This Week in PLOS Medicine: Tobacco Control in India, Abortion & Preterm Birth, & Evidence & Global Health Interventions
This week PLOS Medicine publishes the following new articles:
The burden of cardiovascular disease (CVD), a major cause of illness and death in high-income countries for many years, is rapidly rising in low- and middle-income countries. Sanjay Basu and colleagues simulated the effect of multiple tobacco control and pharmacological interventions on deaths from heart attack and stroke in India between 2013 and 2022. The authors conclude that implementing smoke-free laws and increased tobacco taxes would be the most effective strategies for averting future CVD deaths in India (and possibly other low- and middle-income countries). These two interventions alone would yield substantial and rapid health benefits by preventing an estimated 9 million deaths in India over the next decade.
Gordon Smith and colleagues report that the link between abortion and preterm delivery in a subsequent pregnancy has disappeared over the last 20-30 years in Scotland. The authors find that abortion was a strong risk factor for subsequent preterm birth in the 1980s, but over the next 20 years, the link progressively weakened and was no longer present among women giving birth from 2000 onwards. The likely explanation for these findings is changes in methods of abortion. These findings are important as the current recommendations to discuss a possible increased risk of preterm birth if a woman has an abortion were based on studies before 2000, so current guidelines may need to be revised.
Evidence-based decision-making is critical to informing policy. Jill Luoto and colleagues apply different community or public health evidence frameworks to the same body of evidence for three advocated global health interventions and compare what ratings and policy recommendations result from each. The authors find a gap between what is currently available and the needs for an evidence framework appropriate for application to a global health setting in a low- and middle-income country context.