Neighbourhood tobacco supply and individual maternal smoking during pregnancy: a fixed-effects longitudinal analysis using routine data.
Neighbourhood tobacco supply and individual maternal smoking during pregnancy: a fixed-effects longitudinal analysis using routine data.
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DOI：
10.1136/tobaccocontrol-2018-054422
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发表时间：
2018-11-02
期刊：
影响因子：
5.2
通讯作者：
Shortt NK
中科院分区：
文献类型：
--
作者：
Clemens T;Dibben C;Pearce J;Shortt NK
烟草政策越来越关注“烟草终局”，承诺在未来二十年内根除烟草使用（流行率低于 5%）。实现最终目标的策略可能包括解决烟草产品的供应问题，但目前支持这一方法的证据主要是横截面的。我们使用 2000 年至 2015 年间在苏格兰分娩的所有妇女的常规产妇记录中的纵向吸烟信息。我们将这些数据与销售烟草产品的零售商的居住密度和怀孕期间吸烟的社区流行率联系起来。在分析中，个别母亲充当了自己的对照，因为我们将怀孕期间吸烟行为的变化与怀孕期间居住流动引起的烟草零售暴露的变化进行了比较。调整后的 OR 显示，吸烟的风险增加与接触零售商密度的增加相关（OR 1.67，95%CI 1.27 至 2.20）。研究结果提供了迄今为止最有力的证据，证明社区烟草供应与吸烟之间存在关联，并且首次在孕妇中进行了此类研究。这些发现为针对烟草制品供应的干预措施提供了支持性证据，以实现最终目的。
Tobacco policy is increasingly focusing on the ‘tobacco endgame’ which commits to eradicating tobacco use (prevalence below 5%) within the next two decades. Strategies for achieving the endgame are likely to include addressing the supply of tobacco products, yet current evidence to support this approach is primarily cross-sectional. We use longitudinal smoking information from routine maternity records of all women who gave birth in Scotland between 2000 and 2015. We linked this data to the residential density of retailers selling tobacco products and the neighbourhood prevalence of smoking during pregnancy. In the analysis, individual mothers act as their own controls because we compare changes in their smoking behaviour between pregnancies to changes in exposure to tobacco retailing that arises from residential movement between pregnancies. Adjusted ORs showed an increased risk of being a smoker associated with increases in exposure to retailer density (OR 1.67, 95% CI 1.27 to 2.20). The results provide the strongest evidence to date of an association between the neighbourhood availability of tobacco and smoking, and the first to do so among pregnant women. These findings provide supportive evidence for interventions targeting the supply of tobacco products in achieving the endgame.
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