Equity Impact of Population-level Interventions and Policies to Reduce Smoking in Adults
Thursday, April 10, 2014
Posted by: Natalia Gromov
Drug Alcohol Depend. 2014
Mar 13. pii: S0376-8716(14)00774-1.
Equity Impact of
Population-level Interventions and Policies to Reduce Smoking in Adults: A
Brown T, Platt S, Amos A.
The aim of this study was to assess the effectiveness of population-level
interventions/policies to reduce socioeconomic inequalities in adult smoking.
METHODS: Systematic review of studies of population-level
interventions/policies reporting smoking-related outcomes in adults of lower
compared to higher socioeconomic status (SES). RESULTS: 117 studies of 130
interventions/policies were included: smokefree (44); price/tax (27); mass
media campaigns (30); advertising controls (9); cessation support (9); settings-based
interventions (7); multiple policies (4). The distribution of equity effects
was: 33 positive, 36 neutral, 38 negative, 6 mixed, 17 unclear. Most neutral
equity studies benefited all SES groups. Fourteen price/tax studies were equity
positive. Voluntary, regional and partial smokefree policies were more likely
to be equity negative than national, comprehensive smokefree policies. Mass
media campaigns had inconsistent equity effects. Cigarette marketing controls
were equity positive or neutral. Targeted national smoking cessation services
can be equity positive by achieving higher reach among low SES, compensating
for lower quit rates. CONCLUSIONS: Few studies have assessed the equity impact
of tobacco control policy/interventions. Price/tax increases had the most
consistent positive equity impact. More research is needed to strengthen the
evidence-base for reducing smoking inequalities and to develop effective
equity-orientated tobacco control strategies.