1
|
Cohen GH, Bor J, Keyes KM, Demmer RT, Stellman SD, Puac-Polanco V, Galea S. What was the impact of tobacco taxes on smoking prevalence and coronary heart disease mortality in the United States -2005-2016, and did it vary by race and gender? Prev Med 2023; 175:107653. [PMID: 37532031 DOI: 10.1016/j.ypmed.2023.107653] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/10/2023] [Accepted: 07/29/2023] [Indexed: 08/04/2023]
Abstract
Tobacco taxes have reduced smoking and coronary heart disease (CHD) mortality, yet few studies have examined heterogeneity of these associations by race and gender. We constructed a yearly panel (2005-2016) that included age-adjusted cigarette smoking prevalence and CHD mortality rates across all 50 U.S. States and the District of Columbia using the Behavioral Risk Factor Surveillance System and Wide-ranging Online Data for Epidemiological Research. We examined associations between changes in total cigarette excise taxes (i.e., federal and state) and changes in smoking prevalence and CHD mortality, using linear regression models with state and year fixed effects. Each dollar of tobacco tax was associated with a reduction in age-adjusted smoking prevalence 1 year later of -0.4 [95% CIs: -0.6, -0.2] percentage points; and a relative reduction in the rate of CHD mortality 2 years later of -2.0% [95% CIs: -3.7%, -0.3%], or -5 deaths/100,000 in absolute terms. Associations between tobacco taxes and smoking prevalence were statistically significantly different by race and gender and were strongest among Black non-Hispanic women (-1.2 [95% CIs: -1.6, -0.8] percentage points). Associations between tobacco taxes and CHD mortality were not statistically significantly different by race and gender, but point estimates for percent changes were highest among Black non-Hispanic men (-2.9%) and Black non-Hispanic women (-3.5%) compared to White non-Hispanic men (-1.8%) and White non-Hispanic women (-1.5%). These findings suggest that tobacco taxation is an effective intervention for reducing smoking prevalence and CHD mortality among White and Black non-Hispanic populations in the United States.
Collapse
Affiliation(s)
- Gregory H Cohen
- Boston University School of Public Health, Department of Epidemiology, 715 Albany St., Boston, MA 02118, United States of America.
| | - Jacob Bor
- Boston University School of Public Health, Department of Global Health, 715 Albany St., Boston, MA 02118, United States of America
| | - Katherine M Keyes
- Columbia University, Mailman School of Public Health, Department of Epidemiology, 722 West 168th St., New York, NY 10032, United States of America
| | - Ryan T Demmer
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, 300 West Bank Office Building, 1300 S. 2nd St., Minneapolis, MN 55454, United States of America
| | - Steven D Stellman
- Columbia University, Mailman School of Public Health, Department of Epidemiology, 722 West 168th St., New York, NY 10032, United States of America
| | - Victor Puac-Polanco
- Harvard Medical School, Department of Health Care Policy, 180 Longwood Avenue, Boston, MA 02115, United States of America
| | - Sandro Galea
- Boston University School of Public Health, Office of the Dean, 715 Albany St., Boston, MA 02118, United States of America
| |
Collapse
|
2
|
Akter S, Islam MR, Rahman MM, Rouyard T, Nsashiyi RS, Hossain F, Nakamura R. Evaluation of Population-Level Tobacco Control Interventions and Health Outcomes: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2322341. [PMID: 37418258 PMCID: PMC10329215 DOI: 10.1001/jamanetworkopen.2023.22341] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/22/2023] [Indexed: 07/08/2023] Open
Abstract
Importance Smoking causes considerable noncommunicable diseases, perinatal morbidity, and mortality. Objective To investigate the associations of population-level tobacco-control policies with health outcomes. Data Sources PubMed, EMBASE, Web of Science, Cumulated Index to Nursing and Allied Health Literature, and EconLit were searched from inception to March 2021 (updated on 1 March 2022). References were manually searched. Study Selection Studies reporting on associations of population-level tobacco control policies with health-related outcomes were included. Data were analyzed from May to July 2022. Data Extraction and Synthesis Data were extracted by 1 investigator and cross-checked by a second investigator. Analyses were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Main Outcomes and Measures The primary outcomes were respiratory system disease (RSD), cardiovascular disease (CVD), cancer, mortality, hospitalization, and health care utilization. The secondary outcomes were adverse birth outcomes, such as low birth weight and preterm birth. Random-effects meta-analysis was used to estimate pooled odds ratios (ORs) and 95% CIs. Results Of 4952 records identified, 144 population-level studies were included in the final analysis; 126 studies (87.5%) were of high or moderate quality. The most frequently reported policies were smoke-free legislation (126 studies), followed by tax or price increases (14 studies), multicomponent tobacco control programs (12 studies), and a minimum cigarette purchase age law (1 study). Smoke-free legislation was associated with decreased risk of all CVD events (OR, 0.90; 95% CI, 0.86-0.94), RSD events (OR, 0.83; 95% CI, 0.72-0.96), hospitalization due to CVD or RSD (OR, 0.91; 95% CI, 0.87-0.95), and adverse birth outcomes (OR, 0.94; 95% CI, 0.92-0.96). These associations persisted in all sensitivity and subgroup analyses, except for the country income category, for which a significant reduction was only observed in high-income countries. In meta-analysis, there was no clear association of tax or price increases with adverse health outcomes. However, for the narrative synthesis, all 8 studies reported statistically significant associations between tax increases and decreases in adverse health events. Conclusions and Relevance In this systematic review and meta-analysis, smoke-free legislation was associated with significant reductions in morbidity and mortality related to CVD, RSD, and perinatal outcomes. These findings support the need to accelerate the implementation of smoke-free laws to protect populations against smoking-related harm.
Collapse
Affiliation(s)
- Shamima Akter
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Md. Rashedul Islam
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Md. Mizanur Rahman
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Thomas Rouyard
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | | | - Fahima Hossain
- Global Public Health Research Foundation, Dhaka, Bangladesh
| | - Ryota Nakamura
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
- Graduate School of Economics, Hitotsubashi University, Tokyo, Japan
| |
Collapse
|
3
|
Gambaryan M, Kontsevaya A, Drapkina O. Impact of National Tobacco Control Policy on Rates of Hospital Admission for Pneumonia: When Compliance Matters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105893. [PMID: 37239619 DOI: 10.3390/ijerph20105893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
A number of studies claim that tobacco control (TC) regulations are associated with reductions in smoking-related hospitalisation rates, but very few have estimated the impact of TC laws (TCL) at both countrywide and regional levels, and none of them have studied the impact of TCL in relation to compliance with TC regulations. This study evaluates the effects of Russian TCL on hospital admission (HA) rates for pneumonia countrywide and in 10 Russian regions and the extent of these effects in connection with the compliance with TCL. Methods: HA rates for pneumonia from 2005-2019 were analysed to compare the periods before and after the adoption of TCL in 2013. An interrupted time series design and a Poisson regression model were used to estimate the immediate and long-term effects of TCL on pneumonia annual hospitalisation rates after the TCL adoption, compared with the pre-law period. The 10 Russian regions were compared using the TCL implementation scale (TCIS) developed on the basis of the results of the Russian TC policy evaluation survey; Spearman's rank correlation and linear regression models were employed. Results showed a 14.3% reduction in HA rates for pneumonia (RR 0.88; p = 0.01) after the adoption of TCL in Russia with significant long-term effect after 2013 (RR 0.86; p = 0.006). Regions with better enforcement of TCL exhibited greater reductions in pneumonia HA rates (rsp = -0.55; p = 0.04); (β = -4.21; p = 0.02). Conclusions: TCL resulted in a sustained reduction in pneumonia hospitalisation rates, but these effects, varying by region, may depend on the scale of the TCL enforcement.
Collapse
Affiliation(s)
- Marine Gambaryan
- National Medical Research Centre for Therapy and Preventive Medicine of the Ministry of Health of Russia, 101990 Moscow, Russia
| | - Anna Kontsevaya
- National Medical Research Centre for Therapy and Preventive Medicine of the Ministry of Health of Russia, 101990 Moscow, Russia
| | - Oxana Drapkina
- National Medical Research Centre for Therapy and Preventive Medicine of the Ministry of Health of Russia, 101990 Moscow, Russia
| |
Collapse
|
4
|
Gambaryan MG, Drapkina OM, Kontsevaya AV, Popovich MV, Salagai OO. Monitoring and evaluation of the implementation of tobacco control legislation for protecting people from tobacco smoke exposure and health consequences of tobacco use. Methodical guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- M. G. Gambaryan
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. V. Kontsevaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - M. V. Popovich
- National Medical Research Center for Therapy and Preventive Medicine
| | | |
Collapse
|
5
|
Pennington M. Foucault and Hayek on public health and the road to serfdom. PUBLIC CHOICE 2021; 195:125-143. [PMID: 34511655 PMCID: PMC8422831 DOI: 10.1007/s11127-021-00926-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 08/26/2021] [Indexed: 06/13/2023]
Abstract
This paper draws on the work of Michel Foucault and Friedrich Hayek to understand threats to personal and enterprise freedom, arising from public health governance. Whereas public choice theory examines the incentives these institutions provide to agents, the analysis here understands those incentives as framed by discursive social constructions that affect the identity, power, and positionality of different actors. It shows how overlapping discourses of scientific rationalism may generate a 'road to serfdom' narrowing freedom of action and expression across an expanding terrain. As such, the paper contributes to the growing literature emphasising the importance of narratives, stories and metaphors as shaping political economic action in ways feeding through to outcomes and institutions.
Collapse
Affiliation(s)
- Mark Pennington
- Department of Political Economy, King’s College, University of London, London, UK
| |
Collapse
|
6
|
Oliver JF. The impact of smoke-free air laws and conventional cigarette taxes on cardiovascular hospitalizations. Nicotine Tob Res 2021; 24:663-669. [PMID: 34480580 DOI: 10.1093/ntr/ntab158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/03/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Smoke-free air legislation and conventional cigarette taxes have long been used to reduce smoking initiation, prevalence, and conventional cigarette consumption. However, the extent to which these policies affect population health across a range of diagnoses and age groups remains less well understood. METHODS Analyses use 2005-2014 hospital inpatient discharge data from up to 40 US states to estimate the effects of smoke-free air laws and conventional cigarette taxes on cardiovascular hospitalizations among working age and older adults. RESULTS An increase in the percent of a county's population covered by smoke-free air laws yielded a significant decline of 2.4% (RR: 0.976, 95%CI: 0.954, 0.997) in acute cerebrovascular disease hospitalizations among older adults. Moreover, significant declines of 2.0% (RR: 0.980, 95%CI: 0.967, 0.994) and 2.8% (RR: 0.972, 95%CI:0.949, 0.996) in acute cerebrovascular disease were observed among older adults in the first year and subsequent years after smoke-free air legislation was implemented, respectively. Conventional cigarette taxes did not yield a significant change in acute cerebrovascular disease hospitalizations, nor did either tobacco control policy lead to a significant decline in acute myocardial infarction hospitalizations. CONCLUSIONS Smoke-free air laws play an important role in reducing adult cardiovascular hospitalizations. These findings confirm existing research on acute cerebrovascular disease outcomes, as well as the modest effects on acute myocardial infarction hospitalizations observed in state- and national-level analyses. IMPLICATIONS Current research at the local level finds smoke-free air laws yield 40% declines in acute myocardial infarction hospitalizations and 29% declines in acute cerebrovascular disease.State- and national-level analyses find smaller effects of smoke-free air laws, and largely omits analyses of working age adults. Existing research likely suffers from omitted variable bias, including state-level tobacco control funding and local-level conventional cigarette taxes. Using adult hospitalization data from up to 40 states, this study confirms existing evidence at the national and state level, and provides new evidence that smoke-free air laws significantly reduce acute cerebrovascular disease hospitalizations among older adults.
Collapse
Affiliation(s)
- Jon F Oliver
- Department of Health Policy & Management, Yale School of Public Health, New Haven, CT, USA
| |
Collapse
|
7
|
Loftus CJ, Ahn J, Hagedorn JC, Cain M, Holt S, Merguerian P, Shnorhavorian M. The impact of the dependent care provision on individuals with spina bifida transitioning to adulthood. J Pediatr Urol 2021; 17:289.e1-289.e9. [PMID: 33563555 DOI: 10.1016/j.jpurol.2021.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Under the Affordable Care Act, the Dependent Care Provision (DCP) was enacted in 2010 and expanded healthcare coverage for millions of young adults ages 19-25 by allowing them to stay on their parents' insurance until age 26. It is unknown whether the DCP has impacted young adults with SB who are at risk for lapses in insurance coverage as they transition into adult care. OBJECTIVE Our aim was to determine the impact of the DCP on access to care (insurance status) and healthcare-quality (hospital admissions for potentially preventable conditions). METHODS Using the National Inpatient Sample (an all-payor national dataset of hospital admissions), we analyzed pre/post DCP changes for admissions of SB patients ages 19-25. Our outcomes of interest were rates of insurance coverage and proportion of admissions due to potentially preventable conditions (UTI, pyelonephritis, skin conditions, osteomyelitis, sepsis, and pneumonia). Analysis included a difference-in-differences logistic regression model which compared the pre/post DCP difference (2006-s quarter of 2010 vs. 2011-2013) in patients ages 19-25 to the difference in patients ages 26-32 who were ineligible for the DCP policy. RESULTS For admissions of SB patients ages 19-25, the DCP was not associated with improved insurance status compared to admissions ages 26-32 (0% vs. -0.4%, p = 0.10) and rates of private insurance decreased in both age groups, but more so in ages 26-32 (-2.0% vs. -3.9%, p < 0.001). Private insurance rates increased for admissions of white patients ages 19-25 but not for black and Hispanic groups. An increase in overall insurance status was also seen in young adults from high-income zip codes. Admissions for potentially preventable conditions increased in both age groups by a similar degree (+2.6% vs. +2.5%, p = 0.82). DISCUSSION Under the Affordable Care Act, the DCP failed to improve rates of private insurance or decrease rates of noninsurance for admissions of young adults with SB. Certain race and socioeconomic groups benefited more from this national healthcare policy. Meanwhile, admissions for potentially preventable conditions are common in spina bifida patients, and increased over the study period, suggesting a need for further investigation into optimizing the delivery of healthcare to this complex patient population. CONCLUSION The DCP did not result in improved overall insurance rates or in improved rates of private insurance for admissions of SB patients 18-25 years old.
Collapse
Affiliation(s)
- Christopher J Loftus
- Department of Urology, University of Washington Medical Center, 1959 NE Pacific St, Box 356510, Seattle, WA 98195, USA.
| | - Jennifer Ahn
- Department of Urology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States
| | - Judith C Hagedorn
- Department of Urology, University of Washington Medical Center, 1959 NE Pacific St, Box 356510, Seattle, WA 98195, USA
| | - Mark Cain
- Department of Urology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States
| | - Sarah Holt
- Department of Urology, University of Washington Medical Center, 1959 NE Pacific St, Box 356510, Seattle, WA 98195, USA
| | - Paul Merguerian
- Department of Urology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States
| | - Margarett Shnorhavorian
- Department of Urology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States
| |
Collapse
|
8
|
Mayne SL, Jacobs DR, Schreiner PJ, Widome R, Gordon-Larsen P, Kershaw KN. Associations of Smoke-Free Policies in Restaurants, Bars, and Workplaces With Blood Pressure Changes in the CARDIA Study. J Am Heart Assoc 2019; 7:e009829. [PMID: 30571595 PMCID: PMC6405556 DOI: 10.1161/jaha.118.009829] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Smoke‐free legislation has been associated with reductions in secondhand smoke exposure and cardiovascular disease. However, it remains unknown whether smoke‐free policies are associated with reductions in blood pressure (BP). Methods and Results Longitudinal data from 2606 nonsmoking adult participants of the CARDIA (Coronary Artery Risk Development in Young Adults) Study (1995–2011) were linked to state, county, and local‐level 100% smoke‐free policies in bars, restaurants, and/or nonhospitality workplaces based on participants’ census tract of residence. Mixed‐effects models estimated associations of policies with BP and hypertension trajectories over 15 years of follow‐up. Fixed‐effects regression estimated associations of smoke‐free policies with within‐person changes in systolic and diastolic BP and hypertension. Models were adjusted for sociodemographic, health‐related, and policy/geographic covariates. Smoke‐free policies were associated with between‐person differences and within‐person changes in systolic BP. Participants living in areas with smoke‐free policies had lower systolic BP on average at the end of follow‐up compared with those in areas without policies (adjusted predicted mean differences [in mm Hg]: restaurant: −1.14 [95% confidence interval: −2.15, −0.12]; bar: −1.52 [−2.48, −0.57]; workplace: −1.41 [−2.32, −0.50]). Smoke‐free policies in restaurants and bars were associated with mean within‐person reductions in systolic BP of −0.85 (−1.61, −0.09) and −1.08 (−1.82, −0.34), respectively. Only restaurant policies were associated with a significant within‐person reduction in diastolic BP, of −0.58 (−1.15, −0.01). Conclusions While the magnitude of associations was small at the individual level, results suggest a potential mechanism through which reductions in secondhand smoke because of smoke‐free policies may improve population‐level cardiovascular health. See Editorial by https://10.1161/JAHA.118.011120
Collapse
Affiliation(s)
- Stephanie L Mayne
- 1 Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - David R Jacobs
- 2 Division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis MN
| | - Pamela J Schreiner
- 2 Division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis MN
| | - Rachel Widome
- 2 Division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis MN
| | - Penny Gordon-Larsen
- 3 Department of Nutrition University of North Carolina Gillings School of Global Public Health Chapel Hill NC
| | - Kiarri N Kershaw
- 1 Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| |
Collapse
|
9
|
Stallings-Smith S, Hamadi HY, Peterson BN, Apatu EJI, Spaulding AC. Smoke-Free Policies and 30-Day Readmission Rates for Chronic Obstructive Pulmonary Disease. Am J Prev Med 2019; 57:621-628. [PMID: 31564604 DOI: 10.1016/j.amepre.2019.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Previous evidence has shown that smoke-free policies reduce hospital admissions due to respiratory causes, but the impact on 30-day readmission has not been determined. As 25 states in the U.S. have not adopted comprehensive smoke-free legislation, it is likely that patients return to an environment that increases risk of a secondary event. The aim of this study is to investigate the impact of smoke-free policies on 30-day readmission rates for adults aged ≥65 years following hospitalization for chronic obstructive pulmonary disease in the U.S. METHODS Data from the U.S. Tobacco Control Laws Database, Centers for Medicare and Medicaid Services Hospital Readmissions Reduction Program, American Hospital Association, Area Health Resource File, and U.S. Census Bureau Current Population Survey were merged at the county level for years 2013-2016 and analyzed in 2018. Hierarchical Poisson regression models were utilized to calculate incidence rate ratios to determine the impact of full, partial, and no smoke-free policies on 30-day readmission rates after chronic obstructive pulmonary disease hospitalization. RESULTS Multivariable analysis adjusting for both county and hospital characteristics revealed that the presence of full (incidence rate ratio=0.81, 95% CI=0.76, 0.88) and partial (incidence rate ratio=0.87, 95% CI=0.81, 0.92) smoke-free policies were associated with fewer 30-day readmissions for chronic obstructive pulmonary disease-related hospitalizations when compared with counties with no smoke-free policy. CONCLUSIONS The implementation of smoke-free policies is an effective measure for reducing 30-day readmissions following hospitalization due to chronic obstructive pulmonary disease, with stronger policies resulting in decreased risk. Efforts to reduce chronic obstructive pulmonary disease-related 30-day readmissions should include the implementation of smoke-free policies.
Collapse
Affiliation(s)
- Sericea Stallings-Smith
- Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, Florida.
| | - Hanadi Y Hamadi
- Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida
| | - Breck N Peterson
- Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, Florida
| | - Emma J I Apatu
- Department of Health Research Methods, Evidence, and Impact, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Aaron C Spaulding
- Department of Health Sciences Research, Division of Health Care Policy and Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida
| |
Collapse
|
10
|
Gao M, Li Y, Wang F, Zhang S, Qu Z, Wan X, Wang X, Yang J, Tian D, Zhang W. The effect of smoke-free legislation on the mortality rate of acute myocardial infarction: a meta-analysis. BMC Public Health 2019; 19:1269. [PMID: 31533693 PMCID: PMC6749716 DOI: 10.1186/s12889-019-7408-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/31/2019] [Indexed: 12/29/2022] Open
Abstract
Background Several studies have demonstrated that smoke-free legislation is associated with a reduced risk of mortality from acute myocardial infarction (AMI). This study aimed to examine and quantify the potential effect of smoke-free legislation on AMI mortality rate in different countries. Methods Studies were identified using a systematic search of the scientific literature from electronic databases, including PubMed, Web of Science, ScienceDirect, Embase, Google Scholar, and China National Knowledge Infrastructure (CNKI), from their inception through September 30, 2017. A random effects model was employed to estimate the overall effects of smoke-free legislation on the AMI mortality rate. Subgroup analysis was performed to explore the possible causes of heterogeneity in risk estimates based on sex and age. The results of meta-analysis after excluding the studies with a high risk of bias were reported in this study. Results A total of 10 eligible studies with 16 estimates of effect size were included in this meta-analysis. Significant heterogeneity in the risk estimates was identified (overall I2 = 94.6%, p < 0.001). Therefore, a random effects model was utilized to estimate the overall effect of smoke-free legislation. There was an 8% decline in AMI mortality after introducing smoke-free legislation (RR = 0.92, 95% confidence interval (CI): 0.90–0.94). The results of subgroup analyses showed that smoke-free legislation was significantly associated with lower rates of mortality for the following 5 diagnostic subgroups: smoke-free in workplaces, restaurants and bars (RR = 0.92, 95% CI: 0.90–0.95), smaller sample size (RR = 0.92, 95% CI: 0.89–0.95), study location in Europe (RR = 0.90, 95% CI: 0.85–0.94), regional study area (RR = 0.92, 95% CI: 0.89–0.94), and no previous local smoke-free legislation (RR = 0.91, 95% CI: 0.90–0.93). However, there was not much difference in AMI mortality rates after the legislation between the longer (RR = 0.92, 95% CI: 0.86–0.98) and shorter follow-up duration subgroups (RR = 0.92, 95% CI: 0.89–0.94). Conclusion Smoke-free legislation could significantly reduce the AMI mortality rate by 8%. The reduction in the AMI mortality rate was more significant in studies with more comprehensive laws, without prior smoke-free bans, with a smaller sample size, at the regional level, and with a location in Europe. Electronic supplementary material The online version of this article (10.1186/s12889-019-7408-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Min Gao
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China
| | - Yanyu Li
- School of Humanities and Social Sciences, North China Electric Power University, Baoding, 071000, China
| | - Fugang Wang
- People's Bank of China Jinan Branch, Jinan, 250021, China
| | - Shengfa Zhang
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China
| | - Zhiyong Qu
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China
| | - Xia Wan
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Xiaohua Wang
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China
| | - Jie Yang
- Tobacco control office, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Donghua Tian
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China
| | - Weijun Zhang
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China.
| |
Collapse
|
11
|
Chaloupka FJ, Powell LM, Warner KE. The Use of Excise Taxes to Reduce Tobacco, Alcohol, and Sugary Beverage Consumption. Annu Rev Public Health 2019; 40:187-201. [DOI: 10.1146/annurev-publhealth-040218-043816] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In countries around the world, tobacco use, excessive alcohol consumption, and consumption of sugar-sweetened beverages (SSBs) are significant contributors to the global epidemic of noncommunicable diseases. As a consequence, they contribute, as well, to excess health care costs and productivity losses. A large and growing body of research documents that taxes specific to such products, known as excise taxes, reduce consumption of these products and thereby diminish their adverse health consequences. Although such taxation has historically been motivated primarily by revenue generation, governments are increasingly using these taxes to discourage unhealthy consumption. We review the global evidence on the impact of taxes and prices on the consumption of these products and the health and social consequences. We then evaluate arguments commonly raised against these taxes, identify best practices in excise tax policy, and conclude with a summary of the current status of tobacco, alcohol, and SSB excise taxes globally.
Collapse
Affiliation(s)
- Frank J. Chaloupka
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois 60608, USA
| | - Lisa M. Powell
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois 60612, USA
| | - Kenneth E. Warner
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109-2029, USA
| |
Collapse
|
12
|
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.
Collapse
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.)
| |
Collapse
|