The downstream effects of state tobacco control policies on maternal smoking during pregnancy and birth outcomes.

BACKGROUND: Research has demonstrated that the implementation of tobacco control policies is associated with improved birth outcomes. Ascertainment of prenatal smoking on the US birth certificate has changed over the past decade to record smoking across each trimester. METHODS: Using 2005-2015 birth certificate data on 26,436,541 singletons from 47 states and DC linked to state-level cigarette taxes and smoke-free legislation, we conducted conditional mixed-process models to examine the impact of tobacco control policies on prenatal smoking and quitting, then on the associated changes in birth outcomes. We included interactions between race/ethnicity, education, and taxes and present average marginal effects. RESULTS: Among white and black mothers with less than a high school degree, 36.0% and 14.1%, respectively, smoked during the first trimester and their babies had the poorest birth outcomes. However, they were the most responsive to cigarette taxes. Every $1.00 increase in taxes was associated with a 3.45 percentage point decrease in prenatal smoking among white mothers and a 1.20 percentage point decrease among black mothers. These reductions translated to increases in birth weight by 4.19 g for babies born to white mothers and 0.89 g for babies born to black mothers. Among smokers, there was some evidence that taxes increased quitting and improved birth outcomes, although most associations were not statistically significant. We found limited effects of smoke-free legislation on smoking, quitting or birth outcomes. CONCLUSIONS: Cigarette taxes continue to have important downstream effects on reducing prenatal smoking and improving birth outcomes among the most vulnerable mothers and infants.

Capital social e qualidade de vida em adolescentes trabalhadores em um município de médio porte de Minas Gerais, Brasil / Social capital and the quality of life in adolescents workers in a medium size city of Minas Gerais, Brazil

Considerando-se a escassez na produção científica de temas sobre os adolescentes trabalhadores, a presente pesquisa objetivou mensurar o capital social e sua possível relação com a qualidade de vida entre adolescentes trabalhadores. Realizou-se um estudo transversal analítico com 363 adolescentes trabalhadores assistidos por uma Entidade Filantrópica de Apoio ao adolescente em Sete Lagoas, Minas Gerais. A caracterização sócio-demográfica foi obtida por meio de questões referentes a sexo, idade, cor de pele, e saneamento básico (abastecimento de água, presença de sanitário no interior do domicílio, rede de esgoto, coleta de lixo). As informações sobre acess0/uso de serviços de saúde diziam respeito à posse de plano de saúde, uso regular do serviço público de saúde...

The role of tobacco control policies in reducing smoking and deaths in a middle income nation: results from the Thailand SimSmoke simulation model.

OBJECTIVES: With the male smoking prevalence near 60% in 1991, Thailand was one of the first Asian nations to implement strict tobacco control policies. However, the success of their efforts has not been well documented. METHODS: The role of tobacco control policies are examined using the "SimSmoke" tobacco control model. We first validated the model against survey data on smoking prevalence. We then distinguished the effect of policies implemented between 1991 and 2006 from long-term trends in smoking rates. We also estimated smoking attributable deaths and lives saved as a result of the policies. RESULTS: The model validates well against survey data. The model shows that by the year 2006, policies implemented between 1991 and 2006 had already decreased smoking prevalence by 25% compared to what it would have been in the absence of the policies. Tax increases on cigarettes and advertising bans had the largest impact, followed by media anti-smoking campaigns, clean air laws and health warnings. The model estimates that the policies saved 31 867 lives by 2006 and will have saved 319,456 lives by 2026. CONCLUSIONS: The results document the success of Thailand in reducing smoking prevalence and reducing the number of lives lost to smoking, thereby showing the potential of tobacco control policies specifically in a middle-income country. Additional improvements can be realised through higher taxes, stronger clean air policies, comprehensive cessation treatment policies, and targeted media campaigns.

Temas de politica social

Contiene: Narcotrafico y problemas sociales; el consumo de la pasta de cocaina, movilidad espacial y movilidad social generada por el narcotrafico; efectos del narcotrafico en la salud y la educacion; debate