A systematic review and meta-analysis from North America and Europe has found that the introduction of antismoking legislation covering workplaces and public spaces is associated with significant reductions of about 10% in both preterm births and pediatric hospital visits for asthma.
The findings, published online March 27 in the Lancet, also suggest that significant health benefits and associated public-health cost savings from smoking bans may be reaped beginning in the first year after antismoking legislation takes hold (doi:10.1016/S0140-6736[14]60082-9).
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A study has found that the introduction of antismoking legislation covering workplaces and public spaces is associated with significant reductions of about 10% in both preterm births and pediatric hospital visits for asthma.
For their research, Jasper V. Been, Ph.D., of Maastricht University, the Netherlands, and his colleagues, evaluated 11 studies (5 from North America and 6 from European countries) published during 2008 and 2013. The included studies captured 247,168 million asthma exacerbations and about 2.5 million births. In these study areas, which fell within either local or national bans on smoking in the workplace, public places, and/or restaurants and bars, bans were followed by significant drops in preterm births (–10.4%) and childhood emergency department visits and hospital attendances (–10.1%).
Low birth weight was not seen as significantly changed in Dr. Been and his colleagues’ study (–1.7%; P = .31), but the researchers did see about a 5% decline in children born very small for their gestational age.
For several of the included studies, the drops were immediate. Significant drops in preterm births of 3% or more were seen in the first year following the implementation of some bans, with additional gradual declines occurring in subsequent years. With hospital visits for pediatric asthma, some studies saw drops as high as 20% per year after bans.
In an editorial comment accompanying the study, Dr. Sara Kalkhoran and Stanton A. Glantz, Ph.D., of the University of California, San Francisco, wrote that the findings add to a growing body of evidence that "smoke-free laws bring rapid health benefits and improved lives, whilst, at the same time, reducing medical costs by avoiding emergency department visits and admissions to hospitals."
Dr. Been and his colleagues’ study was funded by the Thrasher Fund, Lung Foundation Netherlands, the International Pediatric Research Fund, Commonwealth Fund, and Maastricht University. None of the study authors or editorial writers declared conflicts of interest.