Impact of a stepwise introduction of smoke-free legislation on the rate of preterm births: analysis of routinely collected birth data.
Identifieur interne : 000047 ( Main/Corpus ); précédent : 000046; suivant : 000048Impact of a stepwise introduction of smoke-free legislation on the rate of preterm births: analysis of routinely collected birth data.
Auteurs : Bianca Cox ; Evelyne Martens ; Benoit Nemery ; Jaco Vangronsveld ; Tim S. NawrotSource :
- BMJ (Clinical research ed.) [ 1756-1833 ] ; 2013.
English descriptors
- KwdEn :
- Adult, Belgium (epidemiology), Female, Humans, Incidence, Infant, Newborn, Infant, Premature, Logistic Models, Male, Pregnancy, Premature Birth (epidemiology), Restaurants, Smoking (legislation & jurisprudence), Smoking Prevention, Tobacco Smoke Pollution (legislation & jurisprudence), Tobacco Smoke Pollution (prevention & control), Workplace.
- MESH :
- chemical , legislation & jurisprudence : Tobacco Smoke Pollution.
- epidemiology : Belgium, Premature Birth.
- legislation & jurisprudence : Smoking.
- chemical , prevention & control : Tobacco Smoke Pollution.
- Adult, Female, Humans, Incidence, Infant, Newborn, Infant, Premature, Logistic Models, Male, Pregnancy, Restaurants, Smoking Prevention, Workplace.
Abstract
OBJECTIVE
To investigate the incidence of preterm delivery in the Belgian population after implementation of smoke-free legislation in three phases (in public places and most workplaces January 2006, in restaurants January 2007, and in bars serving food January 2010).
DESIGN
Logistic regression analyses on routinely collected birth data from January 2002 to December 2011.
SETTING
Flanders, Belgium.
POPULATION
All live born singleton births delivered at 24-44 weeks of gestation (n = 606,877, with n = 448,520 spontaneous deliveries).
MAIN OUTCOME MEASURES
Preterm birth (gestational age <37 weeks).
RESULTS
We found reductions in the risk of preterm birth after the introduction of each phase of the smoking ban. No decreasing trend was evident in the years or months before the bans. We observed a step change in the risk of spontaneous preterm delivery of -3.13% (95% CI -4.37% to -1.87%; P<0.01) on 1 January 2007 (ban on smoking in restaurants), and an annual slope change of -2.65% (-5.11% to -0.13%; P=0.04) after 1 January 2010 (ban on smoking in bars serving food). The analysis for all births gave similar results: a step change of -3.18% (-5.38% to -0.94%; P<0.01) on 1 January 2007, and an annual slope change of -3.50% (-6.35% to -0.57%; P=0.02) after 1 January 2010. These changes could not be explained by personal factors (infant sex, maternal age, parity, socioeconomic status, national origin, level of urbanisation); time related factors (underlying trends, month of the year, day of the week); or population related factors (public holidays, influenza epidemics, and short term changes in apparent temperature and particulate air pollution).
CONCLUSION
Our study shows a consistent pattern of reduction in the risk of preterm delivery with successive population interventions to restrict smoking. This finding is not definitive but it supports the notion that smoking bans have public health benefits from early life.
DOI: 10.1136/bmj.f441
PubMed: 23412829
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pubmed:23412829Le document en format XML
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Nawrot</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="RBID">pubmed:23412829</idno><idno type="pmid">23412829</idno><idno type="doi">10.1136/bmj.f441</idno><idno type="wicri:Area/Main/Corpus">000047</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000047</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Impact of a stepwise introduction of smoke-free legislation on the rate of preterm births: analysis of routinely collected birth data.</title><author><name sortKey="Cox, Bianca" sort="Cox, Bianca" uniqKey="Cox B" first="Bianca" last="Cox">Bianca Cox</name><affiliation><nlm:affiliation>Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, 3590 Diepenbeek, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Martens, Evelyne" sort="Martens, Evelyne" uniqKey="Martens E" first="Evelyne" last="Martens">Evelyne Martens</name></author><author><name sortKey="Nemery, Benoit" sort="Nemery, Benoit" uniqKey="Nemery B" first="Benoit" last="Nemery">Benoit Nemery</name></author><author><name sortKey="Vangronsveld, Jaco" sort="Vangronsveld, Jaco" uniqKey="Vangronsveld J" first="Jaco" last="Vangronsveld">Jaco Vangronsveld</name></author><author><name sortKey="Nawrot, Tim S" sort="Nawrot, Tim S" uniqKey="Nawrot T" first="Tim S" last="Nawrot">Tim S. Nawrot</name></author></analytic><series><title level="j">BMJ (Clinical research ed.)</title><idno type="eISSN">1756-1833</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Belgium (epidemiology)</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Infant, Newborn</term><term>Infant, Premature</term><term>Logistic Models</term><term>Male</term><term>Pregnancy</term><term>Premature Birth (epidemiology)</term><term>Restaurants</term><term>Smoking (legislation & jurisprudence)</term><term>Smoking Prevention</term><term>Tobacco Smoke Pollution (legislation & jurisprudence)</term><term>Tobacco Smoke Pollution (prevention & control)</term><term>Workplace</term></keywords><keywords scheme="MESH" type="chemical" qualifier="legislation & jurisprudence" xml:lang="en"><term>Tobacco Smoke Pollution</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Belgium</term><term>Premature Birth</term></keywords><keywords scheme="MESH" qualifier="legislation & jurisprudence" xml:lang="en"><term>Smoking</term></keywords><keywords scheme="MESH" type="chemical" qualifier="prevention & control" xml:lang="en"><term>Tobacco Smoke Pollution</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Infant, Newborn</term><term>Infant, Premature</term><term>Logistic Models</term><term>Male</term><term>Pregnancy</term><term>Restaurants</term><term>Smoking Prevention</term><term>Workplace</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To investigate the incidence of preterm delivery in the Belgian population after implementation of smoke-free legislation in three phases (in public places and most workplaces January 2006, in restaurants January 2007, and in bars serving food January 2010).</p></div><div type="abstract" xml:lang="en"><p><b>DESIGN</b></p><p>Logistic regression analyses on routinely collected birth data from January 2002 to December 2011.</p></div><div type="abstract" xml:lang="en"><p><b>SETTING</b></p><p>Flanders, Belgium.</p></div><div type="abstract" xml:lang="en"><p><b>POPULATION</b></p><p>All live born singleton births delivered at 24-44 weeks of gestation (n = 606,877, with n = 448,520 spontaneous deliveries).</p></div><div type="abstract" xml:lang="en"><p><b>MAIN OUTCOME MEASURES</b></p><p>Preterm birth (gestational age <37 weeks).</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>We found reductions in the risk of preterm birth after the introduction of each phase of the smoking ban. No decreasing trend was evident in the years or months before the bans. We observed a step change in the risk of spontaneous preterm delivery of -3.13% (95% CI -4.37% to -1.87%; P<0.01) on 1 January 2007 (ban on smoking in restaurants), and an annual slope change of -2.65% (-5.11% to -0.13%; P=0.04) after 1 January 2010 (ban on smoking in bars serving food). The analysis for all births gave similar results: a step change of -3.18% (-5.38% to -0.94%; P<0.01) on 1 January 2007, and an annual slope change of -3.50% (-6.35% to -0.57%; P=0.02) after 1 January 2010. These changes could not be explained by personal factors (infant sex, maternal age, parity, socioeconomic status, national origin, level of urbanisation); time related factors (underlying trends, month of the year, day of the week); or population related factors (public holidays, influenza epidemics, and short term changes in apparent temperature and particulate air pollution).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Our study shows a consistent pattern of reduction in the risk of preterm delivery with successive population interventions to restrict smoking. This finding is not definitive but it supports the notion that smoking bans have public health benefits from early life.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">23412829</PMID><DateCompleted><Year>2013</Year><Month>04</Month><Day>02</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1756-1833</ISSN><JournalIssue CitedMedium="Internet"><Volume>346</Volume><PubDate><Year>2013</Year><Month>Feb</Month><Day>14</Day></PubDate></JournalIssue><Title>BMJ (Clinical research ed.)</Title><ISOAbbreviation>BMJ</ISOAbbreviation></Journal><ArticleTitle>Impact of a stepwise introduction of smoke-free legislation on the rate of preterm births: analysis of routinely collected birth data.</ArticleTitle><Pagination><MedlinePgn>f441</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/bmj.f441</ELocationID><ELocationID EIdType="pii" ValidYN="Y">bmj.f441</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To investigate the incidence of preterm delivery in the Belgian population after implementation of smoke-free legislation in three phases (in public places and most workplaces January 2006, in restaurants January 2007, and in bars serving food January 2010).</AbstractText><AbstractText Label="DESIGN" NlmCategory="METHODS">Logistic regression analyses on routinely collected birth data from January 2002 to December 2011.</AbstractText><AbstractText Label="SETTING" NlmCategory="METHODS">Flanders, Belgium.</AbstractText><AbstractText Label="POPULATION" NlmCategory="METHODS">All live born singleton births delivered at 24-44 weeks of gestation (n = 606,877, with n = 448,520 spontaneous deliveries).</AbstractText><AbstractText Label="MAIN OUTCOME MEASURES" NlmCategory="METHODS">Preterm birth (gestational age <37 weeks).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">We found reductions in the risk of preterm birth after the introduction of each phase of the smoking ban. No decreasing trend was evident in the years or months before the bans. We observed a step change in the risk of spontaneous preterm delivery of -3.13% (95% CI -4.37% to -1.87%; P<0.01) on 1 January 2007 (ban on smoking in restaurants), and an annual slope change of -2.65% (-5.11% to -0.13%; P=0.04) after 1 January 2010 (ban on smoking in bars serving food). The analysis for all births gave similar results: a step change of -3.18% (-5.38% to -0.94%; P<0.01) on 1 January 2007, and an annual slope change of -3.50% (-6.35% to -0.57%; P=0.02) after 1 January 2010. These changes could not be explained by personal factors (infant sex, maternal age, parity, socioeconomic status, national origin, level of urbanisation); time related factors (underlying trends, month of the year, day of the week); or population related factors (public holidays, influenza epidemics, and short term changes in apparent temperature and particulate air pollution).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Our study shows a consistent pattern of reduction in the risk of preterm delivery with successive population interventions to restrict smoking. 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