The impact of smoke-free legislation on educational differences in birth outcomes

Bibliographic Data

ID11174264
AuthorsBritt Mckinnon (0000-0002-3109-5474, Department of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Quebec, Canada, corresponding author), Nathalie Auger (0000-0002-2412-0459, Institut national de santé publique du Québec, Montreal, Quebec, Canada), Jay S Kaufman (0000-0003-1606-401X, Department of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Quebec, Canada)
Year2015
Volume69
Issue10
Pages937-943
Publication date2015-10-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueJournal of Epidemiology and Community Health (JOURNAL)
Journal identifiersISSN: 0143-005X • E-ISSN: 1470-2738
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/jech-2015-205779
PMID25987722
OpenAlexW2128324687
LanguageEN
Citations received3
References cited27

BACKGROUND: Smoke-free legislation may have positive effects on birth outcomes. Given that smoking and secondhand smoke during pregnancy vary with socioeconomic position, legislation may have greater effects in some socioeconomic groups. For this study, we evaluated the impact of a 2006 ban on smoking in public places in the Canadian province of Quebec on preterm birth, small-for-gestational-age birth and birth weight, and on educational differences in these birth outcomes. METHODS: We analysed data on singleton births in Quebec between 2003 and 2010. Logistic regression was used to model the association of smoke-free legislation with preterm birth (<37 weeks), very preterm birth (<34 weeks), small-for-gestational-age birth (<10th centile for gestational age and sex), low birth weight (<2500 g) and mean birth weight, adjusting for secular trends before and after legislation. Interaction terms were included to assess differential effects by level of maternal education. RESULTS: Smoke-free legislation was associated with average reductions of 3.1 preterm births (95% CI 0.1 to 6.0), 2.3 very preterm births (95% CI 0.9 to 3.7), 5.9 small-for-gestational-age births (95% CI 2.6 to 9.3) and 1.0 low birthweight infants (95% CI 0.4 to 1.6) per 1000 live births, as well as a 17.1 g increase in mean birth weight (95% CI 10.7 to 23.6). Legislation was associated with improved birth outcomes in all categories of maternal education. CONCLUSIONS: Smoke-free legislation in Quebec was associated with reductions in preterm and small-for-gestational-age births, and an increase in birth weight. There was no compelling evidence that legislation impacted educational gradients in birth outcomes

Birth weight · Environmental health · Gestational age · Legislation · Low birth weight · Obstetrics · Population · Pregnancy · Premature birth · Small for gestational age · Socioeconomic status · Cancer Risks and Factors · Demography · Gestational Diabetes Research and Management · Medicine · Smoking Behavior and Cessation · Pediatrics