News

Toronto hospital admissions for heart and lung conditions decreased after city passed smoke-free laws

May 19, 2010

By Patricia Nicholson

The number of people admitted to Toronto hospitals for cardiovascular and respiratory conditions dropped by one-third after the city legislated smoke-free workplaces, public spaces, restaurants and bars, according to new research from the Institute for Clinical Evaluative Sciences (ICES) and the University of Toronto.

Toronto implemented a series of smoke-free laws from 1999 to 2004. In 1999, the city required all workplaces and public places to be smoke-free. This was followed in 2001 with a ban on smoking in restaurants, bowling alleys and dinner theatres, except for designated smoking rooms. The last phase made all bars, casinos, racetracks and billiard halls smoke-free in 2004.

Previous studies of smoke-free legislation have shown that municipal smoking bans are associated with a decrease in the number of heart attacks in the affected area. The researchers at ICES and U of T wanted to investigate whether smoking bans were also linked to lower incidence of two other cardiovascular conditions – angina and stroke – as well as to three lung conditions: asthma, chronic obstructive pulmonary disease (COPD) and pneumonia or bronchitis.

The researchers looked at hospitalization rates for these heart and respiratory conditions in the three years before any smoking legislation was passed, and after each phase of the legislation took effect. They also looked at hospitalization rates during the same periods in two other Ontario municipalities that did not have smoking bans at the time (Durham Region and Thunder Bay).

The results showed a significant decrease in cardiovascular and respiratory hospitalizations after the smoking bans took effect. Hospitalizations for heart conditions dropped by 39 per cent, and hospitalizations for lung conditions dropped 33 per cent. The largest drop was seen after the second phase of the ban, making restaurants smoke-free.

Neither of the two municipalities without smoking bans experienced these decreases. The researchers also found that Toronto hospitalizations for other conditions unrelated to smoking – such as appendicitis and bowel obstruction – did not decrease during the study period.

The researchers noted that the strong association between smoke-free legislation and decreased hospitalizations for heart and lung conditions suggests that smoking bans are related to public health improvements.

The research appears in the May 18, 2010 issue of CMAJ.

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