烟草控制法律与儿童哮喘
2018/01/15
摘要
背景：环境烟草暴露增加儿童哮喘严重程度。严格的国家层面的烟草控制可以有效降低吸烟率。儿童哮喘回访调查（儿童ACBS）是一个由儿童哮喘监护人发起的国家级专业调查。美国肺科协会年度控烟报告评价控烟法律在各州实施情况，包括税收级别（烟草税与国家平均收入相关），无烟空气评级（在禁烟场所的数量）。
方法：研究提取2006~2010年对应州和年度烟草评级的ACBS数据。在首要分析中，研究者通过回归分析(按年份调整后）探究州税分级对于儿童哮喘严重程度的影响。而次要分析主要评价无烟空气评级对于家庭内吸烟的影响。
结果：研究纳入来自35各州超过5年的12860个回访内容，覆盖2400万人。研究将112单独州控烟分级与患者数据按照州和年进行整合。而更高的税率分级与严重程度下降相关（调整后OR=1.40， P=0.007, 95%CI:1.10-1.80）。而更好的无烟空气分级则与家庭内吸烟率下降无关(将收入和住宅类型因素进行联合调整）
结论：更为严格的烟草税率与哮喘严重程度下降有关。需进一步研究明确无烟空气法律对于家内部环境的作用。本研究支持进一步加强联邦和国家进行烟草调控。
Tobacco Control Laws and Pediatric Asthma.
Pediatrics. 2018 Jan;141(Suppl 1):S130-S136. doi: 10.1542/peds.2017-1026P.
Hatoun J, Davis-Plourde K, Penti B, Cabral H, Kazis L.
Abstract
BACKGROUND:Exposure to environmental tobacco smoke increases pediatric asthma severity. Strict, state-level tobacco control reduces smoking. The Child Asthma Call-Back Survey (Child ACBS) is a nationally representative survey of the guardians of children with asthma. The American Lung Association's annual State of Tobacco Control report grades tobacco control laws in each state including a tax grade (cigarette excise tax relative to the national mean), and a smoke-free air grade (number of locations where smoking is prohibited).
METHODS:We joined Child ACBS data from 2006 to 2010 with corresponding state and year tobacco grades. In the primary analysis, we investigated the effect of state tax grades on a child's asthma severity by using a logistic regression model adjusting for year. A secondary analysis assessed the impact of smoke-free air grades on in-home smoking.
RESULTS:Our analysis included 12 860 Child ACBS interviews from 35 states over 5 years, representing over 24 million individuals. We merged 112 unique State of Tobacco Control grades with patient data by state and year. A higher tax grade was associated with reduced severity (adjusted odds ratio = 1.40; P = .007, 95% confidence interval: 1.10-1.80). A better smoke-free air grade was not associated with decreased in-home smoking after adjusting for confounding by income and type of residence.
CONCLUSIONS:A stronger tobacco tax is associated with reduced asthma severity. Further study is needed to determine the effect of smoke-free air laws on in-home environmental. This work supports ongoing efforts to strengthen tobacco control through federal and state regulations.
背景：环境烟草暴露增加儿童哮喘严重程度。严格的国家层面的烟草控制可以有效降低吸烟率。儿童哮喘回访调查（儿童ACBS）是一个由儿童哮喘监护人发起的国家级专业调查。美国肺科协会年度控烟报告评价控烟法律在各州实施情况，包括税收级别（烟草税与国家平均收入相关），无烟空气评级（在禁烟场所的数量）。
方法：研究提取2006~2010年对应州和年度烟草评级的ACBS数据。在首要分析中，研究者通过回归分析(按年份调整后）探究州税分级对于儿童哮喘严重程度的影响。而次要分析主要评价无烟空气评级对于家庭内吸烟的影响。
结果：研究纳入来自35各州超过5年的12860个回访内容，覆盖2400万人。研究将112单独州控烟分级与患者数据按照州和年进行整合。而更高的税率分级与严重程度下降相关（调整后OR=1.40， P=0.007, 95%CI:1.10-1.80）。而更好的无烟空气分级则与家庭内吸烟率下降无关(将收入和住宅类型因素进行联合调整）
结论：更为严格的烟草税率与哮喘严重程度下降有关。需进一步研究明确无烟空气法律对于家内部环境的作用。本研究支持进一步加强联邦和国家进行烟草调控。
（上海交通大学医学院附属瑞金医院呼吸与危重症医学科 周剑平 万欢英 摘译）
（Pediatrics. 2018 Jan;141(Suppl 1):S130-S136. doi: 10.1542/peds.2017-1026P.）
（Pediatrics. 2018 Jan;141(Suppl 1):S130-S136. doi: 10.1542/peds.2017-1026P.）
Tobacco Control Laws and Pediatric Asthma.
Pediatrics. 2018 Jan;141(Suppl 1):S130-S136. doi: 10.1542/peds.2017-1026P.
Hatoun J, Davis-Plourde K, Penti B, Cabral H, Kazis L.
Abstract
BACKGROUND:Exposure to environmental tobacco smoke increases pediatric asthma severity. Strict, state-level tobacco control reduces smoking. The Child Asthma Call-Back Survey (Child ACBS) is a nationally representative survey of the guardians of children with asthma. The American Lung Association's annual State of Tobacco Control report grades tobacco control laws in each state including a tax grade (cigarette excise tax relative to the national mean), and a smoke-free air grade (number of locations where smoking is prohibited).
METHODS:We joined Child ACBS data from 2006 to 2010 with corresponding state and year tobacco grades. In the primary analysis, we investigated the effect of state tax grades on a child's asthma severity by using a logistic regression model adjusting for year. A secondary analysis assessed the impact of smoke-free air grades on in-home smoking.
RESULTS:Our analysis included 12 860 Child ACBS interviews from 35 states over 5 years, representing over 24 million individuals. We merged 112 unique State of Tobacco Control grades with patient data by state and year. A higher tax grade was associated with reduced severity (adjusted odds ratio = 1.40; P = .007, 95% confidence interval: 1.10-1.80). A better smoke-free air grade was not associated with decreased in-home smoking after adjusting for confounding by income and type of residence.
CONCLUSIONS:A stronger tobacco tax is associated with reduced asthma severity. Further study is needed to determine the effect of smoke-free air laws on in-home environmental. This work supports ongoing efforts to strengthen tobacco control through federal and state regulations.
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日常诊疗中慢性阻塞性肺病诊断和控烟支持：证据和实践的差异
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长期吸食大麻者和吸烟者认知、行为和精神健康状态分析
