Greaves Lorraine, Johnson Joy, Bottorff Joan, Kirkland Susan, Jategaonkar Natasha, McGowan Melissa, McCullough Lucy, Battersby Lupin
British Columbia Centre of Excellence for Women's Health, BC Women's Hospital, E-311 4500 Oak St., Vancouver, BC V6H 3N1.
Can J Public Health. 2006 Jul-Aug;97(4):310-5. doi: 10.1007/BF03405610.
While comprehensive tobacco policies have reduced the prevalence of smoking in Canada, some groups remain vulnerable to tobacco use and display high rates of smoking. This article reviews three types of tobacco policies--tax and price, smoking location restrictions and sales restrictions--and examines the consequences for Aboriginal people, youth and low-income people.
A better practices review model was used to assess the strength of studies published between 1990 and 2004 that examined the effects of these tobacco policies on the three vulnerable populations of interest. A total of 72 studies were assessed and 42 judged medium or high strength. A gender-based and diversity analysis was applied to assess the differential impacts on females and males and/or diverse characteristics within these populations. Intended and unintended consequences were examined.
Few studies assessed the potential or differential effects of tobacco policies on the three selected populations. In these, it was difficult to disentangle the effects of each policy in a comprehensive tobacco control environment, and there is need for improved indicators and greater attention to sex and gender analysis.
Research is required to measure the intended and unintended impacts of tobacco policies on populations vulnerable to tobacco use. There are problems in assessing these studies that could be resolved with more precise indicator development. An equity-based framework for assessing the effects of tobacco policies is needed that is conceptually linked to health determinants and inequities. The article concludes with a set of recommendations for research, evaluation, policy and ethics arising from this review.
尽管全面的烟草政策已降低了加拿大的吸烟率，但一些群体仍然容易受到烟草使用的影响，且吸烟率较高。本文回顾了三种烟草政策——税收与价格政策、吸烟场所限制政策和销售限制政策，并研究了这些政策对原住民、青少年和低收入人群的影响。
采用一种最佳实践回顾模型来评估1990年至2004年间发表的研究的力度，这些研究考察了这些烟草政策对三个目标弱势群体的影响。总共评估了72项研究，其中42项被判定为中等或高强度。应用基于性别的差异分析来评估这些政策对男性和女性以及这些人群中不同特征群体的不同影响。同时考察了预期和非预期的后果。
很少有研究评估烟草政策对这三个特定人群的潜在或差异影响。在这些研究中，在全面的烟草控制环境下很难区分每项政策的影响，并且需要改进指标，并更加关注性别分析。
需要开展研究来衡量烟草政策对易受烟草使用影响人群的预期和非预期影响。评估这些研究存在一些问题，通过更精确地制定指标可以解决这些问题。需要一个基于公平的框架来评估烟草政策的影响，该框架在概念上与健康决定因素和不公平现象相关联。本文最后给出了一系列基于本次综述的关于研究、评估、政策和伦理方面的建议。
