
go back to reference Tan CE, Glantz SA: Association between smoke-free legislation and hospitalizations for cardiac, cerebrovascular, and respiratory diseases: a meta-analysis.Circulation 2012,126(18):2177–2183. 10.1161/CIRCULATIONAHA.112.121301CrossRefPubMedPubMedCentral Tan CE, Glantz SA: Association between smoke-free legislation and hospitalizations for cardiac, cerebrovascular, and respiratory diseases: a meta-analysis.Circulation 2012,126(18):2177–2183. 10.1161/CIRCULATIONAHA.112.121301CrossRefPubMedPubMedCentral
30.
go back to reference Herman PM, Walsh ME: Hospital admissions for acute myocardial infarction, angina, stroke, and asthma after implementation of Arizona's comprehensive statewide smoking ban.Am J Public Health 2011,101(3):491–496. 10.2105/AJPH.2009.179572CrossRefPubMedPubMedCentral Herman PM, Walsh ME: Hospital admissions for acute myocardial infarction, angina, stroke, and asthma after implementation of Arizona's comprehensive statewide smoking ban.Am J Public Health 2011,101(3):491–496. 10.2105/AJPH.2009.179572CrossRefPubMedPubMedCentral
31.
go back to reference Naiman A, Glazier RH, Moineddin R: Association of anti-smoking legislation with rates of hospital admission for cardiovascular and respiratory conditions.CMAJ 2010,182(8):761–767. 10.1503/cmaj.091130CrossRefPubMedPubMedCentral Naiman A, Glazier RH, Moineddin R: Association of anti-smoking legislation with rates of hospital admission for cardiovascular and respiratory conditions.CMAJ 2010,182(8):761–767. 10.1503/cmaj.091130CrossRefPubMedPubMedCentral
32.
go back to reference Humair JP, Garin N, Gerstel E, Carballo S, Carballo D, Keller PF, et al.: Acute respiratory and cardiovascular admissions after a public smoking ban in Geneva, Switzerland.PLoS One 2014,9(3):e90417. 10.1371/journal.pone.0090417CrossRefPubMedPubMedCentral Humair JP, Garin N, Gerstel E, Carballo S, Carballo D, Keller PF, et al.: Acute respiratory and cardiovascular admissions after a public smoking ban in Geneva, Switzerland.PLoS One 2014,9(3):e90417. 10.1371/journal.pone.0090417CrossRefPubMedPubMedCentral
33.
go back to reference Kent BD, Sulaiman I, Nicholson TT, Lane SJ, Moloney ED: Acute pulmonary admissions following implementation of a national workplace smoking ban.Chest 2012,142(3):673–679. 10.1378/chest.11-2757CrossRefPubMed Kent BD, Sulaiman I, Nicholson TT, Lane SJ, Moloney ED: Acute pulmonary admissions following implementation of a national workplace smoking ban.Chest 2012,142(3):673–679. 10.1378/chest.11-2757CrossRefPubMed
34.
go back to reference Dove MS, Dockery DW, Connolly GN: Smoke-free air laws and asthma prevalence, symptoms, and severity among nonsmoking youth.Pediatrics 2011,127(1):102–109. 10.1542/peds.2010-1532CrossRefPubMedPubMedCentral Dove MS, Dockery DW, Connolly GN: Smoke-free air laws and asthma prevalence, symptoms, and severity among nonsmoking youth.Pediatrics 2011,127(1):102–109. 10.1542/peds.2010-1532CrossRefPubMedPubMedCentral
35.
go back to reference Mackay D, Haw S, Ayres JG, Fischbacher C, Pell JP: Smoke-free legislation and hospitalizations for childhood asthma.N Engl J Med 2010,363(12):1139–1145. 10.1056/NEJMoa1002861CrossRefPubMed Mackay D, Haw S, Ayres JG, Fischbacher C, Pell JP: Smoke-free legislation and hospitalizations for childhood asthma.N Engl J Med 2010,363(12):1139–1145. 10.1056/NEJMoa1002861CrossRefPubMed
36.
go back to reference Hahn EJ, Rayens MK, Adkins S, Simpson N, Frazier S, Mannino DM: Fewer hospitalizations for chronic obstructive pulmonary disease in communities with smoke-free public policies.Am J Public Health 2014,104(6):1059–1065. 10.2105/AJPH.2014.301887CrossRefPubMedPubMedCentral Hahn EJ, Rayens MK, Adkins S, Simpson N, Frazier S, Mannino DM: Fewer hospitalizations for chronic obstructive pulmonary disease in communities with smoke-free public policies.Am J Public Health 2014,104(6):1059–1065. 10.2105/AJPH.2014.301887CrossRefPubMedPubMedCentral
37.
go back to reference Stallings-Smith S, Zeka A, Goodman P, Kabir Z, Clancy L: Reductions in cardiovascular, cerebrovascular, and respiratory mortality following the national Irish smoking ban: interrupted time-series analysis.PLoS One 2013,8(4):e62063. 10.1371/journal.pone.0062063CrossRefPubMedPubMedCentral Stallings-Smith S, Zeka A, Goodman P, Kabir Z, Clancy L: Reductions in cardiovascular, cerebrovascular, and respiratory mortality following the national Irish smoking ban: interrupted time-series analysis.PLoS One 2013,8(4):e62063. 10.1371/journal.pone.0062063CrossRefPubMedPubMedCentral
38.
go back to reference Head P, Jackson BE, Bae S, Cherry D: Hospital discharge rates before and after implementation of a city-wide smoking ban in a Texas city, 2004–2008.Prev Chronic Dis 2012, 9:E179.CrossRefPubMedPubMedCentral Head P, Jackson BE, Bae S, Cherry D: Hospital discharge rates before and after implementation of a city-wide smoking ban in a Texas city, 2004–2008.Prev Chronic Dis 2012, 9:E179.CrossRefPubMedPubMedCentral
39.
go back to reference Tashkin DP, Rennard S, Hays JT, Ma W, Lawrence D, Lee TC: Effects of varenicline on smoking cessation in patients with mild to moderate COPD: a randomized controlled trial.Chest 2011,139(3):591–599. 10.1378/chest.10-0865CrossRefPubMed Tashkin DP, Rennard S, Hays JT, Ma W, Lawrence D, Lee TC: Effects of varenicline on smoking cessation in patients with mild to moderate COPD: a randomized controlled trial.Chest 2011,139(3):591–599. 10.1378/chest.10-0865CrossRefPubMed
40.
go back to reference Pierce JP, Leon M: Effectiveness of smoke-free policies.Lancet Oncol 2008,9(7):614–615. 10.1016/S1470-2045(08)70167-0CrossRefPubMed Pierce JP, Leon M: Effectiveness of smoke-free policies.Lancet Oncol 2008,9(7):614–615. 10.1016/S1470-2045(08)70167-0CrossRefPubMed
41.
go back to reference Wakefield M, Trotter L, Cameron M, Woodward A, Inglis G, Hill D: Association between exposure to workplace secondhand smoke and reported respiratory and sensory symptoms: cross-sectional study.J Occup Environ Med 2003,45(6):622–627. 10.1097/01.jom.0000069242.06498.86CrossRefPubMed Wakefield M, Trotter L, Cameron M, Woodward A, Inglis G, Hill D: Association between exposure to workplace secondhand smoke and reported respiratory and sensory symptoms: cross-sectional study.J Occup Environ Med 2003,45(6):622–627. 10.1097/01.jom.0000069242.06498.86CrossRefPubMed
42.
go back to reference Goodman P, Agnew M, McCaffrey M, Paul G, Clancy L: Effects of the Irish smoking ban on respiratory health of bar workers and air quality in Dublin pubs.Am J Respir Crit Care Med 2007,175(8):840–845. 10.1164/rccm.200608-1085OCCrossRefPubMed Goodman P, Agnew M, McCaffrey M, Paul G, Clancy L: Effects of the Irish smoking ban on respiratory health of bar workers and air quality in Dublin pubs.Am J Respir Crit Care Med 2007,175(8):840–845. 10.1164/rccm.200608-1085OCCrossRefPubMed
43.
go back to reference Centers for Disease Control and Prevention: Decrease in smoking prevalence--Minnesota, 1999–2010.MMWR Morb Mortal Wkly Rep 2011,60(5):138–141. Centers for Disease Control and Prevention: Decrease in smoking prevalence--Minnesota, 1999–2010.MMWR Morb Mortal Wkly Rep 2011,60(5):138–141.
Metadata
Title
Impact of a countywide smoke-free workplace law on emergency department visits for respiratory diseases: a retrospective cohort study
Authors
Ivana T Croghan
Jon O Ebbert
J Taylor Hays
Darrell R Schroeder
Alanna M Chamberlain
Véronique L Roger
Richard D Hurt
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2015
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-15-6

Other articles of this Issue 1/2015

BMC Pulmonary Medicine 1/2015 Go to the issue