title: What are the effects of tobacco policies on vulnerable populations? A better practices review.
abstract: BACKGROUND
  While comprehensive tobacco policies have reduced the prevalence of smoking in Canada, some groups remain vulnerable to tobacco use and display high rates of smoking. This article reviews three types of tobacco policies--tax and price, smoking location restrictions and sales restrictions--and examines the consequences for Aboriginal people, youth and low-income people.
  
  
  METHODS
  A better practices review model was used to assess the strength of studies published between 1990 and 2004 that examined the effects of these tobacco policies on the three vulnerable populations of interest. A total of 72 studies were assessed and 42 judged medium or high strength. A gender-based and diversity analysis was applied to assess the differential impacts on females and males and/or diverse characteristics within these populations. Intended and unintended consequences were examined.
  
  
  RESULTS
  Few studies assessed the potential or differential effects of tobacco policies on the three selected populations. In these, it was difficult to disentangle the effects of each policy in a comprehensive tobacco control environment, and there is need for improved indicators and greater attention to sex and gender analysis.
  
  
  CONCLUSIONS
  Research is required to measure the intended and unintended impacts of tobacco policies on populations vulnerable to tobacco use. There are problems in assessing these studies that could be resolved with more precise indicator development. An equity-based framework for assessing the effects of tobacco policies is needed that is conceptually linked to health determinants and inequities. The article concludes with a set of recommendations for research, evaluation, policy and ethics arising from this review.
authors.affiliation: British Columbia Centre of Excellence for Women's Health, BC Women's Hospital, E-311 4500 Oak St., Vancouver, BC V6H 3N1. lgreaves@cw.bc.ca
authors.forename: Lorraine
authors.initials: L
authors.lastname: Greaves
authors.forename: Joy
authors.initials: J
authors.lastname: Johnson
authors.forename: Joan
authors.initials: J
authors.lastname: Bottorff
authors.forename: Susan
authors.initials: S
authors.lastname: Kirkland
authors.forename: Natasha
authors.initials: N
authors.lastname: Jategaonkar
authors.forename: Melissa
authors.initials: M
authors.lastname: McGowan
authors.forename: Lucy
authors.initials: L
authors.lastname: McCullough
authors.forename: Lupin
authors.initials: L
authors.lastname: Battersby
mesh_terms: D002170:Canada / Q000453:epidemiology; D003132:Commerce / Q000331:legislation & jurisprudence; D005260:Female; D006801:Humans; D008297:Male; D011640:Public Policy; D012907:Smoking / Q000453:epidemiology; D019460:Tobacco Industry / Q000331:legislation & jurisprudence*; D035862:Vulnerable Populations