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Papaioannou D, Hamer-Kiwacz S, Mooney C, Cooper C, O'Cathain A, Sprange K, Moody G. Recording harms in randomized controlled trials of behavior change interventions: a scoping review and map of the evidence. J Clin Epidemiol 2024; 169:111275. [PMID: 38336177 DOI: 10.1016/j.jclinepi.2024.111275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES Randomized controlled trials evaluate diverse interventions. This can include medical interventions such as drugs or surgical procedures, or behavior change interventions (BCIs) that aim to change a habit, belief, or attitude to improve health, for example, healthy eating, psychological wellbeing. Harms are often recorded poorly or inconsistently within randomized controlled trials of BCIs. This scoping review aimed to collate and describe literature on categories, definitions, and mechanisms of harms from BCIs; methods of identifying plausible harms; and recommendations for recording harms. STUDY DESIGN AND SETTING A scoping review was conducted. Three databases (MEDLINE, PsycINFO, and CINAHL) were searched. Reference list checking and citation searching were performed. Articles were included if they discussed (1) interventions that aimed to modify behavior, (2) categories or mechanisms of harms, and (3) methods or recommendations for recording harms. All research designs were included. One reviewer reviewed titles, abstracts, and full texts; queries were checked with another reviewer. Data were extracted and synthesized descriptively by one reviewer and checked by another reviewer. A thematic map was constructed to summarize the review findings. Harms described from specific BCIs were identified, and examples were selected and summarized. RESULTS The review included 37 articles. Nineteen of 37 articles contributed to a thematic review. Three articles described categories of harms; categories of harm included physical, psychological, group and social interactions, cultural, equity, opportunity cost, environmental, and economic. Seven articles included mechanisms or underlying factors for harms including feelings of failure leading to shame or stigma, and group interventions enabling knowledge exchange on unhealthy behaviors. Twelve articles provided recommendations for recording harms, including taking a proportionate approach by focusing on the most plausible and important harms, collecting different perspectives on whether harms had occurred (eg, caregivers and family members), and using qualitative research methods to identify harms. One article described a three-step method to identify plausible harms from an intervention, and six articles supported aspects of the method. Eighteen of 37 articles contributed to a review which collated harms arising from specific interventions, for example, a peer support intervention in inflammatory bowel disease caused distressing conversations which might lead to anxiety and confrontation with a possible negative future. CONCLUSION BCIs can cause harm. This review identified categories and proposed mechanisms of harms, as well as methods and recommendations for identifying and recording harms in BCIs for inclusion in forthcoming recommendations.
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Affiliation(s)
- Diana Papaioannou
- Clinical Trials Research Unit, Division of Population Health, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Sienna Hamer-Kiwacz
- Clinical Trials Research Unit, Division of Population Health, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Cara Mooney
- Clinical Trials Research Unit, Division of Population Health, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Cindy Cooper
- Clinical Trials Research Unit, Division of Population Health, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Alicia O'Cathain
- Health and Care Research Unit, Division of Population Health, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Kirsty Sprange
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Gwenllian Moody
- Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK
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Zhang H, Zhou X, Tian L, Huang J, E M, Yin J. Passive smoking and risk of gestational diabetes mellitus: A systematic review and meta-analysis. Tob Induc Dis 2023; 21:115. [PMID: 37718995 PMCID: PMC10501223 DOI: 10.18332/tid/169722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/23/2023] [Accepted: 07/17/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION Pregestational smoking increases the risk of gestational diabetes mellitus (GDM) and is a common health problem during pregnancy, with its incidence on the rise worldwide, especially in China. This study is a meta-analysis of passive smoking as a risk factor associated with GDM. METHODS Two independent reviewers searched passive smoking and the risk of GDM in PubMed, Medline, Web of Knowledge, Science Direct, China National Knowledge Internet (CNKI) and Wanfang databases (up to May 2023). The authors extracted the study data independently and used the Newcastle-Ottawa scale (NOS) to evaluate the quality of the included articles. A meta-analysis was conducted using a random effects model depending on the size of the heterogeneity. Begg's and Egger's tests were performed to assess publication bias. RESULTS The overall relative risk for GDM caused by passive smoking was 1.47 (95% CI: 1.31-1.64), with moderate heterogeneity between studies (I2=41.7%, p=0.079). Subgroup and sensitivity analyses were stable, and no evidence of publication bias was found. CONCLUSIONS Passive smoking is a risk factor for GDM, even in those who are not active smokers. To eliminate the effects of other confounding factors, larger prospective cohort studies are required to clarify the relationship between passive smoking and the occurrence of GDM.
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Affiliation(s)
- Haijie Zhang
- Shanxi Health Commission Key Laboratory of Nervous System Disease Prevention and Treatment, Sinopharm Tongmei General Hospital, Datong, China
- Department of Clinical Nutrition, Sinopharm Tongmei General Hospital, Datong, China
- The Innovation Center of Coal Mine Public Health Graduate Student of Shanxi Province Sinopharm Tongmei General Hospital, Datong, China
| | - Xin Zhou
- Yangzhou Center for Disease Control and Prevention, Yangzhou, China
| | - Lixia Tian
- Shanxi Health Commission Key Laboratory of Nervous System Disease Prevention and Treatment, Sinopharm Tongmei General Hospital, Datong, China
- Department of Neurosurgery, Sinopharm Tongmei General Hospital, Datong, China
| | - Jianjun Huang
- Shanxi Health Commission Key Laboratory of Nervous System Disease Prevention and Treatment, Sinopharm Tongmei General Hospital, Datong, China
- The Innovation Center of Coal Mine Public Health Graduate Student of Shanxi Province Sinopharm Tongmei General Hospital, Datong, China
- Department of Neurosurgery, Sinopharm Tongmei General Hospital, Datong, China
| | - Meng E
- Yangzhou Center for Disease Control and Prevention, Yangzhou, China
| | - Jinzhu Yin
- Shanxi Health Commission Key Laboratory of Nervous System Disease Prevention and Treatment, Sinopharm Tongmei General Hospital, Datong, China
- The Innovation Center of Coal Mine Public Health Graduate Student of Shanxi Province Sinopharm Tongmei General Hospital, Datong, China
- Department of Central Laboratory, Sinopharm Tongmei General Hospital, Datong, China
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Su Z, McDonnell D, Abbas J, Shi L, Cai Y, Yang L. Secondhand Smoke Exposure of Expectant Mothers in China: Factoring in the Role of Culture in Data Collection. JMIR Cancer 2021; 7:e24984. [PMID: 34617907 PMCID: PMC8532012 DOI: 10.2196/24984] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/26/2020] [Accepted: 12/24/2020] [Indexed: 01/22/2023] Open
Abstract
Cancer is the leading cause of death worldwide. Tobacco smoking, including secondhand smoking, causes cancer and is responsible for over 22% of global cancer deaths. The adverse impacts of secondhand smoke are more pronounced for expectant mothers, and can deteriorate both mothers’ and infants’ health and well-being. Research suggests that secondhand smoke significantly increases expectant mothers’ risk of miscarriage, cancer, and other chronic disease conditions, and exposes their unborn babies to an increased likelihood of having life-long poor health. In China, a pregnant woman’s family members, such as her husband, parents, or in-laws, are the most likely people to be smoking around her. Due to traditional Chinese cultural practices, even though some expectant mothers understand the harm of secondhand smoke, they may be reluctant to report their family members’ smoking behaviors. Resulting in severe underreporting, this compromises health experts’ ability to understand the severity of the issue. This paper proposes a novel approach to measure secondhand smoke exposure of pregnant women in the Chinese context. The proposed system could act as a stepping stone that inspires creative methods to help researchers more accurately measure secondhand smoking rates of expectant mothers in China. This, in turn, could help health experts better establish cancer control measures for expectant mothers and decrease their cancer risk.
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Affiliation(s)
- Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, University of Texas Health San Antonio, San Antonio, TX, United States
| | - Dean McDonnell
- Department of Humanities, Institute of Technology Carlow, Carlow, Ireland
| | - Jaffar Abbas
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lili Shi
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Chen J, Liu P, Hu W, Xu Y, Deng J. Facial nerve palsy may indicate coronary artery lesions in Kawasaki disease. Clin Rheumatol 2021; 40:4191-4197. [PMID: 34059986 DOI: 10.1007/s10067-021-05791-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/17/2021] [Accepted: 05/23/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Facial nerve palsy (FNP) is extremely rare in Kawasaki disease (KD) and the incidence is just 0.9-1.3%. Our objective was to study the clinical features and prognosis of KD accompanied with FNP and to determine whether FNP indicated an increased risk of coronary artery lesions (CALs) in KD. METHODS An observational study was performed on 9 patients diagnosed as KD accompanied with FNP in Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China between September 2012 and December 2019. Patients were followed up from September 2012 till September 2020. Clinical features, laboratory and echocardiography findings, treatments, and prognosis were analyzed retrospectively. And the clinical data of patients with FNP (group A, n = 9) were compared to matched KD patients without FNP (group B, n = 27) in order to determine whether FNP indicated an increased risk of CALs in KD. The matching factors included sex, age, days of illness at the intravenous immunoglobulin use, and classic/incomplete KD forms. RESULTS Clinical data of 9 patients were analyzed in this study. Patients tended to be younger than 24 months of age (88.9%) and 55.6% were under 12 months. Median onset of FNP was day 10 of illness. Eight patients (88.9%) showed unilateral FNP. The levels of laboratory inflammatory markers (White blood cells count, neutrophil percentage, C-reactive protein, erythrocyte sedimentation rate, etc.) were significantly increased in most cases. CALs were noted in 8 of 9 patients (88.9%). Coronary artery aneurysms occurred in 4 cases (44.4%) and the remaining 4 patients showed coronary artery dilation. All patients were given intravenous immunoglobulin therapy (2 g/kg), aspirin (30-50 mg/kg/day), and short-term dexamethasone. During follow-up, both FNP and CALs were completely recovered in all patients. The duration time of FNP ranged from 10 to 130 days. And the time for CALs to normal ranged from 12 to 282 days. The occurrence of CALs was significantly higher in patients with FNP than those without FNP (88.9% vs. 25.9%, P < 0.05). CONCLUSIONS KD accompanied with FNP is rare but may indicate an increased risk of CALs. Clinicians should take KD into consideration when children suffer from long-term fever with FNP, even with incomplete diagnostic features. With a long-term follow-up, both FNP and CALs have a good prognosis. KEY POINTS • Facial nerve palsy may indicate an increased risk of coronary artery lesions in Kawasaki disease. • Clinicians should take Kawasaki disease into consideration when children suffer from long-term fever with facial nerve palsy, even with incomplete diagnostic features. • Facial nerve palsy and coronary artery lesions have a good prognosis in a long-term follow-up.
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Affiliation(s)
- Jialei Chen
- Pediatric Neurology Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
- , Chengdu City, China.
| | - Ping Liu
- Pediatric Neurology Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Wenguang Hu
- Pediatric Neurology Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yang Xu
- Pediatric Neurology Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Jia Deng
- Pediatric Neurology Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
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Zhao J, Li X, Stewart SL, Gao W, Qi F, Zhang L, Pang Z, Qiao Q, Ning F, Tong E. Cigarette Smoking and Secondhand Smoke Exposure Before and After a Tobacco-Free Olympic Policy Period: Qingdao, China. Nicotine Tob Res 2019; 21:1531-1538. [PMID: 30335156 PMCID: PMC6821375 DOI: 10.1093/ntr/nty215] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 10/16/2018] [Indexed: 11/14/2022]
Abstract
INTRODUCTION We explored the impact of a temporary tobacco-free public policy for the 2008 Summer Olympics on the smoking prevalence and secondhand smoke exposure among the population of a co-hosting city, Qingdao, China. METHODS The Qingdao Diabetes Survey was analyzed for 2006 (n = 4599) and 2009 (n = 4680), which are survey years before and after the tobacco-free Olympics public policy period (July 2007 to January 2009). We analyzed the differences in self-reported smoking prevalence and exposure to secondhand smoke at home and/or workplace, and compared odds of smoking by survey year and of exposure to secondhand smoke among nonsmokers. RESULTS From 2006 to 2009, the male smoking prevalence declined from 51.4% (95% confidence interval [CI] = 49.0% to 53.9%) to 42.6% (95% CI = 40.2% to 45.1%), and the proportion of lighter smokers decreased more. Among nonsmokers, the secondhand smoke exposure rate declined from 62.2% (95% CI = 60.5% to 63.9%) to 56.8% (95% CI = 55.1% to 58.6%). Regression analyses show 34% lower odds of men smoking after Olympics (OR = 0.66, 95% CI = 0.57% to 0.77%). Rural residents and individuals who are not retired were more likely to smoke. Female nonsmokers report 17% less exposure to secondhand smoke after Olympics (OR = 0.83, 95% CI = 0.70% to 0.98%). Urban nonsmokers were more likely to be exposed than their rural counterparts. CONCLUSIONS Smoking prevalence among men and secondhand smoke exposure among women significantly decreased in Qingdao, China, after the tobacco-free Olympics public policy period. As only the proportion of lighter smokers decreased, this may help explain why urban nonsmokers reported increased exposure. Unintended increased secondhand smoke exposure and cessation support need to be addressed in large-scale policy campaigns. IMPLICATIONS Hosting the Olympic Games can help to initiate large-scale tobacco-free public policies for hosting cities. Although previous studies have demonstrated reduction in nonsmoker exposure to secondhand smoke, the impact on the hosting city's smoking prevalence or exposure rates is unclear. After the Olympic Games in Qingdao, China, smoking prevalence among men significantly decreased, mostly due to light smokers. Secondhand smoke exposure at home and/or workplace significantly decreased among female nonsmokers. Urban nonsmokers had an unintended consequence of increased secondhand smoke exposure after the tobacco-free Olympic policy period. Concurrent promotion of cessation support for heavier smokers may be needed.
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Affiliation(s)
- Jing Zhao
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Xiaojing Li
- Department of Chronic Disease Prevention, Qingdao Municipal Center for Disease Control & Prevention, Qingdao, China
| | | | - Weiguo Gao
- Qingdao Endocrinology and Diabetes Hospital, Qingdao, China
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Fei Qi
- Department of Chronic Disease Prevention, Qingdao Municipal Center for Disease Control & Prevention, Qingdao, China
| | - Lei Zhang
- Qingdao Endocrinology and Diabetes Hospital, Qingdao, China
| | - Zengchang Pang
- Department of Chronic Disease Prevention, Qingdao Municipal Center for Disease Control & Prevention, Qingdao, China
| | - Qing Qiao
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Feng Ning
- Department of Chronic Disease Prevention, Qingdao Municipal Center for Disease Control & Prevention, Qingdao, China
- Department of Statistics and Epidemiology, Medical College, Qingdao, China
| | - Elisa Tong
- University of California, Davis, Sacramento, CA
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Tan T, Shi L, Chen X, Cai Y. Changes in the smoking behavior of pregnant women andtheir family members during pregnancy: A cross-sectional study in China. Tob Induc Dis 2018; 16:12. [PMID: 31516412 PMCID: PMC6659502 DOI: 10.18332/tid/85493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/06/2018] [Accepted: 02/19/2018] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Studies regarding the changes in smoking behavior of pregnant women have been mostly conducted in high income countries but rarely in China. This study thus focused on investigating the changes in smoking behavior among pregnant women and their family members in China, both before and during pregnancy. METHODS A cross-sectional study was carried out at nine Women and Children’s Hospitals in Shanghai, China, in 2014. A total of 2831 gestational households were recruited. The chi-squared test, paired sample t-test and logistical regression analysis were used during statistical analysis. RESULTS The prevalence of smoking for all household members significantly declined during pregnancy: 76.2% of the pregnant women, 19.2% of their husbands and 14.0% of other family members quit smoking entirely. The average daily cigarette consumption rate decreased from 5.9 to 0.9 among pregnant women, 11.4 to 9.5 for husbands, and 11.4 to 9.5 for other family members (paired sample t-test, p<0.001). The likelihood that husbands continued smoking during pregnancy was significantly lower for those with a shorter history of smoking, had a lower daily cigarette consumption rate and a household registration in Shanghai. CONCLUSIONS The prevalence of smoking among pregnant women, husbands and other family members significantly declines during pregnancy. Thus, pregnancy is most likely a key period in which to provide families with health education regarding the effects of smoking, both during the pregnancy period and in general. Intervention programs designed to reduce smoking among husbands during pregnancy should focus on those with a long history of smoking, a high rate of daily cigarette consumption, and those with household registration not in Shanghai.
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Affiliation(s)
- Tianyu Tan
- School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Lili Shi
- Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Xiaowen Chen
- Children's Hospital of Fudan University, Shanghai, China
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
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Wang YT, Tsai YW, Tsai TI, Chang PY. Children's exposure to secondhand smoke at home before and after smoke-free legislation in Taiwan. Tob Control 2016; 26:690-696. [PMID: 27885169 PMCID: PMC5661266 DOI: 10.1136/tobaccocontrol-2016-053039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 10/20/2016] [Accepted: 10/26/2016] [Indexed: 01/11/2023]
Abstract
INTRODUCTION In January 2009, Taiwan broadened smoke-free legislation, requiring mass transportation systems, indoor public areas and indoor workplaces with 3 or more people, to become smoke-free. We investigated the secondhand smoke (SHS) exposure at home for children aged 3-11 years in Taiwan before and after the implantation of the legislation. METHODS We studied 7911 children from the 2005, 2009 and 2013 National Health Interview Surveys (cross-sectional, nationally representative household surveys). Logistic regression modelling estimated adjusted ORs (AOR) and 95% CIs for children's SHS exposure at home in 2009 and 2013 (2005 as reference) for the overall sample and for each category of household socioeconomic status (SES) and household composition. RESULTS Prevalence of children SHS exposure at home decreased from 51% (2005) to 32% (2009) and 28% (2013). Compared to 2005, children in 2009 and 2013 had lower likelihoods of SHS exposure at home with AOR of 0.45 (95% CI 0.41 to 0.51) and 0.41 (95% CI 0.36 to 0.46), respectively. All children had reduced SHS exposure at home after the legislation, irrespective of household SES and compositions. Low household income, low parental education level, living with grandparents or living with other adults was individually associated with increased SHS exposure. DISCUSSION The proportion of children exposed to SHS at home in Taiwan declined substantially from 2005 to 2009 after smoke-free legislation, and fell further by 2013, irrespective of SES and household compositions. Still, inequality in SHS exposure at home by SES and household composition warrants future research.
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Affiliation(s)
- Ying-Ting Wang
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Wen Tsai
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Tzu-I Tsai
- Department of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Po-Yin Chang
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA
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Monson E, Arsenault N. Effects of Enactment of Legislative (Public) Smoking Bans on Voluntary Home Smoking Restrictions: A Review. Nicotine Tob Res 2016; 19:141-148. [PMID: 27613902 DOI: 10.1093/ntr/ntw171] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 06/30/2016] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The positive effects of worldwide increases in enactment of legislative bans on smoking in public areas have been well documented. Relatively little is known about the effects of such bans on voluntary home smoking behavior. Meanwhile, private spaces, such as homes, have replaced public spaces as the primary milieu of secondhand smoke exposure. METHODS A systematic search of peer-reviewed articles was conducted using multiple databases including Cochrane Library, Cinahl, Embase, Global Health, Health Star, Joanna Briggs, MEDLINE, PsycINFO, PAIS International, PubMed, and Web of Science. We examined peer-reviewed studies that considered the impact of legislation-based public smoking bans on enactment of private home smoking restrictions. RESULTS Sixteen articles published between 2002 and 2014 were identified and included. Our results suggest overall positive effects post-legislative ban with the majority of studies demonstrating significant increases in home smoking restrictions. Studies focusing on smoking and nonsmoking samples as well as child populations are discussed in depth. CONCLUSIONS Existing evidence indicates an overall significant positive effect post-legislative ban on voluntary home smoking restrictions. While disentangling these effects over space and time remains a challenge, scientific research has converged in dispelling any notion of significant displacement of smoking into the home. Policy makers, especially those in countries without existing public smoking legislation, can rest assured that these types of bans contribute to the minimization of tobacco-related harm. IMPLICATIONS Findings converge in dispelling notions of displacement of smoking into the home as a consequence of legislative bans that prohibit smoking in public spaces. Evidence from the studies reviewed suggests that through their influence on social norms, legislative bans on smoking in public places may encourage citizens to establish voluntary home smoking restrictions, thus decreasing harm related to secondhand smoke.
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Affiliation(s)
- Eva Monson
- Department of Psychiatry, McGill University, Montreal, QC, Canada; .,Department of Sociology and Anthropology, Concordia University, Montreal, QC, Canada
| | - Nicole Arsenault
- Department of Sociology and Anthropology, Concordia University, Montreal, QC, Canada
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Yang L, Tong EK, Mao Z, Hu TW, Lee AH. A Clustered Randomized Controlled Trial to Reduce Secondhand Smoke Exposure Among Nonsmoking Pregnant Women in Sichuan Province, China. Nicotine Tob Res 2015; 18:1163-70. [PMID: 26296651 DOI: 10.1093/ntr/ntv171] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 07/30/2015] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Nonsmoking pregnant women in China have significant exposure to secondhand smoke (SHS). Few interventions have focused on pregnant women reducing their SHS exposure. METHODS This clustered randomized controlled trial, conducted at eight hospitals in Sichuan, China, compared a prenatal health education intervention with usual clinical care as a control. The primary outcome was self-reported "no SHS exposure" before and 3 months after birth. The intervention consisted of three large group educational sessions, standardized clinician advice, brief monthly follow-up calls, and educational materials and resources. A random sample of participants was biochemically validated before birth with hair nicotine, a long-term biomarker of smoke exposure. RESULTS Overall, 1181 participants were randomized to intervention (n = 526) and control (n = 655) groups. More participants in the intervention group than the control group reported no SHS exposure 3 months after birth (Total: 77.9% vs. 52.6%, P < .001; Home: 81.2% vs. 53.3%, P < .001). The intervention group also had greater changes in improved smoke-free homes and SHS knowledge and attitudes. Controlling for covariates, the intervention group was less likely to report SHS exposure than the control group (Total: OR = 0.47, 95% CI = 0.31 to 0.71; Home: OR = 0.33, 95% CI = 0.21 to 0.53), and this effect was sustained 3 months after birth. The adjusted log concentration of hair nicotine for the intervention group decreased by 0.28 log µg/g more than the control group. CONCLUSIONS Our smoke-free health education intervention for nonsmoking pregnant women significantly reduced SHS exposure before and after birth. This intervention model can become part of a standard protocol for the care of pregnant women in hospital settings.
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Affiliation(s)
- Lian Yang
- Department of Health Economics, School of Administration, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Elisa K Tong
- Department of Internal Medicine, University of California, Davis, Sacramento, CA;
| | - Zhengzhong Mao
- Department of Health Economics, Huaxi School of Public Health, University of Sichuan, Chengdu, China
| | - Teh-Wei Hu
- School of Public Health, University of California, Berkeley, Berkeley, CA; Center for International Tobacco Control, Public Health Institute, Berkeley, CA
| | - Anita H Lee
- Center for International Tobacco Control, Public Health Institute, Berkeley, CA
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Wang J, Shih YCT, Qin Y, Young T, Thomas Z, Spivey CA, Solomon DK, Chisholm-Burns M. Trends in Medicare Part D Medication Therapy Management Eligibility Criteria. AMERICAN HEALTH & DRUG BENEFITS 2015; 8:247-255. [PMID: 26380030 PMCID: PMC4567055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 05/19/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND To increase the enrollment rate of medication therapy management (MTM) programs in Medicare Part D plans, the US Centers for Medicare & Medicaid Services (CMS) lowered the allowable eligibility thresholds based on the number of chronic diseases and Part D drugs for Medicare Part D plans for 2010 and after. However, an increase in MTM enrollment rates has not been realized. OBJECTIVES To describe trends in MTM eligibility thresholds used by Medicare Part D plans and to identify patterns that may hinder enrollment in MTM programs. METHODS This study analyzed data extracted from the Medicare Part D MTM Programs Fact Sheets (2008-2014). The annual percentages of utilizing each threshold value of the number of chronic diseases and Part D drugs, as well as other aspects of MTM enrollment practices, were analyzed among Medicare MTM programs that were established by Medicare Part D plans. RESULTS For 2010 and after, increased proportions of Medicare Part D plans set their eligibility thresholds at the maximum numbers allowable. For example, in 2008, 48.7% of Medicare Part D plans (N = 347:712) opened MTM enrollment to Medicare beneficiaries with only 2 chronic disease states (specific diseases varied between plans), whereas the other half restricted enrollment to patients with a minimum of 3 to 5 chronic disease states. After 2010, only approximately 20% of plans opened their MTM enrollment to patients with 2 chronic disease states, with the remaining 80% restricting enrollment to patients with 3 or more chronic diseases. CONCLUSION The policy change by CMS for 2010 and after is associated with increased proportions of plans setting their MTM eligibility thresholds at the maximum numbers allowable. Changes to the eligibility thresholds by Medicare Part D plans might have acted as a barrier for increased MTM enrollment. Thus, CMS may need to identify alternative strategies to increase MTM enrollment in Medicare plans.
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Affiliation(s)
- Junling Wang
- Professor, Health Outcomes and Policy Research, Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Memphis
| | - Ya-Chen Tina Shih
- Professor of Health Economics, and Chief, Section of Cancer Economics and Policy, Department of Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston
| | - Yolanda Qin
- Student, Duke University, Durham, NC, and was a summer intern at the University of Tennessee, College of Pharmacy, Memphis, at the time of this study
| | - Theo Young
- Student, University of Mississippi School of Pharmacy, Jackson, and was a summer intern at the University of Tennessee College of Pharmacy, Memphis, at the time of this study
| | - Zachary Thomas
- Student, University of Tennessee College of Pharmacy, Memphis
| | - Christina A Spivey
- Assistant Professor, Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Memphis
| | - David K Solomon
- Professor, Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Memphis
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11
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Cheng KW, Okechukwu CA, McMillen R, Glantz SA. Association between clean indoor air laws and voluntary smokefree rules in homes and cars. Tob Control 2013; 24:168-74. [PMID: 24114562 DOI: 10.1136/tobaccocontrol-2013-051121] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study examines the influence that smokefree workplaces, restaurants and bars have on the adoption of smokefree rules in homes and cars, and whether there is an association with adopting smokefree rules in homes and cars. METHODS Bivariate probit models were used to jointly estimate the likelihood of living in a smokefree home and having a smokefree car as a function of law coverage and other variables. Household data were obtained from the nationally representative Social Climate Survey of Tobacco Control 2001, 2002 and 2004-2009; clean indoor air law data were from the American Nonsmokers' Rights Foundation Tobacco Control Laws Database. RESULTS 'Full coverage' and 'partial coverage' smokefree legislation is associated with an increased likelihood of having voluntary home and car smokefree rules compared with 'no coverage'. The association between 'full coverage' and smokefree rule in homes and cars is 5% and 4%, respectively, and the association between 'partial coverage' and smokefree rules in homes and cars is 3% and 4%, respectively. There is a positive association between the adoption of smokefree rules in homes and cars. CONCLUSIONS Clean indoor air laws provide the additional benefit of encouraging voluntary adoption of smokefree rules in homes and cars.
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Affiliation(s)
- Kai-Wen Cheng
- College of Public Health, Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
| | - Cassandra A Okechukwu
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Robert McMillen
- Department of Psychology and the Social Science Research Center, Mississippi State University, Starkville, Mississippi, USA
| | - Stanton A Glantz
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
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12
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Tsai YW, Chang LC, Sung HY, Hu TW, Chiou ST. The impact of smoke-free legislation on reducing exposure to secondhand smoke: differences across gender and socioeconomic groups. Tob Control 2013; 24:62-9. [PMID: 24014636 DOI: 10.1136/tobaccocontrol-2013-051004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND On 11 January 2009, Taiwan expanded its smoke-free legislation to all indoor public places and workplaces. This study examined the impact of this policy on secondhand smoke (SHS) exposure in adult non-smokers, across gender and socioeconomic status groups (SES). METHODS An annual sample of about 13,000-14,000 non-smokers was drawn from cross-sectional nationwide data of Taiwan Adult Tobacco Behavior Surveys during 2005-2011. Logistic regressions were used to analyse the aggregate data to estimate the association between the 2009 smoke-free legislation and SHS exposures in homes and workplaces. Interaction terms were used to examine the impact of the 2009 smoke-free policy on reducing differences in SHS exposure across gender, education and income groups. RESULTS The 2009 policy reduced the odds of SHS exposure in homes in 2009 (OR=0.76, 95% CI 0.68 to 0.84) and in workplaces (year 2009: OR=0.49, 95% CI 0.39 to 0.62; year 2010: OR=0.79, 95% CI 0.66 to 0.95). The model with interaction terms showed that men were more likely than women to be exposed to workplace SHS (OR=2.02, 95% CI 1.80 to 2.27) but were less likely to be exposed to home SHS (OR=0.79, 95% CI 0.73 to 0.86). SHS exposure in homes was significantly related to lower socioeconomic status, but the 2009 smoke-free policy reduced the difference in SHS exposure across education levels. CONCLUSIONS The 2009 smoke-free policy reduced the SHS exposure for non-smokers. However, this impact on home SHS did not persist after 2009, and the effect of protection was unequal across gender and SES groups. Thus, further enforcement of smoking restrictions would be needed to reduce the risk of SHS exposure and improve protection against SHS risk among parts of the population with lower socioeconomic status.
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Affiliation(s)
- Yi-Wen Tsai
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Li-Chuan Chang
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Hai-Yen Sung
- Institute for Health & Aging, University of California, San Francisco, California, USA
| | - Teh-Wei Hu
- School of Public Health, University of California, Berkeley, California, USA
| | - Shu-Ti Chiou
- Institution of Public Health & Department of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China Health Promotion Administration, Ministry of Health and Welfare, New Taipei City, Taiwan, Republic of China
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13
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Wahabi HA, Alzeidan RA, Fayed AA, Mandil A, Al-Shaikh G, Esmaeil SA. Effects of secondhand smoke on the birth weight of term infants and the demographic profile of Saudi exposed women. BMC Public Health 2013; 13:341. [PMID: 23587116 PMCID: PMC3641009 DOI: 10.1186/1471-2458-13-341] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 04/11/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Maternal exposure to tobacco smoke during pregnancy is associated with detrimental effects on the mother and the fetus including; impaired fetal growth, low birth weight and preterm delivery. In utero exposure to tobacco is implicated in the etiology of many adults' diseases including obesity, diabetes and hypertension.The objectives of this study were to evaluate the effects of Secondhand Tobacco Smoke (SHS) exposure on newborns' anthropometric measurements and to compare the demographic profile of the women exposed to SHS to those who were not. METHOD This is a retrospective cohort study investigating the effects of SHS during pregnancy on newborns' anthropometry. Women who self-reported SHS exposure were compared with those not exposed. The primary outcomes were birth weight, newborn length and head circumference. Univariate analysis and multivariate regression analysis were performed. Adjusted differences with 95% confidence intervals were calculated. RESULTS Mothers exposed to SHS constituted 31% of the cohort. The mean birth weight of infants of exposed mothers was significantly lower by 35 g, 95% CI: 2-68 g, (P = 0.037) and the mean length was shorter by 0.261 cm, 95% CI 0.058-0.464 cm, (P = 0.012) compared to the infants of unexposed mothers. Women exposed to SHS, were younger, of lower parity and more likely to be illiterate than those who were not exposed in addition, exposed women were less likely to be primiparous. CONCLUSION The prevalence of exposure of Saudi pregnant women to SHS is high at 31% and it is associated with reduced birth weight, and shorter length of the newborn.
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Affiliation(s)
- Hayfaa A Wahabi
- Sheikh Bahamdan Research Chair of Evidence-Based Healthcare and Knowledge Translation, College of Medicine, King Saud University, P.O. Box 102799, Riyadh 11685, Kingdom of Saudi Arabia.
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14
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Chan SSC, Wong DCN, Lam TH. Will mothers of sick children help their husbands to stop smoking after receiving a brief intervention from nurses? Secondary analysis of a randomised controlled trial. BMC Pediatr 2013; 13:50. [PMID: 23565835 PMCID: PMC3626671 DOI: 10.1186/1471-2431-13-50] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 03/27/2013] [Indexed: 05/27/2023] Open
Abstract
Background Second-hand smoke is a severe health hazard for children. Clinical guidelines suggest that nurses advise smoking parents to quit when they accompany their sick children to paediatric settings, but the guidelines did not mention what nurses can do if the parents are not with the children. This study examines the effectiveness of a low-intensity, nurse-led health instructional initiative for non-smoking mothers, to motivate them to take action to help their husbands stop smoking. Methods This was a randomised controlled trial and 1,483 non-smoking women, who were living with husbands who do smoke, were recruited when they accompanied with their sick children on hospital admission in general paediatic wards/outpatient departments of four hospitals in Hong Kong. The women were randomly allocated into intervention and control groups. The former received brief health education counselling from nurses, a purpose-designed health education booklet, a “no smoking” sticker, and a telephone reminder one week later; the control group received usual care. The primary outcome was the women”s action to help their smoking husbands stop smoking at 3-, 6- and 12-month follow-ups. Results A higher proportion of women in the intervention than the control group had taken action to help their husbands stop smoking at the 3-month (76% vs. 65%, P < .001), 6-month (66% vs. 49%, P < .001) and 12-month (52% vs. 40%, P < .001) follow-ups. Women who had received the intervention, had better knowledge of the health hazards of smoking, higher intention to take action, perceived their husbands’ willingness to stop/reduce smoking, had previously advised their husbands to give up smoking, were aware of their husbands’ history of smoking and, were aware that their husbands had made an earlier quit attempt and intended to help them stop smoking at the follow-ups. Conclusions A brief health education intervention by nurses in paediatric settings can be effective in motivating the mothers of sick children to take action to help their husbands quit smoking. We recommend adding the following to the clinical practice guidelines on treating tobacco use and dependence: ‘Nurses should offer every non-smoking mother of a sick child brief advice to encourage their husbands to stop smoking’. Trial registration Current Controlled Trials ISRCTN72290421.
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Affiliation(s)
- Sophia S C Chan
- School of Nursing, University of Hong Kong, 4/F William M W Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
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15
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Rose A, Fagan P, Lawrence D, Hart A, Shavers VL, Gibson JT. The role of worksite and home smoking bans in smoking cessation among U.S. employed adult female smokers. Am J Health Promot 2012; 26:26-36. [PMID: 21879940 DOI: 10.4278/ajhp.091214-quan-391] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Examine the association of work and home smoking bans with quitting behaviors among employed female smokers in the United States. DESIGN Secondary analyses using cross-sectional data from the 2006/2007 Tobacco Use Supplement to the Current Population Survey. SUBJECTS Nationally representative sample of 7610 U.S. employed female smokers, aged 18 to 64 years, who reported working indoors. Setting . N/A. METHODS Multivariate logistic regression analyses were conducted to examine the association of smoking ban policies (complete work and home bans, complete work ban only, complete home ban only, and no complete work or home ban) with intention to quit in the next 30 days, at least one quit attempt in the past year, and sustained abstinence of at least 3 months in the past year. RESULTS Twenty-nine percent of women reported complete work and home smoking bans. Smoking bans were not associated with intention to quit and were marginally associated with sustained abstinence. Regardless of intention to quit, women with complete work and home bans were significantly more likely than those without complete work and home bans to report quit attempts. Among women with no intention to quit, the odds of having a quit attempt were significantly higher among women who had a complete home ban only compared with women without complete work and home bans. CONCLUSIONS Efforts to promote quitting behaviors among employed female smokers may be facilitated by increasing rates of complete smoking bans at both work and home settings.
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Affiliation(s)
- Allison Rose
- Clinical Monitoring Research Program, SAIC-Frederick, Incorporated, NCI-Frederick, Frederick, Maryland MD 20892-7337, USA.
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Chang FC, Chung CH, Chuang YC, Hu TW, Yu PT, Chao KY, Hsiao ML. Effect of media campaigns and smoke-free ordinance on public awareness and secondhand smoke exposure in Taiwan. JOURNAL OF HEALTH COMMUNICATION 2011; 16:343-358. [PMID: 21240721 DOI: 10.1080/10810730.2010.535110] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study evaluated the effect of Taiwan's smoke-free ordinance and media campaigns on public awareness and secondhand smoke exposure. The authors conducted 3 waves of research--in July 2008 (before media campaigns), in December 2008 (during media campaigns), and in March 2009 (3 months after implementation of the smoke-free law). National representative samples of 1074, 1084, and 1094 people, respectively, were interviewed successfully by telephone in the 3 surveys. The results showed that general awareness of smoke-free workplace legislation rose dramatically from 28.5% in July 2008 to 87.6% in December 2008 to 93.6% in March 2009. Exposure to secondhand smoke in the workplace fell from 28.5% in July 2008 to 24.9% in December 2008 to 7.3% in March 2009, and household secondhand smoke exposure decreased from 36.8% to 34.3% to 21.3%, respectively, during the same period. Multivariate analyses results indicated that media campaigns, smoke-free ordinance implementation, having higher education, and having higher income were associated with more awareness of the smoke-free workplace legislation. In addition, smoke-free ordinance implementation, being female, having higher education, and having higher income were associated with less likelihood of reporting secondhand smoke exposure in the workplace. In conclusion, smoke-free ordinance implementation and media campaigns were effective in raising public awareness of the new law and reducing secondhand smoke exposure in workplaces, in public places, and at home.
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Hahn EJ. Smokefree legislation: a review of health and economic outcomes research. Am J Prev Med 2010; 39:S66-76. [PMID: 21074680 DOI: 10.1016/j.amepre.2010.08.013] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 08/13/2010] [Accepted: 08/24/2010] [Indexed: 12/12/2022]
Abstract
CONTEXT Smokefree legislation is a powerful public health intervention. Despite progress in smokefree legislation, over half of U.S. adults remain unprotected by comprehensive smokefree legislation. EVIDENCE ACQUISITION This paper reviews the scientific literature on health and economic outcome studies of smokefree legislation from the past decade, 2000 to early 2010, using MEDLINE and key search terms: smoking, smoking cessation, smoking/legislation and jurisprudence, smoking cessation/legislation and jurisprudence, and health policy. EVIDENCE SYNTHESIS There is a wealth of research showing the health benefits to entire populations when communities implement comprehensive smokefree laws and/or regulations. These laws improve the health of hospitality workers and the general population by improving indoor air quality, reducing acute myocardial infarctions and asthma exacerbations, and improving infant and birth outcomes. Some studies report reduced smoking prevalence and cigarette consumption and improved cessation outcomes after smokefree legislation. In addition to the health benefits, economic studies confirm that smokefree laws do not adversely affect business revenues or operating costs. CONCLUSIONS While there is an abundance of smokefree policy outcomes research showing both the health and economic impacts of smokefree legislation, these outcomes may have more to do with implementation effectiveness than adoption, especially among subpopulations. An emerging body of literature documents not only that disparities in health protections remain among subpopulations, but that health outcomes of smokefree legislation may vary by gender, race/ethnicity, SES, and age. Further research is needed on implementation effectiveness of smokefree legislation and differential effects on subpopulations.
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Affiliation(s)
- Ellen J Hahn
- Kentucky Center for Smoke-Free Policy, College of Nursing and College of Public Health, University of Kentucky, Lexington, Kentucky, USA.
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Hahn EJ, Rayens MK, Langley RE, Adkins SM, Dignan M. Do smoke-free laws in rural, distressed counties encourage cessation? Policy Polit Nurs Pract 2010; 11:302-308. [PMID: 21531965 DOI: 10.1177/1527154410397707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The authors examined the association between smoke-free laws and smoking/cessation behaviors and secondhand smoke exposure among current and former smokers in rural, distressed counties. A quasi-experimental, two-group design compared outcomes between participants from a county with a longstanding smoke-free law (n = 252) and those living in four demographically similar counties without smoke-free laws ( n = 250). Participants were recruited using random digit dialing. Controlling for demographic factors, those in the treatment group reported greater nicotine dependence, were more likely to have smoke-free workplaces, and less likely to have smoke-free homes. There were no differences in smoking status, past-year quit attempts, intent to quit in 5 years, cigarettes per day, or time since last cigarette. Smokers in the treatment group were just as likely to attempt to quit, despite greater nicotine dependence. Findings showed that making nonsmoking the social norm through policy change may be more difficult in rural, distressed areas.
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Affiliation(s)
- Ellen J Hahn
- Tobacco Policy Research Program, University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536, USA.
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Graham H. Why social disparities matter for tobacco-control policy. Am J Prev Med 2009; 37:S183-4. [PMID: 19591761 DOI: 10.1016/j.amepre.2009.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 03/31/2009] [Accepted: 05/05/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Hilary Graham
- Department of Health Sciences, University of York, York, UK.
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Securing the health of disadvantaged women: a critical investigation of tobacco-control policy effects on women worldwide. Am J Prev Med 2009; 37:S117-20. [PMID: 19591749 PMCID: PMC2730584 DOI: 10.1016/j.amepre.2009.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Unintended consequences of tobacco policies: implications for public health practice. Am J Prev Med 2009; 37:S181-2. [PMID: 19591760 DOI: 10.1016/j.amepre.2009.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 05/05/2009] [Accepted: 05/05/2009] [Indexed: 11/21/2022]
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