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Smoke-free legislation and neonatal and infant mortality in Brazil: longitudinal quasi-experimental study.
Hone, Thomas; Szklo, Andre Salem; Filippidis, Filippos T; Laverty, Anthony A; Sattamini, Isabela; Been, Jasper V; Vianna, Cristiane; Souza, Mirian; de Almeida, Liz Maria; Millett, Christopher.
Afiliação
  • Hone T; Department of Primary Care and Public Health, Imperial College London, London, UK thomas.hone12@imperial.ac.uk.
  • Szklo AS; Population Research Division, National Cancer Institute/Ministry of Health Brazil, Rio de Janeiro, Brazil.
  • Filippidis FT; Department of Primary Care and Public Health, Imperial College London, London, UK.
  • Laverty AA; Department of Primary Care and Public Health, Imperial College London, London, UK.
  • Sattamini I; Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, São Paulo, Brazil.
  • Been JV; Division of Neonatology, Department of Paediatrics, Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
  • Vianna C; Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
  • Souza M; Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
  • de Almeida LM; Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom.
  • Millett C; Tobacco Control Deptartment - Latin America, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.
Tob Control ; 29(3): 312-319, 2020 05.
Article em En | MEDLINE | ID: mdl-31152114
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 OUTCOMES MEASURES: 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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Poluição por Fumaça de Tabaco / Fumar / Mortalidade Infantil / Política Antifumo / Morte Perinatal / Morte do Lactente / Prevenção do Hábito de Fumar Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Infant / Male / Middle aged / Newborn / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Poluição por Fumaça de Tabaco / Fumar / Mortalidade Infantil / Política Antifumo / Morte Perinatal / Morte do Lactente / Prevenção do Hábito de Fumar Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Infant / Male / Middle aged / Newborn / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2020 Tipo de documento: Article