Study of Public Place Intervention on Tobacco Exposure (STOPIT)

A prospective study of hospital admissions for acute coronary syndrome to determine if any reduction, and if so, if it is related to smoking status.

A collaboration involving over 50 research teams across Scotland.

Principal Investigator: Professor Jill Pell

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Study Aims

• Assess the impact of smoke-free legislation on the number of admissions for acute coronary syndrome (ACS) to general hospital.
• Determine if any reduction in ACS admissions is related to smoking status.

Study Design

• A prospective study of admissions for ACS to nine general hospitals. The study hospitals accounted for nearly two thirds of ACS admissions in Scotland.
• Using a standard ACS definition of chest pain plus raised troponins (a marker of damage to the heart muscle) in admission blood sample, data were collected from consenting patients on smoking status and exposure to SHS.
• In addition, admission blood samples were tested for cotinine.

Research Instruments & Protocols

• Questionnaire for patients on smoking status and self-reported SHS exposure.

Main Outcomes

• Overall, the number of admissions for ACS decreased from 3235 to 2684 - a 17% reduction. This compared with a 4% reduction in England (no legislation) during the same period, and a mean annual decrease of 3% (maximum decrease 9%) in Scotland in the decade preceding the study.
• The reduction in ACS admissions was not due to an increase in the number of ACS deaths in patients who were not admitted to the hospital - this decreased by 6%.
• There was a 14% reduction in the number of of admissions for ACS among smokers, a 19% reduction among former smokers, and a 21% reduction among persons who had never smoked.
• Among male non-smokers (never and ex-smokers combined), geometric mean serum cotinine concentrations fell from 0.66ng/ml to 0.41ng/ml - a 38% reduction.
• Among female non-smokers geometric mean serum cotinine concentrations fell from 0.66ng/ml to 0.35ng/ml - a 47% reduction.

Updated 17th July 2014