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Investigating the effect of banning non-reduced ignition propensity cigarettes on fatal residential fires in Sweden
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.ORCID iD: 0000-0002-1189-9950
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
2016 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no 2, 334-338 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:Annually, 100 people die as a result of residential fires in Sweden and almost a third of the fatal fires are known to be caused by smoking. In an attempt to reduce the occurrence of these events, reduced ignition propensity (RIP) cigarettes have been developed. They are designed to reduce the risk of fire by preventing the cigarette from burning through the full length when left unattended. In November 2011, a ban was introduced, forbidding the production and sale of all non-RIP cigarettes in all member states of the European Union, including Sweden.

METHODS:Monthly data on all recorded residential fires and associated fatalities in Sweden from January 2000 to December 2013 were analyzed using an interrupted time series design. The effect of the intervention [in relative risk (RR)] was quantified using generalised additive models for location, shape and scale.

RESULTS:There were no statistically significant intervention effects on residential fires (RR 0.95 [95% CI: 0.89-1.01]), fatal residential fires (RR 0.99 [95% CI: 0.80-1.23]), residential fires where smoking was a known cause (RR 1.10 [95% CI: 0.95-1.28]) or fatal residential fires where smoking was a known cause (RR 0.92 [95% CI: 0.63-1.35]).

CONCLUSION:No evidence of an effect of the ban on all non-RIP cigarettes on the risk of residential fires in Sweden was found. The results may not be generalisable to other countries.

Place, publisher, year, edition, pages
Oxford University Press, 2016. Vol. 26, no 2, 334-338 p.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Risk and Environmental Studies
Identifiers
URN: urn:nbn:se:kau:diva-34774DOI: 10.1093/eurpub/ckv180ISI: 000374479200025PubMedID: 26428480OAI: oai:DiVA.org:kau-34774DiVA: diva2:771169
Available from: 2014-12-12 Created: 2014-12-12 Last updated: 2016-06-07Bibliographically approved
In thesis
1. Assessing the effects of societal injury control interventions
Open this publication in new window or tab >>Assessing the effects of societal injury control interventions
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Injuries have emerged as one of the biggest public health issues of the 21th century. Yet, the causal effects of injury control strategies are often questioned due to a lack of randomized experiments. In this thesis, a set of quasi-experimental methods are applied and discussed in the light of causal inference theory and the type of data commonly available in injury surveillance systems. I begin by defining the interrupted time series design as a special case of the regression-discontinuity design, and the method is applied to two empirical cases. The first is a ban on the sale and production of non-reduced ignition propensity (RIP) cigarettes, and the second is a tightening of the licensing rules for mopeds. A two-way fixed effects model is then applied to a case with time-varying starting dates, attempting to identify the causal effects of municipality-provided home help services for the elderly. Lastly, the effect of the Swedish bicycle helmet law is evaluated using the comparative interrupted time series and synthetic control methods. The results from the empirical studies suggest that the stricter licensing rules and the bicycle helmet law were effective in reducing injury rates, while the home help services and RIP cigarette interventions have had limited or no impact on safety as measured by fatalities and hospital admissions. I conclude that identification of the impact of injury control interventions is possible using low cost means. However, the ability to infer causality varies greatly by empirical case and method, which highlights the important role of causal inference theory in applied intervention research. While existing methods can be used with data from injury surveillance systems, additional improvements and development of new estimators specifically tailored for injury data will likely further enhance the ability to draw causal conclusions in natural settings. Implications for future research and recommendations for practice are also discussed.

Abstract [en]

Injuries have emerged as one of the biggest public health issues of the 21th century. Yet, the causal effects of injury control strategies are rarely known due to a lack of randomized experiments. In this thesis, a set of quasi-experimental methods are discussed in the light of causal inference theory and the type of data commonly available in injury surveillance systems. I begin by defining the identifying assumptions of the interrupted time series design as a special case of the regression-discontinuity design, and the method is applied to two empirical cases. The first is a ban on the sale and production of non-fire safe cigarettes and the second is a tightening of the licensing rules for mopeds. A fixed effects panel regression analysis is then applied to a case with time-varying starting dates, attempting to identify the causal effects of municipality-provided home help services for the elderly. Lastly, the causal effect of the Swedish bicycle helmet law is evaluated using a comparative interrupted time series design and a synthetic control design. I conclude that credible identification of the impact of injury control interventions is possible using simple and cost-effective means. Implications for future research and recommendations for practice are discussed.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2016. 59 p.
Series
Karlstad University Studies, ISSN 1403-8099 ; 2016:23
Keyword
causal inference, epidemiology, injury, time series analysis, impact evaluation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Risk and Environmental Studies
Identifiers
urn:nbn:se:kau:diva-41204 (URN)978-91-7063-701-8 (ISBN)
External cooperation:
Public defence
2016-05-19, Eva Erikssonsalen, 21A342, Karlstad, 13:00 (Swedish)
Opponent
Supervisors
Funder
Swedish Civil Contingencies Agency
Available from: 2016-04-29 Created: 2016-04-01 Last updated: 2016-08-25Bibliographically approved

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Bonander, CarlJonsson, AndersNilson, Finn
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