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Anti-smoking legislation has proven positive impact on health of Ontarians


It is estimated that one billion people will die during the 21st century as a result of tobacco-related disease. New research from the Institute for Clinical Evaluative Sciences (ICES) shows a smoking ban implemented in Toronto restaurants in 2001 corresponds with a decrease in hospital admissions for cardiovascular and respiratory conditions.

“This study’s findings are consistent with the understanding that secondhand smoke has detrimental health impacts and legitimizes efforts to further reduce exposure,” says principal investigator and ICES Fellow, Alisa Naiman.

The researchers are quick to point out that anti-smoking legislation, in combination with the annual decline in the number of smokers, the increase in efforts by government and health activists to tighten up restrictions on the sale of tobacco, as well as the general improvement in preventive care have contributed to this decline in hospital admissions.

The 10-year population-based study examined the impact of anti-smoking legislation in Toronto on admissions to hospital for cardiovascular conditions, specifically heart attacks, angina and stroke, and respiratory conditions including asthma, emphysema, and pneumonia or bronchitis. The study found that in Toronto:

  • Hospital admissions for cardiovascular conditions have decreased 39.1 per cent.
  • Hospital admissions for respiratory conditions have dropped 31.7 per cent.
  • There was a 17.4 per cent drop in heart attack hospitalization rate.
  • No significant changes in hospital admissions were found for selected conditions unrelated to second hand smoke exposure. The Ontario municipalities with no smoking ban in place at that time experienced an increase in the heart attack hospitalization rate.

“This study is unique because it looks at the impact of anti-smoking legislation on six cardiovascular and respiratory conditions while previous studies have focused mainly on how smoking bans have impacted only heart attack admissions. These results show an immediate and dramatic decrease in these conditions and offers further evidence that anti-smoking legislation is an integral component of reducing exposure to tobacco smoke and for those who quit reaping the rewards of a healthier lifestyle,” says Rick Glazier, co-author and senior scientist at ICES.

Author affiliations: ICES (A. Naiman, R. Glazier, R. Moineddin) Department of Family and Community Medicine, U of T (A. Naiman, R. Glazier, R. Moineddin) Toronto East General Hospital (A. Naiman) St. Michael’s Hospital (R. Glazier) Dalla Lana School of Public Health, U of T (R. Moineddin).

The study “A 10-year population based study of the impact of anti-smoking legislation on cardiovascular and respiratory outcomes,” is in the April 12, 2010 issue of CMAJ.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.



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