516 Legislative smoking bans improve health outcomes

August 26, 2017

written by Brian R McAvoy.

Clinical question
How effective are legislative smoking bans on morbidity and mortality from second-hand smoke, and smoking prevalence and tobacco consumption?

Bottom line
There was moderate-quality evidence that countries and their populations benefited from enacting national legislative smoking bans. The bans improved health outcomes from reduced exposures to passive smoke, specifically with regard to cardiovascular disease (eg, reduced hospital admission rates). There was also low-quality evidence of reduced mortality for smoking-related illnesses. The evidence on perinatal and respiratory health outcomes was not consistent, nor was the evidence on potential reductions in tobacco consumption.

Caveat
The nature of the intervention precluded randomised controlled trials. Changes in health outcomes could have been due to other things, such as change in healthcare practices. However, many of the studies did use methods of analysis that could control for underlying trends.

Context
Smoking bans have been implemented in a variety of settings, as well as being part of policy in many jurisdictions to protect the public and employees from the harmful effects of second-hand smoke. They also offer the potential to influence social norms and the smoking behaviour of those populations they affect.

Cochrane Systematic Review
Frazer K et al. Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Reviews, 2016, Issue 2. Art. No.: CD005992.DOI: 10.1002/14651858. CD005992.pub3. This review contains 77 studies involving 21 countries.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.