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Zhou A, Li X, Song Y, Hu B, Chen Y, Cui P, Li J. Academic Performance and Peer or Parental Tobacco Use among Non-Smoking Adolescents: Influence of Smoking Interactions on Intention to Smoke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1048. [PMID: 36673810 PMCID: PMC9859142 DOI: 10.3390/ijerph20021048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Intention to smoke is an important predictor of future smoking among adolescents. The purpose of our study was to examine the interaction between academic performance and parents/peer tobacco use on adolescents' intention to smoke. METHODS A multi-stage stratified sampling was used to select participants, involving 9394 students aged between 9-16 years in Changchun city, northeastern China. Multiple logistic regression analyses were conducted to examine the individual effect of academic performance and peer/parental smoking behavior. Stratified logistic regressions were conducted to examine the protective effect of academic performance based on peer or parental smoking. Interaction effects of academic performance × peer/parental smoking on adolescents' intention to smoke were tested. RESULTS Of all the non-smoking students sampled, 11.9% intended to smoke within the next five years. The individual effect of academic performance and peer/parental smoking was significant. The protective effect of academic performance on the intention to smoke was significant regardless of whether peers smoked or not. However, the protective effect was not significant among adolescents with only maternal smoking and both parental smoking. The current study found the significant interaction effects of academic performance × peer smoking and the academic performance × both parents' smoking. Students with poor academic performance were more likely to intend to smoke if their peers or both parents smoked. CONCLUSION These preliminary results suggest that peer smoking or smoking by both parents reinforces the association between low academic performance and the intention to smoke among adolescents. Enhancing school engagement, focusing on social interaction among adolescents with low academic performance, and building smoke-free families may reduce adolescents' intention to smoke.
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Affiliation(s)
| | | | | | | | | | | | - Jinghua Li
- School of Public Health, Jilin University, Changchun 130021, China
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Henderson E, Continente X, Fernández E, Tigova O, Cortés-Francisco N, Gallus S, Lugo A, Semple S, O'Donnell R, Clancy L, Keogan S, Ruprecht A, Borgini A, Tzortzi A, Vyzikidou VK, Gorini G, López-Nicolás A, Soriano JB, Geshanova G, Osman J, Mons U, Przewozniak K, Precioso J, Brad R, López MJ. Secondhand smoke exposure in outdoor children's playgrounds in 11 European countries. ENVIRONMENT INTERNATIONAL 2021; 149:105775. [PMID: 33228970 DOI: 10.1016/j.envint.2020.105775] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Tobacco presence in outdoor children's playgrounds is concerning not only because it leads to secondhand smoke (SHS) exposure, but also cigarette butt pollution and tobacco normalization. OBJECTIVES This study aimed to assess SHS exposure in children's playgrounds, according to area-level socioeconomic status (SES), smoke-free regulations, national smoking prevalence, and SHS exposure prevalence in playgrounds (2017-2018). METHODS We monitored vapor-phase nicotine concentration and tobacco-related variables in 20 different playgrounds in 11 European countries (n = 220 measurements) from March 2017 to April 2018. Playgrounds were selected according to area-level SES. Data on the number of people smoking, and cigarette butts inside the playground and on playground surroundings (<1 m away) were recorded. Playground smoking bans, the Tobacco Control Scale (TCS) score, national smoking prevalence and SHS exposure prevalence in playgrounds were used to group countries. To determine nicotine presence, we dichotomized concentrations using the limit of quantification as a cut-off point (0.06 μg/m3). Nicotine median concentrations were compared using non-parametric tests, and nicotine presence and tobacco-related observational variables using the Chi-squared test. RESULTS Airborne nicotine presence was found in 40.6% of the playgrounds. Median nicotine concentration was <0.06 μg/m3 (Interquartile range: <0.06-0.125) and higher median concentrations were found in more deprived neighborhoods, non-regulated playgrounds, in countries with lower overall TCS scores, higher national smoking prevalence and higher SHS exposure prevalence in playgrounds. Overall, people were smoking in 19.6% of the playgrounds. More than half of playgrounds had cigarette butts visible inside (56.6%) and in the immediate vicinity (74.4%). Presence of butts inside playgrounds was higher in sites from a low area-level SES, in countries with low TCS scores, and greater smoking prevalence and SHS exposure prevalence (p<0.05). CONCLUSIONS There is evidence of SHS exposure in children's playgrounds across Europe. These findings confirm the need for smoking bans in playgrounds and better enforcement in those countries with smoking bans in playgrounds.
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Affiliation(s)
- Elisabet Henderson
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Departament de Ciències Experimentals i de la Salut (DCEXS), Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Xavier Continente
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Olena Tigova
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | | | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, United Kingdom
| | - Rachel O'Donnell
- Institute for Social Marketing and Health, University of Stirling, Stirling, United Kingdom
| | - Luke Clancy
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | - Sheila Keogan
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | - Ario Ruprecht
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Anna Tzortzi
- George D. Behrakis Research Lab-Hellenic Cancer Society, Athens, Greece
| | | | - Giuseppe Gorini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Florence, Italy
| | | | - Joan B Soriano
- Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain; Hospital Universitario La Princesa, Madrid, Spain
| | | | - Joseph Osman
- OFT Conseil, Office Français de santé et bien-être au Travail, Paris, France
| | - Ute Mons
- Cancer Prevention Unit & WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Krzysztof Przewozniak
- The Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland; The Foundation Smart Health - Health in 3D, Warsaw, Poland
| | - José Precioso
- Instituto de Educação, Universidade do Minho, Braga, Portugal
| | - Ramona Brad
- Healthy Romania Generation 2035 Association, Bucharest, Romania
| | - Maria J López
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Departament de Ciències Experimentals i de la Salut (DCEXS), Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
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Valiente R, Escobar F, Pearce J, Bilal U, Franco M, Sureda X. Estimating and mapping cigarette butt littering in urban environments: A GIS approach. ENVIRONMENTAL RESEARCH 2020; 183:109142. [PMID: 32004828 PMCID: PMC7167348 DOI: 10.1016/j.envres.2020.109142] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Cigarette butts are some of the most common form of litter in the World, causing severe environmental damage. Analysing spatial distribution of cigarette butts in the urban environment may lead to useful insights for further interventions to reduce this form of litter. In this study, we present a GIS-based methodology to estimate the density of cigarette butts across a large urban area. METHODS We collected information about discarded cigarette butts in outdoor public spaces by systematic social observation in a diverse sample of areas in Madrid, Spain. We used these data to estimate the density of cigarette butts in public spaces around the entire city by performing GIS analyses based on Kernel Density Estimations. Last, we validated these measures using on-field observations in a set of locations across the city. RESULTS Hospitality venues and public transportation stops were the places with the highest concentrations of cigarette butts, followed by the entrances to educational venues and playgrounds. Central districts showed the highest amount of cigarette butts in contrast to peripheral ones. We found that our measure had good validity, with a correlation coefficient of 0.784. DISCUSSION This is the first study estimating and mapping cigarette butt litter in a large urban area. We identified a set of outdoor public places with high concentrations of cigarette butts and found geographical unevenness in the distribution of this pervasive form of litter across the study area. Our findings demonstrate the ubiquitous nature of cigarette butts in the urban environment and the need for interventions to reduce its impact on both people's health and the environment.
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Affiliation(s)
- Roberto Valiente
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Francisco Escobar
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
| | - Usama Bilal
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, United States.
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, 10027, USA.
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, 10027, USA; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Respiratory Diseases, CIBER en Enfermedades Respiratorias, CIBERES, Madrid, Spain.
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Valiente R, Escobar F, Pearce J, Bilal U, Franco M, Sureda X. Mapping the visibility of smokers across a large capital city. ENVIRONMENTAL RESEARCH 2020; 180:108888. [PMID: 31706598 PMCID: PMC8573742 DOI: 10.1016/j.envres.2019.108888] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 05/29/2023]
Abstract
BACKGROUND Smoking visibility may affect smoking norms with implications for tobacco initiation, particularly amongst youths. Understanding how smoking is distributed across urban environments would contribute to the design and implementation of tobacco control policies. Our objective is to estimate the visibility of smokers in a large urban area using a novel GIS-based methodological approach. METHODS We used systematic social observation to gather information about the presence of smokers in the environment within a representative sample of census tracts in Madrid city in 2016. We designed a GIS-based methodology to estimate the visibility of smokers throughout the whole city using the data collected in the fieldwork. Last, we validated our results in a sample of 40 locations distributed across the city through direct observation. RESULTS We mapped estimates of smokers' visibility across the entire city. The visibility was higher in the central districts and in streets with a high density of hospitality venues, public transportation stops, and retail shops. Peripheral districts, with larger green areas and residential or industrial land uses, showed lower visibility of smokers. Validation analyses found high agreement between the estimated and observed values of smokers' visibility (R = 0.845, p=<0.001). DISCUSSION GIS-based methods enable the development of novel tools to study the distribution of smokers and their visibility in urban environments. We found differences in the visibility by population density and leisure, retail shops and business activities. The findings can support the development of policies to protect people from smoking.
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Affiliation(s)
- Roberto Valiente
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Francisco Escobar
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
| | - Usama Bilal
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, United States.
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.
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Lowrie C, Pearson AL, Thomson G. Inequities in coverage of smokefree outdoor space policies within the United States: school grounds and playgrounds. BMC Public Health 2018; 18:736. [PMID: 29902978 PMCID: PMC6003182 DOI: 10.1186/s12889-018-5602-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 05/24/2018] [Indexed: 11/18/2022] Open
Abstract
Background Previous studies have found extensive geographic and demographic differences in tobacco use. These differences have been found to be reduced by effective public policies, including banning smoking in public spaces. Smokefree outdoor spaces reduce secondhand smoke exposure and de-normalize smoking. Methods After previously publishing a study of smokefree indoor and outdoor space policies, it was brought to the authors’ attention that the dataset used in analyses was incomplete (Lowrie et al., BMC Public Health 17:456, 2017). The current manuscript is a corrected version. Here, we include analyses for outdoor space policies. We evaluated regional and demographic differences in the proportion of the population (both adult and child) covered by smokefree outdoor space policies for school grounds and playgrounds enacted in the United States prior to 2014. Results Children had a low level of protection in playgrounds and schools (8% covered nationwide in both settings). Significant differences in coverage were found by ethnicity, region, income, and education (p < 0.001). The odds of having a smokefree playgrounds policy was lower for jurisdictions with higher proportions of poor households, households with no high school diploma, whites and the Alaska/Hawaii region. Increased ethnic heterogeneity was found to be a significant predictor of increased odds of having a smokefree playgrounds policy, meaning that diversity is protective, with differential effect by region (p < 0.001) – which may relate to urbanicity. Conclusions Disparities in smokefree outdoor space policies have potential to exacerbate existing health inequities. A national increase in smokefree outdoor space policies to protect children in playgrounds and schools is a crucial intervention to reduce such inequities.
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Affiliation(s)
- Christopher Lowrie
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, 673 Auditorium Road, East Lansing, MI, 48824, USA
| | - Amber L Pearson
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, 673 Auditorium Road, East Lansing, MI, 48824, USA. .,Department of Public Health, University of Otago, Wellington, 6021, New Zealand. .,Environmental Science and Policy Program, Michigan State University, East Lansing, MI, 48824, USA.
| | - George Thomson
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
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Lowrie C, Pearson AL, Thomson G. Inequities in coverage of smokefree space policies within the United States. BMC Public Health 2017; 17:456. [PMID: 28511682 PMCID: PMC5434634 DOI: 10.1186/s12889-017-4385-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 05/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have found extensive geographic and demographic differences in tobacco use. These differences have been found to be reduced by effective public policies, including banning smoking in public spaces. Smokefree indoor and outdoor spaces reduce secondhand smoke exposure and denormalize smoking. METHODS We evaluated regional and demographic differences in the proportion of the population covered by smokefree policies enacted in the United States prior to 2014, for both adults and children. RESULTS Significant differences in coverage were found by ethnicity, region, income, and education (p < 0.001). Smokefree policy coverage was lower for jurisdictions with higher proportions of poor households, households with no high school diploma and the Southeast region. Increased ethnic heterogeneity was found to be a significant predictor of coverage in indoor "public spaces generally", meaning that diversity is protective, with differential effect by region (p = 0.004) - which may relate to urbanicity. Children had a low level of protection in playgrounds and schools (~10% covered nationwide) - these spaces were found to be covered at lower rates than indoor spaces. CONCLUSIONS Disparities in smokefree space policies have potential to exacerbate existing health inequities. A national increase in smokefree policies to protect children in playgrounds and schools is a crucial intervention to reduce such inequities.
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Affiliation(s)
- Christopher Lowrie
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, East Lansing, MI, 48824, USA
| | - Amber L Pearson
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, East Lansing, MI, 48824, USA. .,Department of Public Health, University of Otago, Wellington, 6021, New Zealand. .,Environmental Science and Policy Program, Michigan State University, East Lansing, MI, 48824, USA.
| | - George Thomson
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
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Thomson G, Martin J, Gifford H, Parata K, Wilson N. A case study of smokefree outdoor policy options for a city. Aust N Z J Public Health 2017; 41:448-449. [PMID: 28370657 DOI: 10.1111/1753-6405.12665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- George Thomson
- Department of Public Health, University of Otago, New Zealand
| | | | | | | | - Nick Wilson
- Department of Public Health, University of Otago, New Zealand
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National and State-Specific Attitudes toward Smoke-Free Parks among U.S. Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13090864. [PMID: 27589779 PMCID: PMC5036697 DOI: 10.3390/ijerph13090864] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 07/31/2016] [Accepted: 08/26/2016] [Indexed: 11/17/2022]
Abstract
Outdoor places, such as parks, remain a source of secondhand smoke (SHS) exposure. We assessed attitudes toward smoke-free parks among U.S. adults. Data came from the 2009-2010 National Adult Tobacco Survey, a landline and cellular telephone survey of noninstitutionalized adults aged ≥18 in the 50 U.S. states and D.C. Descriptive statistics and logistic regression were used to assess the prevalence and sociodemographic correlates of attitudes toward smoke-free parks, overall and by current tobacco use. Overall, 38.5% of adults reported favorable attitudes toward complete smoke-free parks; prevalence ranged from 29.2% in Kentucky to 48.2% in Maine. Prevalence of favorable attitudes toward smoke-free parks was higher among nonusers of tobacco (44.6%) and noncombustible-only users (30.0%) than any combustible users (21.3%). The adjusted odds of having a favorable attitude were higher among: women; Hispanics and Black non-Hispanics, American Indian and Alaska Native non-Hispanics, and other non-Hispanics; those with an unspecified sexual orientation; and those with children aged ≤17 in the household, relative to each characteristics respective referent group. Odds were lower among: any combustible tobacco and noncombustible-only tobacco users; adults aged 45-64; and those with some college or an undergraduate degree. Opportunities exist to educate the public about the benefits of smoke-free outdoor environments.
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Thomson G, Wilson N, Collins D, Edwards R. Attitudes to smoke-free outdoor regulations in the USA and Canada: a review of 89 surveys. Tob Control 2015; 25:506-16. [DOI: 10.1136/tobaccocontrol-2015-052426] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/25/2015] [Indexed: 11/03/2022]
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Ivory VC, Blakely T, Richardson K, Thomson G, Carter K. Do changes in neighborhood and household levels of smoking and deprivation result in changes in individual smoking behavior? A large-scale longitudinal study of New Zealand adults. Am J Epidemiol 2015; 182:431-40. [PMID: 26271117 DOI: 10.1093/aje/kwv097] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 03/12/2015] [Indexed: 11/12/2022] Open
Abstract
Health behavior takes place within social contexts. In this study, we investigated whether changes in exposure to neighborhood deprivation and smoking prevalence and to household smoking were associated with change in personal smoking behavior. Three waves of biannual data collection (2004-2009) in a New Zealand longitudinal study, the Survey of Family, Income and Employment (SoFIE)-Health, were used, with 13,815 adults (persons aged ≥15 years) contributing to the analyses. Smoking status was dichotomized as current smoking versus never/ex-smoking. Fixed-effects regression analyses removed time-invariant confounding and adjusted for time-varying covariates (neighborhood smoking prevalence and deprivation, household smoking, labor force status, income, household tenure, and family status). A between-wave decile increase in neighborhood deprivation was significantly associated with increased odds of smoking (odds ratio (OR) = 1.08, 95% confidence interval (CI): 1.02, 1.14), but a between-wave increase in neighborhood smoking prevalence was not (OR = 1.04, 95% CI: 0.98, 1.10). Changing household exposures between waves to live with another smoker (compared with a nonsmoker (referent)) increased the odds of smoking (OR = 2.48, 95% CI: 1.84, 3.34), as did changing to living in a sole-adult household (OR = 1.52, 95% CI: 1.07, 2.14). Tobacco control policies and programs should address the broader household and neighborhood circumstances within which individual smoking takes place.
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Pearson AL, Nutsford D, Thomson G. Measuring visual exposure to smoking behaviours: a viewshed analysis of smoking at outdoor bars and cafés across a capital city's downtown area. BMC Public Health 2014; 14:300. [PMID: 24708883 PMCID: PMC3985547 DOI: 10.1186/1471-2458-14-300] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/17/2014] [Indexed: 11/11/2022] Open
Abstract
Background The influence of visual exposure to health-related behaviours, such as smoking, is increasingly acknowledged in the public health literature. Social contagion or normalisation is thought to operate through the visibility of those behaviours. There has been a lack of systematic and comprehensive approaches to quantifying visual exposure to these behaviours over a relatively large geographic area. We describe the novel application of a geographic tool, viewshed analysis, to estimate visual exposure to smoking outside bars/cafés across a downtown area. Methods Smoking was observed for different times and days of the week at 14 outdoor areas of bars/cafés throughout downtown Wellington, New Zealand. We used these data to extrapolate to other bars/cafés with outdoor seating. We then conducted viewshed analyses to estimate visual exposure to smoking at bars/cafés for all public outdoor spaces. Results We observed a smoking point prevalence of 16%. Visibility analyses indicated that estimated visible smoking was highest in the evenings (7-8 pm), where the average values across Wednesday and Friday ranged from zero up to 92 visible smokers (mean = 1.44). Estimated visible smoking at midday ranged from zero to 13 (mean = 0.27). Values were also higher at the end of the week compared with midweek in the evening. Maps indicate that streets with high levels of retail shops and hospitality areas had high values of estimated visible smokers, particularly in the evening where numbers were consistently above 50. Conclusions This paper highlights a useful method for measuring the extent of visual exposure to smoking behaviours across relatively large areas using a geospatial approach. Applying this method in other locations would require consideration of place-specific characteristics which impact on visibility and could be improved through more sophisticated extrapolation of observational data across the study area. The findings of this and similar research could ultimately support the expansion of smokefree public spaces.
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Affiliation(s)
- Amber L Pearson
- Department of Public Health, University of Otago, PO Box 7343, 23A Mein Street, Newtown, Wellington 6242, New Zealand.
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Hood NE, Bernat DH, Ferketich AK, Danesh D, Klein EG. Community Characteristics Associated With Smokefree Park Policies in the United States. Nicotine Tob Res 2014; 16:828-35. [DOI: 10.1093/ntr/ntu007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Thomson G, Russell M, Jenkin G, Patel V, Wilson N. Informing outdoor smokefree policy: Methods for measuring the proportion of people smoking in outdoor public areas. Health Place 2013; 20:19-24. [DOI: 10.1016/j.healthplace.2012.11.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 11/10/2012] [Accepted: 11/28/2012] [Indexed: 10/27/2022]
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"It is just not part of the culture here": young adults' photo-narratives about smoking, quitting, and healthy lifestyles in Vancouver, Canada. Health Place 2013; 22:19-28. [PMID: 23542328 DOI: 10.1016/j.healthplace.2013.02.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 01/31/2013] [Accepted: 02/05/2013] [Indexed: 11/20/2022]
Abstract
In this article we consider young adults' photo-narratives about smoking and quitting and their linkages to themes of healthy lifestyles and the culture of place in Vancouver, Canada. Drawing from a pilot study using participant-driven photography with a group of twelve young women and men ages nineteen to twenty-six, participants' visual and narrative representations of being a smoker and the process of quitting smoking were analyzed. Findings suggest "healthy lifestyle" imperatives within the Vancouver context may be productive for facilitating cessation, but may also have exclusionary effects.
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