OBJECTIVETo evaluate the integrated effects of tobacco control programs through comparing the pre- and post-implementation of the Tianjin Tobacco Control Act (Act), in 4 successive years.

METHODSCase-related data on myocardial infarction was collected by Tianjin Surveillance System, New Case Registry. Both the representative sample size of indoor working places and public places for observation and PM2.5 monitored were selected through the calculation of Survey System, while the representative sample size of people involved in the survey for interview was under the Door to Door and Intercept.

RESULTSThrough comparing the pre- and post-implementation programs on Act, the posting of "No Smoking Sign" had become much more visible in hospitals, schools, governmental buildings and the waiting areas of public transportation. People smoked much less in the main public places, excepting for hotels and public bath rooms (P < 0.05). Exposure to secondhand smoking (SHS) had a 26.5% (P < 0.01) decline, than the Act was implemented in workplace and public place. Despite the number of cases increased in the entire population in Tianjin (β = -0.061, P = 0.00; β = 0.059, P = 0.00), cases with myocardial infarction presented at the hospitals were declining annually, among the indoor workers.

CONCLUSIONAct showed a positive effect in decreasing the number of smokers in public places thus protecting people from the negative effects on SHS. Message on health effect and social benefits on tobacco control should be disseminated to facilitate the comprehensive implementation of the Act.