Reinforcement of tobacco control and reduction in medical utilization for asthma in Taiwan: A population-based study
Journal
International Journal of Environmental Research and Public Health
Journal Volume
16
Journal Issue
20
Pages
3950
Date Issued
2019
Author(s)
Abstract
Environmental air quality can affect asthma control and the development of overt asthmatic manifestations. In this population-based study, we investigated the effect of reinforcing a smoking ban in Taiwan through the enactment of the Tobacco Hazards and Prevention Act (THPA) on healthcare utilization rate by asthmatics. Analysis was performed based on data relevant to non-hospitalized asthmatic patients with insurance claims between 2005 and 2013 from the National Health Insurance Research Database of Taiwan, reported data on Asian dust storms, and penalty rates for violations of the tobacco ban. Poisson regression showed that the risk for outpatient visits for asthma was lower after enactment of the THPA (RR = 0.98, 95% CI = 0.98–0.99), with a yearly trend of a reduced risk (RR = 0.99, 95% CI = 0.99–1.00), also lower in geographic regions with medium (RR = 0.79, 95% CI = 0.79–0.80) and high (RR = 0.91, 95% CI = 0.91–0.92) penalty rates. Subgroup analysis showed that asthma visit rates were reduced in both male and female groups after the enactment of the THPA. The risk of an asthma ER visit was increased after the enactment of the amended THPA (RR = 1.07, 95% CI = 1.05–1.09), although the yearly trend was not significant (RR = 1.00, 95% CI = 1.00–1.00). The risk of emergency room visits for asthma was significantly reduced in regions with medium (RR = 0.68, 95% CI = 0.68–0.69) and high (RR = 0.75, 95% CI = 0.74–0.76) penalty rates. Subgroup analysis showed that the visit rates were similar in both male and female groups. The effectiveness of reinforcing the smoking ban warrants further policies aimed at further reducing passive smoking. ? 2019 by the authors. Licensee MDPI, Basel, Switzerland.
Subjects
Asthma; Healthcare utilization; Smoking; Tobacco ban
SDGs
Other Subjects
tobacco smoke; asthma; health care; health insurance; health risk; regression analysis; smoking; tobacco; adolescent; adult; aged; Article; asthma; child; controlled study; emergency health service; female; geographic distribution; health care system; health care utilization; human; infant; major clinical study; male; medical record; newborn; observational study; outpatient care; passive smoking; patient risk; population research; retrospective study; risk reduction; smoking ban; smoking cessation; Taiwan; trend study; adverse event; asthma; middle aged; prevention and control; Taiwan; Nicotiana tabacum; Adult; Asthma; Female; Humans; Male; Middle Aged; Retrospective Studies; Taiwan; Tobacco Smoke Pollution
Publisher
MDPI AG
Type
journal article