HealthDay News — Comprehensive smoke-free legislation is associated with decreases in hospital admissions for smoking-related cardiovascular and respiratory disease, findings from a meta-analysis suggest.

Within a median 24-months of being enacted, smoking bans were associated with significant reduction in admissions or death for four disease groups: acute coronary events, cerebrovascular events, respiratory disease, and other heart disease, Crystal E. Tan, MS, and Stanton A. Glantz, PhD, both of the University of California in San Francisco, reported in Circulation.

The metaanalysis involved 45 studies evaluating hospitalizations or deaths for smoking-related illness in areas with or without anti-smoking laws, or comparing rates before and after a law was introduced, and included a total of 33 smoke-free laws.

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A random effects meta-regression analysis was used to determine whether a law’s comprehensiveness was associated with stronger reductions in risk. Comprehensiveness was determined based on whether it affected workplaces only; workplaces and restaurants; or workplaces, restaurants and bars.

The researchers found that more comprehensive smoke-free laws correlated with significantly lower rates of hospital admissions or death for coronary events (relative risk [RR]= 0.84; 95% CI: 0.81-0.88), other heart disease (RR=0.61; 95% CI: 0.44-0.84), cerebrovascular accidents (RR=0.84; 95% CI: 0.75-0.93) and respiratory disease (RR=0.76; 95% CI: 0.68-0.84).

Specific medical conditions for which anti-smoking laws reduced hospitalization risk included: acute MI, acute coronary syndrome, ischemic heart disease, angina, coronary heart disease, sudden cardiac death, stroke, asthma, and lung infection.

The laws did not significantly reduce hospitalizations or death for transient ischemic attack, chronic obstructive pulmonary disease, or spontaneous pneumothorax.

Longer follow-up after comprehensive laws were enacted was not associated with a change in disease outcomes for which researchers had data; however, the more comprehensive a law was, the greater the effects were on reducing hospitalizations for smoking-related disease.

“This study provides evidence that smoke-free laws are followed by fewer hospitalizations and lower health care expenditures for a wide range of diseases and that comprehensive laws ending smoking in workplaces, restaurants, and bars are associated with greater effects,” the researchers wrote. “The general public, public health professionals, and policy makers should consider these positive associations as they develop smoke-free legislation and decide whether or not to include exceptions to these laws.”


  1. Glantz SA, Tan CE. Circulation 2012; doi: 10.1161/CIRCULATIONAHA.112.121301.