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Smoke-free or not: a pilot evaluation in selected Beijing Hospitals. BMC Public Health 2013; 13:964. [PMID: 24134057 PMCID: PMC3853022 DOI: 10.1186/1471-2458-13-964] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 10/11/2013] [Indexed: 11/10/2022] Open
Abstract
Background China enacted a policy to ban smoking in hospitals. The Chinese Association for Tobacco Control (CATC) developed a program to help hospitals implement this policy. They conducted a program and an assessment in 3 Chinese cities (Beijing, Shanghai and Guangdong). A more in-depth evaluation was implemented with a sub-sample of hospitals in Beijing (N = 7) to provide an independent assessment. This independent assessment focused on evaluating policy development and an assessment of secondhand smoke (SHS) to determine compliance with the smoke-free policy initiative. Methods Pre- and post-survey data were collected at each of the selected hospitals with a total sample of 2835 physicians at pre-intervention and 2812 at post-intervention. Smoking rates pre- and post-policy implementation, change in knowledge, attitudes and practices among physicians, and compliance with policy were assessed. Measurements of airborne nicotine concentrations in selected locations in each hospital were taken: main hospital lobby; main outpatient center; emergency waiting room; and stairwell adjacent to a large inpatient ward. Hospital policies were collected, translated and rated for incorporated components necessary to implement a smoke-free policy. Results Physicians’ smoking rates decreased and attitudes towards tobacco control improved significantly from pre-to post-intervention. Smoking was still reported in certain areas of the hospital with 96% of passive nicotine monitors as well as self-report indicating continued smoking. Nicotine levels ranged from <0.0056 to 3.94 μg/m3), with an overall mean of .667 μg/m3. Hospitals that established stronger policies seemed to have lower levels of nicotine, suggesting a relationship between policy development and compliance. This finding is interesting but just suggestive and requires further investigation to truly demonstrate if stronger policies improve compliance and produce better outcomes. Conclusion As implementation strategies for smoke-free environments are improved and more resources are focused on hospitals, China is making progress toward achieving smoke-free hospitals. Using a model program could increase the prevalence of SHS policies across China. However, relying only on survey data may not provide an accurate assessment of this progress, and more extensive evaluation efforts are useful to understand how change can and does occur.
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Impacto de la Ley 28/2005 de medidas sanitarias frente al tabaquismo en la prevalencia de la exposición al humo ambiental del tabaco en Barcelona. GACETA SANITARIA 2011; 25:495-500. [DOI: 10.1016/j.gaceta.2011.06.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 06/08/2011] [Accepted: 06/27/2011] [Indexed: 11/24/2022]
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Santiñà M, Grau J, Agustí C, Torres A. [Assessment of effectiveness of a plan against tobacco in a universitary hospital]. ACTA ACUST UNITED AC 2011; 26:215-20. [PMID: 21531160 DOI: 10.1016/j.cali.2010.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2010] [Revised: 11/19/2010] [Accepted: 11/26/2010] [Indexed: 10/18/2022]
Abstract
AIMS Assessment of effectiveness of a plan entitled «Smoke-free hospitals», specifically the reduction in the number of smoking staff and an increase in smoke-free areas. METHOD Interventional, non-controlled, populational study. A baseline study was conducted in 2004 to find out the situation as regards the prevalence of smokers in our hospital and the support of health workers for the smoke-free hospital plan. We used the questionnaire validated for the European smoke free hospital network in a sample of 483 workers randomly selected and stratified by gender, age and establishment. In 2007 we repeated the study with the same methodology to ascertain the progress of the project, in this case a sample of 425 workers was collected. RESULTS The number of smoking workers had decreased from 35.2% to 27.4 (P<.05). This reduction was seen in virtually all sectors, but was less so in nursing staff. In 2007 we had achieved that people only smoke in smoking areas (P<.0001). The plan was supported by smokers and non-smokers. CONCLUSIONS The «Smoke-free hospital» plan has achieved the objectives proposed. The actions carried out helped to enforce the law and respect that hospital areas should not be for smoking, together with strong support to help workers who want to quit smoking are shown to be effective.
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Affiliation(s)
- M Santiñà
- Servicio de Medicina Preventiva y Epidemiología, Dirección de Calidad y Seguridad Clínica, Hospital Clínic, Barcelona, España.
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Nebot M, López MJ, Ariza C, Pérez-Ríos M, Fu M, Schiaffino A, Muñoz G, Saltó E, Fernández E. Impact of the Spanish smoking law on exposure to secondhand smoke in offices and hospitality venues: before-and-after study. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:344-7. [PMID: 19337506 PMCID: PMC2661901 DOI: 10.1289/ehp.11845] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Accepted: 09/19/2008] [Indexed: 05/19/2023]
Abstract
BACKGROUND/OBJECTIVES A smoking law was passed by the Spanish Parliament in December 2005 and was enforced by 1 January 2006. The law bans smoking in all indoor workplaces but only in some hospitality venues, because owners are allowed to establish a smoking zone (venues>100 m2) or to allow smoking without restrictions (venues<100 m2). The objective of the study is to assess the impact of the Spanish smoking law on exposure to secondhand smoke (SHS) in enclosed workplaces, including hospitality venues. MATERIALS AND METHODS The study design is a before-and-after evaluation. We studied workplaces and hospitality venues from eight different regions of Spain. We took repeated samples of vapor-phase nicotine concentration in 398 premises, including private offices (162), public administration offices (90), university premises (43), bars and restaurants (79), and discotheques and pubs (24). RESULTS In the follow-up period, SHS levels were markedly reduced in indoor offices. The median decrease in nicotine concentration ranged from 60.0% in public premises to 97.4% in private areas. Nicotine concentrations were also markedly reduced in bars and restaurants that became smoke-free (96.7%) and in the no-smoking zones of venues with separate spaces for smokers (88.9%). We found no significant changes in smoking zones or in premises allowing smoking, including discotheques and pubs. CONCLUSIONS Overall, this study shows the positive impact of the law on reducing SHS in indoor workplaces. However, SHS was substantially reduced only in bars and restaurants that became smoke-free. Most hospitality workers continue to be exposed to very high levels of SHS. Therefore, a 100% smoke-free policy for all hospitality venues is required.
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López García-Aranda V, Almendro Delia M. Lentos avances en el control del tabaquismo involuntario. Rev Esp Cardiol (Engl Ed) 2008. [DOI: 10.1157/13123986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Precioso J, Lopez MJ, Calheiros JM, Macedo M, Ariza C, Sanchez F, Schiaffino A, Fernández E, Nebot M. [Indoor air pollution caused by cigarette smoke in public places in Portugal]. Rev Saude Publica 2008; 41:808-13. [PMID: 17923902 DOI: 10.1590/s0034-89102007000500015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Accepted: 05/08/2007] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE There have been few studies investigating the level of cigarette smoke pollution to which people in several public and private places are exposed. The purpose of this study was to quantify the level of air pollution produced by cigarette smoking in workplaces and leisure settings. METHODS The study was carried out in Braga, Portugal, in 2005. Nicotine content in indoor air was measured using passive monitors containing a 37-mm diameter filter inside treated with sodium bisulphate. The monitors were installed in predefined public workplaces and leisure settings. Median nicotine content was estimated for each place studied. RESULTS Nicotine was detected in 85% of the samples. Extremely high air contamination levels were found in discos with a median of 82.26 microg/m3, ranging between 5.79 and 106.31 microg/m3. Workplaces of public administration and university buildings showed the lowest nicotine content. CONCLUSIONS The study findings confirm the need to promote the implementation of smoke-free policies in workplaces and leisure settings to protect workers' health and as a reinforcing measure of an environment which facilitates smokers to quit smoking.
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Affiliation(s)
- José Precioso
- Instituto de Educação e Psicologia, Universidade do Minho, Braga, Portugal.
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López MJ, Pérez-Ríos M, Schiaffino A, Nebot M, Montes A, Ariza C, García M, Juárez O, Moncada A, Fernández E. Mortality attributable to passive smoking in Spain, 2002. Tob Control 2008; 16:373-7. [PMID: 18048612 DOI: 10.1136/tc.2006.019679] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Exposure to environmental tobacco smoke (ETS) is associated with a variety of health effects, including lung cancer and ischaemic heart disease. The objective of this study was to estimate the number of deaths caused by exposure to ETS among non-smokers in Spain during the year 2002 METHODS Prevalence of ETS exposure among never smokers was gathered from three region based health interview surveys. The relative risks of lung cancer and ischaemic heart diseases were selected from three meta-analyses. Population attributable risk (PAR) was computed using a range of prevalences (minimum-maximum). The number of deaths attributable to ETS was calculated by applying PARs to mortality not attributable to active smoking in 2002. The analyses were stratified by sex, age and source of exposure (home, workplace and both combined). In addition, a sensitivity analysis was performed for different scenarios. RESULTS Among men, deaths attributable to ETS ranged from 408 to 1703. From 247 to 1434 of these deaths would be caused by the exposure only at home, 136-196 by exposure only in the workplace and 25-73 by exposure at both home and the workplace. Among women, the number of attributable deaths ranged from 820 to 1534. Between 807 and 1477 of these deaths would be caused by exposure only at home, 9-32 by exposure only in the workplace and 4-25 by exposure both at home and in the workplace. CONCLUSION Exposure to ETS at home and at work in Spain could be responsible for 1228-3237 of deaths from lung cancer and ischaemic heart disease. These data confirm that passive smoking is an important public health problem in Spain that needs urgent attention.
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Affiliation(s)
- M J López
- Evaluation and Intervention Methods Unit, Public Health Agency of Barcelona, Barcelona, Spain.
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Sánchez-Martínez F, López MJ, Nebot M, Ariza C. [Tobacco smoke exposure in work centers before the 28/2005 law of health measures against smoking]. Med Clin (Barc) 2007; 129:100-3. [PMID: 17594861 DOI: 10.1157/13107374] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Twose J, Schiaffino A, García M, Borras JM, Fernández E. Correlates of exposure to second-hand smoke in an urban Mediterranean population. BMC Public Health 2007; 7:194. [PMID: 17683585 PMCID: PMC1963452 DOI: 10.1186/1471-2458-7-194] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Accepted: 08/05/2007] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Jorge Twose
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Spain
- Organització Catalana de Transplantaments
| | - Anna Schiaffino
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
| | - Montse García
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
| | - Josep Maria Borras
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
- Department of Clinical Sciences, Universitat de Barcelona, Spain
| | - Esteve Fernández
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Spain
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López MJ, Nebot M, Juárez O, Ariza C, Salles J, Serrahima E. [Estimation of the excess of lung cancer mortality risk associated to environmental tobacco smoke exposure of hospitality workers]. Med Clin (Barc) 2006; 126:13-4. [PMID: 16409945 DOI: 10.1157/13083324] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE To estimate the excess lung cancer mortality risk associated with environmental tobacco (ETS) smoke exposure among hospitality workers. The estimation was done using objective measures in several hospitality settings in Barcelona. METHOD Vapour phase nicotine was measured in several hospitality settings. These measurements were used to estimate the excess lung cancer mortality risk associated with ETS exposure for a 40 year working life, using the formula developed by Repace and Lowrey. RESULTS Excess lung cancer mortality risk associated with ETS exposure was higher than 145 deaths per 100,000 workers in all places studied, except for cafeterias in hospitals, where excess lung cancer mortality risk was 22 per 100,000. In discoteques, for comparison, excess lung cancer mortality risk is 1,733 deaths per 100,000 workers. CONCLUSION Hospitality workers are exposed to ETS levels related to a very high excess lung cancer mortality risk. These data confirm that ETS control measures are needed to protect hospital workers.
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Affiliation(s)
- M José López
- Servei d'Avaluació i Mètodes d'Intervenció, Agència de Salut Pública, Barcelona, Spain.
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Brugal MT, Rodríguez-Martos A, Villalbí JR. Nuevas y viejas adicciones: implicaciones para la salud pública. GACETA SANITARIA 2006; 20 Suppl 1:55-62. [PMID: 16539966 DOI: 10.1157/13086027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
According to certain authors, any pleasure giving behaviour may become a habit, and depending on the circumstances, an addiction. The objective of this study is to examine the situation of addictions in Spain and the responses generated by health policies. In recent years, both the type and pattern of drug consumption in Spain, has undergone a noticeable change. Studies of the evolution of tobacco consumption suggest that the peak has passed, even though prevalence is still high. Alcohol consumption per capita has fallen by 25% in the last 25 years. During the same period, pattern of consumption has been modified. Sporadic drinking, in episodes of binging and drinking away from meals, is one of the patterns on the rise. According to the European Monitoring Centre for Drugs and Drug Addiction, in Spain, 27.8% of the population between 15- 64 years old has consumed an illegal drug at least once in their lives, with the prevalence rising to 38% among the 15- 34 year olds. Cannabis is the most consumed (29% among 1564 age group), followed by cocaine (5.9%), and ecstasy (4.6%). Spain, comparing with other countries of European Union, is the third in cannabis, ecstasy, and amphetamine and the first in cocaine consumption. With respect to the so-called behavioral addictions, no consensus in the field of psychiatry has been reached. The only psychological addiction with clear diagnostic criteria is gambling. The rest (Internet, sex, etc.), perhaps for their novelty, continue to be the object of controversy. New addictions, as much to addictive substances as to addictive behaviors, run parallel to the development of industrialized societies, leisure, free time, and a new way of life. This is the new challenge for Public Health.
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