1
|
Tynan MA, Cohen MA, Harris JR. What happens in Vegas, stays in your lungs: an assessment of fine particulate matter in casinos that prohibit and allow smoking in Las Vegas, Nevada, USA. Tob Control 2024; 33:545-548. [PMID: 36822833 PMCID: PMC10998699 DOI: 10.1136/tc-2022-057861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION Despite progress in adoption of smoke-free policies, smoking in casinos is allowed in some US states, including Nevada. In 2020, for the first time, a resort-style casino in Las Vegas prohibited smoking voluntarily. This study is the first to assess air quality in this casino and compare results with similar casinos that allow smoking. METHODS A real-time personal aerosol monitor evaluated particulate matter with a diameter <2.5 µm (PM2.5), a surrogate for secondhand smoke (SHS). PM2.5 was measured at eight Las Vegas casinos, including the smoke-free casino. Each casino was visited twice, and PM2.5 was assessed in smoking-permitted gaming areas and areas where smoking is otherwise prohibited. RESULTS Average PM2.5 levels were significantly higher in casinos that allow smoking, for both casino gaming areas and areas where smoking is otherwise prohibited (p<0.05). Mean PM2.5 in gaming areas was 164.9 µg/m3 in casinos that allow smoking and 30.5 µg/m3 in the smoke-free casino. Mean PM2.5 in areas where smoking is otherwise prohibited was 83.2 µg/m3 in casinos which allowed smoking in gaming areas, and 48.1 µg/m3 in the smoke-free casino. CONCLUSION Despite robust evidence about the harms of SHS, tens of thousands of casino employees and tens of millions of tourists are exposed to high levels of SHS in Las Vegas casinos annually, with PM2.5 levels 5.4 times higher in gaming areas when compared with a smoke-free casino. The only way to protect people from SHS exposure is to prohibit smoking in all indoor areas.
Collapse
Affiliation(s)
- Michael A Tynan
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, USA
| | - Martin A Cohen
- Department of Environmental & Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Jeffrey R Harris
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, USA
| |
Collapse
|
2
|
Noh JW, Cheon J, Seong H, Kwon YD, Yoo KB. Impacts of Smoking Ban Policies on Billiard Hall Sales in South Korea Using Objective Sales Information of a Credit Card Company: Quasi-Experimental Study. JMIR Public Health Surveill 2024; 10:e50466. [PMID: 38630526 PMCID: PMC11063889 DOI: 10.2196/50466] [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: 07/01/2023] [Revised: 01/01/2024] [Accepted: 03/06/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Smoking ban policies (SBPs) are potent health interventions and offer the potential to influence antismoking behavior. The Korean government completely prohibited smoking in indoor sports facilities, including billiard halls, since the government revised the National Health Promotion Act in December 2017. OBJECTIVE This study aimed to examine the impact of the SBP on the economic outcomes of indoor sports facilities, particularly billiard halls. METHODS This study used credit card sales data from the largest card company in South Korea. Data are from January 2017 to December 2018. Monthly sales data were examined across 23 administrative neighborhoods in Seoul, the capital city of South Korea. We conducted the interrupted time series model using the fixed effects model and the linear regression with panel-corrected standard errors (PCSE). RESULTS The sales and transactions of billiard halls were not significantly changed after the introduction of the SBP in the full PCSE models. The R2 of the full PCSE model was 0.967 for sales and 0.981 for transactions. CONCLUSIONS The introduction of the SBP did not result in substantial economic gains or losses in the sales of billiard halls. In addition to existing price-based policies, the enhanced SBP in public-use facilities, such as billiard halls, can have a positive synergistic effect on reducing smoking prevalence and preventing secondhand smoke. Health policy makers can actively expand the application of SBPs and make an effort to enhance social awareness regarding the necessity and benefits of public SBPs for both smokers and the owners of hospitality facilities.
Collapse
Affiliation(s)
- Jin-Won Noh
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Jooyoung Cheon
- Department of Nursing Science, Sungshin Women's University, Seoul, Republic of Korea
| | - Hohyun Seong
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Public Health and Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Bong Yoo
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| |
Collapse
|
3
|
Hernandez D, Khan F, Albert D, Giovenco D, Branas C, Valeri L, Navas-Acien A. A randomized control trial to support smoke-free policy compliance in public housing. Trials 2023; 24:551. [PMID: 37608390 PMCID: PMC10463922 DOI: 10.1186/s13063-023-07339-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/29/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Smoke-free housing policies in multiunit housing are increasingly widespread interventions to reduce smoking and secondhand smoke exposure. Little research has identified factors that impede compliance with smoke-free housing policies in low-income multiunit housing and test corresponding solutions. METHODS We are using an experimental design to test two compliance support interventions: (A) a "compliance through reduction (via relocation and reduction in personal smoking) and cessation" intervention targets households with smokers and involves support to shift smoking practices to areas beyond the apartment or building setting, reduce personal smoking, and deliver in-residence smoking cessation support services via trained peer educators and (B) a "compliance through resident endorsement" intervention involving voluntary adoption of smoke-free living environments through personal pledges, visible door markers, and/or via social media. We will compare randomly sampled participants in buildings that receive A or B or A plus B to the NYCHA standard approach. DISCUSSION This RCT addresses key gaps in knowledge and capitalizes on key scientific opportunities by (1) leveraging the federal mandate to ban smoking in a public housing system of more than sufficient size to conduct an adequately powered RCT; (2) expanding our understanding of smoke-free policy compliance beyond policy implementation by testing two novel treatments: (a) in-residence smoking cessation and (b) resident endorsement, while (3) addressing population and location-specific tobacco-related disparities. At the conclusion of the study, this RCT will have leveraged a monumental policy shift affecting nearly half a million NYC public housing residents, many of whom disproportionately experience chronic illness and are more likely to smoke and be exposed to secondhand smoke than other city residents. This first-ever RCT will test the effects of much-needed compliance strategies on resident smoking behavior and secondhand smoke exposure in multiunit housing. TRIAL REGISTRATION Clinical Trials Registered, NCT05016505. Registered on August 23, 2021.
Collapse
Affiliation(s)
- Diana Hernandez
- Sociomedical Sciences, Columbia Mailman School of Public Health, New York, USA.
| | - Farzana Khan
- Sociomedical Sciences, Columbia Mailman School of Public Health, New York, USA
| | - David Albert
- Health Policy and Management, Columbia Mailman School of Public Health, New York, USA
| | - Daniel Giovenco
- Sociomedical Sciences, Columbia Mailman School of Public Health, New York, USA
| | - Charles Branas
- Epidemiology, Columbia Mailman School of Public Health, New York, USA
| | - Linda Valeri
- Biostatistics, Columbia Mailman School of Public Health, New York, USA
| | - Ana Navas-Acien
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, USA
| |
Collapse
|
4
|
Titus AR, Gamarel KE, Thrasher JF, Elliott MR, Fleischer NL. Exploring the Potential for Smoke-Free Laws to Reduce Smoking Disparities by Sexual Orientation in the USA. Int J Behav Med 2023; 30:448-454. [PMID: 35579845 PMCID: PMC9669255 DOI: 10.1007/s12529-022-10099-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND We examined associations between smoke-free laws and smoking outcomes in a nationally representative sample of US adults, including exploring whether these associations differed for heterosexual and sexual minority (SM) adults. METHODS We constructed county-level variables representing the percent of the population covered by state-, county-, or city-level smoke-free laws in workplaces and hospitality venues. We combined this information with restricted individual-level adult data with masked county identifiers from the National Health Interview Survey (NHIS), 2013-2018. We used modified Poisson regression to explore associations between each type of smoke-free law and the prevalence ratio (PR) of current smoking, and we used linear regression to explore associations with smoking intensity (mean cigarettes per day). We assessed interactions between smoke-free laws and SM status on the additive scale to determine whether associations were different for SM and heterosexual adults. RESULTS In adjusted models without interaction terms, smoke-free laws in hospitality venues were associated with lower prevalence of current smoking (PR = 0.93, 95% confidence interval (CI) = 0.89, 0.98). Both types of smoke-free laws were associated with lower mean cigarettes per day (workplace law change in mean = - 0.50, 95% CI = - 0.89, - 0.12; hospitality law change in mean = - 0.72, 95% CI = - 1.14,-0.30). We did not observe any statistically significant interactions by SM status, though statistical power was limited. CONCLUSIONS We did not find evidence that smoke-free laws were differentially associated with smoking outcomes for heterosexual and SM adults. Additional studies are needed to further explore the potential for tobacco control policies to address the elevated risk of smoking in SM communities.
Collapse
Affiliation(s)
- Andrea R Titus
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Kristi E Gamarel
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - James F Thrasher
- Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Michael R Elliott
- Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Nancy L Fleischer
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| |
Collapse
|
5
|
Ashford KB, Blair LM, McCubbin AK, Wiggins AT, Rayens MK, Hahn EJ. Municipal smoke-free laws and preterm birth. Am J Obstet Gynecol 2022; 227:767.e1-767.e10. [PMID: 35932874 DOI: 10.1016/j.ajog.2022.07.058] [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: 03/04/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Smoking during pregnancy and prenatal secondhand smoke exposure increase the risk of preterm birth. As Kentucky has the second highest rate of smoking in the United States and no statewide smoke-free law, an examination of the effect of municipal smoke-free legislation on preterm birth is warranted. OBJECTIVE This study used state-level live birth data and county-level municipal smoke-free legislation status to assess the association between the presence and strength of smoke-free laws and the likelihood of preterm birth. Moreover, this study hypothesized that pregnant persons living in counties with comprehensive municipal smoke-free laws prohibiting smoking inside all workplaces and enclosed public places would exhibit a lower likelihood of preterm birth than those living in counties with weak or moderate laws (ie, smoke-free laws with exemptions that do not cover all workplaces and enclosed public places) or no smoke-free law. STUDY DESIGN Using live birth data from the Kentucky Office of Vital Statistics with birth years ranging from 2004 to 2020, a total of 894,372 live births were recorded that indicated that a childbearing person was between the ages of 18 and 49 years and a resident of Kentucky; these live births formed the sample for the study. Municipal ordinances implemented during a given calendar year were coded in the model as present starting with the following calendar year, as the birth records were time deidentified except for the year of birth. This lagged law convention maximized the likelihood that pregnant persons included in the study were exposed to the smoke-free policy for at least a portion of their pregnancy. Multilevel logistic regression was used to assess the effect of smoke-free ordinances on the likelihood of preterm birth, with personal- and county-level variables included as potential covariates and pregnant persons nested within the county of residence. Data analysis was conducted using SAS (version 9.4; SAS Institute, Cary, NC), with an alpha level of .05. RESULTS Nearly all personal-level variables were associated with preterm birth status. Personal factors associated with an increased likelihood of preterm birth included being older (relative to 18-24 years old; odds ratios [95% confidence intervals]: 1.02 [1.01-1.04] and 1.27 [1.24-1.31] for ages 25-34 and 35-49 years, respectively); having a history of preterm birth (odds ratio, 4.65; 95% confidence interval, 4.53-4.78); and smoking before pregnancy (odds ratio, 1.14; 95% confidence interval, 1.12-1.16). Pregnant persons living in counties with comprehensive laws were 9% less likely to have a preterm birth than those living in counties without a smoke-free ordinance (odds ratio, 0.91; 95% confidence interval, 0.89-0.94; P<.001). There was no difference in the likelihood of preterm birth between those living in counties with moderate or weak laws and those unprotected by any smoke-free ordinance in their county of residence. CONCLUSION This study demonstrated that comprehensive municipal smoke-free laws are associated with reduced risk of preterm birth and that moderate or weak smoke-free laws are not. The findings have major implications for public health policy and underscore the potential influence of healthcare providers' advocacy for strong smoke-free policies, prohibiting smoking in all workplaces (including restaurants, bars, and casinos), to support healthy pregnancies.
Collapse
Affiliation(s)
- Kristin B Ashford
- Perinatal Research and Wellness Center, University of Kentucky College of Nursing, Lexington, KY.
| | - Lisa M Blair
- Perinatal Research and Wellness Center, University of Kentucky College of Nursing, Lexington, KY
| | - Andrea K McCubbin
- Perinatal Research and Wellness Center, University of Kentucky College of Nursing, Lexington, KY
| | | | | | - Ellen J Hahn
- University of Kentucky College of Nursing, Lexington, KY
| |
Collapse
|
6
|
Mohindra M, Hernández D. "I think everybody will have to get together for it to work": NYCHA Tenant Perspectives on HUD's 2018 Smoke-Free Mandate Captured Prior to Policy Implementation. Nicotine Tob Res 2022; 24:1654-1660. [PMID: 35325238 PMCID: PMC9575971 DOI: 10.1093/ntr/ntac076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION In July 2018, a new federal mandate by the Department of Housing and Urban Development went into effect requiring all US public housing authorities to implement policies banning smoking in living units, indoor common areas, administrative buildings, and outdoor areas within 25 feet of these buildings. Although some housing authorities had smoke-free policies in place for decades, others had to implement them for the first time. Housing authorities continue to face challenges in ensuring compliance with these policies, and resident perspectives can greatly inform measures to promote adherence. AIMS AND METHODS We conducted in-person interviews with 20 New York City Housing Authority tenants in April 2018. Our thematic analysis examined resident opinions on the upcoming smoke-free housing policy. RESULTS Although 65% of residents supported the policy, 50% anticipated poor adherence due to expected lack of enforcement, safety issues with smoking outdoors, and general discontent with the housing authority and living conditions. However, many participants felt adherence could be improved if the housing authority optimized resource-provision and communication with tenants. CONCLUSIONS Our study adds to existing literature examining tenant views on the controversial topic of mandatory smoke-free housing policies, and our interviews were conducted at a unique time prior to policy implementation in the country's largest public housing authority. Based on our results, we provide recommendations for housing authorities including: (1) information and resource-provision, (2) safety enhancement, and (3) relationship building with tenants in order to maximize policy adherence. IMPLICATIONS Our study is unique because we captured resident views prior to policy implementation in a housing authority without a preexisting smoke-free policy in place. In comparison, most recent research on this topic has focused on the postimplementation period or used survey research methods in the preimplementation phase. Our findings add to extant research about tenant perspectives on smoke-free housing policies and offer suggestions to address barriers to compliance.
Collapse
Affiliation(s)
- Mandakini Mohindra
- Corresponding Author: Mandakini Mohindra, MD, MPH, Department of Medicine, University of California, San Diego, 200 W. Arbor Drive, San Diego, CA 92103-8425, USA. Telephone: (619) 543-6268; E-mail:
| | - Diana Hernández
- Sociomedical Sciences Department, Columbia University Mailman School of Public Health, New York, NY, USA
| |
Collapse
|
7
|
Cheek NN, Reutskaja E, Schwartz B. Balancing the Freedom-Security Trade-Off During Crises and Disasters. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2022; 17:1024-1049. [PMID: 35100077 DOI: 10.1177/17456916211034499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
During crises and disasters, such as hurricanes, terrorist threats, or pandemics, policymakers must often increase security at the cost of freedom. Psychological science, however, has shown that the restriction of freedom may have strong negative consequences for behavior and health. We suggest that psychology can inform policy both by elucidating some negative consequences of lost freedom (e.g., depression or behavioral reactance) and by revealing strategies to address them. We propose four interlocking principles that can help policymakers restore the freedom-security balance. Careful consideration of the psychology of freedom can help policymakers develop policies that most effectively promote public health, safety, and well-being when crises and disasters strike.
Collapse
Affiliation(s)
| | - Elena Reutskaja
- Marketing Department, IESE Business School, University of Navarra
| | - Barry Schwartz
- Haas School of Business, University of California, Berkeley
| |
Collapse
|
8
|
Bakhturidze G, Peikrishvili N, Gvinianidze K. Impact of comprehensive smoke-free policy compliance on SHS exposure and health condition of the Georgian population. Tob Prev Cessat 2021; 7:70. [PMID: 34901565 PMCID: PMC8619785 DOI: 10.18332/tpc/143329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Georgia made steps forward in 2017 and adopted new amendments to its tobacco control legislation, which mostly correspond to the FCTC requirements. Among other changes in the regulations is a ban on smoking in public buildings and public transport, with a few exemptions (casinos, big slot clubs, performances in theatres, taxis). The regulation entered into force on 1 May 2018. METHODS The aim of the study is to assess the outcomes of the comprehensive smoke-free legislation in Georgia. We used a logical model for data collection and analysis. Our evaluation focuses on smoking prevalence related survey data, SHS exposure, monitoring results on compliance of new tobacco control regulations, Quitline data, and air quality measurement results. RESULTS The indoor air quality improved by 91% in the hospitality sector (from 1408 to 126 μg/m3 in 2018 and 117 μg/m3 in 2019), by 80% in public settings (from 531 to 112 μg/m3 in 2018 and 98 μg/m3 in 2019) and sufficiently in healthcare facilities (from 219 to 97-98 μg/m3 in 2018-2019). Demand for Quitline services increased by 30%. New cases of AMI declined by 32% during 2017-2019. CONCLUSIONS A comprehensive smoke-free policy with a high level of compliance (≥95%) had a positive impact on the decline of SHS exposure and tremendous improvement of indoor air quality in public places and promotes a decrease in illnesses related to the cardiovascular system in Georgia. Also, demand increased for smoking-cessation services.
Collapse
Affiliation(s)
- George Bakhturidze
- Framework Convention on Tobacco Control Implementation and Monitoring Center, Tbilisi, Georgia
| | - Nana Peikrishvili
- Framework Convention on Tobacco Control Implementation and Monitoring Center, Tbilisi, Georgia
| | | |
Collapse
|
9
|
Henderson E, Continente X, Fernández E, Tigova O, Cortés-Francisco N, Gallus S, Lugo A, Semple S, Dobson R, Clancy L, Keogan S, Ruprecht A, Borgini A, Tzortzi A, Vyzikidou VK, Gorini G, López-Nicolás A, Soriano JB, Geshanova G, Osman J, Mons U, Przewozniak K, Precioso J, Brad R, López MJ. Secondhand smoke exposure assessment in outdoor hospitality venues across 11 European countries. ENVIRONMENTAL RESEARCH 2021; 200:111355. [PMID: 34022230 PMCID: PMC8417816 DOI: 10.1016/j.envres.2021.111355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/20/2021] [Accepted: 05/17/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Due to partial or poorly enforced restrictions secondhand tobacco smoke (SHS) is still present in outdoor hospitality venues in many European countries. This study aimed to assess SHS concentrations in outdoor hospitality venues across Europe and identify contextual exposure determinants. METHODS Cross-sectional study. We measured airborne nicotine and evidence of tobacco use in terraces of bars, cafeterias, and pubs from 11 European countries in 2017-2018. Sites were selected considering area-level socioeconomic indicators and half were visited during nighttime. We noted the smell of smoke, presence of smokers, cigarette butts, ashtrays, and number of physical covers. Contextual determinants included national smoke-free policies for the hospitality sector, the Tobacco Control Scale score (2016), and the national smoking prevalence (2017-2018). We computed medians and interquartile ranges (IQR) of nicotine concentrations and used multivariate analyses to characterize the exposure determinants. RESULTS Nicotine was present in 93.6% of the 220 sites explored. Overall concentrations were 0.85 (IQR:0.30-3.74) μg/m3 and increased during nighttime (1.45 IQR:0.65-4.79 μg/m3), in enclosed venues (2.97 IQR:0.80-5.80 μg/m3), in venues with more than two smokers (2.79 IQR:1.03-6.30 μg/m3), in venues in countries with total indoor smoking bans (1.20 IQR:0.47-4.85 μg/m3), and in venues in countries with higher smoking prevalence (1.32 IQR:0.49-5.34 μg/m3). In multivariate analyses, nicotine concentrations were also positively associated with the observed number of cigarette butts. In venues with more than two smokers, SHS levels did not significantly vary with the venues' degree of enclosure. CONCLUSIONS Our results suggest that current restrictions in outdoor hospitality venues across Europe have a limited protective effect and justify the adoption of total smoking bans in outdoor areas of hospitality venues.
Collapse
Affiliation(s)
- Elisabet Henderson
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut (DCEXS), Doctor Aiguader, 88, 08003, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain
| | - Xavier Continente
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
| | - Esteve Fernández
- Institut Català d'Oncologia, Av. Granvia de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Spain; Institut d'Investigació Biomèdica de Bellvitge, Av. Granvia de l'Hospitalet 199, 08908, L'Hospitalet de Llobregat, Spain; Universitat de Barcelona, Feixa Llarga, S/n, 08907, L'Hospitalet de Llobregat, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain
| | - Olena Tigova
- Institut Català d'Oncologia, Av. Granvia de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Spain; Institut d'Investigació Biomèdica de Bellvitge, Av. Granvia de l'Hospitalet 199, 08908, L'Hospitalet de Llobregat, Spain; Universitat de Barcelona, Feixa Llarga, S/n, 08907, L'Hospitalet de Llobregat, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain
| | - Nuria Cortés-Francisco
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
| | - Silvano Gallus
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Health Sciences, Via Mario Negri 2, 20156, Milan, Italy
| | - Alessandra Lugo
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Health Sciences, Via Mario Negri 2, 20156, Milan, Italy
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling FK9 4LA, Scotland, UK
| | - Ruaraidh Dobson
- Institute for Social Marketing and Health, University of Stirling, Stirling FK9 4LA, Scotland, UK
| | - Luke Clancy
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | - Sheila Keogan
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | - Ario Ruprecht
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Alessandro Borgini
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Anna Tzortzi
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Str., Athens, 10557, Greece
| | - Vergina K Vyzikidou
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Str., Athens, 10557, Greece
| | - Giuseppe Gorini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Via Cosimo Il Vecchio, 2, 50139, Florence, Italy
| | - Angel López-Nicolás
- Universidad Politécnica de Cartagena (UPCT), Plaza Cronista Isidoro Valverde, S/n, 30202, Cartagena, Spain
| | - Joan B Soriano
- Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain; Hospital Universitario La Princesa (IISP), Diego de León, 62, Planta 6, 28006, Madrid, Spain; Universidad Autónoma de Madrid (UAM), Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain; Instituto Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain
| | - Gergana Geshanova
- Smoke-free Life Coalition, Slivnitsa Blvd, 257, 1202, Sofia, Bulgaria
| | - Joseph Osman
- OFT Conseil, Office Français de Santé et Bien-être Au Travail, Rue Gobert, 12, 75011Paris, France
| | - Ute Mons
- Cancer Prevention Unit & WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Im Neuenheimer Feld, 280, 69120, Heidelberg, Germany; Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50923, Cologne, Germany
| | - Krzysztof Przewozniak
- Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena, 5, 02-781, Warsaw, Poland; The Foundation Smart Health - Health in 3D, Warsaw, Poland; Collegium Civitas, 1 Defilad Square, 00-901, Warsaw, Poland
| | - José Precioso
- Instituto de Educação, Universidade do Minho, 4710-057, Braga, Portugal
| | - Ramona Brad
- Healthy Romania Generation 2035 Association, Bucharest, Romania
| | - Maria J López
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut (DCEXS), Doctor Aiguader, 88, 08003, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
| |
Collapse
|
10
|
Kulhánek A, Lukavská K, Švancarová I, Fidesová H, Gabrhelík R. Changes in tobacco use patterns and motivation to quit related to the new smoke-free legislation in the Czech Republic. J Public Health (Oxf) 2021; 43:348-354. [PMID: 31832643 DOI: 10.1093/pubmed/fdz156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/14/2019] [Accepted: 10/18/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Smoke-free policy belongs to key public health instruments to promote health in populations. In 2017, new comprehensive smoke-free law prohibiting smoking in indoor public places was implemented. We aimed to measure changes in tobacco smoking patterns and changes in motivation to quit in adult smokers prior to and after the new smoke-free legislation came into force. METHODS We conducted a prospective cohort study prior to and post the implementation of Act No. 65/2017 Coll. Self-reported questionnaires were administered to 131 adult smokers by trained nurses in general practitioner offices in Prague. We analysed changes in cigarette consumption per day; ratio of cigarettes smoked in pub, street, work and home; and motivation to quit using regression modelling. RESULTS We found a statistically significant decrease in the daily consumption of cigarettes (an average of 1.7 cigarettes per day, P < 0.001, d = 0.34). Smoking in indoor public spaces decreased to almost zero, while tobacco consumption in outdoor public spaces (such as streets and squares) increased by nearly 20%. We observed statistically significant increase of motivation to quit smoking (P = 0.021, d = 0.21). CONCLUSION The study brings valuable indication of the desired public health impact related to key legislative change in the Czech Republic.
Collapse
Affiliation(s)
- Adam Kulhánek
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Kateřina Lukavská
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.,Department of Psychology, Faculty of Education, Charles University, Czech Republic
| | - Iveta Švancarová
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Hana Fidesová
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| |
Collapse
|
11
|
Matthay EC, Hagan E, Gottlieb LM, Tan ML, Vlahov D, Adler N, Glymour MM. Powering population health research: Considerations for plausible and actionable effect sizes. SSM Popul Health 2021; 14:100789. [PMID: 33898730 PMCID: PMC8059081 DOI: 10.1016/j.ssmph.2021.100789] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/25/2021] [Accepted: 03/30/2021] [Indexed: 11/23/2022] Open
Abstract
Evidence for Action (E4A), a signature program of the Robert Wood Johnson Foundation, funds investigator-initiated research on the impacts of social programs and policies on population health and health inequities. Across thousands of letters of intent and full proposals E4A has received since 2015, one of the most common methodological challenges faced by applicants is selecting realistic effect sizes to inform calculations of power, sample size, and minimum detectable effect (MDE). E4A prioritizes health studies that are both (1) adequately powered to detect effect sizes that may reasonably be expected for the given intervention and (2) likely to achieve intervention effects sizes that, if demonstrated, correspond to actionable evidence for population health stakeholders. However, little guidance exists to inform the selection of effect sizes for population health research proposals. We draw on examples of five rigorously evaluated population health interventions. These examples illustrate considerations for selecting realistic and actionable effect sizes as inputs to calculations of power, sample size and MDE for research proposals to study population health interventions. We show that plausible effects sizes for population health interventions may be smaller than commonly cited guidelines suggest. Effect sizes achieved with population health interventions depend on the characteristics of the intervention, the target population, and the outcomes studied. Population health impact depends on the proportion of the population receiving the intervention. When adequately powered, even studies of interventions with small effect sizes can offer valuable evidence to inform population health if such interventions can be implemented broadly. Demonstrating the effectiveness of such interventions, however, requires large sample sizes.
Collapse
Affiliation(s)
- Ellicott C. Matthay
- Center for Health and Community, University of California, San Francisco, 3333 California St., Suite 465, Campus Box 0844, San Francisco, CA, 94143-0844, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, 2nd Floor, Campus Box 0560, San Francisco, CA, 94143, USA
| | - Erin Hagan
- Center for Health and Community, University of California, San Francisco, 3333 California St., Suite 465, Campus Box 0844, San Francisco, CA, 94143-0844, USA
| | - Laura M. Gottlieb
- Center for Health and Community, University of California, San Francisco, 3333 California St., Suite 465, Campus Box 0844, San Francisco, CA, 94143-0844, USA
| | - May Lynn Tan
- Center for Health and Community, University of California, San Francisco, 3333 California St., Suite 465, Campus Box 0844, San Francisco, CA, 94143-0844, USA
| | - David Vlahov
- Yale School of Nursing at Yale University, 400 West Campus Drive, Room 32306, Orange, CT, 06477, USA
| | - Nancy Adler
- Center for Health and Community, University of California, San Francisco, 3333 California St., Suite 465, Campus Box 0844, San Francisco, CA, 94143-0844, USA
| | - M. Maria Glymour
- Center for Health and Community, University of California, San Francisco, 3333 California St., Suite 465, Campus Box 0844, San Francisco, CA, 94143-0844, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, 2nd Floor, Campus Box 0560, San Francisco, CA, 94143, USA
| |
Collapse
|
12
|
Mamudu HM, Owusu D, Asare B, Williams F, Asare M, Oke A, Poole A, Osedeme F, Ouma OAE. Support for smoke-free public places among adults in four countries in sub-Saharan Africa. Nicotine Tob Res 2020; 22:2141-2148. [PMID: 31927591 DOI: 10.1093/ntr/ntaa008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 01/08/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION There is no known safe level of secondhand smoke exposure; yet, less than 30% of the global population is covered by comprehensive smoke-free policies as of 2016 and there are few smoke-free policies in sub-Saharan Africa (SSA). This study examines the support for smoke-free public places in SSA and delineates their correlates. METHODS Data collected through the Global Adult Tobacco Survey (2012-2017) were analyzed using SAS for descriptive and multivariable analyses, with a significance level set at p < .05. RESULTS No SSA country had comprehensive smoke-free policies, defined as a prohibition of smoking in eight public places. In the four countries whose Global Adult Tobacco Survey data were analyzed (Nigeria, Cameroon, Kenya, and Uganda), support for the prohibition of smoking in public places was over 90% in all eight public places except bars. Support for smoking prohibition in bars was 65.8%, 81.1%, 81.4%, and 91.0% in Nigeria, Cameroon, Kenya, and Uganda, respectively. Factors associated with support for smoke-free bars differed across the four countries, but in all countries, current smokers had decreased odds of support for smoke-free bars. Knowledge of secondhand smoke harm and living in smoke-free homes were associated with increased odds of support for smoke-free bars in all countries except Kenya. CONCLUSION The high support for smoke-free public places should inform the efforts of the public health community and policymakers in these four SSA countries toward meeting their obligations of Article 8 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). IMPLICATIONS Much of the population in SSA is not protected by comprehensive smoke-free policies. It was found that the overwhelming majority of adults in four large countries in SSA support the prohibition of smoking in public places and that knowledge of the health dangers of smoking and exposure to secondhand smoke and home smoking rules increased support for the prohibition. High support for the prohibition of smoking in these four SSA countries suggests tobacco control proponents should advocate for comprehensive smoke-free policies.
Collapse
Affiliation(s)
- Hadii M Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Daniel Owusu
- Tobacco Center of Regulatory Science (GSU TCORS), Georgia State University, Atlanta, GA
| | | | - Faustine Williams
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Matthew Asare
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX
| | - Adekunle Oke
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Amy Poole
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Fenose Osedeme
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Ogwell A E Ouma
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| |
Collapse
|
13
|
Smoking characteristics and lung functions among university athletes. Sci Rep 2020; 10:20118. [PMID: 33208923 PMCID: PMC7676233 DOI: 10.1038/s41598-020-77248-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/09/2020] [Indexed: 12/27/2022] Open
Abstract
Cigarette smoking has negative effects on the respiratory system, particularly pulmonary functions. This study aimed to determine smoking prevalence and characteristics among university athletes. We conducted a cross-sectional study of Thammasat University athletes in Thailand from July to October 2018. Demographic and smoking data were recorded. Exhaled carbon monoxide (CO) levels and lung function data were analysed. A total of 433 subjects (56% men) were included. Mean age was 19.8 ± 1.3 years. Asthma was reported in 5.5%. The prevalence of current cigarette smoking was 23.8%. Tobacco use was 3.0 ± 3.2 cigarettes per day. The Fagerstrom score for nicotine dependence was 0.76 ± 1.47. Compared to non-smokers, smokers were predominately males (70.6% vs 29.4%, P < 0.001), had higher exhaled CO levels (3.75 ± 3.08 ppm vs 2.18 ± 0.73 ppm, P < 0.001), higher FVC (89.65 ± 17.61% vs 83.22 ± 15.72%, P = 0.001), higher FEV1 (92.60 ± 15.36% vs 87.77 ± 11.23%, P = 0.002), but lower FEV1/FVC (78.21 ± 5.38% vs 79.70 ± 5.60%, P = 0.015). Moreover, athletes who smoke, were more likely to: drink alcohol, have a family member who smokes, have a friend who smokes or have a university instructor who smokes. In conclusion, smoking prevalence among university athletes was relatively high, although low nicotine addiction level and good lung functions were found. Home and institute environments had important influences on cigarette use in students. Trial registration: TCTR20180917001
Collapse
|
14
|
Králíková E, Pánková A. Barriers to introduction of smoke-free workplaces in Central Europe: example of the Czech Republic. Cent Eur J Public Health 2020; 28 Suppl:S22-S25. [PMID: 33069177 DOI: 10.21101/cejph.a6160] [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] [Received: 03/01/2020] [Accepted: 07/26/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Smoking at the workplace has a negative impact both on employers' economic interests and employees' health. The aim of this study is to describe the current situation, mainly barriers in implementation and resources in the Czech Republic as an example of a Central European country. METHODS We synthesised relevant review papers with our knowledge of the local situation based upon professional experience of both authors. RESULTS Despite smoke-free laws, some EU workers are still exposed to passive smoking during working hours. The main barriers towards smoke-free workplace implementation are the lack of resources, perception of smoking as a norm, and exceptions for leading personalities and their smoking. Social support increases smoking cessation effectiveness. Low availability of local smoking cessation services is an overall problem in Central Europe. CONCLUSIONS The working environment influences smoking habits. Smoking cessation support is cost-effective not only for the smoking employee but for employers as well. Smoking cessation resources should be available during the working day. No exceptions should be made as they serve as barriers to a smoke-free working environment.
Collapse
Affiliation(s)
- Eva Králíková
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.,Centre for Tobacco Dependence, Third Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Alexandra Pánková
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.,Centre for Tobacco Dependence, Third Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| |
Collapse
|
15
|
Halas G, Schultz ASH, Rothney J, Wener P, Holmqvist M, Cohen B, Kosowan L, Enns JE, Katz A. A Scoping Review of Foci, Trends, and Gaps in Reviews of Tobacco Control Research. Nicotine Tob Res 2020; 22:599-612. [PMID: 30715468 DOI: 10.1093/ntr/nty269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 01/17/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The burden of disease associated with tobacco use has prompted a substantial increase in tobacco-related research, but the breadth of this literature has not been comprehensively examined. This review examines the nature of the research addressing the action areas in World Health Organization's Framework Convention on Tobacco Control (FCTC), the populations targeted and how equity-related concepts are integrated. METHOD A scoping review of published reviews addressing tobacco control within the primary prevention domain. We searched PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Educational Resources Information Centre, and PsycInfo from 2004 to 2018. RESULTS The scoping review of reviews offered a "birds-eye-view" of the tobacco control literature. Within the 681 reviews meeting inclusion criteria, there was a strong focus on smoking cessation targeting individuals; less attention has been given to product regulation, packaging, and labeling or sales to minors. Equity-related concepts were addressed in 167/681 (24.5%); few were focused on addressing inequity through structural and systemic root causes. CONCLUSION This analysis of foci, trends, and gaps in the research pursuant to the FCTC illustrated the particular action areas and populations most frequently addressed in tobacco control research. Further research is needed to address: (1) underlying social influences, (2) particular action areas and with specific populations, and (3) sustained tobacco use through the influence of novel marketing and product innovations by tobacco industry. IMPLICATIONS This scoping review of the breadth of tobacco control research reviews enables a better understanding of which action areas and target populations have been addressed in the research. Our findings alongside recommendations from other reviews suggest prioritizing further research to support policymaking and considering the role of the tobacco industry in circumventing tobacco control efforts. The large amount of research targeting individual cessation would suggest there is a need to move beyond a focus on individual choice and decontextualized behaviors. Also, given the majority of reviews that simply recognize or describe disparity, further research that integrates equity and targets various forms of social exclusion and discrimination is needed and may benefit from working in collaboration with communities where programs can be tailored to need and context.
Collapse
Affiliation(s)
- Gayle Halas
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Annette S H Schultz
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Janet Rothney
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Wener
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Maxine Holmqvist
- Department of Clinical Health Psychology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Benita Cohen
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Leanne Kosowan
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer E Enns
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alan Katz
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
16
|
Noh JW, Choi M, Kwon YD, Yoo KB. Impacts of Smoking Ban Policies on Restaurants in Seoul, South Korea: Analysis of Objective Sales Information. Nicotine Tob Res 2020; 22:950-957. [PMID: 31083716 DOI: 10.1093/ntr/ntz079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 05/12/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND From July 2013 to January 2015, the smoking ban instituted in restaurants in South Korea gradually expanded to cover all restaurants and bars, moving by size of restaurant (≤99 m2, 100-149 m2, ≥150 m2). This study measured the impacts of the smoking ban for restaurants. METHODS This study examined credit, check, or debit card sales data for every September and October from 2012 to 2015 in 711 census tracts in Seoul, South Korea. We accounted for total restaurant sales in each census tract. Our model controlled for the sales amounts for each census tract, type of restaurant, monthly business survey index, number of restaurants, daily average temperature, daily precipitation, and day of the week, and a dummy for census tract. RESULTS These were some positive associations with increase in total sales. However, the significance of the coefficients was not consistent over this period. Overall, our results showed no significant negative effects of smoking ban policy on restaurants. CONCLUSIONS Smoking ban policies produced benefits in terms of health outcomes, without causing significant negative impacts on sales. IMPLICATIONS Although the owners of restaurants anticipated negative impacts on sales from smoking ban policies, the results of this study suggest that restaurants experienced no negative economic impacts on sales from policies with health benefits, which suggest that it would be reasonable to promote and keep on the smoking ban. Also, it is important to apply smoking ban policy to all targets without exclusion.
Collapse
Affiliation(s)
- Jin-Won Noh
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Korea.,Institute of Health Promotion and Policy, Dankook University, Cheonan, Korea
| | - Minjae Choi
- Department of Public Health, Korea University, Seoul, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine, the Catholic University of Korea, Seoul, Korea.,Catholic Institute for Healthcare Management, the Catholic University of Korea, Seoul, Korea
| | - Ki-Bong Yoo
- Department of Health Administration, College of Science and Technology, Yonsei University, Wonju, Korea.,Department of Information and Statistics, College of Health Sciences, Yonsei University, Wonju, Korea
| |
Collapse
|
17
|
Ko H. The effect of outdoor smoking ban: Evidence from Korea. HEALTH ECONOMICS 2020; 29:278-293. [PMID: 31860782 DOI: 10.1002/hec.3979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 10/20/2019] [Accepted: 11/04/2019] [Indexed: 06/10/2023]
Abstract
To address exposure to secondhand smoke, which is highly prevalent in Korea, local governments have implemented smoking bans at open public places (parks, bus stops, and school zones) since 2011. Exploiting temporal and spatial variation in the implementation dates of these bans, this study estimates their causal effects on individual smoking behavior. The individual-level longitudinal data from the 2009-2017 Korean Labor and Income Panel Study are linked to the smoking ban legislation information from the National Law Information Center. I find robust evidence that outdoor smoking bans increased the probability of making a quit attempt by 16%. This effect appears immediately after a ban goes into effect and lasts for three or more years. People who spend more time outdoors are more likely to change smoking behavior. I also find heterogeneity in effects across the amount of monetary penalty. Whereas the policy change did not affect the prevalence of smoking overall, higher penalties had stronger impacts on reducing the intensity of smoking and increasing the propensity to try to quit.
Collapse
Affiliation(s)
- Hansoo Ko
- Wagner Graduate School of Public Service, New York University, New York, New York
- Division of Health Policy & Administration, University of Illinois at Chicago School of Public Health, Chicago, Illinois
| |
Collapse
|
18
|
Mojtabai R, Riehm KE, Cohen JE, Alexander GC, Rutkow L. Clean indoor air laws, cigarette excise taxes, and smoking: Results from the current population survey-tobacco use supplement, 2003-2011. Prev Med 2019; 126:105744. [PMID: 31173803 PMCID: PMC6697615 DOI: 10.1016/j.ypmed.2019.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 05/29/2019] [Accepted: 06/03/2019] [Indexed: 11/30/2022]
Abstract
There was an increase in the number and coverage of state and local clean indoor air laws in the US during the past fifteen years. These laws coincided with increases in federal, state, and local cigarette excise taxes. In light of these changes, the objective of this study was to examine the association between clean indoor air laws, cigarette excise taxes and smoking patterns between 2003 and 2011. Using data on 62,165 adult participants in the 2003 and 2010/2011 Current Population Survey-Tobacco Use Supplement who reported smoking cigarettes in the past year, we examined the association of state and county workplace, bar, and restaurant clean indoor air laws and cigarette excise taxes with quitting and current every-day smoking. Between 2003 and 2011, quitting increased and daily smoking among those who continued to smoke decreased significantly. Participants living in states and counties with higher excise taxes and more comprehensive clean indoor air laws had a higher likelihood of quitting and lower likelihood of everyday smoking. Based on the assumption of no uncontrolled confounding, changes in taxes and laws accounted for 64.8% of the increase in smoking cessation and all of the reduction in everyday smoking. Implementation of state and county-level clean indoor air laws and cigarette taxes appears to have achieved the intended goal of encouraging smokers to either quit or reduce their frequency of smoking.
Collapse
Affiliation(s)
- Ramin Mojtabai
- Department of Mental Health, Hampton House, 624 North Broadway, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Kira E Riehm
- Department of Mental Health, Hampton House, 624 North Broadway, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Hampton House, 624 North Broadway, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; Institute for Global Tobacco Control, 2213 McElderry Street, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - G Caleb Alexander
- Center for Drug Safety and Effectiveness, 615 North Wolfe Street, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; Department of Epidemiology, 615 North Wolfe Street, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; Division of General Internal Medicine, 1800 Orleans Street, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Lainie Rutkow
- Department of Health Policy and Management, Hampton House, 624 North Broadway, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
| |
Collapse
|
19
|
Shafer P. Impact of US Smoke-free Air Laws on Restaurant and Bar Employment, 1990-2015. Nicotine Tob Res 2019; 21:547-550. [PMID: 29309684 DOI: 10.1093/ntr/ntx280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 12/21/2017] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Secondhand smoke exposure is responsible for an estimated 50000 deaths per year among nonsmokers in the United States. Smoke-free air laws reduce secondhand smoke exposure but often encounter opposition over concerns about their economic impact. Expansion of these laws has stagnated and efforts to weaken existing laws may exacerbate existing disparities in exposure. Studies at the state and local levels have found that smoke-free air laws do not generally have an adverse effect, but there are no recent estimates of the impact of these laws nationally. METHODS Employment and sales are two measures commonly used to estimate the economic impact of smoke-free air laws. Sales data are gathered by state and local taxing authorities but not uniformly across jurisdictions. Dynamic panel models are used to estimate a population-weighted national average treatment effect of smoke-free air laws on restaurant and bar employment using data from the Quarterly Census of Employment and Wages for 1990 to 2015. RESULTS A one-percentage point increase in population covered by a restaurant smoke-free air law is associated with a small increase (approximately 0.01%) in restaurant employment (b = .0001, p < .001). The percentage of state population covered by a bar smoke-free air law was not associated with bar employment. DISCUSSION Smoke-free air laws are a powerful tool for protecting hospitality workers and patrons from the dangers of secondhand smoke. Using data from over more than two decades, these results suggest that smoke-free air laws in the United States do not generally have any meaningful effect on restaurant and bar employment. IMPLICATIONS Smoke-free air laws are associated with reductions in negative health outcomes and decreased smoking prevalence. Despite this clear public health argument and strong public support, passage of new laws has stagnated and exemptions are being used to weaken existing laws. The ability to make both a health and business case in support of existing laws may also bolster the case for expansion. This study provides an updated look at the economic impact of smoke-free air laws nationally through 2015. The lack of adverse findings provides additional support for these laws as public health win-win.
Collapse
Affiliation(s)
- Paul Shafer
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC.,Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC
| |
Collapse
|
20
|
'If I pay rent, I'm gonna smoke': Insights on the social contract of smokefree housing policy in affordable housing settings. Health Place 2019; 56:106-117. [PMID: 30716667 DOI: 10.1016/j.healthplace.2019.01.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 12/27/2018] [Accepted: 01/10/2019] [Indexed: 11/24/2022]
Abstract
Smoke-free housing policy in multi-unit housing has emerged as a promising tobacco control initiative, yet full compliance remains elusive and is a critical impediment to policy effectiveness. There is a gap in existing research on potential factors preventing optimal smoke-free policy adoption and corresponding solutions. Using qualitative and quantitative data from resident surveys (N = 115) as well as key informant interviews, a focus group, and observational fieldwork, this study 1) assesses smoking behaviors and experience with secondhand smoke in buildings after adoption of a smoke-free policy; 2) examines resident and property management perceptions of the policy; and 3) identifies socioecological factors that influence the policy's effectiveness in affordable housing settings in New York City. Findings indicate that residents view smoking regulations within the context of broader relationships with the housing provider and other residents. We argue that these "social contracts" strongly influence the effectiveness of smoke-free housing policies and must be acknowledged to maximize compliance.
Collapse
|
21
|
Dang AK, Tran BX, Nguyen LH, Do HT, Nguyen CT, Fleming M, Le HT, Le QNH, Latkin CA, Zhang MWB, Ho RCM. Customers' Perceptions of Compliance with a Tobacco Control Law in Restaurants in Hanoi, Vietnam: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1451. [PMID: 29996487 PMCID: PMC6068709 DOI: 10.3390/ijerph15071451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/07/2018] [Accepted: 07/08/2018] [Indexed: 01/10/2023]
Abstract
The Tobacco Harm Prevention Law has been promulgated in 2012 in Vietnam, prohibiting smoking in public places such as restaurants except for designated smoking areas. However, currently, evidence about Vietnamese customers’ and restaurants’ compliance with the Law is constrained. This study aimed to explore customers’ perceptions; attitudes and practices towards the compliance with tobacco control regulations in the restaurants in Hanoi, Vietnam. A cross-sectional study was performed in October 2015 with 1746 customers in 176 communes in Hanoi, Vietnam. Data about customers’ perceptions on how restaurants comply with the smoking control law and whether customers smoking actively or experienced SHS in restaurants in the last 30 days were collected. Multivariable mixed effects logistic regression model was used to determine the factors related to smoking in the restaurant. Most customers were aware of the law on Tobacco Harm Prevention (79%; n = 1320) and regulations that prohibited smoking in restaurants (78.4%; n = 1137). While 75.8% (n = 1285) of customers perceived that they did not see or rarely saw no-smoking signs, 17.7% (n = 481) of customers reported that they frequently saw direct marketing of tobacco in visited restaurants. About one-fourth of customers witnessed that the staff reminded customers not to smoke inside restaurants (28.8%; n = 313), and 65% (n = 1135) sometimes or always were exposed to secondhand smoke in their visited restaurants. People who were female (OR = 0.02, 95% CI = 0.01⁻0.05) were less likely to report their smoking in the restaurant than their counterparts. Those having higher age (OR = 1.03; 95% CI = 1.01⁻1.06), high school education (OR = 2.14, 95% CI = 1.07⁻4.26), being office workers (OR = 3.24, 95% CI = 1.33⁻7.92) or unemployed (OR = 4.45; 95% CI = 1.09⁻18.15) had a higher likelihood of reporting to be restaurant smokers than those having lower high education or students, respectively. This study highlighted a low level of perceived compliance with the smoke-free law in Vietnamese restaurants. Improving the monitoring systems for the enforcement of the smoking law in restaurants should be prioritized; restaurant owners should implement 100% smoke-free environments as following the best practice towards the tobacco control law along with educational campaigns to promote the awareness of restaurant owners and customers about the tobacco control law.
Collapse
Affiliation(s)
- Anh Kim Dang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Long Hoang Nguyen
- Department of Public Health Sciences, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Hoa Thi Do
- Department of Nutrition and Food Safety, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Mercedes Fleming
- School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland.
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | | | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Melvyn W B Zhang
- Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore 117599, Singapore.
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| |
Collapse
|
22
|
Lowrie C, Pearson AL, Thomson G. Inequities in coverage of smokefree outdoor space policies within the United States: school grounds and playgrounds. BMC Public Health 2018; 18:736. [PMID: 29902978 PMCID: PMC6003182 DOI: 10.1186/s12889-018-5602-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 05/24/2018] [Indexed: 11/18/2022] Open
Abstract
Background Previous studies have found extensive geographic and demographic differences in tobacco use. These differences have been found to be reduced by effective public policies, including banning smoking in public spaces. Smokefree outdoor spaces reduce secondhand smoke exposure and de-normalize smoking. Methods After previously publishing a study of smokefree indoor and outdoor space policies, it was brought to the authors’ attention that the dataset used in analyses was incomplete (Lowrie et al., BMC Public Health 17:456, 2017). The current manuscript is a corrected version. Here, we include analyses for outdoor space policies. We evaluated regional and demographic differences in the proportion of the population (both adult and child) covered by smokefree outdoor space policies for school grounds and playgrounds enacted in the United States prior to 2014. Results Children had a low level of protection in playgrounds and schools (8% covered nationwide in both settings). Significant differences in coverage were found by ethnicity, region, income, and education (p < 0.001). The odds of having a smokefree playgrounds policy was lower for jurisdictions with higher proportions of poor households, households with no high school diploma, whites and the Alaska/Hawaii region. Increased ethnic heterogeneity was found to be a significant predictor of increased odds of having a smokefree playgrounds policy, meaning that diversity is protective, with differential effect by region (p < 0.001) – which may relate to urbanicity. Conclusions Disparities in smokefree outdoor space policies have potential to exacerbate existing health inequities. A national increase in smokefree outdoor space policies to protect children in playgrounds and schools is a crucial intervention to reduce such inequities.
Collapse
Affiliation(s)
- Christopher Lowrie
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, 673 Auditorium Road, East Lansing, MI, 48824, USA
| | - Amber L Pearson
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, 673 Auditorium Road, East Lansing, MI, 48824, USA. .,Department of Public Health, University of Otago, Wellington, 6021, New Zealand. .,Environmental Science and Policy Program, Michigan State University, East Lansing, MI, 48824, USA.
| | - George Thomson
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
| |
Collapse
|
23
|
Dai H, Hao J. The Prevalence of Exposure to Workplace Secondhand Smoke in the United States: 2010 to 2015. Nicotine Tob Res 2018; 19:1300-1307. [PMID: 27986913 DOI: 10.1093/ntr/ntw306] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/08/2016] [Indexed: 11/13/2022]
Abstract
Objective To compare changes in exposure to workplace secondhand smoke (SHS) by industry of employment and occupation from 2010 to 2015. Methods Data were collected from 2010 and 2015 National Health Interview Survey. Weighted estimates of the prevalence of exposure to workplace SHS among currently working nonsmokers in 2010 (n = 12 627) and 2015 (n = 16 399) were compared. Results The prevalence of exposure to workplace SHS among currently working nonsmokers was 10.0% in 2015 and 9.5% in 2010. Exposure to workplace SHS is disproportionally high among male workers, young workers, non-Hispanic blacks, Hispanics, workers with low education and low income, and workers residing in the Southern United States. Tobacco control policies have effectively reduced exposure to workplace SHS in a few white-collar and service job categories but blue-collar workers remain to have a high prevalence of exposure to workplace SHS. From 2010 to 2015, "transportation and warehousing industries" had the largest increase in SHS exposure (13.3%-21.5%, p value = .004) and "arts, entertainment, and recreation industries" had the largest decline in prevalence of exposure to SHS (20.1%-11.5%, p value = .01). In the multivariate analysis, workers with service (aOR = 1.4, p < .0001) and blue-collar occupations (aOR = 2.5, p < .0001) had a significantly higher prevalence of exposure to workplace SHS than those with white-collar occupations. Conclusions Disparities of SHS exposure by industry, occupation, and social demographic class continue to exist. Blue-collar workers, especially those working in "transportation and construction industries," along with young workers and workers in high risk social classes are priority groups for future workplace SHS prevention. Implications An estimated 12.6 million working nonsmokers were regularly exposed to SHS at work in 2015. We compared the changes in prevalence of exposure to workplace SHS from 2010 to 2015 by social demographic class, industry of employment and occupation. Our findings could help inform the policymakers and health practitioners to establish stronger smoke-free air laws and conduct education campaigns to reduce the exposure to workplace SHS, especially among certain industries and occupations with a disproportionally high prevalence of exposure to workplace SHS.
Collapse
Affiliation(s)
- Hongying Dai
- Health Services and Outcomes Research, Children's Mercy Hospital, Kansas City, MO.,Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, MO.,Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO
| | | |
Collapse
|
24
|
Hahn EJ, Rayens MK, Wiggins AT, Gan W, Brown HM, Mullett TW. Lung cancer incidence and the strength of municipal smoke-free ordinances. Cancer 2017; 124:374-380. [DOI: 10.1002/cncr.31142] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/07/2017] [Accepted: 08/14/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Ellen J. Hahn
- Bridging Research Efforts and Advocacy Toward Healthy Environments (BREATHE), College of Nursing; University of Kentucky; Lexington Kentucky
- College of Public Health; University of Kentucky; Lexington Kentucky
| | - Mary Kay Rayens
- Bridging Research Efforts and Advocacy Toward Healthy Environments (BREATHE), College of Nursing; University of Kentucky; Lexington Kentucky
- College of Public Health; University of Kentucky; Lexington Kentucky
| | - Amanda T. Wiggins
- Bridging Research Efforts and Advocacy Toward Healthy Environments (BREATHE), College of Nursing; University of Kentucky; Lexington Kentucky
| | - Wenqi Gan
- College of Public Health; University of Kentucky; Lexington Kentucky
| | - Holly M. Brown
- Bridging Research Efforts and Advocacy Toward Healthy Environments (BREATHE), College of Nursing; University of Kentucky; Lexington Kentucky
| | - Timothy W. Mullett
- Markey Cancer Center, College of Medicine; University of Kentucky; Lexington Kentucky
| |
Collapse
|
25
|
Abstract
OBJECTIVES Thirty states have smoke-free air laws that ban smoking in restaurants and bars, covering nearly two-thirds of the US population. It is well established that these laws generally have a null or positive economic impact on restaurants and bars. However, all establishments in a geographic area are usually treated as a homogeneous group without considering the potential for differential effects by establishment characteristics. This study uses variation in smoke-free air laws over time to estimate their impact on employment in restaurants and bars with a focus on potential differences by employer size (number of employees). A two-pronged approach with a national-level and state-level analysis is used to take advantage of more granular data availability for a single state (North Carolina). DESIGN Observational study using panel data. SETTING 1) US, 2) North Carolina INTERVENTIONS: Smoke-free air laws. OUTCOME MEASURES State-level accommodation and food services employment for all 50 states and District of Columbia from 1990 through 2014 (Quarterly Census of Employment and Wages); county-level restaurant and bar employment in North Carolina from 2001 through 2014 (North Carolina Department of Commerce). RESULTS There is no evidence of a redistributive effect of smoke-free air laws on restaurant and bar employment by employer size. CONCLUSION The lack of a redistributive effect is an important finding for policy-makers considering implementation or expansion of a smoke-free air law to protect employees and patrons from the dangers of exposure to secondhand smoke.
Collapse
Affiliation(s)
- Paul Shafer
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle, North Carolina, USA
| |
Collapse
|
26
|
Bartholomew KS, Abouk R. The Effect of Local Smokefree Regulations on Birth Outcomes and Prenatal Smoking. Matern Child Health J 2017; 20:1526-38. [PMID: 26987859 DOI: 10.1007/s10995-016-1952-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objectives We assessed the impact of varying levels of smokefree regulations on birth outcomes and prenatal smoking. Methods We exploited variations in timing and regulation restrictiveness of West Virginia's county smokefree regulations to assess their impact on birthweight, gestational age, low birthweight, very low birthweight, preterm birth, and prenatal smoking. We conducted regression analysis using state Vital Statistics individual-level data for singletons born to West Virginia residents between 1995-2010 (N = 293,715). Results Only more comprehensive smokefree regulations were associated with statistically significant favorable effects on birth outcomes in the full sample: Comprehensive (workplace/restaurant/bar ban) demonstrated increased birthweight (29 grams, p < 0.05) and gestational age (1.64 days, p < 0.01), as well as reductions in very low birthweight (-0.4 %, p < 0.05) and preterm birth (-1.5 %, p < 0.01); Restrictive (workplace/restaurant ban) demonstrated a small decrease in very low birthweight (-0.2 %, p < 0.05). Among less restrictive regulations: Moderate (workplace ban) was associated with a 23 g (p < 0.01) decrease in birthweight; Limited (partial ban) had no effect. Comprehensive's improvements extended to most maternal groups, and were broadest among mothers 21+ years, non-smokers, and unmarried mothers. Prenatal smoking declined slightly (-1.7 %, p < 0.01) only among married women with Comprehensive. Conclusions Regulation restrictiveness is a determining factor in the impact of smokefree regulations on birth outcomes, with comprehensive smokefree regulations showing promise in improving birth outcomes. Favorable effects on birth outcomes appear to stem from reduced secondhand smoke exposure rather than reduced prenatal smoking prevalence. This study is limited by an inability to measure secondhand smoke exposure and the paucity of data on policy implementation and enforcement.
Collapse
Affiliation(s)
- Karla S Bartholomew
- School of Medicine and Health Sciences, The George Washington University, 2300 I Street NW, Washington, DC, 20037, USA.
| | - Rahi Abouk
- Department of Economics, William Paterson University, Wayne, NJ, 07470, USA
| |
Collapse
|
27
|
Rawal LB, Biswas T, Khandker NN, Saha SR, Bidat Chowdhury MM, Khan ANS, Chowdhury EH, Renzaho A. Non-communicable disease (NCD) risk factors and diabetes among adults living in slum areas of Dhaka, Bangladesh. PLoS One 2017; 12:e0184967. [PMID: 28972972 PMCID: PMC5626026 DOI: 10.1371/journal.pone.0184967] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 09/04/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Despite one-third of the urban population in Bangladesh living in urban slums and at increased risk of non-communicable diseases (NCDs), little is known about the NCD risk profile of this at-risk population. The aim of the study was to identify the prevalence of the NCD risk factors and the association of NCD risk factors with socio-demographic factors among the adults of urban slums in Dhaka, Bangladesh. METHOD A cross-sectional study was conducted among adult slum dwellers (aged 25 and above) residing in three purposively selected urban slums of Dhaka for at least six months preceding the survey. The risk factors assessed were- currently smoking, fruit and vegetable intake, physical activity, hypertension and body mass index (BMI). Information on self-reported diabetes was also taken. A total of 507 participants (252 females; 49.7%) were interviewed and their physical measures were taken using the WHO NCD STEPS instrument. RESULT The overall prevalence of NCD risk factors was: 36.0% (95% CI: 31.82-40.41) for smoking; 95.60% (95% CI: 93.60-97.40) for insufficient fruit and vegetable intake; 15.30% (95% CI:12.12-18.71) for low physical activity;13.70% (95% CI: 10.71-16.92) for hypertension; 22.70% (95% CI: 19.31-26.02) for overweight or obesity; and 5.00% (95%: 3.20-7.00) for self-reported diabetes. In the logistic regression model, the clustering of three or more NCD risk factors was positively associated with younger age groups (p = 0.02), no formal education (p <0.001) and primary education level (p = 0.01), but did not differ by sex of the participants, monthly income and occupation. CONCLUSION All NCD risk factors are markedly high among the urban slum adults. These findings are important to support the formulation and implementation of NCD-related polices and plan of actions that recognize urban slum populations in Bangladesh as a priority sub-population.
Collapse
Affiliation(s)
- Lal B. Rawal
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, Bangladesh
- James P Grant Schools of Public Health, BRAC University, Dhaka, Bangladesh
| | - Tuhin Biswas
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, Bangladesh
- The University of Queensland, Long Pocket Precinct, Indooroopilly Queensland, Australia
| | | | | | | | - Abdullah Nurus Salam Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, Bangladesh
| | | | - Andre Renzaho
- Western Sydney University Locked Bag 1797, Penrith, NSW Australia
| |
Collapse
|
28
|
Yang XY, Yang T, Nie F. Air pollution as a catalyst for supporting tobacco control policies? Evidence from a nationwide study on Chinese medical students. Tob Control 2017; 27:505-512. [PMID: 28814454 DOI: 10.1136/tobaccocontrol-2017-053684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 07/17/2017] [Accepted: 07/26/2017] [Indexed: 11/03/2022]
Abstract
PURPOSE Few studies have discussed how the increasing ambient air pollution may affect policy-related attitudes. Medical professionals constitute an important interest group who analyse and solve public issues within a medicalised framework. The current study investigates whether ambient air pollution is associated with a greater likelihood of supporting tobacco control measures among medical students. METHODS We conducted multistage sampling among the medical students from 42 cities in China. We employed propensity-score matching to eliminate the selection bias and used multilevel logistic regressions for the main analysis (n1=9458, n2=42). RESULTS we found that city-level air particulate matter is consistently associated with the support for tobacco control among medical students, net of other individual-level and city-level covariates. For one standard increase in air particulate matter, people are 1.21 times more likely to fully support tobacco control measures (p<0.05). This association is significantly stronger among medical students who are financially worse-off and are ethnic majority. CONCLUSIONS Environmental pollution has a significant correlation with people's attitudes towards health policies, even when such policies are not directly concerned with the natural environment. Policy makers may use this opportunity to implement tobacco control measures against the backdrop of China's pollution crisis.
Collapse
Affiliation(s)
- Xiaozhao Yousef Yang
- Department of Political Science and Sociology, Murray State University, Murray, Kentucky, USA
| | - Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University, Hangzhou, China
| | - Fanhao Nie
- Department of Social and Behavioral Sciences, Dixie State University, St. George, Utah, USA
| |
Collapse
|
29
|
Rando-Matos Y, Pons-Vigués M, López MJ, Córdoba R, Ballve-Moreno JL, Puigdomènech-Puig E, Benito-López VE, Arias-Agudelo OL, López-Grau M, Guardia-Riera A, Trujillo JM, Martin-Cantera C. Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis. PLoS One 2017; 12:e0181035. [PMID: 28759596 PMCID: PMC5536320 DOI: 10.1371/journal.pone.0181035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 06/26/2017] [Indexed: 11/22/2022] Open
Abstract
Aims The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose) among all populations. Materials and methods Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1) original scientific studies about smokefree legislation, 2) Data before and after legislation were collected, and 3) Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment. Results A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers). Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months). Four (50%) of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1–36%) than for asthma (5–31%). Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46%) of the studies. Conclusions Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms) and, to a lesser degree, rates of hospitalization for asthma.
Collapse
Affiliation(s)
- Yolanda Rando-Matos
- Centre d'Atenció Primària (CAP) Florida Nord. Gerència d’Àmbit d’Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
- * E-mail:
| | - Mariona Pons-Vigués
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
- Universitat de Girona, Girona, Spain
| | - María José López
- Public Health Agency of Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Institut d'Investigació Biomèdic (IIB Sant Pau), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Rodrigo Córdoba
- Centro de Salud Universitario Delicias Sur, Servicio Aragonés de Salud (SALUD), Zaragoza, Spain
- Universidad de Zaragoza, Zaragoza, Spain
| | - José Luis Ballve-Moreno
- Centre d'Atenció Primària (CAP) Florida Nord. Gerència d’Àmbit d’Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
| | - Elisa Puigdomènech-Puig
- Agència de Qualitat i Avaluació Sanitàries, AQuAS, Generalitat de Catalunya, Barcelona, Spain
| | - Vega Estíbaliz Benito-López
- Servicio de Medicina Preventiva, Complejo Asistencial Universitario de Salamanca, Sanidad de Castilla y Leon (SACYL), Salamanca, Spain
- Grupo de investigación: Trastornos sensoriales y neuroplasticidad cerebral (UIC: 083), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Instituto de Neurociencias de Castilla y León (INCYL), Salamanca, Spain
| | - Olga Lucía Arias-Agudelo
- Centre d'Atenció Primària (CAP) San Martí de Provençals, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Mercè López-Grau
- Centre d'Atenció Primària (CAP) Passeig de Sant Joan, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Anna Guardia-Riera
- Àrea Bàsica de Salut l'Hospitalet de Llobregat 6—Sta. Eulàlia sud, Gerència d’Àmbit d’Atenció Primària Hospitalet de Llobregat, Institut Català de la Salut, Barcelona, Spain
| | | | - Carlos Martin-Cantera
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
- Centre d'Atenció Primària (CAP) Passeig de Sant Joan, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain
| |
Collapse
|
30
|
Lowrie C, Pearson AL, Thomson G. Inequities in coverage of smokefree space policies within the United States. BMC Public Health 2017; 17:456. [PMID: 28511682 PMCID: PMC5434634 DOI: 10.1186/s12889-017-4385-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 05/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have found extensive geographic and demographic differences in tobacco use. These differences have been found to be reduced by effective public policies, including banning smoking in public spaces. Smokefree indoor and outdoor spaces reduce secondhand smoke exposure and denormalize smoking. METHODS We evaluated regional and demographic differences in the proportion of the population covered by smokefree policies enacted in the United States prior to 2014, for both adults and children. RESULTS Significant differences in coverage were found by ethnicity, region, income, and education (p < 0.001). Smokefree policy coverage was lower for jurisdictions with higher proportions of poor households, households with no high school diploma and the Southeast region. Increased ethnic heterogeneity was found to be a significant predictor of coverage in indoor "public spaces generally", meaning that diversity is protective, with differential effect by region (p = 0.004) - which may relate to urbanicity. Children had a low level of protection in playgrounds and schools (~10% covered nationwide) - these spaces were found to be covered at lower rates than indoor spaces. CONCLUSIONS Disparities in smokefree space policies have potential to exacerbate existing health inequities. A national increase in smokefree policies to protect children in playgrounds and schools is a crucial intervention to reduce such inequities.
Collapse
Affiliation(s)
- Christopher Lowrie
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, East Lansing, MI, 48824, USA
| | - Amber L Pearson
- Department of Geography, Environment, and Spatial Sciences, Michigan State University, East Lansing, MI, 48824, USA. .,Department of Public Health, University of Otago, Wellington, 6021, New Zealand. .,Environmental Science and Policy Program, Michigan State University, East Lansing, MI, 48824, USA.
| | - George Thomson
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
| |
Collapse
|
31
|
Wintemberg J, McElroy JA, Ge B, Everett KD. Can Smoke-Free Policies Reduce Tobacco Use Disparities of Sexual and Gender Minorities in Missouri? Nicotine Tob Res 2017; 19:1308-1314. [DOI: 10.1093/ntr/ntx078] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 04/03/2017] [Indexed: 11/14/2022]
|
32
|
Kuehnle D, Wunder C. The Effects of Smoking Bans on Self-Assessed Health: Evidence from Germany. HEALTH ECONOMICS 2017; 26:321-337. [PMID: 26749275 DOI: 10.1002/hec.3310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 11/09/2015] [Accepted: 12/01/2015] [Indexed: 06/05/2023]
Abstract
We examine the effects of smoking bans on self-assessed health in Germany taking into account heterogeneities by smoking status, gender and age. We exploit regional variation in the dates of enactment and dates of enforcement across German federal states. Using data from the German Socio-Economic Panel, our difference-in-differences estimates show that non-smokers' health improves, whereas smokers report no or even adverse health effects in response to bans. We find statistically significant health improvements especially for non-smokers living in households with at least one smoker. Non smokers' health improvements materialise largely with the enactment of smoking bans. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
|
33
|
Lidón-Moyano C, Martínez-Sánchez JM, Fu M, Ballbè M, Martín-Sánchez JC, Martínez C, Fernández E. Secondhand smoke risk perception and smoke-free rules in homes: a cross-sectional study in Barcelona (Spain). BMJ Open 2017; 7:e014207. [PMID: 28104712 PMCID: PMC5253536 DOI: 10.1136/bmjopen-2016-014207] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To describe the voluntary adoption of smoke-free homes in Spain among general population and to identify variables associated with its voluntary adoption. METHODS Cross-sectional study of a representative sample (n=731) of the adult population (>26 years) of Barcelona, Spain, in 2013-2014. We defined smoking rules inside the households as complete indoor rules (when smoking was not allowed inside the house), and partial or absent indoor rules (when smoking was allowed in some designated places inside the house or when smoking was allowed everywhere) and described them according to the perceived risk of the secondhand smoke (SHS) exposure. We calculated the prevalence and prevalence ratios (PR) according to sociodemographic variables. RESULTS 57.4% of households had complete indoor smoke-free rules. The prevalence of households with complete indoor rules was higher among women (PRa: 1.15; 95% CI 1.00 to 1.33), married (PRa: 1.18; 95% CI 1.01 to 1.38), never-smokers (PRa: 2.68; 95% CI 2.06 to 3.50) and in households where a minor lived (PRa: 1.40; 95% CI: 1.20-1.65). Believe that breathing tobacco smoke from smokers is dangerous for non-smokers (PRa: 1.77; 95% CI: 1.06-2.97) is associated with the voluntary adoption of complete indoor smoke-free home. CONCLUSIONS Risk perceptions of SHS exposure were associated with the voluntary adoption of indoor smoke-free homes.
Collapse
Affiliation(s)
- Cristina Lidón-Moyano
- Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Jose M Martínez-Sánchez
- Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Montse Ballbè
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
- Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Juan Carlos Martín-Sánchez
- Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Cristina Martínez
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Medicine and Health Sciences School, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
34
|
Haardörfer R, Berg CJ, Escoffery C, Bundy ŁT, Hovell M, Kegler MC. Development of a scale assessing Beliefs About ThirdHand Smoke (BATHS). Tob Induc Dis 2017; 15:4. [PMID: 28104999 PMCID: PMC5240270 DOI: 10.1186/s12971-017-0112-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 01/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Similarly to secondhand smoke (SHS), thirdhand smoke (THS) beliefs may be correlated with smoking behaviors and smokefree policies in the home. Thus, there is a need to develop and validate measures to assess beliefs about THS. METHODS A list of 19 items related to THS were generated by an expert panel and tested in a pilot study. Based on results from an exploratory factor analysis, two factors emerged: THS persistence in the environment and THS impact on health. The scale was reduced to nine items, which showed no differential item functioning by smoking status or smoking ban status in the home. The nine items and the two factor structure were tested in a validation sample from a smoke-free homes intervention that included THS educational materials. RESULTS The 9-item scale showed excellent internal consistency. Confirmatory factor analysis indicated good model fit for the two factor solution in a low-income population. Tests of construct validity indicated differences due to exposure to the smoke-free homes intervention, by smoking status, whether participants own or rent their home, and smoking ban status in the home. CONCLUSIONS The BATHS scale offers researchers a valid and reliable tool to assess THS beliefs.
Collapse
Affiliation(s)
- Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322 USA
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322 USA
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322 USA
| | - Łucja T Bundy
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322 USA
| | - Melbourne Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, San Diego, CA 92182 USA
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322 USA
| |
Collapse
|
35
|
Kermah D, Shaheen M, Pan D, Friedman TC. Association between secondhand smoke and obesity and glucose abnormalities: data from the National Health and Nutrition Examination Survey (NHANES 1999-2010). BMJ Open Diabetes Res Care 2017; 5:e000324. [PMID: 28405342 PMCID: PMC5372029 DOI: 10.1136/bmjdrc-2016-000324] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/22/2016] [Accepted: 01/05/2017] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The objective of this study is to investigate the relationship between cotinine level-confirmed secondhand smoke (SHS) exposure and glycemic parameters and obesity. RESEARCH DESIGN AND METHODS We examined a cohort of 6472 adults from the National Health and Nutrition Examination Surveys, 1999-2010. Serum cotinine levels and self-reported data on smoking were used to determine smoking status. The outcome variables were body mass index (BMI) and glycemic status (HbA1c), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and fasting plasma glucose (FPG). Descriptive, bivariate, and multivariate analyses were conducted. RESULTS Using cotinine level-confirmed smoking status, 1794 (27.4%) of the sample were current smokers, 1681 (25.0%) were former smokers, 1158 (17.8%) were secondhand smokers, and 1839 (29.8%) were non-smokers. In a generalized linear model after controlling for potential confounding variables, secondhand smokers had higher adjusted levels of HOMA-IR, FPG, and BMI compared with non-smokers (p<0.05). Adjustment for BMI demonstrated that some, but not all, of the detrimental effects of SHS on glycemic parameters are mediated by the increased body weight of secondhand smokers. CONCLUSIONS We conclude that SHS is associated with obesity and worsening glycemic parameters. More studies are needed to show a causal relationship between SHS and glycemic parameters and to understand the mechanisms involved in the association.
Collapse
Affiliation(s)
- Dulcie Kermah
- Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| | - Magda Shaheen
- Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| | - Deyu Pan
- Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| | - Theodore C Friedman
- Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| |
Collapse
|
36
|
Chapman Haynes M, St. Claire AW, Boyle RG, Betzner A. Testing and Refining Measures of Secondhand Smoke Exposure Among Smokers and Nonsmokers. Nicotine Tob Res 2016; 20:199-205. [DOI: 10.1093/ntr/ntw315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 11/22/2016] [Indexed: 11/14/2022]
|
37
|
Bakolis I, Kelly R, Fecht D, Best N, Millett C, Garwood K, Elliott P, Hansell AL, Hodgson S. Protective Effects of Smoke-free Legislation on Birth Outcomes in England: A Regression Discontinuity Design. Epidemiology 2016; 27:810-8. [PMID: 27428672 PMCID: PMC5424880 DOI: 10.1097/ede.0000000000000534] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Environmental tobacco smoke has an adverse association with preterm birth and birth weight. England introduced a new law to make virtually all enclosed public places and workplaces smoke free on July 1, 2007. We investigated the effect of smoke-free legislation on birth outcomes in England using Hospital Episode Statistics (HES) maternity data. METHODS We used regression discontinuity, a quasi-experimental study design, which can facilitate valid causal inference, to analyze short-term effects of smoke-free legislation on birth weight, low birth weight, gestational age, preterm birth, and small for gestational age. RESULTS We analyzed 1,800,906 pregnancies resulting in singleton live-births in England between 1 January 2005 and 31 December 2009. In the 1 to 5 months following the introduction of the smoke-free legislation, for those entering their third trimester, the risk of low birth weight decreased by between 8% (95% confidence interval [CI]: 4%, 12%) and 14% (95% CI: 5%, 23%), very low birth weight between 28% (95% CI: 19%, 36%) and 32% (95% CI: 21%, 41%), preterm birth between 4% (95% CI: 1%, 8%) and 9% (95% CI: 2%, 16%), and small for gestational age between 5% (95% CI: 2%, 8%) and 9% (95% CI: 2%, 15%). The estimated impact of the smoke-free legislation varied by maternal age, deprivation, ethnicity, and region. CONCLUSIONS The introduction of smoke-free legislation in England had an immediate estimated beneficial impact on birth outcomes overall, although we did not observe improvements across all age, ethnic, or deprivation groups.See video abstract at http://links.lww.com/EDE/B85.
Collapse
Affiliation(s)
- Ioannis Bakolis
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Dept. Epidemiology and Biostatistics, School of Public Health, Imperial College London W2 1PG, UK
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
- Department of Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Ruth Kelly
- Dept. Epidemiology and Biostatistics, School of Public Health, Imperial College London W2 1PG, UK
- The Medical Research Council, 14th floor, One Kemble Street, London, WC2B 4AN
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Dept. Epidemiology and Biostatistics, School of Public Health, Imperial College London W2 1PG, UK
| | - Nicky Best
- Dept. Epidemiology and Biostatistics, School of Public Health, Imperial College London W2 1PG, UK
| | - Christopher Millett
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, UK
| | - Kevin Garwood
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Dept. Epidemiology and Biostatistics, School of Public Health, Imperial College London W2 1PG, UK
| | - Paul Elliott
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Dept. Epidemiology and Biostatistics, School of Public Health, Imperial College London W2 1PG, UK
- Directorate of Public Health and Primary Care, Imperial College Healthcare NHS Trust, London, UK
| | - Anna L Hansell
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Dept. Epidemiology and Biostatistics, School of Public Health, Imperial College London W2 1PG, UK
- Directorate of Public Health and Primary Care, Imperial College Healthcare NHS Trust, London, UK
| | - Susan Hodgson
- MRC-PHE Centre for Environment and Health, Dept. Epidemiology and Biostatistics, School of Public Health, Imperial College London W2 1PG, UK
| |
Collapse
|
38
|
Lidón-Moyano C, Martínez-Sánchez JM, Fu M, Ballbè M, Martín-Sánchez JC, Martínez C, Saltó E, Fernández E. Impact of the Spanish smoking legislations in the adoption of smoke-free rules at home: a longitudinal study in Barcelona (Spain). Tob Control 2016; 26:557-562. [DOI: 10.1136/tobaccocontrol-2016-053114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 08/01/2016] [Accepted: 08/24/2016] [Indexed: 11/04/2022]
|
39
|
Pederson A, Okoli CT, Hemsing N, O’Leary R, Wiggins A, Rice W, Bottorff JL, Greaves L. Smoking on the margins: a comprehensive analysis of a municipal outdoor smoke-free policy. BMC Public Health 2016; 16:852. [PMID: 27549135 PMCID: PMC4994170 DOI: 10.1186/s12889-016-3466-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 08/05/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND This study examined the formulation, adoption, and implementation of a ban on smoking in the parks and beaches in Vancouver, Canada. METHODS Informed by Critical Multiplism, we explored the policy adoption process, support for and compliance with a local bylaw prohibiting smoking in parks and on beaches, experiences with enforcement, and potential health equity issues through a series of qualitative and quantitative studies. RESULTS Findings suggest that there was unanimous support for the introduction of the bylaw among policy makers, as well as a high degree of positive public support. We observed that smoking initially declined following the ban's implementation, but that smoking practices vary in parks by location. We also found evidence of different levels of enforcement and compliance between settings, and between different populations of park and beach users. CONCLUSIONS Overall success with the implementation of the bylaw is tempered by potential increases in health inequities because of variable enforcement of the ban; greatest levels of smoking appear to continue to occur in the least advantaged areas of the city. Jurisdictions developing such policies need to consider how to allocate sufficient resources to enhance voluntary compliance and ensure that such bylaws do not contribute to health inequities.
Collapse
Affiliation(s)
- Ann Pederson
- BC Women’s Hospital + Health Centre, E305, 4500 Oak Street, Vancouver, BC V6H 3E1 Canada
| | | | - Natalie Hemsing
- BC Centre of Excellence for Women’s Health, Vancouver, BC Canada
| | | | | | - Wendy Rice
- BC Centre of Excellence for Women’s Health, Vancouver, BC Canada
| | - Joan L. Bottorff
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, BC Canada
- Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Lorraine Greaves
- BC Centre of Excellence for Women’s Health, Vancouver, BC Canada
| |
Collapse
|
40
|
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.
Collapse
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
| |
Collapse
|
41
|
Abstract
This article presents a policy analysis of proposed smoke-free legislation in Kentucky during the 2015 General Assembly. Kingdon's three streams model of agenda setting is used to analyze the failure to pass HB145. Secondhand smoke exposure and related deaths are a significant public health problem in Kentucky, a state with one of the highest smoking rates in the U.S. HB145, a comprehensive smoke-free bill, was designed to protect workers and the general public from secondhand smoke and e-cigarette aerosol in enclosed workplaces and public places, with few exemptions. The bill faced intense criticism from opponents who were concerned about violation of personal and business rights and the belief that the decision should be addressed on a local level. HB145 passed the House with amendments but failed to receive a hearing in the Senate. Failure of the smoke-free legislation was due to partisanship, fragmentation of advocacy groups, lack of political bargaining, and conflict of values. As in past years, the policy window did not open for state smoke-free legislation in 2015.
Collapse
Affiliation(s)
| | - Ellen J Hahn
- University of Kentucky, College of Nursing, Lexington, KY, USA
| |
Collapse
|
42
|
Fallin A, Neilands TB, Jordan JW, Ling PM. Social Branding to Decrease Lesbian, Gay, Bisexual, and Transgender Young Adult Smoking. Nicotine Tob Res 2016; 17:983-9. [PMID: 26180223 DOI: 10.1093/ntr/ntu265] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Lesbian, gay, bisexual, and transgender (LGBT) individuals are more likely to smoke than the general population. This study evaluated a Social Branding intervention, CRUSH, which included an aspirational brand, social events, and targeted media to discourage smoking among LGBT young adults in Las Vegas, NV. METHODS Cross-sectional surveys (N = 2,395) were collected in Las Vegas LGBT bars at 2 time points 1 year apart. Multivariate logistic regressions examined associations between campaign exposure, message understanding, and current (past 30 days) smoking, controlling for demographics. RESULTS LGBT individuals were significantly more likely to report current (past 30 day) smoking than heterosexual/straight, gender-conforming participants. Overall, 53% of respondents reported exposure to CRUSH; of those exposed, 60% liked the campaign, 60.3% reported they would attend a CRUSH event on a night when they usually went somewhere else, and 86.3% correctly identified that the campaign was about "partying fresh and smokefree." Current smoking was reported by 47% of respondents at Time 1 and 39.6% at Time 2. There were significant interactions between time and campaign exposure and campaign exposure and understanding the message. Among those who understood the CRUSH smokefree message, the highest level of campaign exposure was significantly associated with 37%-48% lower odds for current smoking. CONCLUSIONS While longitudinal studies would better assess the impact of this intervention, CRUSH shows promise to reduce tobacco use among LGBT bar patrons.
Collapse
Affiliation(s)
- Amanda Fallin
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
| | - Torsten B Neilands
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | | | - Pamela M Ling
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
| |
Collapse
|
43
|
Al Mulla A, Fanous N, Seidenberg AB, Rees VW. Secondhand smoke emission levels in waterpipe cafes in Doha, Qatar. Tob Control 2015; 24:e227-31. [PMID: 25352562 DOI: 10.1136/tobaccocontrol-2014-051717] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 10/08/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND Exposure to the emissions of a tobacco waterpipe is associated with increased health risks among its users as well as those exposed to its secondhand smoke. Waterpipe use is an emerging concern to the tobacco control community, particularly among countries of the Eastern Mediterranean Region. In 2002, Qatar adopted legislation that prohibited cigarette smoking inside public venues, but exempted tobacco waterpipe smoking. To inform the development and enforcement of effective policy, the impact of cigarette and waterpipe use on indoor air quality was monitored in waterpipe cafes in Doha, Qatar. METHODS Particulate matter (PM2.5) levels were measured inside and outside of a sample of 40 waterpipe cafes and 16 smoke-free venues in Doha, Qatar between July and October 2012. In addition, the number of waterpipes being smoked and the number of cigarette smokers were counted within each venue. Non-paired and paired sample t tests were used to assess differences in mean PM2.5 measurements between venue type (waterpipe vs smoke-free) and environment (indoor vs outdoor). RESULTS The mean PM2.5 level inside waterpipe venues (476 μg/m(3)) was significantly higher than the mean PM2.5 level inside smoke-free venues (17 μg/m(3); p<0.001), and significantly higher than the mean PM2.5 level found immediately outside waterpipe venues (35 μg/m(3); p<0.001). In smoke-free venues, the outside mean PM2.5 level (30 μg/m(3)) did not differ significantly from the mean PM2.5 inside levels inside these venues (p=0.121). CONCLUSIONS Elevated levels of particulate pollution were found in waterpipe cafes in Doha, Qatar, potentially endangering the health of employees and patrons. To protect the public from the dangers of secondhand tobacco smoke, and to change social norms around tobacco use, smoke-free policies that apply to all forms of combusted tobacco products, including the waterpipe, are needed.
Collapse
Affiliation(s)
- Ahmad Al Mulla
- Tobacco Control Unit, Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Nadia Fanous
- Tobacco Control Unit, Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Andrew B Seidenberg
- Department of Social & Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, USA
| | - Vaughan W Rees
- Department of Social & Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, USA
| |
Collapse
|
44
|
Hoffman SJ, Tan C. Overview of systematic reviews on the health-related effects of government tobacco control policies. BMC Public Health 2015; 15:744. [PMID: 26242915 PMCID: PMC4526291 DOI: 10.1186/s12889-015-2041-6] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 07/08/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Government interventions are critical to addressing the global tobacco epidemic, a major public health problem that continues to deepen. We systematically synthesize research evidence on the effectiveness of government tobacco control policies promoted by the Framework Convention on Tobacco Control (FCTC), supporting the implementation of this international treaty on the tenth anniversary of it entering into force. METHODS An overview of systematic reviews was prepared through systematic searches of five electronic databases, published up to March 2014. Additional reviews were retrieved from monthly updates until August 2014, consultations with tobacco control experts and a targeted search for reviews on mass media interventions. Reviews were assessed according to predefined inclusion criteria, and ratings of methodological quality were either extracted from source databases or independently scored. RESULTS Of 612 reviews retrieved, 45 reviews met the inclusion criteria and 14 more were identified from monthly updates, expert consultations and a targeted search, resulting in 59 included reviews summarizing over 1150 primary studies. The 38 strong and moderate quality reviews published since 2000 were prioritized in the qualitative synthesis. Protecting people from tobacco smoke was the most strongly supported government intervention, with smoke-free policies associated with decreased smoking behaviour, secondhand smoke exposure and adverse health outcomes. Raising taxes on tobacco products also consistently demonstrated reductions in smoking behaviour. Tobacco product packaging interventions and anti-tobacco mass media campaigns may decrease smoking behaviour, with the latter likely an important part of larger multicomponent programs. Financial interventions for smoking cessation are most effective when targeted at smokers to reduce the cost of cessation products, but incentivizing quitting may be effective as well. Although the findings for bans on tobacco advertising were inconclusive, other evidence suggests they remain an important intervention. CONCLUSION When designing and implementing tobacco control programs, governments should prioritize smoking bans and price increases of tobacco products followed by other interventions. Additional studies are needed on the various factors that can influence a policy's effectiveness and feasibility such as cost, local context, political barriers and implementation strategies.
Collapse
Affiliation(s)
- Steven J Hoffman
- Global Strategy Lab, Faculty of Law, University of Ottawa, 57 Louis Pasteur Street, Ottawa, K1N 6N5, ON, Canada.
- Department of Clinical Epidemiology & Biostatistics and McMaster Health Forum, McMaster University, Hamilton, ON, Canada.
- Department of Global Health & Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
| | - Charlie Tan
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
| |
Collapse
|
45
|
Shamo F, Wilson T, Kiley J, Repace J. Assessing the effect of Michigan's smoke-free law on air quality inside restaurants and casinos: a before-and-after observational study. BMJ Open 2015; 5:e007530. [PMID: 26185176 PMCID: PMC4513515 DOI: 10.1136/bmjopen-2014-007530] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the effect of Michigan's smoke-free air (SFA) law on the air quality inside selected restaurants and casinos. The hypothesis of the study: if the SFA law is effectively implemented in restaurants and casinos, there will be a significant reduction in the particulate matter PM2.5 measured in the same establishments after the law is implemented. SETTING Prelaw and postlaw design study. PARTICIPANTS 78 restaurants in 14 Michigan cities from six major regions of the state, and three Detroit casinos. METHODS We monitored the real-time PM2.5 in 78 restaurants and three Detroit casinos before the SFA law, and again monitored the same restaurants and casinos after implementation of the law, which was enacted on 1 May 2010. PRIMARY AND SECONDARY OUTCOME MEASURES Concentration measurements of secondhand smoke (SHS) fine particles (PM2.5) were compared in each restaurant in the prelaw period to measurements of PM2.5 in the same restaurants during the postlaw period. A second comparison was made for PM2.5 levels in three Detroit casinos prelaw and postlaw; these casinos were exempted from the SFA law. RESULTS Prelaw data indicated that 85% of the restaurants had poor to hazardous air quality, with the average venue having 'unhealthy' air according to Michigan's Air Quality Index for PM2.5. Postlaw, air quality in 93% of the restaurants improved to 'good'. The differences were statistically significant (p<0.0001). By comparison, the three casinos measured had 'unhealthy' air both before and after the law. CONCLUSIONS The significant air quality improvement in the Michigan restaurants after implementation of the SFA law indicates that the law was very effective in reducing exposure to SHS. Since the Detroit casinos were exempted from the law, the air quality was unchanged, and remained unhealthy in both prelaw and postlaw periods.
Collapse
Affiliation(s)
- Farid Shamo
- The Michigan Department of Community Health, Division of Chronic Diseases, Lansing, Michigan, USA
| | - Teri Wilson
- The Michigan Department of Community Health, Division of Chronic Diseases, Lansing, Michigan, USA
| | - Janet Kiley
- The Michigan Department of Community Health, Division of Chronic Diseases, Lansing, Michigan, USA
| | | |
Collapse
|
46
|
Kennedy SM, Davis SP, Thorne SL. Smoke-free policies in U.S. Prisons and jails: A review of the literature. Nicotine Tob Res 2015; 17:629-35. [PMID: 25475088 PMCID: PMC4634865 DOI: 10.1093/ntr/ntu225] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 10/08/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Despite progress in limiting exposure to secondhand smoke (SHS) in the United States, little is known about the impact of smoke-free polices in prisons and jails. SHS exposure in this setting may be great, as smoking prevalence among inmates is more than three times higher than among non-incarcerated adults. To inform the implementation of smoke-free policies, this article reviews the literature on the extent, nature, and impact of smoke-free policies in U.S. prisons and jails. METHODS We systematically searched PubMed, Embase, EconLit, and Social Services Abstracts databases. We examined studies published prior to January 2014 that described policies prohibiting smoking tobacco in adult U.S. correctional facilities. RESULTS Twenty-seven studies met inclusion criteria. Smoke-free policies in prisons were rare in the 1980s but, by 2007, 87% prohibited smoking indoors. Policies reduced SHS exposure and a small body of evidence suggests they are associated with health benefits. We did not identify any studies documenting economic outcomes. Non-compliance with policies was documented in a small number of prisons and jails, with 20%-76% of inmates reporting smoking in violation of a policy. Despite barriers, policies were implemented successfully when access to contraband tobacco was limited and penalties were enforced. CONCLUSION Smoke-free policies have become increasingly common in prisons and jails, but evidence suggests they are not consistently implemented. Future studies should examine the health and economic outcomes of smoke-free policies in prisons and jails. By implementing smoke-free policies, prisons and jails have an opportunity to improve the health of staff and inmates.
Collapse
Affiliation(s)
- Sara M Kennedy
- Biostatistics and Epidemiology, RTI International, Atlanta, GA;
| | - Shane P Davis
- Epidemiology Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Stacy L Thorne
- Epidemiology Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
| |
Collapse
|
47
|
Policy Options to Promote Smokefree Environments for Children and Adolescents. Curr Probl Pediatr Adolesc Health Care 2015; 45:146-81. [PMID: 26032229 DOI: 10.1016/j.cppeds.2015.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 04/14/2015] [Indexed: 11/22/2022]
Abstract
Secondhand smoke (SHS) exposure among children is associated with a wide variety of adverse health risks, including: asthma, otitis media, respiratory infections, impaired lung growth and function, decreased exercise tolerance, cognitive impairments, behavior problems, and sudden infant death syndrome. Unfortunately, over 40% of children aged 3-11 years-15.1 million children-are currently exposed to SHS, with nearly 70% of black children in this age group being exposed. Over the past three decades, great strides have been made in establishing smokefree environments for adults, ultimately reducing their SHS exposure. Regulations have been passed at the organizational, local, and state levels that increasingly ban smoking in the workplace and public places. Children's SHS exposure patterns, however, differ from adults' exposures, with greater time spent in the home and other potentially unregulated venues (school, child care, and car). This means that children have been afforded relatively less protection from SHS by these smokefree regulations. It is imperative, therefore, to seek alternative options for promoting smokefree environments for children throughout the United States. This article explores policy options that promote smokefree environments for children and adolescents: comprehensive smokefree/tobacco-free policies covering indoor/outdoor public places, housing, private vehicles, and child care, as well as Clinical Guidelines regarding patient/family interviews on smoking, SHS, cessation, and voluntary smokefree efforts. The policy section highlights the role of child and adolescent health practitioners in promoting these policies with the hope of fostering engagement of these key stakeholders in the policy process. Note, there are a wide range of important policy and regulatory strategies aimed at reducing tobacco initiation and use among children, adolescents, and young adults; while essential in tobacco prevention and control efforts, a discussion of these strategies is beyond the scope of this article.
Collapse
|
48
|
Chandora RD, Whitney CF, Weaver SR, Eriksen MP. Changes in Georgia restaurant and bar smoking policies from 2006 to 2012. Prev Chronic Dis 2015; 12:E74. [PMID: 25974144 PMCID: PMC4438425 DOI: 10.5888/pcd12.140520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction The purpose of this study is to examine the change in smoking policy status among Georgia restaurants and bars from 2006 to 2012 and to identify restaurant and bar characteristics that are associated with allowing smoking. Methods Data were obtained from similar cross-sectional indoor air surveys conducted in 2006 and 2012 in Georgia. Both surveys were designed to gather information about restaurant and bar smoking policies. Weighted χ2 analyses were performed to identify changes in smoking policy status and other variables from 2006 to 2012. Weighted logistic regression analysis was used to test for significant associations between an establishment’s smoking policy and other characteristics. Results The percentage of restaurants and bars in Georgia that allowed smoking nearly doubled, from 9.1% in 2006 to 17.6% in 2012. The analyses also showed a significant increase in the percentage of establishments that allow smoking when minors are present. Having a liquor license was a significant predictor of allowing smoking. Conclusion The Smokefree Air Act was enacted in 2005 to protect the health and welfare of Georgia citizens, but study results suggest that policy makers should reevaluate the law and consider strengthening it to make restaurants and bars 100% smokefree without exemptions.
Collapse
Affiliation(s)
| | - Carrie F Whitney
- Georgia State University, School of Public Health, Atlanta, Georgia
| | - Scott R Weaver
- Georgia State University, School of Public Health, Atlanta, Georgia
| | | |
Collapse
|
49
|
Panlilio LV, Hogarth L, Shoaib M. Concurrent access to nicotine and sucrose in rats. Psychopharmacology (Berl) 2015; 232:1451-60. [PMID: 25366874 PMCID: PMC4388763 DOI: 10.1007/s00213-014-3787-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Animal models that allow concurrent access to drug and nondrug reinforcers provide unique insight into the etiology, maintenance, and treatment of drug use. OBJECTIVES We sought to develop and utilize a concurrent access procedure with nicotine and sucrose in rats. METHODS Pressing one lever delivered intravenous nicotine, and pressing another lever delivered sucrose pellets, with both reinforcers freely available throughout daily sessions. RESULTS Rats that had been pretrained with nicotine on some days and sucrose on other days responded on both levers when subsequently given concurrent access, but almost all responded at substantially higher rates on the sucrose lever. In contrast, rats pretrained exclusively with nicotine before being given concurrent access showed individual differences, with about half responding more on the nicotine lever. Treatment with the nicotinic receptor partial agonist varenicline selectively decreased nicotine self-administration. Food restriction and removal of the sucrose lever both increased nicotine self-administration. CONCLUSIONS The finding that rats continue to take nicotine when sucrose is concurrently available-and in many cases take it more frequently than sucrose-demonstrates that nicotine self-administration does not only occur in the absence of alternative reinforcement options. As a model of human nicotine use, concurrent access is more naturalistic and has higher face validity than procedures in which only one reinforcer is available or choosing one reinforcer precludes access to other reinforcers. As such, this procedure could be useful for evaluating therapeutic agents and improving our understanding of environmental conditions that promote or discourage nicotine use.
Collapse
Affiliation(s)
- Leigh V Panlilio
- Preclinical Pharmacology Section, Behavioral Neuroscience Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, 21224, USA,
| | | | | |
Collapse
|
50
|
Riker CA, Butler KM, Ricks JM, Record RA, Begley K, Anderson DG, Hahn EJ. Creating Effective Media Messaging for Rural Smoke-free Policy. Public Health Nurs 2015; 32:613-24. [PMID: 25731895 DOI: 10.1111/phn.12188] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Objectives were to (1) explore perceived effectiveness of existing smoke-free print advertisements in rural communities and (2) generate message content, characteristics, and media delivery channels that resonate with residents. DESIGN AND SAMPLE Qualitative methods design. Thirty-nine rural adults recruited by community partners. MEASURES Content analysis of findings from individuals in four focus groups who participated in general discussion and reviewed eight print ads related to secondhand smoke (SHS) and smoke-free policy. RESULTS Six content themes were identified: smoking/SHS dangers, worker health, analogies, economic impact, rights, and nostalgia. Seven message characteristics were recognized: short/to the point, large enough to read, graphic images, poignant stories, statistics/charts/graphs, message sender, and messages targeting different groups. Four media delivery channels were considered most effective: local media, technology, billboard messages, and print materials. CONCLUSIONS Seeking input from key informants is essential to reaching rural residents. Use of analogies in media messaging is a distinct contribution to the literature on effective smoke-free campaigns. Other findings support previous studies of effective messaging and delivery channels. Further research is needed to examine effectiveness of themes related to message content in smoke-free ads and delivery strategies. Effective media messaging can lead to policy change in rural communities to reduce exposure to SHS.
Collapse
Affiliation(s)
- Carol A Riker
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | - Karen M Butler
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | - JaNelle M Ricks
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | | | - Kathy Begley
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | | | - Ellen J Hahn
- Colleges of Nursing and Public Health, University of Kentucky, Lexington, Kentucky
| |
Collapse
|