title: Clean Indoor Air Acts reduce the burden of adverse cardiovascular outcomes.
abstract: OBJECTIVE
  Second-hand smoke is associated with an increased risk of adverse health outcomes, such as acute myocardial infarction (AMI) and coronary heart disease (CHD). At present, 38 US states/territories have enacted Clean Indoor Air Acts (CIAAs). The purpose of the current study was to compare the prevalence of self-reported health outcomes on a state/territory-wide level 1 year prior to CIAA implementation and at least 1 year after CIAA implementation for each respective state/territory.
  
  
  METHODS
  Pre-test, post-test study.
  
  
  METHODS
  Seventeen states/territories with pre- and post-CIAA data were included in the current study. All data (AMI, CHD/angina, former and current smoker rates) were collected from the Behavioral Risk Factor Surveillance System (BRFSS) in the year prior to each state/territory's respective CIAA implementation (baseline) and 2009 (most recent year with BRFSS data).
  
  
  RESULTS
  Between baseline and 2009, 10 states/territories (58.8%) had a significant decrease in the prevalence of CHD/angina or AMI, 11 states/territories (64.7%) had a significant decrease in the prevalence of current smokers, and three states/territories (17.7%) had a significant decrease in the prevalence of both current and former smokers. Six states/territories (35.3%) had a significant increase in the prevalence of former smokers.
  
  
  CONCLUSIONS
  State/territory-wide CIAAs are beneficial in reducing adverse cardiovascular health outcomes in the short term. The prevalence of AMI, CHD/angina, and former and current smokers decreased significantly following CIAA implementation. The current study adds further support for the passage and implementation of CIAAs on a state/territory-wide level. However, further studies need to be conducted to assess the long-term outcomes of CIAAs.
authors.affiliation: St. George's University, School of Medicine, University Centre, Grenada, West Indies. william_lippert@hotmail.com
authors.forename: W C
authors.initials: WC
authors.lastname: Lippert
authors.forename: J
authors.initials: J
authors.lastname: Gustat
mesh_terms: D000328:Adult; D000368:Aged; D016902:Air Pollution, Indoor / Q000331:legislation & jurisprudence / Q000517:prevention & control; D040343:Behavioral Risk Factor Surveillance System; D003327:Coronary Disease / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000517:prevention & control; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011640:Public Policy / Q000331:legislation & jurisprudence*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000331:legislation & jurisprudence*; D014481:United States; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution