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Precioso J, Alves RF, Samorinha C. Smoking in children's playgrounds: Can we do more to protect our children? Tob Prev Cessat 2024; 10:TPC-10-08. [PMID: 38318122 PMCID: PMC10839959 DOI: 10.18332/tpc/182911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/07/2024]
Affiliation(s)
- José Precioso
- Research Centre on Child Studies (CIEC), Institute of Education, University of Minho, Braga, Portugal
| | - Regina F. Alves
- Research Centre on Child Studies (CIEC), Institute of Education, University of Minho, Braga, Portugal
| | - Catarina Samorinha
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Mortensen ASM, Kolstad HA, Hansen KK. Extent of smoking at a Danish hospital with a smoke-free policy. Scand J Public Health 2024; 52:10-14. [PMID: 36271600 DOI: 10.1177/14034948221119637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM One-fifth of the Danish population smoke and exposure to second-hand smoke has well-documented adverse health effects. The smoking policy at hospital level prohibits hospital staff from smoking on the hospital grounds while patients and visitors may smoke in outdoor smoking cabins. This study aimed to quantify smoking at a Danish hospital and document any policy breaches. METHODS In April 2020, we collected cigarette butts and observed smokers at the outdoor grounds to document smoking behaviour. RESULTS In total, 7152 cigarette butts were collected during one week and 368 people were observed smoking at the outdoor grounds during four observation days. Of all collected cigarette butts, 55% were collected outside the smoking cabins and 62% of all smokers were observed smoking outside the smoking cabins. In addition, 31 staff were observed smoking. CONCLUSIONS This study documents that smoking is prevalent at a smoke-free hospital and that the smoking policy is frequently violated. The frequency of smoking outside the cabins may at least partly be influenced by the COVID-19 pandemic. Smoking at a hospital can expose patients, visitors and staff to second-hand smoke with subsequent adverse health effects. Hospitals could play an exemplary role towards a smoke-free society (and not the exception), but the opportunity is not always seized.
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Affiliation(s)
- Anne-Sofie M Mortensen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Denmark
- Department of Public Health, University of Southern Denmark, Denmark
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Denmark
| | - Karoline K Hansen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Denmark
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Erratum: State of the literature discussing smoke-free policies globally: A narrative review. Tob Induc Dis 2024; 22:TID-22-18. [PMID: 38250633 PMCID: PMC10798222 DOI: 10.18332/tid/178467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
[This corrects the article DOI: 10.18332/tid/174781.].
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Baltacı E, Çarkoğlu A, Saraf S, Ergüder T, Ergör G, Hayran M, Hoe C. Understanding the dynamics of compliance to smoke-free policy regulations: Exploring the perspectives of venue owners and staff in Türkiye. Tob Induc Dis 2024; 22:TID-22-11. [PMID: 38235257 PMCID: PMC10792618 DOI: 10.18332/tid/176226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/21/2023] [Accepted: 12/01/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION The study aims to understand the facilitators and barriers associated with enforcing and complying with Türkiye's smoke-free policy from the perspective of hospitality venue owners and employees. METHODS A qualitative open-ended survey was conducted in Istanbul and Ankara in 2021 with 58 respondents from 3 different districts in each city from four types of venues: restaurants, traditional coffee and waterpipe houses, and European-style cafés. The open-ended survey included questions to understand the knowledge, beliefs, and attitudes of respondents about Türkiye's smoke-free policy and their perceptions of the facilitators and/or barriers to smoke-free policy implementation and changes after COVID-19. The data were analyzed using an inductive approach to identify patterns and categorize the data into themes. RESULTS The respondents expressed that the smoke-free policy aimed to protect employees and customers from secondhand smoke (SHS), respect human health, and improve air quality. Findings suggest that the positive attitude of venue owners and staff toward the smoke-free policy serves as a facilitator. However, fear of financial impact, customers' negative attitudes, difficulties in meeting physical requirements, and insufficient enforcement were found to be barriers to implementing the smoke-free policy. The effects of the COVID-19 pandemic were reported as an initial increase in compliance and awareness among customers and staff, but some respondents noted negative changes due to the emotional and financial effects of prolonged restrictions. These challenges have led to decreased attention on the smoke-free policy among venue owners, staff and customers. Respondents' suggested improvements were related to building infrastructure, such as the ventilation systems and educating the public on the harmful health effects of smoking. CONCLUSIONS Despite the general understanding of the dangers of secondhand smoke and the smoke-free policy, this study highlights the challenges in implementing smoke-free policy measures and the continued need to raise awareness about the importance of a 100% smoke-free venue. A comprehensive approach to addressing the tobacco epidemic as a multifaceted public health issue is essential.
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Affiliation(s)
- Ezgi Baltacı
- Heidelberg Institute of Global Health, Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Aslı Çarkoğlu
- Department of Psychology, Kadir Has University, Istanbul, Türkiye
| | - Sejal Saraf
- Johns Hopkins Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Toker Ergüder
- Special Initiative on NCDs and Innovation (SNI), World Health Organization Country Office, Ankara, Türkiye
| | - Gül Ergör
- School of Public Health, Dokuz Eylül University, Izmir, Türkiye
| | - Mutlu Hayran
- Cancer Institute, Hacettepe University, Ankara, Türkiye
| | - Connie Hoe
- Johns Hopkins Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
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Teed JA, Robichaud MO, Duren M, Gouda HN, Kennedy RD. State of the literature discussing smoke-free policies globally: A narrative review. Tob Induc Dis 2024; 22:TID-22-03. [PMID: 38188939 PMCID: PMC10767724 DOI: 10.18332/tid/174781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 01/09/2024] Open
Abstract
Despite the success of the Framework Convention on Tobacco Control (FCTC), most jurisdictions in the world do not have policies that create 100% smoke-free environments in indoor workplaces, indoor public places, public transport, or other public places. We conducted a narrative review of articles that discuss smoke-free policies and describe the state of the current literature. A search of peer-reviewed and gray literature, published between 1 January 2004 and 30 April 2022, was conducted using PubMed and EMBASE databases. We classified articles based on the location of the policy discussed (WHO region, World Bank income classification) and the environment that was being made smoke-free. Insights related to policy development and implementation, as well as compliance and enforcement, were also identified. The search identified 4469 unique citations; 134 articles met the criteria for inclusion and underwent data extraction by two independent coders. The sample included articles published in or about jurisdictions in each WHO region, in high- and low- and mediumincome countries, and articles that discussed policies regulating smoke-free indoor workplaces, indoor public places, public transport, outdoor/quasi-outdoor environments, and other (unspecified) public places. Some important insights from the literature related to smoke-free policy implementation included tobacco industry interference, the important role of civil society, and the need for effective communication, education, and leadership. Enforcement officials' awareness and training, stakeholders' attitudes and beliefs, and understanding social norms were identified as relevant determinants of effective smoke-free policies. There continue to be challenges for implementing smoke-free policies in jurisdictions throughout the globe, in high- and low- and middle-income countries. The literature includes insights to support 100% smoke-free policies in each environment that must be made smoke-free as per the FCTC.
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Affiliation(s)
- Jacqueline A. Teed
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkings University, Baltimore, United States
| | - Meagan O. Robichaud
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkings University, Baltimore, United States
| | - Michelle Duren
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkings University, Baltimore, United States
| | - Hebe N. Gouda
- Tobacco Free Initiative, World Health Organization, Geneva, Switzerland
| | - Ryan David Kennedy
- Institute for Global Tobacco Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
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Affiliation(s)
- Sydney L. Goldberg
- Northeastern University School of Law, Boston, MA, USA
- Mongan Institute Health Policy Research Center and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, USA
| | - Douglas E. Levy
- Mongan Institute Health Policy Research Center and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Hernández D, Khan FY, Albert D, Giovenco D, Branas C, Valeri L, Navas-Acien A. A Randomized Control Trial to support smoke-free policy compliance in public housing. Res Sq 2023:rs.3.rs-2701542. [PMID: 37131643 PMCID: PMC10153389 DOI: 10.21203/rs.3.rs-2701542/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
• Background Smoke-free housing policies in multiunit housing are increasingly widespread interventions to reduce smoking and secondhand smoke exposure. Little research has identified factors that impede compliance with smoke-free housing policies in low-income multiunit housing and test corresponding solutions. • Methods We are using an experimental design to test two compliance support interventions: (A) a "compliance through reduction (via relocation and reduction in personal smoking) and cessation" intervention targets households with smokers and involves support to shift smoking practices to designated areas, reduce personal smoking, and deliver in-residence smoking cessation support services via trained peer educators and (B) a "compliance through resident endorsement" intervention involving voluntary adoption of smoke-free living environments through personal pledges, visible door markers and/or via social media. We will compare randomly sampled participants in buildings that receive A or B or A plus B to the NYCHA standard approach, • Discussion This RCT addresses key gaps in knowledge and capitalizes on key scientific opportunities by: 1) leveraging the federal mandate to ban smoking in a public housing system of more than sufficient size to conduct an adequately powered RCT; 2) expanding our understanding of smoke-free policy compliance beyond policy implementation by testing two novel treatments: a) in-residence smoking cessation and b) resident endorsement, while 3) addressing population and location-specific tobacco-related disparities. At the conclusion of the study, this RCT will have leveraged a monumental policy shift affecting nearly half a million NYC public housing residents, many of whom disproportionately experience chronic illness and are more likely to smoke and be exposed to secondhand smoke than other city residents. This first-ever RCT will test the effects of much-needed compliance strategies on resident smoking behavior and secondhand smoke exposure in multiunit housing. Trial registration: Clinical Trials Registered, NCT05016505 Registered: August 23, 2021 https://clinicaltrials.gov/ct2/show/NCT05016505.
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Affiliation(s)
| | | | - David Albert
- Columbia University Mailman School of Public Health
| | | | | | - Linda Valeri
- Columbia University Mailman School of Public Health
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Ostrowska A, Pinkas J, Giermaziak W, Wierzba W, Gujski M, Jankowski M. Smoke-free homes in Poland during the COVID-19 pandemic - a nationwide cross-sectional survey. Int J Occup Med Environ Health 2023; 36:84-95. [PMID: 36661866 PMCID: PMC10464779 DOI: 10.13075/ijomeh.1896.02002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/07/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Secondhand smoke exposure causes serious health problems. Banning smoking in public venues decreases exposure to secondhand smoke. However, the implementation of smoke-free rules in a private setting (including homes) is largely voluntary. This study aimed to assess the prevalence and characteristics of voluntary smoke-free home rules in Poland during the COVID-19 pandemic as well as to identify factors associated with the voluntary implementation of smoking bans at home. MATERIAL AND METHODS This cross-sectional survey was conducted in March 2022 with a nationally representative sample of 1090 individuals aged ≥18 years in Poland. Data were collected using a computerassisted web interviewing (CAWI) technique. The research tool was an original questionnaire developed for the purpose of this study. RESULTS Nationally, 60.6% of individuals had total ban on smoking in home (100% smoke-free home rules), 34.0% had implemented a partial smokefree home rule and 5.4% had not implemented any smoke-free home rules. Over three-quarters of non-smokers (76.8%) and only one-fifth of smokers (20.7%) had adopted a full smoke-free home rule. In multivariate logistic regression analysis, males (OR = 1.65, 95% CI: 1.22-2.22, p < 0.01), non-smokers (OR = 13.78, 95% CI: 9.80-19.38, p < 0.001), respondents who had higher education (OR = 1.57, 95% CI: 1.15-2.14, p < 0.01) as well as those who lived alone (OR = 2.44, 95% CI: 1.52-3.90, p < 0.001) had higher odds of having a 100% smoke-free home rule. CONCLUSIONS This study demonstrated the negative impact of the COVID-19 pandemic on the implementation of smoke-free home rules in Poland. Less than two-thirds of the Polish population has adopted a total smoke-free home rule, with significant gaps between smokers and nonsmokers. Information on current voluntary smoke-free rules will be useful for further implementation of the smoke-free law in Poland. Int J Occup Med Environ Health. 2023;36(1):84-95.
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Affiliation(s)
- Aurelia Ostrowska
- Centre of Postgraduate Medical Education, Warsaw, Poland (School of Public Health)
| | - Jarosław Pinkas
- Centre of Postgraduate Medical Education, Warsaw, Poland (School of Public Health)
| | | | - Waldemar Wierzba
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
- University of Humanities and Economics in Łódź, Warsaw, Poland (UHE Satellite Campus in Warsaw)
| | - Mariusz Gujski
- Medical University of Warsaw, Warsaw, Poland (Department of Public Health)
| | - Mateusz Jankowski
- Centre of Postgraduate Medical Education, Warsaw, Poland (School of Public Health)
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Asyary A, Veruswati M. Smoking Behavior and Cigarette Expenditure in a Household: Evidence for Smoke-Free Houses Initiation in Indonesia. Int J Prev Med 2023; 14:7. [PMID: 36942034 PMCID: PMC10023842 DOI: 10.4103/ijpvm.ijpvm_113_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 06/18/2021] [Indexed: 01/26/2023] Open
Abstract
Background The household is considered as a private area that is untouched tobacco control policies in developing countries, especially in Indonesia, which has not ratified the Framework Convention on Tobacco Control (FCTC) treaty. Objectives This study aims to identify smoking behavior and expenditure on cigarettes in the household, which are part of the initiation of a policy including a smoke-free home, so it assumes that the home is a public domain in Tegal Regency, Central Java Province, Indonesia. Methods This research is an observational study with a quantitative descriptive design. A total of 225 subjects in the seven regions designated as smoke-free areas were all selected as samples in this study and were willing to be the subject of research. Results The results found that 76.1% of smokers smoked with their nuclear family (wife/children/husband) present. Smoking behavior with the nuclear family inside the home (39.13%) and outside the home (36.96%) was more common than not smoking with the nuclear family. Expenditure for cigarettes per month was one-third of household revenue (IDR 607,521.74) based on the regency minimum wage (UMR) set by the local government. Conclusions The study concludes that smokers who smoke with family still lack knowledge on smoking's impact on health and household economics. The smoke-free regulation that is initiated should include households as a parameter.
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Affiliation(s)
- Al Asyary
- Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
- Center for Educational and Community Services, Faculty of Public Health, Universitas Indonesia (P3M FKM-UI), Depok, Indonesia
- Address for correspondence: Dr. Al Asyary, Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, C Building 2nd Floor, Kampus FKM-UI, Depok - 16424, Indonesia. E-mail:
| | - Meita Veruswati
- Center for Educational and Community Services, Faculty of Public Health, Universitas Indonesia (P3M FKM-UI), Depok, Indonesia
- PhD Program in Business and Management, Management and Science University (MSU), Selangor Darul Ehsan, Malaysia
- Department of Public Health Science, Faculty of Health Sciences, Universitas Muhammadiyah Prof. Dr. HAMKA (UHAMKA), Jakarta, Indonesia
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Lee B, Fung V, Cheng D, Winickoff JP, Rigotti NA, Shah R, McGlave C, Goldberg S, Song G, Doane J, Kingsley M, Henley P, Ursprung S, Banthin C, Levy DE. Implementation Activities in Smoke-Free Public Housing: The Massachusetts Experience. Int J Environ Res Public Health 2022; 20:78. [PMID: 36612394 PMCID: PMC9819479 DOI: 10.3390/ijerph20010078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
A 2018 rule requiring federally-subsidized public housing authorities (PHAs) in the United States to adopt smoke-free policies (SFPs) has sparked interest in how housing agencies can best implement SFPs. However, to date, there is little quantitative data on the implementation of SFPs in public housing. Massachusetts PHAs were among the pioneers of SFPs in public housing, and many had instituted SFPs voluntarily prior to the federal rule. The aim of this study was to examine the adoption, implementation, and outcomes of SFPs instituted in Massachusetts PHAs prior to 2018 using a survey conducted that year. The survey asked if PHAs had SFPs and, if so, what activities were used to implement them: providing information sessions, offering treatment or referral for smoking cessation, soliciting resident input, training staff, partnering with outside groups, using a toolkit, and/or providing outdoor smoking areas. We used multivariable regression to investigate associations between implementation activities and respondent-reported policy outcomes (resident support, complaints about neighbors' smoking, and the number of violations reported per year). Of 238 Massachusetts PHAs, 218 (91%) completed the survey and 161 had an SFP prior to 2018. Common implementation activities were offering smoking cessation treatment/referral (89%) and information sessions for residents (85%). Information sessions for residents were associated with higher resident support (adjusted odds ratio [AOR] 4.3; 95%CI 1.2-15.3). Training staff (AOR 6.3, 95%CI 1.2-31.8) and engaging in ≥5 implementation activities (AOR 4.1, 95%CI 1.2-14.1) were associated with fewer smoking-related complaints. Utilization of multiple implementation activities, especially ones that informed residents and trained PHA staff, was associated with more favorable policy outcomes. We identified five groups of PHAs that shared distinct patterns of SFP implementation activities. Our findings, documenting implementation activities and their associations with SFP outcomes among the early adopters of SPFs in Massachusetts public housing, can help inform best practices for the future implementation of SFPs in multiunit housing.
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Affiliation(s)
- Boram Lee
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA 02114, USA
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Vicki Fung
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - David Cheng
- Harvard Medical School, Boston, MA 02115, USA
- Biostatistics Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jonathan P. Winickoff
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
- Division of General Academic Pediatrics, Massachusetts General for Children, Boston, MA 02114, USA
| | - Nancy A. Rigotti
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA 02114, USA
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Radhika Shah
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Claire McGlave
- School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Sydney Goldberg
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Glory Song
- Office of Statistics and Evaluation, Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA 02108, USA
| | - Jacqueline Doane
- Massachusetts Tobacco Cessation and Prevention Program, Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA 02108, USA
| | - Melody Kingsley
- Office of Statistics and Evaluation, Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA 02108, USA
| | - Patricia Henley
- Massachusetts Tobacco Cessation and Prevention Program, Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA 02108, USA
| | - Sanouri Ursprung
- Office of Statistics and Evaluation, Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA 02108, USA
| | - Christopher Banthin
- Public Health Advocacy Institute, Northeastern University, Boston, MA 02115, USA
| | - Douglas E. Levy
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA 02114, USA
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
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Valentino G, Ortigoza A, Rodriguez Osiac L, Doberti T, Mullachery P, Nazzal C. Smoking Ban Law in Chile: Impact in Newborns' Birth Weight by Women's Age Groups and by City Population Density. Int J Public Health 2022; 67:1605087. [PMID: 36579137 PMCID: PMC9791390 DOI: 10.3389/ijph.2022.1605087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives: We examined the short-term impact of the Smoking Ban Law (SBL) enacted in Chile in 2013 on low birth weight (LBW) rates in cities and its differential effects by different maternal age groups and city density. Methods: We included 885,880 live births from 21 Chilean cities of ≥100,000 inhabitants. We examined the smoking and LBW prevalence distribution before and after the SBL. Through Poisson mixed effect models, we determined whether a meaningful change in LBW rate occurred after SBL implementation in the whole sample and stratified by city population density and maternal age group. Results: LBW prevalence remained stable before and after the SBL implementation (6.1% and 6.3%, respectively), while women's smoking prevalence had a relative reduction of 25.9% (p < 0.00001). No significant changes in LBW rate occurred after the implementation of SBL in the total sample or stratified by city density tertiles or maternal age groups. Conclusion: SBL implementation did not show short-term impact on LBW rate in Chile. Further studies need to examine long-term impact of SBL on low birthweight.
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Affiliation(s)
- Giovanna Valentino
- Carrera de Nutrición, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,School of Public Health, University of Chile, Santiago, Chile
| | - Ana Ortigoza
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States,*Correspondence: Ana Ortigoza,
| | | | - Tamara Doberti
- School of Public Health, University of Chile, Santiago, Chile
| | - Pricila Mullachery
- Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Carolina Nazzal
- School of Public Health, University of Chile, Santiago, Chile
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Sourry RJ, Hyslop F, Butler TG, Richmond RL. Impact of smoking bans and other smoking cessation interventions in prisons, mental health and substance use treatment settings: A systematic review of the evidence. Drug Alcohol Rev 2022; 41:1528-1542. [PMID: 36097413 DOI: 10.1111/dar.13524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
ISSUES We conducted a systematic review to examine whether smoking bans alone are effective in achieving smoking cessation in people released from prison, and patients discharged from mental health or substance use settings. APPROACH We searched health, criminology and social science databases. Detailed search strings were used to combine terms related to smoking bans and cessation interventions in prison, mental health and substance use treatment settings. We used backward and forward snowballing and manual hand searching to find additional studies. Studies were included if they: were published between 1 January 2000 and 25 February 2022; included a complete smoking ban; measured people released from prison and/or mental health and/or substance use patients smoking post-release/discharge from a smoke-free facility; and reported smoking cessation intervention and/or smoking ban outcomes. Methodological quality was assessed using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies and reviewed by two authors. KEY FINDINGS People released from prison, mental health and substance use in-patients who experience a smoking ban while incarcerated or in in-patient settings often relapse to smoking shortly after release or discharge. We found that although smoking bans alone do not promote cessation, multi-component interventions in combination with smoking bans can significantly increase cessation rates post-release/discharge provided they support participants during this time. CONCLUSIONS There is limited evidence to suggest tobacco bans alone in prison, mental health and substance use treatment settings are effective in achieving long-term smoking cessation. This review suggests that combining smoking bans and cessation interventions including pre- and post-release/discharge support can be effective in achieving smoking cessation.
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Affiliation(s)
| | - Fran Hyslop
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Tony G Butler
- School of Population Health, UNSW Sydney, Sydney, Australia
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Opoczyńska-Świeżewska D, Raciborski F, Samoliński B. Reduction in the prevalence of tobacco use accompanying legislative changes in tobacco policy in Poland in the years 2010-2019. Int J Occup Med Environ Health 2022; 35:393-405. [PMID: 35289337 PMCID: PMC10464804 DOI: 10.13075/ijomeh.1896.01867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 12/22/2021] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES Tobacco use is one of the most serious public health problems. Each year, it contributes to preventable disability and death of 8 million people worldwide. The aim of the study was to determine the change in the prevalence of tobacco and e-cigarettes use among Polish adults in the years 2010-2019 and the potential impact of legislative interventions on tobacco consumption in Poland. MATERIAL AND METHODS The research was based on an analysis of secondary data obtained from a cross-sectional study as part of the public opinion monitoring in Poland. The study was carried out in 2 editions (2010 and 2019) on representative samples of approximately 1000 Polish residents >18 years of age. RESULTS The proportion of traditional cigarette smokers decreased from 30.4% to 26.0% in the years 2010-2019 (p < 0.05). In the male group decreased from 40.3% to 31.0% (p < 0.001); among females, the values remained at the same level (21.3%). The greatest change in the percentage of current smokers was recorded in cities with ≥500 000 inhabitants (from 30.3% to 17.1%) and <100 000 inhabitants (from 31.5% to 24.6%) (p < 0.05). The total support for the new legal regulations increased from 73.9% to 89.8% (p < 0.001). The use of e-cigarettes in 2019 declared only 1.9%. CONCLUSIONS The percentage of adult traditional cigarette smokers decreased significantly between 2010 and 2019 (mainly among men). Among women, the percentage of cigarette smokers remained the same. The most significant declines in cigarette smoking were also observed among residents of the largest cities (≥500 000 inhabitants). During the same period, there was a further increase in the acceptance of legal restrictions on smoking cigarettes in public places. E-cigarette use among adults is a niche phenomenon in Poland, but it is much more prevalent among women than men. Int J Occup Med Environ Health. 2022;35(4):393-405.
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Affiliation(s)
- Dagmara Opoczyńska-Świeżewska
- Medical University of Warsaw, Department of Prevention of Environmental Hazards, Allergology and Immunology, Warsaw, Poland
| | - Filip Raciborski
- Medical University of Warsaw, Department of Prevention of Environmental Hazards, Allergology and Immunology, Warsaw, Poland
| | - Bolesław Samoliński
- Medical University of Warsaw, Department of Prevention of Environmental Hazards, Allergology and Immunology, Warsaw, Poland
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Putra IWGAE, Astuti PAS, Duana IMK, Suarjana IK, Mulyawan KH, Kurniasari NMD, Kurniati NM, Dewi KRA, Bam TS. The implementation of smoke-free workplace policy and the determinants affecting indoor smoking in Indonesia. WHO South East Asia J Public Health 2022; 11:97-101. [PMID: 36861632 DOI: 10.4103/who-seajph.who-seajph_178_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
A smoke-free workplace is important to reduce secondhand smoke exposure, raise awareness, encourage smoking cessation, and increase productivity. This study aimed to assess indoor smoking in the workplace as part of a smoke-free policy implementation and the factors associated. This was a cross-sectional study at workplaces in Indonesia from October 2019 to January 2020. The workplaces were divided into private workplaces owned by a company for business and government workplaces that run for public services. Samples were selected using stratified random sampling. Data collection follows time and area observation guidelines, starting in the indoor area and then outdoor. The observation was conducted for at least 20 min for each workplace in 41 districts/cities. Of the 2900 observed workplaces, 1097 (37.8%) were private and 1803 (62.92%) were government workplaces. The proportion of indoor smoking at government workplaces was 34.7%, higher compared to private (14.4%). The results were consistent for each indicator such as people smoking (14.7% vs. 4.5%), electronic cigarette use (0.7% vs. 0.4%), cigarette butts presence (25.8% vs. 9.5%), and smell of cigarette smoke (23.0% vs. 8.6%). The factors associated with indoor smoking were indoor ashtray availability (adjusted odds ratio [AOR] =13.7; 95% confidence interval [CI]: 10.6-17.5), indoor designated smoking area (AOR = 2.4; 95% CI: 1.4-4.0), presence of indoor tobacco advertising, promotion and sponsorships (AOR: 3.3; 95% CI: 1.3-8.89), whereas the presence of no smoking sign was a preventive factor (AOR = 0.6; 95% CI: 0.5-0.8). Indoor smoking remains high, particularly in government workplaces in Indonesia.
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Affiliation(s)
- I Wayan Gede Artawan Eka Putra
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas, Udayana; Department of Research, Udayana Center for NCDs, Tobacco Control, Tuberculosis and Lung Health (Udayana Central), Bali, Indonesia
| | - Putu Ayu Swandewi Astuti
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas, Udayana; Department of Research, Udayana Center for NCDs, Tobacco Control, Tuberculosis and Lung Health (Udayana Central), Bali, Indonesia
| | - I Made Kerta Duana
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas, Udayana; Department of Research, Udayana Center for NCDs, Tobacco Control, Tuberculosis and Lung Health (Udayana Central), Bali, Indonesia
| | - I Ketut Suarjana
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas, Udayana; Department of Research, Udayana Center for NCDs, Tobacco Control, Tuberculosis and Lung Health (Udayana Central), Bali, Indonesia
| | - Ketut Hari Mulyawan
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas, Udayana; Department of Research, Udayana Center for NCDs, Tobacco Control, Tuberculosis and Lung Health (Udayana Central), Bali, Indonesia
| | - Ni Made Dian Kurniasari
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas, Udayana; Department of Research, Udayana Center for NCDs, Tobacco Control, Tuberculosis and Lung Health (Udayana Central), Bali, Indonesia
| | - Ni Made Kurniati
- Department of Research, Udayana Center for NCDs, Tobacco Control, Tuberculosis and Lung Health (Udayana Central), Bali, Indonesia
| | - Kadek Rosi Arista Dewi
- Department of Research, Udayana Center for NCDs, Tobacco Control, Tuberculosis and Lung Health (Udayana Central), Bali, Indonesia
| | - Tara Singh Bam
- International Union Against Tuberculosis and Lung Disease (The Union), Asia Pacific Office, Singapore
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Lui CK, Mulia N, Ye Y, Patterson D, Trieu SL. School and Community Factors Associated With the Adoption of 100% Smoke-free Policy by California Community Colleges, 2003-2019. Am J Health Promot 2022; 36:869-875. [PMID: 35081765 DOI: 10.1177/08901171211073732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Smoke- and tobacco-free policy (SFP) is an effective strategy that can reduce tobacco-related health disparities among young adults. DESIGN Longitudinal design using administrative, survey, policy data sources, and geocoded tobacco outlet and American Community Survey data. SETTING California community colleges (CC) and cities/communities where colleges are located, 2003-2019. SAMPLE 114 California CCs. DATA School-level (i.e., student population and demographics) and community-level data (socio-demographics, local tobacco control policy, tobacco-related norms and availability, and health resources) from 2003 to 2019. MEASURES Key outcome is the year CC adopted a 100% SFP. ANALYSIS Bivariate and multivariate Cox survival models were used to analyze timing of SFP adoption. RESULTS By 2019, 61 out of 114 (53.5%) CCs were 100% SFP. While community smoking prevalence and tobacco availability were not significant, CCs in rural areas were less likely to be smoke-free. CCs located in cities with stronger tobacco policies (hazard ratio (HR) = 1.08, P < .05), which reported higher student health fees (HR = 2.00, P < .05) and received technical assistance for SFP (HR = 4.59, P < .01) were significantly associated with having 100% SFP. CONCLUSION Findings suggest that key community factors (strong city tobacco policies) and school and community resources (student health fees, SFP technical assistance) are associated with the presence of 100% SFP at CCs. Resources from the community or within a college might support remaining CCs in becoming 100% smoke-free.
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Affiliation(s)
- Camillia K Lui
- 1665Alcohol Research Group at Public Health Institute, Emeryville, CA, USA
| | - Nina Mulia
- 1665Alcohol Research Group at Public Health Institute, Emeryville, CA, USA
| | - Yu Ye
- 1665Alcohol Research Group at Public Health Institute, Emeryville, CA, USA
| | - Deidre Patterson
- 1665Alcohol Research Group at Public Health Institute, Emeryville, CA, USA
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Rayens MK, McGeeney T, Wiggins AT, Bucher A, Ickes M, Huntington-Moskos L, Clark P, Hahn EJ. Smoke-free Ordinances and Youth Tobacco Use in Kentucky. Am J Health Promot 2022; 36:673-677. [PMID: 35081759 DOI: 10.1177/08901171211066913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE Determine associations of strength of local smoke-free laws and urban/rural location with cigarette and smokeless tobacco use among high school students in grades 10 and 12. DESIGN Secondary data analysis from the 2004-2018 biennial Kentucky Incentives for Prevention Survey. SETTING Public high schools in Kentucky. SAMPLE N = 353502 10th/12th graders. MEASURES County-level smoke-free law status from the Kentucky Center for Smoke-free Policy; Rural Urban Continuum Codes; self-reported last 30-day alcohol, marijuana, cigarette, and smokeless tobacco use. ANALYSIS Generalized estimating equations modeling assessed the association of law status and urban/rural location with tobacco use across cohorts, controlling for demographics and other substance use. RESULTS Students in counties with a comprehensive smoke-free law were 23% less likely to smoke cigarettes and 16% less likely to use smokeless, compared to those in counties without a law. Students in counties with moderate/weak laws did not differ in likelihood of use for either product, compared to those in counties without a law. Students in urban counties were 14% less likely to smoke, but there was no difference in likelihood of smokeless use by urban/rural location. CONCLUSION Comprehensive smoke-free laws are associated with a lower likelihood of youth cigarette and smokeless use. Rural youth may be at increased risk of cigarette smoking relative to youth in urban areas.
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Affiliation(s)
- Mary Kay Rayens
- University of Kentucky Colleges of Nursing and Public Health, Lexington, KY, USA
| | | | - Amanda T Wiggins
- Ringgold ID: 4530University of Kentucky College of Nursing, Lexington, KY, USA
| | - Amanda Bucher
- Ringgold ID: 4530University of Kentucky College of Nursing, Lexington, KY, USA
| | - Melinda Ickes
- Ringgold ID: 5170University of Kentucky College of Education, Lexington, KY, USA
| | | | - Patti Clark
- Kentucky Cabinet for Health and Family Services, Frankfort, KY, USA
| | - Ellen J Hahn
- University of Kentucky Colleges of Nursing and Public Health, Lexington, KY, USA
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Nasution F, Gurning FP, Siregar PA, Ahsan A, Kusuma D. Implementation of the Smoke-Free Policy in Medan City, Indonesia: Compliance and Challenges. Int J Prev Med 2022; 13:30. [PMID: 35392310 PMCID: PMC8980832 DOI: 10.4103/ijpvm.ijpvm_106_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/26/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Indonesia has an estimated 61.4 million current smokers, and the smoking prevalence among adults is persistently high while that among youth is increasing. In 2014, Medan city enacted the smoke-free policy (SFP) to protect community members against the adverse effects of smoking. Our study examines the implementation of SFP in terms of compliance and challenges. Methods: We conducted a mixed-methods study. Quantitative analyses examined the compliance with six criteria including having signage, no active smoking, no selling, no advertisement, no smoke, and no ashtray at SFP facilities. They included health facilities, educational facilities, places of worship, workplaces, and indoor/outdoor public facilities. The qualitative analysis examined the challenges through in-depth interviews of six key informants. Results: We found the overall compliance of 44%, ranging from 0% at outdoor public facilities to 83% at health facilities. We found relatively higher compliance among facilities within 1-km from the provincial and city health offices compared to those outside of the buffer (but not significant at 5% level, P = 0.070). The challenges identified were lack of budget, monitoring, enforcement, and sensitization. Conclusions: The implementation of SFP in Medan city still has lower compliance and faces many challenges.
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Affiliation(s)
- Fauziah Nasution
- Faculty of Public Health, Universitas Islam Negeri Sumatera Utara, Medan, Indonesia
| | | | | | - Abdillah Ahsan
- Faculty of Economics and Business, University of Indonesia, Depok, Indonesia
| | - Dian Kusuma
- Centre for Health Economics & Policy Innovation, Imperial College Business School, London, UK
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Badanapurkar A, Nelson D, Varghese S, Singh R, Haddad PM. Support and attitudes of Qatar mental health professionals to a proposed mental health inpatient smoking ban: Results of a cross-sectional survey. J Psychiatr Ment Health Nurs 2022; 29:327-345. [PMID: 34143910 DOI: 10.1111/jpm.12777] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Smoking is more common among people with serious mental illness, and it contributes to a reduced life expectancy. Several Western countries have successfully introduced smoke-free policies in inpatient mental health units. There is virtually no information about attitudes to smoking bans in mental health units from countries in the Middle East and North Africa region. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We surveyed mental health professionals working in Qatar's main mental health service to determine support for and attitudes towards a proposed total smoking ban in psychiatric wards. Most staff who completed the survey supported an inpatient smoking ban. However, further analysis, both quantitative and qualitative, showed markedly ambivalent attitudes, that is staff simultaneously held attitudes that supported and opposed a smoking ban. Professionals who did not support a ban were more likely to have not received smoking cessation training in the last 5 years, to be a psychiatrist rather than a nurse or allied mental health professional, to be current smokers and to be a Middle Eastern and North African national. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further staff training is necessary to achieve more consistent attitudes that support a total smoking ban and increase the likelihood of successful implementation. The attitudes in this study showed similarities and differences to those reported for mental health professionals in Western countries. This highlights that local research is necessary to help shape training and successfully implement smoke-free policies. ABSTRACT: Introduction Despite the fact that patients with serious mental illness (SMI) have high rates of smoking and an increased standardized mortality, there is virtually no information about attitudes to smoking bans in mental health units from countries in the Middle East and North Africa region. Aim To assess support for, and attitudes towards, a proposed total smoking ban in psychiatric wards among mental health clinicians in Qatar. Method Cross-sectional survey of mental health professionals working in Qatar's primary mental health service. Results The response rate was 68% (353/520). Support for a ban was assessed with a single-item question; 73% of respondents supported a ban with opposition significantly (p < .05) associated with being a current smoker, a Middle Eastern and North African (MENA) national, a psychiatrist versus a mental health nurse or allied health professional and not receiving smoking cessation training in the last 5 years. A 21-item questionnaire assessed attitudes to a total smoking ban. It showed marked ambivalence with multiple linear regression identifying MENA nationality, male gender and current smoking status as independent variables influencing attitudes. The most strongly held attitude supporting a ban was concern about passive smoking and against a ban was concern it may increase patient agitation. Qualitative data confirmed ambivalent views. Discussion The results show similarities and differences to research from other countries suggesting that cultural factors influence some attitudes to smoke-free policies. Implications for Practice Staff support and smoking cessation education are necessary to achieve more consistent staff attitudes to support smoke-free policies.
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Affiliation(s)
| | - Deborah Nelson
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar.,Curtin University, Perth, WA, Australia
| | - Sejo Varghese
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar
| | - Rajvir Singh
- Acute Care Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Peter M Haddad
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar.,College of Medicine, Qatar University, Doha, Qatar.,University of Manchester, Manchester, UK
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Prabandari YS, Bintoro BS, Purwanta P. A Comprehensive Tobacco Control Policy Program in a Mining Industry in Indonesia: Did It Work? Front Public Health 2022; 10:853862. [PMID: 35400041 PMCID: PMC8987008 DOI: 10.3389/fpubh.2022.853862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/21/2022] [Indexed: 11/22/2022] Open
Abstract
Background Risk factor controls, including smoking cessation and prevention, impact health costs. This study aimed to describe the Kaltim Prima Coal (KPC), one of Indonesia's largest coal mining operations, comprehensive tobacco control policy program in 2015 and its impact on smoking behavior among the employees. Method A survey among 404 employees was conducted to assess the impact of the smoke-free KPC programs. In addition to the descriptive analysis, logistic regression was used to measure the association of intention to the smoking behavior change and the association between intention and the determinants using the Theory of Planned Behavior in 102 smokers. Results A series of tobacco control programs: advocacy, health education, brief interventions for smoking cessation, peer counselor training, media campaigns, and policy regulations were implemented. About 95.5% of the respondents attended the KPC Smoke-Free 2015 programs, and 97.8% reported they already knew that KPC is a total smoke-free area. Nearly 50% of the respondents expressed that the staff complied with the rules and no longer smoked in KPC. Majority of smokers (76.6%) reduced their consumption, and 5.6% of them quit smoking. Among smokers, we found that attitude toward smoking cessation, subjective norm, and perceived control for quitting were related to the intention to stop smoking. Conclusions The KPC smoke-free policy has been comprehensively implemented. Regulations on smoking and tobacco controls should be maintained, and monitoring should be consistently done. Media campaigns on the regulations and the availability of trained peer educators for smoking cessation help need to be applied continuously.
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Affiliation(s)
- Yayi S. Prabandari
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behavior and Promotion, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bagas S. Bintoro
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behavior and Promotion, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Purwanta Purwanta
- Department of Mental Health and Community Health Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Lee EH, Shin SH, Jeong GC. Smoking Awareness and Intention to Quit Smoking in Smoking Female Workers: Secondary Data Analysis. Int J Environ Res Public Health 2022; 19:ijerph19052841. [PMID: 35270534 PMCID: PMC8910725 DOI: 10.3390/ijerph19052841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/17/2022] [Accepted: 02/20/2022] [Indexed: 11/16/2022]
Abstract
Although the smoking rate among women has been continuously increasing recently, it is very difficult to explore the actual situation because of negative social views. This study aimed to analyze the effects of smoking awareness and living environment on the intention to quit smoking among female smokers. After receiving approval from the Research Ethics Committee in September 2021, secondary data analysis was performed for this study. A total of 378 working women who smoked were included in this study. The mean age was 34.4 years. The results showed that women living alone had significantly lower intentions to quit smoking, and women with experience in smoking cessation education had significantly higher intentions to quit smoking. In addition, it was found that the group having awareness of smoking cessation policy and smoking cessation treatment had high intention to quit smoking. As a result of the analysis of decision trees using data mining techniques, the strongest predictor of the intention of female workers who smoke to quit smoking was their perception of smoking cessation policies. In addition, it was found that the state’s policy support was important in that the group with the highest intention to quit smoking was the one with high awareness of both the smoking cessation policy and smoking cessation treatment. Finally, the risk group with the lowest intention to quit smoking was the group with low awareness of the anti-smoking policy, living alone, and having low awareness of the harmfulness of cigarettes. The importance of establishing policies for this vulnerable group, smoking cessation policies and treatment of female smokers, and improving awareness of the harmful effects of tobacco are discussed.
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Affiliation(s)
- Eun-Hye Lee
- Nursing Department, College of Nursing, Sahmyook University, Seoul 01795, Korea; (E.-H.L.); (S.-H.S.)
| | - Sun-Hwa Shin
- Nursing Department, College of Nursing, Sahmyook University, Seoul 01795, Korea; (E.-H.L.); (S.-H.S.)
| | - Goo-Churl Jeong
- Department of Counseling Psychology, Sahmyook University, Seoul 01795, Korea
- Correspondence: ; Tel.: +82-2-3399-1678
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de Oliveira RM, Santos JLF, Furegato ARF. Hospital indicators and inpatient behavior in a psychiatric hospital that implemented the smoking ban. Rev Lat Am Enfermagem 2022; 30:e3611. [PMID: 35920539 PMCID: PMC9342906 DOI: 10.1590/1518-8345.5666.3611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/11/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to compare hospitalization and discharge indicators, medication costs and patient behavior before and after the implementation of the smoking ban in a psychiatric hospital. METHOD ecological, longitudinal and retrospective study carried out in a psychiatric hospital. Secondary data referring to 2142 hospitalizations were collected from medical records. The median test was used to compare the variables before and after the ban. RESULTS after the implementation of the ban, there was a reduction in bed occupancy rate in male units for mental disorders (from 88.8% to 48.4%) and substance dependence (from 94.4% to 42.8%). There was a reduction in the mean length of hospital stay in the male chemical dependency unit (from 13.5 to 12.6) compared to the female unit (from 14.7 to 19.5). There was a reduction in costs of psychotropic drugs and expectorants, episodes of verbal/physical aggressions and physical/chemical restraints. CONCLUSION the smoking ban changed hospital indicators, reduced costs and improved patient behavior, contradicting the myth that it results in hostility. It is hoped that this study will help nurses to review their beliefs related to smoking cessation, as there were positive results for interpersonal relationships and for the management of mental health services.
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Affiliation(s)
| | | | - Antônia Regina Ferreira Furegato
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
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Dai S, Au CT, Chan MHM, Kam RKT, Li AM, Chan KCC. Parental Knowledge, Attitude, and Practice on Tobacco Use, Smoking Cessation, and Children's Environmental Tobacco Smoke Exposure. Front Public Health 2021; 9:733667. [PMID: 34900892 PMCID: PMC8653904 DOI: 10.3389/fpubh.2021.733667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Environmental tobacco smoke (ETS) exposure in children ranks one of the major public health problems in our time. Poor parental knowledge, attitude, and practice (KAP) on ETS often contribute to worse exposure of the kids. Thus, we aimed to document parental KAP regarding tobacco use, smoking cessation and children's ETS exposure, and to analyse how knowledge and attitude relate to practice. Methods: Self-administered KAP questionnaires were distributed to smoking parents recruited from the pediatric unit at the Prince of Wales Hospital, which provides pediatric service to a population of 1.2 million in Hong Kong. The 60-item questionnaire had a range of 0–38 for knowledge, 0–44 for attitude, and 0–40 for practice. Descriptive analyses were performed for KAP response, regression analyses were performed for the exploration of associations and identification of predictive indicators. Results: 145 smoking parents (mean age: 38.0 ± 6.7 yrs.; male: 85.5%) were included. Less than half (39.3%) of them reported a smoke-free policy at home. Among those parents who had private cars, less than half (45.2%) of them had smoke-free policy in their car that they never smoked in the car. Only 25.5% of the participants correctly answered ≥70% of the knowledge questions, and 11.8 % of the participants gave favorable responses to ≥70% of the attitude questions. The total knowledge and the total attitudes score were positively associated (r = 0.49, 95% CI: 0.35–0.79, p < 0.001), yet they were only modestly correlated with parental practice on children's ETS exposure. By multivariate regressions, potential predictive factors for more favorable parental KAP included higher household income, lower parental nicotine dependence level and breastfeeding practice. Conclusions: Parental KAP related to tobacco use and children's ETS exposure needs improvement to address the significant gap between recommended and actual practice. The weak association between knowledge and practice suggested that parental education alone is not adequate to combat ETS exposure in children.
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Affiliation(s)
- Siyu Dai
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China
| | - Chun Ting Au
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | | | | | - Albert Martin Li
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kate Ching-Ching Chan
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Bakhturidze G, Peikrishvili N, Gvinianidze K. Impact of comprehensive smoke-free policy compliance on SHS exposure and health condition of the Georgian population. Tob Prev Cessat 2021; 7:70. [PMID: 34901565 PMCID: PMC8619785 DOI: 10.18332/tpc/143329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Georgia made steps forward in 2017 and adopted new amendments to its tobacco control legislation, which mostly correspond to the FCTC requirements. Among other changes in the regulations is a ban on smoking in public buildings and public transport, with a few exemptions (casinos, big slot clubs, performances in theatres, taxis). The regulation entered into force on 1 May 2018. METHODS The aim of the study is to assess the outcomes of the comprehensive smoke-free legislation in Georgia. We used a logical model for data collection and analysis. Our evaluation focuses on smoking prevalence related survey data, SHS exposure, monitoring results on compliance of new tobacco control regulations, Quitline data, and air quality measurement results. RESULTS The indoor air quality improved by 91% in the hospitality sector (from 1408 to 126 μg/m3 in 2018 and 117 μg/m3 in 2019), by 80% in public settings (from 531 to 112 μg/m3 in 2018 and 98 μg/m3 in 2019) and sufficiently in healthcare facilities (from 219 to 97-98 μg/m3 in 2018-2019). Demand for Quitline services increased by 30%. New cases of AMI declined by 32% during 2017-2019. CONCLUSIONS A comprehensive smoke-free policy with a high level of compliance (≥95%) had a positive impact on the decline of SHS exposure and tremendous improvement of indoor air quality in public places and promotes a decrease in illnesses related to the cardiovascular system in Georgia. Also, demand increased for smoking-cessation services.
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Affiliation(s)
- George Bakhturidze
- Framework Convention on Tobacco Control Implementation and Monitoring Center, Tbilisi, Georgia
| | - Nana Peikrishvili
- Framework Convention on Tobacco Control Implementation and Monitoring Center, Tbilisi, Georgia
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Jiang N, Gill E, Thorpe LE, Rogers ES, de Leon C, Anastasiou E, Kaplan SA, Shelley D. Implementing the Federal Smoke-Free Public Housing Policy in New York City: Understanding Challenges and Opportunities for Improving Policy Impact. Int J Environ Res Public Health 2021; 18:12565. [PMID: 34886292 DOI: 10.3390/ijerph182312565] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022]
Abstract
In 2018, the U.S. Department of Housing and Urban Development required public housing authorities to implement a smoke-free housing (SFH) policy that included individual apartments. We analyzed the policy implementation process in the New York City Public Housing Authority (NYCHA). From June-November 2019, we conducted 9 focus groups with 64 NYCHA residents (smokers and nonsmokers), 8 key informant interviews with NYCHA staff and resident association leaders, and repeated surveys with a cohort of 130 nonsmoking households pre- and 12-month post policy. One year post policy implementation, participants reported widespread smoking violations and multi-level factors impeding policy implementation. These included the shared belief among residents and staff that the policy overreached by "telling people what to do in their own apartments". This hindered compliance and enforcement efforts. Inconsistent enforcement of illegal marijuana use, staff smoking violations, and a lack of accountability for other pressing housing issues created the perception that smokers were being unfairly targeted, as did the lack of smoking cessation resources. Resident support for the policy remained unchanged but satisfaction with enforcement declined (60.1% vs. 48.8%, p = 0.047). We identified multilevel contextual factors that are influencing SFH policy implementation. Findings can inform the design of strategies to optimize policy implementation.
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Asyary A, Veruswati M, Sagala OHS, Saktiansyah OA, Susanna D, Moshammer H. Support of the Implementation of a Whistleblowing System for Smoke-Free Environments: A Mixed Methods Approach. Int J Environ Res Public Health 2021; 18:12401. [PMID: 34886128 DOI: 10.3390/ijerph182312401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/10/2021] [Accepted: 11/22/2021] [Indexed: 11/26/2022]
Abstract
Enforcement of a smoke-free policy is of vital concern in support of the health of smokers and bystanders. Indonesia has issued a smoke-free law, but implementation and enforcement lie with the regional and municipal governments. In a survey of 225 respondents recruited via schools, knowledge about the health effects of smoking and the smoke-free regulation, as well as attitudes towards and commitment and support of the enforcement of the smoke-free regulation in the Kendari City through an electronic whistleblowing system was examined. Furthermore, the participants were asked about the smoking status and smoking behavior. About half of the respondents were students (teenagers), the other half—their parents. Male respondents were strongly overrepresented (85%). Only 18% of the respondents declared to be smokers, mostly adults and males. Both the smokers and the non-smokers supported the smoke-free law and its enforcement through a whistleblowing system. Representatives of the local government were interviewed and participated in focus group discussions. In general, they also exhibited strong support of an electronic enforcement tool. However, issues of efficiency, costs, and responsibility must still be resolved. Nevertheless, an electronic whistleblowing system has the potential to further the health and livelihoods in a community like the Kendari City.
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Boderie NW, Breunis LJ, Biney I, Borsboom J, Ter Braake JG, Koolen L, de Kroon MLA, Been JV. Smokers' responses to being addressed when smoking in an outdoor voluntary smoke-free zone: An observational study. Tob Prev Cessat 2021; 7:65. [PMID: 34722954 PMCID: PMC8527402 DOI: 10.18332/tpc/142498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Addressing smokers who smoke in a voluntary smoke-free area is vital to its successful implementation. Many people perceive barriers in addressing smokers due to fear of negative responses. Insights in actual responses are currently lacking. METHODS This is an observational field study at the voluntary smoke-free zone surrounding the Erasmus MC and two schools in Rotterdam, the Netherlands. In the first month after implementing the zone, Erasmus MC representatives performed rounds to address smokers who were smoking inside the zone. Four people observed addressors for two weeks then they also addressed the smokers. Smokers were classified as employees, patients, students, or other. We noted whether smokers were addressed directly or indirectly, and their verbal and behavioral responses to being addressed. Differences between the responses of the groups were assessed using chi-squared tests. RESULTS In all, 331 smokers were observed of whom 73% were addressed directly. Most verbal reactions were positive (46%) or neutral (18%). Employees were more likely to respond guiltily, whereas patients more often responded angrily than the others. After being addressed, the majority of smokers either extinguished their cigarette (41%) or left to continue smoking outside the smoke-free zone (34%). CONCLUSIONS Most smokers showed a positive or neutral response when being addressed about smoking inside the smoke-free zone and the majority adapted their behavior to comply with the policy. These findings may help decrease barriers for those in doubt about addressing smokers that fail to comply with a smoke-free policy.
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Affiliation(s)
- Nienke W Boderie
- Department of Public Health, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Leonieke J Breunis
- Department of Obstetrics and Gynecology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Isabella Biney
- Department of Public Health, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Obstetrics and Gynecology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jodie Borsboom
- Department of Public Health, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Obstetrics and Gynecology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jonne G Ter Braake
- Department of Public Health, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Obstetrics and Gynecology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Laura Koolen
- Department of Public Health, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Obstetrics and Gynecology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Marlou L A de Kroon
- Department of Obstetrics and Gynecology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Health Sciences, University of Groningen Medical Center, Groningen, Netherlands
| | - Jasper V Been
- Department of Public Health, Erasmus MC, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Obstetrics and Gynecology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, Netherlands
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Shoesmith E, Huddlestone L, Lorencatto F, Shahab L, Gilbody S, Ratschen E. Supporting smoking cessation and preventing relapse following a stay in a smoke-free setting: a meta-analysis and investigation of effective behaviour change techniques. Addiction 2021; 116:2978-2994. [PMID: 33620737 DOI: 10.1111/add.15452] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/16/2020] [Accepted: 02/10/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Admission to a smoke-free setting presents a unique opportunity to encourage smokers to quit. However, risk of relapse post-discharge is high, and little is known about effective strategies to support smoking cessation following discharge. We aimed to identify interventions that maintain abstinence following a smoke-free stay and determine their effectiveness, as well as the probable effectiveness of behaviour change techniques (BCTs) used in these interventions. METHODS Systematic review and meta-analyses of studies of adult smokers aged ≥ 18 years who were temporarily or fully abstinent from smoking to comply with institutional smoke-free policies. Institutions included prison, inpatient mental health, substance misuse or acute hospital settings. A Mantel-Haenszel random-effects meta-analysis of randomized controlled trials (RCTs) was conducted using biochemically verified abstinence (7-day point prevalence or continuous abstinence). BCTs were defined as 'promising' in terms of probable effectiveness (if BCT was present in two or more long-term effective interventions) and feasibility (if BCT was also delivered in ≥ 25% of all interventions). RESULTS Thirty-seven studies (intervention n = 9041, control n = 6195) were included: 23 RCTs (intervention n = 6593, control n = 5801); three non-randomized trials (intervention n = 845, control n = 394) and 11 cohort studies (n = 1603). Meta-analysis of biochemically verified abstinence at longest follow-up (4 weeks-18 months) found an overall effect in favour of intervention [risk ratio (RR) = 1.27, 95% confidence interval (CI) = 1.08-1.49, I2 = 42%]. Nine BCTs (including 'pharmacological support', 'goal-setting (behaviour)' and 'social support') were characterized as 'promising' in terms of probable effectiveness and feasibility. CONCLUSIONS A systematic review and meta-analyses indicate that behavioural and pharmacological support is effective in maintaining smoking abstinence following a stay in a smoke-free institution. Several behaviour change techniques may help to maintain smoking abstinence up to 18 months post-discharge.
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Affiliation(s)
- Emily Shoesmith
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Lisa Huddlestone
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | | | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Elena Ratschen
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
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Horn K, Johnson SB, Patiño SRG, Krost K, Gray T, Dearfield C, Du C, Bernat D. Implementation of the Department of Housing and Urban Development's Smoke-Free Rule: A Socio-Ecological Qualitative Assessment of Administrator and Resident Perceptions. Int J Environ Res Public Health 2021; 18:8908. [PMID: 34501498 PMCID: PMC8431491 DOI: 10.3390/ijerph18178908] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/19/2021] [Accepted: 08/21/2021] [Indexed: 11/26/2022]
Abstract
In July 2018, the United States Department of Housing and Urban Development (HUD) implemented a mandatory smoke-free rule in public housing. This study assessed administrator and resident perceptions of rule implementation during its initial year in the District of Columbia Housing Authority (DCHA). Assessment included nine focus groups (n = 69) with residents and in-depth interviews with administrators (n = 7) and residents (n = 26) from 14 DCHA communities (family = 7 and senior/disabled = 7). Semi-structured discussion guides based on the multi-level socio-ecological framework captured dialogue that was recorded, transcribed verbatim, and coded inductively. Emerging major themes for each socio-ecological framework level included: (1) Individual: the rule was supported due to perceived health benefits, with stronger support among non-smokers; (2) Interpersonal: limiting secondhand smoke exposure was perceived as a positive for vulnerable residents; (3) Organizational: communication, signage, and cessation support was perceived as a need; (4) Community: residents perceived mobility, disability, weather, and safety-related issues as barriers; and (5) Public Policy: lease amendments were perceived as enablers of rule implementation but expressed confusion about violations and enforcement. A majority of administrators and residents reported favorable implications of the mandated HUD rule. The novel application of a socio-ecological framework, however, detected implementation nuances that required improvements on multiple levels, including more signage, cessation support, clarification of enforcement roles, and addressing safety concerns.
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Affiliation(s)
- Kimberly Horn
- Department of Population Health Sciences, Virginia Tech Carilion Research Institute, Riverside Circle, Roanoke, VA 24016, USA
| | - Sallie Beth Johnson
- Department of Public Health and Healthcare Leadership, Radford University Carilion, 101 Elm Avenue, SE, Roanoke, VA 24013, USA;
| | | | - Kevin Krost
- Department of Leadership, Counseling, and Research, Virginia Tech, Blacksburg, VA 24060, USA; (K.K.); (C.D.)
| | - Tiffany Gray
- Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, 905 New Hampshire Avenue, Northwest, Washington, DC 20052, USA; (T.G.); (C.D.); (D.B.)
| | - Craig Dearfield
- Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, 905 New Hampshire Avenue, Northwest, Washington, DC 20052, USA; (T.G.); (C.D.); (D.B.)
| | - Chenguang Du
- Department of Leadership, Counseling, and Research, Virginia Tech, Blacksburg, VA 24060, USA; (K.K.); (C.D.)
| | - Debra Bernat
- Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, 905 New Hampshire Avenue, Northwest, Washington, DC 20052, USA; (T.G.); (C.D.); (D.B.)
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Yau MTK, Okoli CTC. Associations of tobacco use and consumption with rurality among patients with psychiatric disorders: Does smoke-free policy matter? J Rural Health 2021; 38:364-372. [PMID: 34339080 DOI: 10.1111/jrh.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE People with psychiatric disorders (PDs) have high risks for tobacco use and associated health effects; however, little is known about differences in tobacco use status and consumption by urban or rural residence. Among patients with PDs, we examined the association of smoke-free policy on tobacco use by rural/urban residence METHOD: A cross-sectional retrospective study (N = 2060) among patients in a psychiatric facility was conducted. Multi-logistic and multilinear regression analyses assessed differences in outcomes stratified by rural/urban status. RESULTS Among rural residents, a substance use history (odds ratios [ORs[ = 2.82, 95% CI: 2.01-3.96), high school education (OR = 0.71, 95% CI: 0.51-0.98), older age (OR = 0.99, 95% CI: 0.98-1.00), and longer length of hospital stay (OR = 0.99, 95% CI: 0.98-1.00) were associated with tobacco use. Among urban residents, male sex (OR = 1.38, 95% CI: 1.02-1.86), a substance use history (OR = 2.61, 95% CI: 1.86-3.66), and externalizing disorder diagnosis (OR = 2.72, 95% CI: 1.35-5.48) correlated with tobacco use. Increased tobacco consumption among rural residents was associated with being male (β = 0.12, p = 0.007) and having less than a high school education (β = 0.14, P = 0.001). Whereas, White ethnicity (β = 0.14, p = 0.006), having less than a high school education (β = 0.11, p = 0.022), and a psychotic disorder diagnosis (β = 0.25, p = 0.038) were associated with greater tobacco consumption in urban residents. Smoke-free policy was not associated with tobacco use (OR = 1.08, 95% CI: 0.87-1.34) and consumption (β = 0.05, p = 0.134). CONCLUSIONS Despite higher rates of tobacco use among rural patients with PDs, they have similar risk factors as their urban counterparts. However, residing in a location with a smoke-free policy may not contribute to tobacco use behaviors among those with PDs.
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Sendall MC, Fox L, Wraith D. University Staff and Students' Attitudes towards a Completely Smoke-Free Campus: Shifting Social Norms and Organisational Culture for Health Promotion. Int J Environ Res Public Health 2021; 18:7104. [PMID: 34281036 DOI: 10.3390/ijerph18137104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/02/2022]
Abstract
A large university in Queensland, Australia with a diverse staff and student community introduced a campus wide smoke-free policy in 2016. The purpose of this enquiry was to understand attitudes about a new smoke-free policy, its potential impact and the shift in social norms and organizational culture to inform the next phase of implementation. An electronic survey was distributed to all staff and students approximately 12 weeks after the smoke-free policy was implemented. The survey consisted of multiple-choice questions about demographics, smoking behaviour, attitudes towards smoking and tobacco control, awareness of the smoke-free policy, and attitudes towards the effect of a completely smoke-free campus on quality of life, learning and enrolment. The survey was completed by 641 university staff and students. Respondents reported seeking out (80.4%) and socialising in smoke-free environments (86.6%) and supported smoke-free buildings (96.1%), indoor areas (91.6%), and outdoor areas (79%). The results revealed overwhelming support for a completely smoke-free campus (83%) and minority support for designated smoking areas (31%). Overall, respondents reflected positively towards a campus wide smoke-free policy. These findings suggest Queensland’s early adoption of tobacco control laws influenced the social environment, de-normalised smoking, changed behaviour, preference for smoke-free environments and shifted social norms. These findings provide convincing evidence for organisational change and suggest health promotion policy makers should progress the implementation of smoke-free policies nationally across the higher education sector.
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Ratier-Cruz A, Smith JG, Firn M, Rinaldi M. Staff attitudes to completely smoke-free policies and smoking cessation practices in a mental health setting. J Public Health (Oxf) 2021; 42:403-411. [PMID: 32128592 DOI: 10.1093/pubmed/fdaa033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Mental health trusts in England were expected to become completely smoke-free and embed smoking cessation practices by 2018. Such policies are fraught with concerns and have received mixed support from mental health staff. Understanding staff attitudes to these practices prior to enforcement of the policy could help design an effective implementation strategy. METHODS A cross-sectional survey was conducted with clinical and non-clinical staff in a Mental Health Trust to understand smoking cessation practices and attitudes to the implementation of a completely smoke-free policy. RESULTS There were 631 responses. Most participants disagreed with the policy on wards (59.6%) and throughout all mental health settings (57.4%). Clinicians expressed significantly lower organizational policy support (P = 0.001) than non-clinicians (P = 0.001). Psychiatrists were more supportive of the organizational items than nurses and allied health professionals. Clinicians' attitudes towards smoking cessation practices were less positive for those who were current smokers (P < 0.001), but more positive for clinicians who had received or were interested in attending smoking cessation training (P < 0.001). CONCLUSIONS Partial and completely smoke-free policies remain unsupported by staff in mental health settings. Smoking cessation training appears to reinforce rather than alter attitudes towards smoking cessation.
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Affiliation(s)
- A Ratier-Cruz
- South West London & St George's Mental Health NHS Trust, Springfield University Hospital, London SW17 7DJ, UK
| | - J G Smith
- Population Health Research Institute, St George's, University of London, London SW17 0RE, UK
| | - M Firn
- South West London & St George's Mental Health NHS Trust, Springfield University Hospital, London SW17 7DJ, UK
| | - M Rinaldi
- South West London & St George's Mental Health NHS Trust, Springfield University Hospital, London SW17 7DJ, UK
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Garritsen HH, Distelvelt RR, Olsen IG, van de Goor IAM, Kunst AE, Rozema AD. Adolescents' support for an outdoor smoke-free policy at sports clubs in the Netherlands. Tob Prev Cessat 2021; 7:40. [PMID: 34084979 PMCID: PMC8158062 DOI: 10.18332/tpc/134612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/24/2021] [Accepted: 03/17/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Outdoor smoke-free policies (SFPs) at sports clubs may contribute to the prevention of smoking among adolescents. Adolescents' support for such policy is important to its success. The aim of this study is to explore adolescents' perceptions with regard to an outdoor SFP at sports clubs in the Netherlands. METHODS Focus group discussions (n=27) were held with 180 participants (aged 13-18 years) at 16 sports clubs. Thematic analysis was used to analyze the data. RESULTS Participants generally supported an outdoor SFP at sports clubs. Five reasons for this support were reported: 1) children should not be exposed to smoking, 2) smoking and sports (clubs) do not fit together, 3) secondhand smoke is undesirable, 4) an outdoor SFP may enhance a sports club's image, and 5) an outdoor SFP contributes to the prevention of smoking. Some participants voiced considerations against an outdoor SFP, arguing amongst others, that smokers need to be taken into account, and that problems may occur with compliance and enforcement. Support for an outdoor SFP was stronger among participants at clubs with an outdoor SFP than among those without such policy. CONCLUSIONS This study shows that adolescents generally support an outdoor smoke-free policy at sports clubs. After implementation, the outdoor SFP was generally experienced as a normal practice. These results could encourage sports clubs without an outdoor SFP to become smoke-free as well.
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Affiliation(s)
- Heike H Garritsen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Rein R Distelvelt
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Ingri G Olsen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Ien A M van de Goor
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Andrea D Rozema
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
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Hoe C, Ahsan H, Ning X, Wang X, Li D, Wright K, Kennedy RD. Enforcement agencies and smoke-free policy compliance: An observational study in Qingdao, China. Tob Induc Dis 2021; 19:26. [PMID: 33859546 PMCID: PMC8040544 DOI: 10.18332/tid/133635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/21/2021] [Accepted: 02/22/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION In recent years, tobacco control policy initiatives have emerged at the subnational level in China. In 2013, for example, Qingdao enacted a 100% smoke-free policy that gave regulatory authority to multiple enforcement agencies. Given that little is known about the extent of smoke-free policy compliance in smaller Chinese cities, this study assessed compliance with Qingdao's Tobacco Control Regulation and whether compliance differed by enforcement agency. METHODS A cross-sectional observational study was undertaken between October and November 2018. Venues were selected based on enforcement agency and included restaurants, retail stores, schools, government buildings, hospitals, business offices, and other hospitality venues. Comprehensive lists of venues were identified where they existed, and a random sample of venues were subsequently selected. For venue categories for which there were no comprehensive lists, a walking protocol was used. Observational data included evidence of smoking, the presence of no-smoking signage, and designated smoking areas (DSAs). Descriptive statistics were obtained. Subsequently, logistic regression models were used to determine the association between enforcement agency and policy compliance. RESULTS A total of 694 venues were observed. For all venue types, 64.7% were compliant with the composite indicator 'evidence of smoking'. Findings also showed that smoke-free compliance varied by enforcement agency (p<0.001). Venues with evidence of smoking and not posting of no-smoking signs at the main entrance were lowest among venues that fall under Public Security Bureau. Compliance with posting no-smoking signs inside was lowest in venues that fall under the Industry and Commercial Administration (I&C). While Qingdao's smoke-free policy prohibits DSAs, our findings showed that 2% of venues that fall under the jurisdiction of I&C had DSAs. CONCLUSIONS An effective coordination mechanism that can ensure a consistent and standardized approach is urgently needed in Qingdao. With such a concerted effort, it will be possible to achieve the target of 100% smoke-free indoor places in Qingdao.
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Affiliation(s)
- Connie Hoe
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Hanaa Ahsan
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Xuejuan Ning
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | | | | | - Kathy Wright
- International Union Against Tuberculosis and Lung Disease, New York City, United States
| | - Ryan D. Kennedy
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
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Yang Y, Yang XY, Yang T, He W, Peng S, Rockett IR. Social deprivation and secondhand smoke exposure among urban male residents: A nationwide study in China. Tob Induc Dis 2021; 19:21. [PMID: 33767605 PMCID: PMC7983223 DOI: 10.18332/tid/132290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/01/2021] [Accepted: 01/08/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Social deprivation is a known determinant of health and related behaviors. Many studies have linked socioeconomic factors to secondhand smoke (SHS) exposure. However, no studies have examined the relationship between social deprivation and SHS exposure. This study examined whether contextual social deprivation – variously based on living in a house without a car, that was overcrowded, or had an unemployed member (s) – had an independent association with SHS exposure at both individual and regional levels among Chinese residents. METHODS A cross-sectional multistage sampling design was utilized to interview subjects from 6 selected cities in China. A standardized questionnaire selected sociodemographic characteristics, contextual social deprivation and SHS exposure. Multilevel logistic regression models were used to assess the association between social deprivation and SHS exposure. RESULTS A total of 5782 valid questionnaires were collected in this study. Among 2930 non-smokers, the SHS exposure prevalence was 21.9% (95% CI: 19.5– 24.30). Multilevel logistic regression showed a negative association between household income, regional GDP, and SHS exposure, respectively, and positive associations between contextual social deprivation and SHS exposure. CONCLUSIONS Findings support the central proposition that contextual social deprivation must be factored into SHS exposure messages. Our research underscores the importance of reducing health inequality in controlling SHS exposure.
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Affiliation(s)
- Yixin Yang
- School of Public Affairs, Zhejiang University, Hangzhou, China.,Center of Social Welfare and Governance, Zhejiang University, Hangzhou, China
| | - Xiaozhao Y Yang
- School of Sociology and Anthropology, Sun Yat-sen University, Qingdao, China
| | - Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenjiong He
- School of Public Affairs, Zhejiang University, Hangzhou, China.,Center of Social Welfare and Governance, Zhejiang University, Hangzhou, China
| | - Sihui Peng
- Department of Health Psychology, Jinan University, Jinan, China
| | - Ian R Rockett
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, United States.,Department of Psychiatry, University of Rochester Medical Center, Rochester, United States
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Boderie NW, Mölenberg FJ, Sheikh A, Bramer WM, Burdorf A, van Lenthe FJ, Been JV. Assessing public support for extending smoke-free policies beyond enclosed public places and workplaces: protocol for a systematic review and meta-analysis. BMJ Open 2021; 11:e040167. [PMID: 33550229 PMCID: PMC7925902 DOI: 10.1136/bmjopen-2020-040167] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Smoke-free enclosed public environments are effective in reducing exposure to secondhand smoke and yield major public health benefits. Building on this, many countries are now implementing smoke-free policies regulating smoking beyond enclosed public places and workplaces. In order to successfully implement such 'novel smoke-free policies', public support is essential. We aim to provide the first comprehensive systematic review and meta-analysis assessing levels and determinants of public support for novel smoke-free policies. METHODS AND ANALYSIS The primary objective of this review is to summarise the level of public support for novel smoke-free policies. Eight online databases (Embase.com, Medline ALL Ovid, Web of Science Core Collection, WHO Library Database, Latin American and Caribbean Health Sciences Literature, Scientific Online Library Online, PsychINFO and Google Scholar) will be searched from 1 January 2004 by two independent researchers with no language restrictions. The initial search was performed on 15 April 2020 and will be updated prior to finalisation of the report. Studies are eligible if assessing support for novel smoke-free policies in the general population (age ≥16 years) and have a sample size of n≥400. Studies funded by the tobacco industry or evaluating support among groups with vested interest are excluded. The primary outcome is proportion of public support for smoke-free policies, subdivided according to the spaces covered: (1) indoor private spaces (eg, cars) (2) indoor semiprivate spaces (eg, multi-unit housing) (3) outdoor (semi)private spaces (eg, courtyards) (4) non-hospitality outdoor public spaces (eg, parks, hospital grounds, playgrounds) and (5) hospitality outdoor public spaces (eg, restaurant terraces). The secondary objective is to identify determinants associated with public support on three levels: (1) within-study determinants (eg, smoking status) (2) between-study determinants (eg, survey year) and (3) context-specific determinants (eg, social norms). Risk of bias will be assessed using the Mixed Methods Appraisal Tool and a sensitivity analysis will be performed excluding studies at high risk of bias. ETHICS AND DISSEMINATION No formal ethical approval is required. Findings will be disseminated to academics, policymakers and the general public.
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Affiliation(s)
- Nienke W Boderie
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Famke Jm Mölenberg
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Aziz Sheikh
- Centre of Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Wichor M Bramer
- Medical Library, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jasper V Been
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Division of Neonatology, Department of Paediatrics, Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
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Singh A, Dobbie F, Kinnunen TI, Okello G, Semple S, Okyere PB, Logo DD, Lartey KF, McNeil A, Britton J, Bauld L, Owusu-Dabo E. Adherence to smoke-free policies in Ghana: Findings from a cross-sectional survey of hospitality venue owners and staff. Tob Prev Cessat 2021; 7:4. [PMID: 33474517 PMCID: PMC7811357 DOI: 10.18332/tpc/131058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Implementation of and compliance with smoke-free policies (SFPs) can be problematic in many low- and middle-income countries (LMICs) due to limited resources. This study evaluated knowledge, opinions and compliance related to Ghana’s SFPs among owners and staff of hospitality venues by city, staff designation, and venue type. METHODS A cross-sectional study design was used in venue types including hotels, bars, pubs and restaurants in the three cities of Kumasi, Accra, and Tamale, in Ghana. Data were collected between July and September 2019. Interviewer administered face-to-face surveys were conducted with owners and staff (n=142) recruited from randomly selected hospitality venues (n=154) in these three large cities of Ghana. The relationship between knowledge, opinions, and compliance items on SFPs, and city, venue type and staff designation was first studied using χ2 or a Fisher’s exact test, and then with univariate logistic regression model analysis. RESULTS Of the 142 respondents, some had heard of Ghana’s 2012 Tobacco Control Act (27.5%), smoking restriction in public places (29%), smoke-free places (22%), and display of ‘no smoking’ signage (6.3%). Knowledge levels were higher in Accra compared to Tamale (OR=3.08; 95% CI: 1.10–8.60). Staff designation and type of venue did not have any relationship with knowledge levels. Support for SFPs was over 80%, but opinions in support of SFPs were lower in Accra than Tamale (OR=0.25; 95% CI: 0.08–0.71). Compliance with SFPs was similar in the three cities. Hotels were three times more compliant compared to bars and pubs (OR=3.16; 95% CI: 1.48–6.71). CONCLUSIONS The study highlights the strong support for restriction of smoking in public places including hospitality venues despite poor knowledge and low compliance levels with the current SFPs. A review of the current SFP in Ghana together with education of hospitality staff on the benefits and requirements of SFPs is recommended.
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Affiliation(s)
- Arti Singh
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Fiona Dobbie
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Tarja I Kinnunen
- Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
| | | | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, United Kingdom
| | - Portia Boakye Okyere
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Kwabena Fosu Lartey
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ann McNeil
- King's College London, London, United Kingdom
| | - John Britton
- University of Nottingham, Nottingham, United Kingdom
| | - Linda Bauld
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Septiono W, Kuipers MAG, Ng N, Kunst AE. The impact of local smoke-free policies on smoking behaviour among adults in Indonesia: a quasi-experimental national study. Addiction 2020; 115:2382-2392. [PMID: 32386096 PMCID: PMC7687215 DOI: 10.1111/add.15110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 11/25/2019] [Accepted: 05/01/2020] [Indexed: 01/17/2023]
Abstract
AIMS To investigate to what extent the adoption of local smoke-free policies (SFPs) in Indonesia in 2007-13 was associated with changes in adult smoking behaviour. DESIGN A quasi-experimental study. SETTING Indonesia, 2007 and 2013. PARTICIPANTS A total of 1 052 611 > 25-year-old adults. Data were derived from the 2007 and 2013 Indonesian national health survey. MEASUREMENTS For both years, provincial and district SFPs were identified from government documents in 497 districts in 33 provinces. Multi-level logistic regression analysis assessed the association of adoption of provincial and district SFPs between 2007 and 2013 with smoking continuation (among ever-smokers), current smoking and high smoking intensity (among current smokers). We controlled for survey year, SFP in 2007, socio-demographics and district characteristics. FINDINGS Provincial SFP exposure was associated with lower odds of smoking continuation [strong SFP versus no SFP: odds ratio (OR) = 0.71, 95% confidence interval (CI) = 0.66-0.76] and smoking intensity (strong SFP: OR= 0.91, 95% CI = 0.86-0.97), but also with higher odds of current smoking (strong SFP versus no SFP: OR = 1.08; 95% CI = 1.04-1.12). District SFP exposure was associated with higher odds of smoking continuation (strong SFP versus no SFP: OR = 1.07, 95% CI = 1.01-1.14) and current smoking (strong SFP versus no SFP: OR = 1.09, 95% CI = 1.05-1.14), but with lower odds of smoking intensity (moderately strong SFP versus no SFP: OR = 0.95, 95% CI = 0.91-0.99). CONCLUSIONS There may be an association between the adoption of local smoke-free policies in Indonesia and decreased adult smoking intensity. However, the evidence is inconsistent, which may reflect problems with policy implementation and enforcement.
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Affiliation(s)
- Wahyu Septiono
- Department of Public Health, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Mirte A. G. Kuipers
- Department of Public Health, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Nawi Ng
- Department of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Epidemiology and Global Health, Faculty of MedicineUmeå UniversityUmeåSweden
| | - Anton E. Kunst
- Department of Public Health, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
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Jankowski M, Pinkas J, Zgliczyński WS, Kaleta D, Wierzba W, Gujski M, Rees VW. Voluntary Smoke-Free Home Rules and Exposure to Secondhand Smoke in Poland: A National Cross-Sectional Survey. Int J Environ Res Public Health 2020; 17:E7502. [PMID: 33076351 PMCID: PMC7602554 DOI: 10.3390/ijerph17207502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 11/18/2022]
Abstract
Smoke-free policies have been shown to significantly reduce secondhand smoke (SHS) exposure in private and public places. The objectives of this study were to: (1) to assess the prevalence and characteristics of voluntary smoke-free home rules in Poland; and (2) assess the association of smoke-free rules with self-reported SHS exposure in private homes. A cross-sectional survey was conducted in September 2019 with a nationally representative sample of 1011 individuals aged 15 and over. Nationally, 66.1% of individuals had a 100% smoke-free home rule (78.9% of non-smokers and 18.6% of smokers; p < 0.001), while a further 24.6% had adopted a partial home smoking rule. SHS exposure in the home during past month was reported by 6.1% of respondents (11.5% of smokers and 4.5% of non-smokers; p < 0.001). The lowest level of SHS exposure (1.8%) was observed among respondents who had implemented a full smoke-free home rule. Non-smokers had higher odds of having adopted a total smoke-free home rule compared with smokers (aOR: 19.17; 95% CI: 12.89-28.50). Moreover, non-smokers had lower odds (aOR: 0.35; 95% CI: 0.20-0.61; p < 0.001) of self-reporting SHS smoke exposure at home. Although two-thirds of the Polish population have adopted a full smoke-free home rule in their homes, smokers continue to lag in adoption rates relative to non-smokers.
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Affiliation(s)
- Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland; (M.J.); (J.P.); (W.S.Z.)
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland; (M.J.); (J.P.); (W.S.Z.)
| | - Wojciech S. Zgliczyński
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland; (M.J.); (J.P.); (W.S.Z.)
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Medical University of Lodz, 90-647 Łódź, Poland;
| | - Waldemar Wierzba
- UHE Satellite Campus in Warsaw, University of Humanities and Economics in Łódź, 01-513 Warsaw, Poland;
| | - Mariusz Gujski
- Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Vaughan W. Rees
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Prado-Galbarro FJ, Auchincloss AH, Pérez-Ferrer C, Sanchez-Franco S, Barrientos-Gutierrez T. Adolescent Tobacco Exposure in 31 Latin American Cities before and after the Framework Convention for Tobacco Control. Int J Environ Res Public Health 2020; 17:E7423. [PMID: 33053821 PMCID: PMC7601699 DOI: 10.3390/ijerph17207423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 11/30/2022]
Abstract
Our objective was to describe the prevalence and changes in tobacco use and tobacco control policies in Latin American countries and cities before and after ratification of the 2003 Framework Convention on Tobacco Control (FCTC). Country-level tobacco policy data came from reports on the global tobacco epidemic (World Health Organization, 2007-2014). Global Youth Tobacco Survey data, 2000-2011, came from six countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru), 31 cities and 132,065 students. Pre- and post-FCTC prevalence and relative changes were estimated. All countries showed improvements in tobacco control policies but Mexico and Peru showed the smallest improvements. In general, adolescents reduced their tobacco use, reported less exposure to smoking at home, more tobacco education, and more retailer refusals to sell them cigarettes. Adolescents reported smaller reductions in secondhand smoke exposure outside the home and no change in exposure to tobacco media/promotions. Pre-FCTC prevalence and relative changes during the post-FCTC period were more heterogeneous across cities than across countries. Despite overall improvements in tobacco policies and the decline in exposure to tobacco, policies related to media/promotions and secondhand smoke need strengthening. There was wide variation in adolescent exposure to tobacco between cities (within countries), which suggested major heterogeneity of policy implementation at the local level.
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Affiliation(s)
- Francisco-Javier Prado-Galbarro
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico; (F.-J.P.-G.); (C.P.-F.)
| | - Amy H. Auchincloss
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA 19129, USA;
| | - Carolina Pérez-Ferrer
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico; (F.-J.P.-G.); (C.P.-F.)
| | - Sharon Sanchez-Franco
- Department of Public Health, School of Medicine, Universidad de Los Andes, 111711 Bogota, Colombia;
| | - Tonatiuh Barrientos-Gutierrez
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico; (F.-J.P.-G.); (C.P.-F.)
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Atiba YM, Olubodun T, Odukoya OO. Young Peoples' support for a smoke-free campus policy: A case for smoke-free campuses in the statewide smoking law in Lagos State, Nigeria. Ann Afr Med 2020; 19:53-59. [PMID: 32174616 PMCID: PMC7189885 DOI: 10.4103/aam.aam_27_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Smoke-free policies are increasingly being enacted in several countries. In 2014, Lagos State, the commercial capital of Nigeria, enacted a statewide smoke-free policy; however, university campuses were excluded from the list of public places where smoking would be disallowed. This study aimed to assess students’ support for smoke-free campus policies, their attitudes, and exposure toward secondhand smoke (SHS). Methods: This cross-sectional descriptive study was carried out among 421 university undergraduates in two premier universities in the state. Respondents were selected using a multistage sampling method, and the data were collected using a pretested self-administered questionnaire. Results: Many (55.4%) of the respondents agreed that students who are non-smokers have the right to inhale smoke-free air on campuses and expressed feelings of irritation (57.1%) or anger (17.1%) when exposed to SHS on campus. Majority (80.1%) of the respondents were in support of a smoke-free policy on their campus and in favor of a ban on smoking in enclosed spaces on campus (79.6%). Exposure to SHS on campus was high, as one in five respondents were exposed to SHS in their hostel rooms (19.9%) and 44.9% were exposed in outdoor campus spaces in the preceding week. There was a statistically significant association between respondents’ age, gender, smoking status, and attitudes toward SHS and support for a smoke-free campus policy. Conclusion: Although the majority of the students were non-smokers, significant exposure to SHS on campuses still exists. There is a huge support for smoke-free campus policies. The state government should consider including campuses on the list of smoke-free public spaces in the review of the statewide smoking law.
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Affiliation(s)
- Yetunde Morenike Atiba
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Tope Olubodun
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos; Department of Community Health and Primary Care; Non-Communicable Disease Research Group, Lagos University Teaching Hospital, Lagos, Nigeria
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Spaducci G, McNeill A, Hubbard K, Stewart D, Yates M, Robson D. Smoking-related violence in a mental health setting following the implementation of a comprehensive smoke-free policy: A content analysis of incident reports. Int J Ment Health Nurs 2020; 29:202-211. [PMID: 31513336 DOI: 10.1111/inm.12659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2019] [Indexed: 11/28/2022]
Abstract
Smoke-free policies in mental health settings are important to protect health but are often impeded by staff concerns that physical violence may increase. We aimed to address the literature gap about the frequency, nature, and management of physical violence in relation to smoking. We compared the antecedents and containment of smoking-related incidents of physical violence over a two-year period, (12 months when an indoor-only smoke-free policy was in place, followed by 12 months after a new comprehensive smoke-free policy was introduced) using incident reports completed by staff in a large mental health organization in London, UK. Sixty-one smoking-related incidents occurred during the indoor-only smoke-free policy period; 32 smoking-related incidents occurred during the comprehensive smoke-free policy. We identified four antecedent categories for physical violence: i) patient request to smoke denied by staff; ii) during a supervised smoking break; iii) staff response to a patient breach of the smoke-free policy iv) asking for, trading or stealing smoking materials. The antecedent pattern changed across the two policy periods, with fewer incidents of denying a patient's request to smoke and a greater number of incidents involving staff responding to breaches occurring after the introduction of the comprehensive smoke-free policy. The prohibition of smoking breaks removed this source of violence. Timeout and PRN medication were the most common containment interventions. Understanding the context of smoking-related violence may inform clinical guidelines about its prevention and management.
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Affiliation(s)
- Gilda Spaducci
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
| | - Kathryn Hubbard
- Health Services and Population Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Duncan Stewart
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Mary Yates
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, London, UK
| | - Deborah Robson
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Byron MJ, Cohen JE, Frattaroli S, Gittelsohn J, Drope JM, Jernigan DH. Implementing smoke-free policies in low- and middle-income countries: A brief review and research agenda. Tob Induc Dis 2019; 17:60. [PMID: 31582949 PMCID: PMC6770618 DOI: 10.18332/tid/110007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/14/2019] [Accepted: 06/12/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Some low- and middle-income countries (LMICs) struggle to implement smoke-free policies. We sought to review the academic and gray literature, and propose a research agenda to improve implementation of smoke-free policies and make them more effective in LMICs. METHODS We reviewed 10 databases for variations of (‘implementation’ /‘enforcement’ /‘compliance’) and (‘smoke-free’ /‘ban’ /‘restriction’) and (‘tobacco’ /‘smoking’). We also reviewed cited sources and the gray literature including non-governmental organization reports. We included articles that described problems that arose, attempted solutions, lessons learned, and research questions posed regarding smoke-free policy implementation in LMICs. We excluded studies of high-income countries, institution-level implementation, voluntary smoke-free policies, smoke-free homes, and outdoor smoke-free policies. RESULTS The academic literature review led to 4931 unique articles, reduced to 1541 after title screening, 331 after abstract screening, and 101 after full-text review. The citation and gray literature review led to an additional 179 publications of which 67 met the inclusion criteria. In total we retained 168 sources. We conducted a narrative review and synthesis of the literature, extracting key themes and noting research gaps. CONCLUSIONS We find that progress is urgently needed in five categories: identifying the critical lessons learned for effective implementation, evaluating different enforcement approaches, learning how to rejuvenate stalled smoke-free policies, learning how to increase ground-level will to enforce policies, and developing a conceptual framework that explains implementation. Investigation into these topics can improve implementation of smoke-free policies in LMICs.
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Affiliation(s)
- M Justin Byron
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, United States.,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, United States.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, United States
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Shannon Frattaroli
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Jeffrey M Drope
- American Cancer Society, Atlanta, United States.,Department of Political Science, Marquette University, Milwaukee, United States
| | - David H Jernigan
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, United States
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Scheeres A, Xhezo R, Julius R, Coffman R, Frisby J, Weber L, Streeter J, Leone F, Bettigole C, Lawman H. Changes in voluntary admission and restraint use after a comprehensive tobacco-free policy in inpatient psychiatric health facilities. Subst Abus 2019; 41:252-258. [PMID: 31295085 DOI: 10.1080/08897077.2019.1635556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Cardiovascular and respiratory diseases, predominantly due to tobacco use, are the leading causes of death among individuals with serious and persistent mental illness. However, many psychiatric health facilities do not routinely treat tobacco use disorder. The purpose of the current study was to examine the impact of implementing a tobacco-free policy in inpatient psychiatric health facilities in a large, urban setting on behavioral problems, treatment access, and tobacco treatment. Methods: Data on seclusion and restraint incidents, voluntary commitment at admission for each hospitalization episode, and nicotine replacement therapy (NRT) prescriptions were collected through secondary analysis of Medicaid administrative records from baseline in January 2015 (n = 8983) to follow-up in December 2016 (n = 9685) at 14 inpatient psychiatric health facilities. Results: There were no significant changes from baseline to follow-up in odds of seclusion and restraint incidents or voluntary admission status. There was a significant increase in the odds of NRT prescriptions at both 30 and 180 days post discharge (odds ratio [OR] range = 1.58-2.09, P < .01). Conclusions: In a large, urban setting among Medicaid enrollees, implementation of a tobacco-free policy in inpatient psychiatric health facilities had no negative impact on behavioral problems or treatment access and improved access to NRT, although overall NRT use remained low. This study challenges perceptions among some providers that addressing tobacco use disorder will negatively impact treatment outcomes in individuals with serious mental illness. These findings support tobacco-free policies in psychiatric health facilities and the role of psychiatric health providers in treating tobacco use in this population, which is at high risk for tobacco-related mortality.
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Affiliation(s)
- Annaka Scheeres
- Division of Chronic Disease Prevention, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
| | - Regina Xhezo
- Community Behavioral Health, Philadelphia, Pennsylvania, USA
| | - Rose Julius
- Community Behavioral Health, Philadelphia, Pennsylvania, USA
| | - Ryan Coffman
- Division of Chronic Disease Prevention, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
| | - Jarma Frisby
- Division of Chronic Disease Prevention, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
| | - Luise Weber
- Community Behavioral Health, Philadelphia, Pennsylvania, USA
| | | | - Frank Leone
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cheryl Bettigole
- Division of Chronic Disease Prevention, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
| | - Hannah Lawman
- Division of Chronic Disease Prevention, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
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Young JT, Puljević C, Love AD, Janca EK, Segan CJ, Baird D, Whiffen R, Pappos S, Bell E, Kinner SA. Staying Quit After Release (SQuARe) trial protocol: a randomised controlled trial of a multicomponent intervention to maintain smoking abstinence after release from smoke-free prisons in Victoria, Australia. BMJ Open 2019; 9:e027307. [PMID: 31167867 PMCID: PMC6561422 DOI: 10.1136/bmjopen-2018-027307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Smoke-free policies have been introduced in prisons internationally. However, high rates of relapse to smoking after release from prison indicate that these policies typically result in short-term smoking cessation only. These high rates of relapse, combined with a lack of investment in relapse prevention, highlight a missed opportunity to improve the health of a population who smoke tobacco at two to six times the rate of the general population. This paper describes the rationale and design of a randomised controlled trial, testing the effectiveness of a caseworker-delivered intervention promoting smoking cessation among former smokers released from smoke-free prisons in Victoria, Australia. METHODS AND ANALYSIS The multicomponent, brief intervention consists of behavioural counselling, provision of nicotine spray and referral to Quitline and primary care to promote use of government-subsidised smoking cessation pharmacotherapy. The intervention is embedded in routine service delivery and is administered at three time points: one prerelease and two postrelease from prison. Control group participants will receive usual care. Smoking abstinence will be assessed at 1 and 3 months postrelease, and confirmed with carbon monoxide breath testing. Linkage of participant records to survey and routinely collected administrative data will provide further information on postrelease use of health services and prescribed medication. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Corrections Victoria Research Committee, the Victorian Department of Justice Human Research Ethics Committee, the Department of Human Services External Request Evaluation Committee and the University of Melbourne Human Research Ethics Committee. Results will be submitted to major international health-focused journals. In case of success, findings will assist policymakers to implement urgently needed interventions promoting the maintenance of prison-initiated smoking abstinence after release, to reduce the health disparities experienced by this marginalised population. TRIAL REGISTRATION NUMBER ACTRN12618000072213; Pre-results.
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Affiliation(s)
- Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Cheneal Puljević
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
| | - Alexander D Love
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Emilia K Janca
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Catherine J Segan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Donita Baird
- Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | | | - Stan Pappos
- Australian Community Support Organisation, Richmond, Victoria, Australia
| | - Emma Bell
- Australian Community Support Organisation, Richmond, Victoria, Australia
| | - Stuart A Kinner
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Mater Research Institute-UQ, The University of Queensland, Brisbane, Queensland, Australia
- Netherlands Institute for the Study of Crime and Law Enforcement, Amsterdam, The Netherlands
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Abstract
Background and Purpose College and university tobacco control programs have historically neglected cessation. In 2012, the University of California Office of the President (UCOP) released a Smoke and Tobacco Free policy that became effective in January 2014. The policy provided for a comprehensive education and outreach campaign that included resources and referrals for cessation. We sought to determine whether all University of California (UC) campuses met UCOP standards. Methods We reviewed the Smoke & Tobacco Free policies created by UCOP and posted at ten UC campuses, searched the tobacco free websites of each campus for cessation resources, and contacted tobacco-free task forces. Results We found that all UC campuses met the UCOP standard by addressing tobacco cessation in their campus policies. The provision of cessation services and resources was limited and varied substantially by campus, and no campuses reported collecting data on the use of cessation programs. Conclusion Consistent with concerns that college and university tobacco policies neglect cessation, UC campuses mentioned tobacco cessation resources and programs but did not provide consistent services. These campuses also did not report on the use of tobacco cessation resources, making it difficult to assess the effects of offering different types of cessation programs.
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Affiliation(s)
- Jocelyn Huey
- Department of Clinical Pharmacy, University of California, San Francisco
| | - Dorie E Apollonio
- Department of Clinical Pharmacy, University of California, San Francisco
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46
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Hawkins SS, Kull M, Baum CF. US state cigarette tax increases and smoke-free legislation in relation to cigarette expenditure across household socio-economic circumstances: a quasi-experimental study. Addiction 2019; 114:721-729. [PMID: 30461118 DOI: 10.1111/add.14505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/03/2018] [Accepted: 11/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS While research has focused on outcomes of tobacco control policies, less is known about the mechanisms by which policies may affect tobacco use. We estimated the associations of changes in cigarette taxes and smoke-free legislation with (1) any household cigarette expenditure and (2) the level of household expenditure on cigarettes, as well as (3) tested interactions with socio-economic circumstances. DESIGN Difference-in-differences regression models to estimate the associations between changes in US state cigarette taxes and smoke-free legislation with changes in household expenditure on cigarettes. SETTING Forty US states and District of Columbia. PARTICIPANTS From annual, cross-sectional surveys (with a longitudinal component) between 2000 and 2014, 128 138 households interviewed quarterly in the Consumer Expenditure Survey. MEASUREMENTS Dependent measures included any household cigarette expenditure, expenditure in real dollars and budget share of cigarette expenditure. Policy measures included state cigarette taxes and 100% smoke-free legislation. Covariates included respondent age, race/ethnicity, sex; household education; poverty level; family structure; and number of children and adults. FINDINGS Every $1.00 cigarette tax increase was associated with a 1.5 percentage point (-0.028, -0.002) reduction in any cigarette expenditure and an increase of 0.1% (0.1%, 0.1%) budget share and $10.11 ($8.38, $11.84) absolute expenditure. The association with absolute expenditure was stronger among smoking households above poverty level ($10.73; $8.94, $12.51) than below ($4.72; $2.37, $7.07). The enactment of smoke-free legislation was associated with $2.33 (-$4.56, -$0.10) less expenditure, but not with any expenditure (0.1%; -1.6%, 1.8%) or budget share (-0.1%; -0.1%, 0.1%). The association with absolute expenditure was stronger among households above poverty level (-$2.62; -$4.95, -$0.29) than below (-$0.34; -$4.27, $3.58) CONCLUSION: Cigarette tax increases in the United States between 2000 and 2014 may have reduced smoking prevalence due to an absolute and relative increase in household tobacco expenditure while smoke-free policies appear to have led to a reduction in expenditure. Although tax increases had a stronger impact on absolute expenditure among households above the poverty level, impact on relative expenditure was similar, and consequences for socio-economic inequalities in smoking will vary based on the broader financial situation of households.
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Affiliation(s)
| | - Melissa Kull
- Chapin Hall at the University of Chicago, Chicago, IL, USA
| | - Christopher F Baum
- Boston College, School of Social Work, Chestnut Hill, MA, USA.,Department of Economics, Boston College, Chestnut Hill, MA, USA.,German Institute for Economic Research (DIW Berlin), Berlin, Germany
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47
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Pons-Vigués M, Rando-Matos Y, Rodriguez-Blanco T, Ballvé-Moreno JL, Ripoll J, Llobera J, Morán J, López-Jiménez T, Violán-Fors C, Bolibar B. Effect of the comprehensive smoke-free law on time trends in smoking behaviour in primary healthcare patients in Spain: a longitudinal observational study. BMJ Open 2019; 9:e020120. [PMID: 30833307 PMCID: PMC6443085 DOI: 10.1136/bmjopen-2017-020120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE This study aimed to analyse the impact of comprehensive smoke-free legislation (SFL) on the prevalence and incidence of adult smoking in primary healthcare (PHC) patients from three Spanish regions, overall and stratified by sex. DESIGN Longitudinal observational study conducted between 2008 and 2013. SETTING 66 PHC teams in Catalonia, Navarre and the Balearic Islands (Spain). PARTICIPANTS Population over 15 years of age assigned to PHC teams. PRIMARY AND SECONDARY OUTCOMES MEASURES Quarterly age-standardised prevalence of non-smoker, smoker and ex-smoker and incidence of new smoker, new ex-smoker and ex-smoker relapse rates were estimated with data retrieved from PHC electronic health records. Joinpoint analysis was used to analyse the trends of age-standardised prevalence and incidence rates. Trends were expressed as annual percentage change and average annual percent change. RESULTS The overall standardised smoker prevalence rate showed a significant downward trend (higher in men than women) and the overall standardised ex-smoker prevalence rate showed a significant increased trend (higher in women than men) in the three regions. Standardised smoker and ex-smoker prevalence rates were higher for men than women in all regions. With regard to overall trends of incidence rates, new smokers decreased significantly in Catalonia and Navarre and similarly in men and women, new ex-smokers decreased significantly and more in men in Catalonia and the Balearic Islands, and ex-smoker relapse increased in Catalonia (particularly in women) and decreased in Navarre. CONCLUSIONS Trends in smoking behaviour in PHC patients remain unchanged after the implementation of comprehensive SFL. The impact of the comprehensive SFL might have been lessened by the effect of the preceding partial SFL.
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Affiliation(s)
- Mariona Pons-Vigués
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
- Departament d’Infermeria, Universitat de Girona, Girona, Spain
| | - Yolanda Rando-Matos
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Centre d’Atenció Primària (CAP) Florida Nord, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Rodriguez-Blanco
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Josep Lluís Ballvé-Moreno
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Centre d’Atenció Primària (CAP) Florida Nord, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
| | - Joana Ripoll
- Primary Care Research Unit of Mallorca, Baleares Health services-IbSalut, Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Joan Llobera
- Primary Care Research Unit of Mallorca, Baleares Health services-IbSalut, Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Julio Morán
- Equipo de Atención Primaria de Tafalla, Servicio Navarro de Salud, Barasoain, Spain
| | - Tomàs López-Jiménez
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Concepción Violán-Fors
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Bonaventura Bolibar
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
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Abstract
Tobacco use and exposure to secondhand smoke (SHS) remain leading causes of preventable disease, disability, and mortality in the United States. Rural populations are among those being left behind in the recent declining smoking rates and have become a focus of discussions on tobacco-related disparities. This article describes tobacco-related disparities in rural populations including tobacco use, exposure to SHS, smoke-free policies, and tobacco taxes. Nurses, as social justice and tobacco control policy advocates, are needed especially at the local level, where much of the policy work occurs and where nursing's voice is respected and can be powerful.
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Affiliation(s)
| | | | - Brody Maack
- 1 North Dakota State University, Fargo, ND, USA
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49
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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50
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Abstract
Background: Rates of electronic cigarettes (e-cigarette) use (vaping) have increased among college students over the past decade. Objectives: The current study sought to provide an in-depth examination of college students' beliefs about and attitudes toward cigarettes and e-cigarettes that may influence support/non-support of tobacco-free policies on college campuses and within their communities. Methods: Between August and December 2015, five focus groups (n = 22) were conducted at a large Southern University. Focus group discussions addressed social acceptance and areas where students commonly smoked/vaped on campus. Sessions were transcribed verbatim. Two researchers independently coded the transcripts and identified themes. A third researcher independently reviewed the coding and thematic analysis process (triangulation of researchers). Results: Participants expressed positive attitudes toward smoke-free policies that did not target college students, especially those that protected vulnerable populations (e.g., children). However, some were skeptical of tobacco-free policies that included e-cigarettes. Participants believed the campus tobacco-free policy had moved smokers' behavior off campus, but many reported seeing people vape in locations where smoking was not allowed (i.e., library, dorm rooms). Most perceived smoking to be less acceptable than vaping; smoking was described as 'dirty', while vaping was glamorized as a cultural trend. Conclusions/Importance: Findings from our qualitative study suggest that college students are supportive of smoke-free policies, but they are less supportive of comprehensive tobacco-free policies that include e-cigarettes. College campuses and surrounding communities should plan for education about policy protection via communication channels viewed frequently by students when including vaping devices in their comprehensive tobacco-free policies/ordinances.
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Affiliation(s)
- Page D Dobbs
- Department of Health and Exercise Science, University of Oklahoma , Norman , Oklahoma , USA
| | - David T Rolfe
- Department of Physical Education, School Health, and Movement Studies, Central Washington University , Ellensburg , Washington , USA
| | - Marshall K Cheney
- Department of Health and Exercise Science, University of Oklahoma , Norman , Oklahoma , USA
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