Hi again! This week I’m going to be discussing an article that the Washington Post recently published about smoke free laws and their beneficial effects.
Here is a link to that article:
http://www.washingtonpost.com/wpdyn/content/article/2010/09/15/AR2010091505209.html
This article talks about research that has shown how smoking bans have led to less children being hospitalized with asthma and other respiratory related problems. Other studies have also shown that the rate of heart attacks in adults to go down. The study, which was conducted in Scotland, showed that asthma related hospitalization of children has been gone down 13% each year after 2006, the year that the ban was enforced. However, before 2006, the rate was increasing by 5% a year. This study has shown us that smoke free laws can bring immediate and tangible improvements to our community. The article also touches on other states and cities that have experienced similar results. 35 states and Washington D.C. all have banned smoking in workplaces, restaurants, and bars. This article is clearly touching on an important public health issue. Even though the amount of smokers has significantly decreased, it is still a huge issue in our country that not only affects the smoker but also the people around them. The article reported a staggering fact that 40% of all children who go to the hospital for asthma attacks live with smokers. What separates the application of these smoking bans from being a medical issue is that a doctor may be the one who is individually treating each child suffering from asthma but it is the job of the public health professional to stop that child from ever having to go to the doctor in the first place. He or she is helping the community as a whole by implementing a preventive measure such as a smoking ban. The studies that this article talks about are observational studies. More specifically, they are case studies. The researchers picked a specific time frame, in this case January 2000 to October 2009, and looked at the evidence from each case and pulled out the information that was “relevant.” In this case, that evidence was how many children were admitted per day with asthma related health problems.
This article talks about research that has shown how smoking bans have led to less children being hospitalized with asthma and other respiratory related problems. Other studies have also shown that the rate of heart attacks in adults to go down. The study, which was conducted in Scotland, showed that asthma related hospitalization of children has been gone down 13% each year after 2006, the year that the ban was enforced. However, before 2006, the rate was increasing by 5% a year. This study has shown us that smoke free laws can bring immediate and tangible improvements to our community. The article also touches on other states and cities that have experienced similar results. 35 states and Washington D.C. all have banned smoking in workplaces, restaurants, and bars. This article is clearly touching on an important public health issue. Even though the amount of smokers has significantly decreased, it is still a huge issue in our country that not only affects the smoker but also the people around them. The article reported a staggering fact that 40% of all children who go to the hospital for asthma attacks live with smokers. What separates the application of these smoking bans from being a medical issue is that a doctor may be the one who is individually treating each child suffering from asthma but it is the job of the public health professional to stop that child from ever having to go to the doctor in the first place. He or she is helping the community as a whole by implementing a preventive measure such as a smoking ban. The studies that this article talks about are observational studies. More specifically, they are case studies. The researchers picked a specific time frame, in this case January 2000 to October 2009, and looked at the evidence from each case and pulled out the information that was “relevant.” In this case, that evidence was how many children were admitted per day with asthma related health problems.
I chose to discuss this article because I think it is a really good example of the kind of work that is done in the field of public health and the good that can come from it. I also chose to speak about this because it touched on something that I lived through not too long ago. I can remember back to when New York City first implemented a ban on smoking in restaurants and bars. It was a huge controversy for a long period of time but once passed, was considered a huge victory for the health of New York City citizens. Even though I was much younger, I can remember sitting in restaurants and smelling the smoke from the smoking section wafting over to our table. The smell always made me feel so nauseous. After the ban was in place, the difference in restaurants was extreme. While there is still a lot of work to be done, it is clear from this article that in recent years, great progress has been made in the reduction of smoking related health problems!
Overall, this was a good discussion of the article. However, the type of observational study was actually an ecologic study, not a case study, and you did not discuss the potential strengths and weaknesses of this type of study. The study found that banning smoking in the whole country is associated with decreased asthma hospital visits in the whole country. The authors points out why they think this happened, but unfortunately, as an ecologic study, it can't directly prove that banning smoking directly led to decreased asthma. For example, what if there was another intervention that occurred during that time period (e.g. cigarette taxes were raised)? Or, what if the decrease in asthma visits was due to a new asthma medicine? In an ecologic study, there is no "control" group, which is one of the reasons why it is actually the weakest of the observational epi study designs.
ReplyDeleteYou mentioned that 40% of children who go to the hospital for asthma attacks live with smokers, but why is this a stunning statistic? If half the population smokes, that wouldn't be noteworthy. It's important to mention that this percentage is *out of proportion* to the percentage of smokers in the general population (which is about 21%)--otherwise, that statistic isn't very meaningful.
I think this was probably the hardest blog assignment for the whole term, and the class did not spend all that much time on epidemiology, so don't worry too much--but I hope you learned a little bit from my comments.