The DECIDE evidence to recommendation framework applied to a potential extension of the Tobacco Act in Sweden

Transcription

1 The DECIDE evidence to recommendation framework applied to a potential extension of the Tobacco Act in Sweden Karin Guldbrandsson Linda Maripuu Jenny Hansson Regina Winzer Public Health Agency of Sweden karin.guldbrandsson@folkhalsomyndigheten.se

2 Background: an assignment from the Government The Public Health Agency of Sweden received an assignment to investigate the prevalence of secondhand smoke in public places outdoors and suggest measures to decrease this exposure (deadline October 2014). Including: Potential result: A change of the Swedish exposed to second-hand smoke Tobacco Act? attitudes towards smoke-free outdoor areas reviews of effects of smoke-free policies international experiences concerning the implementation of more restrictive smoking bans 2.

3 Background the DECIDE framework Quality of evidence alone is seldom sufficient to make recommendations on public health interventions. Other sources of information, e.g. ethical considerations, cost effectiveness and implementability, are important complements. The DECIDE* framework captures such criteria in a structured manner. *Developing and Evaluating Communication strategies to support Informed Decisions and practice based on Evidence 3.

4 DECIDE a system for making recommendations EU-project Norwegian Knowledge Centre for the Health Services, Oslo A stakeholder panel and a structured form Sid 4.

5 Aim of the study The aim of this study was to apply the DECIDE framework to the Government assignment regarding reduction of secondhand smoke in public areas i Sweden 5.

6 Method Population based survey exposure to second hand smoke outdoors and support for making different places smoke-free Literature reviews health effects of second hand smoke how far particles from cigarettes spread outdoors the occurrence of cigarette smoke pollutants in different outdoor places effects of smoking restrictions on attitudes regarding smoke-free environments effects of smoking restrictions on health outcomes effects of smoking restrictions on smoking behavior in the population DECIDE a DECIDE-form with relevant information was prepared a DECIDE-panel was gathered and carried through 6.

7 The DECIDE-form The main question: Should smoking be restricted in public outdoor areas? verktyget Background and the problem (2 items) Benefits and harms (4 items) Resource-use (2 items) Feasibility (2 items) Equity (1 item) Acceptability (2 items) Balance of consequences. Recommendation

8 Acceptability (an example on support for making different places smoke-free) Place Positive to smoke-free area (%) Public entrances 85 % Public transport platforms 70 % Parks, bathing places and play grounds 61 % Open air restaurants 61 % Sport arenas and festival areas 59 % Pavements and pedestrian streets 25 % 8.

9 The DECIDE panel The main question: Should smoking be restricted in public outdoor areas? The panel participants represented: The Swedish Council on Health Technology Assessment Professions Against Tobacco Swedish Association of Local Authorities and Regions The Asthma and Allergy association Uppsala County Council The Swedish Hospitality Industry The Swedish Property Federation 9.

10 Results Five stakeholders in the panel did recommend the option desirable consequences outweigh undesirable consequences in most settings if the Swedish Tobacco Act is extended to include outdoor public areas Two stakeholders in the panel did not recommend the option undesirable consequences outweigh desirable consequences in most settings if the Swedish Tobacco Act is extended to include outdoor public areas This result constituted one of several parts in the final report to the government. 10.

11 Conclusion The DECIDE framework appeared to be a useful tool in order to compile and assess relevant criteria during investigations regarding changes of public health regulations. The DECIDE framework seemed to facilitate structured input from key actors and may support national decision making. The panel participants lifted the advantages with early involvement of relevant actors when using the DECIDE framework. Thanks for your attention! 11.