{"title":"烟草控制政策对吸烟率和戒烟率的社会经济不平等的影响：欧盟生态研究（2009-2020）。","authors":"Ariadna Feliu, Esteve Fernandez, Irene Tamí-Maury, Cristina Martinez","doi":"10.1136/bmjph-2024-002418","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tobacco control efforts have succeeded in reducing smoking prevalence and increasing smoking cessation rates in the European Union Member States (EU27). However, the impact of these policies has been unequal across different income groups.</p><p><strong>Methods: </strong>Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the prevalence of smoking and quit ratios from the Eurobarometer surveys (2009, n=27 788; and 2020, n=28 288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (between 2009 and 2020) using scatter plots and multiple linear regression models.</p><p><strong>Findings: </strong>In the EU27, high inequalities exist among different income groups. High-income residents had lower smoking prevalence (19 vs 40%) and higher quit ratios (55 vs 32%) compared with the low-income group. Positive changes in smoking indicators from 2009 to 2020 were stronger in the high-income group. There was a stronger negative correlation between TCS scores and smoking prevalence in high-income groups (r<sub>sp</sub>=-0.615, p<0.01; r<sub>sp</sub>=-0.498; p=0.01) and between its relative changes but only in the high-income group (r<sub>sp</sub>=-0.478; p=0.01). A positive correlation was observed between TCS scores and quit ratios (r<sub>sp</sub>=0.580, r<sub>sp</sub>=0.548, both p<0.01) in high- and moderate-income populations.</p><p><strong>Conclusions: </strong>Declines in smoking prevalence and increases in quit ratios were considerably lower in moderate- and low-income groups. Tailoring tobacco control policies to address financial, social and structural barriers, such as ensuring free access to cessation services, implementing targeted outreach programmes, adopting culturally and linguistically appropriate interventions, among others, is essential for making these measures more equitable, which is key for the EU27 to achieve its tobacco-free goal by 2040.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002418"},"PeriodicalIF":0.0000,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336528/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of tobacco control policies on socioeconomic inequalities in smoking prevalence and quit ratios: an ecological study in the European Union (2009-2020).\",\"authors\":\"Ariadna Feliu, Esteve Fernandez, Irene Tamí-Maury, Cristina Martinez\",\"doi\":\"10.1136/bmjph-2024-002418\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Tobacco control efforts have succeeded in reducing smoking prevalence and increasing smoking cessation rates in the European Union Member States (EU27). However, the impact of these policies has been unequal across different income groups.</p><p><strong>Methods: </strong>Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the prevalence of smoking and quit ratios from the Eurobarometer surveys (2009, n=27 788; and 2020, n=28 288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (between 2009 and 2020) using scatter plots and multiple linear regression models.</p><p><strong>Findings: </strong>In the EU27, high inequalities exist among different income groups. High-income residents had lower smoking prevalence (19 vs 40%) and higher quit ratios (55 vs 32%) compared with the low-income group. Positive changes in smoking indicators from 2009 to 2020 were stronger in the high-income group. There was a stronger negative correlation between TCS scores and smoking prevalence in high-income groups (r<sub>sp</sub>=-0.615, p<0.01; r<sub>sp</sub>=-0.498; p=0.01) and between its relative changes but only in the high-income group (r<sub>sp</sub>=-0.478; p=0.01). A positive correlation was observed between TCS scores and quit ratios (r<sub>sp</sub>=0.580, r<sub>sp</sub>=0.548, both p<0.01) in high- and moderate-income populations.</p><p><strong>Conclusions: </strong>Declines in smoking prevalence and increases in quit ratios were considerably lower in moderate- and low-income groups. Tailoring tobacco control policies to address financial, social and structural barriers, such as ensuring free access to cessation services, implementing targeted outreach programmes, adopting culturally and linguistically appropriate interventions, among others, is essential for making these measures more equitable, which is key for the EU27 to achieve its tobacco-free goal by 2040.</p>\",\"PeriodicalId\":101362,\"journal\":{\"name\":\"BMJ public health\",\"volume\":\"3 2\",\"pages\":\"e002418\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-08-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336528/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ public health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjph-2024-002418\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ public health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bmjph-2024-002418","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景：在欧洲联盟成员国（欧盟27国），烟草控制工作在降低吸烟率和提高戒烟率方面取得了成功。然而，这些政策对不同收入群体的影响是不平等的。方法：以国家为分析单位进行生态学研究。我们使用2010年欧盟27国的烟草控制量表（TCS）和欧洲晴雨表调查(2009年，n= 27788；2020年，n=28 288)。我们使用散点图和多元线性回归模型分析了TCS分数（2010年）与吸烟指标之间的关系及其相对变化（2009年至2020年）。研究发现：在欧盟27国，不同收入群体之间存在高度不平等。与低收入人群相比，高收入人群的吸烟率较低（19% vs 40%），戒烟率较高（55% vs 32%）。从2009年到2020年，吸烟指标的积极变化在高收入群体中更为明显。高收入人群TCS评分与吸烟率呈较强的负相关(rsp=-0.615, psp=-0.498；P =0.01)，但仅在高收入组(rsp=-0.478；p = 0.01)。TCS评分与戒烟率呈正相关（rsp=0.580, rsp=0.548）。结论：在中低收入人群中，吸烟率的下降和戒烟率的增加明显较低。调整烟草控制政策以解决财政、社会和结构性障碍，例如确保免费获得戒烟服务，实施有针对性的外展规划，采取文化和语言上适当的干预措施等，对于使这些措施更加公平至关重要，这是欧盟27国到2040年实现其无烟草目标的关键。
Impact of tobacco control policies on socioeconomic inequalities in smoking prevalence and quit ratios: an ecological study in the European Union (2009-2020).
Background: Tobacco control efforts have succeeded in reducing smoking prevalence and increasing smoking cessation rates in the European Union Member States (EU27). However, the impact of these policies has been unequal across different income groups.
Methods: Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the prevalence of smoking and quit ratios from the Eurobarometer surveys (2009, n=27 788; and 2020, n=28 288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (between 2009 and 2020) using scatter plots and multiple linear regression models.
Findings: In the EU27, high inequalities exist among different income groups. High-income residents had lower smoking prevalence (19 vs 40%) and higher quit ratios (55 vs 32%) compared with the low-income group. Positive changes in smoking indicators from 2009 to 2020 were stronger in the high-income group. There was a stronger negative correlation between TCS scores and smoking prevalence in high-income groups (rsp=-0.615, p<0.01; rsp=-0.498; p=0.01) and between its relative changes but only in the high-income group (rsp=-0.478; p=0.01). A positive correlation was observed between TCS scores and quit ratios (rsp=0.580, rsp=0.548, both p<0.01) in high- and moderate-income populations.
Conclusions: Declines in smoking prevalence and increases in quit ratios were considerably lower in moderate- and low-income groups. Tailoring tobacco control policies to address financial, social and structural barriers, such as ensuring free access to cessation services, implementing targeted outreach programmes, adopting culturally and linguistically appropriate interventions, among others, is essential for making these measures more equitable, which is key for the EU27 to achieve its tobacco-free goal by 2040.
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