The impact of smoke-free legislation on fetal, infant and child health: a systematic review and meta-analysis protocol

INTRODUCTION: Second-hand smoke (SHS) exposure is estimated to kill 600 000 people worldwide annually. The WHO recommends that smoke-free indoor public environments are enforced through national legislation. Such regulations have been shown to reduce SHS exposure and, consequently, respiratory and cardiovascular morbidity. Evidence of particular health benefit in children is now emerging, including reductions in low birthweight deliveries, preterm birth and asthma exacerbations. We aim to comprehensively assess the impact of smoke-free legislation on fetal, infant and childhood outcomes. This can inform further development and implementation of global policy and strategies to reduce early life SHS exposure. METHODS: Two authors will search online databases (1975–present; no language restrictions) of published and unpublished/in-progress studies, and references and citations to articles of interest. We will consult experts in the field to identify additional studies. Studies should describe associations between comprehensive or partial smoking bans in public places and health outcomes among children (0–12 years): stillbirth, preterm birth, low birth weight, small for gestational age, perinatal mortality, congenital anomalies, bronchopulmonary dysplasia, upper and lower respiratory infections and wheezing disorders including asthma. The Cochrane Effectiveness Practice and Organisational Care (EPOC)-defined study designs are eligible. Study quality will be assessed using the Cochrane 7-domain-based evaluation for randomised and clinical trials, and EPOC criteria for quasiexperimental studies. Data will be extracted by two reviewers and presented in tabular and narrative form. Meta-analysis will be undertaken using random-effects models, and generic inverse variance analysis for adjusted effect estimates. We will report sensitivity analyses according to study quality and design characteristics, and subgroup analyses according to coverage of ban, age group and parental/maternal smoking status. Publication bias will be assessed. ETHICS AND DISSEMINATION: Ethics assessment is not required. RESULTS: Will be presented in one manuscript. The protocol is registered with PROSPERO, registration number CRD42013003522

Expansion of Smoke-Free Policies:Stepping Up FCTC’s Game

The Framework Convention for Tobacco Control (FCTC) is undoubtedly the most efficient international instrument for tobacco control. Article 8 FCTC shapes many smoke-free policies worldwide and in doing so it is usually associated with smoke-free regulation in enclosed public spaces. Our paper highlights that the FCTC contains a sound foundation for smoke-free policies that stretch beyond enclosed public places, such as open public spaces and (quasi-)private spaces. We demonstrate, in particular, that such wide smoke-free regulation, which is gaining momentum around the globe, is versatile and compatible with human rights standards. As such, these expanded smoke-free policies contribute to a wider culture of smoking denormalisation that scales up FCTC’s aspiration for tobacco control and subsequently to a smoke-free global society

Investigating the effects of comprehensive smoke-free legislation on neonatal and infant mortality in Thailand using the synthetic control method

Background: Almost all of the evidence on the benefits of smoke-free legislation on child health comes from evaluations in high-income countries. We investigated the effects of Thailand’s 2010 comprehensive smokefree legi

Dotted and Undotted Algebraic Spinor Fields in General Relativity

We investigate using Clifford algebra methods the theory of algebraic dotted and undotted spinor fields over a Lorentzian spacetime and their realizations as matrix spinor fields, which are the usual dotted and undotted two component spinor fields. We found that some ad hoc rules postulated for the covariant derivatives of Pauli sigma matrices and also for the Dirac gamma matrices in General Relativity cover important physical meaning, which is not apparent in the usual matrix presentation of the theory of two components dotted and undotted spinor fields. We also discuss some issues related to the the previous one and which appear in a proposed "unified" theory of gravitation and electromagnetism which use two components dotted and undotted spinor fields and also paravector fields, which are particular sections of the even subundle of the Clifford bundle of spacetime.Comment: some new misprints have been correcte