Key result
Anti-tobacco legislation is linked to up to ~18% fewer UA and AMI hospitalizations.
Why the study?
The impact of anti-smoking measures within Federal Law N 15-FL on hospitalization rates for acute cardiovascular conditions in Russian regions was not well studied.
Do anti-tobacco policy measures reduce hospitalization rates for acute myocardial infarction and unstable angina?
Observational
Yes
Do anti-tobacco policy measures reduce hospitalization rates for acute myocardial infarction and unstable angina?
Effect estimate: 16.3-18.4% reduction for UA and 10.5-10.6% reduction for AMI in Samara; 14.3-14.4% reduction for UA and 7.5-7.7% reduction for AMI in Arkhangelsk
p-value: p=0.011 to 0.026
Implementation of anti-tobacco legislation in Russia was associated with significant regional reductions in hospitalizations for acute myocardial infarction and unstable angina.
Supports cardiovascular benefits of anti-tobacco laws; leaves open causality and generalizability in observational data.
Aim: to study the impact of anti-smoking measures within the Federal Law N 15-FL on the number of hospitalization of patients with acute cardiovascular conditions in the Samara and Arkhangelsk Regions and the Chuvash Republic. Methods: Monthly hospitalization rates for acute myocardial infarction and unstable angina were analyzed usinginterrupted time series by means of the STATA 15.0 software package, which includes the ITS module in three regions of the Russian Federation from 01.01.2012 to 31.12.2017, and by gender (men and women) and age (0-59 years and 60 years and older). Results. Reduction in hospital incidence after each stage of the anti-tobacco policy was obwerved in two of the three regions. In the Samara Region we observed a reductionby 16.3 % in 2013 and by 18.4 % in 2014 for unstable angina and by 10.6 % in 2013 and by 10.5 % in 2014 for acute myocardial infarction, respectively. In the Arkhangelsk Region the number of hospitalizations decreased by 14.3 % in 2013 and by 14.4 % in 2014 for unstable angina, and by 7.5 % in 2013 and by 7.7 % in 2014 for acute myocardial infarction. No significant decrease was observed in the Chuvash Republic. Gender stratification revealed a decrease in the hospital incidence of acute myocardial infarction and unstable angina in women in the Samara and Arkhangelsk Regions, and in men - only in the Samara region. The percentage of reduction in unstable angina was higher than in the acute myocardial infarction. An analysis of age groups in the Samara Region showed a decrease in the number of hospitalizations for acute myocardial infarction and unstable angina in both age groups, and in the Arkhangelsk Region only in people over 60 years of age. Conclusions: anti-tobacco legislation introduced in Russia in 2013 and 2014 is likely to have contributed to a decrease in the number of hospitalizations for acute cardiovascular diseases, but the effect varied across genders and age-groups.
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Kontsevaya et al. (2020) conducted an observational in Acute myocardial infarction and unstable angina. Anti-tobacco policy measures (Federal Law N 15-FL) vs. Pre-legislation period was evaluated on Monthly hospitalization rates for acute myocardial infarction and unstable angina (16.3-18.4% reduction for UA and 10.5-10.6% reduction for AMI in Samara; 14.3-14.4% reduction for UA and 7.5-7.7% reduction for AMI in Arkhangelsk, p=0.011 to 0.026). Anti-tobacco legislation introduced in Russia in 2013 and 2014 was associated with up to an 18.4% reduction in hospitalizations for unstable angina and a 10.6% reduction for acute myocardial infarction in two of the three studied regions.
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