Previous Studies May Have Overestimated Health Benefits of Public Smoking Bans

Previous studies of tobacco policies aimed at reducing hospitalizations may have overestimated the benefits of bans on public smoking and underestimated the benefits of cigarette taxes, according to a new study co-authored by AHRQ. Researchers conducted a nationwide evaluation of the effects of smoking bans and cigarette taxes on acute myocardial infarction (heart attack), heart failure and pneumonia. The findings show that raising cigarette taxes can have an immediate beneficial effect by reducing costly hospitalizations, but that smoking bans do not offer the same benefit. To conduct the research, authors used data from AHRQ’s Healthcare Cost and Utilization Project (HCUP) to analyze hospitalization rates from 28 states from 2001 to 2008. HCUP is the nation’s most comprehensive source of hospital data, including information on inpatient care, ambulatory surgery and emergency department visits. The new study, “A Nationwide Assessment of the Association of Smoking Bans and Cigarette Taxes With Hospitalizations for Acute Myocardial Infarction, Heart Failure and Pneumonia,” appeared Sept. 12 in Medical Care Research and Review. Access the abstract.

2016 Sep 12. pii: 1077558716668646. [Epub ahead of print]

A Nationwide Assessment of the Association of Smoking Bans and Cigarette Taxes With Hospitalizations for Acute Myocardial Infarction, Heart Failure, and Pneumonia.

Ho V1, Ross JS2, Steiner CA3, Mandawat A4, Short M5, Ku-Goto MH5, Krumholz HM2.

Author information

Abstract

Multiple studies claim that public place smoking bans are associated with reductions in smoking-related hospitalization rates. No national study using complete hospitalization counts by area that accounts for contemporaneous controls including state cigarette taxes has been conducted. We examine the association between county-level smoking-related hospitalization rates and comprehensive smoking bans in 28 states from 2001 to 2008. Differences-in-differences analysis measures changes in hospitalization rates before versus after introducing bans in bars, restaurants, and workplaces, controlling for cigarette taxes, adjusting for local health and provider characteristics. Smoking bans were not associated with acute myocardial infarction or heart failure hospitalizations, but lowered pneumonia hospitalization rates for persons ages 60 to 74 years. Higher cigarette taxes were associated with lower heart failure hospitalizations for all ages and fewer pneumonia hospitalizations for adults aged 60 to 74. Previous studies may have overestimated the relation between smoking bans and hospitalizations and underestimated the effects of cigarette taxes.