Smoke-free legislation and socioeconomic inequalities in smoking-related morbidity and mortality among adults: a systematic review
Background Previous systematic reviews examining the impact of smoke-free legislation (SFL) suggest more beneficial impacts in higher socioeconomic status (SES) groups. However, these have focused on associated changes in smoking behaviour due to a paucity of studies examining health outcomes. This...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Publishing
2018-03-01
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| Series: | Tobacco Induced Diseases |
| Subjects: | |
| Online Access: | http://www.journalssystem.com/tid/Smoke-free-legislation-and-socioeconomic-inequalities-in-smoking-related-morbidity,84127,0,2.html |
| _version_ | 1818569514347921408 |
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| author | Marhazlinda Jamaludin Gaurang P. Nazar Raffaele Palladino Georgios Tsakos Richard G. Watt Christopher Millett |
| author_facet | Marhazlinda Jamaludin Gaurang P. Nazar Raffaele Palladino Georgios Tsakos Richard G. Watt Christopher Millett |
| author_sort | Marhazlinda Jamaludin |
| collection | DOAJ |
| description | Background
Previous
systematic reviews examining the impact of smoke-free legislation (SFL) suggest
more beneficial impacts in higher socioeconomic status (SES) groups. However, these
have focused on associated changes in smoking behaviour
due to a paucity of studies examining health outcomes. This review includes
more recent evidence to assess the impact of comprehensive and partial SFL on
socioeconomic inequalities in smoking-related:
a) disease-specific morbidity and mortality and b) all-cause mortality among
adults.
Methods
We searched
Medline and fourteen other databases up to September 2016. Studies in English, reporting
the differential impacts by SES of SFL on smoking-related morbidity and mortality among
adults (≥18 years) were eligible. Following data extraction, quality and risk
of bias among the included studies were assessed using the Cochrane EPOC and EPHPP criteria. Harvest plot and narrative methods were used to illustrate
either i)neutral effect of SFL on inequalities, ii) positive effect (greater
benefits among lower SES groups, iii) negative effect (greater benefits among higher
SES groups) or iv) mixed/unclear effect.
Results
Eight studies (six
interrupted time-series and two before-after studies), all from high-income countries were included; five
studies examined the impact of comprehensive SFL and three the impact of
partial SFL. Implementation of comprehensive SFL led to either a positive
effect (three studies) or no effect (two studies) on socioeconomic inequalities
in health outcomes; partial SFL led to either no effect (two studies) or
unclear effect (one study). The choice of the socioeconomic
indicator may have had an important influence on findings. Except for the before-after studies, most studies
were judged to be high quality with a suitable study design.
Conclusions
Comprehensive SFL potentially
reduces inequalities in smoking-related health
outcomes, partial SFL may not. All countries should implement comprehensive SFL
to achieve the Sustainable Development Goal targets to reduce premature NCD
mortality and inequalities. |
| first_indexed | 2024-12-14T06:49:01Z |
| format | Article |
| id | doaj.art-af668344f61c4d82bc3331a0d049bf00 |
| institution | Directory Open Access Journal |
| issn | 1617-9625 |
| language | English |
| last_indexed | 2024-12-14T06:49:01Z |
| publishDate | 2018-03-01 |
| publisher | European Publishing |
| record_format | Article |
| series | Tobacco Induced Diseases |
| spelling | doaj.art-af668344f61c4d82bc3331a0d049bf002022-12-21T23:12:57ZengEuropean PublishingTobacco Induced Diseases1617-96252018-03-0116110.18332/tid/8412784127Smoke-free legislation and socioeconomic inequalities in smoking-related morbidity and mortality among adults: a systematic reviewMarhazlinda Jamaludin0Gaurang P. Nazar1Raffaele Palladino2Georgios Tsakos3Richard G. Watt4Christopher Millett5University of Malaya, Department of Community Dentistry and Clinical Prevention, MalaysiaPublic Health Foundation of India, Health Promotion Division, IndiaImperial College London, Public Health Policy Evaluation Unit, School of Public Health, United KingdomUniversity College London, Department of Epidemiology and Public Health, United KingdomUniversity College London, Department of Epidemiology and Public Health, United KingdomImperial College London, Public Health Policy Evaluation Unit, School of Public Health, United KingdomBackground Previous systematic reviews examining the impact of smoke-free legislation (SFL) suggest more beneficial impacts in higher socioeconomic status (SES) groups. However, these have focused on associated changes in smoking behaviour due to a paucity of studies examining health outcomes. This review includes more recent evidence to assess the impact of comprehensive and partial SFL on socioeconomic inequalities in smoking-related: a) disease-specific morbidity and mortality and b) all-cause mortality among adults. Methods We searched Medline and fourteen other databases up to September 2016. Studies in English, reporting the differential impacts by SES of SFL on smoking-related morbidity and mortality among adults (≥18 years) were eligible. Following data extraction, quality and risk of bias among the included studies were assessed using the Cochrane EPOC and EPHPP criteria. Harvest plot and narrative methods were used to illustrate either i)neutral effect of SFL on inequalities, ii) positive effect (greater benefits among lower SES groups, iii) negative effect (greater benefits among higher SES groups) or iv) mixed/unclear effect. Results Eight studies (six interrupted time-series and two before-after studies), all from high-income countries were included; five studies examined the impact of comprehensive SFL and three the impact of partial SFL. Implementation of comprehensive SFL led to either a positive effect (three studies) or no effect (two studies) on socioeconomic inequalities in health outcomes; partial SFL led to either no effect (two studies) or unclear effect (one study). The choice of the socioeconomic indicator may have had an important influence on findings. Except for the before-after studies, most studies were judged to be high quality with a suitable study design. Conclusions Comprehensive SFL potentially reduces inequalities in smoking-related health outcomes, partial SFL may not. All countries should implement comprehensive SFL to achieve the Sustainable Development Goal targets to reduce premature NCD mortality and inequalities.http://www.journalssystem.com/tid/Smoke-free-legislation-and-socioeconomic-inequalities-in-smoking-related-morbidity,84127,0,2.htmlWCTOH |
| spellingShingle | Marhazlinda Jamaludin Gaurang P. Nazar Raffaele Palladino Georgios Tsakos Richard G. Watt Christopher Millett Smoke-free legislation and socioeconomic inequalities in smoking-related morbidity and mortality among adults: a systematic review Tobacco Induced Diseases WCTOH |
| title | Smoke-free legislation and socioeconomic inequalities in smoking-related morbidity and mortality among adults: a systematic review |
| title_full | Smoke-free legislation and socioeconomic inequalities in smoking-related morbidity and mortality among adults: a systematic review |
| title_fullStr | Smoke-free legislation and socioeconomic inequalities in smoking-related morbidity and mortality among adults: a systematic review |
| title_full_unstemmed | Smoke-free legislation and socioeconomic inequalities in smoking-related morbidity and mortality among adults: a systematic review |
| title_short | Smoke-free legislation and socioeconomic inequalities in smoking-related morbidity and mortality among adults: a systematic review |
| title_sort | smoke free legislation and socioeconomic inequalities in smoking related morbidity and mortality among adults a systematic review |
| topic | WCTOH |
| url | http://www.journalssystem.com/tid/Smoke-free-legislation-and-socioeconomic-inequalities-in-smoking-related-morbidity,84127,0,2.html |
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