Publications by authors named "Heikki Hiilamo"

Background: The WHO Framework Convention on Tobacco Control (WHO FCTC) Article 13 requires countries to ban tobacco advertising, promotion and sponsorship (TAPS), and bans are recommended to cover electronic cigarettes (e-cigarettes). We examined youth e-cigarette prevalence by TAPS regulations in countries with different income levels.

Methods: We analysed data on 165 299 respondents from 48 countries with 2016/2018 WHO FCTC implementation reports and 2016-2019 Global Youth Tobacco Survey.

View Article and Find Full Text PDF

Introduction: Despite a decline in global smoking prevalence among adolescents, around 21 million youth report current cigarette smoking. Exposure to tobacco advertising, promotion and sponsorship (TAPS) is a risk factor for smoking initiation, and therefore the Article 13 of the WHO Framework Convention on Tobacco Control (WHO FCTC) requires comprehensive TAPS bans. We examined the associations between changes in youth cigarette smoking and implementation of Article 13.

View Article and Find Full Text PDF

Background: The COVID-19 pandemic has shaken everyday life causing morbidity and mortality across the globe. While each country has been hit by the pandemic, individual countries have had different infection and health trajectories. Of all welfare state institutions, healthcare has faced the most immense pressure due to the pandemic and hence, we take a comparative perspective to study COVID-19 related health system performance.

View Article and Find Full Text PDF

Grandparental care has become an involuntary choice in life for many families, mainly due to parents' unavailability to provide care and the lack of public or affordable private childcare. This phenomenon has raised concerns regarding the effects of grandparental care along the dimensions of child development. This study aims to test the association between grandparental care and child development in three dimensions: subjective wellbeing, behavioural traits and study performance.

View Article and Find Full Text PDF

Importance: Children who are placed in out-of-home care may have poorer outcomes in adulthood, on average, compared with their peers, but the direction and magnitude of these associations need clarification.

Objective: To estimate associations between being placed in out-of-home care in childhood and adolescence and subsequent risks of experiencing a wide range of social and health outcomes in adulthood following comprehensive adjustments for preplacement factors.

Design, Setting, And Participants: This cohort and cosibling study of all children born in Finland between 1986 and 2000 (N = 855 622) monitored each person from their 15th birthday either until the end of the study period (December 2018) or until they migrated, died, or experienced the outcome of interest.

View Article and Find Full Text PDF

Introduction: The world's first global health treaty, WHO Framework Convention on Tobacco Control (FCTC) aims to reduce tobacco product demand by focusing on tobacco taxes, smoking bans, health warning labels, and tobacco advertising bans. Previous studies almost unanimously suggest that FCTC has prompted countries to implement more effective tobacco demand reduction policies.

Aims And Methods: By taking into account the pre-FCTC status, country income level, and state capacity we studied if ratifying FCTC was associated with tobacco demand reduction measures in 2018/2019.

View Article and Find Full Text PDF

Background: Childhood family income has been shown to be associated with later psychiatric disorders, substance misuse and violent crime, but the consistency, strength and causal nature of these associations remain unclear.

Methods: We conducted a nationwide cohort and co-sibling study of 650 680 individuals (426 886 siblings) born in Finland between 1986 and 1996 to re-examine these associations by accounting for unmeasured confounders shared between siblings. The participants were followed up from their 15th birthday until they either migrated, died, met criteria for the outcome of interest or reached the end of the study period (31 December 2017 or 31 December 2018 for substance misuse).

View Article and Find Full Text PDF

Objective: The aim of this study was to investigate the arguments used by the alcohol industry and actors aligning with it as a lobbying strategy on Twitter to influence the reform of the Finnish alcohol law during its preparation phase between 2014 and 2017, when the original purpose of the law reform was changed from reducing alcohol-related harm to liberalizing alcohol policy.

Method: Primary data were collected on Twitter between 2014 and 2017 from six alcohol industry actors (n = 1,085 tweets). The Twitter data were analyzed by coding using Microsoft Excel and by content and thematic analyses using a modified version of the European Centre for Monitoring Alcohol Marketing's (2011) seven key messages of the alcohol industry.

View Article and Find Full Text PDF

Aim: The aim of this study was to investigate the strategies used by the alcohol industry to influence the reform of the Alcohol Act in Finland during the preparation phase between 2016 and 2017. The study answers the following research question: what strategies were used by the alcohol industry to change the original purpose of the reform on alcohol in Finland?

Method: Primary data were collected through 16 expert interviews with experts who had participated in the preparation of the alcohol reform in Finland, while secondary data were collected from prior literature, journal articles and Google databases.

Results: The results identified three main political strategies used by the alcohol industry to influence the reform of the law on alcohol in Finland during the preparation phase between 2016 and 2017: "information", under which the alcohol industry lobbied politicians in Parliament through Members of Parliament of the National Coalition Party due to the close ties between the two; "constituency building", under which the alcohol industry formed alliances with interest groups in the grocery-retail business in Finland, to advocate for liberalisation of the law, as well as the use of social media - specifically Twitter - to lobby the public; and lastly, "policy substitution" to promote self-regulation.

View Article and Find Full Text PDF

Cumulative contributions of social and health-related determinants to long-term unemployment during early working life among young adults are poorly understood. Therefore, we used four cumulative indices of both parental and own social and health-related determinants of such unemployment among a cohort which comprised a complete census of children born in Finland in 1987. The cohort participants were registered in the Medical Birth Register, and they were followed-up through 2015 (N = 46 521).

View Article and Find Full Text PDF

Background: Parental mental disorders have been shown to predict offspring's mental health problems. We examined whether pathways from parental mental disorders to offspring's psychiatric work disability in early adulthood are mediated through offspring's mental disorders and social disadvantage in adolescence.

Methods: Study population consisted of the 1987 Finnish Birth Cohort.

View Article and Find Full Text PDF

Objective: To quantify changes in tobacco tax rates and cigarette affordability after countries ratified the WHO Framework Convention on Tobacco Control (FCTC) using with the WHO MPOWER standards.

Methods: We used logistic regression to assess the association of FCTC ratification with adoption of at least 50% and 75% (high) of retail price tobacco tax rates for the most sold brands in countries, accounting for years since ratification and other covariates. We also compared cigarette affordability in 2014 with 1999.

View Article and Find Full Text PDF

Multiple factors, including marijuana decriminalization/legalization, tobacco endgame discourse, and alcohol industry pressures, suggest that the retail regulatory environment for psychoactive or addictive substances is a dynamic one in which new options may be considered. In most countries, the regulation of tobacco, marijuana, and alcohol is neither coherent, nor integrated, nor proportional to the potential harms caused by these substances. We review the possible consequences of restricting tobacco sales to outlets run by government-operated alcohol retail monopolies, as well as the likely obstacles to such a policy.

View Article and Find Full Text PDF

Objectives: We sought to evaluate changes in countries' enacting advertising bans after the effect of ratifying the WHO Framework Convention on Tobacco Control (FCTC).

Methods: We compared adoption of advertising bans on five areas (TV and radio, print media, billboards, point-of-sale, sponsorship) in countries that did versus did not ratify the FCTC, accounting for years since the ratification of the Convention.

Results: On average, passage of complete advertising bans accelerated after FCTC ratification.

View Article and Find Full Text PDF

Objectives: More knowledge of the associations between over-indebtedness and health is needed. This study is the first longitudinal register-based study analysing long-term health consequences of severe over-indebtedness.

Methods: Adult Finnish persons, identified in 2010 as having been over-indebted for at least 15 years, were compared with matched controls (total N = 48,778).

View Article and Find Full Text PDF

Objectives: We sought to evaluate the effect of ratifying the World Health Organization Framework Convention on Tobacco Control (FCTC) on countries enacting smoke-free laws covering indoor workplaces, restaurants, and bars.

Methods: We compared adoption of smoke-free indoor workplace, restaurant, and bar laws in countries that did versus did not ratify the FCTC, accounting for years since the ratification of the FCTC and for countries' World Bank income group.

Results: Ratification of the FCTC significantly (P < .

View Article and Find Full Text PDF

Between September and December 2010 the European Commission Health & Consumer Protection Directorate-General (DGSANCO) held a public consultation on a possible revision of the European Union Tobacco Products Directive (2001/37/EC). We used content analysis of the tobacco industry's and related parties' 300 submissions to the public consultation to determine if tobacco industry and its allies in Europe are prepared to reduce harm of the tobacco products as their public statements assert. The industry submission resorted to traditional tobacco industry arguments where illicit trade and freedom of choice were emphasized and misrepresented the conclusions of a DGSANCO-commissioned scientific report on smokeless tobacco products.

View Article and Find Full Text PDF

We investigates the effects of ratifying the WHO Framework Convention of Tobacco Control (FTCT), state capacity, path-dependency and tobacco industry activity on the implementation of effective health warning labels (HWL) on cigarette packs among low and middle income countries (LMIC). Using logistic regression in separate analyses for FCTC Article 11 compliant HWLs and graphic HWLs (GHWL), we found that the odds of FCTC compliance increased by a factor of 1.31 for each year after FCTC entered into force in the country (p < 0.

View Article and Find Full Text PDF

Objectives: To understand the competition between and among tobacco companies and health groups that led to graphical health warning labels (GHWL) on all tobacco products in India.

Methods: Analysis of internal tobacco industry documents in the Legacy Tobacco Document Library, documents obtained through India's Right to Information Act, and news reports.

Results: Implementation of GHWLs in India reflects a complex interplay between the government and the cigarette and bidi industries, who have shared as well as conflicting interests.

View Article and Find Full Text PDF

Context: In 2012, Washington State and Colorado legalized the recreational use of marijuana, and Uruguay, beginning in 2014, will become the first country to legalize the sale and distribution of marijuana. The challenge facing policymakers and public health advocates is reducing the harms of an ineffective, costly, and discriminatory "war on drugs" while preventing another public health catastrophe similar to tobacco use, which kills 6 million people worldwide each year.

Methods: Between May and December 2013, using the standard snowball research technique, we searched the Legacy Tobacco Documents Library of previously secret tobacco industry documents (http://legacy.

View Article and Find Full Text PDF

Background: In the aftermath of the global financial crisis, millions of households have been left with debts that they are unable to manage. Indebtedness may impair the wellbeing of those affected by it for years to come. This systematic review focuses on the long-term consequences of indebtedness on health.

View Article and Find Full Text PDF

Most inequality research on the relationship between inequality and mental health has focused on cross-country variation. Findings from within-country data are mixed. We examined whether changes in municipal Gini index or in the share of people living in relative poverty were linked to changes in the use of antidepressants in several Finnish municipalities between 1995 and 2010.

View Article and Find Full Text PDF

Objectives: We quantified the pattern and passage rate of cigarette package health warning labels (HWLs), including the effect of the Framework Convention on Tobacco Control (FCTC) and HWLs voluntarily implemented by tobacco companies.

Methods: We used transition probability matrices to describe the pattern of HWL passage and change rate in 4 periods. We used event history analysis to estimate the effect of the FCTC on adoption and to compare that effect between countries with voluntary and mandatory HWLs.

View Article and Find Full Text PDF

A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy.

View Article and Find Full Text PDF