Smoke-free legislation and neonatal and infant mortality in Brazil: longitudinal quasi-experimental study.
Tob Control
; 29(3): 312-319, 2020 05.
Article
en En
| MEDLINE
| ID: mdl-31152114
ABSTRACT
OBJECTIVE:
To examine the associations of partial and comprehensive smoke-free legislation with neonatal and infant mortality in Brazil using a quasi-experimental study design.DESIGN:
Monthly longitudinal (panel) ecological study from January 2000 to December 2016.SETTING:
All Brazilian municipalities (n=5565).PARTICIPANTS:
Infant populations. INTERVENTION Smoke-free legislation in effect in each municipality and month. Legislation was encoded as basic (allowing smoking areas), partial (segregated smoking rooms) or comprehensive (no smoking in public buildings). Associations were quantified by immediate step and longer term slope/trend changes in outcomes. STATISTICAL ANALYSES Municipal-level linear fixed-effects regression models. MAIN OUTCOMESMEASURES:
Infant and neonatal mortality.RESULTS:
Implementation of partial smoke-free legislation was associated with a -3.3 % (95% CI -6.2% to -0.4%) step reduction in the municipal infant mortality rate, but no step change in neonatal mortality. Comprehensive smoke-free legislation implementation was associated with -5.2 % (95% CI -8.3% to -2.1%) and -3.4 % (95% CI -6.7% to -0.1%) step reductions in infant and neonatal mortality, respectively, and a -0.36 (95% CI -0.66 to-0.06) annual decline in the infant mortality rate. We estimated that had all smoke-free legislation introduced since 2004 been comprehensive, an additional 10 091 infant deaths (95% CI 1196 to 21 761) could have been averted.CONCLUSIONS:
Strengthening smoke-free legislation in Brazil is associated with improvements in infant health outcomes-particularly under comprehensive legislation. Governments should accelerate implementation of comprehensive smoke-free legislation to protect infant health and achieve the United Nation's Sustainable Development Goal three.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Contaminación por Humo de Tabaco
/
Fumar
/
Mortalidad Infantil
/
Política para Fumadores
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Muerte Perinatal
/
Muerte del Lactante
/
Prevención del Hábito de Fumar
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Infant
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Male
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Middle aged
/
Newborn
/
Pregnancy
País/Región como asunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Tob Control
Asunto de la revista:
TRANSTORNOS RELACIONADOS COM SUBSTANCIAS
Año:
2020
Tipo del documento:
Article
País de afiliación:
Reino Unido