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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Overview of systematic reviews on the health-related effects of government tobacco control policies

Authors: Steven J. Hoffman, Charlie Tan

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Government interventions are critical to addressing the global tobacco epidemic, a major public health problem that continues to deepen. We systematically synthesize research evidence on the effectiveness of government tobacco control policies promoted by the Framework Convention on Tobacco Control (FCTC), supporting the implementation of this international treaty on the tenth anniversary of it entering into force.

Methods

An overview of systematic reviews was prepared through systematic searches of five electronic databases, published up to March 2014. Additional reviews were retrieved from monthly updates until August 2014, consultations with tobacco control experts and a targeted search for reviews on mass media interventions. Reviews were assessed according to predefined inclusion criteria, and ratings of methodological quality were either extracted from source databases or independently scored.

Results

Of 612 reviews retrieved, 45 reviews met the inclusion criteria and 14 more were identified from monthly updates, expert consultations and a targeted search, resulting in 59 included reviews summarizing over 1150 primary studies. The 38 strong and moderate quality reviews published since 2000 were prioritized in the qualitative synthesis. Protecting people from tobacco smoke was the most strongly supported government intervention, with smoke-free policies associated with decreased smoking behaviour, secondhand smoke exposure and adverse health outcomes. Raising taxes on tobacco products also consistently demonstrated reductions in smoking behaviour. Tobacco product packaging interventions and anti-tobacco mass media campaigns may decrease smoking behaviour, with the latter likely an important part of larger multicomponent programs. Financial interventions for smoking cessation are most effective when targeted at smokers to reduce the cost of cessation products, but incentivizing quitting may be effective as well. Although the findings for bans on tobacco advertising were inconclusive, other evidence suggests they remain an important intervention.

Conclusion

When designing and implementing tobacco control programs, governments should prioritize smoking bans and price increases of tobacco products followed by other interventions. Additional studies are needed on the various factors that can influence a policy’s effectiveness and feasibility such as cost, local context, political barriers and implementation strategies.
Appendix
Available only for authorised users
Footnotes
1
The exact number of primary studies could not be calculated because some reviews did not report the number of studies they summarized. The estimate of 1150 primary studies is conservative.
 
2
Evidence from systematic reviews on the effects of providing telephone counselling and cessation advice from healthcare workers was not included due to the clinical context in which these interventions were implemented. This overview focuses on evidence from evaluations of government tobacco control policies.
 
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Metadata
Title
Overview of systematic reviews on the health-related effects of government tobacco control policies
Authors
Steven J. Hoffman
Charlie Tan
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2041-6

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