Impacto de la implantación de una política de trabajo libre de humo en una empresa

WITHDRAWN: Interventions for preventing tobacco smoking in public places

BACKGROUND

Environmental tobacco smoke is a health hazard. Reducing exposure to tobacco smoke in public places is a widespread public health goal. There is, however, considerable variation in the extent to which this goal has been achieved in different settings and societies. There is therefore a need to identify effective strategies for reducing tobacco consumption in public places.

OBJECTIVES

To evaluate the effectiveness of interventions to reduce tobacco consumption in public places.

SEARCH STRATEGY

We searched the Tobacco Addiction Review Group trials register, MEDLINE and EMBASE in March 2006. We handsearched a key journal and abstracts from international conferences on tobacco. We checked the bibliographies of identified studies and reviews for additional references.

SELECTION CRITERIA

We considered randomized and controlled trials, controlled and uncontrolled before-and-after studies and interrupted time series. The main outcome of interest was levels and measures of compliance with bans and restrictions. We considered strategies aimed at populations, including education campaigns, written material, non-smoking and warning signs, and comprehensive strategies. We also considered strategies aimed at individual smokers.

DATA COLLECTION AND ANALYSIS

Information relating to the characteristics and content of all kinds of interventions, participants, outcomes and methods of each study was abstracted by one reviewer and checked by two others. Studies were combined using qualitative narrative synthesis.

MAIN RESULTS

Twenty of 25 studies reporting information about interventions to reduce smoking in public places met all the inclusion criteria. Three were controlled before-and-after studies and 17 were uncontrolled before-and-after studies. The most effective strategies used comprehensive, multi-component approaches to implement policies banning smoking within institutions. Less comprehensive strategies, such as posted warnings and educational material, had a moderate effect. Five studies showed that prompting individual smokers had an immediate effect, but such strategies are unlikely to be acceptable as a public health intervention.

AUTHORS' CONCLUSIONS

Carefully planned and resourced, multi-component strategies effectively reduced smoking within public places. Less comprehensive strategies were less effective. Most studies were done in the USA and, despite increasing evidence from Europe, there is a need to identify ways in which these strategies can be adopted and used in countries with different attitudes to tobacco use. Future studies should also consider the use of more rigorous experimental designs.

Barriers and challenges for tobacco control in a smoke-free hospital

The study aimed to identify the extent of smoking, compliance with tobacco restrictions, and attitudes toward smoking and tobacco control measures among the employees in a Comprehensive Cancer Center from 2001 to 2006 where a smoke-free policy was progressively introduced. Four cross-sectional surveys were conducted from 2001 to 2006. Survey items include smoking status, smoking history, environmental tobacco exposure, and agreement with tobacco initiatives. The prevalence of smoking has declined from 34.5% in 2001 to 30.6% in 2006. The decrease was present in all professional groups: Doctors from 20.0% in 2001 to 15.2% in 2006 and administrative clerks from 56.0% in 2001 to 37.0% in 2006 reduced the most. Among nurses, the prevalence of smoking was still high with a 2-point percent reduction (from 34.0% in 2004 to 32.6% in 2006). Other changes of the pattern of smoking were apparent: a reduction on the number of cigarettes smoked, decrease of daily smokers, and increase of smoking abstinence during the hospital duty. Compliance with smoke-free areas increased. We observed a very significant decrease of the perception of exposure to environmental tobacco exposure at work. The Smoke Free project helped to achieve a healthy work environment. Tailored smoking cessation programs should be designed to help healthcare professionals to stop smoking. In addition, healthcare professionals should play a key role in promoting a healthy smoke-free lifestyle.

Correlates of exposure to second-hand smoke in an urban Mediterranean population

BACKGROUND

To describe the socio-demographic factors associated with exposure to second-hand smoke (SHS) in different settings (home, leisure, and workplace).

METHODS

We analysed cross-sectional data on self-reported SHS exposure in 1059 non-daily smokers interviewed in the Cornellà Health Interview Survey Follow-up Study in 2002. We calculated age-adjusted prevalence rates and prevalence rate ratios of SHS exposure at home, at the workplace, during leisure time, and in any of these settings.

RESULTS

The age-standardized prevalence rate of SHS exposure in any setting was 69.5% in men and 62.9% in women. Among men, 25.9% reported passive smoking at home, 55.1% during leisure time, and 34.0% at the workplace. Among women, prevalence rates in these settings were 34.1%, 44.3% and 30.1%, respectively. Overall exposure to SHS decreased with age in both men and women. In men, SHS exposure was related to marital status, physical activity, smoking, and alcohol intake. In women, SHS exposure was related to educational level, marital status, occupational status, self-perceived health, smoking-related illness, and alcohol intake.

CONCLUSION

The prevalence of SHS exposure in this population was high. The strongest association with exposure were found for age and occupational status in men, and age and educational level in women.

Evaluación de un programa de deshabituación tabáquica en el medio laboral

AIMS

To evaluate the effects of a worksite smoking cessation program conducted to reduce the prevalence of smokers among staff of the town council of Sabadell (Spain).

POPULATION AND METHODS

A pre-post intervention study was conducted. A survey was performed to determine the prevalence and characteristics of smokers and to invite them to participate in a smoking cessation program. The intervention involved an individual visit with medical history, measurement of carbon monoxide in expired air and prescription of nicotine replacement therapy followed by 12 sessions of group therapy over 1 year to reinforce abstinence. Follow-up to evaluate abstinence took place at 6, 12 and 24 months. A post-intervention survey was carried out to evaluate the program's effectiveness.

RESULTS

A total of 1,203 questionnaires were sent with a response rate of 51%. Thirty-three percent of the subjects (n = 204) were smokers and 101 smokers enrolled in the program. Abstinence rates at 12 and 24 months were 45% and 33% respectively with no differences between sexes. Low and moderate nicotine dependence was associated with a greater probability of abstinence at 6 (OR = 6.7; p = 0.01) and 12 months (OR = 5.4: p = 0.05), adjusted by sex, age, and compliance with nicotine replacement therapy. The prevalence of smokers in the post-intervention questionnaire was 19%. In addition, 26% (n = 10) of subjects who quit smoking in the 12-month study period without participating in the program reported quitting because of the program.

CONCLUSIONS

The results indicate that worksite smoking cessation programs can substantially contribute to reducing the prevalence of smoking.