Balancing absolute and relative risk reduction in tobacco control policy: the example of antenatal smoking in Victoria, Australia

Australian and New Zealand Journal of Public Health
Nathan GrillsLeonard Sunil Piers

Abstract

This descriptive epidemiological analysis aims to explore the benefits, risks and policy balance between a whole-of-population and high-risk reduction approach to reducing antenatal smoking prevalence. Using Victorian hospital antenatal statistics the rate-ratio for smoking in each hypothesised high prevalence group was calculated and combined with the absolute number of births in each high-risk group. The effect on smoking prevalence of whole-of-population reductions and high-risk group reductions was then modelled. In Victoria, there were higher rates of antenatal smoking among single [RR = 4.67 (3.46-4.42)], teenage women [RR (95%CI) = 3.26 (3.00-3.54)] of indigenous ethnicity [RR = 4.39 (3.94, 4.88)] with low income [RR = 4.67 (4.17-5.22)] and low education attainment [RR = 3.89 (3.47-4.36)] who lived in less accessible areas [RR = 2.14 (1.92-2.39)]. However, as each of these high-risk groups represents a relatively small proportion of mothers, most antenatal smokers are aged 25-34, educated, city-based, non-Indigenous and non-impoverished. The majority of Victorian women who smoke in pregnancy do not belong to traditional high-risk groups. Absolute reductions in smoking prevalence in high-risk groups can potentially be ach...Continue Reading

References

Apr 28, 2004·Australian and New Zealand Journal of Public Health·Mohammad Siahpush
Jun 19, 2004·Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco·Toya RussellLesa Woodby
Mar 7, 2006·Lancet·C W WarrenUNKNOWN Global Tobacco Surveillance System (GTSS) collaborative group
Apr 9, 2008·The Medical Journal of Australia·Denise L Chan, Elizabeth A Sullivan
Apr 17, 2008·Australian and New Zealand Journal of Public Health·David P ThomasJoan Cunningham
May 9, 2008·Clinical Obstetrics and Gynecology·Julie T CrawfordRobert L Goldenberg

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Citations

Jul 21, 2020·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Jillian A PattersonJonathan M Morris

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