Article Text
Abstract
Introduction This study examined the impact of antismoking activities targeting the general population and an advertising campaign targeting smoking during pregnancy on the prevalence of smoking during pregnancy in New South Wales (NSW), Australia.
Methods Monthly prevalence of smoking during pregnancy was calculated using linked health records for all pregnancies resulting in a birth (800 619) in NSW from 2003 to 2011. Segmented regression of interrupted time series data assessed the effects of the extension of the ban on smoking in enclosed public places to include licensed premises (evaluated in combination with the mandating of graphic warnings on cigarette packs), television advertisements targeting smoking in the general population, print and online magazine advertisements targeting smoking during pregnancy and increased tobacco tax. Analyses were conducted for all pregnancies, and for the population stratified by maternal age, parity and socioeconomic status. Further analyses adjusted for the effect of the Baby Bonus maternity payment.
Results Prevalence of smoking during pregnancy decreased from 2003 to 2011 overall (0.39% per month), and for all strata examined. For pregnancies overall, none of the evaluated initiatives was associated with a change in the trend of smoking during pregnancy. Significant changes associated with increased tobacco tax and the extension of the smoking ban (in combination with graphic warnings) were found in some strata.
Conclusions The declining prevalence of smoking during pregnancy between 2003 and 2011, while encouraging, does not appear to be directly related to general population antismoking activities or a pregnancy-specific campaign undertaken in this period.
- priority/special populations
- public policy
- taxation
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Footnotes
Contributors All authors contributed to the study. The study was conceived by AH, and designed by AH, DTT and AKC. The analysis was executed by DTT. KE, DP and LJ contributed to the design. AH drafted the manuscript, with input from all authors.
Funding This research was supported by an Australian National Health and Medical Research Council Project Grant (#1028543) and AH is supported by a National Heart Foundation Future Leader Fellowship (#100411). The funders had no involvement in the study design; the collection, analysis or interpretation of the data; in the writing of the report or the decision to submit the report for publication.
Competing interests All authors have completed the ICMJE uniform disclosure form and declare: all authors had financial support from the National Health and Medical Research Council for the submitted work; AH also received financial support from the National Heart Foundation; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Ethics approval NSW Population and Health Services Research Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The data sets were constructed with the permission of each of the source data custodians and with specific ethical approvals. Authors do not have permission to share patient-level data because of the highly confidential nature of the data. Permission to access to the data is restricted to researchers named and approved by relevant human research ethics committees.