Association between fire-safe cigarette legislation and residential fire deaths in the United States

BACKGROUND: Cigarettes and other tobacco-related smoking products have traditionally been a major ignition source for residential fire deaths. In the United States, all 50 states and the District of Columbia have passed laws requiring that cigarettes self-extinguish if they are not being smoked (so-called fire-safe cigarette laws). The purpose of this study was to quantify the association between state-level implementation of fire-safe cigarette legislation and the rate of residential fire death. METHODS: Poisson regression was used to analyze state-years data. Main intervention: Implementation dates for fire-safe cigarette legislation in each state. Outcome: Residential fire mortality rate. RESULTS: Implementation of fire-safe cigarette legislation was associated with a 19% reduction in overall residential fire mortality rates, adjusted for demographic differences between states (rate ratio = 0.81, 95% confidence interval: 0.79, 0.84). This is approximately similar to the estimated proportion of residential fire deaths in which smoking materials are an ignition source (23%). Legislation implementation was associated with a protective effect for every age, sex, race, and ethnicity strata that we examined. State-specific residential fire mortality death rates decreased (defined as a drop of at least 5%) in 32 states after fire-safe cigarette legislation was implemented. In 12 states there was either less than a 5% decrease or an increase, and seven states had insufficient deaths to evaluate state-level changes. CONCLUSIONS: Implementation of fire-safe cigarette is associated with reductions in residential fire mortality rates.