Estimating the Potential Impact of Tobacco Control Policies on Adverse Maternal and Child Health Outcomes in the United States Using the SimSmoke Tobacco Control Policy Simulation Model.
Estimating the Potential Impact of Tobacco Control Policies on Adverse Maternal and Child Health Outcomes in the United States Using the SimSmoke Tobacco Control Policy Simulation Model.
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使用 SimSmoke 烟草控制政策模拟模型估计烟草控制政策对美国不良孕产妇和儿童健康结果的潜在影响。
DOI：
10.1093/ntr/ntv178
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Zhang,Yian
中科院分区：
文献类型：
--
作者：
Levy,David;Mohlman,MaryKatherine;Zhang,Yian
大量研究证明了产前吸烟与不良妇幼健康（MCH）结果之间的因果关系。研究还揭示了烟草控制政策对产前吸烟的影响。本研究的目的是评估控烟政策对产前吸烟率和不良母婴健康结局的影响。方法扩展ussimsmobs模拟模型，考虑不良的MCH结果。该模型估计了产前吸烟率，并应用标准归因方法，使用妇幼保健患病率和相对吸烟风险的估计值来估计一段时间内由吸烟引起的妇幼保健结果。然后，该模型估计烟草控制政策对避免不良生育结果的影响。结果不同控烟政策对由吸烟引起的妇幼保健不良出生结局数量的影响不同。提高卷烟税和全面禁止营销的影响最大，在2015年至2065年期间，所有结果将减少5%至10%。在此期间影响最小（减少2%-3%）的政策是戒烟治疗、健康警告和完全无烟法律。所有政策与每个税收水平的组合在所有结果中导致23%至28%的下降。我们的研究结果表明，强有力的烟草控制政策对预防不良妇幼保健结果有重大影响，包括对低出生体重和早产儿童的长期健康影响。这些好处在讨论烟草控制时往往被忽视。
IntroductionNumerous studies document the causal relationship between prenatal smoking and adverse maternal and child health (MCH) outcomes. Studies also reveal the impact that tobacco control policies have on prenatal smoking. The purpose of this study is to estimate the effect of tobacco control policies on prenatal smoking prevalence and adverse MCH outcomes.MethodsThe USSimSmokesimulation model was extended to consider adverse MCH outcomes. The model estimates prenatal smoking prevalence and, applying standard attribution methods, uses estimates of MCH prevalence and relative smoking risks to estimate smoking-attributable MCH outcomes over time. The model then estimates the effect of tobacco control policies on adverse birth outcomes averted.ResultsDifferent tobacco control policies have varying impacts on the number of smoking-attributable adverse MCH birth outcomes. Higher cigarette taxes and comprehensive marketing bans individually have the biggest impact with a 5% to 10% reduction across all outcomes for the period from 2015 to 2065. The policies with the lowest impact (2%–3% decrease) during this period are cessation treatment, health warnings, and complete smoke-free laws. Combinations of all policies with each tax level lead to 23% to 28% decreases across all outcomes.ConclusionsOur findings demonstrate the substantial impact of strong tobacco control policies for preventing adverse MCH outcomes, including long-term health implications for children exposed to low birth weight and preterm birth. These benefits are often overlooked in discussions of tobacco control.
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