The impact of Ontario smoke-free legislation on secondhand smoke in enclosed public places

Many studies have evaluated the impact of indoor smoking bans on secondhand smoke (SHS) exposure. No studies have assessed the impact of a smoking ban on SHS in enclosed areas outside separately ventilated, designated smoking rooms (DSRs). This study evaluated the overall impact of the Smoke-Free Ontario Act implemented May 31, 2006, on SHS in bars and coffee shops and the impact of banning DSRs on SHS outside DSRs. Air particulate matter (PM) and carcinogenic particulate polycyclic aromatic hydrocarbons (PPAH) were measured in May 2006 before the ban inside and outside DSRs in Toronto venues (13 coffee shops and 14 bars) that allowed smoking only in DSRs, and in Windsor venues (10 coffee shops and 10 bars) where smoking was allowed in shared spaces. Measurements were repeated 2 months post-ban. Air quality index values (AQIs) were calculated. Mixed model analysis was applied, taking into account measurement errors for repeated measures. Post ban, mean PM and PPAH levels were reduced by 87% (from 494 to 67 mm(2)/m(3)) and 94% (from 196 to 11 ng/m(3)), respectively, inside Toronto DSRs. Mean PM and PPAH levels were reduced by 10% (from 124 to 111 mm(2)/m(3)) and 46% (from 45 to 24 ng/m(3)), respectively, outside Toronto DSRs. In all Windsor venues, mean PM and PPAH levels were reduced by 83% (from 488 to 81 mm(2)/m(3)) and 90% (from 107 to 10 ng/m(3)), respectively. All reductions were statistically significant (p < 0.0001). In Toronto venues, the AQI was reduced from the "very unhealthy" range inside DSRs and the "moderate" range outside Toronto DSRs to the "good" range, and in Windsor venues from the "unhealthy for sensitive groups" range to the "good" range post-ban. Pre-ban PPAH levels including those outside Toronto DSRs may be associated with cardiovascular injury. DSRs did not provide adequate protection from SHS. The Smoke-Free Ontario Act produced a significant and firm reduction in SHS exposure in venues both with and without DSRs.

Tobacco-related medical education and physician interventions with parents who smoke: Survey of Canadian family physicians and pediatricians

OBJECTIVE

To examine the relationship between physicians' tobacco-related medical training and physicians' confidence in their tobacco-related skills and smoking-related interventions with parents of child patients.

DESIGN

Mailed survey.

SETTING

Canada.

PARTICIPANTS

The survey was mailed to 800 family physicians and 800 pediatricians across Canada, with a corrected response rate of 65% (N = 900).

MAIN OUTCOME MEASURES

Physicians' self-reported tobacco-related education, knowledge, and skills, as well as smoking-related interventions with parents of child patients. Cochran-Mantel-Haenszel chi(2) tests were used to examine relationships between variables, controlling for tobacco-control involvement and physician specialty. Data analysis was conducted in 2008.

RESULTS

Physicians reporting tobacco-related medical education were more likely to report being "very confident" in advising parents about the effects of smoking and the use of a variety of cessation strategies (P < .05). Furthermore, physicians with tobacco-related training were more likely to help parents of child patients quit smoking whether or not the children had respiratory problems (P < .05). Physicians with continuing medical education in this area were more likely to report confidence in their tobacco-related skills and to practise more smoking-related interventions than physicians with other forms of training.

CONCLUSION

There is a strong relationship between medical education and physicians' confidence and practices in protecting children from secondhand smoke. Physicians with continuing medical education training are more confident in their tobacco-related skills and are more likely to practise smoking-related interventions than physicians with other tobacco-related training.

Do indoor smoke-free laws provide bar workers with adequate protection from secondhand smoke?

OBJECTIVE

To determine if bar workers are adequately protected from secondhand smoke by an Act that prohibits indoor smoking in public workplaces, including bars and restaurants, but allows smoking on unenclosed contiguous patios.

METHODS

A purposive sample of 25 bars with outdoor patios in Toronto, Canada was drawn. Air carcinogenic particulate polycyclic aromatic hydrocarbons (PPAH) were measured on patios and inside bars in August-September, 2006, 2-3 months after implementation of the Smoke-Free Ontario Act. Taking into account repeated measures, mixed model analysis was applied to examine the level of fine particle PPAH (ng/m(3)) by number of lit cigarettes per patio area.

RESULTS

Smoking on patios was common. With increasing numbers (0, 1.0-4.3, 4.4-8.7, 8.8-16.7 and 16.8-41.7) of lit cigarettes per 1000 ft(2) of patio area, there were increases in geometric mean (geometric standard deviation) PPAH levels, 4.7 (2.4), 9.1 (3.7), 16.9 (2.9), 19.1 (3.0) and 27.0 (2.9) ng/m(3) on patios. Mixed model analysis showed that PPAH levels increased significantly with number of lit cigarettes per patio area (p=0.0004). High levels of PPAH on patios may be associated with sustained vascular injury.

CONCLUSIONS

Complete smoking bans including outdoor workspaces are needed to adequately protect hospitality workers from secondhand smoke.

Prevalence and correlates of purchasing contraband cigarettes on First Nations reserves in Ontario, Canada

AIMS

Non-First Nations people purchasing cigarettes on First Nations reserves do not pay applicable taxes. We estimated prevalence and identified correlates of purchasing contraband cigarettes on reserves; we also quantified the share of contraband purchased on reserves relative to reported total cigarette consumption and the associated financial impact on taxation revenue.

DESIGN

Data from the Ontario Tobacco Survey, a regionally stratified representative population telephone survey that over-samples smokers.

SETTING

Ontario, Canada.

PARTICIPANTS

A total of 1382 adult current smokers.

MEASUREMENTS

Reported status of purchasing cigarettes on reserves and the quantity of cigarettes bought on reserves. The prevalence of purchasing cigarettes on reserves was assessed with descriptive statistics. A two-part model was used to analyse correlates of having recently purchased contraband.

FINDINGS

A total of 25.8% reported recent purchasing and 11.5% reported usual purchasing. Heavy smoking, having no plans to quit and lower education were correlated with recent purchasing. Heavy smoking and not having plans to quit were also correlated with buying more packs of cigarettes on reserves. Contraband purchases on reserves accounted for 14.0% of the reported total cigarette consumption and resulted in an estimated tax loss of $122.2 million.

CONCLUSIONS

There was substantial purchasing of contraband cigarettes on reserves in Ontario, resulting in significant losses in tax revenues. The availability of these cheap cigarettes undermines the effectiveness of tobacco taxation to reduce smoking. Wherever indicated, governments should strengthen their contraband prevention and control measures, as recommended by the Framework Convention on Tobacco Control, to ensure that tobacco taxation achieves its intended health benefits and that tax revenues are protected.

Methods for quantification of exposure to cigarette smoking and environmental tobacco smoke: focus on developmental toxicology

Active and passive smoking have been associated with an array of adverse effects on health. The development of valid and accurate scales of measurement for exposures associated with health risks constitutes an active area of research. Tobacco smoke exposure still lacks an ideal method of measurement. A valid estimation of the risks associated with tobacco exposure depends on accurate measurement. However, some groups of people are more reluctant than others to disclose their smoking status and exposure to tobacco. This is particularly true for pregnant women and parents of young children, whose smoking is often regarded as socially unacceptable. For others, recall of tobacco exposure may also prove difficult. Because relying on self-report and the various biases it introduces may lead to inaccurate measures of nicotine exposure, more objective solutions have been suggested. Biomarkers constitute the most commonly used objective method of ascertaining nicotine exposure. Of those available, cotinine has gained supremacy as the biomarker of choice. Traditionally, cotinine has been measured in blood, saliva, and urine. Cotinine collection and analysis from these sources has posed some difficulties, which have motivated the search for a more consistent and reliable source of this biomarker. Hair analysis is a novel, noninvasive technique used to detect the presence of drugs and metabolites in the hair shaft. Because cotinine accumulates in hair during hair growth, it is a unique measure of long-term, cumulative exposure to tobacco smoke. Although hair analysis of cotinine holds great promise, a detailed evaluation of its potential as a biomarker of nicotine exposure, is needed. No studies have been published that address this issue. Because the levels of cotinine in the body are dependent on nicotine metabolism, which in turn is affected by factors such as age and pregnancy, the characterization of hair cotinine should be population specific. This review aims at defining the sensitivity, specificity, and clinical utilization of different methods used to estimate exposure to cigarette smoking and environmental tobacco smoke.

Factors associated with the adoption of a smoking ban in Quebec households

The home represents an important source of exposure to environmental tobacco smoke for non-smokers, including children, who live with smokers. Our goal is to identify the sociodemographic factors associated with the adoption of smoking bans in "smoker households" in Quebec. Selected associations are compared with three other Canadian provinces (Ontario, British Columbia and Nova Scotia). This is a cross-sectional study involving 2648 respondents. Logistic regression analysis is employed. Few smoker households in Quebec (21%) have a ban on smoking; the presence of a non-smoker is strongly linked to the existence of such a ban; the presence of a child under the age of 6 is less strongly associated with the adoption of a ban in Quebec than in the other provinces, and the presence of an adolescent shows no association whatsoever. In addition to the child health benefits of household smoking bans, greater emphasis should be placed on the impact that such bans can have on children's future smoking behaviour. One option from a health promotion standpoint might be to organize a campaign aimed at non-smokers who live with smokers, in order to urge them to be less tolerant of environmental tobacco smoke.

Reference values for hair cotinine as a biomarker of active and passive smoking in women of reproductive age, pregnant women, children, and neonates: systematic review and meta-analysis

Exposure to environmental tobacco smoke (ETS) is most often estimated using questionnaires, but they are unreliable. Biomarkers can provide valid information on ETS exposure, the preferred biomarker being cotinine. However, no reference range of hair cotinine exists to distinguish among active, passive, and unexposed nonsmokers. This study identifies cutoffs to validate cotinine as a marker for exposure to ETS. Data were obtained from six databases (four US, one Canada, one France). Active smoking and exposure to ETS were measured in the hair of women of reproductive age, pregnant women, their children, and neonates. Subjects were classified into active smokers, passively exposed to ETS, and unexposed nonsmokers. A total of 1746 cases were available for analysis. For active smokers, mean hair cotinine concentrations (95% confidence interval) were 2.3 to 3.1 ng/mg for nonpregnant women and 1.5 to 1.9 ng/mg for pregnant women. In the group of passive smokers, mean hair cotinine concentrations were 0.5 to 0.7 ng/mg for nonpregnant women, 0.04 to 0.09 ng/mg for pregnant women, 0.9 to 1.1 for children, and 1.2 to 1.7 for neonates. Among unexposed nonsmokers, mean hair cotinine was 0.2 to 0.4 ng/mg in nonpregnant women, 0.06 to 0.09 ng/mg in pregnant women, and 0.3 to 0.4 ng/mg in children. Cutoff values for hair cotinine were established to distinguish active smokers from passive or unexposed (0.8 ng/mg for nonpregnant women and 0.2 ng/mg for pregnant women). A cutoff value of 0.2 ng/mg was accurate in discriminating between exposed children and unexposed. These new values should facilitate clinical diagnosis of active and passive exposure to tobacco smoke. Such diagnosis is critical in pregnancy and in a large number of tobacco-induced medical conditions.

The role of spending money and drinking alcohol in adolescent smoking

AIMS

Previous studies have shown inconsistent findings with regard to the association between amount of spending money and adolescent smoking. Drinking alcohol may be a mediator of the association between spending money and adolescent smoking. However, no studies have examined this potential role. The objective of this study was to investigate the association between amount of spending money and adolescent smoking and the potential mediation role of alcohol use in this association.

DESIGN

The 2003 Ontario Student Drug Use Survey of students in grades 7-12.

MEASUREMENTS

Multivariable logistic, probit and linear regression models were used to investigate the association between amount of spending money and smoking, and the contribution of drinking alcoholic beverages to this relationship.

FINDINGS

Spending money was associated positively with experimental smoking, current smoking and daily consumption of cigarettes (P < 0.01). The analysis adjusted for confounders showed that students with spending money > or =$20/week were significantly more likely to be experimental smokers, students with > or =$30/week were significantly more likely to be current smokers and students with > or =$60/week smoked significantly more cigarettes/day (P < or = 0.05), compared to students with <$10/week. Alcohol use was an important mediator, responsible for 81% of the association of spending money with experimental smoking, 38% with current smoking and 37% with daily consumption of cigarettes.

CONCLUSIONS

Amount of spending money was associated significantly and positively with smoking among adolescents, and alcohol use mediated this association. Integrated tobacco prevention programs may be more effective, and increasing taxes on cigarettes and alcohol would increase price sensitivity among youth and protect against adolescent smoking.

Perceptions of industry responsibility and tobacco control policy by US tobacco company executives in trial testimony

OBJECTIVE

Trial testimony from the United States provides a unique opportunity to examine strategies of the American tobacco industry. This paper examines congruence between the arguments for tobacco control policy presented by representatives of the American tobacco industry at trial and the stages of responsibility associated with corporate social responsibility principles in other industries.

DATA SOURCES

Trial testimony collected and coded by the Deposition and Trial Testimony Archive (DATTA).

STUDY SELECTION

All available testimony was gathered from representative senior staff from major tobacco companies: Brown & Williamson, Philip Morris, RJ Reynolds, and Liggett.

DATA EXTRACTION

Transcripts from each witness selected were collected and imported in text format into WinMax, a qualitative data program. The documents were searched for terms relating to tobacco control policies, and relevant terms were extracted. A hand search of the documents was also conducted by reading through the testimony. Inferred responsibility for various tobacco control policies (health information, second-hand smoking, youth smoking) was coded.

DATA SYNTHESIS

The level of responsibility for tobacco control policy varied according to the maturity of the issue. For emerging issues, US tobacco company representatives expressed defensiveness while, for more mature issues, such as youth smoking, they showed increased willingness to deal with the issue. This response to social issues is consistent with corporate social responsibility strategies in other industries.

CONCLUSION

While other industries use corporate social responsibility programmes to address social issues to protect their core business product, the fundamental social issue with tobacco is the product itself. As such, the corporate nature of tobacco companies is a structural obstacle to reducing harm caused by tobacco use.

Autonomy (vs. sociotropy) and depressive symptoms in quitting smoking: evidence for trait-congruence and the role of gender

According to Beck's cognitive theory of depression, autonomy (high achievement concerns) and sociotropy (high interpersonal concerns) are vulnerability factors for depression when achievement or interpersonal stressors, respectively, are experienced. This hypothesis was tested among men and women attempting to quit smoking, an achievement stressor that can provoke depressive symptoms. Smokers recruited from the community (N=210) provided information about their quit attempt through mailed questionnaires. For the 48-h period following the quit, relationships among autonomy, sociotropy, coping, depressive symptoms and lapsing were assessed. Structural equation models supported the trait-congruence hypothesis because greater autonomy, but not sociotropy, was associated with elevated depressive symptoms among both men and women smokers. However, results were stronger for men (beta=.47, p=.0001) than for women (beta=.20, p=.05). After accounting for autonomy's relationship with depressive symptoms, greater autonomy was inversely associated with lapsing among men (beta=-.35, p=.01), but not women. Results point to the potential usefulness of a theoretical approach to understanding relationships between depressive symptoms and smoking cessation, and indicate that autonomous personality may be an important factor in smoking cessation in men.

The impact of tobacco tax cuts on smoking initiation among Canadian young adults

BACKGROUND

Although the majority of smokers initiate smoking during their teenage years, significant rates of initiation occur among young adults. Adolescents are more price sensitive than adults, but little is known about the impact of tobacco taxation on smoking initiation among young adults. Using a longitudinal design, this study examined the impact of decreased cigarette price, resulting from tobacco tax cuts, on smoking initiation among Canadian young adults aged 20 to 24 years.

METHODS

Using Statistics Canada's National Population Health Survey longitudinal file, this study examined young adults who did not smoke at baseline in 1994-1995 (n=636, representing over 1 million young adults) and who were reassessed at follow-up (1996-1997). Multivariable logistic regression analysis using bootstrap weights was conducted to estimate the impact of decreased cigarette price on smoking initiation. The analysis controlled for the potential confounding effect of sociodemographic and tobacco control variables. Sensitivity analyses were conducted. Price elasticity was estimated. Analyses were conducted in 2003 and 2004.

RESULTS

Approximately 10% of young adults had initiated smoking at follow-up. Decreased cigarette price was significantly associated with higher smoking initiation (adjusted odds ratio per $1 decrease for a carton of cigarettes=1.15, 95% confidence interval [CI]=1.01-1.32, p=0.042). Sensitivity analyses showed similar results. Price elasticity was 3.36 (95% CI=0.07-6.75).

CONCLUSIONS

Young adults are sensitive to cigarette prices. Reductions in cigarette prices will lead to increased smoking initiation among this group. Tobacco taxation should be an effective strategy to reduce smoking initiation among young adults.

The economic impact of a smoke-free bylaw on restaurant and bar sales in Ottawa, Canada

AIMS

On 1 August 2001, the City of Ottawa (Canada's Capital) implemented a smoke-free bylaw that completely prohibited smoking in work-places and public places, including restaurants and bars, with no exemption for separately ventilated smoking rooms. This paper evaluates the effects of this bylaw on restaurant and bar sales. DATA AND MEASURES: We used retail sales tax data from March 1998 to June 2002 to construct two outcome measures: the ratio of licensed restaurant and bar sales to total retail sales and the ratio of unlicensed restaurant sales to total retail sales. Restaurant and bar sales were subtracted from total retail sales in the denominator of these measures.

DESIGN AND ANALYSIS

We employed an interrupted time-series design. Autoregressive integrated moving average (ARIMA) intervention analysis was used to test for three possible impacts that the bylaw might have on the sales of restaurants and bars. We repeated the analysis using regression with autoregressive moving average (ARMA) errors method to triangulate our results.

FINDINGS

Outcome measures showed declining trends at baseline before the bylaw went into effect. Results from ARIMA intervention and regression analyses did not support the hypotheses that the smoke-free bylaw had an impact that resulted in (1) abrupt permanent, (2) gradual permanent or (3) abrupt temporary changes in restaurant and bar sales.

CONCLUSIONS

While a large body of research has found no significant adverse impact of smoke-free legislation on restaurant and bar sales in the United States, Australia and elsewhere, our study confirms these results in a northern region with a bilingual population, which has important implications for impending policy in Europe and other areas.

Smoking cessation and lung cancer mortality in a cohort of middle-aged Canadian women

PURPOSE

To determine the impact of smoking cessation on lung cancer mortality among women.

METHODS

Survival analysis is used to assess the effect of smoking cessation on lung cancer death in the dietary cohort of 49,165 women aged 40 to 59 years enrolled in the Canadian National Breast Screening Study.

RESULTS

During an average of 10.3 years of follow-up, 106 women died of lung cancer. The risk of lung cancer mortality among women who quit before age 50 (HR=0.26; 95% CI, 0.13-0.55 among women who quit at ages 40-49) or quit in the previous 10 years (HR=0.39; 95% CI, 0.22-0.69) is substantially lower than the risk among current smokers. Women who quit after age 40 or have quit for less than 20 years are at substantially higher risk of lung cancer mortality compared with never smokers. Both duration of smoking cessation and age at quitting have independent effects on lung cancer mortality, after controlling for number of cigarettes smoked per day and number of years smoked, as well as other potential confounding variables.

CONCLUSION

These findings suggest that programs and policies to promote early cessation of smoking and prevention of relapse should be a public health priority.

Tobacco industry links to faculties of medicine in Canada

BACKGROUND

The tobacco industry uses various strategies to promote itself as a socially responsible, ethical industry, including establishing links with health institutions and medical research. The purpose of this study was to identify the relationships between the tobacco industry and Canadian faculties of medicine, specifically research funding and donations from tobacco industry sources, and faculty-specific policies regarding the acceptance of tobacco industry funds.

METHODS

Information about policies and practices regarding research funding and donations from 1996-1999 was requested from the 16 Canadian faculties of medicine and their parent universities, as part of a larger cross-sectional survey-centred study that examined links between the tobacco industry and Canadian universities.

RESULTS

All 16 faculties of medicine (100%) reported on research funding and 11/16 (70%) reported on donations from the tobacco industry. Twenty-five percent (4/16) of the faculties received research funding from the tobacco industry and 27% (3/11) received donations. No Canadian medical school had a policy that banned tobacco industry research funding or donations.

INTERPRETATION

The tobacco industry have made donations and given research funding to faculties of medicine in Canada. This may present major conflicts of interest that undermine public health and have implications for the scientific integrity of the medical research enterprise. Faculties of medicine should consider developing policies that prohibit tobacco industry research funding and donations, with the intent of preventing conflicts and precluding ethical dilemmas arising from links with the tobacco industry. They should also encourage parent universities to establish similar policies at an institutional level.

Tobacco industry links to faculties of medicine in Canada

BACKGROUND

The tobacco industry uses various strategies to promote itself as a socially responsible, ethical industry, including establishing links with health institutions and medical research. The purpose of this study was to identify the relationships between the tobacco industry and Canadian faculties of medicine, specifically research funding and donations from tobacco industry sources, and faculty-specific policies regarding the acceptance of tobacco industry funds.

METHODS

Information about policies and practices regarding research funding and donations from 1996-1999 was requested from the 16 Canadian faculties of medicine and their parent universities, as part of a larger cross-sectional survey-centred study that examined links between the tobacco industry and Canadian universities.

RESULTS

All 16 faculties of medicine (100%) reported on research funding and 11/16 (70%) reported on donations from the tobacco industry. Twenty-five percent (4/16) of the faculties received research funding from the tobacco industry and 27% (3/11) received donations. No Canadian medical school had a policy that banned tobacco industry research funding or donations.

INTERPRETATION

The tobacco industry have made donations and given research funding to faculties of medicine in Canada. This may present major conflicts of interest that undermine public health and have implications for the scientific integrity of the medical research enterprise. Faculties of medicine should consider developing policies that prohibit tobacco industry research funding and donations, with the intent of preventing conflicts and precluding ethical dilemmas arising from links with the tobacco industry. They should also encourage parent universities to establish similar policies at an institutional level.

Interest in self-help materials among a general population sample of smokers

Previous studies have shown that self-help materials can be effective in helping people quit smoking. However, it is not known what proportion of smokers in the general population are interested in this method of cessation. A representative sample of 267 daily smokers participated in a random digit dialing telephone survey. Respondents were asked about their level of interest in self-help materials that would help them quit smoking. Potential predictors of level of interest were examined first through bivariate analyses, followed by a multinomial logistic regression. Of daily smokers, 27% were very interested in receiving a self-help booklet, 28% were somewhat interested, and 45% were not at all interested. Interest in self-help materials was positively related to intent to quit in the next 6 months and to low family income.

Dimensions underlying legislator support for tobacco control policies

OBJECTIVE

To propose and test a new classification system for characterising legislator support for various tobacco control policies.

DESIGN

Cross sectional study.

SUBJECTS

Federal and provincial legislators in Canada serving as of October 1996 who participated in the Canadian Legislator Study (n = 553; response rate 54%).

MAIN OUTCOME MEASURES

A three factor model (Voters, Tobacco industry, Other interest groups) that assigns nine tobacco control policies according to legislators' hypothesised perceptions of which group is more directly affected by these policies.

RESULTS

Based on confirmatory factor analysis, the proposed model had an acceptable fit and showed construct validity. Multivariate analysis indicated that three of the predictors (believing that the government has a role in health promotion, being a non-smoker, and knowledge that there are more tobacco than alcohol caused deaths) were associated with all three factor scales. Several variables were associated with two of the three scales. Some were unique to each scale.

CONCLUSIONS

Based on our analyses, legislator support for tobacco control policies can be grouped according to our a priori factor model. The information gained from this work can help advocates understand how legislators think about different types of tobacco control policies. This could lead to the development of more effective advocacy strategies.

Support for tobacco control policies: how congruent are the attitudes of legislators and the public?

OBJECTIVES

To examine the congruence in perceptions and attitudes of legislators and the public regarding tobacco and tobacco control policies.

METHODS

Two cross-sectional surveys were used, one of elected federal and provincial legislators and one of adult residents in Ontario, Canada. Perceptions and attitudes were analyzed as dependent variables using multiple logistic regression, and adjusted for age, sex, educational attainment, and smoking status.

FINDINGS

Congruence was found in most instances, however, some differences were found. Legislators were more likely than the public to agree that most smokers are addicted and were more supportive of a smoking ban in workplaces, but these differences disappeared after controlling for socio-demographic characteristics. Legislators were also more aware than the public of the magnitude of deaths due to tobacco compared to alcohol, whereas the public was more supportive of strong penalties against stores that sell cigarettes to minors.

CONCLUSIONS

Our findings provide considerable evidence for congruence in the "real-world" (unadjusted) perceptions and attitudes of Ontario legislators and the Ontario public toward tobacco control policies. Such findings are positive for tobacco control advocates and should be leveraged to bring forward strong tobacco policies in the political arena.

Effects of gender in social control of smoking cessation

This study of 93 men and 117 women smokers during an ongoing quit attempt examined the roles of gender and social network influences on quitting. For men, social influences appeared to positively affect their ability to reduce their smoking but were less effective for women. Specifically, increased reports of a spouse or partner's influence, and family and friends' influence, were associated with greater reductions in men's smoking 2 days and 4 months post quit date, respectively. In contrast, for women, greater reports of spouse or partner influence and of family and friends' influence were associated with smaller reductions in smoking. Sex differences in social control strategies and perceived autonomy supportiveness of those strategies are discussed as possible explanations for these results.