Online Program

Just beyond access: Exploring the affect statewide smoke-free legislation had on reducing emergency department visits among the adult asthma population

Tuesday, November 5, 2013

Catrina Chambers, PhD, MSPH, Caridovascular Research Institution Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
Scott Cummings, PhD, Public Policy Analysis, Saint Louis University, Saint Louis, MO
Kathleen Gillespie, PhD, School of Public Health, Saint Louis University, Saint Louis, MO
James Gilsinan, PhD, Public Policy Analysis, Saint Louis Univeristy, Saint Louis, MO
Approximately, 19.3% of asthmatics smoke and portions of nonsmoking asthmatics continue to be exposed to secondhand smoke (SHS) in public places. Complexities of asthma coupled with SHS increases the risk of emergency department (ED) use. However, implementing statewide smoking bans may deter ED use among the asthma population. Objective: To determine whether there are variations in asthma-related ED use among the adult asthma population by types of statewide smoke-free legislation between the years of 2000-2010. Methods: Using data from the Behavioral Risk Factor Surveillance Survey 2000-2010, we examined the association between asthma-related ED use and types of statewide smoke-free legislation. Results: Asthmatics residing in states with comprehensive and partial statewide smoking bans reported fewer ED visits over a short period. The relative risk of reporting asthma-related ED visits during that time was 2.14 (95%, CI 1.64 to 2.23) times higher in non-policy states compared to partial policy states and 1.67 (95%, CI 1.25 to 1.71) times higher in non-policy states compared to comprehensive policy states. The findings also showed that statewide policy had a short-term net policy effect on reducing ED visits while controlling for certain socio-demographic factors and specific health characteristics. Conclusion: Statewide smoking bans had a 12-48 month impact on arresting asthma-related ED use among adult asthmatics. The variation in the length of policy effect between partial and comprehensive policy may be due to individual behaviors, tobacco prevention spending, and the need for systematic renewal of preventive health partnerships.

Learning Areas:

Chronic disease management and prevention
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Compare asthma-related emergency department visits among the adult asthma population by statewide smoke-free policies between 2001 through 2010. Explain the net policy effect of statewide smoke-free legislation had on asthma-related emergency department visits, while controlling for sociodemographic and specific health characteristics. Develop public health policy recommendations aimed toward increasing tobacco prevention spending and formulating statewide smoking ordinance.

Keyword(s): Health Care Utilization, Tobacco Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: this research was a product of my dissertation research while I was a student at Saint Louis University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.