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. 2017 Dec;74(6):687-704.
doi: 10.1177/1077558716668646. Epub 2016 Sep 12.

A Nationwide Assessment of the Association of Smoking Bans and Cigarette Taxes With Hospitalizations for Acute Myocardial Infarction, Heart Failure, and Pneumonia

Vivian Ho  1   2 , Joseph S Ross  3 , Claudia A Steiner  4 , Aditya Mandawat  5 , Marah Short  1 , Meei-Hsiang Ku-Goto  1 , Harlan M Krumholz  3
Affiliations

A Nationwide Assessment of the Association of Smoking Bans and Cigarette Taxes With Hospitalizations for Acute Myocardial Infarction, Heart Failure, and Pneumonia

Vivian Ho et al. Med Care Res Rev. 2017 Dec.

Abstract

Multiple studies claim that public place smoking bans are associated with reductions in smoking-related hospitalization rates. No national study using complete hospitalization counts by area that accounts for contemporaneous controls including state cigarette taxes has been conducted. We examine the association between county-level smoking-related hospitalization rates and comprehensive smoking bans in 28 states from 2001 to 2008. Differences-in-differences analysis measures changes in hospitalization rates before versus after introducing bans in bars, restaurants, and workplaces, controlling for cigarette taxes, adjusting for local health and provider characteristics. Smoking bans were not associated with acute myocardial infarction or heart failure hospitalizations, but lowered pneumonia hospitalization rates for persons ages 60 to 74 years. Higher cigarette taxes were associated with lower heart failure hospitalizations for all ages and fewer pneumonia hospitalizations for adults aged 60 to 74. Previous studies may have overestimated the relation between smoking bans and hospitalizations and underestimated the effects of cigarette taxes.

Keywords: cigarette taxes; heart failure; myocardial infarction; smoking bans.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Ross reports that he is a member of a scientific advisory board for FAIR Health, Inc. Dr. Krumholz reports that he chairs a scientific advisory board for UnitedHealthcare. Vivian Ho, Dr. Claudia Steiner, Dr. Aditya Mandawat, Marah Short. and Meei-Hsiang Ku-Goto declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Population-weighted hospitalization rates for counties where comprehensive smoking bans were implemented in 2003-2006 compared to counties that never introduced bans
See this image and copyright information in PMC

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