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Reinforcement of Tobacco Control and Reduction in Medical Utilization for Asthma in Taiwan: A Population-Based Study

Author

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  • Huang-Ju Liang

    (Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 108, Taiwan
    Center for Quality Management, National Taiwan University Hospital, Taipei 100, Taiwan)

  • Ming-Jiuan Wu

    (Department of Business and Management, Ming Chi University of Technology, New Taipei City 243, Taiwan)

  • Jih-Shuin Jerng

    (Center for Quality Management, National Taiwan University Hospital, Taipei 100, Taiwan
    Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan)

  • Chiang-Hsing Yang

    (Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 108, Taiwan)

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.

Suggested Citation

  • Huang-Ju Liang & Ming-Jiuan Wu & Jih-Shuin Jerng & Chiang-Hsing Yang, 2019. "Reinforcement of Tobacco Control and Reduction in Medical Utilization for Asthma in Taiwan: A Population-Based Study," IJERPH, MDPI, vol. 16(20), pages 1-10, October.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:20:p:3950-:d:277397
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    References listed on IDEAS

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    1. Herman, P.M. & Walsh, M.E., 2011. "Hospital admissions for acute myocardial infarction, angina, stroke, and asthma after implementation of arizona's comprehensive statewide smoking ban," American Journal of Public Health, American Public Health Association, vol. 101(3), pages 491-496.
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    3. Eisner, M.D. & Yelin, E.H. & Katz, P.P. & Shiboski, S.C. & Henke, J. & Blanc, P.D., 2000. "Predictors of cigarette smoking and smoking cessation among adults with asthma," American Journal of Public Health, American Public Health Association, vol. 90(8), pages 1307-1311.
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