| 许晴晴,严永富,董文兰,刘世炜.全球不同控烟措施应用场景下潜在的短期控烟效果的Meta分析[J].中华流行病学杂志,2023,44(4):650-656 |
| 全球不同控烟措施应用场景下潜在的短期控烟效果的Meta分析 |
| Potential short-term effects of tobacco control scheme under various application scenarios of tobacco control measures across the globe: a Meta-analysis |
| 收稿日期:2022-07-15 出版日期:2023-04-18 |
| DOI：10.3760/cma.j.cn112338-20220715-00630 |
| 中文关键词: 控烟 措施 短期效果 Meta分析 |
| 英文关键词: Tobacco control Measures Short-term effects Meta-analysis |
| 基金项目:国家重点研发计划（2017YFC1310902）；烟草流行监测和控烟综合干预（131031001000210013） |
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| 中文摘要: |
| 目的 在梳理全球控烟措施效果的模拟预测研究现状、理清不同控烟措施的实施场景的基础上，系统分析提高烟草税、全面无烟环境立法、烟草包装健康警示、防止向未成年人销售烟草、禁止烟草营销、提供戒烟帮助、开展控烟宣传活动（七大类控烟措施）不同应用场景下潜在的短期控烟效果。方法 系统检索PubMed、Embase、EconLit、PsychINFO和CINAHL数据库截至2022年4月有关控烟措施效果模拟预测的研究。根据纳入和排除标准收集资料，采用R软件对七大类控烟措施不同应用场景下潜在的短期控烟效果进行Meta分析。结果 共纳入22篇文献，研究地点涉及16个国家，其中美国、墨西哥和意大利分别进行5、3和2次研究。纳入研究均选取了提高烟草税、全面无烟环境立法和开展控烟宣传活动措施，部分研究选取了防止向未成年人销售烟草措施（21项）、禁止烟草营销措施（20项）和提供戒烟帮助及烟草包装健康警示措施（19项）。Meta分析结果显示，提高烟草税对不同年龄组的价格弹性影响不同，15~17岁组的价格弹性最大，为0.044（95%CI：0.038~0.051）；工作场所全面无烟环境立法的潜在短期控烟效果高于对餐厅和室内其他公共场所；防止向未成年人销售烟草措施对＜16岁组的影响大于16~17岁组；其他控烟措施的实施力度越强，潜在的短期控烟效果影响越大。七大类控烟措施间比较发现，提供戒烟帮助的戒烟率增加幅度最大，为0.404（95%CI：0.357~0.456）；防止向未成年人销售烟草表现为优时，对＜16岁组影响的吸烟率下降幅度、开始吸烟率下降幅度最大，分别为0.292（95%CI：0.269~0.315）和0.292（95%CI：0.270~0.316）。结论 通过Meta分析获得七大类控烟措施不同应用场景下潜在的短期控烟效果。从短期效果看，提供戒烟帮助将大幅度提高戒烟率，完全落实防止向未成年人销售烟草措施时将大幅度降低<16岁组的吸烟率和开始吸烟率，为我国和其他国家控烟措施模拟研究提供重要的参考依据。 |
| 英文摘要: |
| Objective based on summarizing the simulation and prediction of tobacco control measures across the globe and sorting out the various scenarios of tobacco control measures, the potential short-term effects of seven tobacco control measures in different scenarios were systematically analyzed. Methods Until April 2022, PubMed, Embase, EconLit, PsychINFO, and CINAHL databases were used to retrieve literature about tobacco control measures simulation and prediction models across the globe. Inclusion and exclusion criteria were strictly followed. Meta-analysis for the potential short-term effects of seven tobacco control measures in different scenarios was performed using the R software. Results A total of 22 papers covering 16 countries were selected. Five studies were conducted in the United States, three in Mexico, and two in Italy. There were all papers with the measures to tax increases, smoke-free air laws, and mass media campaigns, 21 papers with youth access restrictions, 20 with marketing restrictions, and 19 with cessation treatment programs and health warnings. The tax increases had diverse influences on the price elasticity of different age groups. The price elasticity in the age group 15-17 years was the highest, which was 0.044 (95%CI: 0.038-0.051). The potential short-term effects of smoke-free air laws in workplaces were higher than in restaurants and other indoor public places. The effects of youth access restrictions were greater in the age group ＜16 years than in the age group 16-17. The stronger the implementation of other measures, the greater the potential short-term effects. A comparison of seven tobacco control measures showed that the cessation treatment programs increase in cessation rate was the highest, 0.404 (95%CI: 0.357-0.456). The reduction in smoking rate and reduction in initiation rate of youth access restrictions strongly enforced and publicized was the highest in the age group ＜16 years, 0.292 (95%CI: 0.269-0.315), and 0.292 (95%CI: 0.270-0.316).Conclusions The potential short-term effects of seven tobacco control measures in different scenarios were evaluated more accurately and objectively through Meta-analysis. In the short term, cessation treatment programs will substantially increase smoking cessation rates, and strong youth access enforcement will sharply reduce smoking and initiation rates among adolescents under 16. These results also offer strong data-related support for the simulation and prediction of tobacco control measures in China and other countries. |
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