Impact of UK Tobacco Control Policies on Inequalities in Youth Smoking Uptake: A Natural Experiment Study.
Impact of UK Tobacco Control Policies on Inequalities in Youth Smoking Uptake: A Natural Experiment Study.
复制标题
DOI：
10.1093/ntr/ntaa101
复制
发表时间：
2020-10-29
期刊：
影响因子：
--
通讯作者：
Green MJ
中科院分区：
文献类型：
--
作者：
Anyanwu PE;Craig P;Katikireddi SV;Green MJ
2006年至2008年，英国国家实施了公共场所无烟立法，并将购买烟草的法律的年龄从16岁提高到18岁。我们评估了这些英国政策变化对青少年吸烟率和不平等的直接和长期影响。我们研究了1994年至2016年英国年度家庭调查中14992名青年（11-15岁）的74960人-年纵向数据。离散时间事件历史分析研究了青年吸烟过渡率（开始，实验和升级到每日吸烟或戒烟）或其不平等（父母教育）的变化是否与政策实施相关。平行分析审查了无烟立法和法律的年龄的变化。我们将结果解释为两项立法的综合影响，因为它们的实施日期太接近，无法确定单独的影响。模型根据性别、年龄、英国国家、历史年份、烟草税和电子烟流行率进行调整，对缺失数据进行多重插补。对于这两项政策，实施后开始吸烟减少（法律的年龄比值比[OR]的变化：0.67; 95%置信区间[CI]：0.55至0.81;无烟立法OR：0.68; 95% CI：0.56至0.82），而开始吸烟的不平等在随后几年缩小。法律的年龄变化与从开始吸烟到偶尔吸烟的进展每年增加（OR：1.26; 95% CI：1.07 - 1.50）和实施后戒烟减少（OR：0.57; 95% CI：0.35 - 0.94）相关。无烟立法也观察到类似的效果，但CI重叠了零。诸如此类的政策在预防和减少青年开始吸烟的社会经济不平等方面可能非常有效。英国无烟立法的实施和烟草购买的法律的年龄从16岁提高到18岁，与吸烟开始的立即减少和随后几年吸烟开始的不平等缩小有关。虽然这些政策与开始吸烟的减少有关，但在立法后，偶尔吸烟的进展增加，戒烟减少。
UK countries implemented smoke-free public places legislation and increased the legal age for tobacco purchase from 16 to 18 years between 2006 and 2008. We evaluated the immediate and long-term impacts of these UK policy changes on youth smoking uptake and inequalities therein. We studied 74 960 person-years of longitudinal data from 14 992 youths (aged 11–15 years) in annual UK household surveys between 1994 and 2016. Discrete-time event history analyses examined whether changes in rates of youth smoking transitions (initiation, experimentation, and escalation to daily smoking or quitting) or their inequalities (by parental education) were associated with policy implementation. Parallel analyses examined smoke-free legislation and the change in legal age. We interpret the results as a combined effect of the two pieces of legislation as their implementation dates were too close to identify separate effects. Models were adjusted for sex, age, UK country, historical year, tobacco taxation, and e-cigarette prevalence, with multiple imputation for missing data. For both policies, smoking initiation reduced following implementation (change in legal age odds ratio [OR]: 0.67; 95% confidence interval [CI]: 0.55 to 0.81; smoke-free legislation OR: 0.68; 95% CI: 0.56 to 0.82), while inequalities in initiation narrowed over subsequent years. The legal age change was associated with annual increases in progression from initiation to occasional smoking (OR: 1.26; 95% CI: 1.07 to 1.50) and a reduction in quitting following implementation (OR: 0.57; 95% CI: 0.35 to 0.94). Similar effects were observed for smoke-free legislation but CIs overlapped the null. Policies such as these may be highly effective in preventing and reducing socioeconomic inequalities in youth smoking initiation. UK implementation of smoke-free legislation and an increase in the legal age for tobacco purchase from 16 to 18 years were associated with an immediate reduction in smoking initiation and a narrowing of inequalities in initiation over subsequent years. While the policies were associated with reductions in the initiation, progression to occasional smoking increased and quitting decreased following the legislation.
登录
查看更多内容
自然实验：对公共卫生干预研究的方法，方法和贡献的概述。
影响因子：
20.8
作者：
Craig P;Katikireddi SV;Leyland A;Popham F
通讯作者：
Popham F
影响因子：
4.2
作者：
Chassin, L;Presson, CC;Sherman, SJ
通讯作者：
Sherman, SJ
影响因子：
168.9
作者：
Been, Jasper V.;Nurmatov, Ulugbek B.;Sheikh, Aziz
通讯作者：
Sheikh, Aziz
影响因子：
12.7
作者：
Farrelly, Matthew C.;Loomis, Brett R.;Caraballo, Ralph S.
通讯作者：
Caraballo, Ralph S.
影响因子：
2.9
作者：
Barreto, Sandhi Maria;de Figueiredo, Roberta Carvalho;Giatti, Luana
通讯作者：
Giatti, Luana