Association of strong smoke-free laws with dentists' advice to quit smoking, 2006-2007

Smoke-free hospitality environments and cognitive health: A population-based study in the United States

Introduction

Cigarette smoking is among the largest risk factors for cognitive decline in later life. This study examines the associations between hospitality smoke-free coverage in the US and the prevalence of self-rated cognitive function decline and disparities therein.

Methods

I use the repeated cross-sectional Behavioral Risk Factor Surveillance data collected between 2017 and 2022 from a sample of Americans 45 years and older and estimate logistic regression models predicting self-rated cognitive function decline by calculated smoke-free hospitality coverage in restaurants and bars.

Results

Fully adjusted models indicate a marginally statistically significant 0.16 percentage point reduction [CI -0.35 to 0.02] in the probability of self-rated cognitive function decline for a 10 % increase in the smoke-free bar coverage. The effect is statistically significant and larger for women, a 0.29 [CI -0.50 to -0.01] percentage point decrease, and for non-smokers, a 0.35 [CI -0.56 to -0.15] percentage point decrease. I do not find a parallel effect of smoke-free restaurant laws and I find no effect of either law on self-rated cognitive function decline-related limitations in daily life for either hospitality law.

Conclusions

The findings suggest that smoke-free bar laws could play a role in preventing cognitive decline among older adults in the United States. Effective public health strategies against cognitive decline should include both targeted and broad-based policy measures.

Cigarette taxes, prices, and disparities in current smoking in the United States

Increasing cigarette taxes has been the cornerstone of tobacco control policy. Recent work has argued that raising cigarette taxes alone may no longer be an effective strategy for lowering smoking rates. We largely confirm these findings but also find that increases in price continue to predict lower smoking participation in most model specifications. We argue that raising cigarette prices via taxation remains an effective public health policy. We discuss the advantages of homogeneous tax environments and minimum price laws for eliminating opportunities for consumers to offset tax increases by searching for lowest taxes.

Impact of a tobacco cessation intervention on adherence to tobacco use treatment guidelines among village health workers in Vietnam

Community health workers (in Vietnam referred to as village health workers) have the potential to play a key role in expanding access to evidence-based tobacco use treatment. We conducted a cluster randomized controlled trial in community health centers in Vietnam that compared the effect of provider advice and cessation assistance (i.e. brief counseling and patient education materials) (BC) vs. BC + three sessions of in-person counseling delivered by a village health worker (BC+R) on providers' and village health workers' adherence to tobacco use treatment guidelines. All village health workers and health care providers received training. This paper presents data on the effect of the intervention on village health workers' adherence to tobacco use treatment guidelines, including asking about tobacco use, advising smokers to quit, offering assistance and their attitude, norms, and self-efficacy related to tobacco use treatment. We examined changes in adherence to tobacco use treatment guidelines before and 12 months after the intervention among 89 village health workers working in the 13 community health centers enrolled in the BC+R study condition. Village health workers' adherence to tobacco use treatment guidelines increased significantly. Village health workers were more likely to ask about tobacco use (3.4% at baseline, 32.6% at 12 months), offer advice to quit (4.5% to 48.3%) and offer assistance (1.1% to 38.2%). Perceived barriers to treating tobacco use decreased significantly. Self-efficacy and attitudes towards treating tobacco use improved significantly. Increased adherence to tobacco use treatment guidelines was associated with positive attitudes towards their role in delivering tobacco use treatment and increasing awareness of the community health center smoke-free policy. The findings suggest that, with training and support systems, village health workers can extend their role to include smoking cessation services. This workforce could represent a sustainable resource for supporting smokers who wish to quit.

Key Factors Inhibiting Legislative Progress Toward Smoke-Free Coverage in Appalachia

The Appalachian Region has among the highest rates of smoking and smoking-related illness in the United States. Strong smoke-free legislation could help protect nonsmoking residents from the harmful effects of secondhand smoke. However, there is a dearth of state, county, city, and subcounty smoke-free law coverage throughout Appalachia. As of July 2016, only 21% of Appalachian residents were covered by comprehensive smoke-free laws (i.e., 100% coverage for workplaces, restaurants, and bars). Only 46% of Appalachians lived in places with 100% smoke-free workplace laws, only 30% lived in places with 100% smoke-free restaurant laws, and only 29% lived in places with 100% smoke-free bar laws. Reasons for this lack of smoke-free law coverage include socioeconomic disadvantage, the historical importance of tobacco in Appalachian economies, and preemptive state legislation. By understanding the contextual issues that have inhibited smoke-free legislation, smoke-free advocates will be better prepared to lead efforts that expand smoke-free coverage in this region.

Tobacco cessation in Vietnam: Exploring the role of village health workers

The purpose of this study was to explore current tobacco use treatment (TUT) practice patterns, and attitudes and beliefs among Village Health Workers (VHWs) about expanding their role to include delivering smoking cessation interventions and the perceived barriers. We conducted a survey of 449 VHWs from 26 communes in Thai Nguyen province, Vietnam. We assessed TUT practice patterns including asking about tobacco use, advising smokers to quit, offering assistance (3As) and attitudes, self-efficacy, and norms related to TUT. Seventy two per cent of VHWs reported asking patients if they use tobacco, 78.6% offered advice to quit, and 41.4% offered cessation assistance to few or more patients in the past month. Self-efficacy was low, with 53.2% agreeing that they did not have the skills to counsel patients about smoking cessation. The most commonly reported barriers to offering TUT were a lack of training and perceived lack of patient interest. Greater awareness of their commune health centre's smoke-free policy and higher levels of self-efficacy were associated with screening and offering cessation assistance. VHWs support an expanded role in tobacco cessation, but require additional resources and training to increase their self-efficacy and skills to provide effective treatment.

Smoke-Free Laws and Hazardous Drinking: A Cross-Sectional Study among U.S. Adults

Tobacco and alcohol use are strongly associated. This cross-sectional study examined the relationship of smoke-free law coverage and smoke-free bar law coverage with hazardous drinking behaviors among a representative sample of U.S. adult drinkers (n = 17,057). We merged 2009 National Health Interview Survey data, American Nonsmokers’ Rights Foundation U.S. Tobacco Control Laws Database, and Census Population Estimates. Hazardous drinking outcomes included heavy drinking (>14 drinks/week for men; >7 drinks/week for women) and binge drinking (≥5 drinks on one or more days during past year). Chi-square tests compared hazardous drinking by sociodemographic factors. Multivariable logistic regression models were used to examine if smoke-free law and bar law coverages were associated with hazardous drinking, controlling for sociodemographics and smoking status. Subset analyses were conducted among drinkers who also smoked (n = 4074) to assess the association between law coverages and hazardous drinking. Among all drinkers, smoke-free law coverage was not associated with heavy drinking (adjusted odds ratio (AOR) = 1.22, 95% confidence interval (CI) = 0.99–1.50) or binge drinking (AOR = 1.09, 95% CI = 0.93–1.26). Smoke-free bar law coverage was also found to be unrelated to hazardous drinking. Similar results were found among those drinkers who smoked. Findings suggest that smoke-free laws and bar laws are not associated with elevated risk for alcohol-related health issues.

Smoking behavior among third year dental students in Latin American countries: prevalence, perceptions, and risk factors

Objetivo. Analizar la asociación entre ciertos factores de riesgo relacionados con el tabaquismo en estudiantes de tercer año de odontología de países latinoamericanos. Material y métodos. Se analizaron los datos de la Encuesta Mundial de Estudiantes de Profesiones de la Salud (GHPSS, por sus siglas en inglés) mediante la aplicación de modelos de regresión logística. Resultados. De los 5 605 encuestados, 33% fumó y 45% estuvo expuesto al humo de segunda mano durante el mes pasado; 34% fumó en los edificios de las escuelas dentales durante el pasado año y 85% nunca recibió entrenamiento formal en cesación de tabaquismo. Ser boliviano, chileno o mexicano; estar expuestos al humo de segunda mano; no auto-percibirse como un “modelo a seguir” para los pacientes; y no creer que un profesional de salud que fuma es menos propenso a aconsejar a sus pacientes para dejar de fumar fueron factores asociados significativamente con el tabaquismo. Conclusiones. Todas las escuelas dentales deben fomentar las políticas contra el consumo de tabaco y ofrecer servicios de cesación de tabaquismo. La formación sobre cesación debe incorporarse a los planes de estudio con el fin de incluir a los profesionales dentales en la batalla contra la epidemia de tabaquismo.

Relationship of Smokefree Laws and Alcohol Use with Light and Intermittent Smoking and Quit Attempts among US Adults and Alcohol Users

Introduction

Light and intermittent smoking (LITS) has become increasingly common. Alcohol drinkers are more likely to smoke. We examined the association of smokefree law and bar law coverage and alcohol use with current smoking, LITS, and smoking quit attempts among US adults and alcohol drinkers.

Methods

Cross-sectional analyses among a population-based sample of US adults (n = 27,731) using restricted data from 2009 National Health Interview Survey and 2009 American Nonsmokers' Rights Foundation United States Tobacco Control Database. Multivariate logistic regression models examined the relationship of smokefree law coverage and drinking frequency (1) with current smoking among all adults; (2) with 4 LITS patterns among current smokers; and (3) with smoking quit attempts among 6 smoking subgroups. Same multivariate analyses were conducted but substituted smokefree bar law coverage for smokefree law coverage to investigate the association between smokefree bar laws and the outcomes. Finally we ran the above analyses among alcohol drinkers (n = 16,961) to examine the relationship of smokefree law (and bar law) coverage and binge drinking with the outcomes. All models controlled for demographics and average cigarette price per pack. The interactions of smokefree law (and bar law) coverage and drinking status was examined.

Results

Stronger smokefree law (and bar law) coverage was associated with lower odds of current smoking among all adults and among drinkers, and had the same effect across all drinking and binge drinking subgroups. Increased drinking frequency and binge drinking were related to higher odds of current smoking. Smokefree law (and bar law) coverage and drinking status were not associated with any LITS measures or smoking quit attempts.

Conclusions

Stronger smokefree laws and bar laws are associated with lower smoking rates across all drinking subgroups, which provides further support for these policies. More strict tobacco control measures might help reduce cigarette consumption and increase quit attempts.