1
|
Pelekanakis A, O'Loughlin JL, Maximova K, Montreuil A, Kalubi J, Dugas EN, Sylvestre MP. Associations of Quantity Smoked and Socioeconomic Status With Smoke-Free Homes and Cars Among Daily Smokers. HEALTH EDUCATION & BEHAVIOR 2021; 49:488-496. [PMID: 34027700 DOI: 10.1177/10901981211010437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION An association between socioeconomic status (SES) and smoke-free private spaces among smokers could be due to heavier smoking among low SES smokers. We assessed whether quantity smoked or SES are independently associated with smoke-free homes or cars in daily smokers. METHOD Data were drawn from a cross-sectional telephone survey (2011-2012) of 750 daily smokers age ≥18 years in Quebec, Canada (45% response). Multivariable logistic regression was used to model the independent association between (a) number of cigarettes smoked per day, and (b) each of educational attainment, annual household income, or active employment status and smoke-free homes or cars. RESULTS Participants were 41.0 years old on average, 57% were female. Median (IQR) number of cigarettes smoked per day was 14 (10, 20). Forty-eight percent of participants reported smoke-free homes; 34% reported smoke-free cars. Quantity smoked was strongly associated with both smoke-free homes and cars. Income and education (but not actively employed) were associated with smoke-free homes. None of the SES indicators were associated with smoke-free cars. CONCLUSIONS Interventions targeting smokers to promote smoke-free homes and cars should incorporate components to help smokers reduce quantity smoked or preferably, to quit. Interventions targeting smoke-free homes will also need to address SES inequalities by education and income. Our data suggest that reduction in quantity smoked may help smokers reduce SHS exposure in cars, but that an inequality lens may not be relevant.
Collapse
Affiliation(s)
- Annie Pelekanakis
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.,Departement of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Quebec, Canada
| | - Jennifer L O'Loughlin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.,Departement of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Quebec, Canada
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Annie Montreuil
- Institut national de santé publique du Québec, Montréal, Quebec, Canada.,Département de psychologie, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Jodi Kalubi
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.,Departement of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Quebec, Canada.,Centre de recherche en santé publique (CReSP), Université de Montréal & CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada
| | - Erika N Dugas
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Marie-Pierre Sylvestre
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.,Departement of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Quebec, Canada
| |
Collapse
|
2
|
Azagba S, Shan L, Latham K. County Smoke-Free Laws and Cigarette Smoking Among U.S. Adults, 1995-2015. Am J Prev Med 2020; 58:97-106. [PMID: 31732322 DOI: 10.1016/j.amepre.2019.08.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Tobacco use remains the leading cause of preventable death worldwide. Though research on smoke-free policies in the U.S. exists at the state or national level, there is limited evidence on such policies at the county level. This study examined the association between changes in county-level comprehensive smoke-free laws and smoking behavior among U.S. adults. METHODS Data were used from the 1995/1996 to the 2014/2015 Tobacco Use Supplement to the Current Population Survey, analyzed in 2019. Changes in county smoke-free law population coverage over time were used as a natural experiment. Quasi-experimental analyses were performed to examine the association between changes in county-level comprehensive smoke-free laws and smoking behavior (smoking status and number of cigarettes smoked). RESULTS During the study period, current smoking prevalence decreased from 21.6% to 11.9%. Specifically, the prevalence of every day smoking decreased from 17.1% to 9.1% and some days smoking decreased from 4.4% to 2.9%. The number of cigarettes smoked per day for every day smokers decreased from 18.5 to 13.6, and from 5.9 to 4.1 for those who smoked some days. Comprehensive smoke-free legislation was associated with lower odds of cigarette smoking (AOR=0.76, 95% CI=0.74, 0.79). Adults living in counties with comprehensive smoke-free policies smoked fewer cigarettes per day both for every day smokers (β= -1.55, p<0.0001) and some days smokers (β= -0.79, p<0.0001). CONCLUSIONS County smoke-free policies in the U.S. may have contributed significantly to the reduction in smoking prevalence as well as the reduction in the number of cigarettes smoked among continuing cigarette smokers.
Collapse
Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
| | - Lingpeng Shan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Keely Latham
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| |
Collapse
|
3
|
Chiu YL, Lo HC, Lai CH, Hwang SL, Lin FG, Huang SJ, Jiang SH, Li SR, Tzeng YM, Fang WH, Kao S. Effectiveness of a smoking restriction policy on smoking behaviour in the military. Addict Behav 2017; 67:53-57. [PMID: 28012966 DOI: 10.1016/j.addbeh.2016.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 11/29/2016] [Accepted: 12/15/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Yu-Lung Chiu
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | | | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Shu-Ling Hwang
- Center for General Education, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Gong Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.
| | - Shu-Jia Huang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Shiang-Huei Jiang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Shan-Ru Li
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
| | - Ya-Mei Tzeng
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Hui Fang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Senyeong Kao
- School of Public Health, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan.
| |
Collapse
|
4
|
Gregoire B, Azagba S, Asbridge M. Smoke-free homes, smoking susceptibility and familial smoking among never-smoking high school students: a cross-sectional analysis. CMAJ Open 2016; 4:E298-303. [PMID: 27398377 PMCID: PMC4933637 DOI: 10.9778/cmajo.20160010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Research has shown that living in a smoke-free home has a positive effect on adolescents' perceived acceptance of smoking. However, the relationship between smoke-free homes and adolescent smoking behaviours remains unclear. The aim of this study was to examine the association between smoke-free homes and smoking susceptibility among high school students, and to determine whether these associations persist when analyses are stratified by familial smoking status. METHODS We conducted a random cross-sectional survey (2012/2013 Youth Smoking Survey) of primary, junior and high school students in Canada (n = 47 203). Multivariable logistic regression analyses were used to examine the associations between smoke-free homes and susceptibility to smoking among never-smoking high school students, with and without stratification by familial smoking. RESULTS Analyses showed that adolescents living in a smoke-free home had reduced odds of being susceptible to smoking (odds ratio [OR] 0.582, 95% confidence interval [CI] 0.428-0.791) compared with their peers living in households where smoking was permitted. When adolescents had other family members who were smokers, having a smoke-free home was not significantly associated with reduced smoking susceptibility (OR 0.878, 95% CI 0.721-1.071). INTERPRETATION Our results suggest that smoke-free homes may influence future smoking initiation. Optimal success in preventing youth smoking uptake necessitates having a coherent antismoking message between the home smoking environment and familial smoking behaviour.
Collapse
Affiliation(s)
- Bruce Gregoire
- Department of Community Health and Epidemiology (Gregoire, Asbridge), Dalhousie University, Halifax, NS; Propel Centre for Population Health Impact (Azagba), School of Public Health and Health Systems, University of Waterloo, Waterloo, Ont
| | - Sunday Azagba
- Department of Community Health and Epidemiology (Gregoire, Asbridge), Dalhousie University, Halifax, NS; Propel Centre for Population Health Impact (Azagba), School of Public Health and Health Systems, University of Waterloo, Waterloo, Ont
| | - Mark Asbridge
- Department of Community Health and Epidemiology (Gregoire, Asbridge), Dalhousie University, Halifax, NS; Propel Centre for Population Health Impact (Azagba), School of Public Health and Health Systems, University of Waterloo, Waterloo, Ont
| |
Collapse
|
5
|
Azagba S. Effect of smoke-free patio policy of restaurants and bars on exposure to second-hand smoke. Prev Med 2015; 76:74-8. [PMID: 25913419 DOI: 10.1016/j.ypmed.2015.04.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/14/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE While there is increasing support for restricting smoking in restaurant and bar patios, there is limited evidence on the effectiveness of this policy. This study examined the effect of smoke-free patio policy of restaurants and bars on adult second-hand smoke (SHS) exposure. METHODS Data were drawn from the 2005-2012 Canadian Tobacco Use Monitoring Survey (n=89,743), a repeated cross-sectional survey of youth and adult. Regression analysis, a quasi-experimental design was used to examine the effect of provincial smoke-free patio policy on self-reported exposure to SHS. RESULTS Analyses suggest that exposure to SHS on patios of bars and restaurants declined following the adoption of provincial smoke-free patio policy. Relative to pre-policy SHS exposure, regression results showed a reduction in the probability of SHS exposure of up to 25% in Alberta. Similarly, in Nova Scotia, the probability of SHS exposure declined by up to 21%. Analyses stratified by smoking status found similar significant effect on both smokers and non-smokers. CONCLUSIONS Findings suggest that provincial patio smoking ban on bars and restaurants had the intended effect of protecting non-smokers from SHS exposure. This study is consistent with a large body of evidence showing that a strong smoke-free legislation is an effective public health measure.
Collapse
Affiliation(s)
- Sunday Azagba
- Propel Centre for Population Health Impact, University of Waterloo, Canada; School of Public Health and Health Systems, University of Waterloo, Canada.
| |
Collapse
|