Reducing Secondhand Tobacco Smoke (SHTS): Cardiac and Asthma Outcomes

Grants and Contracts Details


The broad, long-term objective is to assess the relationship between reduction in exposure to sec.ondhand tobacco smoke (SHTS) at the community level and health care outcomes associated with acute coronary syndromes and asthma. The specific aim is to evaluate the effects of a community initiative to reduce exposure to SHTS on cardiac and asthma outcomes including the rate of hospital and emergency department (ED) discharges, length of stay, and total hospital costs. Although many local communities have adopted measures to reduce exposure to SHTS, the tobaccogrowing states lag behind in protecting workers from SHTS. The Lexington-Fayette (Kentucky) Urban County Government enacted a smoke-free law on July 1, 2003, making all public buildings smoke-free including, but not limited to, restaurants, bars, bowling alleys, bingo halls, laundromats, and racetracks. Lexington's initiative is considered by the Americans for Nonsmoker's Rights as one of the strictest local laws in the U.S. The effective date was September 29,2003. However, at the time of the grant submission, the enforcement of the initiative was temporarily delayed due to a court injunction. The study will be a time series design using five 6-month time periods; three time points prior to and two time points after enforcement of the Smoke-Free Lexington initiative. The administrative data base (Comp Data) used to summarize and track all Kentucky hospital billing records will be accessed for all Lexington hospitals during each of the five time periods. Comp Data will be queried for hospital discharge diagnosis by DRGs and ICD-9 codes, length of stay, total hospital charges, dates of service, gender, age, and zip code of residence. Since Comp Data does not compile emergency department (ED) discharge information, each Fayette County hospital will provide all data fields of interest above for the ED discharge diagnosis by DRGs and ICD- 9 codes. Based on the enforcement date of the community intervention in Lexington (projected November 1, 2003), the data collection time periods will be in 6-month time intervals from November 1 of a given year to April 30 of the following year. Multiple linear regression will be used to determine predictors for length of stay and total costs; predictors will include year, month, gender, age, and an indicator variable for whether the observation occurred before or after the initiative. For the number of events (hospital and ED discharges) per atrisk population, an incidence rate, Poisson regression will be used with the same predictors.
Effective start/end date7/1/046/30/07


  • Flight Attendant Medical Research Institute: $325,062.00


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