Effect of a two-phase tobacco control regulation on incidence from ischemic stroke and hemorrhagic stroke, Shenzhen, China, 2007–2016
Introduction The Shenzhen government is widely considered to be most efficiently implementing smoke-free legislation in China. We evaluated and compared the impact of Shenzhen’s two-phase smoke-free regulation on the incidence rates for ischemic and hemorrhagic stroke. Methods An interrupted time s...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Publishing
2023-08-01
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| Series: | Tobacco Induced Diseases |
| Subjects: | |
| Online Access: | http://www.tobaccoinduceddiseases.org/Effect-of-a-two-phase-tobacco-control-regulation-on-incidence-from-ischemic-stroke,168123,0,2.html |
| _version_ | 1797650371247603712 |
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| author | Yulin Shi Ji Peng Liqun Liu Zhiguang Zhao Jingfan Xiong Xia Wan |
| author_facet | Yulin Shi Ji Peng Liqun Liu Zhiguang Zhao Jingfan Xiong Xia Wan |
| author_sort | Yulin Shi |
| collection | DOAJ |
| description | Introduction
The Shenzhen government is widely considered to be most efficiently
implementing smoke-free legislation in China. We evaluated and compared the
impact of Shenzhen’s two-phase smoke-free regulation on the incidence rates for
ischemic and hemorrhagic stroke.
Methods
An interrupted time series design was used to capture immediate and
annual incidence changes from 2007 to 2016 for both ischemic and hemorrhagic
stroke due to two-phase smoke-free regulation in Shenzhen, China, by using
a generalized additive model. The first phase, implemented on 9 March 2010,
required five main public places to be smoke-free. In the second phase, the
comprehensive law was expanded to the whole city on 1 March 2014.
Results
The regulation implementation during phase I was associated with a
strong immediate decline in the incidence rate of ischemic stroke (-14.2%, 95%
CI: -19.6 – -8.4) and hemorrhagic stroke (-10.1%, 95% CI: -18.2 – -1.2), but
without showing the annual changes (p>0.05). Following the implementation of
the comprehensive law, the gradual annual effect showed a significant change
in ischemic stroke, with a 6.3% (95% CI: 8.9 – -3.6) reduction. Neither the
immediate nor gradual decreases in hemorrhagic stroke incidences associated
with the comprehensive regulation were statistically significant during phase
II (p>0.05). Subgroup analyses indicate that a much larger health effect of the
regulation during phase I was greater among those aged ≥65 years than among
those aged 35–64 years.
Conclusions
Shenzhen’s two-phase smoke-free regulation was well implemented.
Even though the regulation did not extend to the whole city, the immediate health
benefits on the incidence rates of ischemic stroke and hemorrhagic stroke could be
seen. However, the health benefits brought by the implementation of comprehensive
smoke-free legislation were attenuated by previous smoke-free regulations in five
main public places, which were more evident in hemorrhagic stroke. |
| first_indexed | 2024-03-11T15:59:16Z |
| format | Article |
| id | doaj.art-c953f2d5897a4553a4af64326f725dff |
| institution | Directory Open Access Journal |
| issn | 1617-9625 |
| language | English |
| last_indexed | 2024-03-11T15:59:16Z |
| publishDate | 2023-08-01 |
| publisher | European Publishing |
| record_format | Article |
| series | Tobacco Induced Diseases |
| spelling | doaj.art-c953f2d5897a4553a4af64326f725dff2023-10-25T08:34:11ZengEuropean PublishingTobacco Induced Diseases1617-96252023-08-0121August1910.18332/tid/168123168123Effect of a two-phase tobacco control regulation on incidence from ischemic stroke and hemorrhagic stroke, Shenzhen, China, 2007–2016Yulin Shi0Ji Peng1Liqun Liu2Zhiguang Zhao3Jingfan Xiong4Xia Wan5https://orcid.org/0000-0002-0738-5631Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, ChinaShenzhen Center for Disease Control and Prevention, Shenzhen, ChinaDepartment of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, ChinaShenzhen Center for Disease Control and Prevention, Shenzhen, ChinaShenzhen Center for Disease Control and Prevention, Shenzhen, ChinaDepartment of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, ChinaIntroduction The Shenzhen government is widely considered to be most efficiently implementing smoke-free legislation in China. We evaluated and compared the impact of Shenzhen’s two-phase smoke-free regulation on the incidence rates for ischemic and hemorrhagic stroke. Methods An interrupted time series design was used to capture immediate and annual incidence changes from 2007 to 2016 for both ischemic and hemorrhagic stroke due to two-phase smoke-free regulation in Shenzhen, China, by using a generalized additive model. The first phase, implemented on 9 March 2010, required five main public places to be smoke-free. In the second phase, the comprehensive law was expanded to the whole city on 1 March 2014. Results The regulation implementation during phase I was associated with a strong immediate decline in the incidence rate of ischemic stroke (-14.2%, 95% CI: -19.6 – -8.4) and hemorrhagic stroke (-10.1%, 95% CI: -18.2 – -1.2), but without showing the annual changes (p>0.05). Following the implementation of the comprehensive law, the gradual annual effect showed a significant change in ischemic stroke, with a 6.3% (95% CI: 8.9 – -3.6) reduction. Neither the immediate nor gradual decreases in hemorrhagic stroke incidences associated with the comprehensive regulation were statistically significant during phase II (p>0.05). Subgroup analyses indicate that a much larger health effect of the regulation during phase I was greater among those aged ≥65 years than among those aged 35–64 years. Conclusions Shenzhen’s two-phase smoke-free regulation was well implemented. Even though the regulation did not extend to the whole city, the immediate health benefits on the incidence rates of ischemic stroke and hemorrhagic stroke could be seen. However, the health benefits brought by the implementation of comprehensive smoke-free legislation were attenuated by previous smoke-free regulations in five main public places, which were more evident in hemorrhagic stroke.http://www.tobaccoinduceddiseases.org/Effect-of-a-two-phase-tobacco-control-regulation-on-incidence-from-ischemic-stroke,168123,0,2.htmlsmoke-free legislationsecond-hand smoketobaccostrokeinterrupted time series |
| spellingShingle | Yulin Shi Ji Peng Liqun Liu Zhiguang Zhao Jingfan Xiong Xia Wan Effect of a two-phase tobacco control regulation on incidence from ischemic stroke and hemorrhagic stroke, Shenzhen, China, 2007–2016 Tobacco Induced Diseases smoke-free legislation second-hand smoke tobacco stroke interrupted time series |
| title | Effect of a two-phase tobacco control regulation on incidence from ischemic stroke and hemorrhagic stroke, Shenzhen, China, 2007–2016 |
| title_full | Effect of a two-phase tobacco control regulation on incidence from ischemic stroke and hemorrhagic stroke, Shenzhen, China, 2007–2016 |
| title_fullStr | Effect of a two-phase tobacco control regulation on incidence from ischemic stroke and hemorrhagic stroke, Shenzhen, China, 2007–2016 |
| title_full_unstemmed | Effect of a two-phase tobacco control regulation on incidence from ischemic stroke and hemorrhagic stroke, Shenzhen, China, 2007–2016 |
| title_short | Effect of a two-phase tobacco control regulation on incidence from ischemic stroke and hemorrhagic stroke, Shenzhen, China, 2007–2016 |
| title_sort | effect of a two phase tobacco control regulation on incidence from ischemic stroke and hemorrhagic stroke shenzhen china 2007 2016 |
| topic | smoke-free legislation second-hand smoke tobacco stroke interrupted time series |
| url | http://www.tobaccoinduceddiseases.org/Effect-of-a-two-phase-tobacco-control-regulation-on-incidence-from-ischemic-stroke,168123,0,2.html |
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