Estimating the Effects of Cigarette Taxes on Birth Outcomes

Sen, Anindya; Piérard, Emmanuelle

doi:10.3138/cpp.37.2.257

Cited by 12 publications

(26 citation statements)

References 30 publications

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“… 39 , 53 Tobacco taxes were associated with a decreased risk of infant mortality in two studies assessing this association. 57 , 60 In one of these studies, however, an increase in fetal deaths was also observed. 60 One study showed significant reductions in paediatric asthma prevalence following tobacco tax increases.…”

Section: Resultsmentioning

confidence: 91%

“…Risk of bias of individual studies is reported in detail in the appendix (pp 32, 33) . For the EPOC studies, risk of bias was low in 23 studies, 16 , 17 , 18 , 28 , 30 , 31 , 32 , 33 , 36 , 37 , 39 , 40 , 44 , 45 , 46 , 47 , 48 , 51 , 52 , 53 , 58 , 63 , 64 moderate in 16, 19 , 34 , 35 , 41 , 42 , 43 , 49 , 50 , 54 , 55 , 56 , 57 , 59 , 60 , 61 , 62 and high in two. 29 , 38 For the non-EPOC studies, risk of bias was high for two studies 66 , 67 and unclear for one.…”

Section: Resultsmentioning

confidence: 98%

“…After removal of duplicates, 12 392 unique citations were screened by title and abstract, and 65 full texts were sourced. Of these, 41 EPOC studies 16 , 17 , 18 , 19 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 and three non-EPOC studies 65 , 66 , 67 fit the inclusion criteria ( figure 1 ; appendix, pp 6, 7 ). The EPOC studies included data from more than 57 million births, and from 4·6 million GP diagnoses and 2·7 million hospital admissions for respiratory conditions.…”

Section: Resultsmentioning

confidence: 99%

“…The appendix (pp 8–20) details the main characteristics of the EPOC studies. Among these, 26 were interrupted time series studies, 16 , 17 , 18 , 19 , 31 , 32 , 37 , 38 , 40 , 42 , 43 , 45 , 46 , 48 , 50 , 51 , 52 , 54 , 55 , 57 , 58 , 59 , 61 , 62 , 63 , 64 14 were controlled interrupted time series studies, 28 , 29 , 33 , 34 , 35 , 36 , 39 , 41 , 44 , 47 , 49 , 53 , 56 , 60 and one had a regression discontinuity design, 30 a quasi-experimental design bearing close resemblance to interrupted time series methodology. 68 The three non-EPOC studies were uncontrolled before-and-after studies ( appendix, p 21 ).…”

Section: Resultsmentioning

confidence: 99%

“…65 , 66 , 67 Model characteristics of individual studies can be found in the appendix (pp 22–31) . The EPOC studies were done in 14 countries across North America (24 studies) 18 , 28 , 29 , 31 , 33 , 35 , 36 , 38 , 39 , 41 , 42 , 43 , 45 , 46 , 47 , 49 , 50 , 53 , 54 , 56 , 57 , 59 , 60 , 61 and Europe (16 studies), 16 , 17 , 30 , 32 , 34 , 37 , 40 , 44 , 48 , 51 , 52 , 55 , 58 , 62 , 63 , 64 with one study from Hong Kong, China. 19 Several US studies assessed the same outcomes in partially overlapping study populations.…”

Section: Resultsmentioning

confidence: 99%

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Effect of tobacco control policies on perinatal and child health: a systematic review and meta-analysis

Faber

Kumar

Mackenbach

et al. 2017

The Lancet Public Health

164

130

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SummaryBackgroundTobacco smoking and smoke exposure during pregnancy and childhood cause considerable childhood morbidity and mortality. We did a systematic review and meta-analysis to investigate whether implementation of WHO's recommended tobacco control policies (MPOWER) was of benefit to perinatal and child health.MethodsWe searched 19 electronic databases, hand-searched references and citations, and consulted experts to identify studies assessing the association between implementation of MPOWER policies and child health. We did not apply any language restrictions, and searched the full time period available for each database, up to June 22, 2017. Our primary outcomes of interest were perinatal mortality, preterm birth, hospital attendance for asthma exacerbations, and hospital attendance for respiratory tract infections. Where possible and appropriate, we combined data from different studies in random-effects meta-analyses. This study is registered with PROSPERO, number CRD42015023448.FindingsWe identified 41 eligible studies (24 from North America, 16 from Europe, and one from China) that assessed combinations of the following MPOWER policies: smoke-free legislation (n=35), tobacco taxation (n=11), and smoking cessation services (n=3). Risk of bias was low in 23 studies, moderate in 16, and high in two. Implementation of smoke-free legislation was associated with reductions in rates of preterm birth (–3·77% [95% CI −6·37 to −1·16]; ten studies, 27 530 183 individuals), rates of hospital attendance for asthma exacerbations (–9·83% [–16·62 to −3·04]; five studies, 684 826 events), and rates of hospital attendance for all respiratory tract infections (–3·45% [–4·64 to −2·25]; two studies, 1 681 020 events) and for lower respiratory tract infections (–18·48% [–32·79 to −4·17]; three studies, 887 414 events). Associations appeared to be stronger when comprehensive smoke-free laws were implemented than when partial smoke-free laws were implemented. Among two studies assessing the association between smoke-free legislation and perinatal mortality, one showed significant reductions in stillbirth and neonatal mortality but did not report the overall effect on perinatal mortality, while the other showed no change in perinatal mortality. Meta-analysis of studies on other MPOWER policies was not possible; all four studies on increasing tobacco taxation and one of two on offering disadvantaged pregnant women help to quit smoking that reported on our primary outcomes had positive findings. Assessment of publication bias was only possible for studies assessing the association between smoke-free legislation and preterm birth, showing some degree of bias.InterpretationSmoke-free legislation is associated with substantial benefits to child health. The majority of studies on other MPOWER policies also indicated a positive effect. These findings provide strong support for implementation of such policies comprehensively across the world.FundingChief Scientist Office Scotland, Farr Institute, Netherlands Lung Foundation, Erasmus...

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Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Effect of tobacco control policies on perinatal and child health: a systematic review and meta-analysis

Faber

Kumar

Mackenbach

et al. 2017

The Lancet Public Health

164

130

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Evaluation of Population-Level Tobacco Control Interventions and Health Outcomes

et al. 2023

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ImportanceSmoking causes considerable noncommunicable diseases, perinatal morbidity, and mortality.ObjectiveTo investigate the associations of population-level tobacco-control policies with health outcomes.Data SourcesPubMed, EMBASE, Web of Science, Cumulated Index to Nursing and Allied Health Literature, and EconLit were searched from inception to March 2021 (updated on 1 March 2022). References were manually searched.Study SelectionStudies reporting on associations of population-level tobacco control policies with health-related outcomes were included. Data were analyzed from May to July 2022.Data Extraction and SynthesisData were extracted by 1 investigator and cross-checked by a second investigator. Analyses were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline.Main Outcomes and MeasuresThe primary outcomes were respiratory system disease (RSD), cardiovascular disease (CVD), cancer, mortality, hospitalization, and health care utilization. The secondary outcomes were adverse birth outcomes, such as low birth weight and preterm birth. Random-effects meta-analysis was used to estimate pooled odds ratios (ORs) and 95% CIs.ResultsOf 4952 records identified, 144 population-level studies were included in the final analysis; 126 studies (87.5%) were of high or moderate quality. The most frequently reported policies were smoke-free legislation (126 studies), followed by tax or price increases (14 studies), multicomponent tobacco control programs (12 studies), and a minimum cigarette purchase age law (1 study). Smoke-free legislation was associated with decreased risk of all CVD events (OR, 0.90; 95% CI, 0.86-0.94), RSD events (OR, 0.83; 95% CI, 0.72-0.96), hospitalization due to CVD or RSD (OR, 0.91; 95% CI, 0.87-0.95), and adverse birth outcomes (OR, 0.94; 95% CI, 0.92-0.96). These associations persisted in all sensitivity and subgroup analyses, except for the country income category, for which a significant reduction was only observed in high-income countries. In meta-analysis, there was no clear association of tax or price increases with adverse health outcomes. However, for the narrative synthesis, all 8 studies reported statistically significant associations between tax increases and decreases in adverse health events.Conclusions and RelevanceIn this systematic review and meta-analysis, smoke-free legislation was associated with significant reductions in morbidity and mortality related to CVD, RSD, and perinatal outcomes. These findings support the need to accelerate the implementation of smoke-free laws to protect populations against smoking-related harm.

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Association of Cigarette Price Differentials With Infant Mortality in 23 European Union Countries

et al. 2017

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IMPORTANCE Raising the price of cigarettes by increasing taxation has been associated with improved perinatal and child health outcomes. Transnational tobacco companies have sought to undermine tobacco tax policy by adopting pricing strategies that maintain the availability of budget cigarettes.OBJECTIVE To assess associations between median cigarette prices, cigarette price differentials, and infant mortality across the European Union.

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Estimating the Effects of Cigarette Taxes on Birth Outcomes

Cited by 12 publications

References 30 publications

Effect of tobacco control policies on perinatal and child health: a systematic review and meta-analysis

Effect of tobacco control policies on perinatal and child health: a systematic review and meta-analysis

Evaluation of Population-Level Tobacco Control Interventions and Health Outcomes

Association of Cigarette Price Differentials With Infant Mortality in 23 European Union Countries

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