Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Department of Respiratory Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
Thorax. 2023 Feb;78(2):144-150. doi: 10.1136/thoraxjnl-2021-218436. Epub 2022 Mar 11.
Many countries have implemented indoor smoking bans over the past two decades. Although smoking bans have been shown to reduce cardiovascular outcomes, little is known about their impact on respiratory health. This study investigated the impact of a nationwide indoor smoking ban on smoking behaviour and lung function.
We used repeated cross-sectional data from two large cohorts of the general population comprising 31 807 Swiss and 62 093 Danish adults. We compared associations between smoking ban and smoking prevalence and prebronchodilator lung function trends in Denmark (indoor smoking ban introduced in 2007) and Switzerland (indoor smoking ban introduced in 2010) from 2005 to 2010 using a quasi-experimental study design. We performed difference-in-difference analyses with linear regression models adjusted for age, sex, weight and height.
Denmark had a stronger decrease in active smokers compared with Switzerland. Also, forced expiratory volume in the first second was higher in Danish adults than in Swiss adults: 26 mL (95% CI 2.4 to 49) 1 year, 88 mL (65 to 112) 2 years, and 74 mL (51 to 98) 3 years after smoking ban implementation. Correspondingly, forced vital capacity was higher in Danish adults compared with Swiss adults (80 mL (50 to 109) after 1 year and 126 mL (97 to 155) after two and 3 years). Improvements were observed in both never-smokers and ever-smokers, most pronounced in ever-smokers.
Nationwide indoor smoking ban is associated with less smoking and improved lung function in the general population. Implementing an indoor smoking ban can improve lung function by influencing smoking behaviour and reducing secondhand smoke.
在过去的二十年中，许多国家实施了室内禁烟令。尽管禁烟令已被证明可以降低心血管疾病的发病风险，但对于其对呼吸系统健康的影响却知之甚少。本研究旨在调查全国性室内禁烟令对吸烟行为和肺功能的影响。
我们使用了来自瑞士和丹麦两个大型人群队列的重复横断面数据，共纳入了 31807 名瑞士成年人和 62093 名丹麦成年人。我们比较了 2005 年至 2010 年间丹麦（2007 年引入室内禁烟令）和瑞士（2010 年引入室内禁烟令）的吸烟率和预支气管扩张剂肺功能趋势与禁烟令之间的关联，采用准实验研究设计。我们使用线性回归模型进行了差值分析，并调整了年龄、性别、体重和身高因素。
与瑞士相比，丹麦的吸烟者人数下降更为明显。此外，丹麦成年人的第一秒用力呼气量（FEV1）高于瑞士成年人：1 年后增加 26ml（95%CI：2.4 至 49），2 年后增加 88ml（65 至 112），3 年后增加 74ml（51 至 98）。相应地，丹麦成年人的用力肺活量（FVC）高于瑞士成年人（1 年后增加 80ml（50 至 109），2 年后增加 126ml（97 至 155），3 年后增加 126ml（97 至 155））。在从未吸烟者和曾经吸烟者中均观察到了改善，其中曾经吸烟者的改善更为显著。
全国性室内禁烟令与人群中吸烟减少和肺功能改善有关。实施室内禁烟令可以通过影响吸烟行为和减少二手烟暴露来改善肺功能。
