• Erin L Mead, Raul Cruz-Cano, Debra Bernat, Laurie Whitsel, Jidong Huang, Chris Sherwin, and Rose Marie Robertson.
• School of Public Health, Department of Behavioral and Community Health, University of Maryland at College Park, 4200 Valley Drive, College Park, MD 20742, USA. Electronic address: emead1@umd.edu.
• Prev Med. 2016 Nov 1; 92: 169-175.

IntroductionRacial disparities in acute myocardial infarctions (AMIs) are increasing over time. Previous studies have shown that the implementation of smoke-free policies is associated with reduced AMI rates. The objective of this study was to determine the association between smoke-free policy and AMI hospitalization rates and smoking by race.MethodsHealthcare Cost and Utilization Project data from Florida from 2000-2013 were analyzed using interrupted time series analysis to determine the relationship between Florida's smoke-free restaurant and workplace laws and AMI among the total adult population (aged ≥18years), by age, race, and gender. Behavioral Risk Factor Surveillance System data from Florida from 2000 to 2010 were analyzed using logistic regression to determine the association between policy and the adult smoking prevalence.ResultsAfter implementation of the smoke-free policy, no statistically significant associations between AMI hospitalization rates or smoking prevalence were detected in the total population. In the subgroup analysis, the policy was associated with declines in AMI hospitalization rates among non-Hispanic white adults aged 18-44years (β=-0.001 per 10,000, p-value=0.0083). No other relationships with AMI hospitalization rates and smoking prevalence were found in the subgroup analysis.ConclusionsMore comprehensive smoke-free and tobacco control policies are needed to further reduce AMI hospitalization rates, particularly among minority populations. Further research is needed to understand and address how the implementation of smoke-free policies affects secondhand smoke exposure among racial and ethnic minorities.Copyright © 2016 Elsevier Inc. All rights reserved.

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