The impact of the 2002 delaware smoking ordinance on heart attack and asthma

John Moraros, Yelena Bird, Shande Chen, Robert Buckingham, Richard S. Meltzer, Surasri Prapasiri, Luis H. Solis

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


In the United States, smoking is the leading cause of death - having a mortality rate of approximately 435,000 people in 2000-accounting for 8.1% of all US deaths recorded that year. Consequently, we analyzed the Delaware Hospital Discharge Database, and identified state and non-state residents discharged with AMI or asthma for the years 1999 to 2004. Statistical data analysis compared the incidence of AMI or asthma for each group before (1999-2002) and after (2003-2004) the amendment. As a result, we found that pre-ordinance and post-ordinance quarterly rates of AMI for Delaware residents were 451 (se = 21) and 430 (se = 21) respectively, representing a 4.7% reduction. Over the same time period, there was negligible change in the incidence of AMI for non-Delaware residents. After adjusting for population growth, the Risk Ratio (RR) for asthma in Delaware residents post-ordinance was 0.95 (95% CI, 0.90 to 0.999), which represented a significant reduction (P = 0.046). By comparison, non-Delaware residents had an increased RR for asthma post-ordinance of 1.62 (95% CI, 1.46 to 1.86; P < 0.0001).The results suggest that Delaware's comprehensive non-smoking ordinance effectively was associated with a statistically significant decrease in the incidence of AMI and asthma in Delaware residents when compared to non-Delaware residents.

Original languageEnglish
Pages (from-to)4169-4178
Number of pages10
JournalInternational Journal of Environmental Research and Public Health
Issue number12
StatePublished - Dec 2010


  • Acute myocardial infarction
  • Asthma
  • Health promotion
  • Prevention
  • Secondhand smoke exposure
  • Smoking


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