Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .
Smoke-free legislation and hospitalizations for acute coronary syndrome.
BACKGROUND Previous studies have suggested a reduction in the total number of hospital admissions for acute coronary syndrome after the enactment of legislation banning smoking in public places . However , it is unknown whether the reduction in admissions involved nonsmokers , smokers , or both . METHODS Since the end of March 2006 , smoking has been prohibited by law in all enclosed public places throughout Scotl and . We collected information prospect ively on smoking status and exposure to  secondh and smoke based on question naires and biochemical findings from all patients admitted with acute coronary syndrome to nine Scottish hospitals during the 10-month period preceding the passage of the legislation and during the same period the next year . These hospitals accounted for 64 % of admissions for acute coronary syndrome in Scotl and , which has a population of 5.1 million . RESULTS Overall , the number of admissions for acute coronary syndrome decreased from 3235 to 2684 - -a 17 % reduction ( 95 % confidence interval , 16 to 18)--as compared with a 4 % reduction in Engl and ( which has no such legislation ) during the same period and a mean annual decrease of 3 % ( maximum decrease , 9 % ) in Scotl and during the decade preceding the study . The reduction in the number of admissions was not due to an increase in the number of deaths of patients with acute coronary syndrome who were not admitted to the hospital ; this latter number decreased by 6 % . There was a 14 % reduction in the number of admissions for acute coronary syndrome among smokers , a 19 % reduction among former smokers , and a 21 % reduction among persons who had never smoked . Persons who had never smoked reported a decrease in the weekly duration of exposure to secondh and smoke ( P<0.001 by the chi-square test for trend ) that was confirmed by a decrease in their geometric mean concentration of serum cotinine from 0.68 to 0.56 ng per milliliter ( P<0.001 by the t-test ) . CONCLUSIONS The number of admissions for acute coronary syndrome decreased after the implementation of smoke-free legislation . A total of 67 % of the decrease involved nonsmokers . However , fewer admissions among smokers also contributed to the overall reduction
Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .