Smoking ban and health at birth: Evidence from Hungary

Hajdu, Tamás; Hajdu, Gábor

doi:10.1016/j.ehb.2018.05.003

Cited by 19 publications

(26 citation statements)

References 66 publications

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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%

“…The appendix (pp 8–20) details the main characteristics of the EPOC studies. Among these, 26 were interrupted time series studies, 16 , 17 , 18 , 19 , 31 , 32 , 37 , 38 , 40 , 42 , 43 , 45 , 46 , 48 , 50 , 51 , 52 , 54 , 55 , 57 , 58 , 59 , 61 , 62 , 63 , 64 14 were controlled interrupted time series studies, 28 , 29 , 33 , 34 , 35 , 36 , 39 , 41 , 44 , 47 , 49 , 53 , 56 , 60 and one had a regression discontinuity design, 30 a quasi-experimental design bearing close resemblance to interrupted time series methodology. 68 The three non-EPOC studies were uncontrolled before-and-after studies ( appendix, p 21 ).…”

Section: Resultsmentioning

confidence: 99%

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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

157

124

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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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Section: Resultsmentioning

confidence: 99%

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

157

124

View full text Add to dashboard Cite

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“…Other studies in USA, England, and Canada showed significantly increased birth weights [40,42,45]. A study in Hungary found an important gain in birth weight (55.5 g) in newborns of female workers of restaurants and bars after the implementation of the law [33]; and a study in USA found a 7 g reduction after the implementation of Local Smoking Ordinances [69].…”

Section: Discussionmentioning

confidence: 99%

“…Dots represent proportion with low birthweight (g) and vertical lines represent 95% confidence intervals for the proportion studies in Netherlands, Switzerland, Hungary, Norway, and 3 in the USA failed to detect an impact [31-33, 39, 46, 68, 70]. Studies in Hungary and Switzerland did not find an effect in preterm births, but did detect a positive effect in very-preterm deliveries [32,33]. The positive effect observed in our study regarding the risk of prematurity (0.25%) is modest compared to the reduction reported in the studies cited: 23% by Page in the state of Colorado in USA, 25% by Kabir in Ireland, 12% by Mackay in Scotland, 4.5% by Simon in Spain, 4.0% by Bakolis in England, 3.5% by Cox in Belgium, 1.5% by Bartholomew in the state Virginia West in USA, but similar to what McKinnon found in Canada (0.31%).…”

Section: Discussionmentioning

confidence: 99%

“…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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Evaluation of Population-Level Tobacco Control Interventions and Health Outcomes

et al. 2023

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ImportanceSmoking causes considerable noncommunicable diseases, perinatal morbidity, and mortality.ObjectiveTo investigate the associations of population-level tobacco-control policies with health outcomes.Data SourcesPubMed, EMBASE, Web of Science, Cumulated Index to Nursing and Allied Health Literature, and EconLit were searched from inception to March 2021 (updated on 1 March 2022). References were manually searched.Study SelectionStudies reporting on associations of population-level tobacco control policies with health-related outcomes were included. Data were analyzed from May to July 2022.Data Extraction and SynthesisData were extracted by 1 investigator and cross-checked by a second investigator. Analyses were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline.Main Outcomes and MeasuresThe primary outcomes were respiratory system disease (RSD), cardiovascular disease (CVD), cancer, mortality, hospitalization, and health care utilization. The secondary outcomes were adverse birth outcomes, such as low birth weight and preterm birth. Random-effects meta-analysis was used to estimate pooled odds ratios (ORs) and 95% CIs.ResultsOf 4952 records identified, 144 population-level studies were included in the final analysis; 126 studies (87.5%) were of high or moderate quality. The most frequently reported policies were smoke-free legislation (126 studies), followed by tax or price increases (14 studies), multicomponent tobacco control programs (12 studies), and a minimum cigarette purchase age law (1 study). Smoke-free legislation was associated with decreased risk of all CVD events (OR, 0.90; 95% CI, 0.86-0.94), RSD events (OR, 0.83; 95% CI, 0.72-0.96), hospitalization due to CVD or RSD (OR, 0.91; 95% CI, 0.87-0.95), and adverse birth outcomes (OR, 0.94; 95% CI, 0.92-0.96). These associations persisted in all sensitivity and subgroup analyses, except for the country income category, for which a significant reduction was only observed in high-income countries. In meta-analysis, there was no clear association of tax or price increases with adverse health outcomes. However, for the narrative synthesis, all 8 studies reported statistically significant associations between tax increases and decreases in adverse health events.Conclusions and RelevanceIn this systematic review and meta-analysis, smoke-free legislation was associated with significant reductions in morbidity and mortality related to CVD, RSD, and perinatal outcomes. These findings support the need to accelerate the implementation of smoke-free laws to protect populations against smoking-related harm.

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Smoking ban and health at birth: Evidence from Hungary

Cited by 19 publications

References 66 publications

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

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

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

Evaluation of Population-Level Tobacco Control Interventions and Health Outcomes

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