Impact of Public Smoking Bans on Social Inequalities in Children’s Exposure to Tobacco Smoke at Home: An Equity-Focused Systematic Review

Nanninga, Sarah; Lehne, Gesa; Ratz, Tiara; Bolte, Gabriele

doi:10.1093/ntr/nty139

Cited by 5 publications

(3 citation statements)

References 45 publications

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“…46 For SHS exposure in households, Nanninga et al reviewed nine studies and argued that, whereas there was little evidence to support whether smoke-free policies reduced socioeconomic inequalities in SHS exposure in the household, their capacity to increase inequalities was unlikely. 47 This paper extends this literature in the context of a recent tobacco control legislation in the Canadian province of Quebec. This province (8.5 million inhabitants) has had among the highest levels of SHS exposure at home across the 10 Canadian provinces (5.7% versus the national average of 3.9% in 2014).…”

Section: Introductionmentioning

confidence: 70%

Socioeconomic inequalities in secondhand smoke exposure before, during and after implementation of Quebec’s 2015 ‘An Act to Bolster Tobacco Control’

et al. 2020

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BackgroundTo better understand whether tobacco control policies are associated with changes in secondhand smoke (SHS) exposure across socioeconomic groups, we monitored differences in socioeconomic inequalities in SHS exposure in households and private vehicles among youth and adults before, during and after adoption of Quebec’s 2015 An Act to Bolster Tobacco Control.MethodsUsing data from the Canadian Community Health Survey, we examined the prevalence of daily exposure to SHS in households and private vehicles among youth (ages 12 to 17) and adults (ages 18+) across levels of household education and income (separately) in 2013/2014, 2015/2016 and 2017/2018. We tested differences in the magnitude of differences in outcomes over time across education and income categories using logistic models with interaction terms, controlling for age and sex.ResultsWe detected inequalities in SHS exposure outcomes at each time point, most markedly at home among youth (OR of SHS exposure among youth living in the 20% poorest households vs the 20% richest=4.9, 95% CI 2.7 to 6.2). There were decreases in SHS exposure in homes and cars in each education/income group over time. The magnitude of inequalities in SHS exposure in homes and cars, however, did not change during this period.ConclusionsThe persistence of socioeconomic inequalities in SHS exposure despite implementation of new tobacco control laws represents an increasingly worrisome public health challenge, particularly among youth. Policymakers should prioritise the reduction of socioeconomic inequalities in SHS exposure and consider the specific needs of socioeconomically disadvantaged populations in the design of future legislation.

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Section: Introductionmentioning

confidence: 70%

Socioeconomic inequalities in secondhand smoke exposure before, during and after implementation of Quebec’s 2015 ‘An Act to Bolster Tobacco Control’

et al. 2020

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“…We used the PROGRESS‐Plus framework, and previous inequality‐focused systematic reviews, to inform our categorization of which groups under each PROGRESS‐Plus criterion would be defined as “more advantaged” or “less advantaged.” 8,28–30 We considered “more advantaged” groups as follows: urban (place of residence, people living in urban areas often have more proximal access to healthcare and other amenities), White (race/ethnicity), employed full‐time (occupation), male (gender or sex), majority religion (religion), more education (Education), less deprived—for area based measures—or higher income level (SES), being married (social capital), and being older (PLUS). We categorized being older as “more advantaged” as evidence suggests older adults have fewer barriers to accessing primary care and are more likely to be offered weight management intervention in routine practice 31–33 .…”

Section: Methodsmentioning

confidence: 99%

A systematic review of inequalities in the uptake of, adherence to, and effectiveness of behavioral weight management interventions in adults

et al. 2022

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The extent to which behavioral weight management interventions affect health inequalities is uncertain, as is whether trials of these interventions directly consider inequalities. We conducted a systematic review, synthesizing evidence on how different aspects of inequality impact uptake, adherence, and effectiveness in trials of behavioral weight management interventions. We included (cluster-) randomized controlled trials of primary care-applicable behavioral weight management interventions in adults with overweight or obesity published prior to March 2020. Data about trial uptake, intervention adherence, attrition, and weight change by PROGRESS-Plus criteria (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other discriminating factors) were extracted. Data were synthesized narratively and summarized in harvest plots. We identified 91 behavioral weight loss interventions and 12 behavioral weight loss maintenance interventions. Fifty-six of the 103 trials considered inequalities in relation to at least one of intervention or trial uptake (n = 15), intervention adherence (n = 15), trial attrition (n = 32), or weight outcome (n = 34). Most trials found no inequalities gradient. If a gradient was observed for trial uptake, intervention adherence, and trial attrition, those considered "more advantaged" did best. Alternative methods of data synthesis that enable data to be pooled and increase statistical power may enhance understanding of inequalities in behavioral weight management interventions.

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“…29 Open access have been used in systematic reviews of various intervention types since. [30][31][32][33][34][35] Even where there is heterogeneity in measures used, Harvest plots allow for all available and relevant data to be used and presented. 29 36 37 Several study features can be graphically demonstrated on a single plot, such as study quality, statistical significance and sample size.…”

Section: Data Synthesis Narrative Synthesis and Harvest Plotsmentioning

confidence: 99%

Inequalities in the uptake of, adherence to and effectiveness of behavioural weight management interventions: systematic review protocol

et al. 2020

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IntroductionIt has been suggested that interventions focusing on individual behaviour change, such as behavioural weight management interventions, may exacerbate health inequalities. These intervention-generated inequalities may occur at different stages, including intervention uptake, adherence and effectiveness. We will synthesise evidence on how different measures of inequality moderate the uptake, adherence and effectiveness of behavioural weight management interventions in adults.Methods and analysisWe will update a previous systematic literature review from the United States Preventive Services Taskforce to identify trials of behavioural weight management interventions in adults aged 18 years and over that were, or could feasibly be, conducted in or recruited from primary care. Medline, Cochrane database (CENTRAL) and PsycINFO will be searched. Only randomised controlled trials (RCTs) and cluster-RCTs will be included. Two investigators will independently screen articles for eligibility and conduct risk of bias assessment. We will curate publication families for eligible trials. The PROGRESS-Plus acronym (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other discriminating factors) will be used to consider a comprehensive range of health inequalities. Data on trial uptake, intervention adherence, weight change and PROGRESS-Plus-related data will be extracted. Data will be synthesised narratively. We will present a Harvest plot for each PROGRESS-Plus criterion and whether each trial found a negative, positive or no health inequality gradient. We will also identify potential sources of unpublished original research data on these factors which can be synthesised through a future individual participant data meta-analysis.Ethics and disseminationEthical approval is not required as no primary data are being collected. The completed systematic review will be disseminated in a peer-reviewed journal, at conferences, and contribute to the lead author’s PhD thesis. Authors of trials included in the completed systematic review may be invited to collaborate on a future individual participant data meta-analysis.PROSPERO registration numberCRD42020173242.

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Impact of Public Smoking Bans on Social Inequalities in Children’s Exposure to Tobacco Smoke at Home: An Equity-Focused Systematic Review

Cited by 5 publications

References 45 publications

Socioeconomic inequalities in secondhand smoke exposure before, during and after implementation of Quebec’s 2015 ‘An Act to Bolster Tobacco Control’

Socioeconomic inequalities in secondhand smoke exposure before, during and after implementation of Quebec’s 2015 ‘An Act to Bolster Tobacco Control’

A systematic review of inequalities in the uptake of, adherence to, and effectiveness of behavioral weight management interventions in adults

Inequalities in the uptake of, adherence to and effectiveness of behavioural weight management interventions: systematic review protocol

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