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一项针对专家对一般人群和弱势群体的烟草控制策略相对有效性的意见的横断面调查:在缺乏证据的情况下,我们会选择什么?

A cross-sectional survey of experts' opinions about the relative effectiveness of tobacco control strategies for the general population versus disadvantaged groups: what do we choose in the absence of evidence?

机构信息

Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.

出版信息

BMC Public Health. 2013 Dec 8;13:1144. doi: 10.1186/1471-2458-13-1144.

Abstract

BACKGROUND

There is a clear disparity in smoking rates according to social disadvantage. In the absence of sufficiently robust data regarding effective strategies for reducing smoking prevalence in disadvantaged populations, understanding the views of tobacco control experts can assist with funding decisions and research agendas.

METHODS

A web-based cross-sectional survey was conducted with 192 respondents (response rate 65%) sampled from the Australian and New Zealand Tobacco Control Contacts list and a literature search. Respondents were asked to indicate whether a number of tobacco control strategies were perceived to be effective for each of: the general population; Aboriginal and Torres Strait Islander people; those with a low income; and people with a mental illness.

RESULTS

A high proportion of respondents indicated that mass media and increased tobacco taxation (84% and 89% respectively) were effective for the general population. Significantly lower proportions reported these two strategies were effective for sub-populations, particularly Aboriginal and Torres Strait Islanders (58% and 63% respectively, p's < .0001). Subsidised medication was the only strategy associated with a greater proportion of respondents perceiving it to be effective in disadvantaged sub-populations compared to the general population. Tailored quit programs and culturally relevant programs were nominated as additional effective strategies for disadvantaged populations.

CONCLUSIONS

Views about subsidised medications in particular, suggest the need for robust cost-effectiveness data relevant to disadvantaged groups to avoid wastage of scarce tobacco control resources. Strategies perceived to be effective for disadvantaged populations such as tailored or culturally relevant programs require rigorous evaluation so that potential adoption of these approaches is evidence-based.

摘要

背景

根据社会劣势,吸烟率存在明显差异。由于缺乏针对弱势人群降低吸烟率的有效策略的充分有力数据,了解烟草控制专家的观点有助于为资金决策和研究议程提供参考。

方法

通过对澳大利亚和新西兰烟草控制联系人名单以及文献检索中的 192 名受访者(回应率为 65%)进行了一项基于网络的横断面调查。受访者被要求表明他们认为以下烟草控制策略对以下人群是否有效:一般人群;原住民和托雷斯海峡岛民;收入低的人群;和患有精神疾病的人群。

结果

大多数受访者表示大众媒体和提高烟草税(分别为 84%和 89%)对一般人群有效。显著比例的受访者表示,这两个策略对亚人群(特别是原住民和托雷斯海峡岛民)的效果较低(分别为 58%和 63%,p 值均<0.0001)。与一般人群相比,只有补贴药物被更多的受访者认为对弱势亚人群有效。量身定制的戒烟计划和文化相关的项目被提名作为弱势人群的其他有效策略。

结论

特别是对于补贴药物的看法表明,需要为弱势群体提供相关的强有力的成本效益数据,以避免浪费稀缺的烟草控制资源。对于弱势人群有效的策略,如量身定制的或文化相关的项目,需要进行严格的评估,以便这些方法的潜在采用是基于证据的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47bd/3890507/52a565775f0b/1471-2458-13-1144-1.jpg

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