Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland.
Nicotine Tob Res. 2017 Nov 7;19(12):1441-1449. doi: 10.1093/ntr/ntw210.
It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries during the past two decades. This paper aims to investigate the impact of price and non-price related population-wide tobacco control policies on smoking by socioeconomic group in nine European countries between 1990 and 2007.
Individual-level education, occupation and smoking status were obtained from nationally representative surveys. Country-level price-related tobacco control policies were measured by the relative price of cheapest cigarettes and of cigarettes in the most popular price category. Country-level non-price policies were measured by a summary score covering four policy domains: smoking bans or restrictions in public places and workplaces, bans on advertising and promotion, health warning labels, and cessation services. The associations between policies and smoking were explored using logistic regressions, stratified by education and occupation, and adjusted for age, Gross Domestic Product, period and country fixed effects.
The price of popular cigarettes and non-price policies were negatively associated with smoking among men. The price of the cheapest cigarettes was negatively associated with smoking among women. While these favorable effects were generally in the same direction for all socioeconomic groups, they were larger and statistically significant in lower socioeconomic groups only.
Tobacco control policies as implemented in nine European countries, have probably helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors. Policies with larger effects on lower socioeconomic groups are needed to reverse this trend.
Socioeconomic inequalities in smoking widened between the 1990s and the 2000s in Europe. During the same period, there were intensified tobacco control policies in many European countries. It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries. This study shows that tobacco control policies as implemented in the available European countries have helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors.
在过去的二十年中，不确定在欧洲国家中，烟草控制政策是否导致了吸烟的社会经济不平等程度的缩小或扩大。本文旨在研究 1990 年至 2007 年间，九个欧洲国家中与价格和非价格相关的全民烟草控制政策对不同社会经济群体吸烟的影响。
从全国代表性调查中获取了个体层面的教育、职业和吸烟状况。用最便宜香烟和最受欢迎价格类别香烟的相对价格来衡量国家层面的价格相关烟草控制政策。用涵盖四个政策领域的综合评分来衡量国家层面的非价格政策：公共场所和工作场所的禁烟或禁烟令、广告和促销禁令、健康警示标签和戒烟服务。使用逻辑回归，按教育和职业分层，调整年龄、国内生产总值、时期和国家固定效应，探索政策与吸烟之间的关联。
最受欢迎香烟的价格和非价格政策与男性吸烟呈负相关。最便宜香烟的价格与女性吸烟呈负相关。虽然这些有利影响在所有社会经济群体中基本相同，但在较低社会经济群体中更大且具有统计学意义。
在九个欧洲国家实施的烟草控制政策可能有助于降低总体人群的吸烟率，特别是在较低社会经济群体中。吸烟的社会经济不平等程度扩大可能是由其他因素造成的。需要对较低社会经济群体有更大影响的政策来扭转这一趋势。
在欧洲，吸烟的社会经济不平等程度在 20 世纪 90 年代和 21 世纪初扩大。在此期间，许多欧洲国家加强了烟草控制政策。不确定在欧洲国家，烟草控制政策是否导致了吸烟的社会经济不平等程度的缩小或扩大。本研究表明，在现有的欧洲国家实施的烟草控制政策有助于降低总人群的吸烟率，特别是在较低社会经济群体中。吸烟的社会经济不平等程度扩大可能是由其他因素造成的。
