Effect of Local Smoke-Free Ordinances on Smoking Prevalence in Kentucky, 2002-2009
Effect of Local Smoke-Free Ordinances on Smoking Prevalence in Kentucky, 2002-2009
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DOI：
10.14423/smj.0000000000001000
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发表时间：
2019-07-01
影响因子：
1.1
通讯作者：
Hahn, Ellen J.
中科院分区：
文献类型：
--
作者：
Christian, W. Jay;Walker, Courtney J.;Hahn, Ellen J.
目的肯塔基州是美国吸烟率最高的州之一，该州的许多地方社区都颁布了无烟法令，禁止在工作场所和向公众开放的封闭建筑物内吸烟。研究表明，这些条例显然有利于公共卫生，但它们对所涵盖人口中吸烟率的影响仍不清楚。本研究探讨了地方无烟条例对肯塔基州吸烟率的影响。方法我们使用了由肯塔基州无烟政策中心维护的无烟条例数据库、肯塔基州行为风险因素监测系统调查数据和美国人口普查数据。我们估计了肯塔基州成年人生活在不同强度的无烟法令县的比例;检查了无烟法令和吸烟率之间的二元关联;并拟合了针对各种县级人口统计学，社会经济学和地理因素进行调整的回归模型。结果吸烟患病率约5%的县与无烟条例，即使调整其他相关因素，包括在整个研究地区的患病率下降的趋势。有一个轻微的剂量反应效应与无烟条例的强度调整后，这些协变量。无烟法令似乎对几年内的吸烟流行率产生了适度的影响。结论调查结果表明，虽然吸烟率下降整个国家在研究期间，县无烟条例经历了更大的下降。未来的研究应该更详细地研究无烟条例的强度，以更好地了解它们对吸烟流行率的影响。
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.