Date

6-2015

Document Type

Thesis

Degree Name

M.P.H.

Department

Dept. of Public Health & Preventive Medicine

Institution

Oregon Health & Science University

Abstract

On January 1, 2009 the Oregon Indoor Clean Air Act took effect, banning smoking in all workplaces including restaurants and bars except certified smoke shops and cigar bars, and banning smoking in all outdoor areas within 10 feet of an entrance to a workplace throughout Oregon. While it is well established that exposure to secondhand smoke can lead to acute myocardial infarction (AMI), and that smoking ban legislation is associated with a reduction in the incidence of AMI in affected communities, the effect of Oregon’s legislation on AMI has not been fully studied. This thesis research project used a generalized linear mixed model to assess the impact of the 2009 legislation on hospital admissions for AMI. The study used hospital discharge data for 2007 to 2010, comparing counties without a pre-existing comprehensive smoking ban (“case” counties) with counties with pre-existing comprehensive smoking bans (“control” counties). The study found that while there was an annual 5.5% decrease in AMI over the study period (RR 0.95; 95% CI 0.92 to 0.97; p<0.01), there was not a greater decrease around January 1, 2009 (p=0.99). For case counties, there was no significant difference in AMI admissions between the pre- and post-legislative period after adjusting for seasonality and temporal trend (RR 1.00; 95% CI 0.93 to 1.08; p=0.99). For the control counties the rate ratio for the pre- and post-legislative period after adjusting for seasonality and temporal trend was also not significant (RR = 1.08; 95% CI 0.93 to 1.24; p=0.31). These results indicate that while it is reasonable to assume Oregon’s comprehensive smoking ban had some impact on secondhand smoke exposure, and that any reduction is likely to impact AMI admissions, the no impact of the legislation on AMI admissions was detected in this study.

Identifier

doi:10.6083/M4XP73PZ

School

School of Medicine

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