1
|
Kibria MG, Islam T, Badiuzzaman M, Mamun AA, Sultana P, Hawlader MDH. Assessing the choice of smoke-free policies for multiunit housing and its associated determinants in Bangladesh: a cross-sectional study. BMJ Open 2024; 14:e074928. [PMID: 38642999 PMCID: PMC11033630 DOI: 10.1136/bmjopen-2023-074928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/11/2023] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This study aimed to assess the desire for smoke-free housing, determine the choice of smoke-free policies for multiunit housing (MUH), and identify the factors associated with policy choice among MUH residents in Bangladesh. DESIGN We conducted a cross-sectional study from April to November 2019 using a semi-structured survey questionnaire. SETTING This study was conducted in seven divisional cities of Bangladesh: Dhaka, Chattogram, Rajshahi, Khulna, Sylhet, Barishal, and Rangpur. PARTICIPANTS A total of 616 adult individuals living in MUH for at least 2 years participated in the study. PRIMARY OUTCOME MEASURE Multinomial logistic regression was used to identify the determinants of the choice of smoke-free policies for MUH. RESULTS Overall, 94.8% of the respondents wanted smoke-free housing. Among those who wanted smoke-free housing, 44.9% preferred a smoke-free building policy, 28.3% preferred a smoke-free common area policy, 20.2% favoured a smoke-free unit policy, and 6.7% did not know what policy they should choose. Three factors were found to be significantly associated with the choice of a smoke-free building policy: staying at home for more than 12 hours (adjusted OR (aOR): 2.6; 95% CI 1.035 to 6.493), being a non-smoker (aOR: 3.2; 95% CI 1.317 to 7.582), and having at least one family member who smoked (aOR: 3.0; 95% CI 1.058 to 8.422). Results also showed that residents having at least one child under 15 in the family (aOR: 0.3; 95% CI 0.152 to 0.778) were less likely to choose a smoke-free common area policy and that women (aOR: 3.7; 95% CI 1.024 to 13.188) were more likely to choose a smoke-free unit policy. CONCLUSIONS MUH residents in urban Bangladesh highly demanded smoke-free housing. Most residents favoured a smoke-free building policy for MUH. Those who stayed at home for a longer time, were non-smokers, and had smoking family members were more likely to choose this policy.
Collapse
Affiliation(s)
- Md Golam Kibria
- Department of Research, Centre for Development Action, Dhaka, Bangladesh
| | - Taslima Islam
- Department of Monitoring, Evaluation and Learning, Social Development Foundation, Dhaka, Bangladesh
- Centre for Development Action, Dhaka, Bangladesh
| | - Muhammad Badiuzzaman
- Centre for Development Action, Dhaka, Bangladesh
- Department of Research and Policy, Transparency International Bangladesh, Dhaka, Bangladesh
| | - Abdullah Al Mamun
- Centre for Development Action, Dhaka, Bangladesh
- High Court Division, Supreme Court of Bangladesh, Dhaka, Bangladesh
| | - Papia Sultana
- Centre for Development Action, Dhaka, Bangladesh
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| | | |
Collapse
|
2
|
Kim S, Lee Y, Han C, Kim MK, Kawachi I, Oh J. Effects of municipal smoke-free ordinances on secondhand smoke exposure in the Republic of Korea. Front Public Health 2023; 11:1062753. [PMID: 37050961 PMCID: PMC10084937 DOI: 10.3389/fpubh.2023.1062753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/10/2023] [Indexed: 03/28/2023] Open
Abstract
ObjectiveTo reduce premature deaths due to secondhand smoke (SHS) exposure among non-smokers, the Republic of Korea (ROK) adopted changes to the National Health Promotion Act, which allowed local governments to enact municipal ordinances to strengthen their authority to designate smoke-free areas and levy penalty fines. In this study, we examined national trends in SHS exposure after the introduction of these municipal ordinances at the city level in 2010.MethodsWe used interrupted time series analysis to assess whether the trends of SHS exposure in the workplace and at home, and the primary cigarette smoking rate changed following the policy adjustment in the national legislation in ROK. Population-standardized data for selected variables were retrieved from a nationally representative survey dataset and used to study the policy action’s effectiveness.ResultsFollowing the change in the legislation, SHS exposure in the workplace reversed course from an increasing (18% per year) trend prior to the introduction of these smoke-free ordinances to a decreasing (−10% per year) trend after adoption and enforcement of these laws (β2 = 0.18, p-value = 0.07; β3 = −0.10, p-value = 0.02). SHS exposure at home (β2 = 0.10, p-value = 0.09; β3 = −0.03, p-value = 0.14) and the primary cigarette smoking rate (β2 = 0.03, p-value = 0.10; β3 = 0.008, p-value = 0.15) showed no significant changes in the sampled period. Although analyses stratified by sex showed that the allowance of municipal ordinances resulted in reduced SHS exposure in the workplace for both males and females, they did not affect the primary cigarette smoking rate as much, especially among females.ConclusionStrengthening the role of local governments by giving them the authority to enact and enforce penalties on SHS exposure violation helped ROK to reduce SHS exposure in the workplace. However, smoking behaviors and related activities seemed to shift to less restrictive areas such as on the streets and in apartment hallways, negating some of the effects due to these ordinances. Future studies should investigate how smoke-free policies beyond public places can further reduce the SHS exposure in ROK.
Collapse
Affiliation(s)
- Siwoo Kim
- Institute of Environmental Medicine, SNU Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Yuri Lee
- Department of Health and Medical Information, Myongji College, Seoul, Republic of Korea
| | - Changwoo Han
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Min Kyung Kim
- Tufts Clinical and Translational Science Institute, Boston, MA, United States
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Juhwan Oh
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- *Correspondence: Juhwan Oh,
| |
Collapse
|
3
|
Siddiqi K, Siddiqui F, Boeckmann M, Islam Z, Khan A, Dobbie F, Khan Z, Kanaan M. Attitudes of smokers towards tobacco control policies: findings from the Studying Tobacco users of Pakistan (STOP) survey. Tob Control 2022; 31:112-116. [PMID: 33318127 DOI: 10.1136/tobaccocontrol-2020-055995] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/22/2020] [Accepted: 10/30/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Public attitude is a political driver in successful implementation of tobacco control policies. We assessed support for a range of tobacco control policies among smokers in Pakistan. METHODS We conducted a household survey among adult smokers in 10 cities of Pakistan, using a two-stage random sampling strategy to select households and Kish grid method to select one smoker per household. Attitudes were measured using a five-point ordinal scale on four policy statements: a complete ban on tobacco sale within 10 years; raising the legal age to buy tobacco from 18 to 21; increasing tobacco taxes to fund healthcare and a ban on smoking in cars with minors. RESULTS 6014 participants were interviewed between September 2019 and March 2020. Most participants demonstrated strong support for all policy statements: a ban on smoking in cars with minors (86.5%); a complete ban on tobacco sale within 10 years (82.1%); raising the legal age to buy tobacco (77.9%) and increasing tobacco taxes (68.1%). Smokers' support for tobacco control policies increased with age but decreased with higher educational attainment and heaviness of smoking. CONCLUSIONS There is strong support among smokers in Pakistan to strengthen tobacco control. Given this, policy-makers should strongly consider strengthening existing national policies on tobacco control.
Collapse
Affiliation(s)
- Kamran Siddiqi
- Department of Health Sciences, University of York, UK, York, North Yorkshire, UK
- Hull York Medical School, York, UK
| | - Faraz Siddiqui
- Department of Health Sciences, University of York, UK, York, North Yorkshire, UK
| | - Melanie Boeckmann
- School of Public Health, University of Bielefeld-Germany, Bielefeld, Germany
| | - Ziauddin Islam
- Tobacco Control Cell, Pakistan Ministry of National Health Services Regulations and Coordination, Islamabad, Islamabad, Pakistan
| | | | - Fiona Dobbie
- Usher Institute, University of Edinburgh, University of Stirling, Edinburgh, UK
| | - Zohaib Khan
- Office of Research Innovation and Commercialisation, Khyber Medical University, Peshawar, Pakistan
| | - Mona Kanaan
- Department of Health Sciences, University of York, UK, York, North Yorkshire, UK
| |
Collapse
|
4
|
Harutyunyan A, Hayrumyan V, Sargsyan Z, Torosyan A, Dekanosidze A, Kegler M, Sturua L, Berg CJ. Smokers' and non-smokers' secondhand smoke experiences and interactions to reduce exposure in Armenia and Georgia. Tob Prev Cessat 2021; 7:6. [PMID: 33537511 PMCID: PMC7845734 DOI: 10.18332/tpc/131059] [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: 07/28/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Armenia and Georgia have high rates of smoking and secondhand smoke exposure (SHSe). Greater progress in recent smoke-free legislation in Georgia and Armenia provides a pivotal time for examining the impact on smokers' and non-smokers' experiences and interactions regarding SHSe. METHODS Surveys were conducted in 28 communities in Armenia (n=705) and Georgia (n=751) in 2018 and assessed past 30-day SHSe and smoking in different contexts, as well as attitudes toward and interactions regarding SHSe. RESULTS In this sample (mean age 43.4 years, SD=13.5; 60.5% female; 27.3% smokers), SHSe among non-smokers was usually in homes (42.7%), cars (42.4%), and outdoor public places (38.2%); smokers also reported smoking usually in these places (70.0%, 62.1%, and 60.0%, respectively). Smokers indicated greater likelihood of putting out cigarettes and non-smokers indicated greater likelihood of asking smokers to put them out in places where smoking was prohibited versus allowed (76.5% vs 57.3%, and 46.6% vs 30.7%, respectively). Moreover, 89.9% of smokers indicated being very likely to put out cigarettes around small children if asked and 75.8% indicated trying to minimize SHSe. While 39.7% of participants reported seeing requests to smokers to put out cigarettes in the past 6 months, only 23.3% of smokers reported being asked to do so. Non-smokers in Georgia versus Armenia reported greater likelihood of engaging in behaviors to lower SHSe (p<0.001). CONCLUSIONS Smoke-free legislation may catalyze more behaviors to lower SHSe, particularly among non-smokers; however, private settings (e.g. homes) remain prominent SHSe sources. Public health efforts must consider implications of such policies on SHSe in private settings.
Collapse
Affiliation(s)
- Arusyak Harutyunyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Varduhi Hayrumyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Arevik Torosyan
- National Institute of Health named after academician S. Avdalbekyan, Ministry of Health, Yerevan, Armenia
| | - Ana Dekanosidze
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Michelle Kegler
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, United States.,Winship Cancer Institute, Emory University, Atlanta, United States
| | - Lela Sturua
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia.,Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States.,George Washington Cancer Center, George Washington University, Washington, United States
| |
Collapse
|
5
|
Gao C, Yao Y, Niu H, Li L, Li M, Qu Y, Wang R, Zhang P, Li M, Yan S, Li B. Urban-rural differences in related factors of second-hand smoke exposure: a cross-sectional study of adult non-smokers in Northeast China. J Public Health (Oxf) 2020; 41:321-328. [PMID: 30053172 DOI: 10.1093/pubmed/fdy120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 06/10/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND this study aims to examine the different factors associated with exposure to second-hand smoke (SHS) between urban and rural areas and to facilitate a reduction in SHS exposure in Northeast China. METHODS a multistage stratified random cluster sampling design was used in this 2012 cross-sectional survey in Jilin Province, Northeast China. A total of 13 056 non-smokers were included in this study. The Rao-Scott χ2 test, multiple regression analysis and discriminant function analysis were used. RESULTS the SHS prevalence among adult non-smokers was 60.2% in urban areas and 61.8% in rural areas. In urban areas, males were more likely to be exposed to SHS, while in rural areas, females were more likely to be exposed to SHS (P < 0.05). Increasing age was a protective factor against SHS exposure both in urban and rural areas (P < 0.05). Tobacco-relevant knowledge was positively associated with SHS exposure. Among urban non-smokers, high education level and engagement in manual work were risk factors for SHS exposure, and retired subjects were less likely to be exposed to SHS (P < 0.01). CONCLUSIONS non-smokers from urban and rural areas differ in the factors associated with SHS exposure, and urban-rural differentials, especially with regard to gender, should be considered in tobacco control.
Collapse
Affiliation(s)
- Chunshi Gao
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, 1163 Xinmin Street, Changchun, Jilin, China
| | - Yan Yao
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, 1163 Xinmin Street, Changchun, Jilin, China
| | - Huikun Niu
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, 1163 Xinmin Street, Changchun, Jilin, China
| | - Lu Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, 1163 Xinmin Street, Changchun, Jilin, China
| | - Meiqi Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, 1163 Xinmin Street, Changchun, Jilin, China
| | - Yangming Qu
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, 1163 Xinmin Street, Changchun, Jilin, China
| | - Rui Wang
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Peng Zhang
- Department of Neurology, Stroke Center, The First Hospital of Jilin University, Changchun, China
| | - Meng Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, 1163 Xinmin Street, Changchun, Jilin, China
| | - Shoumeng Yan
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, 1163 Xinmin Street, Changchun, Jilin, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, 1163 Xinmin Street, Changchun, Jilin, China
| |
Collapse
|
6
|
Zhu J, Li J, He Y, Li N, Xu G, Yu J. The influence and interaction of exposure to pro-smoking and anti-smoking messaging on youth smoking behaviour and susceptibility. Tob Induc Dis 2020; 17:86. [PMID: 31889948 PMCID: PMC6897048 DOI: 10.18332/tid/114066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/07/2019] [Accepted: 11/07/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Exposure to tobacco-related information is an important factor in youth smoking initiation. This study aims to explore the relationship between exposure to pro-smoking and anti-smoking media and adolescents’ current smoking status and susceptibility to smoking, as well as the interaction between exposure to pro-smoking and anti-smoking media information. METHODS This cross-sectional study was conducted in 2017. We recruited 12278 students from junior, senior and vocational high schools located in Shanghai, China. The exposure of participants to tobacco promotional and control messages over the past 30 days was examined, as well as current smoking and susceptibility to never smokers’ initiation. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using complex samples procedure logistic regression, adjusting for related covariables. RESULTS There were 89.3% and 91.5% of adolescents exposed to tobacco pro-smoking and anti-smoking messages. Exposure was more prevalent among males, suburb school and vocational school students. Exposure to pro-tobacco and antitobacco messages, separately, increased and decreased the risk of current smoking and susceptibility to never-smokers’ smoking, respectively, especially among males and junior high school students. Risk was associated with the exposure level (p-trend<0.001). Tobacco control messaging was found to mitigate the influences of tobacco promotion on the risk of both current smoking (AOR=0.64; 95% CI: 0.41–0.99) and susceptibility to smoking (AOR=0.65; 95% CI: 0.46–0.93). CONCLUSIONS Exposure to tobacco-related messages was highly prevalent and associated with youth smoking and susceptibility to smoking. It is therefore important to enhance the comprehensiveness and enforcement of promotion bans. Given that tobacco control information can counter the impact of tobacco promotion information on smoking risk, the publicity and dissemination of tobacco control information should be consistently strengthened.
Collapse
Affiliation(s)
- Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Jiahui Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yaping He
- School of Public Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Na Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Gang Xu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Jinming Yu
- School of Public Health, Fudan University, Shanghai, People's Republic of China
| |
Collapse
|
7
|
Wu YS, Wang MP, Ho SY, Cheung YT, Kwong A, Lai V, Lam TH. Positive perceptions of electronic cigarettes relative to combustible cigarettes are associated with weaker support for endgame policies on combustible cigarettes: A population-based cross-sectional study in Hong Kong. Tob Induc Dis 2019; 17:61. [PMID: 31582950 PMCID: PMC6770616 DOI: 10.18332/tid/110697] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 07/08/2019] [Accepted: 07/13/2019] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Positive perceptions of electronic cigarettes (e-cigarettes) relative to combustible cigarettes (CCs) may erode support for endgame policies on CCs through smoking renormalization (increasing public acceptance of smoking). We investigated the associations between perceptions of e-cigarettes relative to CCs and support for endgame policies on CCs in Hong Kong. METHODS Adult respondents (N=2004) were surveyed using landline random digit dialing in 2015. Perceived relative harm and relative addictiveness of e-cigarettes were combined as an overall perception of e-cigarettes relative to CCs with 5 levels and we analyzed individually 'neutral/positive/mixed/unknown' perceptions against the 'negative' perception. Five individual items with dichotomous responses assessed the support for endgame policies on CCs. Support for banning the sale/use of CCs (yes/no) was also assessed. Multivariable regressions yielded adjusted odds ratios (AORs) of supporting endgame policies (individual policy items, all 5 policy items, at least 1 policy item, banning the sale/use of CCs) in relation to perceptions of e-cigarettes relative to CCs, adjusting for age, education attainment, marital status, CC smoking status and ever e-cigarette use. RESULTS Support for individual endgame policy items (from 51.8% to 80.0%), banning the sale (63.8%) and use (67.5%) of CCs were generally high. Few respondents perceived e-cigarettes as more harmful (16.6%) or more addictive (9.3%) than CCs. Positive perceptions of e-cigarettes (24.0%) were associated with less support for 'ban CC sales in 10 years if there is a product providing nicotine not made from tobacco' (AOR=0.62, 95% CI: 0.40-0.97), 'ban CC use when it's prevalence falls below 5%' (AOR=0.66, 95% CI: 0.44-0.98) and 'banning the sale of CCs' (AOR=0.63, 95% CI: 0.42-0.94). CONCLUSIONS Positive perceptions of e-cigarettes relative to CCs were associated with less support for endgame policies on CCs in Hong Kong. Public health actions are needed to disseminate evidence-based knowledge of e-cigarettes.
Collapse
Affiliation(s)
- Yongda S. Wu
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong
| | - Yee Tak Cheung
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
| | - Antonio Kwong
- Hong Kong Council on Smoking and Health, Wan Chai, Hong Kong
| | - Vienna Lai
- Hong Kong Council on Smoking and Health, Wan Chai, Hong Kong
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
8
|
Kastaun S, Kotz D, Brown J, Shahab L, Boeckmann M. Public attitudes towards healthcare policies promoting tobacco cessation in Germany: results from the representative German study on tobacco use (DEBRA study). BMJ Open 2019; 9:e026245. [PMID: 31462463 PMCID: PMC6720139 DOI: 10.1136/bmjopen-2018-026245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 04/23/2019] [Accepted: 08/01/2019] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess public acceptance of four possible healthcare policies supporting tobacco dependence treatment in line with the Framework Convention for Tobacco Control, Article 14 recommendations in Germany. DESIGN Cross-sectional household survey. SETTING Data were drawn from the German population and collected through computer-assisted, face-to-face interviews. PARTICIPANTS Representative random sample of 2087 people (>14 years) from the German population. OUTCOME MEASURES Public acceptance was measured regarding (1) treatment cost reimbursement, (2) standard training for health professionals on offering cessation treatment, and making cessation treatment a standard part of care for smokers with (3) physical or (4) mental disorders. Association characteristics with smoking status and socio-economic status (SES) were assessed. RESULTS Support for all policies was high (50%-68%), even among smokers (48%-66%). Ex-smokers and never-smokers were more likely to support standard training on cessation for health professionals than current smokers (OR 1.43, 95% CI 1.07 to 1.92; OR 1.43; 95% CI 1.14 to 1.79, respectively). Ex-smokers were also more likely than current smokers to support cessation treatment for smokers with mental disorders (OR 1.39, 95% CI 1.11 to 1.73). Men were less likely than women to support cessation treatment for smokers with physical diseases (OR 0.74, 95% CI 0.60 to 0.91) and free provision of treatment (OR 0.80, 95% CI 0.66 to 0.97). Offering cessation treatment to smokers with physical disorders was generally more accepted than to those with mental health issues. CONCLUSIONS The majority of the German population supports healthcare policies to improve the availability and affordability of tobacco dependence treatment. Non-smokers were more supportive than current smokers of two of the four policies, but odds of support were only about 40% higher. SES characteristics were not consistently associated with public acceptance. TRIAL REGISTRATION NUMBER DRKS00011322.
Collapse
Affiliation(s)
- Sabrina Kastaun
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Heinrich-Heine-University, Düsseldorf, Düsseldorf, Germany
| | - Daniel Kotz
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Heinrich-Heine-University, Düsseldorf, Düsseldorf, Germany
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
| | - Melanie Boeckmann
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Heinrich-Heine-University, Düsseldorf, Düsseldorf, Germany
- Department of Environment and Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| |
Collapse
|
9
|
Park E, Cho SI, Seo HG, Kim Y, Jung HS, Driezen P, Ouimet J, Quah ACK, Fong GT. Attitudes of Korean smokers towards smoke-free public places: findings from the longitudinal ITC Korea Survey, 2005-2010. BMJ Open 2019; 9:e025298. [PMID: 31401589 PMCID: PMC6701818 DOI: 10.1136/bmjopen-2018-025298] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Prior to December 2012, restaurants in South Korea were required to implement only partial smoking bans. This study documents the changes in Korean smokers' attitudes towards smoking bans between 2005 and 2010 and explores the effects of anti-smoking advertising as a correlate of support for total smoking bans in public places. DESIGN Longitudinal cohort study of Korean adult smokers. SETTING The data were derived from three waves (2005, 2008 and 2010) of the International Tobacco Control (ITC) Korea Survey. PARTICIPANTS The ITC Korea Survey respondents were a probability-based, nationally representative sample of Korean smokers aged 19 and older. The current analysis includes 995 smokers who participated in Wave 1 (2005), 1737 smokers who participated in Wave 2 (2008) and 1560 smokers who participated in Wave 3 (2010). PRIMARY AND SECONDARY OUTCOME MEASURES Changes in respondents' awareness of secondhand smoke (SHS) harm, attitudes towards smoking bans and personal rules for smoking in private homes and/or vehicles were analysed. Correlates of support for smoking bans in public places were examined using generalised estimating equation regression models. RESULTS More than 80% of Korean smokers are aware of the harms of SHS. The proportion of smokers who support smoke-free restaurants or smoke-free bars increased twofold between 2005 and 2010. Smokers who were aware of the dangers of SHS were more likely to support a total smoking ban in workplaces. Noticing anti-smoking advertising or information was not significantly associated with support for a total smoking ban in public places. CONCLUSIONS Korean smokers became more supportive of smoking bans in public places between 2005 and 2008. These results show that smokers' attitudes towards smoking bans can change with the implementation of smoke-free policies, even in a country that has a high prevalence of smokers.
Collapse
Affiliation(s)
- Eunja Park
- Center for Food and Drug Policy Research, Korea Institute for Health and Social Affairs, Sejong, Korea (the Republic of)
| | - Sung-il Cho
- Department of Public Health Science, Seoul National University Graduate School of Public Health, Seoul, Korea (the Republic of)
| | - Hong Gwan Seo
- Center for Cancer Prevention and Detection, National Cancer Center, Goyangsi, Korea (the Republic of)
| | - Yeol Kim
- Center for Cancer Prevention and Detection, National Cancer Center, Goyangsi, Korea (the Republic of)
| | - Hyun-Suk Jung
- Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Korea (the Republic of)
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Janine Ouimet
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| |
Collapse
|
10
|
Abstract
China is in the midst of a lung cancer epidemic on an unprecedented scale. In 2015, there were an estimated 733,000 new lung cancer cases (17% of total cancer incidence) and 610,000 deaths (21.7% of total cancer mortality) in China. Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer mortality in China. Tobacco smoke exposure is the primary factor driving current lung cancer trends. In 2015, smoking prevalence was 27.7% (52.1% among men and 2.7% among women). China has taken substantial steps to control tobacco use in recent years, including 19 cities implementing comprehensive smoke free laws and expansion of cessation services. However, significant challenges remain in order to meet the 2030 Healthy China goal of reducing smoking prevalence to 20%. In particular, ongoing attention is needed to continuing to control secondhand smoke exposure, to further enhance smoking cessation services, and to address novel alternative nicotine delivery devices (ANDS).
Collapse
Affiliation(s)
- Mark Parascandola
- Tobacco Control Research Branch, National Cancer Institute, Bethesda, MD, USA
| | - Lin Xiao
- Center for Disease Control and Prevention, Beijing 102206, China
| |
Collapse
|
11
|
Kuang Hock L, Hui Li L, Chien Huey T, Yuvaneswary V, Sayan P, Muhd Yusoff MF, Kuang Kuay L, Miaw Yn L, Kee Chee C, Sumarni Mohd G. Support for smoke-free policy among Malaysian adults: findings from a population-based study. BMJ Open 2019; 9:e020304. [PMID: 30760510 PMCID: PMC6377523 DOI: 10.1136/bmjopen-2017-020304] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Public opinion and support can be powerful mandates for smoke-free policy. However, the scarcity of evidence on public opinion among Malaysians necessitates further investigation. Therefore, this study aimed to determine the level of support for smoke-free policy at various public domains and its associated factors among Malaysian adults. DESIGN Data were derived from the Global Adult Tobacco Survey, Malaysia (GATS-M). GATS-M is a nationwide study that employed a multistage, proportionate-to-size sampling strategy to select a representative sample of 5112 Malaysian adults aged 15 years and above. Multiple logistic regression was used to identify factors associated with support for smoke-free policy in selected public domains that is, workplaces, restaurants, bars, hotels, casinos, karaoke centres, public transport terminals and shopping centres. RESULTS The level of support for enactment of a smoke-free policy at selected public domains varied from 37.8% to 94.4%, with the highest support was for gazetted smoke-free domains, namely, shopping centres (94.4%, 95% CI: 93.2% to 95.3%) and public transport terminals (85.2%, 95% CI: 83.3% to 86.9%). Multiple logistic regression revealed that non-smokers were more likely to support smoke-free policy at all domains. In addition, respondents who worked in workplaces with total or partial smoking restrictions were more likely to support a smoke-free policy ((total restriction adjusted OR (AOR): 14.94 (6.44 to 34.64); partial restriction AOR: 2.96 (1.138 to 6.35); non-restriction was applied as a reference). CONCLUSION A majority of the Malaysian adult population supported the smoke-free policy, especially at gazetted smoke-free domains. Therefore, expansion of a total smoking ban to workplaces, restaurants, bars, hotels, casinos and karaoke centres is strongly recommended to reduce exposure to secondhand smoke and to denormalise smoking behaviour.
Collapse
Affiliation(s)
| | - Lim Hui Li
- Hospital Sultan Haji Ahmad Shah, Mentakab, Pahang, Malaysia
| | | | | | - Pan Sayan
- Institute of Public Health, Kuala Lumpur, Malaysia
| | | | | | - Ling Miaw Yn
- Institute of Public Health, Kuala Lumpur, Malaysia
| | | | | |
Collapse
|
12
|
Tadesse T, Zawdie B. Non-compliance and associated factors against smoke-free legislation among health care staffs in governmental hospitals in Addis Ababa, Ethiopia: an observational cross-sectional study. BMC Public Health 2019; 19:91. [PMID: 30660180 PMCID: PMC6339307 DOI: 10.1186/s12889-019-6407-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/07/2019] [Indexed: 11/18/2022] Open
Abstract
Background In 2014, the Ethiopian government passed a new smoking legislation that banned smoking in public and workplaces including health care facilities. However, data’s on level of non-compliance and associated factors with non-compliance towards smoke-free legislation in hospital settings of the country has not been studied yet. Methods Hospital-based Cross-sectional study design triangulated with observational study was conducted in five hospitals. Data were collected through direct observation and interviews using checklist, structured and pre-tested questionnaires for observational study and survey of hospital employee respectively. Nine data collectors and one supervisor were involved in data collection. Three hundred fifty (350) health care staffs were interviewed. Fifteen (15) buildings were purposively observed for observational non-compliance in the selected hospitals. Data were entered by Epi Info and analyzed using SPSS version 21 software. Logistic regression was used to compute the crude and adjusted odds ratios for the factors affecting employee non-compliance with the legislation. A p-value of < 0.05 at 95% CI was considered to be statistically significant. Results Anti-smoking signs were absent from a high proportion of hospital areas (97% overall) although visible cigarette butts were generally not observed in most areas of the hospitals. Non-compliance level among health care staffs was 50(10.3%).Associated factors affecting to the non-compliance level of the staff were: being male (AOR = 5.89, p value = 0.001), having poor knowledge (AOR = 2.71, p-value = 0.022) and having Unfavorable attitudes (AOR = 6.15, p-value = 0.000). Conclusions Non-compliance level was high and needs careful implementation for 100% smoke-free legislation in addressing knowledge and attitudes of health care staffs.
Collapse
Affiliation(s)
- Tamiru Tadesse
- Health Inspectorate Directorate, Ministry of Health, Addis Ababa, Ethiopia.
| | - Belay Zawdie
- Department of Biomedical Sciences, Faculty of Medicine, Jimma University, Southwest, Jimma, Ethiopia
| |
Collapse
|
13
|
Verguet S, Tarr G, Gauvreau CL, Mishra S, Jha P, Liu L, Xiao Y, Qiu Y, Zhao K. Distributional benefits of tobacco tax and smoke-free workplaces in China: A modeling study. J Glob Health 2018; 7:020701. [PMID: 29188029 PMCID: PMC5681709 DOI: 10.7189/jogh.07.020701] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background Tobacco taxation and smoke–free workplaces reduce smoking, tobacco–related premature deaths and associated out–of–pocket health care expenditures. We examine the distributional consequences of a price increase in tobacco products through an excise tax hike, and of an implementation of smoke–free workplaces, in China. Methods We use extended cost–effectiveness analysis (ECEA) to evaluate, across income quintiles of the male population (the large majority of Chinese smokers), the premature deaths averted, the change in tax revenues generated, and the financial risk protection procured (eg, poverty cases averted, defined as the number of individuals no longer facing tobacco–related out–of–pocket expenditures for disease treatment, that would otherwise impoverish them), that would follow a 75% increase in cigarette prices through substantial increments in excise tax fully passed onto consumers, and a nationwide total implementation of workplace smoking bans. Results A 75% increase in cigarette prices would avert about 24 million premature deaths among the current Chinese male population, with a third among the bottom income quintile, increase additional tax revenues by US$ 46 billion annually, and prevent around 9 million poverty cases, 19% of which among the bottom income quintile. Implementation of smoking bans in workplaces would avert about 12 million premature deaths, with a fifth among the bottom income quintile, decrease tax revenues by US$ 7 billion annually, and prevent around 4 million poverty cases, 12% of which among the bottom income quintile. Conclusions Increased excise taxes on tobacco products and workplace smoking bans can procure large health and economic benefits to the Chinese population, especially among the poor.
Collapse
Affiliation(s)
- Stéphane Verguet
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Gillian Tarr
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | | | - Sujata Mishra
- Center for Global Health Research, Saint Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Prabhat Jha
- Center for Global Health Research, Saint Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Lingrui Liu
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Yue Xiao
- China National Health Development Research Center, Beijing, China
| | - Yingpeng Qiu
- China National Health Development Research Center, Beijing, China
| | - Kun Zhao
- China National Health Development Research Center, Beijing, China
| |
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
Teloniatis SI, Tzortzi A, Evangelopoulou V, Behrakis P. Relation between individual factors and support for smoking bans in bars in Greece: A cross-sectional study of the 2013 Global Adult Tobacco Survey (GATS). Tob Prev Cessat 2017; 3:118. [PMID: 32432193 PMCID: PMC7232813 DOI: 10.18332/tpc/74705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/17/2017] [Accepted: 06/12/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Smoking rates among the general population and among youth are decreasing in Greece. Low compliance with smoke-free legislation in indoor places in Greece renders non-smokers exposed to secondhand smoke, especially when frequenting bars. The aim of the current study was to identify the factors related to support for smoking bans in bars in Greece. METHODS A cross-sectional secondary data analysis was conducted on the 2013 Greek Global Adult Tobacco Survey. Multivariate regression was used to analyze individual factors and their relation to support for the smoking ban in bars. The total sample was nationally representative of the Greek population and included 3961 residents over the age of 15 with 2061 supporting a ban in bars. RESULTS Overall, 50.5% (95% CI: 46.5-54.4) of Greeks supported the smoking ban in bars. Among them, 1,832 (74.9%, 95% CI=70.1-79.1) were non-smokers and 229 (13.7%, 95% CI=10.6-17.5) were smokers. Age over 65 years was significantly related to increased support for the smoking ban in bars compared to those aged 15-24 years (p<0.05). Belief that secondhand smoke causes lung cancer was significantly related (p<0.001) to having increased support for the ban. Increased knowledge of smoking-related harm was significantly related to increased support for the ban in bars (p<0.001). Male non-smokers were significantly less likely to support the ban in bars than females (p<0.05). CONCLUSIONS Increasing knowledge and awareness of smoking-related harm will enhance smoking ban support and compliance, improving tobacco prevention and cessation, especially among the youth and young adults.
Collapse
Affiliation(s)
| | - Anna Tzortzi
- George D. Behrakis Research Laboratory, Hellenic Cancer Society, Athens, Greece.,Institute of Public Health, The American College of Greece, Athens, Greece
| | - Vaso Evangelopoulou
- George D. Behrakis Research Laboratory, Hellenic Cancer Society, Athens, Greece
| | - Panagiotis Behrakis
- Biomedical Research Foundation, Academy of Athens, Athens, Greece.,Institute of Public Health, The American College of Greece, Athens, Greece
| |
Collapse
|
16
|
Kruger J, Patel R, Kegler M, Babb SD, King BA. Perceptions of harm from secondhand smoke exposure among U.S. adults, 2009-2010. Tob Induc Dis 2016; 14:3. [PMID: 26839528 PMCID: PMC4736086 DOI: 10.1186/s12971-016-0069-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 01/26/2016] [Indexed: 12/03/2022] Open
Abstract
Background Exposure to secondhand smoke (SHS) causes significant disease and death. We assessed the prevalence and correlates of perceptions about the health harm of SHS among U.S. adults at the national and state level. Methods Data came from the 2009–2010 National Adult Tobacco Survey, a national landline and cellular telephone survey. Perceptions about the health harms of SHS were assessed as follows: ‘not at all harmful’, ‘somewhat harmful’, and ‘very harmful’. Descriptive statistics were used to assess the prevalence of SHS harm perceptions by tobacco use and sociodemographic factors, including sex, age, race/ethnicity, education, marital status, annual household income, region, sexual orientation, children in the household, and smoke-free law coverage. Logistic regression was used to assess odds of perceiving SHS to be “very harmful” (vs. “not at all harmful” or “somewhat harmful”), adjusting for the aforementioned factors. Results Nationally, 64.5 % of adults perceived SHS as ‘very harmful’ (state range: 73.5 % [Utah] to 53.7 % [Kentucky]). By tobacco use, the perception that SHS is ‘very harmful’ was: 76.5 % among nonusers of tobacco; 62.1 % among noncombustible only users; 47.9 % among combustible only users; and 40.8 % among dual combustible and noncombustible users. Following adjustment, the perception that SHS was ‘very harmful’ was higher among females, non-Hispanic minorities and Hispanics, respondents living with children, and states with 100 % smoke-free law coverage. Among current tobacco users the odds of perceiving SHS to be ‘very harmful’ was lower in the Midwest than the West. Conclusions Almost two-thirds of American adults perceive SHS as ‘very harmful’; however, currently only half of all Americans are protected by comprehensive state or local smoke-free laws. These findings underscore the importance of public education campaigns to increase awareness of SHS exposure harm and the benefits of smoke-free environments. Expanding comprehensive smoke-free laws could protect all Americans from SHS.
Collapse
Affiliation(s)
- Judy Kruger
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Roshni Patel
- Contractor Support for NCCDPHP/NGIS, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA USA
| | - Michelle Kegler
- Emory University, Rollins School of Public Health, Atlanta, GA USA
| | - Steven D Babb
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| |
Collapse
|
17
|
Yang T, Jiang S, Barnett R, Oliffe JL, Wu D, Yang X, Yu L, Cottrell RR. Who smokes in smoke-free public places in China? Findings from a 21 city survey. HEALTH EDUCATION RESEARCH 2016; 31:36-47. [PMID: 26546594 PMCID: PMC4883029 DOI: 10.1093/her/cyv054] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 10/16/2015] [Indexed: 05/30/2023]
Abstract
Efforts toward controlling secondhand smoke in public places have been made throughout China. However, in contrast to the western world, significant challenges remain for effectively implementing smoke-free regulations. This study explores individual and regional factors which influence smoking in smoke-free public places. Participants included 16 866 urban residents, who were identified through multi-stage sampling conducted in 21 Chinese cities. The reported smoking prevalence in smoke-free public places was 41.2%. Of those who smoked in smoke-free public places, 45.9% had been advised to stop smoking. Participants stated that no-smoking warnings/signs with 'please' in the statement had a better likelihood of gaining compliance and preventing smoking in public spaces. Multilevel logistic regression analysis showed that ethnicity, education, occupation, type of smoking, age of smoking initiation, smoking situation, stress, household smoking restrictions and city population were all associated with smoking in smoke-free public places. Interestingly local smoke-free regulations were not associated with smoking in public places. The findings underscore that efforts to restrict smoking in public places in China should emphasize strong enforcement, while simultaneously raising public awareness of the perils of second hand smoke.
Collapse
Affiliation(s)
- Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University, School of Medicine, Hangzhou 310058, China,
| | - Shuhan Jiang
- Center for Tobacco Control Research, Zhejiang University, School of Medicine, Hangzhou 310058, China
| | - Ross Barnett
- Department of Geography, University of Canterbury, Private Bag 4800, Christchurch, New Zealand
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver V6T 1Z3, Canada
| | - Dan Wu
- Center for Tobacco Control Research, Zhejiang University, School of Medicine, Hangzhou 310058, China
| | - Xiaozhao Yang
- Department of Sociology, Purdue University, West Lafayette, IN 47907, USA and
| | - Lingwei Yu
- Center for Tobacco Control Research, Zhejiang University, School of Medicine, Hangzhou 310058, China
| | - Randall R Cottrell
- Public Health Studies Program, School of Health and Applied Human Sciences, University of North Carolina, Wilmington, NC 28403, USA
| |
Collapse
|
18
|
Support for smoke-free policies in the Cyprus hospitality industry. Int J Public Health 2015; 60:911-7. [DOI: 10.1007/s00038-015-0747-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 02/02/2023] Open
|
19
|
Fong GT, Sansone G, Yan M, Craig L, Quah ACK, Jiang Y. Evaluation of smoke-free policies in seven cities in China, 2007-2012. Tob Control 2015; 24 Suppl 4:iv14-20. [PMID: 26407720 DOI: 10.1136/tobaccocontrol-2015-052508] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/09/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND China is the world's largest consumer of tobacco, with hundreds of millions of people exposed daily to secondhand smoke (SHS). Comprehensive smoke-free policies are the only effective way to protect the population from the harms of SHS. China does not have a comprehensive national smoke-free law but some local-level regulations have been implemented. OBJECTIVE To evaluate local level smoke-free regulations across 7 cities in China by measuring the prevalence of smoking in public places (workplaces, restaurants and bars), and support for smoke-free policies over time. METHODS Data were from Waves 2 to 4 of the International Tobacco Control (ITC) China Survey (2007-2012), a face-to-face cohort survey of approximately 800 smokers in each of 7 cities in mainland China. Multivariate logistic regression models estimated with generalised estimating equations were used to test the changes in variables over time. RESULTS As of 2012, over three-quarters of respondents were exposed to smoking in bars; more than two-thirds were exposed to smoking in restaurants and more than half were exposed to smoking in indoor workplaces. Small decreases in the prevalence of smoking were found overall from Waves 2 to 4 for indoor workplaces, restaurants and bars, although the decline was minimal for bars. Support for complete smoking bans increased over time for each venue, although it was lowest for bars. CONCLUSIONS Existing partial smoking bans across China have had minimal impact on reducing smoking in public places. A strongly enforced, comprehensive national smoke-free law is urgently needed in order to achieve greater public health gains.
Collapse
Affiliation(s)
- Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada Ontario Institute for Cancer Research, Toronto, Ontario, Canada School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Genevieve Sansone
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Mi Yan
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Lorraine Craig
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Yuan Jiang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
20
|
Gneiting U. From global agenda-setting to domestic implementation: successes and challenges of the global health network on tobacco control. Health Policy Plan 2015; 31 Suppl 1:i74-86. [PMID: 26253698 DOI: 10.1093/heapol/czv001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2015] [Indexed: 11/13/2022] Open
Abstract
Global policy attention to tobacco control has increased significantly since the 1990 s and culminated in the first international treaty negotiated under the auspices of the World Health Organization--the Framework Convention on Tobacco Control (FCTC). Although the political process that led to the creation of the FCTC has been extensively researched, the FCTC's progression from an aspirational treaty towards a global health governance framework with tangible policy effects within FCTC member countries has not been well-understood to date. This article analyses the role of the global health network of tobacco control advocates and scientists, which formed during the FCTC negotiations during the late 1990 s, in translating countries' commitment to the FCTC into domestic policy change. By comparing the network's influence around two central tobacco control interventions (smoke-free environments and taxation), the study identifies several scope conditions, which have shaped the network's effectiveness around the FCTC's implementation: the complexity of the policy issue and the relative importance of non-health expertise, the required scope of domestic political buy-in, the role of the general public as network allies, and the strength of policy opposition. These political factors had a greater influence on the network's success than the evidence base for the effectiveness of tobacco control interventions. The network's variable success points to a trade-off faced by global health networks between their need to maintain internal cohesion and their ability to form alliances with actors in their social environment.
Collapse
|
21
|
Im PK, McNeill A, Thompson ME, Fong GT, Xu S, Quah ACK, Jiang Y, Shahab L. Individual and interpersonal triggers to quit smoking in China: a cross-sectional analysis. Tob Control 2015; 24 Suppl 4:iv40-7. [PMID: 25888422 DOI: 10.1136/tobaccocontrol-2014-052198] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 03/31/2015] [Indexed: 11/04/2022]
Abstract
AIMS To determine the most prominent individual and interpersonal triggers to quit smoking in China and their associations with sociodemographic characteristics. METHODS Data come from Waves 1-3 (2006-2009) of the International Tobacco Control (ITC) China Survey, analysed cross-sectionally as person-waves (N=14,358). Measures included sociodemographic and smoking characteristics. Those who quit between waves (4.3%) were asked about triggers that 'very much' led them to stop smoking, and continuing smokers about triggers that 'very much' made them think about quitting. Triggers covered individual (personal health concerns, cigarette price, smoking restrictions, advertisements, warning labels) and interpersonal factors (family/societal disapproval of smoking, setting an example to children, concerns about secondhand smoke). RESULTS Over a third of respondents (34.9%) endorsed at least one trigger strongly; quitters were more likely than smokers to mention any trigger. While similar proportions of smokers endorsed individual (24.4%) and interpersonal triggers (24.0%), quitters endorsed more individual (61.1%) than interpersonal (48.3%) triggers. However, the most common triggers (personal health concerns; setting an example to children) were the same, endorsed by two-thirds of quitters and a quarter of smokers, as were the least common triggers (warning labels; cigarette price), endorsed by 1 in 10 quitters and 1 in 20 smokers. Lower dependence among smokers and greater education among all respondents were associated with endorsing any trigger. CONCLUSIONS Individual rather than interpersonal triggers appear more important for quitters. Major opportunities to motivate quit attempts are missed in China, particularly with regard to taxation and risk communication. Interventions need to focus on more dependent and less-educated smokers.
Collapse
Affiliation(s)
- Pek Kei Im
- Department of Anthropology, University College London, London, UK Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Ann McNeill
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada Ontario Institute for Cancer Research, Toronto, Ontario, Canada School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Steve Xu
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Yuan Jiang
- National Tobacco Control Office, Chinese Center for Disease Control and Prevention, China
| | - Lion Shahab
- Department of Epidemiology and Public Health, University College London, London, UK
| |
Collapse
|
22
|
Kegler MC, Hua X, Solomon M, Wu Y, Zheng PP, Eriksen M. Factors associated with support for smoke-free policies among government workers in Six Chinese cities: a cross-sectional study. BMC Public Health 2014; 14:1130. [PMID: 25367740 PMCID: PMC4240887 DOI: 10.1186/1471-2458-14-1130] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 10/24/2014] [Indexed: 11/15/2022] Open
Abstract
Background A certain level of public support for smoke-free environments is a prerequisite for adoption and enforcement of policies and can be used as an indicator of readiness for legislative action. This study assessed support for comprehensive smoke-free policies in a range of settings such as hotels and colleges among government workers in China and identified factors associated with support for smoke-free policies. Understanding the extent to which government workers, a large segment of the working population in China, report a smoke-free workplace and support for smoke-free policies may be important indicators of readiness for strengthened policies given their role in formulating, implementing and enforcing regulations. Methods Data were from an evaluation of the Tobacco Free Cities initiative of Emory University’s Global Health Institute-China Tobacco Control Partnership. Self-administered surveys were completed by 6,646 workers in 160 government agencies in six Chinese cities. Multivariate logistic regression was used to identify factors associated with support for smoke-free worksites, bars, hotels, and colleges. Results Over half (54.6%) of participants were male. A large percentage of the male workers smoked (45.9%,) whereas very few women did (1.9%). Fewer than 50% of government workers reported smoke-free policies at work, with 19.0% reporting that smoking is allowed anywhere. Support for smoke-free policies was generally very high, with the lowest levels of support for smoke-free bars (79.0%) and hotels (82.3%), higher levels of support for restaurants (90.0%) and worksites (93.0%), and above 95% support for hospitals, schools, colleges, public transportation and religious settings. Knowledge of the harmfulness of secondhand smoke was positively associated with support for smoke-free policies. Stricter worksite smoking policies were associated with support for smoke-free workplaces and bars, but not hotels and colleges. Women and nonsmokers were more supportive of smoke-free policies in general. Conclusion Government workers play important roles in formulating, implementing and enforcing regulations; results suggest support for a more comprehensive approach to smoke-free environments in China among workers across a broad range of agencies.
Collapse
Affiliation(s)
- Michelle C Kegler
- Rollins School of Public Health, Emory University, 1518 Clifton Road NE, 30322 Atlanta, GA, USA.
| | | | | | | | | | | |
Collapse
|
23
|
Yang T, Abdullah AS, Li L, Rockett IRH, Lin Y, Ying J, Guo W, Wu D, Li M. Public place smoke-free regulations, secondhand smoke exposure and related beliefs, awareness, attitudes, and practices among Chinese urban residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:2370-83. [PMID: 23749054 PMCID: PMC3717741 DOI: 10.3390/ijerph10062370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 05/28/2013] [Accepted: 05/29/2013] [Indexed: 11/25/2022]
Abstract
Objective: To evaluate the association between smoke-free regulations in public places and secondhand smoke exposure and related beliefs, awareness, attitudes, and behavior among urban residents in China. Methods: We selected one city (Hangzhou) as the intervention city and another (Jiaxing) as the comparison. A structured self-administered questionnaire was used for data collection, and implemented at two time points across a 20-month interval. Both unadjusted and adjusted logistic methods were considered in analyses. Multiple regression procedures were performed in examining variation between final and baseline measures. Results: Smoke-free regulations in the intervention city were associated with a significant decline in personal secondhand smoke exposure in government buildings, buses or taxis, and restaurants, but there was no change in such exposure in healthcare facilities and schools. In terms of personal smoking beliefs, awareness, attitudes, and practices, the only significant change was in giving quitting advice to proximal family members. Conclusions: There was a statistically significant association between implementation of smoke-free regulations in a city and inhibition of secondhand tobacco smoking exposure in public places. However, any such impact was limited. Effective tobacco control in China will require comprehensive laws implemented fully and supported by penalties and a combination of strong public health education.
Collapse
Affiliation(s)
- Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China; E-Mails: (L.L.); (W.G.); (D.W.)
- Author to whom correspondence should be addressed; E-Mail:
| | - Abu S. Abdullah
- School of Public Health, Guangxi Medical University, Nanning 530021, China; E-Mail:
- Boston Medical Center, Boston University Medical Campus, Boston, MA 02118, USA
| | - Li Li
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China; E-Mails: (L.L.); (W.G.); (D.W.)
| | - Ian R. H. Rockett
- Injury Control Research Center and Department of Epidemiology (School of Public Health), West Virginia University, Morgantown, WV 26506, USA; E-Mail:
| | - Yan Lin
- International Union Against Tuberculosis and Lung Disease, Beijing 100005, China; E-Mail:
| | - Jun Ying
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH 45221, USA; E-Mail:
| | - Wei Guo
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China; E-Mails: (L.L.); (W.G.); (D.W.)
| | - Dan Wu
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China; E-Mails: (L.L.); (W.G.); (D.W.)
| | - Mu Li
- Sydney School of Public Health, University of Sydney, NSW 2006, Australia; E-Mail:
| |
Collapse
|
24
|
Katanoda K, Jiang Y, Park S, Lim MK, Qiao YL, Inoue M. Tobacco control challenges in East Asia: proposals for change in the world's largest epidemic region. Tob Control 2013; 23:359-68. [PMID: 23596197 PMCID: PMC4078676 DOI: 10.1136/tobaccocontrol-2012-050852] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
East Asia is one of the world's largest tobacco epidemic regions. Although several international studies have evaluated the status of tobacco control in this region, the findings have not been integrated with knowledge on domestic activities at the national and municipal levels. We analysed the current tobacco control situation in three East Asian countries, Japan, China and the Republic of Korea, using both international and domestic data sources. We collected data between 2008 and 2011 in each country according to the framework of WHO's MPOWER (Monitoring, Protect, Offer, Warn, Enforcement and Raise) approach for guiding implementation of the WHO Framework Convention on Tobacco Control. Analysis revealed that 37-53% of adult men were current smokers and that smoking prevalence among middle-aged men reached 63%. Less than 20% of male smokers plan to quit and the use of nicotine replacement drugs was 14% at maximum. Forty-six percent or more of men and 20% or more of women were exposed to passive smoking at workplaces and at home, respectively. Many tobacco industry activities remain unrestricted and prevalent. Our findings indicate an urgent need for the following set of policies: raise cigarette prices to increase the quit attempt rate, particularly among adult men; develop a multi-component quitting assistance system to provide adequate assistance for smoking cessation; implement effective smoke-free policies in workplaces and public places to reduce exposure to passive smoking; and rebuild the administrative structure to denormalise tobacco industry activities. The importance of these standard approaches should be reaffirmed by all tobacco control policymakers in East Asia.
Collapse
Affiliation(s)
- Kota Katanoda
- Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Yuan Jiang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sohee Park
- Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Min Kyung Lim
- National Cancer Information Center, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - You-Lin Qiao
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Manami Inoue
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| |
Collapse
|
25
|
Xu Y, Wu Q, Xu S, Xu J, Wan X, Guo Y. Environmental secondhand smoke exposure and policy assessment at five venues in Zhejiang Province, China. Asia Pac J Public Health 2013; 26:622-30. [PMID: 23355055 DOI: 10.1177/1010539512472360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to assess environmental secondhand smoke exposure and tobacco control policy at 5 venues. A cross-sectional study was conducted involving 134 settings and 2727 adults in Zhejiang, China. The results show that the proportions of venues that had complete smoking ban were as follows: health administrative organizations (71.9%), hospitals (70.0%), schools (66.7%), public transportation vehicles (24.0%), and government agencies (11.8%). The proportions of venues where smoking was noticed were as follows: public transportation vehicles (88.0%), government agencies (47.1%), hospitals (46.7%), health administrative organizations (40.6%), and schools (30.0%). Venues with completely indoor smoking ban were 5 times more likely to be smoke-free at the time of survey than other venues without smoking ban (odds ratio = 5.39, 95% confidence interval = 1.92-15.14). It indicated that implementation of indoor smoking ban can reduce indoor secondhand smoke exposure.
Collapse
Affiliation(s)
- Yue Xu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - QingQing Wu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - ShuiYang Xu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - JinHang Xu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Xia Wan
- School of Basic Medicine of Peking Union Medical College, Beijing, China
| | - YuJie Guo
- Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| |
Collapse
|
26
|
Radwan GN, Loffredo CA, Aziz R, Abdel-Aziz N, Labib N. Implementation, barriers and challenges of smoke-free policies in hospitals in Egypt. BMC Res Notes 2012; 5:568. [PMID: 23069011 PMCID: PMC3519804 DOI: 10.1186/1756-0500-5-568] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 09/20/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use is a serious public health challenge in North Africa, and health professionals play a vital role in tobacco control. In Egypt, limited data are available on the knowledge and attitudes of health care providers regarding tobacco control policies. Such data are especially relevant due to Egypt's tobacco control laws, adopted in 2007, prohibiting smoking in hospitals and other public places. This study surveyed 49 senior administrative staff, 267 physicians, 254 nurses, and 109 administrative employees working in El-Kasr El-Aini Hospital in Cairo, assessing their knowledge and attitudes regarding Egypt's tobacco control laws and barriers to their effective implementation in health care facilities. We also investigated the hospital's compliance with smoke-free policies. RESULTS The majority (>90%) of the hospital workers knew that exposure to second-hand smoke is harmful to health. Physicians and nurses had a more favorable attitude towards the smoking ban when compared to administrative employees. Hospital staff identified the following barriers to successfully implementing the smoking ban: lax enforcement of tobacco control laws, the lack of penalties for violators, the lack of cessation programs, and the prevalence of smoking among physicians. CONCLUSIONS Overall, smoke-free policies were poorly enforced in this large teaching hospital in Cairo, Egypt. Interventions to address the identified barriers to their implementation could include the provision of cessation training and services as well as effective communication programs to educate health care workers at all levels regarding the dangers of second-hand smoke exposure and effective measures for protection.
Collapse
|
27
|
Yang T, Rockett IRH, Li M, Xu X, Gu Y. Tobacco advertising, environmental smoking bans, and smoking in Chinese urban areas. Drug Alcohol Depend 2012; 124:121-7. [PMID: 22261180 DOI: 10.1016/j.drugalcdep.2011.12.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2011] [Revised: 12/20/2011] [Accepted: 12/21/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate whether cigarette smoking in Chinese urban areas was respectively associated with exposure to tobacco advertising and smoking bans in households, workplaces, and public places. METHODS Participants were 4735 urban residents aged 15 years and older, who were identified through multi-stage quota-sampling conducted in six Chinese cities. Data were collected on individual sociodemographics and smoking status, and regional tobacco control measures. The sample was characterized in terms of smoking prevalence, and multilevel logistic models were employed to analyze the association between smoking and tobacco advertising and environmental smoking restrictions, respectively. RESULTS Smoking prevalence was 30%. Multilevel logistic regression analysis showed that smoking was positively associated with exposure to tobacco advertising, and negatively associated with workplace and household smoking bans. CONCLUSIONS The association of smoking with both tobacco advertising and environmental smoking bans further justifies implementation of comprehensive smoking interventions and tobacco control programs in China.
Collapse
Affiliation(s)
- Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | | | | | | | | |
Collapse
|
28
|
Rosenberg M, Pettigrew S, Wood L, Ferguson R, Houghton S. Public support for tobacco control policy extensions in Western Australia: a cross-sectional study. BMJ Open 2012; 2:e000784. [PMID: 22382124 PMCID: PMC3293129 DOI: 10.1136/bmjopen-2011-000784] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Policy makers seeking to introduce new tobacco control measures need to anticipate community support to assist them in planning appropriate implementation strategies. This study assessed community support for plain packaging and smoking bans in outdoor locations in Australia. DESIGN Analytical cross-sectional survey. SETTING AND PARTICIPANTS 2005 Western Australian adults participated in a computer-assisted telephone interview. Random household telephone numbers were used to obtain a representative sample. OUTCOME MEASURES Support for plain packaging of cigarettes and smoking bans at outdoor venues by demographic characteristics. RESULTS Around half of the survey respondents supported plain packaging and almost a further quarter reported being neutral on the issue. Only one in three smokers disagreed with the introduction of a plain packaging policy. A majority of respondents supported smoking bans at five of the six nominated venues, with support being strongest among those with children under the age of 15 years. The venues with the highest levels of support were those where smoke-free policies had already been voluntarily introduced by the venue managers, where children were most likely to be in attendance, and that were more limited in size. CONCLUSIONS The study results demonstrate community support for new tobacco control policies. This evidence can be used by public policy makers in their deliberations relating to the introduction of more extensive tobacco control regulations.
Collapse
Affiliation(s)
- Michael Rosenberg
- Health Promotion Evaluation Unit, School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia
| | - Simone Pettigrew
- Health Promotion Evaluation Unit, School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia
| | - Lisa Wood
- Centre for the Built Environment and Health, School of Population Health, The University of Western Australia, Perth, Australia
| | - Renee Ferguson
- Health Promotion Evaluation Unit, School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia
| | - Stephen Houghton
- Centre for Child and Adolescent Related Disorders, The University of Western Australia, Perth, Australia
| |
Collapse
|
29
|
Yang J, Hammond D, Driezen P, Fong GT, Jiang Y. Health knowledge and perception of risks among Chinese smokers and non-smokers: findings from the Wave 1 ITC China Survey. Tob Control 2011; 19 Suppl 2:i18-23. [PMID: 20935195 PMCID: PMC5654747 DOI: 10.1136/tc.2009.029710] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Awareness of health risks of smoking is strongly associated with smoking behaviour. However, there are no population-based studies of smoking-related health knowledge in China. OBJECTIVE The aim of current study was to use a population-based sample from the International Tobacco Control China Wave 1 survey to examine variations between current, former and never smokers' health knowledge about smoking and the impact of health knowledge awareness on smokers' intention to quit. METHODS A face-to-face interview was conducted with 5986 adult smokers and non-smokers from six cities in China. Respondents were asked whether they believed smoking causes heart disease, stroke, impotence, lung cancer, emphysema, stained teeth, premature ageing in smokers and lung cancer in non-smokers. Current smokers were also asked additional questions on how smoking affects their current and future health as well as whether they had plans to quit smoking and if they believe they would have health benefit from quitting. FINDINGS The overall awareness of health risks of smoking in China was low compared to developed countries. Current smokers in China were less likely than non-smokers and former smokers to acknowledge the consequences of smoking. Current smokers who were more aware of the health consequences of smoking were more likely to intend to quit smoking. CONCLUSION These findings highlight the need to increase awareness about the health effects of smoking in China, particularly among current smokers to increase quitting.
Collapse
Affiliation(s)
- Jilan Yang
- Department of Health Studies and Gerontology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada
| | | | | | | | | |
Collapse
|