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Park MB. Comparison of secondhand smoking exposure between self-report and creatinine-corrected urine cotinine: Result from Korean NHANES 2009-2018. J Formos Med Assoc 2024; 123:218-227. [PMID: 37586974 DOI: 10.1016/j.jfma.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 03/29/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND/PURPOSE Second-hand smoking (SHS) is usually examined by self-report (SR). However, there is a possibility that SR may not accurately measure SHS exposure. This study aimed to identify yearly trends and gender differences in SHS by SR and cotinine. METHODS We used data from the 2009-2018 Korea National Health and Nutrition Examination Survey (KNHANES) and included adults aged 19 years and older. We analyzed data of 47,907 respondents on SHS exposures in the past week and of 23,572 respondents who had both urine cotinine and creatinine measurements. SHS exposure was defined as those who answered 'yes' to whether or not they were exposed to smoking by SR. We performed descriptive analysis, Average annual percentage change (AAPC), and multiple regression analysis. All analyses were weighted reflecting the multi-stratified cluster sampling. RESULTS Exposure to SHS indoors at the work place (WSHS) (2009: 44.8%, 2018: 12.3%), indoors at home (HSHS) (2009: 14.1%, 2018: 3.9%), and indoors at public places (PSHS) (2013: 55.6%, 2018: 15.4%) decreased steadily over the years. WSHS and PSHS exposure was higher for males but HSHS was higher for females. However, the concentration of cotinine-to-creatinine ratio (Co/Cr) was higher among females regardless of SHS exposure status and environment. Multiple regression analysis showed that among males, the association between Co/Cr education level and WSHS was the strongest, and among females, the association was the strongest with HSHS. In addition, home exposure to SHS intensified the differences in Co/Cr levels between males and females. CONCLUSION Our study confirmed that cotinine-induced SHS showed different results by year and gender compared to SR. In particular, Co/Cr level in females was higher than in males regardless of exposure by SR, suggesting that SR did not correctly evaluate SHS. To reflect reality more accurately, biomarkers should be monitored along with SR.
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Affiliation(s)
- Myung-Bae Park
- Department of Health and Welfare, Pai Chai University, Daejeon, Republic of Korea.
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2
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Nunes-Rubinstein M, Leão T. Arguments used by proponents and opponents in Brazil's regulatory discussions of e-cigarettes and heated tobacco products. Tob Control 2023; 32:296-301. [PMID: 34531313 DOI: 10.1136/tobaccocontrol-2021-056628] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/19/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To identify proponents and opponents of the commercialisation and marketing of e-cigarettes and heated tobacco products (HTPs), identify the arguments used on both sides and compare how the arguments have changed over time, we analysed three policy discussions occurring in 2009, 2018 and 2019. METHODS We conducted a content analysis of one document and six videos from these discussions, provided on the Brazilian Health Regulatory Agency website, or upon request. RESULTS The arguments most used by tobacco companies were related to claims that the use of e-cigarettes and HTPs is less harmful than conventional tobacco. Unions that support its commercialisation also argued that lifting the ban would prevent smuggling and guarantee their quality. On the other side, universities, medical and anti-tobacco institutions argued that such devices may have health risks, including the risk of inducing cigarette smoking. In 2009, most arguments belonged to the 'health' theme, while in 2018 and 2019 economic arguments and those related to morals and ethics were frequently used. CONCLUSIONS Those that supported the commercialisation and marketing of e-cigarettes and HTPs first focused on arguments of harm reduction, while 10 years later the right to access and potential economic consequences also became common. Public health agents and academics must gather evidence to effectively respond to these arguments and discuss these policies, and must prepare themselves to use and respond to arguments related to moral and economic themes.
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Affiliation(s)
| | - Teresa Leão
- EPI-Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
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3
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Williams S, Hill SE, Oyebode O. 'Choice should be made through… educated decisions not regressive dictates': discursive framings of a proposed 'sugar tax' in Bermuda: analysis of submissions to a government consultation. Global Health 2022; 18:89. [PMID: 36271432 PMCID: PMC9587584 DOI: 10.1186/s12992-022-00877-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/22/2022] [Indexed: 11/21/2022] Open
Abstract
Background Several governments have introduced taxes on products with high sugar content as part of their obesity prevention strategies. Bermuda is the first jurisdiction to apply such measures in the Caribbean – a region of small island developing states and territories with high obesity prevalence and substantial reliance on imported food products. This study examines how commercial and health actors framed the proposed introduction of a 75% import tariff on high-sugar products, based on written submissions to the Bermudan government. Methods Eleven submissions containing written comments were analysed with reference to their framing of the proposed import tariff, the ‘problem’ of obesity, and the relationship between the two (including alternative policy approaches for tackling obesity). Results Key emergent frames were complexity, partnership, products, personal responsibility, affordability and evidence. Respondents favoured different framings, depending on whether they supported or opposed the proposed import duty. Commercial actors were universally opposed, presenting obesity as a ‘complex’ problem that would be better addressed through government-industry partnerships (a framing particularly favoured by international and regional business associations). Increased product range and an emphasis on personal responsibility were also positioned as policy alternatives. Health actors expressed partial support for the proposed sugar tax, although this was tempered by a perceived lack of evidence where the proposal differed from sugar taxes introduced elsewhere. Like commercial respondents, health actors framed obesity as a ‘complex’ problem and emphasised the need for other measures, including efforts to address the affordability of fruits and vegetables. Conclusion In responding to a proposed ‘sugar tax’ in Bermuda, commercial actors opposed the proposal and stated a clear preference for ‘partnership’ approaches to tackling obesity. Commercial responses were dominated by local businesses (with only two responses received from international or regional business associations), perhaps reflecting Bermuda’s reliance on tourism and hospitality and the specificity of the proposed intervention (that is, an import tariff rather than an excise tax). The much smaller number of responses from health actors suggests limited civil society capacity. Nevertheless, the Bermudan government successfully introduced a 75% tariff on high-sugar imports, demonstrating the potential for policy innovation to address obesity in small-island jurisdictions. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00877-7.
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Affiliation(s)
- Sarah Williams
- Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK.,SPECTRUM research consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), University of Edinburgh, EH8 9AG, Edinburgh, UK.,Office for Health Improvement and Disparities, London, UK
| | - Sarah E Hill
- SPECTRUM research consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), University of Edinburgh, EH8 9AG, Edinburgh, UK.,Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Oyinlola Oyebode
- Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK.
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4
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González-Rozada M, Prieto-Lara E, Sandoval GA. Effect of comprehensive smoke-free legislation on the tourism industry in countries of the Caribbean Community. Rev Panam Salud Publica 2022; 46:e146. [PMID: 36211235 PMCID: PMC9534343 DOI: 10.26633/rpsp.2022.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/28/2022] [Indexed: 11/24/2022] Open
Abstract
Objective.
To assess whether the introduction of comprehensive smoke-free legislation affected tourism in four Caribbean Community (CARICOM) countries – Barbados, Guyana, Jamaica, and Trinidad and Tobago.
Methods.
We compared the evolution of three tourism variables – tourist arrivals, tourist expenditure, and average length of stay – in a country implementing smoke-free environments (treated country) with the evolution of these variables in the same country if smoke-free legislation had not been implemented. We used a synthetic control method to recreate this counterfactual scenario by constructing a synthetic country using a weighted average of several donor-pool CARICOM countries that did not introduce legislation on smoke-free environments during the period analyzed. We quantified the effect of the smoke-free environments on tourism as the difference between tourism variables in the treated and synthetic country. To assess whether the estimated effect of the smoke-free environments was the result of chance, we compared the effects of legislation in the treated country to placebo effects in the donor pool by assuming comprehensive smoke-free legislation was introduced in the same year as in the treated country.
Results.
Implementing smoke-free environments did not affect the arrival of tourists, tourism expenditure, or the average length of stay in the four countries.
Conclusions.
Our findings provide strong evidence that public policies banning smoking in public places do not affect hospitality and tourism businesses. Given the economic significance of this industry in the Caribbean, the local evidence provided by this study will help to effectively counteract interference by the tobacco industry and advance towards a smoke-free Caribbean.
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Affiliation(s)
| | - Elisa Prieto-Lara
- Pan American Health Organization, Washington, DC, United States of America
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6
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Mamudu HM, Owusu D, Asare B, Williams F, Asare M, Oke A, Poole A, Osedeme F, Ouma OAE. Support for smoke-free public places among adults in four countries in sub-Saharan Africa. Nicotine Tob Res 2020; 22:2141-2148. [PMID: 31927591 DOI: 10.1093/ntr/ntaa008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 01/08/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION There is no known safe level of secondhand smoke exposure; yet, less than 30% of the global population is covered by comprehensive smoke-free policies as of 2016 and there are few smoke-free policies in sub-Saharan Africa (SSA). This study examines the support for smoke-free public places in SSA and delineates their correlates. METHODS Data collected through the Global Adult Tobacco Survey (2012-2017) were analyzed using SAS for descriptive and multivariable analyses, with a significance level set at p < .05. RESULTS No SSA country had comprehensive smoke-free policies, defined as a prohibition of smoking in eight public places. In the four countries whose Global Adult Tobacco Survey data were analyzed (Nigeria, Cameroon, Kenya, and Uganda), support for the prohibition of smoking in public places was over 90% in all eight public places except bars. Support for smoking prohibition in bars was 65.8%, 81.1%, 81.4%, and 91.0% in Nigeria, Cameroon, Kenya, and Uganda, respectively. Factors associated with support for smoke-free bars differed across the four countries, but in all countries, current smokers had decreased odds of support for smoke-free bars. Knowledge of secondhand smoke harm and living in smoke-free homes were associated with increased odds of support for smoke-free bars in all countries except Kenya. CONCLUSION The high support for smoke-free public places should inform the efforts of the public health community and policymakers in these four SSA countries toward meeting their obligations of Article 8 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). IMPLICATIONS Much of the population in SSA is not protected by comprehensive smoke-free policies. It was found that the overwhelming majority of adults in four large countries in SSA support the prohibition of smoking in public places and that knowledge of the health dangers of smoking and exposure to secondhand smoke and home smoking rules increased support for the prohibition. High support for the prohibition of smoking in these four SSA countries suggests tobacco control proponents should advocate for comprehensive smoke-free policies.
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Affiliation(s)
- Hadii M Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Daniel Owusu
- Tobacco Center of Regulatory Science (GSU TCORS), Georgia State University, Atlanta, GA
| | | | - Faustine Williams
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Matthew Asare
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX
| | - Adekunle Oke
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Amy Poole
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Fenose Osedeme
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Ogwell A E Ouma
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
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Hakoum MB, Bou-Karroum L, Al-Gibbawi M, Khamis AM, Raslan AS, Badour S, Agarwal A, Alturki F, Guyatt G, El-Jardali F, Akl EA. Reporting of conflicts of interest by authors of primary studies on health policy and systems research: a cross-sectional survey. BMJ Open 2020; 10:e032425. [PMID: 32690493 PMCID: PMC7371338 DOI: 10.1136/bmjopen-2019-032425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES The objective of this study was to assess the frequency and types of conflict of interest (COI) disclosed by authors of primary studies of health policy and systems research (HPSR). DESIGN We conducted a cross-sectional survey using standard systematic review methodology for study selection and data extraction. We conducted descriptive analyses. SETTING We collected data from papers published in 2016 in 'health policy and service journals' category in Web of Science database. PARTICIPANTS We included primary studies (eg, randomised controlled trials, cohort studies, qualitative studies) of HPSR published in English in 2016 peer-reviewed health policy and services journals. OUTCOME MEASURES Reported COI disclosures including whether authors reported COI or not, form in which COI disclosures were provided, number of authors per paper who report any type of COI, number of authors per paper who report specific types and subtypes of COI. RESULTS We included 200 eligible primary studies of which 132 (66%) included COI disclosure statements of authors. Of the 132 studies, 19 (14%) had at least one author reporting at least one type of COI and the most frequently reported type was individual financial COI (n=15, 11%). None of the authors reported individual intellectual COIs or personal COIs. Financial and individual COIs were reported more frequently compared with non-financial and institutional COIs. CONCLUSION A low percentage of HPSR primary studies included authors reporting COI. Non-financial or institutional COIs were the least reported types of COI.
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Affiliation(s)
- Maram B Hakoum
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Lama Bou-Karroum
- Center for Systematic Reviews for Health Policy and Systems Research, American University of Beirut, Beirut, Lebanon
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | - Assem M Khamis
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | | | - Sanaa Badour
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Arnav Agarwal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Fadel Alturki
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Fadi El-Jardali
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Knowledge to Policy (K2P) Center, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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8
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Pasetes SV, Ling PM, Apollonio DE. Cognitive performance effects of nicotine and industry affiliation: a systematic review. Subst Abuse 2020; 14:1178221820926545. [PMID: 32547048 PMCID: PMC7271274 DOI: 10.1177/1178221820926545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 04/22/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Studies assessing the cognitive performance effects of nicotine show inconsistent results and tobacco industry funding has been correlated with study outcomes. We conducted a systematic review of the primary literature assessing the cognitive performance effects of nicotine and assessed potential associations between tobacco and pharmaceutical industry affiliation and reported study conclusions. METHODS We searched PubMed, EMBASE, PsycINFO, BIOSIS, and Web of Science for peer-reviewed journal articles published between 2009 and 2016 that: (1) were randomized controlled trials; (2) investigated the effects of nicotine on cognitive performance in a laboratory setting; (3) administered nicotine to healthy adults (18-60 years); and (4) included participants were nonsmokers or minimally deprived smokers (⩽2 hours of abstaining from smoking). Study disclosures and tobacco industry documents were reviewed to determine industry funding. RESULTS Searches yielded 3,771 abstracts; 32 studies were included in the review. The majority of studies investigated the effects of nicotine on attention (n = 22). Nicotine had a non-uniform effect on attention: studies reported positive (41%; n = 9), mixed (41%; n = 9), and no effect (18%; n = 4). The majority of study authors had received prior tobacco industry funding (59%; n = 19), however over half of tobacco-industry funded authors did not report this (53%; n = 10). CONCLUSIONS Nicotine does not appear to be associated with consistent cognitive performance effects. Although no association was found between reported outcomes and tobacco or pharmaceutical industry funding, findings likely underestimate the influence of industry funding due to strict inclusion criteria and incomplete data on pharmaceutical industry funding. CLINICAL TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Sarah V. Pasetes
- Department of Clinical Pharmacy,
University of California, San Francisco, USA
| | - Pamela M. Ling
- Department of Medicine, Division of
General Internal Medicine, Center for Tobacco Control Research and Education,
University of California, San Francisco, USA
| | - Dorie E. Apollonio
- Department of Clinical Pharmacy,
University of California, San Francisco, USA
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9
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Noh JW, Choi M, Kwon YD, Yoo KB. Impacts of Smoking Ban Policies on Restaurants in Seoul, South Korea: Analysis of Objective Sales Information. Nicotine Tob Res 2020; 22:950-957. [PMID: 31083716 DOI: 10.1093/ntr/ntz079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 05/12/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND From July 2013 to January 2015, the smoking ban instituted in restaurants in South Korea gradually expanded to cover all restaurants and bars, moving by size of restaurant (≤99 m2, 100-149 m2, ≥150 m2). This study measured the impacts of the smoking ban for restaurants. METHODS This study examined credit, check, or debit card sales data for every September and October from 2012 to 2015 in 711 census tracts in Seoul, South Korea. We accounted for total restaurant sales in each census tract. Our model controlled for the sales amounts for each census tract, type of restaurant, monthly business survey index, number of restaurants, daily average temperature, daily precipitation, and day of the week, and a dummy for census tract. RESULTS These were some positive associations with increase in total sales. However, the significance of the coefficients was not consistent over this period. Overall, our results showed no significant negative effects of smoking ban policy on restaurants. CONCLUSIONS Smoking ban policies produced benefits in terms of health outcomes, without causing significant negative impacts on sales. IMPLICATIONS Although the owners of restaurants anticipated negative impacts on sales from smoking ban policies, the results of this study suggest that restaurants experienced no negative economic impacts on sales from policies with health benefits, which suggest that it would be reasonable to promote and keep on the smoking ban. Also, it is important to apply smoking ban policy to all targets without exclusion.
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Affiliation(s)
- Jin-Won Noh
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Korea.,Institute of Health Promotion and Policy, Dankook University, Cheonan, Korea
| | - Minjae Choi
- Department of Public Health, Korea University, Seoul, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine, the Catholic University of Korea, Seoul, Korea.,Catholic Institute for Healthcare Management, the Catholic University of Korea, Seoul, Korea
| | - Ki-Bong Yoo
- Department of Health Administration, College of Science and Technology, Yonsei University, Wonju, Korea.,Department of Information and Statistics, College of Health Sciences, Yonsei University, Wonju, Korea
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10
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Lin H, Chang C, Liu Z, Zheng Y. Subnational smoke-free laws in China. Tob Induc Dis 2019; 17:78. [PMID: 31772556 PMCID: PMC6856824 DOI: 10.18332/tid/112665] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/19/2019] [Accepted: 09/28/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Implementing comprehensive smoke-free laws is an important part of tobacco control and has been promoted since China ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2005. This study shows the predictors of adopting subnational smoke-free laws and their alignment with Article 8 of WHO FCTC. METHODS The legislations of 125 cities from China’s top three city grades were assessed, covering the cities that have smoke-free laws. Logistic regression is applied to evaluate the characteristics of cities that adopted a smoke-free law. We also compare each smoke-free law with the WHO FCTC Article 8 requirements. RESULTS Provincial capital cities were more likely to adopt smoke-free laws compared with other cities. Smoke-free laws vary from comprehensive to partial bans with major exemptions. Among the 21 cities that have enacted smoke-free laws, 9 cities prohibited smoking in all indoor workplaces, indoor public places (restaurants, bars, health facilities, government buildings and schools) and public transportation. More than half of the smoke-free laws still allow designated indoor smoking rooms. Smoke-free laws that clearly ban e-cigarettes in smoke-free areas have been implemented in only two cities (Nanning and Hangzhou). CONCLUSIONS This study shows that a number of Chinese cities have taken legislative measures to protect people from exposure to tobacco smoke. It identifies signs of progress but also areas for improvement, such as the scope of smoke-free laws, imperfect implementation of such laws, and the potential omission of e-cigarettes from the legislation.
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Affiliation(s)
- Haoxiang Lin
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Zhao Liu
- Tobacco Medicine and Tobacco Cessation Center, China-Japan Friendship Hospital, Beijing, China
| | - Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
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Wei Y, Borland R, Zheng P, Fu H, Wang F, He J, Feng Y. Evaluation of the Effectiveness of Comprehensive Smoke-Free Legislation in Indoor Public Places in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16204019. [PMID: 31640111 PMCID: PMC6843952 DOI: 10.3390/ijerph16204019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/08/2019] [Accepted: 10/18/2019] [Indexed: 11/16/2022]
Abstract
This study evaluated compliance with the comprehensive smoke-free law in public indoor places introduced in Shanghai in March 2017. Observations and PM2.5 monitoring over 30 min intervals in 8 types of the venue were conducted three times: within a month before implementation and 3- and 12-months post implementation. Observations of evidence of smoking decreased from 66.2% before legislation to 52.8% three months after (p = 0.002) and 49.7% one year after (p < 0.001). The density of lit cigarettes also reduced significantly after implementation (p < 0.001). When adjusting for outdoor, indoor PM2.5 levels were significantly lower after the legislation, but only by a small amount (three months later: −0.27, p = 0.08; one year later: −0.12; p = 0.03). Evidence of compliance was weakest in farmer’s markets and bars, and smoking in male toilets did not change significantly. The reduction in smoking was affected by the management performance of their obligations. The comprehensive smoke-free law led to modest reductions in smoking and PM2.5 levels as a result, but from levels suggesting quite high levels of pre-compliance. However, compliance was limited in some areas, suggesting more effort is required on management to gain better compliance in some places like farmer’s markets, bars, and toilets.
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Affiliation(s)
- Yanxia Wei
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Ron Borland
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne 3010, Australia.
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Hua Fu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Fan Wang
- Department of Politics, East China Normal University, Shanghai 200241, China.
| | - Jingyi He
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Yitian Feng
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China.
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McCambridge J, Daube M, McKee M. Brussels Declaration: a vehicle for the advancement of tobacco and alcohol industry interests at the science/policy interface? Tob Control 2019; 28:7-12. [PMID: 29941544 PMCID: PMC6317438 DOI: 10.1136/tobaccocontrol-2018-054264] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/21/2018] [Accepted: 03/27/2018] [Indexed: 11/17/2022]
Abstract
The case for policies to be based on evidence appeared to gain a major boost with the publication of the Brussels Declaration, apparently with support from many leading scientists and institutions. Yet, as we show in this analysis, there are major concerns about how it was developed and, in particular, the extensive involvement of tobacco and alcohol industry actors. We describe how its coverage of conflicts of interest and vested interests is consistent with the perspectives of these same actors. The process of developing the Declaration successfully involved science advisors, other senior officials in governments and politicians in its preparation. Despite this, the final Declaration fails to address the need for safeguards to protect the integrity of science or policy from corporate interests, including in relation to the tobacco industry. This undermines Article 5.3 of the Framework Convention on Tobacco Control which seeks to protect public health policies from interference by the tobacco companies. More broadly, the Declaration offers potential to serve as a vehicle for advancing the vested interests of corporate sectors in public policymaking and appears to have been regarded in this way by a range of organisations related to the alcohol industry. This exercise is now being extended to the continent of Africa, which is strategically important to both the tobacco and alcohol industries. It will be important to study carefully to what extent initiatives like this form part of the global political strategies of tobacco and alcohol industry actors.
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Affiliation(s)
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Martin McKee
- ECOHOST, London School of Hygiene and Tropical Medicine, London, UK
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13
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Berg CJ, Fong GT, Thrasher JF, Cohen JE, Maziak W, Lando H, Drope J, Mejia R, Barnoya J, Nakkash R, Salloum RG, Parascandola M. The impact and relevance of tobacco control research in low-and middle-income countries globally and to the US. Addict Behav 2018; 87:162-168. [PMID: 30041132 DOI: 10.1016/j.addbeh.2018.07.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/11/2018] [Accepted: 07/15/2018] [Indexed: 11/15/2022]
Abstract
International and cross-cultural research is critical for understanding multilevel influences on health, health behaviors, and disease. A particularly relevant area of need for such research is tobacco control. The tobacco epidemic is one of the biggest public health threats globally, killing over 7 million people a year. Research critical to addressing this public health problem has leveraged variability in tobacco use, history, product market, and policies across different countries, settings, and populations, particularly in low- and middle-income countries (LMICs) where the tobacco burden is increasing. These efforts are needed in order to advance the science and inform practice and policy in various settings, including the US. Several funding agencies provide support for international research focused on tobacco control in LMICs because of the importance and implications of such research. This paper provides some concrete examples of how such research has advanced our knowledge-base and informed practice and policy globally, particularly in high-income countries including the US. Some prominent themes emphasized in this manuscript include: the development of knowledge regarding the diverse tobacco products on the market; better understanding of tobacco use and its impact among different populations; generating knowledge about the impacts including unintended consequences of tobacco control policy interventions; and better understanding tobacco industry strategies and informing advocacy efforts. In summary, international tobacco control research, particularly in LMICs, is critical in effectively and efficiently building the evidence base to advance tobacco control research, policy, and practice globally, including the US, with the ultimate goal of curbing the tobacco epidemic.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Geoffrey T Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L G1 Canada, Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, United States; Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 2213 McElderry Street, Baltimore, MD 21205, United States.
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8h Street, AHC5 505, Miami, FL 33199, United States.
| | - Harry Lando
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN 55454, United States.
| | - Jeffrey Drope
- Department of Economic and Health Policy Research, American Cancer Society, 250 Williams St, Atlanta, GA, 30303, United States.
| | - Raul Mejia
- Centro de Estudios de Estado y Sociedad, Sánchez de Bustamante 27, C1173AAA, Buenos Aires, Argentina.
| | - Joaquin Barnoya
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, 660 South Euclid Ave, St. Louis, MS 63110, United States.
| | - Rima Nakkash
- Department of Health Promotion and Community Health, American University of Beirut, PO, Box 11-0236, Beirut, Lebanon.
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States.
| | - Mark Parascandola
- Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, United States.
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Complexity and conflicts of interest statements: a case-study of emails exchanged between Coca-Cola and the principal investigators of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). J Public Health Policy 2018; 39:49-56. [PMID: 29180754 DOI: 10.1057/s41271-017-0095-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Statements on conflicts of interest provide important information for readers of scientific papers. There is now compelling evidence from several fields that papers reporting funding from organizations that have an interest in the results often generate different findings from those that do not report such funding. We describe the findings of an analysis of correspondence between representatives of a major soft drinks company and scientists researching childhood obesity. Although the studies report no influence by the funder, the correspondence describes detailed exchanges on the study design, presentation of results and acknowledgement of funding. This raises important questions about the meaning of standard statements on conflicts of interest.
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Dang AK, Tran BX, Nguyen LH, Do HT, Nguyen CT, Fleming M, Le HT, Le QNH, Latkin CA, Zhang MWB, Ho RCM. Customers' Perceptions of Compliance with a Tobacco Control Law in Restaurants in Hanoi, Vietnam: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1451. [PMID: 29996487 PMCID: PMC6068709 DOI: 10.3390/ijerph15071451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/07/2018] [Accepted: 07/08/2018] [Indexed: 01/10/2023]
Abstract
The Tobacco Harm Prevention Law has been promulgated in 2012 in Vietnam, prohibiting smoking in public places such as restaurants except for designated smoking areas. However, currently, evidence about Vietnamese customers’ and restaurants’ compliance with the Law is constrained. This study aimed to explore customers’ perceptions; attitudes and practices towards the compliance with tobacco control regulations in the restaurants in Hanoi, Vietnam. A cross-sectional study was performed in October 2015 with 1746 customers in 176 communes in Hanoi, Vietnam. Data about customers’ perceptions on how restaurants comply with the smoking control law and whether customers smoking actively or experienced SHS in restaurants in the last 30 days were collected. Multivariable mixed effects logistic regression model was used to determine the factors related to smoking in the restaurant. Most customers were aware of the law on Tobacco Harm Prevention (79%; n = 1320) and regulations that prohibited smoking in restaurants (78.4%; n = 1137). While 75.8% (n = 1285) of customers perceived that they did not see or rarely saw no-smoking signs, 17.7% (n = 481) of customers reported that they frequently saw direct marketing of tobacco in visited restaurants. About one-fourth of customers witnessed that the staff reminded customers not to smoke inside restaurants (28.8%; n = 313), and 65% (n = 1135) sometimes or always were exposed to secondhand smoke in their visited restaurants. People who were female (OR = 0.02, 95% CI = 0.01⁻0.05) were less likely to report their smoking in the restaurant than their counterparts. Those having higher age (OR = 1.03; 95% CI = 1.01⁻1.06), high school education (OR = 2.14, 95% CI = 1.07⁻4.26), being office workers (OR = 3.24, 95% CI = 1.33⁻7.92) or unemployed (OR = 4.45; 95% CI = 1.09⁻18.15) had a higher likelihood of reporting to be restaurant smokers than those having lower high education or students, respectively. This study highlighted a low level of perceived compliance with the smoke-free law in Vietnamese restaurants. Improving the monitoring systems for the enforcement of the smoking law in restaurants should be prioritized; restaurant owners should implement 100% smoke-free environments as following the best practice towards the tobacco control law along with educational campaigns to promote the awareness of restaurant owners and customers about the tobacco control law.
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Affiliation(s)
- Anh Kim Dang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Long Hoang Nguyen
- Department of Public Health Sciences, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Hoa Thi Do
- Department of Nutrition and Food Safety, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Mercedes Fleming
- School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland.
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | | | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Melvyn W B Zhang
- Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore 117599, Singapore.
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
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Lie JLY, Fooks G, de Vries NK, Heijndijk SM, Willemsen MC. Can't see the woods for the trees: exploring the range and connection of tobacco industry argumentation in the 2012 UK standardised packaging consultation. Tob Control 2018; 27:448-454. [PMID: 28743794 DOI: 10.1136/tobaccocontrol-2017-053707] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Transnational tobacco company (TTC) submissions to the 2012 UK standardised packaging consultation are studied to examine TTC argumentation in the context of Better Regulation practices. METHODS A content analysis was conducted of Philip Morris International and British American Tobacco submissions to the 2012 UK consultation. Industry arguments concerning expected costs and (contested) benefits of the policy were categorised into themes and frames. The inter-relationship between frames through linked arguments was mapped to analyse central arguments using an argumentation network. RESULTS 173 arguments were identified. Arguments fell into one of five frames: ineffectiveness, negative economic consequences, harm to public health, increased crime or legal ramifications. Arguments highlighted high costs to a wide range of groups, including government, general public and other businesses. Arguments also questioned the public health benefits of standardised packaging and highlighted the potential benefits to undeserving groups. An increase in illicit trade was the most central argument and linked to the greatest variety of arguments. CONCLUSIONS In policy-making systems characterised by mandatory impact assessments and public consultations, the wide range of cost (and contested benefits) based arguments highlights the risk of TTCs overloading policy actors and causing delays in policy adoption. Illicit trade related arguments are central to providing a rationale for these arguments, which include the claim that standardised packaging will increase health risks. The strategic importance of illicit trade arguments to industry argumentation in public consultations underlines the risks of relying on industry data relating to the scale of the illicit trade.
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Affiliation(s)
| | - Gary Fooks
- School for Languages and Social Science, Aston University, Birmingham, UK
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17
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Murad M, Marsh L, McGee R. The contribution of smokefree outdoor areas in achieving New Zealand's Smokefree 2025 goal. Health Promot J Austr 2018; 30:199-206. [PMID: 29582509 DOI: 10.1002/hpja.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 02/16/2018] [Indexed: 11/07/2022] Open
Abstract
ISSUES ADDRESSED With the adoption of Smokefree 2025, further commitment from local government to extend smokefree outdoor area policies is becoming increasingly important in the presence of high public support. The aim of this study was to identify local government commitment in the Canterbury/West Coast (CWC) region to the New Zealand Smokefree 2025 goal through provision of smokefree outdoor areas. METHODS Document analysis of the different stages of council long-term plans (LTPs) was undertaken, including 239 draft LTP documents, 5926 public submissions on these documents and 13 final LTP documents. A comparison between the 2015 final document and the 2012 final document was undertaken. Following this, semi-structured telephone interviews were undertaken with council staff. RESULTS No council had referred to Smokefree 2025 or smokefree community spaces in any 2015 LTP draft document. Each of the CWC councils received a number of smokefree-related submissions, with the main theme being the extension of current Smokefree Outdoor Area Policy. The final LTP documents showed that 5 councils had included a brief statement about Smokefree 2025. Smokefree issues were mentioned more often in the 2012 LTP compared to the 2015 LTP. CONCLUSIONS This research highlights a need for more commitment by local government to achieving the Smokefree 2025 goal. So what? There are opportunities for health groups to work with councils to try and enhance their overall commitment to Smokefree 2025 and promote wellbeing.
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Affiliation(s)
- Manal Murad
- Cancer Society Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Louise Marsh
- Cancer Society Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Rob McGee
- Cancer Society Social & Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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18
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Velicer C, St Helen G, Glantz SA. Tobacco papers and tobacco industry ties in regulatory toxicology and pharmacology. J Public Health Policy 2018; 39:34-48. [PMID: 29116189 PMCID: PMC5775030 DOI: 10.1057/s41271-017-0096-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Indexed: 11/21/2022]
Abstract
We examined the relationship between the tobacco industry and the journal Regulatory Toxicology and Pharmacology (RTP) using the Truth Tobacco Industry Documents Library and internet sources. We determined the funding relationships, and categorised the conclusions of all 52 RTP papers on tobacco or nicotine between January 2013 and June 2015, as "positive", "negative" or "neutral" for the tobacco industry. RTP's editor, 57% (4/7) of associate editors and 37% (14/38) of editorial board members had worked or consulted for tobacco companies. Almost all (96%, 50/52) of the papers had authors with tobacco industry ties. Seventy-six percent (38/50) of these papers drew conclusions positive for industry; none drew negative conclusions. The two papers by authors not related to the tobacco industry reached conclusions negative to the industry (p < .001). These results call into question the confidence that members of the scientific community and tobacco product regulators worldwide can have in the conclusions of papers published in RTP.
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Affiliation(s)
- Clayton Velicer
- Center for Tobacco Control Research and Education, University of California San Francisco, 530 Parnassus, Suite 366, San Francisco, CA, 94143-1390, USA
| | - Gideon St Helen
- Center for Tobacco Control Research and Education, University of California San Francisco, 530 Parnassus, Suite 366, San Francisco, CA, 94143-1390, USA
- Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Stanton A Glantz
- Center for Tobacco Control Research and Education, University of California San Francisco, 530 Parnassus, Suite 366, San Francisco, CA, 94143-1390, USA.
- Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA.
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
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19
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Gravely S, Nyamurungi KN, Kabwama SN, Okello G, Robertson L, Heng KKC, Ndikum AE, Oginni AS, Rusatira JC, Kakoulides S, Huffman MD, Yusuf S, Bianco E. Knowledge, opinions and compliance related to the 100% smoke-free law in hospitality venues in Kampala, Uganda: cross-sectional results from the KOMPLY Project. BMJ Open 2018; 8:e017601. [PMID: 29306880 PMCID: PMC5780705 DOI: 10.1136/bmjopen-2017-017601] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study evaluated knowledge, opinions and compliance related to Uganda's comprehensive smoke-free law among hospitality venues in Kampala Uganda. DESIGN This multi-method study presents cross-sectional findings of the extent of compliance in the early phase of Uganda's comprehensive smoke-free law (2 months postimplementation; pre-enforcement). SETTING Bars, pubs and restaurants in Kampala Uganda. PROCEDURE AND PARTICIPANTS A two-stage stratified cluster sampling procedure was used to select hospitality sites stratified by all five divisions in Kampala. A total of 222 establishments were selected for the study. One hospitality representative from each of the visited sites agreed to take part in a face-to-face administered questionnaire. A subsample of hospitality venues were randomly selected for tobacco air quality testing (n=108). Data were collected between June and August 2016. OUTCOME MEASURES Knowledge and opinions of the smoke-free law among hospitality venue staff and owners. The level of compliance with the smoke-free law in hospitality venues through: (1) systematic objective observations (eg, active smoking, the presence of designated smoking areas, 'no smoking' signage) and (2) air quality by measuring the levels of tobacco particulate matter (PM2.5) in both indoor and outdoor venues. RESULTS Active smoking was observed in 18% of venues, 31% had visible 'no smoking' signage and 47% had visible cigarette remains. Among interviewed respondents, 57% agreed that they had not been adequately informed about the smoke-free law; however, 90% were supportive of the ban. Nearly all respondents (97%) agreed that the law will protect workers' health, but 32% believed that the law would cause financial losses at their establishment. Indoor PM2.5 levels were hazardous (267.6 µg/m3) in venues that allowed smoking and moderate (29.6 µg/m3) in smoke-free establishments. CONCLUSIONS In the early phase of Uganda's smoke-free law, the level of compliance in hospitality venues settings in Kampala was suboptimal. Civil society and the media have strong potential to inform and educate the hospitality industry and smokers of the benefits and requirements of the smoke-free law.
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Affiliation(s)
- Shannon Gravely
- International Tobacco Control Policy Evaluation (ITC)Project, Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Steven Ndugwa Kabwama
- School of Public Health, Makerere University, Kampala, Uganda
- Mental Health and Substance Abuse, Ministry of Health, Kampala, Uganda
| | - Gabriel Okello
- Respiratory Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Achiri Elvis Ndikum
- Association for the Promotion of Youth Leadership, Advocacy and Volunteerism (APYLAV), Yaounde, Cameroon
| | | | | | | | - Mark D Huffman
- Department of Preventive Medicine and Medicine-Cardiology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Salim Yusuf
- Department of Medicine and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Eduardo Bianco
- Centro de Investigación para la Epidemia del Tabaquismo, Montevideo, Uruguay
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20
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Guerrero-López CM, Molina M, Colchero MA. Employment changes associated with the introduction of taxes on sugar-sweetened beverages and nonessential energy-dense food in Mexico. Prev Med 2017; 105S:S43-S49. [PMID: 28890354 DOI: 10.1016/j.ypmed.2017.09.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 08/31/2017] [Accepted: 09/02/2017] [Indexed: 11/19/2022]
Abstract
We assessed changes in employment in the manufacturing industry, the commercial sector and national unemployment rates, associated with the fiscal policies implemented in 2014 in Mexico: a 1 peso per liter excise tax to sugar-sweetened beverages (SSB) and an 8% tax on nonessential energy-dense food. We used data from three nationally representative surveys. Controlling for contextual variables, we used interrupted time series analyses to model changes in number of employees in the SSB and nonessential energy-dense food industry, in commercial establishments selling beverages and food and changes in national unemployment rates. Our results show that there were no significant changes in employment associated with the taxes in the manufacturing industries (for beverages and nonessential energy-dense food). We found a very small increasing trend in the post-tax period for employment in commercial stores and a decreasing trend in the unemployment rate. However, these changes are negligible and unlikely to be caused by the implementation of the taxes. In conclusion, there were no employment reductions associated with the fiscal policies implemented in Mexico in 2014 on SSB and nonessential energy-dense food.
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Affiliation(s)
- Carlos M Guerrero-López
- Center for Health Systems Research, Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. 62100, Cuernavaca, Mor., Mexico.
| | - Mariana Molina
- Center for Health Systems Research, Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. 62100, Cuernavaca, Mor., Mexico
| | - M Arantxa Colchero
- Center for Health Systems Research, Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. 62100, Cuernavaca, Mor., Mexico.
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Abstract
OBJECTIVES Thirty states have smoke-free air laws that ban smoking in restaurants and bars, covering nearly two-thirds of the US population. It is well established that these laws generally have a null or positive economic impact on restaurants and bars. However, all establishments in a geographic area are usually treated as a homogeneous group without considering the potential for differential effects by establishment characteristics. This study uses variation in smoke-free air laws over time to estimate their impact on employment in restaurants and bars with a focus on potential differences by employer size (number of employees). A two-pronged approach with a national-level and state-level analysis is used to take advantage of more granular data availability for a single state (North Carolina). DESIGN Observational study using panel data. SETTING 1) US, 2) North Carolina INTERVENTIONS: Smoke-free air laws. OUTCOME MEASURES State-level accommodation and food services employment for all 50 states and District of Columbia from 1990 through 2014 (Quarterly Census of Employment and Wages); county-level restaurant and bar employment in North Carolina from 2001 through 2014 (North Carolina Department of Commerce). RESULTS There is no evidence of a redistributive effect of smoke-free air laws on restaurant and bar employment by employer size. CONCLUSION The lack of a redistributive effect is an important finding for policy-makers considering implementation or expansion of a smoke-free air law to protect employees and patrons from the dangers of exposure to secondhand smoke.
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Affiliation(s)
- Paul Shafer
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle, North Carolina, USA
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Lencucha R, de Lima Pontes C. The context and quality of evidence used by tobacco interests to oppose ANVISA's 2012 regulations in Brazil. Glob Public Health 2017; 13:1204-1215. [PMID: 28884634 DOI: 10.1080/17441692.2017.1373839] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Evidence is an important resource for policy makers. Alongside its practical utility, evidence is a persuasive strategic and rhetorical tool. This study scrutinises the information used by tobacco interests in opposition to Brazil's National Health Surveillance Agency's (ANVISA) 2012 regulations. We analysed one prominent document widely cited in the policy discourse, produced by Fundação Getulio Vargas (FGV) in 2010 when ANVISA initiated public consultations. The FGV document formed the basis of opposition to the regulations. We conducted four levels of analysis of the FGV document: (1) identifying the main arguments, (2) linking the arguments with evidence, (3) analysing the quality of evidence and (4) a contextual analysis, examining how evidence was interpreted and represented. Three of five arguments were supported by information produced by an external source. Sixty eight percent of evidence sources were supported by the tobacco industry and only 31% were peer-reviewed. Information was often misrepresented in the arguments. Tobacco interests continue to draw from sources they claim are scientific to legitimise their opposition to tobacco regulation. The information from these sources are often misrepresented, used to distract from the health objectives of policy and receive direct or indirect support from the tobacco industry.
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Affiliation(s)
- Raphael Lencucha
- a Faculty of Medicine, School of Physical and Occupational Therapy , McGill University , Montreal , Canada
| | - Clelio de Lima Pontes
- a Faculty of Medicine, School of Physical and Occupational Therapy , McGill University , Montreal , Canada
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23
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Smith M, Signal L, Edwards R, Hoek J. Children's and parents' opinions on the sport-related food environment: a systematic review. Obes Rev 2017; 18:1018-1039. [PMID: 28560820 DOI: 10.1111/obr.12558] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 11/27/2022]
Abstract
Sport is a key setting for interventions to address child obesity given its obesogenic nature. Understanding children's and parents' opinions on the sport-related food environment is critical in developing effective programmes and policies to improve children's health. This systematic review synthesizes quantitative and qualitative research examining children's and parents' opinions on the sport-related food environment. During July 2016, a range of electronic databases of academic and grey literature were searched. Thirty-two publications (11 including children, 17 parents and 4 both) were included for review. The publications were assessed using the Analysis Grid for Environments Linked to Obesity framework to categorize the sport-related food environment into the physical, sociocultural, economic and political environments. The literature available investigating children's and parents' opinions of the sport-related food environment suggests that many children and parents consider the environment neither conducive to nor supportive of children's healthy food behaviours or wider health and well-being. Both groups would likely support actions to change and improve it. This systematic review found that original research specifically investigating children's and parents' perspectives on almost all aspects of the sport-related food environment is limited. Thus, there is scope for further investigation into this important part of children's food environments.
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Affiliation(s)
- M Smith
- Health Promotion and Policy Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
| | - L Signal
- Health Promotion and Policy Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
| | - R Edwards
- Health Promotion and Policy Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
| | - J Hoek
- Department of Marketing, University of Otago, Dunedin, New Zealand
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Popova L, Owusu D, Jenson D, Neilands TB. Factual text and emotional pictures: overcoming a false dichotomy of cigarette warning labels. Tob Control 2017; 27:tobaccocontrol-2016-053563. [PMID: 28428337 PMCID: PMC5650578 DOI: 10.1136/tobaccocontrol-2016-053563] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 03/15/2017] [Accepted: 03/17/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND In reviewing the first set of pictorial warning labels in the USA, the courts equated textual labels with facts and information, and images with emotion. This study tested the differences in perceived informativeness and emotion between textual and pictorial cigarette warning labels. METHODS An online study with 1838 US adults who were non-smokers (n=764), transitioning smokers (quit smoking in the past 2 years or currently trying to quit, n=505) or current smokers (n=569). Each participant evaluated 9 out of 81 text and pictorial cigarette warning labels. Participants reported to what extent they perceived the label as informative and factual and the negative emotions they felt while looking at each label. We used linear mixed models to account for the nesting of multiple observations within each participant. RESULTS There were no significant differences in perceived informativeness between textual (mean 6.15 on a 9-point scale) and pictorial labels (6.14, p=0.80, Cohen's d=0.003). Textual labels evoked slightly less emotion (4.21 on a 9-point scale) than pictorial labels (4.42, p<0.001, Cohen's d=0.08). Perceived informativeness and emotion were strongly correlated (Pearson r=0.53, p<0.001). CONCLUSION Our findings contradict courts' conclusions that pictorial messages are emotional and not factual. Pictorial labels are rated as informative and factual, textual labels evoke emotion, and emotionality and informativeness are strongly correlated. These findings serve as evidence for the Food and Drug Administration (FDA) to counteract the claim that pictorial warning labels, by definition, are not 'purely factual and uncontroversial'.
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Affiliation(s)
- Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Daniel Owusu
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Desmond Jenson
- TobaccoControl Legal Consortium, a program of the Public Health Law Center, at the Mitchell Hamline School of Law, Saint Paul, Minnesota, USA
| | - Torsten B Neilands
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
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Crosbie E, Sosa P, Glantz SA. The importance of continued engagement during the implementation phase of tobacco control policies in a middle-income country: the case of Costa Rica. Tob Control 2017; 26:60-68. [PMID: 26856614 PMCID: PMC4977207 DOI: 10.1136/tobaccocontrol-2015-052701] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 01/08/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To analyse the process of implementing and enforcing smoke-free environments, tobacco advertising, tobacco taxes and health warning labels from Costa Rica's 2012 tobacco control law. METHOD Review of tobacco control legislation, newspaper articles and interviewing key informants. RESULTS Despite overcoming decades of tobacco industry dominance to win enactment of a strong tobacco control law in March 2012 consistent with WHO's Framework Convention on Tobacco Control, the tobacco industry and their allies lobbied executive branch authorities for exemptions in smoke-free environments to create public confusion, and continued to report in the media that increasing cigarette taxes led to a rise in illicit trade. In response, tobacco control advocates, with technical support from international health groups, helped strengthen tobacco advertising regulations by prohibiting advertising at the point-of-sale (POS) and banning corporate social responsibility campaigns. The Health Ministry used increased tobacco taxes earmarked for tobacco control to help effectively promote and enforce the law, resulting in high compliance for smoke-free environments, advertising restrictions and health warning label (HWL) regulations. Despite this success, government trade concerns allowed, as of December 2015, POS tobacco advertising, and delayed the release of HWL regulations for 15 months. CONCLUSIONS The implementation phase continues to be a site of intensive tobacco industry political activity in low and middle-income countries. International support and earmarked tobacco taxes provide important technical and financial assistance to implement tobacco control policies, but more legal expertise is needed to overcome government trade concerns and avoid unnecessary delays in implementation.
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Affiliation(s)
- Eric Crosbie
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
- Department of Politics, University of California Santa Cruz, Santa Cruz, California, USA
| | - Patricia Sosa
- International Advocacy Center, Campaign for Tobacco Free Kids, Washington DC, USA
| | - Stanton A Glantz
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
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Pieroni L, Salmasi L. The Economic Impact of Smoke-Free Policies on Restaurants, Cafés, and Bars: Panel Data Estimates From European Countries. JOURNAL OF POLICY ANALYSIS AND MANAGEMENT : [THE JOURNAL OF THE ASSOCIATION FOR PUBLIC POLICY ANALYSIS AND MANAGEMENT] 2017; 36:853-879. [PMID: 28991425 DOI: 10.1002/pam.22016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this paper, we investigate the extent to which the economic outcomes of restaurants, bars, and cafés have been affected by the introduction of anti-smoking regulations in Europe. We use an unexploited panel database to collect a comprehensive set of information on financial indicators regarding the balance sheets of private and public companies in various economic sectors. The results show that smoke-free policies did not significantly affect the firms' economic performance, irrespective of the balance sheet indicators analyzed. Moreover, the results are robust to various econometric specifications and suggest that the recent enforcement of anti-smoking legislation in Europe has improved public health without a corresponding negative impact on revenues and employment in the hospitality industry.
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Schillo BA, Babb S, Juster HR. Developing Approaches for Evaluating Smoke-Free Policies. Health Promot Pract 2016; 12:166S-72S. [DOI: 10.1177/1524839911414564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article describes how several tobacco control organizations identified and responded to an emerging need for technical assistance on how to evaluate smoke-free policies. The authors outline the purposes of evaluating smoke-free policies and present examples of evaluation approaches and tools. Examples are provided of how evaluation has been used to advance the adoption, implementation, and defense of smoke-free policies. Opportunities for further research are identified. Finally, the authors review lessons learned and discuss their implications for evaluating policy initiatives addressing other public health issues.
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Affiliation(s)
| | - Stephen Babb
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Aherrera A, Çarkoğlu A, Hayran M, Ergör G, Eirüder T, Kaplan B, Susan J, Zheng L, Cohen JE, Navas-Acien A. Factors that influence attitude and enforcement of the smoke-free law in Turkey: a survey of hospitality venue owners and employees. Tob Control 2016; 26:540-547. [PMID: 27645254 DOI: 10.1136/tobaccocontrol-2016-053088] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/23/2016] [Indexed: 11/04/2022]
Abstract
INTRODUCTION In 2009, Turkey extended the smoke-free legislation to hospitality venues. Compliance, however, remains low in some hospitality venues. We identified characteristics associated with knowledge of health effects that can be prevented by the smoke-free law, the attitude towards and enforcement of the law. METHODS In 2014, we conducted 400 interviews with hospitality venue owners and employees in 7 cities in Turkey. The venues were identified based on a random sampling strategy in a previous phase of the study. RESULTS Over one-third (37.3%) of hospitality owners and employees had adequate knowledge of the health effects from secondhand smoke (SHS), 71.3% had a positive attitude towards the law and 19.5% had personally enforced the law. Participants who worked 70 hours or more per week were more likely to have a positive attitude towards the law. Older individuals, women, participants working in bars/nightclubs, venue owners receiving fines for non-compliance and current smokers were less likely to have a positive attitude towards the law. Participants working in traditional coffee houses, former smokers, and participants with a high school education or greater were more likely to enforce the law. Smokers who quit or reduced smoking because of the law were more likely to enforce the law compared with those who were not influenced by the law. CONCLUSIONS Although the attitude towards the law was positive, interventions are needed to increase knowledge on the health effects of SHS and facilitate enforcement of the law, particularly among subgroups less likely to have a positive attitude and enforce the law.
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Affiliation(s)
- Angela Aherrera
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Asli Çarkoğlu
- Department of Psychology, Kadir Has University, Istanbul, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Gül Ergör
- Izmir Dokuz Eylül School of Medicine, Izmir, Turkey
| | - Toker Eirüder
- World Health Organization Country Office, Ankara, Turkey
| | - Bekir Kaplan
- Ministry of Health, General Directorate of Health Research, Ankara, Turkey
| | - Jolie Susan
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura Zheng
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Toumbourou JW. Beneficial Action within Altruistic and Prosocial Behavior. REVIEW OF GENERAL PSYCHOLOGY 2016. [DOI: 10.1037/gpr0000081] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article integrates knowledge from health psychology, life course development, and social psychology to outline a theoretical framework for identifying, investigating, promoting, and evaluating beneficial action. Beneficial action is defined as a subset of prosocial (motivated to benefit others that may include self-interest) and altruistic (prosocial motivation without self-interest) behavior that uses consequential (scientific) knowledge to increase freedom within the global population. Beneficial action theory seeks to increase political and social actions that are planned and evaluated to ensure key tasks in human development. Central among these is the broadening of social identity to ensure that the human potential to use science to modify the natural environment achieves benefits for the global population. This article presents a theoretical framework for conceptualizing the psychological processes that underlie the development, application and evaluation of beneficial action for individuals and populations. The need to conceptualize beneficial action arises from 3 related observations. First, the certainty of knowledge of the beneficial outcome of a specific human action increases the moral motivation to engage in that action. For example, there is consensus among psychologists and other professions that it is unethical to engage in therapeutic practices that have evidence for neutral or harmful consequences. Second, due to the rapid increase in scientific knowledge, the range of human action that has scientifically ascertainable consequences is rapidly expanding. Third, advancing scientific knowledge means that human actions have increasingly powerful consequences for humanity and the natural world, warranting careful consideration of how to ensure global population benefits.
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Murthy VH. Reducing Exposure to Secondhand Smoke. Public Health Rep 2016; 131:515-7. [DOI: 10.1177/0033354916662206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Which Images and Features in Graphic Cigarette Warnings Predict Their Perceived Effectiveness? Findings from an Online Survey of Residents in the UK. Ann Behav Med 2016; 49:639-49. [PMID: 25697135 DOI: 10.1007/s12160-015-9693-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Many countries are implementing graphic warnings for cigarettes. Which graphic features influence their effectiveness remains unclear. PURPOSE To identify features of graphic warnings predicting their perceived effectiveness in discouraging smoking. METHOD Guided by the Common-Sense Model of responses to health threats, we content-analyzed 42 graphic warnings for attributes of illness risk representations and media features (e.g., photographs, metaphors). Using data from 15,536 survey participants, we conducted stratified logistic regressions testing which attributes predict participant selections of warnings as effective. RESULTS Images of diseased body parts predicted greater perceived effectiveness; OR = 6.53-12.45 across smoking status (smoker, ex-smoker, young non-smoker) groups. Features increasing perceived effectiveness included images of dead or sick persons, children, and medical technology; focus on cancer; and photographs. Attributes decreasing perceived effectiveness included infertility/impotence, addictiveness, cigarette chemicals, cosmetic appearance, quitting self-efficacy, and metaphors. CONCLUSIONS These findings on representational and media attributes predicting perceived effectiveness can inform strategies for generating graphic warnings.
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Abstract
Whether U.S. county governments are responsive to their policy environments is a critical question in light of evidence that counties have expanded their policy portfolios and governmental professionalism to meet increased citizen demands. This study examines whether economic interests and political preferences influence decisions by counties to impose smoking bans in nonhospitality workplaces, restaurants, and bars. Results show that counties are responsive to their environments, but that the nature of responsiveness varies by the policy in question and the form of government. These results therefore shed light on the ability of counties to function as democratic institutions.
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Affiliation(s)
- Vickie D. Ybarra
- RWJF Center for Health Policy at UNM, University of New Mexico, Albuquerque, NM, USA
| | - Timothy B. Krebs
- Department of Political Science, University of New Mexico, Albuquerque, NM, USA
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Reactions to Smoke-free Policies and Messaging Strategies in Support and Opposition: A Comparison of Southerners and Non-Southerners in the US. HEALTH BEHAVIOR AND POLICY REVIEW 2015; 2:408-420. [PMID: 26702405 DOI: 10.14485/hbpr.2.6.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES We explored differences in support for smoke-free policies among Southerners versus non-Southerners within a quota-based non-probability sample of adults in the United States. METHODS In 2013, a cross-sectional online survey was conducted among 2501 adults assessing tobacco use, reactions to personal and public smoke-free policies, and persuasiveness of various message frames regarding smoke-free bar/restaurant policies. RESULTS Southerners were no different from non-Southerners in support for most public and private smoke-free policies. The most effective pro-policy messages regarded hospitality, health, and individual rights/responsibilities; the most persuasive anti-policy messages involved individual rights/responsibilities. Compared to non-Southerners, Southerners rated pro-policy messages involving economic impact, religion/morality, and hospitality as more persuasive. CONCLUSIONS Factors other than public opinion accounting for lagging policy adoption must be explored.
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Boes S, Marti J, Maclean JC. The Impact of Smoking Bans on Smoking and Consumer Behavior: Quasi-Experimental Evidence from Switzerland. HEALTH ECONOMICS 2015; 24:1502-1516. [PMID: 25251559 DOI: 10.1002/hec.3108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 07/14/2014] [Accepted: 08/26/2014] [Indexed: 06/03/2023]
Abstract
In this paper, we exploit the progressive implementation of smoking bans in public venues at the state level in Switzerland to evaluate both the direct effects on smoking and the potential unintended consequences of these legislations on consumer behaviors as measured by visiting restaurants/bars and discos ('going out'). Our results indicate that public venue smoking bans in Switzerland reduce smoking rates, but the findings do not emerge until 1 year following the ban. This pattern of results is consistent with delays in ban enforcement on the part of business owners, difficulties in changing addictive behaviors such as smoking, and/or learning on the part of smokers. We find evidence that smoking bans influence going-out behavior and there is substantial heterogeneity across venue and consumer characteristics.
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Affiliation(s)
- Stefan Boes
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, LU, Switzerland
| | - Joachim Marti
- Medicine and Health Leeds, University of Leeds, Leeds, UK
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Ye X, Chen S, Yao Z, Gao Y, Xu Y, Zhou S, Zhu Z, Wang L, Yang Y. Smoking behaviors before and after implementation of a smoke-free legislation in Guangzhou, China. BMC Public Health 2015; 15:982. [PMID: 26420222 PMCID: PMC4588461 DOI: 10.1186/s12889-015-2353-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 09/25/2015] [Indexed: 12/02/2022] Open
Abstract
Background According to the partial smoke-free legislation implemented on 1 September 2010 in Guangzhou, China, smoke-free did not cover all indoor areas. Some places have a full smoking ban (100 % smoke-free), other places have a partial smoking ban, and homes have no ban. This study aimed to compare the smoking behaviors before and after implementation of a smoke-free legislation. Method A repeated cross-sectional survey was conducted on smoking-related behaviors with a total of 4,900 respondents before, and 5,135 respondents after the legislation was instituted. For each wave of the survey, a three-stage stratified sampling process was used to obtain a representative sample. Pearson’s Chi-square test was used to determine differences of smoking prevalence and quit ratio between the two samples. Logistic regression models were used to examine the associations of a smoke-free legislation with smoking behaviors. Results The overall daily smoking rate declined significantly from 20.8 % to 18.2 % (p < 0.05), especially among those aged 15–24 years. The quit ratios increased significantly (from 14.5 % to 17.9 %), but remained low among 15–44 year olds. The overall self-reported smoking behaviors in locations with a full smoking ban decreased significantly from 36.4 % to 24.3 % with the greater drops occurring in cultural venues, public transport vehicles, and government offices. Smoking in places with partial smoking bans remained high (89.6 % vs. 90.4 %), although a slight decrease was observed in some of these areas. The implementation of a smoke-free legislation did not lead to more smoking in homes (91.0 % vs 89.4 %), but smoking in homes remained high. Conclusions These findings highlight the urgent need for a comprehensive smoke-free legislation covering all public places in Guangzhou, simultaneously educational interventions and campaigns promoting voluntary changes in home smoking need to occur.
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Affiliation(s)
- Xiaohua Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
| | - Sidong Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
| | - Zhenjiang Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
| | - Yanhui Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
| | - Ya Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
| | - Shudong Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
| | - Zhengwei Zhu
- Guangzhou Association on Tobacco Control, Guangzhou, China.
| | - Liang Wang
- College of Public Health, East Tennessee State University, Johnson, USA.
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
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Evans-Reeves KA, Hatchard JL, Gilmore AB. 'It will harm business and increase illicit trade': an evaluation of the relevance, quality and transparency of evidence submitted by transnational tobacco companies to the UK consultation on standardised packaging 2012. Tob Control 2015; 24:e168-77. [PMID: 25472733 PMCID: PMC4484371 DOI: 10.1136/tobaccocontrol-2014-051930] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 10/29/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Transnational tobacco companies (TTCs) submitted evidence to the 2012 UK Consultation on standardised packaging (SP) to argue the policy will have detrimental economic impacts and increase illicit tobacco trade. METHODS A content analysis of the four TTC submissions to the consultation assessed the relevance and quality of evidence TTCs cited to support their arguments. Investigative research was used to determine whether the cited evidence was industry connected. Fisher's exact tests were used to compare the relevance and quality of industry-connected and independent from the industry evidence. The extent to which TTCs disclosed financial conflicts of interest (COI) when citing evidence was examined. RESULTS We obtained 74 pieces of TTC-cited evidence. The quality of the evidence was poor. TTCs cited no independent, peer-reviewed evidence that supported their arguments. Nearly half of the evidence was industry-connected (47%, 35/74). None of this industry-connected evidence was published in peer-reviewed journals (0/35) and 66% (23/35) of it was opinion only. Industry-connected evidence was of significantly poorer quality than independent evidence (p<0.001). COIs were not disclosed by TTCs in 91% (32/35) of cases. CONCLUSIONS In the absence of peer-reviewed research to support their arguments, TTCs relied on evidence they commissioned and the opinions of TTC-connected third-parties. Such connections were not disclosed by TTCs when citing this evidence and were time consuming to uncover. In line with Article 5.3 of the Framework Convention on Tobacco Control and broader transparency initiatives, TTCs should be required to disclose their funding of all third-parties and any COIs when citing evidence.
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Affiliation(s)
- K A Evans-Reeves
- Tobacco Control Research Group and member of UK Centre for Tobacco and Alcohol Studies, University of Bath, Bath, UK
| | - J L Hatchard
- Tobacco Control Research Group and member of UK Centre for Tobacco and Alcohol Studies, University of Bath, Bath, UK
| | - A B Gilmore
- Tobacco Control Research Group and member of UK Centre for Tobacco and Alcohol Studies, University of Bath, Bath, UK
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Onigbogi OO, Odukoya O, Onigbogi M, Sekoni O. Knowledge and attitude toward smoke-free legislation and second-hand smoking exposure among workers in indoor bars, beer parlors and discotheques in Osun State of Nigeria. Int J Health Policy Manag 2015; 4:229-34. [PMID: 25844384 DOI: 10.15171/ijhpm.2015.44] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 02/26/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND One of the requirements of the Osun State smoke-free legislation is to ensure smoke-free enclosed and partially enclosed workplaces. This survey was conducted to assess the knowledge and attitude of workers in indoor bars, beer parlors and discotheques to smoke-free legislation in general and the Osun State smoke-free law in particular. METHODS A convenience sampling of 36 hospitality centers was conducted. Interviewer-administered questionnaires were used to elicit responses about the objectives from non-smoking workers. The questionnaires had sections on knowledge of the Osun State smoke-free law, attitude toward the law and smoke-free legislation in general and exposure to second-hand tobacco smoke by the workers. Questions were also asked about the second-hand tobacco smoking status of these workers. The data were analyzed using SPSS version 15.0. RESULTS We had 154 participants recruited into the study. There were 75 males (48.0%) and 79 females (52.0%). On the overall, respondents had a good knowledge of the effects of second-hand smoke on health (70.2%) with 75.0% of them being aware of the general smoke-free law and 67.3% being aware of the Osun State smoke-free law although none of them had ever seen a copy of the law. A high proportion (60.0%) was in support of the Osun smoke-free law although all of them think that the implementation of the law could reduce patronage and jeopardize their income. Attitude toward second-hand smoking was generally positive with 72.0% of them having no tolerance for second-hand tobacco smoke in their homes. Most participants (95.5%) had been exposed to tobacco smoke in the workplace within the past week. CONCLUSION Despite the high level of awareness of the respondents about the dangers of second hand smoke and their positive attitude to smoke-free laws, nearly all were constantly being exposed to second hand smoke at work. This calls for policy level interventions to improve the implementation of the smoke-free law.
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Affiliation(s)
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Modupe Onigbogi
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oluwakemi Sekoni
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
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García-Altés A, Pinilla J, Marí-Dell'Olmo M, Fernández E, López MJ. Economic Impact of Smoke-Free Legislation: Did the Spanish Tobacco Control Law Affect the Economic Activity of Bars and Restaurants? Nicotine Tob Res 2015; 17:1397-400. [PMID: 25586775 DOI: 10.1093/ntr/ntu346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 12/29/2014] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The potential of smoke-free bans to negatively impact the hospitality business has been an argument of the hospitality and tobacco industry against such legislation. A partial smoke-free legislation was introduced in Spain in 2006 allowing smoking in most bars and restaurants due to the pressure of the hospitality sector. However, this partial ban was later amended in 2011 to include all the hospitality premises without exceptions. The stepped Spanish process permits to evaluate whether the entry into force of the smoke-free legislation had any effect on the economic activity of the hospitality sector. METHODS We employed a pooled time series cross-sectional design, with national data over 6 years (2006-2011). The dependent variable used was the total number of bars and restaurants per 100,000 inhabitants. The explanatory variables used were the average amount of spending per household in bars and restaurants, and the total unemployment rate in Spain by regions. RESULTS For every 1% increase in the unemployment rate there was a 0.05% decrease in the number of bars and restaurants. In 2007, the number of bars and restaurants was significantly reduced by 13.06% (all others factors being held constant), 4.87% in 2008, and 10.42% in 2009. No statistically significant effect of the smoke-free legislation emerged from 2010 (6.76%) to 2011 (7.69%). CONCLUSION The new Spanish smoke-free legislation had no effect on the number of bars and restaurants.
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Affiliation(s)
- Anna García-Altés
- Fundación Instituto de Investigación en Servicios Sanitarios (IISS), València, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Jaime Pinilla
- Department of Quantitative Methods in Economics, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Marc Marí-Dell'Olmo
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Maria José López
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain
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Thrasher JF, Kim SH, Rose I, Craft MK. Media coverage of smoke-free policies after their innovation. JOURNAL OF HEALTH COMMUNICATION 2015; 20:297-305. [PMID: 25564972 DOI: 10.1080/10810730.2014.925017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Smoke-free policies are critical to global tobacco control, and prior research on media coverage of smoke-free policies primarily focused on the period when they were first innovated; however, the scientific basis for smoke-free policies has broadened, and how media coverage has changed, if at all, is unknown. The authors characterized the actors, arguments, and favorability of media coverage of smoke-free policies from 2006 to 2009, by content-analyzing 452 news stories in the 4 primary newspapers in South Carolina. Most media coverage was favorable (45%) or mixed (43%) toward smoke-free policies, and negative coverage decreased over time (B = -1.001, SE = 0.326; p = .008). The most prevalent argument concerned the harms of secondhand smoke (44%). A higher percentage of articles mentioned economic arguments against (26%) than for (17%) smoke-free policies (χ(2) = 10.89, p < .01, for the difference between 26% and 17%), and these percentages did not change over time. Advocates and media should improve communications to more effectively represent scientific evidence regarding the null or positive impact of smoke-free policies on businesses.
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Affiliation(s)
- James F Thrasher
- a Department of Health Promotion, Education, and Behavior, Arnold School of Public Health , University of South Carolina , Columbia , South Carolina , USA
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The smoking ban next door: Do hospitality businesses in border areas have reduced sales after a statewide smoke-free policy? Health Policy 2015; 119:44-9. [DOI: 10.1016/j.healthpol.2014.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 09/18/2014] [Accepted: 09/22/2014] [Indexed: 11/17/2022]
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Martínez-Sánchez JM, Ballbè M, Fu M, Martín-Sánchez JC, Gottlieb M, Saltó E, Vardavas CI, Daynard R, Connolly GN, Fernández E. Attitudes towards electronic cigarettes regulation in indoor workplaces and selected public and private places: a population-based cross-sectional study. PLoS One 2014; 9:e114256. [PMID: 25469996 PMCID: PMC4254991 DOI: 10.1371/journal.pone.0114256] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 11/05/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Currently, there is an intensive debate about the regulation of the use of electronic cigarettes (e-cigarettes) in indoor places. The aim of this study was to assess the attitudes toward e-cigarette use in indoor workplaces and selected public and private venues among the general population in Barcelona (Spain) in 2013-2014. METHODS This is a cross-sectional study of a representative sample of the population of Barcelona (n = 736). The field work was conducted between May 2013 and February 2014. We computed the prevalence and the adjusted odds ratios (OR) derived from multivariable logistic regression models. RESULTS The awareness of e-cigarettes was 82.3%. Forty five percent of respondents did not agree with the use of e-cigarettes in public places and 52.3% in workplaces. The proportion of disapproval of the use of e-cigarettes in indoor places was higher at 71.5% for schools and 65.8% for hospitals and health care centers; while the prevalence of disapproval of e-cigarette use in homes and cars was lower (18.0% and 32.5%, respectively). Respondents who disagreed on the use of e-cigarettes in indoor workplaces were more likely to be older (OR = 1.64 and 1.97 for groups 45-64 and ≧65 years old, respectively), those with a high educational level (OR = 1.60), and never and former smokers (OR = 2.34 and 2.16, respectively). Increased scores in the Fagerström test for cigarette dependence were also related to increased support for their use. CONCLUSIONS Based on this population based study, half of the general population of Barcelona does not support the use of e-cigarettes in indoor workplaces and public places, with the percentage reaching 65% for use in schools, hospitals and health care centers. Consequently, there is good societal support in Spain for the politicians and legislators to promote policies restricting e-cigarettes use in workplaces and public places, including hospitality venues.
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Affiliation(s)
- Jose M. Martínez-Sánchez
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d’Investigació Biomèdica de Bellvitge - IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
- Public Health Advocacy Institute, Northeastern University School of Law, Boston, Massachusetts, United States of America
| | - Montse Ballbè
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d’Investigació Biomèdica de Bellvitge - IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
- Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona - IDIBAPS, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d’Investigació Biomèdica de Bellvitge - IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Juan C. Martín-Sánchez
- Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Mark Gottlieb
- Public Health Advocacy Institute, Northeastern University School of Law, Boston, Massachusetts, United States of America
| | - Esteve Saltó
- Health Plan Directorate, Ministry of Health, Generalitat de Catalunya, Spain
- Department of Public Health, Universitat de Barcelona, Barcelona, Spain
| | - Constantine I. Vardavas
- Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Richard Daynard
- Public Health Advocacy Institute, Northeastern University School of Law, Boston, Massachusetts, United States of America
| | - Gregory N. Connolly
- Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d’Investigació Biomèdica de Bellvitge - IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
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Rashid A, Manan AA, Yahya N, Ibrahim L. The support for smoke free policy and how it is influenced by tolerance to smoking - experience of a developing country. PLoS One 2014; 9:e109429. [PMID: 25338116 PMCID: PMC4206272 DOI: 10.1371/journal.pone.0109429] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/31/2014] [Indexed: 11/19/2022] Open
Abstract
This cross sectional survey was conducted to determine the support in making Penang UNESCO World Heritage Site (GTWHS) smoke free and to determine the influence of tolerance towards smoking on this support. This is the first phase in making Penang, Malaysia a smoke free state. A multistage sampling process was done to select a sample of respondents to represent the population of GTWHS. Attitude towards smoking was assessed using tolerance as a proxy. A total of 3,268 members of the community participated in the survey. A big majority (n = 2969; 90.9%) of the respondents supported the initiative. Support was lowest among the owners and residents/tenants, higher age groups, the Chinese, men, respondents who had poor knowledge of the places gazetted as smoke free, and respondents with poor knowledge of the health effects on smokers and on passive smokers. The odds (both adjusted and unadjusted) of not supporting the initiative was high among those tolerant to smoking in public areas. Tolerance towards smoking was associated with 80.3% risk of non-support in the respondents who were tolerant to smoking and a 57.2% risk in the population. Health promotion and education concerning the harm of tobacco smoke in Malaysia, which has mainly targeted smokers, must change. Health education concerning the risks of second hand smoke must also be given to non-smokers and efforts should be made to denormalize smoking.
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Affiliation(s)
- Abdul Rashid
- Department of Public Health Medicine, Penang Medical College, Georgetown, Penang, Malaysia
| | - Azizah Ab Manan
- Penang State Health Department, Georgetown, Penang, Malaysia
| | - Noorlia Yahya
- Penang State Health Department, Georgetown, Penang, Malaysia
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43
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Mamudu HM, Dadkar S, Veeranki SP, He Y, Barnes R, Glantz SA. Multiple streams approach to tobacco control policymaking in a tobacco-growing state. J Community Health 2014; 39:633-45. [PMID: 24370600 PMCID: PMC4074267 DOI: 10.1007/s10900-013-9814-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Smokefree policies (SFPs) have diffused throughout the US and worldwide. However, the development of SFPs in the difficult policy environment of tobacco-producing states and economies worldwide has not been well-explored. In 2007, Tennessee, the third largest tobacco producer in the US, enacted the Non-Smoker Protection Act (NSPA). This study utilizes the multiple streams model to provide understanding of why and how this policy was developed by triangulating interviews with key stakeholders and legislative debates with archival documents. In June 2006, the Governor unexpectedly announced support for SFP, which created a window of opportunity for policy change. The Campaign for Healthy and Responsible Tennessee, a health coalition, seized this opportunity and worked with the administration and the Tennessee Restaurant Association to negotiate a comprehensive SFP, however, a weaker bill was used by the legislative leadership to develop the NSPA. Although the Governor and the Tennessee Restaurant Association's support generated an environment for 100% SFP, health groups did not fully capitalize on this environmental change and settled for a weak policy with several exemptions. This study suggests the importance for proponents of policy change to understand changes in their environment and be willing and able to capitalize on these changes.
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Affiliation(s)
- Hadii M Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, S. Dossett Drive, Lamb Hall, P.O. Box 70264, Johnson City, TN, 37614, USA,
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44
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Caballero Hidalgo A, Pinilla Domínguez J. [Impact of new Spanish smoke-free legislation on the business activity of bars, cafes and restaurants]. GACETA SANITARIA 2014; 28:456-60. [PMID: 24950950 DOI: 10.1016/j.gaceta.2014.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 05/06/2014] [Accepted: 05/06/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE to analyze the impact of Spanish smoke-free legislation (Law 42/2010) on the business activity of bars, cafés, and restaurants. METHODS we used the micro-data from the Household Budget Survey for 2010 and 2011. The linking files allowed close follow-up of the households that remained in the sample for 2 consecutive years. Taking the year 2010 as the base reference for our analyses, we quantified how levels of consumption expenses on hospitality venues have changed over the years, differentiating between smoking households and non-smoking households. RESULTS the marginal effects of the first stage of the two-part model showed that the mean probability of expenditure on hospitality venues was 96% in smoking households and was 86% in non-smoking households. There were no statistically significant variations in the probability of expenditure between 2010 and 2011. The proportion of expenditure on hospitality venues in total household consumption expenditure in smoking households was 7.961% and 7.796% in 2010 and 2011, respectively. These proportions were 7.25% in 2010 and 7.272% in 2011 for non-smoking households. The difference in differences estimator, which takes into account both differences between years and households, showed no statistically significant differences in levels of household consumption. CONCLUSIONS the introduction of the Law 42/2010 has had no impact on the levels of household consumption expenses on hospitality venues. Changes in consumption expenses could be explained by sociodemographic characteristics (such as the number of children per household) and the impact of the economic crisis (unemployment and a decrease in household income).
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Affiliation(s)
- Araceli Caballero Hidalgo
- Departamento de Métodos Cuantitativos en Economía y Gestión, Facultad de Economía, Empresa y Turismo, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | - Jaime Pinilla Domínguez
- Departamento de Métodos Cuantitativos en Economía y Gestión, Facultad de Economía, Empresa y Turismo, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
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45
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Been JV, Nurmatov UB, Cox B, Nawrot TS, van Schayck CP, Sheikh A. Effect of smoke-free legislation on perinatal and child health: a systematic review and meta-analysis. Lancet 2014; 383:1549-60. [PMID: 24680633 DOI: 10.1016/s0140-6736(14)60082-9] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Smoke-free legislation has the potential to reduce the substantive disease burden associated with second-hand smoke exposure, particularly in children. We investigated the effect of smoke-free legislation on perinatal and child health. METHODS We searched 14 online databases from January, 1975 to May, 2013, with no language restrictions, for published studies, and the WHO International Clinical Trials Registry Platform for unpublished studies. Citations and reference lists of articles of interest were screened and an international expert panel was contacted to identify additional studies. We included studies undertaken with designs approved by the Cochrane Effective Practice and Organisation of Care that reported associations between smoking bans in workplaces, public places, or both, and one or more predefined early-life health indicator. The primary outcomes were preterm birth, low birthweight, and hospital attendances for asthma. Effect estimates were pooled with random-effects meta-analysis. This study is registered with PROSPERO, number CRD42013003522. FINDINGS We identified 11 eligible studies (published 2008-13), involving more than 2·5 million births and 247,168 asthma exacerbations. All studies used interrupted time-series designs. Five North American studies described local bans and six European studies described national bans. Risk of bias was high for one study, moderate for six studies, and low for four studies. Smoke-free legislation was associated with reductions in preterm birth (four studies, 1,366,862 individuals; -10·4% [95% CI -18·8 to -2·0]; p=0·016) and hospital attendances for asthma (three studies, 225,753 events: -10·1% [95% CI -15·2 to -5·0]; p=0·0001). No significant effect on low birthweight was identified (six studies, >1·9 million individuals: -1·7% [95% CI -5·1 to 1·6]; p=0·31). INTERPRETATION Smoke-free legislation is associated with substantial reductions in preterm births and hospital attendance for asthma. Together with the health benefits in adults, this study provides strong support for WHO recommendations to create smoke-free environments. FUNDING Thrasher Fund, Lung Foundation Netherlands, International Paediatric Research Foundation, Maastricht University, Commonwealth Fund.
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Affiliation(s)
- Jasper V Been
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands; Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK; Department of Paediatrics, Maastricht University Medical Centre, Maastricht, Netherlands.
| | - Ulugbek B Nurmatov
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
| | - Bianca Cox
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium; Department of Public Health, University of Leuven, Leuven, Belgium
| | - Constant P van Schayck
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands; Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands; Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
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46
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Cornelsen L, McGowan Y, Currie-Murphy LM, Normand C. Systematic review and meta-analysis of the economic impact of smoking bans in restaurants and bars. Addiction 2014; 109:720-7. [PMID: 24529192 DOI: 10.1111/add.12486] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 11/28/2013] [Accepted: 01/02/2014] [Indexed: 11/30/2022]
Abstract
AIMS To review systematically the literature on the economic impact of smoking bans in bars and restaurants and provide an estimate of the impact size using meta-analysis. METHODS Studies were identified by systematic database searches and screening references of reviews and relevant studies. Google and web-pages of tobacco control agencies were also searched. The review identified 56 studies using absolute sales, sales ratio or employment data and employing regression methods to evaluate the impact of smoking bans in the United States, Australia or in countries in South America or Europe. The meta-analysis included 39 comparable studies, with 129 cases identified based on the outcome measure, scope of the ban, type of establishment and geographical location. Methodological quality was assessed based on four pre-determined criteria. Study and case selection and data extraction were conducted independently by two researchers. RESULTS Random-effects meta-analysis of all cases showed no associations between smoking bans and changes in absolute sales or employment. An increase in the share of bar and restaurant sector sales in total retail sales was associated with smoking bans [0.23 percentage-points; 95% confidence interval (CI) 0.08-0.375]. When cases were separated by business type (bars or restaurants or wider hospitality including bars and restaurants), some differential impacts emerged. CONCLUSIONS Meta-analysis of the economic impact of smoking bans in hospitality sector showed overall no substantial economic gains or losses. Differential impacts were observed across individual business types and outcome variable, but at aggregate level these appear to balance out.
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Affiliation(s)
- Laura Cornelsen
- London School of Hygiene and Tropical Medicine, London, UK; Centre of Health Policy and Management, Trinity College Dublin, Dublin, Ireland
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47
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Zafar M. Prevalence of smoking and associated risk factors among medical professionals in hospitals of karachi, pakistan. Int J Prev Med 2014; 5:457-62. [PMID: 24829733 PMCID: PMC4018594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 10/13/2013] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Cigarette smoking is the largest preventable risk factor for morbidity and mortality in developed countries where at least one in four adults smoke cigarettes. Healthcare providers who smoke are less likely to advise patients to quit smoking. The aim of this study is to find out the frequency of tobacco smoking among medical professionals in tertiary care hospitals of Karachi, and to identify the common factors responsible for the continuation of smoking among healthcare providers. METHODS This descriptive cross-sectional study was carried out at public and private tertiary Care Hospitals/Institutes at Karachi. A self-administered questionnaire was used to collect data from 180 subjects. An informed consent was obtained from all the subjects. The data were analyzed using SPSS version 16.0. RESULTS Prevalence of smoking was 29%. High prevalence of smoking was among male doctors as compared to female doctors. Sixty-eight per cent of smokers started smoking between 20 to 30 years of age. Age less than 35 years, male and public sectors hospitals were more likely OR 1.23, CI (0.98-2.41), 6.40 CI (4.48-10.52) and 2.61 CI (2.20-3.78) respectively. CONCLUSIONS The Result of the study suggests that while healthcare smoking habits appear to be high, they are not uniformly low when compared from an international perspective. Health promotion programs focused on self-efficacy may be an effective tool for reducing the initiation, frequency, and amount of cigarette smoking among healthcare providers.
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Affiliation(s)
- Mubashir Zafar
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan,Correspondence to: Dr. Mubashir Zafar, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan. E-mail:
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48
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Hatchard JL, Fooks GJ, Evans-Reeves KA, Ulucanlar S, Gilmore AB. A critical evaluation of the volume, relevance and quality of evidence submitted by the tobacco industry to oppose standardised packaging of tobacco products. BMJ Open 2014; 4:e003757. [PMID: 24523419 PMCID: PMC3927933 DOI: 10.1136/bmjopen-2013-003757] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To examine the volume, relevance and quality of transnational tobacco corporations' (TTCs) evidence that standardised packaging of tobacco products 'won't work', following the UK government's decision to 'wait and see' until further evidence is available. DESIGN Content analysis. SETTING We analysed the evidence cited in submissions by the UK's four largest TTCs to the UK Department of Health consultation on standardised packaging in 2012. OUTCOME MEASURES The volume, relevance (subject matter) and quality (as measured by independence from industry and peer-review) of evidence cited by TTCs was compared with evidence from a systematic review of standardised packaging . Fisher's exact test was used to assess differences in the quality of TTC and systematic review evidence. 100% of the data were second-coded to validate the findings: 94.7% intercoder reliability; all differences were resolved. RESULTS 77/143 pieces of TTC-cited evidence were used to promote their claim that standardised packaging 'won't work'. Of these, just 17/77 addressed standardised packaging: 14 were industry connected and none were published in peer-reviewed journals. Comparison of TTC and systematic review evidence on standardised packaging showed that the industry evidence was of significantly lower quality in terms of tobacco industry connections and peer-review (p<0.0001). The most relevant TTC evidence (on standardised packaging or packaging generally, n=26) was of significantly lower quality (p<0.0001) than the least relevant (on other topics, n=51). Across the dataset, TTC-connected evidence was significantly less likely to be published in a peer-reviewed journal (p=0.0045). CONCLUSIONS With few exceptions, evidence cited by TTCs to promote their claim that standardised packaging 'won't work' lacks either policy relevance or key indicators of quality. Policymakers could use these three criteria-subject matter, independence and peer-review status-to critically assess evidence submitted to them by corporate interests via Better Regulation processes.
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Affiliation(s)
- Jenny L Hatchard
- Tobacco Control Research Group, University of Bath, and UK Centre for Tobacco and Alcohol Studies, Bath, UK
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49
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Fallin A, Neilands TB, Jordan JW, Ling PM. Secondhand smoke exposure among young adult sexual minority bar and nightclub patrons. Am J Public Health 2013; 104:e148-53. [PMID: 24328626 DOI: 10.2105/ajph.2013.301657] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared exposure to secondhand smoke (SHS) and attitudes toward smoke-free bar and nightclub policies among patrons of lesbian, gay, bisexual, and transgender (LGBT) and non-LGBT bars and nightclubs. METHODS We conducted randomized time-location sampling surveys of young adults (aged 21-30 years) in 7 LGBT (n = 1113 patrons) and 12 non-LGBT (n = 1068 patrons) venues in Las Vegas, Nevada, in 2011, as part of a cross-sectional study of a social branding intervention to promote a tobacco-free lifestyle and environment in bars and nightclubs. RESULTS Compared with non-LGBT bars and nightclubs, patrons of LGBT venues had 38% higher adjusted odds of having been exposed to SHS in a bar or nightclub in the past 7 days but were no less likely to support smoke-free policies and intended to go out at least as frequently if a smoke-free bar and nightclub law was passed. CONCLUSIONS The policy environment in LGBT bars and nightclubs appears favorable for the enactment of smoke-free policies, which would protect patrons from SHS and promote a smoke-free social norm.
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Affiliation(s)
- Amanda Fallin
- Amanda Fallin and Pamela M. Ling are with the Center for Tobacco Control Research and Education, Pamela M. Ling is also with the Division of General Internal Medicine, Department of Medicine, and Torsten B. Neilands is with the Center for AIDS Prevention Studies, University of California San Francisco. Jeffrey W. Jordan is with the Rescue Social Change Group, San Diego, CA
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Ma ZQ, Fisher MA. The effect of Philadelphia and Pennsylvania Clean Indoor Air Act on food services and drinking places sales and numbers, 1998-2011. Prev Chronic Dis 2013; 10:E201. [PMID: 24286275 PMCID: PMC3843543 DOI: 10.5888/pcd10.130143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Philadelphia enacted its Clean Indoor Air Act (CIAA) nearly 2 years before the statewide CIAA. In this study, we assessed the economic impact of CIAAs on 4 types of food services and drinking places and addressed the predominant limitation of previous pre–post ban studies, namely the lack of control for confounders and changes in secular trends over time. Methods We analyzed data from Pennsylvania Department of Revenue Quarterly 1998–2011 taxable county-level revenue sales and number of food services and drinking places. Region-specific and type-specific adjusted sales and number of food services and drinking places accounted for consumer spending as a general economic indicator. Segmented regression analysis of interrupted time-series methodology assessed changes in trend and level. Results Pennsylvania CIAA had no significant effect on adjusted sales or numbers except for an increase in sales in Philadelphia for limited-service eating places and in the surrounding 4 counties for special food services. Philadelphia CIAA was associated with an increase in adjusted numbers of full-service restaurants in Philadelphia and the rest of the state, special food services in Philadelphia, and drinking places in the rest of the state, and a decrease in the number of special food services in the surrounding counties. Philadelphia CIAA had no significant effect on adjusted sales except for an increase in special food services in the rest of the state. Conclusion Overall, CIAAs had no negative business-related impact and, for the most part, suggest a positive impact on restaurant sales and numbers. Our results provide further support for comprehensive CIAA ordinance for restaurants.
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Affiliation(s)
- Zhen-Qiang Ma
- Pennsylvania Department of Health, Bureau of Epidemiology, 625 Forster St, Room 1000, Harrisburg, PA 17120. E-mail:
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