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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


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
Publication statusPublished - Dec 2010
Externally publishedYes


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


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