Smoke-free legislation and acute coronary events

January 01, 0001

Smoke-free legislation and acute coronary events

These UK researchers performed a systematic review and meta- analysis to test for a reduced risk of acute coronary events with comprehensive smoke-free legislation. The performed two independent systematic reviews using PubMed, Embase and Science Direct. Meta-analysis was undertaken using a random effects model to obtain a pooled estimate of the relative risk. Linear regression was used to examine possible bias. Meta- regression was used to look for causes of heterogeneity.

The researchers found: "The 17 eligible studies (10 from North America, 6 from Europe and 1 from Australasia) provided 35 estimates of effect size. Apart from five subgroup analyses, all of the published results suggested a reduction in the incidence of acute coronary events following the introduction of smoke-free legislation. Meta-analysis produced a pooled estimate of the relative risk of 0.90. There was significant heterogeneity but there was no evidence of small study bias. On univariate random effects meta-regression analysis, studies with longer data collection following legislation produced greater estimates of risk reduction and remained significant after adjustment for other study characteristics."

The researchers concluded: "There is now a large body of evidence supporting a reduction in acute coronary events following the implementation of comprehensive smoke-free legislation, with the effect increasing over time from implementation. Countries that have not yet adopted smoke-free legislation should be encouraged to do so."

This systematic review and meta-analysis found evidence of a public health benefits, specifically a decrease in acute coronary events, after smoke-free legislation was passed.

For the full abstract, click here.

Heart 96(19):1525-1530 © 2010 BMJ Publishing Group Ltd & British Cardiovascular Society
Meta-analysis of the effect of comprehensive smoke-free legislation on acute coronary events. D F Mackay, M O Irfan, S Haw, J P Pell. Correspondence to Jill Pell: [email protected]

Category: K. Circulatory. Keywords: acute coronary events, myocardial infarction, cigarettes, smoke- free, legislation, systematic review and meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 26 October 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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