National Center for Health Marketing, CDC, Atlanta, Georgia 30333, USA.
Am J Prev Med. 2010 Feb;38(2 Suppl):S275-89. doi: 10.1016/j.amepre.2009.10.029.
In 2001, a systematic review for the Guide to Community Preventive Services identified strong evidence of effectiveness of smoking bans and restrictions in reducing exposure to environmental (secondhand) tobacco smoke. As follow-up to that earlier review, the focus here was on the evidence on effectiveness of smokefree policies in reducing tobacco use. Smokefree policies implemented by worksites or communities prohibit smoking in workplaces and designated public areas. The conceptual approach was modified for this review; an updated search for evidence was conducted; and the available evidence was evaluated. Published articles that met quality criteria and evaluated changes in tobacco-use prevalence or cessation were included in the review. A total of 57 studies were identified in the period 1976 through June 2005 that met criteria to be candidates for review; of these, 37 met study design and quality of execution criteria to qualify for final assessment. Twenty-one studies measured absolute differences in tobacco-use prevalence with a median effect of -3.4 percentage points (interquartile interval: -6.3 to -1.4 percentage points). Eleven studies measured differences in tobacco-use cessation among tobacco users exposed to a smokefree policy compared with tobacco users not exposed to a smokefree policy. The median absolute change was an increase in cessation of 6.4 percentage points (interquartile interval: 1.3 to 7.9 percentage points). The qualifying studies provided sufficient evidence that smokefree policies reduce tobacco use among workers when implemented in worksites or by communities. Finally, a systematic economic review identified four studies that, overall, demonstrated economic benefits from a smokefree workplace policy. Additional research is needed to more fully evaluate the total economic effects of these policies.
2001 年，《社区预防服务指南》进行了系统回顾，确认了禁烟令和限制措施在减少环境（二手）烟草烟雾暴露方面的有效性有充分证据。作为对早期审查的后续，这里的重点是评估无烟政策在减少烟草使用方面的有效性。工作场所或社区实施的无烟政策禁止在工作场所和指定的公共场所吸烟。为这次审查修改了概念方法；对证据进行了更新搜索；并评估了现有证据。符合质量标准并评估了烟草使用流行率或戒烟变化的已发表文章被纳入审查。在 1976 年至 2005 年 6 月期间，共确定了 57 项符合审查条件的研究；其中，37 项符合研究设计和执行质量标准，有资格进行最终评估。21 项研究测量了烟草使用流行率的绝对差异，中位数效应为-3.4 个百分点（四分位区间：-6.3 至-1.4 个百分点）。11 项研究测量了暴露于无烟政策的烟草使用者与未暴露于无烟政策的烟草使用者之间的烟草使用戒烟差异。绝对变化的中位数是戒烟率增加了 6.4 个百分点（四分位区间：1.3 至 7.9 个百分点）。合格研究提供了充分的证据表明，在工作场所或社区实施无烟政策可减少工人的烟草使用。最后，系统的经济审查确定了四项研究，总体上表明无烟工作场所政策具有经济效益。需要进一步研究，以更全面地评估这些政策的总体经济影响。
