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Qiao K, Liu H, Li X, Jin Q, Wang Y, Gu M, Bai X, Qin T, Yang Y. An intervention study on a hospital-community integrated management model of tobacco dependence based on a community intervention trial. Front Psychiatry 2023; 14:1029640. [PMID: 36960455 PMCID: PMC10027698 DOI: 10.3389/fpsyt.2023.1029640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
Objective To assess the effect of the hospital-community integrated management model of tobacco dependence on smoking cessation among community residents compared with a brief smoking cessation intervention. Methods Our study recruited 651 smokers who were willing to quit in 19 communities in Beijing and conducted a 6-month smoking cessation intervention. The control group receiving a brief smoking cessation intervention and the pilot group receiving an integrated smoking cessation intervention. Intention-to-treat analysis (ITT) and generalized estimating equations were used to assess the effects of the integrated intervention and smoking cessation medication on average number of cigarettes smoked per day (ACSD) and smoking cessation rate. Results Simple effects analysis showed that smokers taking medication had significantly lower ACSD than those not taking medication at follow-up, the control group reduced smoking by 3.270, 4.830, and 4.760 cigarettes in the first, third and sixth months, respectively, while the pilot group reduced by 6.230, 5.820, and 4.100 cigarettes. The integrated intervention significantly reduced ACSD among medication-taking smokers at 1st month (reduced by 3.420, P < 0.05) and 3rd month (reduced by 2.050, P < 0.05), but had no significant effect among non-medication taking smokers. The 3rd month smoking cessation rate among medication-taking smokers was 27.0%, which was significantly higher than the smokers with brief smoking cessation intervention. Conclusion The integrated hospital-community intervention can significantly promote smoking cessation among smokers taking medication, but the issue of payment for medication and additional labor compensation for medical staff should be addressed before its popularization.
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Affiliation(s)
- Kun Qiao
- School of Public Health, Capital Medical University, Beijing, China
| | - Han Liu
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xingming Li
- School of Public Health, Capital Medical University, Beijing, China
- *Correspondence: Xingming Li,
| | - Qianying Jin
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yao Wang
- School of Public Health, Capital Medical University, Beijing, China
| | - Mingyu Gu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xinyuan Bai
- School of Public Health, Capital Medical University, Beijing, China
| | - Tingting Qin
- School of Public Health, Capital Medical University, Beijing, China
| | - Yutong Yang
- School of Public Health, Capital Medical University, Beijing, China
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Henderson E, Continente X, Fernández E, Tigova O, Cortés-Francisco N, Gallus S, Lugo A, Semple S, Dobson R, Clancy L, Keogan S, Ruprecht A, Borgini A, Tzortzi A, Vyzikidou VK, Gorini G, López-Nicolás A, Soriano JB, Geshanova G, Osman J, Mons U, Przewozniak K, Precioso J, Brad R, López MJ. Secondhand smoke exposure assessment in outdoor hospitality venues across 11 European countries. ENVIRONMENTAL RESEARCH 2021; 200:111355. [PMID: 34022230 PMCID: PMC8417816 DOI: 10.1016/j.envres.2021.111355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/20/2021] [Accepted: 05/17/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Due to partial or poorly enforced restrictions secondhand tobacco smoke (SHS) is still present in outdoor hospitality venues in many European countries. This study aimed to assess SHS concentrations in outdoor hospitality venues across Europe and identify contextual exposure determinants. METHODS Cross-sectional study. We measured airborne nicotine and evidence of tobacco use in terraces of bars, cafeterias, and pubs from 11 European countries in 2017-2018. Sites were selected considering area-level socioeconomic indicators and half were visited during nighttime. We noted the smell of smoke, presence of smokers, cigarette butts, ashtrays, and number of physical covers. Contextual determinants included national smoke-free policies for the hospitality sector, the Tobacco Control Scale score (2016), and the national smoking prevalence (2017-2018). We computed medians and interquartile ranges (IQR) of nicotine concentrations and used multivariate analyses to characterize the exposure determinants. RESULTS Nicotine was present in 93.6% of the 220 sites explored. Overall concentrations were 0.85 (IQR:0.30-3.74) μg/m3 and increased during nighttime (1.45 IQR:0.65-4.79 μg/m3), in enclosed venues (2.97 IQR:0.80-5.80 μg/m3), in venues with more than two smokers (2.79 IQR:1.03-6.30 μg/m3), in venues in countries with total indoor smoking bans (1.20 IQR:0.47-4.85 μg/m3), and in venues in countries with higher smoking prevalence (1.32 IQR:0.49-5.34 μg/m3). In multivariate analyses, nicotine concentrations were also positively associated with the observed number of cigarette butts. In venues with more than two smokers, SHS levels did not significantly vary with the venues' degree of enclosure. CONCLUSIONS Our results suggest that current restrictions in outdoor hospitality venues across Europe have a limited protective effect and justify the adoption of total smoking bans in outdoor areas of hospitality venues.
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Affiliation(s)
- Elisabet Henderson
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut (DCEXS), Doctor Aiguader, 88, 08003, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain
| | - Xavier Continente
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
| | - Esteve Fernández
- Institut Català d'Oncologia, Av. Granvia de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Spain; Institut d'Investigació Biomèdica de Bellvitge, Av. Granvia de l'Hospitalet 199, 08908, L'Hospitalet de Llobregat, Spain; Universitat de Barcelona, Feixa Llarga, S/n, 08907, L'Hospitalet de Llobregat, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain
| | - Olena Tigova
- Institut Català d'Oncologia, Av. Granvia de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Spain; Institut d'Investigació Biomèdica de Bellvitge, Av. Granvia de l'Hospitalet 199, 08908, L'Hospitalet de Llobregat, Spain; Universitat de Barcelona, Feixa Llarga, S/n, 08907, L'Hospitalet de Llobregat, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain
| | - Nuria Cortés-Francisco
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
| | - Silvano Gallus
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Health Sciences, Via Mario Negri 2, 20156, Milan, Italy
| | - Alessandra Lugo
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Health Sciences, Via Mario Negri 2, 20156, Milan, Italy
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling FK9 4LA, Scotland, UK
| | - Ruaraidh Dobson
- Institute for Social Marketing and Health, University of Stirling, Stirling FK9 4LA, Scotland, UK
| | - Luke Clancy
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | - Sheila Keogan
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | - Ario Ruprecht
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Alessandro Borgini
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Anna Tzortzi
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Str., Athens, 10557, Greece
| | - Vergina K Vyzikidou
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Str., Athens, 10557, Greece
| | - Giuseppe Gorini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Via Cosimo Il Vecchio, 2, 50139, Florence, Italy
| | - Angel López-Nicolás
- Universidad Politécnica de Cartagena (UPCT), Plaza Cronista Isidoro Valverde, S/n, 30202, Cartagena, Spain
| | - Joan B Soriano
- Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain; Hospital Universitario La Princesa (IISP), Diego de León, 62, Planta 6, 28006, Madrid, Spain; Universidad Autónoma de Madrid (UAM), Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain; Instituto Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain
| | - Gergana Geshanova
- Smoke-free Life Coalition, Slivnitsa Blvd, 257, 1202, Sofia, Bulgaria
| | - Joseph Osman
- OFT Conseil, Office Français de Santé et Bien-être Au Travail, Rue Gobert, 12, 75011Paris, France
| | - Ute Mons
- Cancer Prevention Unit & WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Im Neuenheimer Feld, 280, 69120, Heidelberg, Germany; Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50923, Cologne, Germany
| | - Krzysztof Przewozniak
- Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena, 5, 02-781, Warsaw, Poland; The Foundation Smart Health - Health in 3D, Warsaw, Poland; Collegium Civitas, 1 Defilad Square, 00-901, Warsaw, Poland
| | - José Precioso
- Instituto de Educação, Universidade do Minho, 4710-057, Braga, Portugal
| | - Ramona Brad
- Healthy Romania Generation 2035 Association, Bucharest, Romania
| | - Maria J López
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut (DCEXS), Doctor Aiguader, 88, 08003, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
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Ghenadenik AE, Gauvin L, Frohlich KL. Smoking in Young Adults: A Study of 4-Year Smoking Behavior Patterns and Residential Presence of Features Facilitating Smoking Using Data From the Interdisciplinary Study of Inequalities in Smoking Cohort. Nicotine Tob Res 2021; 22:1997-2005. [PMID: 32052039 DOI: 10.1093/ntr/ntaa035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 02/10/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Young adults have the highest prevalence of smoking among all age groups in most industrialized countries and exhibit great variability in smoking behavior. Differences in associations between features in residential environments and smoking initiation, prevalence, and cessation have been extensively examined in the literature. Nonetheless, in many cases, findings remain inconsistent. This paper proposes that a potential driver of these inconsistencies is an almost exclusive focus on point-specific smoking outcomes, without consideration for the different behavior patterns that this age group may experience over time. AIMS AND METHODS Based on data from the Interdisciplinary Study of Inequalities in Smoking cohort of 18- to 25-year-old Montreal residents (n = 1025), we examined associations between 4-year smoking patterns measured at three timepoints and proximal presence/density of tobacco retail outlets and presence of smoker accommodation facilities in Montreal, Canada. Associations were tested using two-level multinomial and logistic models. RESULTS In fully adjusted models, compared to never-smokers, residents of areas with a higher density of tobacco retail were more likely to (1) be characterized as established smokers, (2) have experienced repeated changes in smoking status (being "switchers") during the 4-year study period, and (3) be former smokers. CONCLUSIONS From a conceptual standpoint, these findings highlight the importance of acknowledging and examining smoking behavior patterns among young adults. Furthermore, specific pattern-feature associations may point to unique mechanisms by which features could influence smoking behavior patterns. These findings require replication and extension, including testing hypotheses regarding tobacco retail density's role in sustaining smoking and in influencing changes in smoking status. IMPLICATIONS Results from this study highlight the importance of describing and examining different young adult smoking behavior patterns and how they may be influenced by residential environment features such as the density of tobacco retail. Findings suggest that young adults residing in areas with a higher density of tobacco retailers are more likely to have experienced repeated changes in smoking status and to be established smokers. Further research in this area is needed to advance knowledge of the putative mechanisms by which residential features may influence smoking behavior patterns and to ultimately orient policy and interventions seeking to curb smoking at the local level.
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Affiliation(s)
- Adrian E Ghenadenik
- Département de médecine sociale et préventive, École de santé publique (ESPUM), Université de Montréal, Montreal, Canada.,Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montreal, Canada.,Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Lise Gauvin
- Département de médecine sociale et préventive, École de santé publique (ESPUM), Université de Montréal, Montreal, Canada.,Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Katherine L Frohlich
- Département de médecine sociale et préventive, École de santé publique (ESPUM), Université de Montréal, Montreal, Canada.,Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montreal, Canada
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4
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Nee-Nee J, Sutherland K, Holland R, Wilson M, Ackland S, Bocock C, Cartmell A, Earp J, Grove C, Hewson C, Jefferies W, Keefe L, Lockyer J, Patel S, Quintans M, Robbie M, Teape L, Yang J, Wilson N, Hoek J, Thomson G. Tobacco pack display at hospitality venues after the introduction of standardised tobacco packaging in New Zealand: a field observation study. BMJ Open 2019; 9:e027868. [PMID: 31494599 PMCID: PMC6731942 DOI: 10.1136/bmjopen-2018-027868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES In March 2018, New Zealand (NZ) introduced standardised tobacco packaging that also featured new pictorial warnings, with implementation completed by early June 2018. We evaluated how the new packaging affected tobacco pack displays in outdoor areas of hospitality venues. DESIGN Before-and-after descriptive field observation study. SETTING Central city area of the capital city of NZ (Wellington). PARTICIPANTS Observations of people smoking and tobacco packs were made at 56 hospitality venues with outdoor tables (2422 separate venue observations), after the introduction of standardised tobacco packaging. Comparisons were made with a prior study in the same setting, from a time when tobacco packaging still featured brand imagery. RESULTS A total of 8191 patrons, 1113 active smokers and 889 packs and pouches (522 of known orientation) were observed over 2422 venue observations. There were 0.80 visible packs per active smoker in 2018, compared with 1.26 in 2014 (risk ratio (RR)=0.64, 95% CI 0.60 to 0.67, p<0.0001). The new packs in 2018 were also less likely to be displayed face-up, compared with packs in 2014, which had brand imagery on the front face (RR=0.77, 95% CI 0.72 to 0.83, p<0.0001). Pack and pouch display (RR=3.09 in 2014 and 3.10 in 2018) and active smoking (RR=3.16 in 2014 compared with 3.32 in 2018) were higher at venues without children present, compared with venues with children present (this finding was consistent over time). CONCLUSIONS The reduction in the number of visible packs per active smoker, along with the reduction in face-up positioning of packs, suggests that smokers found the new standardised packs less attractive. Countries introducing standardised packaging should consider evaluating social display of tobacco packaging.
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Affiliation(s)
- Johanna Nee-Nee
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Kirsty Sutherland
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Rebecca Holland
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Miriam Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Samuel Ackland
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Claudia Bocock
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Abbie Cartmell
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jack Earp
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Christina Grove
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Charlotte Hewson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Will Jefferies
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Lucy Keefe
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jamie Lockyer
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Saloni Patel
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Miguel Quintans
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Michael Robbie
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Lauren Teape
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jess Yang
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - George Thomson
- Department of Public Health, University of Otago, Wellington, New Zealand
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Lowrie C, Pearson AL, Thomson G. Inequities in coverage of smokefree outdoor space policies within the United States: school grounds and playgrounds. BMC Public Health 2018; 18:736. [PMID: 29902978 PMCID: PMC6003182 DOI: 10.1186/s12889-018-5602-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 05/24/2018] [Indexed: 11/18/2022] Open
Abstract
Background Previous studies have found extensive geographic and demographic differences in tobacco use. These differences have been found to be reduced by effective public policies, including banning smoking in public spaces. Smokefree outdoor spaces reduce secondhand smoke exposure and de-normalize smoking. Methods After previously publishing a study of smokefree indoor and outdoor space policies, it was brought to the authors’ attention that the dataset used in analyses was incomplete (Lowrie et al., BMC Public Health 17:456, 2017). The current manuscript is a corrected version. Here, we include analyses for outdoor space policies. We evaluated regional and demographic differences in the proportion of the population (both adult and child) covered by smokefree outdoor space policies for school grounds and playgrounds enacted in the United States prior to 2014. Results Children had a low level of protection in playgrounds and schools (8% covered nationwide in both settings). Significant differences in coverage were found by ethnicity, region, income, and education (p < 0.001). The odds of having a smokefree playgrounds policy was lower for jurisdictions with higher proportions of poor households, households with no high school diploma, whites and the Alaska/Hawaii region. Increased ethnic heterogeneity was found to be a significant predictor of increased odds of having a smokefree playgrounds policy, meaning that diversity is protective, with differential effect by region (p < 0.001) – which may relate to urbanicity. Conclusions Disparities in smokefree outdoor space policies have potential to exacerbate existing health inequities. A national increase in smokefree outdoor space policies to protect children in playgrounds and schools is a crucial intervention to reduce such inequities.
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Affiliation(s)
- Christopher Lowrie
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, 673 Auditorium Road, East Lansing, MI, 48824, USA
| | - Amber L Pearson
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, 673 Auditorium Road, East Lansing, MI, 48824, USA. .,Department of Public Health, University of Otago, Wellington, 6021, New Zealand. .,Environmental Science and Policy Program, Michigan State University, East Lansing, MI, 48824, USA.
| | - George Thomson
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
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Living with Smoker(s) and Smoking Cessation in Chinese Adult Smokers: Cross-Sectional and Prospective Evidence from Hong Kong Population Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010074. [PMID: 29304007 PMCID: PMC5800173 DOI: 10.3390/ijerph15010074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 12/23/2017] [Accepted: 12/27/2017] [Indexed: 12/02/2022]
Abstract
Background: Results on the environmental influence on unassisted quitting are scarce. We investigated the associations of living with smoker(s) with quitting in Chinese adult smokers. Methods: We examined both cross-sectional and prospective data in the Hong Kong Population Health Survey recruited participants in 2003/04, and followed up to 2006. Unconditional logistic regression yielded adjusted odds ratios (AORs) of (i) planning to quit, (ii) ex-smoking (cross-sectional), and quitting (prospective) for living with smoker(s). 1679 ever smokers aged 18+ years at baseline, and 323 of them who were successfully followed-up were included in the cross-sectional, and prospective analysis. Results: At baseline, living with smoker(s) was significantly associated with lower odds of planning to quit in current smokers (AOR 0.41, 95% CI 0.25–0.68), and lower odds of ex-smoking (AOR 0.45, 95% CI 0.34–0.58), particularly if the smoker(s) smoked inside home (AOR 0.35, 95% CI 0.26–0.47). Prospectively, living with smoker(s) non-significantly predicted lower odds of new quitting (AOR 0.48, 95% CI 0.13–1.78). Conclusions: Our study has provided the first evidence in a Chinese general population that living with smoker(s) is an important barrier against smoking cessation. To boost quit rate in nonusers of smoking cessation services, smoking at home should be banned, especially for populations living in crowed urban environments that are typical of economically developed cities in China.
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Thomson G, Wilson N. Smokefree signage at children's playgrounds: Field observations and comparison with Google Street View. Tob Induc Dis 2017; 15:37. [PMID: 28852374 PMCID: PMC5569489 DOI: 10.1186/s12971-017-0143-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 08/20/2017] [Indexed: 11/29/2022] Open
Abstract
Background Although there is global growth in outdoor smokefree areas, little is known about the associated smokefree signage. We aimed to study smokefree signage at playgrounds and to compare field observations with images from Google Street View (GSV). Methods We randomly selected playgrounds in 21 contiguous local government areas in the lower North Island of New Zealand, all of which had smokefree playground policies. Field data were collected on smokefree signage along with dog control signage to allow for comparisons. The sensitivity and specificity of using GSV for data collection were calculated. Results Out of the 63 playgrounds studied, only 44% (95% CI: 33%–57%) had any smokefree signage within 10 m of the playground equipment. The mean number of such signs was 0.8 per playground (range: 0 to 6). Sign size varied greatly from 42 cm2 up to 2880 cm2; but was typically fairly small (median = 600 cm2; ie, as per a 20 × 30 cm rectangle). Qualitatively the dog signs appeared to use clearer images and were less wordy than the smokefree signs. Most playground equipment (82%), could be seen on GSV, but for these settings the sensitivity for identifying smokefree signs was poor at 16%. Yet specificity was reasonable at 96%. Conclusions The presence and quality of smokefree signage was poor in this sample of children’s playgrounds in this developed country setting. There appears to be value in comparing smokefree signage with other types of signage (eg, dog control signage). Google Street View was not a sensitive tool for studying such signage. Electronic supplementary material The online version of this article (10.1186/s12971-017-0143-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Nick Wilson
- University of Otago, Wellington, New Zealand
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8
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Lowrie C, Pearson AL, Thomson G. Inequities in coverage of smokefree space policies within the United States. BMC Public Health 2017; 17:456. [PMID: 28511682 PMCID: PMC5434634 DOI: 10.1186/s12889-017-4385-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 05/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have found extensive geographic and demographic differences in tobacco use. These differences have been found to be reduced by effective public policies, including banning smoking in public spaces. Smokefree indoor and outdoor spaces reduce secondhand smoke exposure and denormalize smoking. METHODS We evaluated regional and demographic differences in the proportion of the population covered by smokefree policies enacted in the United States prior to 2014, for both adults and children. RESULTS Significant differences in coverage were found by ethnicity, region, income, and education (p < 0.001). Smokefree policy coverage was lower for jurisdictions with higher proportions of poor households, households with no high school diploma and the Southeast region. Increased ethnic heterogeneity was found to be a significant predictor of coverage in indoor "public spaces generally", meaning that diversity is protective, with differential effect by region (p = 0.004) - which may relate to urbanicity. Children had a low level of protection in playgrounds and schools (~10% covered nationwide) - these spaces were found to be covered at lower rates than indoor spaces. CONCLUSIONS Disparities in smokefree space policies have potential to exacerbate existing health inequities. A national increase in smokefree policies to protect children in playgrounds and schools is a crucial intervention to reduce such inequities.
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Affiliation(s)
- Christopher Lowrie
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, East Lansing, MI, 48824, USA
| | - Amber L Pearson
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, East Lansing, MI, 48824, USA. .,Department of Public Health, University of Otago, Wellington, 6021, New Zealand. .,Environmental Science and Policy Program, Michigan State University, East Lansing, MI, 48824, USA.
| | - George Thomson
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
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9
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Beyond Smoking Prevalence: Exploring the Variability of Associations between Neighborhood Exposures across Two Nested Spatial Units and Two-Year Smoking Trajectory among Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13010106. [PMID: 26751461 PMCID: PMC4730497 DOI: 10.3390/ijerph13010106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 12/28/2015] [Accepted: 12/28/2015] [Indexed: 01/19/2023]
Abstract
Young adults have the highest prevalence of smoking amongst all age groups. Significant uptake occurs after high school age. Although neighborhood exposures have been found to be associated with smoking behavior, research on neighborhood exposures and the smoking trajectories among young adults, and on the role of geographic scale in shaping findings, is scarce. We examined associations between neighborhood exposures across two nested, increasingly large spatial units and smoking trajectory over two years among young adults living in Montreal, Canada. A sample of 2093 participants aged 18-25 years from the Interdisciplinary Study of Inequalities in Smoking (ISIS) was surveyed. The dependent variable was self-reported smoking trajectory over the course of two years. Residential addresses, data on presence of tobacco retail outlets, and the presence of smoking accommodation facilities were coded and linked to spatial units. Three-level multinomial models were used to examine associations. The likelihood of being a smoker for 2+ years was significantly greater among those living in larger spatial unit neighborhoods that had a greater presence of smoking accommodation. This association was not statistically significant at the smaller spatial units. Our findings highlight the importance of studying young adults' smoking trajectories in addition to static smoking outcomes, and point to the relevance of considering spatial scale in studies of neighborhoods and smoking.
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Azagba S. Effect of smoke-free patio policy of restaurants and bars on exposure to second-hand smoke. Prev Med 2015; 76:74-8. [PMID: 25913419 DOI: 10.1016/j.ypmed.2015.04.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/14/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE While there is increasing support for restricting smoking in restaurant and bar patios, there is limited evidence on the effectiveness of this policy. This study examined the effect of smoke-free patio policy of restaurants and bars on adult second-hand smoke (SHS) exposure. METHODS Data were drawn from the 2005-2012 Canadian Tobacco Use Monitoring Survey (n=89,743), a repeated cross-sectional survey of youth and adult. Regression analysis, a quasi-experimental design was used to examine the effect of provincial smoke-free patio policy on self-reported exposure to SHS. RESULTS Analyses suggest that exposure to SHS on patios of bars and restaurants declined following the adoption of provincial smoke-free patio policy. Relative to pre-policy SHS exposure, regression results showed a reduction in the probability of SHS exposure of up to 25% in Alberta. Similarly, in Nova Scotia, the probability of SHS exposure declined by up to 21%. Analyses stratified by smoking status found similar significant effect on both smokers and non-smokers. CONCLUSIONS Findings suggest that provincial patio smoking ban on bars and restaurants had the intended effect of protecting non-smokers from SHS exposure. This study is consistent with a large body of evidence showing that a strong smoke-free legislation is an effective public health measure.
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Affiliation(s)
- Sunday Azagba
- Propel Centre for Population Health Impact, University of Waterloo, Canada; School of Public Health and Health Systems, University of Waterloo, Canada.
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Chaiton M, Schwartz R. Reducing the burden of tobacco: what's the endgame? Isr J Health Policy Res 2014; 3:36. [PMID: 25379170 PMCID: PMC4221701 DOI: 10.1186/2045-4015-3-36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 10/23/2014] [Indexed: 11/10/2022] Open
Abstract
Tobacco use causes a tremendous amount of morbidity and mortality globally, with a staggering level of financial costs. In many countries, public health interventions have been able to reduce the prevalence of smoking and the associated burden. However, despite these successes, there is still much work left to be done. This commentary argues that the tobacco control interventions recommended by the World Health Organization are necessary but not sufficient to adequately address the consequences of tobacco use.
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Affiliation(s)
- Michael Chaiton
- Dalla Lana School of Public Health, University of Toronto, Ontario Tobacco Research Unit, 155 College St, Toronto, Ontario M5T 3M7 Canada
| | - Robert Schwartz
- Dalla Lana School of Public Health, University of Toronto, Ontario Tobacco Research Unit, 155 College St, Toronto, Ontario M5T 3M7 Canada
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