title: Decrease in mortality rate and hospital admissions for acute myocardial infarction after the enactment of the smoking ban law in São Paulo city, Brazil.
abstract: Smoking restriction laws have spread worldwide during the last decade. Previous studies have shown a decline in the community rates of myocardial infarction after enactment of these laws. However, data are scarce about the Latin American population. In the first phase of this study, we reported the successful implementation of the law in São Paulo city, with a decrease in carbon monoxide rates in hospitality venues.
  
  
  
  To evaluate whether the 2009 implementation of a comprehensive smoking ban law in São Paulo city was associated with a reduction in rates of mortality and hospital admissions for myocardial infarction.
  
  
  
  We performed a time-series study of monthly rates of mortality and hospital admissions for acute myocardial infarction from January 2005 to December 2010. The data were derived from DATASUS, the primary public health information system available in Brazil and from Mortality Information System (SIM). Adjustments and analyses were performed using the Autoregressive Integrated Moving Average with exogenous variables (ARIMAX) method modelled by environmental variables and atmospheric pollutants to evaluate the effect of smoking ban law in mortality and hospital admission rate. We also used Interrupted Time Series Analysis (ITSA) to make a comparison between the period pre and post smoking ban law.
  
  
  
  We observed a reduction in mortality rate (-11.9% in the first 17 months after the law) and in hospital admission rate (-5.4% in the first 3 months after the law) for myocardial infarction after the implementation of the smoking ban law.
  
  
  
  Hospital admissions and mortality rate for myocardial infarction were reduced in the first months after the comprehensive smoking ban law was implemented.
authors: Medicine Faculty, Heart Institute, University of São Paulo, São Paulo, São Paulo, Brazil.
authors: Tania M O
authors: TMO
authors: Abe
authors: Medicine Faculty, Heart Institute, University of São Paulo, São Paulo, São Paulo, Brazil.
authors: Jaqueline
authors: J
authors: Scholz
authors: Municipal Health Secretary, Municipality of São Paulo, São Paulo, São Paulo, Brazil.
authors: Eduardo
authors: E
authors: de Masi
authors: Medicine Faculty, Heart Institute, University of São Paulo, São Paulo, São Paulo, Brazil.
authors: Moacyr R C
authors: MRC
authors: Nobre
authors: Medicine Faculty, Heart Institute, University of São Paulo, São Paulo, São Paulo, Brazil.
authors: Roberto Kalil
authors: RK
authors: Filho
mesh_terms: D000393:Air Pollutants / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015233:Models, Statistical; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality*; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence*
chemical_list: D000393:Air Pollutants
keywords: Environment; Public policy; Secondhand smoke; Surveillance and monitoring