中国北京市实施全面控烟政策后慢性阻塞性肺疾病住院趋势。

Trends in Hospital Admissions for Chronic Obstructive Pulmonary Diseases After Comprehensive Tobacco Control Policies in Beijing, China.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China.

Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, 100191, China.

出版信息

Nicotine Tob Res. 2022 Nov 12;24(12):1978-1984. doi: 10.1093/ntr/ntac137.

DOI:10.1093/ntr/ntac137

PMID:35808957

Abstract

INTRODUCTION

Only a few studies have examined the effectiveness of tobacco control policies on respiratory conditions, and the results were less consistent. The 2015 Beijing tobacco control policy package incorporating all six components of MPOWER has been implemented since Jun 2015. The present study aimed to evaluate the impact of a comprehensive tobacco control policy package on hospital admissions for chronic obstructive pulmonary disease (COPD) in Beijing, China.

AIMS AND METHODS

An interrupted time-series study was conducted based on the hospital admission information for about 18 million residents, who were covered by the Beijing Medical Claim Data for Employees from January 2013 to June 2017. The average percentage change of COPD hospital admission rates and reductions in hospital admission numbers were estimated by segmented Poisson regression models.

RESULTS

There were 54 040 COPD hospital admissions with a crude rate of 67.2 per 100 000 residents during the observational period. After the implementation of the policy package, the hospital admission rates of COPD were reduced by -14.7% (95%CI: -17.8%, -11.5%) immediately. The secular trend was slowed down by -3.0% (95% CI: -5.6%, -0.4%) annually. A total of 5 581 reductions in COPD hospital admissions were estimated during the 25 months post-law period, accounting for 17.5% (95% CI: 12.5%, 22.5%) of overall COPD hospital admissions. More reductions were shown in males and those aged over 65 years old.

CONCLUSIONS

The results indicated significant protections against hospitalization of COPD after the 2015 Beijing comprehensive tobacco control policy package. The results provide support for public health benefits for respiratory conditions from WHO-recommended tobacco control measures.

IMPLICATIONS

Only a few studies have examined the effectiveness of tobacco control policies on respiratory conditions, and the results were less consistent. Based on medical records for about 18 million residents, this study showed an association between comprehensive tobacco control policies and significant reductions of hospital admissions for chronic obstructive pulmonary disease. The results provide support for public health benefits for respiratory conditions from WHO-recommended tobacco control measures.

摘要

简介

只有少数研究考察了控烟政策对呼吸状况的有效性，结果也不一致。2015 年北京控烟政策包纳入了 MPOWER 的全部六项内容，自 2015 年 6 月起实施。本研究旨在评估全面控烟政策包对中国北京慢性阻塞性肺疾病（COPD）住院人数的影响。

目的和方法

基于 2013 年 1 月至 2017 年 6 月约 1800 万参保员工的北京医保数据，采用医院住院信息，进行了一项基于时间序列的中断研究。采用分段泊松回归模型估计 COPD 住院率的平均百分比变化和住院人数的减少。

结果

观察期间，共有 54040 例 COPD 住院，粗住院率为 67.2/10 万居民。政策包实施后，COPD 住院率立即下降 14.7%（95%CI：-17.8%，-11.5%）。每年的趋势减缓了 3.0%（95%CI：-5.6%，-0.4%）。在法律实施后的 25 个月内，估计 COPD 住院人数减少了 5581 例，占 COPD 总住院人数的 17.5%（95%CI：12.5%，22.5%）。男性和 65 岁以上人群的降幅更大。