Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;
Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands; Alliance Smokefree Holland, The Hague, The Netherlands.
Nicotine Tob Res. 2015 Nov;17(11):1369-76. doi: 10.1093/ntr/ntv004. Epub 2015 Jan 12.
Tobacco control policies seemed to have failed to reduce socioeconomic inequalities in smoking in the past. It has been argued that a comprehensive mix of policies is needed. Our aim was to assess whether tobacco control policy development in the Netherlands between 1988 and 2011 was associated with educational inequalities in smoking cessation and cigarette consumption.
Data were derived from the cross-sectional Dutch Continuous Survey of Smoking Habits, with a study sample of 259,140 respondents from 1988 through 2011. Outcomes were the quit ratio and mean number of cigarettes smoked per day. The determinant was the Tobacco Control Scale (TCS). We used multilevel logistic regression modeling, with years, quarters, and individuals as levels, and controlled for sex, age, and time.
A significant association between the TCS and smoking cessation was found in 2001-2011, but not in 1988-2000. Associations for low- and high-education groups were similar (OR = 1.23; 95% CI = 1.12-1.34 and OR = 1.17; 95% CI = 1.03-1.32 respectively). The TCS was not significantly associated with the number of cigarettes smoked per day for either the low- or high-education groups (B = -0.09; 95% CI = -0.46-0.27 and B = -0.59; 95% CI = -1.24-0.06 respectively).
Strong tobacco control policies introduced in the Netherlands after 2000 were positively associated with national trends in smoking cessation, whereas weaker policies introduced gradually before 2000 were not. However, these measures do not seem to have either widened or narrowed educational inequalities in smoking cessation rates-both groups benefitted about equally.
过去，烟草控制政策似乎未能降低吸烟的社会经济不平等。有人认为，需要综合运用多种政策。我们的目的是评估荷兰在 1988 年至 2011 年间的烟草控制政策发展是否与戒烟和香烟消费方面的教育不平等有关。
数据来自 1988 年至 2011 年期间进行的荷兰连续吸烟习惯横断面调查，研究样本为 259140 名受访者。结果是戒烟率和每天吸烟的平均支数。决定因素是烟草控制量表（TCS）。我们使用多水平逻辑回归模型，以年、季度和个人为水平，并控制了性别、年龄和时间。
在 2001-2011 年期间，TCS 与戒烟之间存在显著关联，但在 1988-2000 年期间则没有。低教育和高教育群体的关联相似（OR = 1.23；95% CI = 1.12-1.34 和 OR = 1.17；95% CI = 1.03-1.32）。对于低教育和高教育群体，TCS 与每天吸烟的支数均无显著关联（B = -0.09；95% CI = -0.46-0.27 和 B = -0.59；95% CI = -1.24-0.06）。
荷兰在 2000 年后推出的强有力的烟草控制政策与全国范围内的戒烟趋势呈正相关，而在 2000 年前逐步推出的较弱政策则没有。然而，这些措施似乎没有扩大或缩小戒烟率方面的教育不平等——两个群体都同样受益。
