Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.
Am J Public Health. 2010 Nov;100(11):2206-12. doi: 10.2105/AJPH.2009.189662. Epub 2010 Sep 23.
We examined the rate of acute myocardial infarction (AMI) deaths in Massachusetts before and after the implementation of a comprehensive smoke-free workplace law in July 2004.
We used Poisson regression models to examine the impact of the state law in cities and towns with and without previous local smoking bans and the effect of the local laws for the period of 1999 through 2006.
The AMI mortality rate decreased by 7.4% (95% confidence interval [CI] = 3.3%, 11.4%) after implementation of the state law. The state ban had an impact in cities and towns with no prior local smoking ban (9.2% decrease; P < .001) but not cities and towns with a prior local smoking ban. However, there was a nonsignificant 4.9% (95% CI = -5.0%, 13.9%) decrease associated with the local smoking ban that preceded the effect of the state ban. The effect of the state ban was modest (-1.6%) in the first 12 months after implementation but much larger after the first 12 months (-18.6%; P < .001).
Comprehensive statewide smoke-free workplace laws in Massachusetts were associated with an estimated 270 fewer AMI deaths per year. These results add to the evidence suggesting that smoke-free air laws are associated with lower rates of AMI.
我们调查了 2004 年 7 月马萨诸塞州实施全面禁烟工作场所法前后急性心肌梗死（AMI）死亡的发生率。
我们使用泊松回归模型，研究了州法律在有无先前地方性禁烟令的城镇中的影响，以及在 1999 年至 2006 年期间地方法律的效果。
州法实施后，AMI 死亡率下降了 7.4%（95%置信区间[CI]为 3.3%，11.4%）。该州禁令对没有先前地方性禁烟令的城镇（下降 9.2%；P<0.001）有影响，但对有先前地方性禁烟令的城镇没有影响。然而，在州禁令生效之前，先前的地方性禁烟令与 AMI 死亡率下降了 4.9%（95%CI=-5.0%，13.9%），但无统计学意义。州禁令实施后的头 12 个月，其影响较小（-1.6%），但在头 12 个月之后，影响较大（-18.6%；P<0.001）。
马萨诸塞州全州范围内全面的无烟工作场所法律与每年估计减少 270 例 AMI 死亡有关。这些结果增加了证据表明，禁烟令与 AMI 发生率降低有关。
