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）：作为环境烟草烟雾（ETS）负面影响的证据，越来越流行的公共政策反应是通过100％无烟禁令对吸烟施加限制。疾病控制与预防中心（CDC）和医学研究所（IOM）在证据表明，吸烟禁令降低吸烟率和成人非吸烟者对ETS的暴露，建议各州和地区在所有非居住的印度室内地点，包括工厂，餐厅和酒吧，包括所有非居住的印度室内地点吸烟。但是，文献中缺少包括CDC和IOM报告在内的文献中缺少全面评估吸烟禁令有效性所必需的关键联系。具体而言，尚不清楚州和地方一级的吸烟禁令是否会影响儿童和婴儿的健康。无烟法律的基本原理隐含地假设，从减少成人香烟消耗和成人ETS暴露的下降会带来公共卫生的收益，这扩展到儿童。这些收益（先验）将扩展到婴儿和儿童的假设可能是正确的。一方面，由于吸烟禁令而导致的成年吸烟率降低可能会减少儿童，婴儿和孕妇的ETS暴露。但是，如果吸烟者从100％无烟工作和其他公共场所的吸烟转变为在家吸烟（当儿童，婴儿或孕妇在场时），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在家中吸烟的患病率，并导致儿童的ETS暴露更高。如果没有有关吸烟禁令之间联系的信息，吸烟到家庭的潜在转变以及对儿童和婴儿健康的影响，则可能会低估禁止吸烟的干预措施的成本或收益，这反过来又可能会对此类政策进行适当的评估。拟议的研究旨在解决文献中的这一关键差距 并提供了第一个估计，即100％无烟法规如何影响吸烟场所以及它们如何影响儿童和婴儿的健康。该研究将按类型（工作场所，餐厅和独立式酒吧）以及其他烟草控制政策与来自国家健康访谈调查（NHIS）的父母和儿童记录以及来自美国Natality Files（NF）的出生记录（NF）的父母和儿童记录相匹配。这两个数据集都是全国代表性的，并且具有较大的样本量，从而最大程度地提高了统计能力和精度，并允许评估各种社会经济因素的差异效应。 NHIS包括有关ETS相关呼吸健康措施的信息，NF包括有关出生体重和妊娠的信息，这两者都受到自身吸烟和ETS的影响。拟议研究的估计值将解决文献中缺少的联系，并为对各个场所吸烟的州和地方限制进行全面评估提供宝贵的意见。