Response to Letter Regarding Article, “Effect of the Italian Smoking Ban on Population Rates of Acute Coronary Events”

Abstract

We thank Drs Gasparrini and Gorini for their interest in our work. hey suggested that we test for a nonlinear time trend in the occurrence of coronary events. We did so for the reference period (2000 to 2004) before the smoking ban. A quadratic term gives a better fit to the model than a linear term among 35-to 64-year-old individuals (likelihood ratio test probability value, 0.024) and among 65-to 74-year-old individuals (likelihood ratio test probability value, 0.005). The introduction of troponin as a diagnostic tool may be one explanation for the first increase in coronary events. The results are very similar to those presented in our article 1 : We found a decrease in acute coronary events for those aged 35 to 64 years, with a relative risk of 0.89 (95% confidence interval, 0.85 to 0.94) in 2005 compared with 2002 to 2004, as well as for those aged 65 to 74 years, with a relative risk of 0.90 (95% confidence interval, 0.86 to 0.95) in 2005 compared with 2002 to 2004.