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Akter S, Rahman MM, Rouyard T, Aktar S, Nsashiyi RS, Nakamura R. A systematic review and network meta-analysis of population-level interventions to tackle smoking behaviour. Nat Hum Behav 2024:10.1038/s41562-024-02002-7. [PMID: 39375543 DOI: 10.1038/s41562-024-02002-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/04/2024] [Indexed: 10/09/2024]
Abstract
This preregistered systematic review and meta-analysis (PROSPERO: CRD 42022311392) aimed to synthesize the effectiveness of all available population-level tobacco policies on smoking behaviour. Our search across 5 databases and leading organizational websites resulted in 9,925 records, with 476 studies meeting our inclusion criteria. In our narrative summary and both pairwise and network meta-analyses, we identified anti-smoking campaigns, health warnings and tax increases as the most effective tobacco policies for promoting smoking cessation. Flavour bans and free/discounted nicotine replacement therapy also showed statistically significant positive effects on quit rates. The network meta-analysis results further indicated that smoking bans, anti-tobacco campaigns and tax increases effectively reduced smoking prevalence. In addition, flavour bans significantly reduced e-cigarette consumption. Both the narrative summary and the meta-analyses revealed that smoking bans, tax increases and anti-tobacco campaigns were associated with reductions in tobacco consumption and sales. On the basis of the available evidence, anti-tobacco campaigns, smoking bans, health warnings and tax increases are probably the most effective policies for curbing smoking behaviour.
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Grants
- Health and Labour Sciences Research Grant 20FA1022 Ministry of Health, Labour and Welfare (Ministry of Health, Labour and Welfare, Japan)
- Health and Labour Sciences Research Grant 20FA1022 Ministry of Health, Labour and Welfare (Ministry of Health, Labour and Welfare, Japan)
- Health and Labour Sciences Research Grant 20FA1022 Ministry of Health, Labour and Welfare (Ministry of Health, Labour and Welfare, Japan)
- Health and Labour Sciences Research Grant 20FA1022 Ministry of Health, Labour and Welfare (Ministry of Health, Labour and Welfare, Japan)
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Affiliation(s)
- Shamima Akter
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Md Mizanur Rahman
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Thomas Rouyard
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
- Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA
| | - Sarmin Aktar
- Global Public Health Research Foundation, Dhaka, Bangladesh
| | | | - Ryota Nakamura
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan.
- Graduate School of Economics, Hitotsubashi University, Tokyo, Japan.
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Horn K, Johnson SB, Patiño SRG, Krost K, Gray T, Dearfield C, Du C, Bernat D. Implementation of the Department of Housing and Urban Development's Smoke-Free Rule: A Socio-Ecological Qualitative Assessment of Administrator and Resident Perceptions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8908. [PMID: 34501498 PMCID: PMC8431491 DOI: 10.3390/ijerph18178908] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/19/2021] [Accepted: 08/21/2021] [Indexed: 11/26/2022]
Abstract
In July 2018, the United States Department of Housing and Urban Development (HUD) implemented a mandatory smoke-free rule in public housing. This study assessed administrator and resident perceptions of rule implementation during its initial year in the District of Columbia Housing Authority (DCHA). Assessment included nine focus groups (n = 69) with residents and in-depth interviews with administrators (n = 7) and residents (n = 26) from 14 DCHA communities (family = 7 and senior/disabled = 7). Semi-structured discussion guides based on the multi-level socio-ecological framework captured dialogue that was recorded, transcribed verbatim, and coded inductively. Emerging major themes for each socio-ecological framework level included: (1) Individual: the rule was supported due to perceived health benefits, with stronger support among non-smokers; (2) Interpersonal: limiting secondhand smoke exposure was perceived as a positive for vulnerable residents; (3) Organizational: communication, signage, and cessation support was perceived as a need; (4) Community: residents perceived mobility, disability, weather, and safety-related issues as barriers; and (5) Public Policy: lease amendments were perceived as enablers of rule implementation but expressed confusion about violations and enforcement. A majority of administrators and residents reported favorable implications of the mandated HUD rule. The novel application of a socio-ecological framework, however, detected implementation nuances that required improvements on multiple levels, including more signage, cessation support, clarification of enforcement roles, and addressing safety concerns.
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Affiliation(s)
- Kimberly Horn
- Department of Population Health Sciences, Virginia Tech Carilion Research Institute, Riverside Circle, Roanoke, VA 24016, USA
| | - Sallie Beth Johnson
- Department of Public Health and Healthcare Leadership, Radford University Carilion, 101 Elm Avenue, SE, Roanoke, VA 24013, USA;
| | | | - Kevin Krost
- Department of Leadership, Counseling, and Research, Virginia Tech, Blacksburg, VA 24060, USA; (K.K.); (C.D.)
| | - Tiffany Gray
- Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, 905 New Hampshire Avenue, Northwest, Washington, DC 20052, USA; (T.G.); (C.D.); (D.B.)
| | - Craig Dearfield
- Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, 905 New Hampshire Avenue, Northwest, Washington, DC 20052, USA; (T.G.); (C.D.); (D.B.)
| | - Chenguang Du
- Department of Leadership, Counseling, and Research, Virginia Tech, Blacksburg, VA 24060, USA; (K.K.); (C.D.)
| | - Debra Bernat
- Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, 905 New Hampshire Avenue, Northwest, Washington, DC 20052, USA; (T.G.); (C.D.); (D.B.)
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Titus AR, Thrasher JF, Gamarel KE, Meza R, Fleischer NL. Smoke-Free Laws and Disparities in Secondhand Smoke Exposure Among Nonsmoking Adults in the United States, 1999-2014. Nicotine Tob Res 2021; 23:1527-1535. [PMID: 33690865 PMCID: PMC8372649 DOI: 10.1093/ntr/ntab038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 03/02/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Little is known about the relationship between smoke-free laws and persistent disparities in secondhand smoke (SHS) exposure among nonsmoking adults in the United States. AIMS AND METHODS We constructed time-varying smoke-free law measures representing whether or not at least 50% of each US county's population was covered by smoke-free laws in workplaces and hospitality venues (restaurants/bars). We merged these data with restricted data on cotinine-derived SHS exposure among nonsmokers from the National Health and Nutrition Examination Survey, 1999-2014 (N = 25 444). Using logistic regression, we estimated associations between smoke-free law coverage and SHS exposure among all nonsmokers, and within age strata (25-39, 40-59, 60+). We explored differential associations by gender, race/ethnicity, education, and poverty-income ratio (PIR) by testing the significance of interactions terms for the full sample and within age strata. RESULTS In adjusted models, hospitality coverage was associated with lower odds of SHS exposure in the full sample (odds ratio [OR] = 0.62; 95% confidence interval [CI] = 0.51-0.76), and within each age group, with ORs ranging from 0.58 (ages 25-39) to 0.67 (ages 60+). Workplace coverage was associated with lower SHS exposure only among younger adults (OR = 0.81; 95% CI = 0.65-0.99). Within the full sample and among adults ages 40-59, hospitality laws were associated with narrowing SHS exposure differentials between males and females. Among adults ages 40-59, workplace laws were associated with narrowing exposure differentials between males and females, but worsening exposure disparities by PIR. CONCLUSIONS Smoke-free laws may reduce SHS exposure among adult nonsmokers, but may be insufficient to improve disparities in SHS exposure. IMPLICATIONS In a repeated cross-sectional sample of adult nonsmokers, smoke-free laws in hospitality venues were consistently associated with lower odds of SHS exposure and appeared to narrow exposure differentials between males and females. Associations between workplace smoke-free laws and SHS exposure were variable by age. Among adults ages 40-59, workplace laws were associated with narrowing exposure differentials between males and females while exacerbating exposure differentials by PIR. Differential patterns of association highlight the need to examine the impacts of tobacco control policies on downstream health equity.
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Affiliation(s)
- Andrea R Titus
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Kristi E Gamarel
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Rafael Meza
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Nancy L Fleischer
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Sedney CL, Khodaverdi M, Pollini R, Dekeseredy P, Wood N, Haggerty T. Assessing the impact of a restrictive opioid prescribing law in West Virginia. Subst Abuse Treat Prev Policy 2021; 16:14. [PMID: 33526045 PMCID: PMC7852151 DOI: 10.1186/s13011-021-00349-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The Opioid Reduction Act (SB 273) took effect in West Virginia in June 2018. This legislation limited ongoing chronic opioid prescriptions to 30 days' supply, and first-time opioid prescriptions to 7 days' supply for surgeons and 3 days' for emergency rooms and dentists. The purpose of this study was to determine the effect of this legislation on reducing opioid prescriptions in West Virginia, with the goal of informing future similar policy efforts. METHODS Data were requested from the state Prescription Drug Monitoring Program (PDMP) including overall number of opioid prescriptions, number of first-time opioid prescriptions, average daily morphine milligram equivalents (MME) and prescription duration (expressed as "days' supply") given to adults during the 64 week time periods before and after legislation enactment. Statistical analysis was done utilizing an autoregressive integrated moving average (ARIMA) interrupted time series analysis to assess impact of both legislation announcement and enactment while controlling secular trends and considering autocorrelation trends. Benzodiazepine prescriptions were utilized as a control. RESULTS Our analysis demonstrates a significant decrease in overall state opioid prescribing as well as a small change in average daily MME associated with the date of the legislation's enactment when considering serial correlation in the time series and accounting for pre-intervention trends. There was no such association found with benzodiazepine prescriptions. CONCLUSION Results of the current study suggest that SB 273 was associated with an average 22.1% decrease of overall opioid prescriptions and a small change in average daily MME relative to the date of legislative implementation in West Virginia. There was, however, no association of the legislation on first-time opioid prescriptions or days' supply of opioid medication, and all variables were trending downward prior to implementation of SB 273. The control demonstrated no relationship to the law.
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Affiliation(s)
- Cara L Sedney
- School of Medicine, West Virginia University, Morgantown, WV, 26505, USA.
| | - Maryam Khodaverdi
- West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA
| | - Robin Pollini
- Department of Behavioral Medicine & Psychiatry, West Virginia University, Morgantown, WV, USA
- Department of Epidemiology, West Virginia University, Morgantown, WV, USA
| | | | - Nathan Wood
- West Virginia Board of Pharmacy, Charleston, WV, USA
| | - Treah Haggerty
- School of Medicine, West Virginia University, Morgantown, WV, 26505, USA
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Patanavanich R, Glantz SA. Association between tobacco control policies and hospital admissions for acute myocardial infarction in Thailand, 2006-2017: A time series analysis. PLoS One 2020; 15:e0242570. [PMID: 33264315 PMCID: PMC7710088 DOI: 10.1371/journal.pone.0242570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/04/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Studies in many countries have documented reductions of acute myocardial infarction (AMI) hospitalizations with smokefree policies. However, evidence on the association of cigarette tax with AMI events is unclear. There have been no studies of the associations between these two policies and AMI hospitalizations in Thailand. Methods We used negative binomial time series analyses of AMI hospitalizations (ICD-10 codes I21.0-I21.9), stratified by sex and age groups, from October 2006 to September 2017 to determine whether there was a change in AMI hospitalizations as a result of the changes in cigarette prices and the implementation of a 100% smokefree law. Results Cigarette price increases were associated with a significant 4.7% drop in AMI hospitalizations among adults younger than 45 (incidence rate ratio [IRR], 0.953; 95% confidence interval [CI], 0.914–0.993; p = 0.021). Implementation of the 100% smokefree law was followed by a significant 13.1% drop in AMI hospitalizations among adults younger than 45 (IRR, 0.869; 95% CI, 0.801–0.993; P = 0.001). There were not significant associations in older age groups. Conclusions The Thai cigarette tax policy and the smokefree law were associated with reduced AMI hospitalizations among younger adults. To improve effectiveness of the policies, taxes should be high enough to increase cigarette price above inflation rates, making cigarettes less likely to be purchased; smokefree laws should be strictly enforced.
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Affiliation(s)
- Roengrudee Patanavanich
- Center for Tobacco Control Research and Education, Department of Medicine, University of California San Francisco, San Francisco, California, United State of America
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Stanton A. Glantz
- Center for Tobacco Control Research and Education, Department of Medicine, University of California San Francisco, San Francisco, California, United State of America
- * E-mail:
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Odoi EW, Nagle N, DuClos C, Kintziger KW. Disparities in Temporal and Geographic Patterns of Myocardial Infarction Hospitalization Risks in Florida. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4734. [PMID: 31783516 PMCID: PMC6926732 DOI: 10.3390/ijerph16234734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/23/2019] [Accepted: 11/24/2019] [Indexed: 12/12/2022]
Abstract
Knowledge of geographical disparities in myocardial infarction (MI) is critical for guiding health planning and resource allocation. The objectives of this study were to identify geographic disparities in MI hospitalization risks in Florida and assess temporal changes in these disparities between 2005 and 2014. This study used retrospective data on MI hospitalizations that occurred among Florida residents between 2005 and 2014. We identified spatial clusters of hospitalization risks using Kulldorff's circular and Tango's flexible spatial scan statistics. Counties with persistently high or low MI hospitalization risks were identified. There was a 20% decline in hospitalization risks during the study period. However, we found persistent clustering of high risks in the Big Bend region, South Central and southeast Florida, and persistent clustering of low risks primarily in the South. Risks decreased by 7%-21% in high-risk clusters and by 9%-28% in low-risk clusters. The risk decreased in the high-risk cluster in the southeast but increased in the Big Bend area during the last four years of the study. Overall, risks in low-risk clusters were ahead those for high-risk clusters by at least 10 years. Despite MI risk declining over the study period, disparities in MI risks persist. Eliminating/reducing those disparities will require prioritizing high-risk clusters for interventions.
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Affiliation(s)
- Evah W. Odoi
- Comparative and Experimental Medicine, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN 37996, USA;
| | - Nicholas Nagle
- Department of Geography, The University of Tennessee, Knoxville, TN 37996, USA;
| | - Chris DuClos
- Environmental Public Health Tracking, Division of Community Health Promotion, Florida Department of Health, Tallahassee, FL 32399, USA;
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Kawamura K, Nakai A, Yamada K, Morioka I. [Association of the Status of Implementation of Nonsmoking at Eating and Drinking Establishments with Prevalence of Persons with Subjective Symptoms, Prevalence of Persons with Diseases under Treatment, Medical Expenses, and Mortality Rate: Examination Using Prefectural Data]. Nihon Eiseigaku Zasshi 2019; 74. [PMID: 31534066 DOI: 10.1265/jjh.19006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The purpose of this study was to confirm the association of the status of implementation of nonsmoking at eating and drinking establishments with the prevalence of persons with subjective symptoms, the prevalence of persons with diseases under treatment, medical expenses, and mortality rate using prefectural data. METHODS The prefectural rate of eating and drinking establishments implementing nonsmoking (hereafter, nonsmoking rate) was calculated using the data from "Tabelog®". The variables of interest were the prevalence of persons with subjective symptoms, the prevalence of persons with diseases under treatment, medical expenses (total, hospitalization and nonhospitalization expenses), and the mortality rates of malignant neoplasms (lung cancer, stomach cancer, and colon cancer), heart disease, acute myocardial infarction, cerebrovascular disease, cerebral infarction, and pneumonia in each prefecture. The partial correlation coefficient was estimated between the nonsmoking rate and the variable of interest using the smoking rate by prefectural as the control variable. RESULTS The nonsmoking rate showed a significantly negative correlation with the medical expenses. When eating and drinking establishments were divided into "restaurant", "café", and "bar", the nonsmoking rate also indicated a significantly negative correlation with the medical expenses in any category. It was negatively related to the mortality rates of cerebrovascular disease, cerebral infarction, and pneumonia. The negative correlation was stronger in females than in males. CONCLUSIONS These results suggest that the implementation of nonsmoking at eating and drinking establishments may reduce the mortality rates of diseases, such as cerebrovascular disease, cerebral infarction, and pneumonia, and medical expenses. Thus, it is important to implement nonsmoking at eating and drinking establishments in line with the Revised Health Promotion Act.
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Affiliation(s)
- Kosuke Kawamura
- Department of Nursing, Faculty of Nursing, Kyoto Tachibana University.,Graduate School of Health and Nursing Science, Wakayama Medical University
| | - Ai Nakai
- Graduate School of Health and Nursing Science, Wakayama Medical University
| | - Kazuko Yamada
- Graduate School of Health and Nursing Science, Wakayama Medical University
| | - Ikuharu Morioka
- Graduate School of Health and Nursing Science, Wakayama Medical University
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Lee PN, Fry JS, Thornton AJ. Updating the evidence relating smoking bans to incidence of heart disease. Regul Toxicol Pharmacol 2018; 101:172-186. [PMID: 30500390 DOI: 10.1016/j.yrtph.2018.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 10/25/2018] [Accepted: 11/26/2018] [Indexed: 11/18/2022]
Abstract
In our latest update of the evidence on smoking bans and heart disease we summarize 59 studies. We take account of the underlying trends in incidence rates as far as possible by using control data in eight studies, and by adjustment based on observed trends in cases pre- and post-ban in 40 studies, being unable to make an adjustment in the remaining 11 studies. Overall, based on 62 independent estimates from the 59 studies, we estimate that bans reduce incidence by 5.0% (95% CI 3.2-6.8%), though this estimate reduces to 2.9% (0.01-5.6%) when we exclude regional estimates where national estimates are available, and studies where trend adjustment is not possible. For 25 of the studies, quadratic rather than linear adjustment is possible, but this hardly affects the overall estimates. Ban effects are somewhat greater when the pre-ban period studied is relatively short, and in smaller studies. We compare our findings with those in other recent reviews, one of which totally ignored underlying trends and results from control populations. We discuss reasons why we believe there is likely to be a true small effect of smoking bans, and weaknesses in the data which preclude reaching any very confident conclusion.
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Affiliation(s)
- Peter N Lee
- P.N. Lee Statistics and Computing Ltd, 17 Cedar Road, Sutton, Surrey, SM2 5DA, UK.
| | - John S Fry
- ROELEE Statistics Ltd, 17 Cedar Road, Sutton, Surrey, SM2 5DA, UK
| | - Alison J Thornton
- Independent Consultant, Oak Cottage, Beer Farm, Okehampton, Devon, EX20 1SG, UK
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Mayne SL, Widome R, Carroll AJ, Schreiner PJ, Gordon-Larsen P, Jacobs DR, Kershaw KN. Longitudinal Associations of Smoke-Free Policies and Incident Cardiovascular Disease: CARDIA Study. Circulation 2018; 138:557-566. [PMID: 29735485 PMCID: PMC6202173 DOI: 10.1161/circulationaha.117.032302] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/21/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Smoke-free legislation has been associated with lower rates of cardiovascular disease hospital admissions in ecological studies. However, prior studies lacked detailed information on individual-level factors (eg, sociodemographic and clinical characteristics) that could potentially confound associations. Our objective was to estimate associations of smoke-free policies with incident cardiovascular disease in a longitudinal cohort after controlling for sociodemographics, cardiovascular disease risk factors, and policy covariates. METHODS Longitudinal data from 3783 black and white adults in the CARDIA study (Coronary Artery Risk Development in Young Adults; 1995-2015) were linked to state, county, and local 100% smoke-free policies in bars, restaurants, and nonhospitality workplaces by Census tract. Extended Cox regression estimated hazard ratios (HRs) of incident cardiovascular disease associated with time-dependent smoke-free policy exposures. Models were adjusted for sociodemographic characteristics, cardiovascular disease risk factors, state cigarette tax, participant-reported presence of a smoking ban at their workplace, field center, and metropolitan statistical area poverty. RESULTS During a median follow-up of 20 years (68 332 total person-years), 172 participants had an incident cardiovascular disease event (2.5 per 1000 person-years). Over the follow-up period, 80% of participants lived in areas with smoke-free policies in restaurants, 67% in bars, and 65% in nonhospitality workplaces. In fully adjusted models, participants living in an area with a restaurant, bar, or workplace smoke-free policy had a lower risk of incident cardiovascular disease compared with those in areas without smoke-free policies (HR, 0.75, 95% confidence interval, 0.49-1.15; HR, 0.76, 95% confidence interval, 0.47-1.24; HR, 0.54, 95% confidence interval, 0.34-0.86, respectively; HR, 0.58, 95% confidence interval, 0.33-1.00 for living in an area with all 3 types of policies compared with none). The estimated preventive fraction was 25% for restaurant policies, 24% for bar policies, and 46% for workplace policies. CONCLUSIONS Consistent with prior ecological studies, these individual-based data add to the evidence that 100% smoke-free policies are associated with lower risk of cardiovascular disease among middle-aged adults.
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Affiliation(s)
- Stephanie L Mayne
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.L.M., A.J.C., K.N.K.)
| | - Rachel Widome
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneap-olis (R.W., P.J.S., D.R.J.)
| | - Allison J Carroll
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.L.M., A.J.C., K.N.K.)
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneap-olis (R.W., P.J.S., D.R.J.)
| | - Penny Gordon-Larsen
- Department of Nutrition, University of North Carolina Gillings School of Public Health, Chapel Hill (P.G.-L.)
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneap-olis (R.W., P.J.S., D.R.J.)
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.L.M., A.J.C., K.N.K.)
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Higgins ST. Editorial: 3rd Special Issue on behavior change, health, and health disparities. Prev Med 2016; 92:1-5. [PMID: 27693562 PMCID: PMC5384999 DOI: 10.1016/j.ypmed.2016.09.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 09/23/2016] [Indexed: 01/22/2023]
Abstract
This Special Issue of Preventive Medicine (PM) is the 3rd that we have organized on behavior change, health, and health disparities. This is a topic of critical importance to improving U.S. population health. There is broad scientific consensus that personal behaviors such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. Hence, effectively promoting health-related behavior change needs to be a key component of health care research and policy. There is also broad recognition that while these problems extend throughout the population, they disproportionately impact economically disadvantaged populations and other vulnerable populations and represent a major contributor to health disparities. Thus, behavior change represents an essential step in curtailing health disparities, which receives special attention in this 3rd Special Issue. We also devote considerable space to the longstanding challenges of reducing cigarette smoking and use of other tobacco and nicotine delivery products in vulnerable populations, obesity, and for the first time food insecurity. Across each of these topics we include contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges.
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Affiliation(s)
- Stephen T Higgins
- Vermont Center on Behavior and Health, Departments of Psychiatry and Psychological Science, University of Vermont, United States.
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