Changes in hospitalizations for chronic respiratory diseases after two successive smoking bans in Spain

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dc.contributor.author Galán, Iñaki
dc.contributor.author Simón, Lorena
dc.contributor.author Boldo, Elena
dc.contributor.author Ortiz, Cristina
dc.contributor.author Cuenca, Rafael Fernández
dc.contributor.author Linares, Cristina
dc.contributor.author Medrano, María José
dc.contributor.author Pastor-Barriuso, Roberto
dc.contributor.other UAM. Departamento de Medicina Preventiva y Salud Pública y Microbiología es_ES
dc.contributor.other Instituto de Investigación Sanitaria Hospital Universitario de La Paz (IdiPAZ) es_ES
dc.date.accessioned 2017-11-03T15:00:01Z
dc.date.available 2017-11-03T15:00:01Z
dc.date.issued 2017-05-01
dc.identifier.citation PLos One 12.5 (2017): e0177979 en_US
dc.identifier.issn 1932-6203 es_ES
dc.identifier.uri http://hdl.handle.net/10486/680110
dc.description.abstract This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Existing evidence on the effects of smoke-free policies on respiratory diseases is scarce and inconclusive. Spain enacted two consecutive smoke-free regulations: a partial ban in 2006 and a comprehensive ban in 2011. We estimated their impact on hospital admissions via emergency departments for chronic obstructive pulmonary disease (COPD) and asthma. Methods Data for COPD (ICD-9 490-492, 494-496) came from 2003-2012 hospital admission records from the fourteen largest provinces of Spain and from five provinces for asthma (ICD-9 493). We estimated changes in hospital admission rates within provinces using Poisson additive models adjusted for long-term linear trends and seasonality, day of the week, temperature, influenza, acute respiratory infections, and pollen counts (asthma models). We estimated immediate and gradual effects through segmented-linear models. The coefficients within each province were combined through random-effects multivariate meta-analytic models. Results The partial ban was associated with a strong significant pooled immediate decline in COPDrelated admission rates (14.7%, 95%CI: 5.0, 23.4), sustained over time with a one-year decrease of 13.6% (95%CI: 2.9, 23.1). The association was consistent across age and sex groups but stronger in less economically developed Spanish provinces. Asthma-related admission rates decreased by 7.4% (95%CI: 0.2, 14.2) immediately after the comprehensive ban was implemented, although the one-year decrease was sustained only among men (9.9%, 95%CI: 3.9, 15.6). Conclusions The partial ban was associated with an immediate and sustained strong decline in COPDrelated admissions, especially in less economically developed provinces. The comprehensive ban was related to an immediate decrease in asthma, sustained for the medium-term only among men en_US
dc.description.sponsorship This work was supported by Grant FIS PI11/01276 from the Institute of Health Carlos III, Ministry of Economy and Competitiveness en_US
dc.format.extent 14 pag. es_ES
dc.format.mimetype application/pdf en
dc.language.iso spa en
dc.publisher Public Library of Science en_US
dc.relation.ispartof PLos One en_US
dc.rights © 2017 Galán et al. es_ES
dc.subject.other Smoke-free policies en_US
dc.subject.other Respiratory diseases en_US
dc.subject.other Poisson en_US
dc.subject.other Decrease in asthma en_US
dc.subject.other Changes in hospitalizations en_US
dc.title Changes in hospitalizations for chronic respiratory diseases after two successive smoking bans in Spain en_US
dc.type article en
dc.subject.eciencia Medicina es_ES
dc.relation.publisherversion https://doi.org/10.1371/journal.pone.0177979 es_ES
dc.identifier.doi 10.1371/journal.pone.0177979 es_ES
dc.identifier.publicationfirstpage e0177979-1 es_ES
dc.identifier.publicationissue 5 es_ES
dc.identifier.publicationlastpage e0177979-14 es_ES
dc.identifier.publicationvolume 12 es_ES
dc.relation.projectID Gobierno de España. FIS PI11/01276 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion en
dc.rights.cc Reconocimiento es_ES
dc.rights.accessRights openAccess en
dc.authorUAM Galán Labaca, Ignacio (262111)


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