ReviewTobacco control2023
Using systems science to advance health equity in tobacco control: a causal loop diagram of smoking.
Review in Tobacco control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- System dynamics modelling methods for public health policy evaluation: a systematic literature review focussing on mental health and substance use disorders.BMC public health · 2026Pooled it
- Pooled it
- Article
- What makes patient navigation work? Identifying functions and forms and conducting causal loop diagramming to specify components of a successful colorectal cancer patient navigation program.Implementation science communications · 2026Article
- Financial Stress and Tobacco Expenditure in Australian Households: A Cross-Sectional Analysis of Prevalence and Association Across Wealth and Income Levels.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- SimSmoke simulation models by educational status: past and future US trends and the potential role of policy.Tobacco control · 2025Article
- SimSmoke simulation models distinguished by race/ethnicity: past and future trends and the potential role of policy.Journal of the National Cancer Institute. Monographs · 2025Article
- The CAMPUS Study: A Systems Approach to Alcohol-Involved Sexual Violence on College Campuses.Journal of studies on alcohol and drugs · 2025Article
- Lifecycle Management as a Roadmap to the Tobacco Endgame.World journal of clinical medicine research · 2025Article
- Projecting the impact of strengthened tobacco control policy on disparities in US states with persistently high smoking rates.Tobacco induced diseases · 2025Article
- Using qualitative systems mapping to analyze the linkages between the behavioral and social (BeSD) determinants of routine childhood immunization in LMICs.BMC public health · 2024Review
- Analysis of how a complex systems perspective is applied in studies on socioeconomic inequalities in health and health behaviour-a call for reporting guidelines.Health research policy and systems · 2024Article
- Improving dissemination products and practices for community-based organisations serving LGBTQ+ communities in the USA: a thematic analysis.BMJ public health · 2024Article
- Recommendations to advance equity in tobacco control.Tobacco control · 2024Article
- The current state of complex systems research on socioeconomic inequalities in health and health behavior-a systematic scoping review.The international journal of behavioral nutrition and physical activity · 2024Article
- Assessing the Feasibility of Conducting Smoking Cessation Outreach in Food Pantries: A Pilot Intervention Study.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Article
- Optimizing process flow diagrams to guide implementation of a colorectal cancer screening intervention in new settings.Cancer causes & control : CCC · 2023Article
- The use of participatory systems mapping as a research method in the context of non-communicable diseases and risk factors: a scoping review.Health research policy and systems · 2023Article
- A Systematic Review Evaluating Disparities in State-Run Quitline Utilization and Effectiveness in the U.S.AJPM focus · 2023Review
- Increasing use of systems science in cardiovascular disease prevention to understand how to address geographic health disparities in communities with a disproportionate burden of risk.Frontiers in cardiovascular medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 3 countries.
Funding
Abstract
objectivesDevelop and use a causal loop diagram (CLD) of smoking among racial/ethnic minority and lower-income groups to anticipate the intended and unintended effects of tobacco control policies.
methodsWe developed a CLD to elucidate connections between individual, environmental and structural causes of racial/ethnic and socioeconomic disparities in smoking. The CLD was informed by a review of conceptual and empirical models of smoking, fundamental cause and social stress theories and 19 qualitative interviews with tobacco control stakeholders. The CLD was then used to examine the potential impacts of three tobacco control policies.
resultsThe CLD includes 24 constructs encompassing individual (eg, risk perceptions), environmental (eg, marketing) and structural (eg, systemic racism) factors associated with smoking. Evaluations of tobacco control policies using the CLD identified potential unintended consequences that may maintain smoking disparities. For example, the intent of a smoke-free policy for public housing is to reduce smoking among residents. Our CLD suggests that the policy may reduce smoking among residents by reducing smoking among family/friends, which subsequently reduces pro-smoking norms and perceptions of tobacco use as low risk. On the other hand, some residents who smoke may violate the policy. Policy violations may result in financial strain and/or housing instability, which increases stress and reduces feelings of control, thus having the unintended consequence of increasing smoking.
conclusionsThe CLD may be used to support stakeholder engagement in action planning and to identify non-traditional partners and approaches for tobacco control.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.