Impact of 100% Smoke-Free Laws on the Health of Children and Infants

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• 批准号: 8446281
• 负责人: Dhaval M. Dave
• 金额: $ 15.4万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8446281
• 关键词: Accounting; Address; Adoption; Adult; Adverse effects; Age; Air; Area; Behavior; Birth Records; Birth Weight; Centers for Disease Control and Prevention (U.S.); Child; Child health care; Cigarette; Consumption; Costs and Benefits; Data Set; Economic Factors; Education; Effectiveness; Employment; Environment; Environmental Tobacco Smoke; Ethnic Origin; Evaluation; Exposure to; Health; Health Benefit; Health Care Costs; Health protection; Home environment; Hour; Household; Incidence; Income; Infant; Infant Health; Institute of Medicine (U.S.); Intervention; Laws; Lead; Link; Literature; Location; Low Birth Weight Infant; Measures; Morbidity - disease rate; National Health Interview Survey; Parents; Policies; Population; Pregnancy; Pregnant Women; Premature Birth; Public Health; Public Policy; Race; Recommendation; Records; Regulation; Reporting; Research; Restaurants; Sample Size; Site; Smoke; Smoker; Smoking; Statutes and Laws; Work; Workplace; age group; base; cost; disorder prevention; improved; maternal cigarette smoking; non-smoker; non-smoking; public policy on tobacco; respiratory; response; smoke-free policy; smoking prevalence; socioeconomics

DESCRIPTION (provided by applicant): As evidence of the negative effects of environmental tobacco smoke (ETS) has mounted, an increasingly popular public policy response has been to impose restrictions on smoking through 100% smoke-free bans. The Centers for Disease Control and Prevention (CDC) and the Institute of Medicine (IOM), amidst evidence that smoking bans reduce smoking prevalence and adult non-smokers' exposure to ETS, recommend that states and localities enact complete bans on smoking in all non-residential indoor locations, including worksites, restaurants, and bars. However, a key link necessary for a comprehensive evaluation of the effectiveness of smoking bans has been missing from the literature including the CDC and IOM reports. Specifically, it is not known whether and to what extent smoking bans at the state and local levels impact the health of children and infants. The rationale for smoke-free laws implicitly presumes there are public health gains from reducing adult cigarette consumption and declines in adult ETS exposure that extend to children. The presumption that these gains, a priori, will extend to infants and children may or may not be correct. On the one hand, decreases in adult smoking prevalence as a result of the smoking bans may reduce ETS exposure among children, infants, and pregnant women. However, if smokers shift from consuming cigarettes at 100% smoke free work and other public places to smoking at home (when children, infants, or pregnant women are present) then these policies may have a harmful effect on children and infants. Such compensatory behavior by smokers can potentially increase the prevalence of smoking at home and lead to higher ETS exposures among children. Without information on the link between smoking bans, potential shifts in smoking to the home, and the impact on child and infant health, either the costs or benefits of interventions banning smoking may be understated, which in turn may skew the proper evaluation of such policies. The proposed study aims to address this critical gap in the literature and provide the first estimates of how 100% smoke-free regulations impact the venue of smoking and how they impact the health of children and infants. The study will match information on all local and state-level 100% smoke-free legislation by type (workplace, restaurant, and freestanding bar) and other tobacco-control policies to parent and child records from the National Health Interview Surveys (NHIS) and birth records from the U.S. Natality Files (NF). Both datasets are nationally-representative and have large sample sizes, thus maximizing statistical power and precision, and allowing an assessment of differential effects across various socio-economic factors. The NHIS includes information on ETS-related measures of adverse respiratory health and the NF includes information on birth- weight and gestation, both of which have been found to be impacted by own smoking and ETS exposure. The estimates from the proposed research will address the missing link in the literature and provide valuable inputs towards a comprehensive evaluation of state and local restrictions on smoking in various venues.

描述（由申请人提供）：随着环境烟草烟雾 (ETS) 负面影响的证据不断增加，越来越受欢迎的公共政策反应是通过 100% 无烟禁令来限制吸烟。疾病控制与预防中心 (CDC) 和医学研究所 (IOM) 有证据表明，禁烟令可降低吸烟率和成年非吸烟者接触 ETS 的机会，建议各州和地方在所有非住宅室内场所（包括工作场所、餐馆和酒吧）全面禁止吸烟。然而，包括疾病预防控制中心和国际移民组织的报告在内的文献中却缺少全面评估禁烟令有效性所必需的关键环节。具体而言，尚不清楚州和地方各级的禁烟令是否以及在多大程度上影响儿童和婴儿的健康。无烟法的基本原理隐含地假设，减少成人香烟消费和减少成人 ETS 接触可以带来公共健康收益，并延伸到儿童。这些收益将延伸到婴儿和儿童的先验假设可能正确，也可能不正确。一方面，禁烟令导致成人吸烟率下降，可能会减少儿童、婴儿和孕妇的 ETS 暴露。然而，如果吸烟者从在 100% 无烟工作场所和其他公共场所吸烟转向在家中（当有儿童、婴儿或孕妇在场时）吸烟，那么这些政策可能会对儿童和婴儿产生有害影响。吸烟者的这种补偿行为可能会增加家庭吸烟的流行率，并导致儿童接触更多的 ETS。如果没有关于禁烟令、吸烟向家庭的潜在转移以及对儿童和婴儿健康的影响之间联系的信息，禁烟干预措施的成本或收益可能会被低估，这反过来可能会扭曲对此类政策的正确评估。拟议的研究旨在解决文献中的这一关键空白 并提供 100% 无烟法规如何影响吸烟场所以及如何影响儿童和婴儿健康的初步估计。该研究将把所有地方和州级按类型（工作场所、餐厅和独立酒吧）划分的 100% 无烟立法和其他烟草控制政策的信息与国家健康访谈调查 (NHIS) 中的父母和儿童记录以及美国出生档案 (NF) 中的出生记录进行匹配。这两个数据集都具有全国代表性并且样本量大，从而最大限度地提高统计能力和精度，并允许评估各种社会经济因素的差异影响。 NHIS 包括与 ETS 相关的不良呼吸系统健康指标的信息，NF 包括出生体重和妊娠的信息，这两者均被发现受到自身吸烟和 ETS 暴露的影响。拟议研究的估计将解决文献中缺失的环节，并为全面评估州和地方对各个场所吸烟的限制提供有价值的投入。