The Effect of a Smoking Ban on Hospitalization Rates for Cardiovascular and Respiratory Conditions in Prince Edward Island, Canada

Background: This is the first study to have examined the effect of smoking bans on hospitalizations in the Atlantic Canadian socio-economic, cultural and climatic context. On June 1, 2003 Prince Edward Island (PEI) enacted a province-wide smoking ban in public places and workplaces. Changes in hospital admission rates for cardiovascular (acute myocardial infarction, angina, and stroke) and respiratory (chronic obstructive pulmonary disease and asthma) conditions were examined before and after the smoking ban. Methods: Crude annual and monthly admission rates for the above conditions were calculated from April 1, 1995 to December 31, 2008 in all PEI acute care hospitals. Autoregressive Integrated Moving Average time series models were used to test for changes in mean and trend of monthly admission rates for study conditions, control conditions and a control province after the comprehensive smoking ban. Age-and sex-based analyses were completed. Results: The mean rate of acute myocardial infarctions was reduced by 5.92 cases per 100,000 person-months (P = 0.04) immediately after the smoking ban. The trend of monthly angina admissions in men was reduced by 20.44 cases per 100,000 person-months (P = 0.01) in the 67 months after the smoking ban. All other cardiovascular and respiratory admission changes were non-significant. Conclusions: A comprehensive smoking ban in PEI reduced the overall mean number of acute myocardial infarction admissions and the trend of angina hospital admissions.