Fewer hospitalizations for chronic obstructive pulmonary disease in communities with smoke-free public policies

Am J Public Health. 2014 Jun;104(6):1059-65. doi: 10.2105/AJPH.2014.301887. Epub 2014 Apr 17.


Objectives: We determined the impact of smoke-free municipal public policies on hospitalizations for chronic obstructive pulmonary disease (COPD).

Methods: We conducted a secondary analysis of hospital discharges with a primary diagnosis of COPD in Kentucky between July 1, 2003, and June 30, 2011 using Poisson regression. We compared the hospitalization rates of regions with and without smoke-free laws, adjusting for personal and population covariates, seasonality, secular trends over time, and geographic region.

Results: Controlling for covariates such as sex, age, length of stay, race/ethnicity, education, income, and urban-rural status, among others, we found that those living in a community with a comprehensive smoke-free law or regulation were 22% less likely to experience hospitalizations for COPD than those living in a community with a moderate-weak law or no law. Those living in a community with an established law were 21% less likely to be hospitalized for COPD than those with newer laws or no laws.

Conclusions: Strong smoke-free public policies may provide protection against COPD hospitalizations, particularly after 12 months, with the potential to save lives and decrease health care costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Behavioral Risk Factor Surveillance System
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Kentucky / epidemiology
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Public Policy
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Smoke-Free Policy*