Impact of smoke-free legislation on perinatal and infant mortality: a national quasi-experimental study

Been, J. V., Mackay, D. F. , Millett, C., Pell, J. P. , van Schayck, O. C.P. and Sheikh, A. (2015) Impact of smoke-free legislation on perinatal and infant mortality: a national quasi-experimental study. Scientific Reports, 5, 13020. (doi: 10.1038/srep13020) (PMID:26268789) (PMCID:PMC4534797)

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Smoke-free legislation is associated with improved early-life outcomes; however its impact on perinatal survival is unclear. We linked individual-level data with death certificates for all registered singletons births in England (1995–2011). We used interrupted time series logistic regression analysis to study changes in key adverse perinatal events following the July 2007 national, comprehensive smoke-free legislation. We studied 52,163 stillbirths and 10,238,950 live-births. Smoke-free legislation was associated with an immediate 7.8% (95%CI 3.5–11.8; p < 0.001) reduction in stillbirth, a 3.9% (95%CI 2.6–5.1; p < 0.001) reduction in low birth weight, and a 7.6% (95%CI 3.4–11.7; p = 0.001) reduction in neonatal mortality. No significant impact on SIDS was observed. Using a counterfactual scenario, we estimated that in the first four years following smoke-free legislation, 991 stillbirths, 5,470 cases of low birth weight, and 430 neonatal deaths were prevented. In conclusion, smoke-free legislation in England was associated with clinically important reductions in severe adverse perinatal outcomes.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Pell, Professor Jill and Mackay, Professor Daniel
Authors: Been, J. V., Mackay, D. F., Millett, C., Pell, J. P., van Schayck, O. C.P., and Sheikh, A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:Scientific Reports
Publisher:Nature Publishing Group
ISSN (Online):2045-2322
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in Scientific Reports 5:13020
Publisher Policy:Reproduced under a Creative Commons License

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