Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Impact of UK tobacco control policies on inequalities in youth smoking uptake: a natural experiment study

Anyanwu, Philip Emeka, Craig, Peter, Katikireddi, Srinivasa Vittal and Green, Michael James 2020. Impact of UK tobacco control policies on inequalities in youth smoking uptake: a natural experiment study. Nicotine and Tobacco Research , ntaa101. 10.1093/ntr/ntaa101

[thumbnail of ntaa101.pdf] PDF - Published Version
Available under License Creative Commons Attribution.

Download (398kB)

Abstract

Introduction UK countries implemented smoke-free public places legislation and increased the legal age for tobacco purchase from 16 to 18 years between 2006 and 2008. We evaluated the immediate and long-term impacts of these UK policy changes on youth smoking uptake and inequalities therein. Aims and Methods We studied 74 960 person-years of longitudinal data from 14 992 youths (aged 11–15 years) in annual UK household surveys between 1994 and 2016. Discrete-time event history analyses examined whether changes in rates of youth smoking transitions (initiation, experimentation, and escalation to daily smoking or quitting) or their inequalities (by parental education) were associated with policy implementation. Parallel analyses examined smoke-free legislation and the change in legal age. We interpret the results as a combined effect of the two pieces of legislation as their implementation dates were too close to identify separate effects. Models were adjusted for sex, age, UK country, historical year, tobacco taxation, and e-cigarette prevalence, with multiple imputation for missing data. Results For both policies, smoking initiation reduced following implementation (change in legal age odds ratio [OR]: 0.67; 95% confidence interval [CI]: 0.55 to 0.81; smoke-free legislation OR: 0.68; 95% CI: 0.56 to 0.82), while inequalities in initiation narrowed over subsequent years. The legal age change was associated with annual increases in progression from initiation to occasional smoking (OR: 1.26; 95% CI: 1.07 to 1.50) and a reduction in quitting following implementation (OR: 0.57; 95% CI: 0.35 to 0.94). Similar effects were observed for smoke-free legislation but CIs overlapped the null. Conclusions Policies such as these may be highly effective in preventing and reducing socioeconomic inequalities in youth smoking initiation. Implications UK implementation of smoke-free legislation and an increase in the legal age for tobacco purchase from 16 to 18 years were associated with an immediate reduction in smoking initiation and a narrowing of inequalities in initiation over subsequent years. While the policies were associated with reductions in the initiation, progression to occasional smoking increased and quitting decreased following the legislation.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Oxford University Press (OUP): Policy B - Oxford Open Option C
ISSN: 1462-2203
Date of First Compliant Deposit: 15 September 2020
Date of Acceptance: 26 May 2020
Last Modified: 05 Jan 2024 05:35
URI: https://orca.cardiff.ac.uk/id/eprint/134842

Citation Data

Cited 8 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item

Downloads

Downloads per month over past year

View more statistics