Evidence map›Paper›PMID 34818369›Full record

ArticlePloS one2021

The impact of changing cigarette smoking habits and smoke-free legislation on orofacial cleft incidence in the United Kingdom: Evidence from two time-series studies.

Matthew Fell, Craig Russell, Jibby Medina, Toby Gillgrass, Shaheel Chummun, Alistair R M Cobb, Jonathan Sandy, Yvonne Wren, Andrew Wills, Sarah J Lewis

Abstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Matthew FellCleft Collective, Bristol Dental School, University of Bristol, Bristol, United Kingdom.ORCID 0000-0002-7776-2877
Craig RussellScottish Cleft Service, Royal Hospital for Children, Glasgow, United Kingdom.
Jibby MedinaClinical Effectiveness Unit, Royal College of Surgeons of England, London, United Kingdom.
Toby GillgrassScottish Cleft Service, Royal Hospital for Children, Glasgow, United Kingdom.
Shaheel ChummunSouth West Cleft Service, University Hospitals Bristol and Weston NHS Trust, Bristol, United Kingdom.
Alistair R M CobbSouth West Cleft Service, University Hospitals Bristol and Weston NHS Trust, Bristol, United Kingdom.
Jonathan SandyCleft Collective, Bristol Dental School, University of Bristol, Bristol, United Kingdom.
Yvonne WrenCleft Collective, Bristol Dental School, University of Bristol, Bristol, United Kingdom.
Andrew WillsFaculty of Health Sciences, University of Bristol, Bristol, United Kingdom.
Sarah J LewisMedical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.

Funding

Medical Research Council MR/T002093/1
6 · The paper itself

Abstract

backgroundBoth active and passive cigarette smoking have previously been associated with orofacial cleft aetiology. We aimed to analyse the impact of declining active smoking prevalence and the implementation of smoke-free legislation on the incidence of children born with a cleft lip and/or palate within the United Kingdom. METHODS AND

findingsWe conducted regression analysis using national administrative data in the United Kingdom between 2000-2018. The main outcome measure was orofacial cleft incidence, reported annually for England, Wales and Northern Ireland and separately for Scotland. First, we conducted an ecological study with longitudinal time-series analysis using smoking prevalence data for females over 16 years of age. Second, we used a natural experiment design with interrupted time-series analysis to assess the impact of smoke-free legislation. Over the study period, the annual incidence of orofacial cleft per 10,000 live births ranged from 14.2-16.2 in England, Wales and Northern Ireland and 13.4-18.8 in Scotland. The proportion of active smokers amongst females in the United Kingdom declined by 37% during the study period. Adjusted regression analysis did not show a correlation between the proportion of active smokers and orofacial cleft incidence in either dataset, although we were unable to exclude a modest effect of the magnitude seen in individual-level observational studies. The data in England, Wales and Northern Ireland suggested an 8% reduction in orofacial cleft incidence (RR 0.92, 95%CI 0.85 to 0.99; P = 0.024) following the implementation of smoke-free legislation. In Scotland, there was weak evidence for an increase in orofacial cleft incidence following smoke-free legislation (RR 1.16, 95%CI 0.94 to 1.44; P = 0.173).

conclusionsThese two ecological studies offer a novel insight into the influence of smoking in orofacial cleft aetiology, adding to the evidence base from individual-level studies. Our results suggest that smoke-free legislation may have reduced orofacial cleft incidence in England, Wales and Northern Ireland.

Indexed as

BrainCigarette SmokingCleft LipCleft PalateHumansIncidenceNicotianaSmokersSmokingTobacco Smoke PollutionUnited KingdomTobacco Smoke Pollution

Identifiers

PMID34818369
PMCPMC8612573

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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.