Fewer hospitalizations for chronic obstructive pulmonary disease in communities with smoke-free public policies.
OBJECTIVE
We determined the impact of smoke-free municipal public policies on hospitalizations for chronic obstructive pulmonary disease (COPD).


METHODS
We conducted a secondary analysis of hospital discharges with a primary diagnosis of COPD in Kentucky between July 1, 2003, and June 30, 2011 using Poisson regression. We compared the hospitalization rates of regions with and without smoke-free laws, adjusting for personal and population covariates, seasonality, secular trends over time, and geographic region.


RESULTS
Controlling for covariates such as sex, age, length of stay, race/ethnicity, education, income, and urban-rural status, among others, we found that those living in a community with a comprehensive smoke-free law or regulation were 22% less likely to experience hospitalizations for COPD than those living in a community with a moderate-weak law or no law. Those living in a community with an established law were 21% less likely to be hospitalized for COPD than those with newer laws or no laws.


CONCLUSIONS
Strong smoke-free public policies may provide protection against COPD hospitalizations, particularly after 12 months, with the potential to save lives and decrease health care costs.
Ellen J. Hahn, Mary Kay Rayens, and Nick Simpson are with the Tobacco Policy Research Program, University of Kentucky College of Nursing and College of Public Health, Lexington. Sarah Adkins and Susan Frazier are with the University of Kentucky College of Nursing. Susan Frazier is also with the RICH Heart Program, University of Kentucky College of Nursing. David M. Mannino is with the Department of Preventive Medicine and Environmental Health, University of Kentucky College of Public Health.
Ellen J
EJ
Hahn
Mary Kay
MK
Rayens
Sarah
S
Adkins
Nick
N
Simpson
Susan
S
Frazier
David M
DM
Mannino
D000368:Aged; D000369:Aged, 80 and over; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011640:Public Policy; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000628:therapy; D061845:Smoke-Free Policy