Impact pathway link Evidence Evidence Rating Abuse and neglect in Exposure to multiple adverse childhood experiences (abuse and childhood is linked to coping household dysfunction) increases the likelihood of smoking by age 14, mechanisms such as smoking chronic smoking as adults, and the presence of smoking related and alcohol abuse. diseases (). People who continue to use There is a clear association between tobacco use and increased alcohol or substances are morbidity and mortality () likely to develop other health problems later in life. Epidemiological studies have demonstrated that alcohol, tobacco and other substances represent a significant burden of disease () What interventions impact these factors? Impact pathway Effective intervention Outcomes Evidence rating link Child abuse and SafeCare Lower rates of referral to child neglect Home visitation program to reduce child abuse protection services for child abuse and neglect in families with a history of and neglect (). maltreatment Home visiting See Page 15 Dysfunctional Smoking cessation Decrease in tobacco consumption behaviours Interventions aiming to reduce child and family Increase and adherence to home and exposure to environmental tobacco smoking car smoking bans (). may be more successful than smoking cessation programs. How do we measure the impact?
Impact pathway link Evidence Evidence Rating Abuse and neglect in childhood is linked to coping mechanisms such as smoking and alcohol abuse. Exposure to multiple adverse childhood experiences (abuse and household dysfunction) increases the likelihood of smoking by age 14, chronic smoking as adults, and the presence of smoking related diseases (). People who continue to use alcohol or substances are likely to develop other health problems later in life. There is a clear association between tobacco use and increased morbidity and mortality () Epidemiological studies have demonstrated that alcohol, tobacco and other substances represent a significant burden of disease () What interventions impact these factors? Impact pathway link Effective intervention Outcomes Evidence rating Child abuse and neglect SafeCare Home visitation program to reduce child abuse and neglect in families with a history of maltreatment Lower rates of referral to child protection services for child abuse and neglect (). Home visiting See Page 15 Dysfunctional behaviours Smoking cessation Interventions aiming to reduce child and family exposure to environmental tobacco smoking may be more successful than smoking cessation programs. Decrease in tobacco consumption Increase and adherence to home and car smoking bans (). How do we measure the impact?