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

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