Smoking Bans and Circulatory System Disease Mortality Reduction in Macao (China): Using GRA Models

Area of Science:

• Public Health
• Epidemiology
• Cardiovascular Disease Research

Background:

• Macao implemented comprehensive smoking bans starting in 2012.
• Significant reductions in smoking prevalence, particularly among women, have been observed.
• A concurrent decline in circulatory system disease (CSD) mortality trends has been noted.

Purpose of the Study:

• To investigate the association between smoking rates and circulatory system disease (CSD) mortality in Macao.
• To determine the impact of smoking bans on CSD mortality.
• To identify key factors influencing CSD mortality.

Main Methods:

• Grey relational analysis (GRA) was used to prioritize factors impacting CSD mortality.
• Regression analysis with bootstrapping was employed to assess relationships.
• Data analysis focused on smoking rates, income, and physician density.

Main Results:

• Smoking rate emerged as the most significant factor influencing CSD mortality in Macao.
• This association was particularly pronounced in the female population.
• An estimated 5 CSD deaths per 100,000 women were avoided annually, representing 11.45% of mean CSD mortality.

Conclusions:

• Reduced smoking rates among women are a primary driver of decreased CSD mortality post-smoking bans.
• Continued promotion of smoking cessation is crucial for reducing smoking-related CSD mortality, especially in men.
• Public health strategies should focus on sustained smoking cessation efforts.