Smoke-Free Legislation in Spain and Prematurity

Simón, Lorena; Pastor-Barriuso, Roberto; Boldo, Elena; Fernández-Cuenca, Rafael; Ortíz, Cristina; Linares, Cristina; Medrano, María; Galán, Iñaki

doi:10.1542/peds.2016-2068

Cited by 17 publications

(24 citation statements)

References 29 publications

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“…As in the case of our study, w study showing no effect in the proportion of SGA, in the United States [46], while six in Netherlands, Scotland, Ireland, Spain, England and Canada showed a reduction in SGA following the introduction of anti-tobacco laws [31,36,37,41,42,45].…”

Section: Discussionsupporting

confidence: 71%

“…Anti-tobacco laws have shown positive effect on hospitalizations for respiratory tract infection and asthma in children [27][28][29][30]. Likewise, anti-tobacco laws have reduced adverse effects on newborns from Canada, United States, Ireland, England, Belgium, Norway, Spain, the Netherlands, Switzerland, Hungary, Scotland and Uruguay [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46]. Nevertheless, the information from developing and middle-income countries is still limited.…”

Section: Introductionmentioning

confidence: 99%

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The impact of anti-tobacco legislation on birth weight in Peru

Mallma

Cárcamo

Kaufman

2020

glob health res policy

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Background: Tobacco exposure remains a significant issue for public health, especially for pregnant women. It increases the risk for premature labor, low birth weight and small for gestational age (SGA), among other effects. To reduce these risks, many countries have enacted public policies to curb tobacco exposure. Peru enacted anti-tobacco laws that forbid smoking in public places, require prevention text and images in products and publicity, along with restriction of sales to adults. We evaluated the effect of the implementation of this law on newborn outcomes: birth weight, prematurity and SGA. Methods: This was a quasi-experimental study that utilized data from the Peruvian Live Birth Registry. Children born to mothers from urban areas were the intervention group, while children born to mothers from rural areas were considered the control group. Only singletons with information on birth weight and gestational age, born to mothers aged 12 to 49 years were included in the study. In addition, newborns with birth weights greater than + 4 standard deviations (SD) or less than − 4 SD from the gestational age-specific mean were excluded. To measure the effect of legislation on birth weight we performed a difference in differences analysis. Results: A total of 2,029,975 births were included in the analysis. After adjusting for characteristics of the mother and the child, and contextual variables, the anti-tobacco law in Peru reduced the incidence of prematurity by 30 cases per 10,000 live births (95% CI: 19 to 42). Conclusions: The reform had negligible effects on overall birth weights and on the incidence of SGA. This modest result suggests the need for a more aggressive fight against tobacco, prohibiting all types of advertising and promotion of tobacco products, among others measures.

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

The impact of anti-tobacco legislation on birth weight in Peru

Mallma

Cárcamo

Kaufman

2020

glob health res policy

View full text Add to dashboard Cite

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“…After removal of duplicates, 12 392 unique citations were screened by title and abstract, and 65 full texts were sourced. Of these, 41 EPOC studies 16 , 17 , 18 , 19 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 and three non-EPOC studies 65 , 66 , 67 fit the inclusion criteria ( figure 1 ; appendix, pp 6, 7 ). The EPOC studies included data from more than 57 million births, and from 4·6 million GP diagnoses and 2·7 million hospital admissions for respiratory conditions.…”

Section: Resultsmentioning

confidence: 99%

Effect of tobacco control policies on perinatal and child health: a systematic review and meta-analysis

Faber

Kumar

Mackenbach

et al. 2017

The Lancet Public Health

160

130

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SummaryBackgroundTobacco smoking and smoke exposure during pregnancy and childhood cause considerable childhood morbidity and mortality. We did a systematic review and meta-analysis to investigate whether implementation of WHO's recommended tobacco control policies (MPOWER) was of benefit to perinatal and child health.MethodsWe searched 19 electronic databases, hand-searched references and citations, and consulted experts to identify studies assessing the association between implementation of MPOWER policies and child health. We did not apply any language restrictions, and searched the full time period available for each database, up to June 22, 2017. Our primary outcomes of interest were perinatal mortality, preterm birth, hospital attendance for asthma exacerbations, and hospital attendance for respiratory tract infections. Where possible and appropriate, we combined data from different studies in random-effects meta-analyses. This study is registered with PROSPERO, number CRD42015023448.FindingsWe identified 41 eligible studies (24 from North America, 16 from Europe, and one from China) that assessed combinations of the following MPOWER policies: smoke-free legislation (n=35), tobacco taxation (n=11), and smoking cessation services (n=3). Risk of bias was low in 23 studies, moderate in 16, and high in two. Implementation of smoke-free legislation was associated with reductions in rates of preterm birth (–3·77% [95% CI −6·37 to −1·16]; ten studies, 27 530 183 individuals), rates of hospital attendance for asthma exacerbations (–9·83% [–16·62 to −3·04]; five studies, 684 826 events), and rates of hospital attendance for all respiratory tract infections (–3·45% [–4·64 to −2·25]; two studies, 1 681 020 events) and for lower respiratory tract infections (–18·48% [–32·79 to −4·17]; three studies, 887 414 events). Associations appeared to be stronger when comprehensive smoke-free laws were implemented than when partial smoke-free laws were implemented. Among two studies assessing the association between smoke-free legislation and perinatal mortality, one showed significant reductions in stillbirth and neonatal mortality but did not report the overall effect on perinatal mortality, while the other showed no change in perinatal mortality. Meta-analysis of studies on other MPOWER policies was not possible; all four studies on increasing tobacco taxation and one of two on offering disadvantaged pregnant women help to quit smoking that reported on our primary outcomes had positive findings. Assessment of publication bias was only possible for studies assessing the association between smoke-free legislation and preterm birth, showing some degree of bias.InterpretationSmoke-free legislation is associated with substantial benefits to child health. The majority of studies on other MPOWER policies also indicated a positive effect. These findings provide strong support for implementation of such policies comprehensively across the world.FundingChief Scientist Office Scotland, Farr Institute, Netherlands Lung Foundation, Erasmus...

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“…In this issue of Pediatrics, Simón et al, 3 in their article "Smoke-free Legislation in Spain and Prematurity, " present data from Spain revealing a reduction in preterm births and low birth weight infants with the institution of partial and comprehensive smoking bans. This study attempts to tease out the effects of specific ban restrictions based on the gradual bans that were put in place in Spain.…”

mentioning

confidence: 99%

“…In January 2011, this ban was modified to include almost all public places. Simón et al 3 report that the more comprehensive 2011 ban was associated with reduction in preterm births of 4.5% and a reduction of low birth weight infants of 3.5% 1 year postimplementation. The more significant reduction in small for gestational age infants (1.7%) occurred after the more limited 2006 ban.…”

mentioning

confidence: 99%

Smoke-Free Legislation in Spain and Prematurity

Abstract: The implementation of the Spanish smoke-free policies was associated with a risk reduction for preterm births and low birth weight infants, especially with the introduction of the more restrictive ban.

Cited by 17 publications

References 29 publications

The impact of anti-tobacco legislation on birth weight in Peru

The impact of anti-tobacco legislation on birth weight in Peru

Effect of tobacco control policies on perinatal and child health: a systematic review and meta-analysis

More Evidence Linking Smoke-Free Legislation and Lower Risk of Prematurity and Low Birth Weight

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