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Sassano M, Mariani M, Pastorino R, Ricciardi W, La Vecchia C, Boccia S. Association of national smoke-free policies with per-capita cigarette consumption and acute myocardial infarction mortality in Europe. J Epidemiol Community Health 2024; 78:388-394. [PMID: 38485217 PMCID: PMC11103332 DOI: 10.1136/jech-2023-220746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 02/03/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Evidence on the association between smoke-free policies and per-capita cigarette consumption and mortality due to acute myocardial infarction (AMI) in Europe is limited. Hence, we aimed to assess this association and to evaluate which factors influence it. METHODS We performed an interrupted time series analysis, including 27 member states of the European Union and the UK, on per-capita cigarette consumption and AMI mortality.A multivariate meta-regression was used to assess the potential influence of other factors on the observed associations. RESULTS Around half of the smoke-free policies introduced were associated with a level or slope change, or both, of per-capita cigarette consumption and AMI mortality (17 of 35). As for cigarette consumption, the strongest level reduction was observed for the smoking ban issued in 2010 in Poland (rate ratio (RR): 0.47; 95% CI: 0.41, 0.53). Instead, the largest level reduction of AMI mortality was observed for the intervention introduced in 2012 in Bulgaria (RR: 0.38; 95% CI: 0.34, 0.42).Policies issued more recently or by countries with a lower human development index were found to be associated with a larger decrease in per-capita cigarette consumption. In addition, smoking bans applying to bars had a stronger inverse association with both cigarette consumption and AMI mortality. CONCLUSIONS The results of our study suggest that smoke-free policies are effective at reducing per-capita cigarette consumption and AMI mortality. It is extremely important to monitor and register data on tobacco, its prevalence and consumption to be able to tackle its health effects with concerted efforts.
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Affiliation(s)
- Michele Sassano
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marco Mariani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberta Pastorino
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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2
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Felsinger R, Groman E. Price Policy and Taxation as Effective Strategies for Tobacco Control. Front Public Health 2022; 10:851740. [PMID: 35450118 PMCID: PMC9016194 DOI: 10.3389/fpubh.2022.851740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/15/2022] [Indexed: 11/28/2022] Open
Abstract
Objective Only 13% of the world's population are living in countries imposing appropriate tobacco tax-rates. This study aims to promote the implementation of price policy measures as a striking tobacco control strategy in Austria and to encourage other countries to further increase their taxes to WHO best-practice levels. Method This study used the yearly economic data from Austria from 1997 to 2015. Applying a model for regression analysis, the price elasticity of total tobacco consumption was estimated. Results Between 1997 and 2015 the price elasticity of demand for tobacco products (including cigarettes, cigars, and other tobaccos) was -0.661, however, the result is statistically insignificant. When excluding 2 anomalous years and removing a variable of the regression model the elasticity was -0.691 and statistically significant, indicating that a 1% increase in tobacco prices will result in a 0.691% decrease of tobacco consumption. Conclusion The responsiveness of Austrian smokers to price changes has increased during the last decades. Because other activities showed no significance in the analysis, this study should encourage countries world-wide to use price policy and taxation more intensively in order to reduce smoking rates effectively.
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Affiliation(s)
- Richard Felsinger
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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3
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Christian WJ, Walker CJ, Huang B, Hahn EJ. Effect of Local Smoke-Free Ordinances on Smoking Prevalence in Kentucky, 2002-2009. South Med J 2019; 112:369-375. [PMID: 31282965 PMCID: PMC6687407 DOI: 10.14423/smj.0000000000001000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Many local communities in Kentucky, a state with one of the highest smoking prevalence rates in the United States, have enacted smoke-free ordinances that prohibit smoking in workplaces and enclosed buildings open to the public. Research has shown that such ordinances are clearly beneficial for public health, but their influence on smoking prevalence in the populations they cover remains unclear. This study explores the effect of local smoke-free ordinances on smoking prevalence in Kentucky. METHODS We used a database of smoke-free ordinances maintained by the Kentucky Center for Smoke-Free Policy, Kentucky Behavioral Risk Factor Surveillance System survey data, and US Census data. We estimated the proportion of Kentucky adults living in counties with smoke-free ordinances of varying strength; examined bivariate associations between smoke-free ordinances and smoking prevalence; and fit regression models that adjusted for various county-level demographic, socioeconomic, and geographic factors. RESULTS Smoking prevalence was approximately 5% lower in counties with smoke-free ordinances, even after adjusting for other relevant factors, including a trend in decreasing prevalence throughout the study region. There was a slight dose-response effect related to the strength of smoke-free ordinances after adjustment for these covariates. Smoke-free ordinances appear to have a modest effect on smoking prevalence across the span of several years. CONCLUSIONS Findings demonstrate that although smoking prevalence fell throughout the state during the study period, counties with smoke-free ordinances experienced a greater decline. Future research should examine the strength of smoke-free ordinances in greater detail to better understand their influence on smoking prevalence.
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Affiliation(s)
- W Jay Christian
- From the Department of Epidemiology, College of Public Health, the Markey Cancer Center, College of Medicine, and BREATHE, College of Nursing, University of Kentucky, Lexington
| | - Courtney J Walker
- From the Department of Epidemiology, College of Public Health, the Markey Cancer Center, College of Medicine, and BREATHE, College of Nursing, University of Kentucky, Lexington
| | - Bin Huang
- From the Department of Epidemiology, College of Public Health, the Markey Cancer Center, College of Medicine, and BREATHE, College of Nursing, University of Kentucky, Lexington
| | - Ellen J Hahn
- From the Department of Epidemiology, College of Public Health, the Markey Cancer Center, College of Medicine, and BREATHE, College of Nursing, University of Kentucky, Lexington
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Scaioli G, Bert F, Martorana M, Gili R, Thomas R, Gualano MR, Siliquini R. Advertisement of electronic cigarettes in Italy: characteristics of online videos and the most popular promotional messages. HEALTH EDUCATION RESEARCH 2018; 33:473-480. [PMID: 30247572 DOI: 10.1093/her/cyy030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 09/18/2018] [Indexed: 06/08/2023]
Abstract
Given the increasing popularity of electronic cigarettes (ECs) and a lack of regulation of EC advertising, this study aimed to analyse online videos promoting ECs to assess the main marketing messages that could influence consumers' perceptions of associated risks and benefits. A web search of EC advertising videos was performed on YouTube by using keywords related to EC promotion. An evaluation grid was used to analyse promotional messages contained in each video. The most frequent promotional messages were related to health benefits (67.7%) and to the possibility of quitting smoking (57.4%). Messages that could also be appealing to adolescents and young adults, such as those promoting the multiple flavors available and the technological improvement of ECs, were present in 41.2% and 42.7% of the videos respectively. ECs similar to traditional cigarettes in appearance were included in 52.9% of the videos. EC promotional videos address messages not only to smokers who want to quit or decrease tobacco consumption but also to nonsmokers, especially young people. The use of ECs similar to traditional cigarettes may be a gateway to tobacco cigarette use. Since EC use may represent an important public health concern, regulatory policies on EC advertising should be established.
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Affiliation(s)
- G Scaioli
- Department of Public Health Sciences, University of Turin, Via Santena 5bis, Turin, Italy
| | - F Bert
- Department of Public Health Sciences, University of Turin, Via Santena 5bis, Turin, Italy
| | - M Martorana
- Department of Public Health Sciences, University of Turin, Via Santena 5bis, Turin, Italy
| | - R Gili
- Department of Public Health Sciences, University of Turin, Via Santena 5bis, Turin, Italy
| | - R Thomas
- Department of Public Health Sciences, University of Turin, Via Santena 5bis, Turin, Italy
| | - M R Gualano
- Department of Public Health Sciences, University of Turin, Via Santena 5bis, Turin, Italy
| | - R Siliquini
- Department of Public Health Sciences, University of Turin, Via Santena 5bis, Turin, Italy
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Abu Ghazaleh H, Mulnier H, Duaso M. A qualitative approach exploring the experiences of smoking and quitting attempts in type 1 diabetes. J Clin Nurs 2018; 27:3091-3103. [DOI: 10.1111/jocn.14499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2018] [Indexed: 12/26/2022]
Affiliation(s)
| | | | - Maria Duaso
- Florence Nightingale Faculty of Nursing and Midwifery; London UK
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Borsari L, Storani S, Malagoli C, Filippini T, Tamelli M, Malavolti M, Nicolini F, Vinceti M. Impact of Referral Sources and Waiting Times on the Failure to Quit Smoking: One-Year Follow-Up of an Italian Cohort Admitted to a Smoking Cessation Service. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1234. [PMID: 29891823 PMCID: PMC6025586 DOI: 10.3390/ijerph15061234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/01/2018] [Accepted: 06/09/2018] [Indexed: 11/21/2022]
Abstract
In Italy, the National Health Service offers specialized evidence-based support to smokers who would like to quit through smoking cessation (SC) services. We conducted a two-year prospective study, involving all 288 subjects treated for smoking cessation at the SC service of Reggio Emilia, to assess the association of referral sources and waiting times with the risk of treatment failure, by following participants up to one year after the quit date. We performed Cox-regression analysis, including demographic and smoking-related characteristics as confounding variables. The treatment failure rate at 12 months was 59.4% (171/288), including only 12 subjects lost to follow-up. The main mode of entry was self-referral (42.4%), followed by 32.6% from general practice, 17.4% from hospital and 7.6% from other sources. Only 27.8% participants were involved in the SC-program within 60 days of the first contact, as the guidelines suggest. The risk of treatment failure at 12 months showed little association with the type of referral source, while it correlated with waiting times ≥ 60 days (hazard ratio = 1.59; 95% confidence interval 1.10⁻2.29). This study provides evidence of long-term high quit rates from a SC service, with few subjects lost to follow-up and biochemical verification of almost all abstinent subjects. Timeliness in care provision could further improve the outcome.
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Affiliation(s)
- Lucia Borsari
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy.
| | - Simone Storani
- Local Health Authority of Reggio Emilia-IRCCS, via Amendola 2, 42122 Reggio Emilia, Italy.
| | - Carlotta Malagoli
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
| | - Tommaso Filippini
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
| | - Marco Tamelli
- Promotion Health Researcher, League against Cancer, via Amendola 2, 42122 Reggio Emilia, Italy.
| | - Marcella Malavolti
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
| | - Fausto Nicolini
- Local Health Authority of Reggio Emilia-IRCCS, via Amendola 2, 42122 Reggio Emilia, Italy.
| | - Marco Vinceti
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA.
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Lorenzoni G, Azzolina D, Lanera C, Brianti G, Gregori D, Vanuzzo D, Baldi I. Time trends in first hospitalization for heart failure in a community-based population. Int J Cardiol 2018; 271:195-199. [PMID: 29885830 DOI: 10.1016/j.ijcard.2018.05.132] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 05/22/2018] [Accepted: 05/31/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND This study aims to assess time trends in first hospitalization for heart failure (HF) in a community-based population over the period from 1977 to 2014. METHODS Population-based cohort study using resources from the "Martignacco project" started in 1977 and promoted by the WHO. Three thousand and sixty-six subjects were involved in the project with follow-up through December 2014. Estimates were made for age-specific incidence rates for the first hospitalization for HF by birth cohort, calendar period, and gender. To disentangle the effects of age, calendar period, and birth cohort on the overall temporal trend in HF, we performed an age-period-cohort (APC) analysis. RESULTS An incident hospitalization for HF was reported for 427 subjects. In the APC model, a cohort effect with a turning point in 1930 was observed. After 1930, a sharp decrease in the rate ratios (RRs) occurred in among both genders. The estimated RR in the 1940 birth cohort decreased to 0.43, (95% CI 0.19-0.92), in men and to 0.45, (95% CI 0.16-1.26), in women. A residual effect of calendar period on RR was observed with a plateau in 1995 for women and in 2000 for men, followed by a decline. CONCLUSIONS The current findings showed that HF hospitalization incidence has declined over the period considered in subjects over 65 years living in a geographically defined community in Northeast Italy. Moreover, the age of birth, calendar period of diagnosis, and birth cohort play an important role in the incidence of the first hospitalization for HF.
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Affiliation(s)
- Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Corrado Lanera
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Giorgio Brianti
- Department of Prevention, ASS 4 'Medio Friuli', Udine, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Diego Vanuzzo
- National Association of Hospital Cardiologists, ANMCO (Associazione Nazionale Medici Cardiologi Ospedalieri) and Heart Care Foundation (Fondazione per il Tuo Cuore) Onlus, Firenze, Italy; Center for Cardiovascular Prevention, ASS 4 'Medio Friuli', Udine, Italy
| | - Ileana Baldi
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
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Mayne SL, Auchincloss AH, Tabb LP, Stehr M, Shikany JM, Schreiner PJ, Widome R, Gordon-Larsen P. Associations of Bar and Restaurant Smoking Bans With Smoking Behavior in the CARDIA Study: A 25-Year Study. Am J Epidemiol 2018; 187:1250-1258. [PMID: 29860468 PMCID: PMC5982712 DOI: 10.1093/aje/kwx372] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 11/17/2017] [Accepted: 12/07/2017] [Indexed: 11/14/2022] Open
Abstract
Indoor smoking bans have often been associated with reductions in smoking prevalence. However, few studies have evaluated their association with within-person changes in smoking behaviors. We linked longitudinal data from 5,105 adults aged 18-30 years at baseline from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-2011) to state, county, and local policies mandating 100% smoke-free bars and restaurants by census tract. We used fixed-effects models to examine the association of smoking bans with within-person change in current smoking risk, smoking intensity (smoking ≥10 cigarettes/day on average vs. <10 cigarettes/day), and quitting attempts, using both linear and nonlinear adjustment for secular trends. In models assuming a linear secular trend, smoking bans were associated with a decline in current smoking risk and smoking intensity and an increased likelihood of a quitting attempt. The association with current smoking was greatest among participants with a bachelor's degree or higher. In models with a nonlinear secular trend, pooled results were attenuated (confidence intervals included the null), but effect modification results were largely unchanged. Findings suggest that smoking ban associations may be difficult to disentangle from other tobacco control interventions and emphasize the importance of evaluating equity throughout policy implementation.
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Affiliation(s)
- Stephanie L Mayne
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Loni Philip Tabb
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Mark Stehr
- School of Economics, LeBow College of Business, Drexel University, Philadelphia, Pennsylvania
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Rachel Widome
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Bohr S, Almarzouqi F, Pallua N. Extensive burn injury caused by fundamental electronic cigarette design flaw. ANNALS OF BURNS AND FIRE DISASTERS 2016; 29:231-233. [PMID: 28149256 PMCID: PMC5266244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 06/23/2016] [Indexed: 06/06/2023]
Abstract
Currently, electronic cigarette (EC) devices are widely used as an alternative to conventional smoking. The underlying technical principle is an electric coil-based vaporizer unit, which vaporizes various solutions for inhalation purposes with a rechargeable lithium battery unit as power source. We report a case of extensive burn injury resulting from the thermal explosion of a battery unit within an EC device. Though internal thermal instabilities of lithium ion batteries are a known safety issue, the unique feature here is a pronounced amplification of the extent of burn injury due to an additional scalding burn mechanism that resulted from heating of the liquid reservoir adjacent to the battery. Thus, we demonstrate a relevant design flaw in various EC devices, which in the authors' opinion needs to be addressed both by manufacturers and safety regulations.
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Affiliation(s)
- S. Bohr
- Corresponding author: Stefan Bohr,
Department of Plastic and Hand Surgery - Burn Centre, University Clinics RWTH Aachen,Pauwelsstr. 30 / 9th Floor, B2 R11, 52074 Aachen,Germany.+49 (0) 241-80-35284+49 (0) 241-80-82634
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10
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Frazer K, Callinan JE, McHugh J, van Baarsel S, Clarke A, Doherty K, Kelleher C. Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database Syst Rev 2016; 2:CD005992. [PMID: 26842828 PMCID: PMC6486282 DOI: 10.1002/14651858.cd005992.pub3] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Smoking bans have been implemented in a variety of settings, as well as being part of policy in many jurisdictions to protect the public and employees from the harmful effects of secondhand smoke (SHS). They also offer the potential to influence social norms and the smoking behaviour of those populations they affect. Since the first version of this review in 2010, more countries have introduced national smoking legislation banning indoor smoking. OBJECTIVES To assess the effects of legislative smoking bans on (1) morbidity and mortality from exposure to secondhand smoke, and (2) smoking prevalence and tobacco consumption. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register, MEDLINE, EMBASE, PsycINFO, CINAHL and reference lists of included studies. We also checked websites of various organisations. Date of most recent search; February 2015. SELECTION CRITERIA We considered studies that reported legislative smoking bans affecting populations. The minimum standard was having an indoor smoking ban explicitly in the study and a minimum of six months follow-up for measures of smoking behaviour. Our search included a broad range of research designs including: randomized controlled trials, quasi-experimental studies (i.e. non-randomized controlled studies), controlled before-and-after studies, interrupted time series as defined by the Cochrane Effective Practice and Organisation of Care Group, and uncontrolled pre- and post-ban data. DATA COLLECTION AND ANALYSIS One author extracted characteristics and content of the interventions, participants, outcomes and methods of the included studies and a second author checked the details. We extracted health and smoking behaviour outcomes. We did not attempt a meta-analysis due to the heterogeneity in design and content of the studies included. We evaluated the studies using qualitative narrative synthesis. MAIN RESULTS There are 77 studies included in this updated review. We retained 12 studies from the original review and identified 65 new studies. Evidence from 21 countries is provided in this update, an increase of eight countries from the original review. The nature of the intervention precludes randomized controlled trials. Thirty-six studies used an interrupted time series study design, 23 studies use a controlled before-and-after design and 18 studies are before-and-after studies with no control group; six of these studies use a cohort design. Seventy-two studies reported health outcomes, including cardiovascular (44), respiratory (21), and perinatal outcomes (7). Eleven studies reported national mortality rates for smoking-related diseases. A number of the studies report multiple health outcomes. There is consistent evidence of a positive impact of national smoking bans on improving cardiovascular health outcomes, and reducing mortality for associated smoking-related illnesses. Effects on respiratory and perinatal health were less consistent. We found 24 studies evaluating the impact of national smoke-free legislation on smoking behaviour. Evidence of an impact of legislative bans on smoking prevalence and tobacco consumption is inconsistent, with some studies not detecting additional long-term change in existing trends in prevalence. AUTHORS' CONCLUSIONS Since the first version of this review was published, the current evidence provides more robust support for the previous conclusions that the introduction of a legislative smoking ban does lead to improved health outcomes through reduction in SHS for countries and their populations. The clearest evidence is observed in reduced admissions for acute coronary syndrome. There is evidence of reduced mortality from smoking-related illnesses at a national level. There is inconsistent evidence of an impact on respiratory and perinatal health outcomes, and on smoking prevalence and tobacco consumption.
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Affiliation(s)
- Kate Frazer
- University College DublinSchool of Nursing, Midwifery & Health SystemsHealth Sciences CentreBelfieldDublin 4Ireland
| | - Joanne E Callinan
- Milford Care CentreLibrary & Information Service, Education, Research & Quality DepartmentPlassey Park RoadCastletroyLimerickIreland000
| | - Jack McHugh
- University College DublinSchool of Public Health, Physiotherapy and Sports ScienceBelfieldDublin 4Ireland
| | - Susan van Baarsel
- University College DublinSchool of Medicine and Medical ScienceDublinIreland
| | - Anna Clarke
- National Immunisation OfficeManor StreetDublin 7Ireland
| | - Kirsten Doherty
- Education and Research CentreDepartment of Preventive Medicine and Health PromotionSt Vincent's University HospitalElm ParkDublin 4Ireland
| | - Cecily Kelleher
- University College DublinSchool of Public Health, Physiotherapy and Sports ScienceBelfieldDublin 4Ireland
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11
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The Effects of Educational Campaigns and Smoking Bans in Public Places on Smokers' Intention to Quit Smoking: Findings from 17 Cities in China. BIOMED RESEARCH INTERNATIONAL 2015; 2015:853418. [PMID: 26064959 PMCID: PMC4434188 DOI: 10.1155/2015/853418] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 04/12/2015] [Accepted: 04/17/2015] [Indexed: 11/17/2022]
Abstract
Despite the perceived success of educational campaigns and smoking bans in public places in China, the actual effects have not been investigated. This study examines the effects of the two policies by major characteristics of smokers and whether the affected smokers have intention to quit smoking. A cross-sectional survey was conducted in 17 cities in China and 16,616 participants were selected using multistage stratified sampling. Logistic regression models were used to examine the effects of educational campaigns and smoking bans in public places on their intention to quit smoking. Results show that the Chinese government should try every means to build its tobacco control publicity and implement various forms of public educational campaigns to enhance smokers' knowledge of the health consequences of smoking. In addition, China should emphasize the enforcement of the existing smoking prohibitions and regulations by implementing local tobacco control legislation and total prohibitions in all public places and workplaces.
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12
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Bert F, Scaioli G, Gualano MR, Siliquini R. How can we bring public health in all policies? Strategies for healthy societies. J Public Health Res 2015; 4:393. [PMID: 25918692 PMCID: PMC4407037 DOI: 10.4081/jphr.2015.393] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/21/2015] [Indexed: 11/22/2022] Open
Abstract
New scenarios are emerging in the European and worldwide context: the ageing of society, the climate changes, the increasing of health inequalities and the financial crisis. In this context, the scientific community and the decision-makers agree on the role of health in all policies (HiAP) strategy in improving the population's health. The HiAP takes into account factors not strictly related to health but with important health consequences. To bring public health in all policies a change is needed, but there are some obstacles to overcome: for instance, the lack of evidence regarding the governance tools and frameworks for HiAP, the difficulty of convincing stakeholders and producing a cultural change in the political positioning of decision-makers. Consequently, it is necessary: i) to implement stronger and responsible decision-support approaches, such as health impact assessment and health technology assessment; ii) to encourage and coordinate all relevant sectors in playing their part in reducing health gaps within the European Union; iii) to strengthen cooperation and make better use of existing networks and existing public health and related institutions. The final aim will be to monitor the impact of the health determinants in order to promote the effective implementation of HiAP approach. Significance for public healthThis paper makes public health professionals aware of the pivotal role that they could play in reducing health inequalities and in helping to overcome the crisis of the European health systems. It discusses how, thanks to a systematic approach based on new instruments like health impact assessment and health technology assessment, and thanks also to a stronger cooperation among stakeholders and policy makers, it is possible to monitor the health determinants and consequently to bring health in all policies.
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Affiliation(s)
- Fabrizio Bert
- Department of Public Health, University of Turin, Italy
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