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PLoS One. 2017 Jul 31;12(7):e0181035. doi: 10.1371/journal.pone.0181035. eCollection 2017.

Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis.

Author information

1
Centre d'Atenció Primària (CAP) Florida Nord. Gerència d'Àmbit d'Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain.
2
Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
3
Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
4
Universitat de Girona, Girona, Spain.
5
Public Health Agency of Barcelona, Barcelona, Spain.
6
CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
7
Institut d'Investigació Biomèdic (IIB Sant Pau), Barcelona, Spain.
8
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
9
Centro de Salud Universitario Delicias Sur, Servicio Aragonés de Salud (SALUD), Zaragoza, Spain.
10
Universidad de Zaragoza, Zaragoza, Spain.
11
Agència de Qualitat i Avaluació Sanitàries, AQuAS, Generalitat de Catalunya, Barcelona, Spain.
12
Servicio de Medicina Preventiva, Complejo Asistencial Universitario de Salamanca, Sanidad de Castilla y Leon (SACYL), Salamanca, Spain.
13
Grupo de investigación: Trastornos sensoriales y neuroplasticidad cerebral (UIC: 083), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
14
Instituto de Neurociencias de Castilla y León (INCYL), Salamanca, Spain.
15
Centre d'Atenció Primària (CAP) San Martí de Provençals, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain.
16
Centre d'Atenció Primària (CAP) Passeig de Sant Joan, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain.
17
Àrea Bàsica de Salut l'Hospitalet de Llobregat 6-Sta. Eulàlia sud, Gerència d'Àmbit d'Atenció Primària Hospitalet de Llobregat, Institut Català de la Salut, Barcelona, Spain.
18
Centro de Salud Cuevas del Almanzora, Almería, Spain.

Abstract

AIMS:

The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose) among all populations.

MATERIALS AND METHODS:

Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1) original scientific studies about smokefree legislation, 2) Data before and after legislation were collected, and 3) Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment.

RESULTS:

A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers). Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months). Four (50%) of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1-36%) than for asthma (5-31%). Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46%) of the studies.

CONCLUSIONS:

Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms) and, to a lesser degree, rates of hospitalization for asthma.

PMID:
28759596
PMCID:
PMC5536320
DOI:
10.1371/journal.pone.0181035
[Indexed for MEDLINE]
Free PMC Article

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