Beneficial impacts of a national smokefree environments law on an indigenous population: a multifaceted evaluation
Beneficial impacts of a national smokefree environments law on an indigenous population: a multifaceted evaluation
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DOI：
10.1186/1475-9276-8-12
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发表时间：
2009-04-30
影响因子：
4.8
通讯作者：
Wilson, Nick
中科院分区：
文献类型：
--
作者：
Edwards, Richard;Gifford, Heather;Wilson, Nick
背景：世界各地越来越多地实施无烟环境立法。评估基本上发现，立法很受欢迎，遵守程度很高，并报告空气质量得到改善，二手烟暴露（SHS）减少。尚未探讨立法对包括土著人民在内的处境不利群体的影响。我们从多方面评估了《新西兰无烟环境修正法案》中无烟工作场所条款对新西兰毛利人的影响。毛利人是新西兰的土著居民。2004年12月，《无烟环境修正法》将现有的无烟立法扩展到几乎所有室内工作场所（包括餐馆和酒吧）。方法：审查现有数据和委托研究，以确定评估新立法的证据：包括对立法的态度和支持；利益相关者对法案和实施过程的看法；对工作场所和其他环境中接触SHS的影响；以及对吸烟相关行为的影响。结果：毛利人大力支持立法，到2006年，无烟餐馆达到90%，无烟酒吧达到84%。接受采访的毛利人利益相关者大多支持立法的实施方式。据报告，毛利人和非毛利人在工作场所暴露于SHS的人数也同样减少，2003年前一周有27%的成年毛利人报告在室内工作场所暴露于SHS， 2006年为9%。家庭中接触二手烟的情况有所下降，在有一个或多个吸烟者的毛利人家庭中可能下降得更多。例如，报告在家中吸烟的14-15岁毛利儿童的比例从2001年的47%下降到2007年的37%。在毛利人和非毛利人中，因社交而吸烟的人数也出现了类似的减少。对吸烟率影响的证据好坏参半。毛利人对新法律的回应是越来越多地打电话给国家戒烟热线服务。结论：新西兰无烟环境修正法案具有一系列积极影响，包括减少毛利人社区的二手烟暴露。如果在其他有土著人口的国家复制这一经验，它表明全面的无烟环境立法将对土著群体的健康产生有益的影响，并有助于减少社会内部健康方面的不平等。
Background: Smokefree environments legislation is increasingly being implemented around the world. Evaluations largely find that the legislation is popular, compliance is high and report improved air quality and reduced exposure to secondhand smoke (SHS). The impact of the legislation on disadvantaged groups, including indigenous peoples has not been explored. We present findings from a multifaceted evaluation of the impact of the smokefree workplace provisions of the New Zealand Smokefree Environments Amendment Act on Maori people in New Zealand. Maori are the indigenous people of New Zealand. The Smokefree Environments Amendment Act extended existing smokefree legislation to almost all indoor workplaces in December 2004 (including restaurants and pubs/bars).Methods: Review of existing data and commissioned studies to identify evidence for the evaluation of the new legislation: including attitudes and support for the legislation; stakeholders views about the Act and the implementation process; impact on SHS exposure in workplaces and other settings; and impact on smoking-related behaviours.Results: Support for the legislation was strong among Maori and reached 90% for smokefree restaurants and 84% for smokefree bars by 2006. Maori stakeholders interviewed were mostly supportive of the way the legislation had been introduced. Reported exposure to SHS in workplaces decreased similarly in Maori and non-Maori with 27% of employed adult Maori reporting SHS exposure indoors at work during the previous week in 2003 and 9% in 2006. Exposure to SHS in the home declined, and may have decreased more in Maori households containing one or more smokers. For example, the proportion of 14-15 year old Maori children reporting that smoking occurred in their home fell from 47% in 2001 to 37% in 2007. Similar reductions in socially-cued smoking occurred among Maori and non-Maori. Evidence for the effect on smoking prevalence was mixed. Maori responded to the new law with increased calls to the national Quitline service.Conclusion: The New Zealand Smokefree Environments Amendment Act had a range of positive effects, including reducing SHS exposure among Maori communities. If the experience is replicated in other countries with indigenous populations, it suggests that comprehensive smokefree environments legislation will have beneficial effects on the health of indigenous groups and could contribute to reducing inequalities in health within societies.