Smoke-Free Policy and Chronic Obstructive Pulmonary Disease Hospitalizations

Smoke-Free Policy and Chronic Obstructive Pulmonary Disease Hospitalizations

Audience: Tobacco control advocates, policymakers, and researchers

Key Points: Tobacco smoke exposure is the major risk factor for chronic obstructive pulmonary disease (COPD), a primary cause of hospitalization in older adults. This study investigated the effect of smoke-free laws on hospitalizations for COPD in Kentucky from July 1, 2003 to June 30, 2010.

The design is a retrospective longitudinal study of cases that met inclusion criteria (namely primary or secondary ICD-9 codes of 491,492, or 496). 12,628 hospitalizations during the 7-year time period were included in the preliminary analysis. Counties were combined into 54 county groupings. Age- and gender-adjusted rates of COPD hospitalizations were determined for each month within each county cluster. Counties with laws/ordinances in any city were coded as having a law and were not combined with other counties for the analysis.

Counties with laws had lower COPD rates (Chi-square=59.0, p<.0001), controlling for personal and community characteristics and seasonality. There was a 16% lower likelihood of COPD in those living in smoke-free communities, compared to those not protected by a law.

Educational Experience: Interactive poster or lecture/panel

Benefits: Smoke-free laws are clearly associated with reductions in hospitalizations for acute myocardial infarctions and in ED visits for asthma. This finding suggests that smoke-free public policies also provide protection against the exacerbations of COPD that lead to hospitalizations. This study adds to the literature supporting the positive health outcomes from smoke-free legislation.

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