1
|
Buettner-Schmidt K, Miller DR, Maack B. Disparities in Rural Tobacco Use, Smoke-Free Policies, and Tobacco Taxes. West J Nurs Res 2019; 41:1184-1202. [PMID: 30774036 PMCID: PMC6613179 DOI: 10.1177/0193945919828061] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tobacco use and exposure to secondhand smoke (SHS) remain leading causes of preventable disease, disability, and mortality in the United States. Rural populations are among those being left behind in the recent declining smoking rates and have become a focus of discussions on tobacco-related disparities. This article describes tobacco-related disparities in rural populations including tobacco use, exposure to SHS, smoke-free policies, and tobacco taxes. Nurses, as social justice and tobacco control policy advocates, are needed especially at the local level, where much of the policy work occurs and where nursing's voice is respected and can be powerful.
Collapse
Affiliation(s)
| | | | - Brody Maack
- 1 North Dakota State University, Fargo, ND, USA
| |
Collapse
|
2
|
Kopp BT, Hinton A, Lu R, Cooper S, Nagaraja H, Wewers ME. Impact of Presence of Children on Indoor Tobacco Restrictions in Households of Urban and Rural Adult Tobacco Users. Acad Pediatr 2018; 18:920-927. [PMID: 29653256 PMCID: PMC6179946 DOI: 10.1016/j.acap.2018.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 03/26/2018] [Accepted: 04/05/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Secondhand smoke exposure in children is changing as a result of new public policy and electronic nicotine products (e-cigarettes). We examined factors related to self-imposed indoor household tobacco restrictions, with emphasis on children in the household and associations with combustible and noncombustible product use. METHODS A cross-sectional survey of urban and rural Ohio adult tobacco users classified participants as exclusive combustible users, smokeless tobacco (SLT) users, e-cigarette users, or dual users. They were further stratified according to combustible or noncombustible product use and the presence of indoor tobacco use restrictions. Multiple logistic regression determined factors associated with indoor tobacco restrictions. RESULTS A total of 1210 tobacco users participated, including 25.7% with children living in the home. Half allowed combustible and two thirds allowed noncombustible tobacco use indoors. Urban location (odds ratio [OR] = 1.58), younger age (OR = 0.88 per 5 year), male sex (OR = 1.40), college education (OR = 1.40), household income of more than $15,000 (OR = 1.78), and being married (OR = 2.43) were associated with a higher likelihood of banning combustible products indoors. SLT (OR = 8.12) and e-cigarette (OR = 5.85) users were more likely to have indoor bans compared to combustible users. Children in the household (OR = 1.89), older age (OR = 1.12 per 5 years), and nonwhite race (OR = 1.68) were associated with a higher likelihood of banning noncombustible products indoors. Combustible (OR = 4.54) and e-cigarette (OR = 3.04) users were more likely than SLT users to have indoor bans. CONCLUSIONS Indoor restrictions on tobacco use remain infrequent in homes with children and are associated with user type and socioeconomic factors. Public policy should target modifiable risk factors for in-home secondhand smoke exposure.
Collapse
Affiliation(s)
- Benjamin T Kopp
- Divison of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio; The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
| | - Alice Hinton
- The Ohio State University College of Public Health Division of Biostatistics, Ohio
| | - Rong Lu
- The Ohio State University College of Public Health Division of Biostatistics, Ohio
| | - Sarah Cooper
- The Ohio State University College of Public Health Division of Health Behavior & Health Promotion, Ohio
| | - Haikady Nagaraja
- The Ohio State University College of Public Health Division of Biostatistics, Ohio
| | - Mary Ellen Wewers
- The Ohio State University College of Public Health Division of Health Behavior & Health Promotion, Ohio
| |
Collapse
|
3
|
La Torre G, Sestili C, Cocchiara RA, Cianfanelli S, Lia L, Mannocci A. Passive Smoking Indicators in Italy: Does the Gross Domestic Product Matter? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092045. [PMID: 30231580 PMCID: PMC6165307 DOI: 10.3390/ijerph15092045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/03/2018] [Accepted: 09/14/2018] [Indexed: 11/16/2022]
Abstract
Background: The aim of this study is to analyse the correlation between regional values of Gross Domestic Product (GDP) and passive smoking in Italy. Methods: The outcome measures were smoking ban respect in public places, workplaces and at home, derived from the PASSI surveillance for the period 2011–2017. The explanatory variable was GDP per capita. The statistical analysis was carried out using bivariate and linear regression analyses, taking into consideration two different periods, Years 2011–2014 and 2014–2017. Results: GDP is showed to be positively correlated with smoking ban respect in public places (r = 0.779 p < 0.001; r = 0.723 p < 0.001 in the two periods, respectively), as well as smoking ban respect in the workplace (r = 0.662 p = 0.001; r = 0.603 p = 0.004) and no smoking at home adherence (r = 0.424 p = 0.056; r = 0.362 p = 0.107). In multiple linear regression GDP is significantly associated to smoking ban respect in public places (adjusted β = 0.730 p < 0.001; β = 0.698 p < 0.001 in the two periods, respectively), smoking ban in workplaces (adjusted β = 0.525 p = 0.020; β = 0.570 p = 0.009) and no smoking at home (adjusted β = 0.332 p = 0.070; β = 0.362 p = 0.052). Conclusions: Smoking ban is more respected in Regions with higher GDP. For a better health promotion, systematic vigilance and sanctions should be maintained and strengthened, particularly in regions with low compliance with smoking bans.
Collapse
Affiliation(s)
- Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Cristina Sestili
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Rosario Andrea Cocchiara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Sara Cianfanelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Lorenza Lia
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Alice Mannocci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| |
Collapse
|
4
|
Huntington-Moskos L, Rayens MK, Wiggins A, Hahn EJ. Radon, Secondhand Smoke, and Children in the Home: Creating a Teachable Moment for Lung Cancer Prevention. Public Health Nurs 2016; 33:529-538. [PMID: 27443982 DOI: 10.1111/phn.12283] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study determined whether having minor children in the home was associated with the teachable moment (TM) constructs of lung cancer worry, perceived risk, health-related self-concept, and the novel construct of synergistic risk. DESIGN AND SAMPLE Secondary data analysis of baseline data from a randomized controlled trial of an intervention to reduce home exposure to radon and secondhand smoke (SHS). Quota sample of adults recruited at a Central Kentucky academic medical center (N = 556). MEASURES Survey items assessed lung cancer worry, perceived risk, synergistic risk perception, and health-related self-concept. RESULTS The presence of children in the home was not a significant predictor of any construct needed to create a TM for lung cancer prevention. Individuals with children living in the home were more likely to be younger, a racial/ethnic minority, a current smoker, and live with a smoker compared to those without children in the home. CONCLUSIONS There is a critical need to raise parental awareness on child health inequities related to the home exposure to radon and SHS. Public health nurses can create TMs for lung cancer prevention through greater awareness of the risks posed by radon and SHS along with promoting home testing and low-cost resources to reduce risk.
Collapse
Affiliation(s)
| | - Mary Kay Rayens
- BREATHE, University of Kentucky (UK), College of Nursing, Lexington, Kentucky
| | - Amanda Wiggins
- BREATHE, University of Kentucky (UK), College of Nursing, Lexington, Kentucky
| | - Ellen J Hahn
- BREATHE, University of Kentucky (UK), College of Nursing, Lexington, Kentucky
| |
Collapse
|
5
|
Yang T, Jiang S, Barnett R, Peng S, Yu L. Individual and city-level determinants of secondhand smoke exposure in China. Int J Health Geogr 2015; 14:36. [PMID: 26714485 PMCID: PMC4696343 DOI: 10.1186/s12942-015-0029-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/18/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Second hand smoke (SHS) exposure is a severe public health problem, especially in low and middle countries, but no studies have examined both individual and city-level variables influencing exposure. METHODS A cross-sectional multistage sampling design was used to survey subjects from 21 cities in China. Using a standardized questionnaire individual level information was collected. City-level variables were retrieved from the National Bureau of Statistics database. Multilevel logistic regression analysis was used to assess SHS exposure variation at both the individual and city level. RESULTS SHS exposure prevalence among non-smokers was 28.1% (95% CI 27.1-29.0). At the individual level lower educational attainment and income and higher exposure to tobacco advertising were associated with higher SHS exposure. On the other hand richer cities, and those with more anti-smoking media news coverage, had less SHS exposure. The presence of city smokefree regulations was unrelated to exposure. CONCLUSIONS Given its human and economic costs, reducing SHS exposure should receive greater priority than it does in China. The results point to the need for the enactment of national smokefree laws in order to combat unacceptably high levels of SHS exposure.
Collapse
Affiliation(s)
- Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Yuhangtang Road, Hangzhou, 310058, China.
| | - Shuhang Jiang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Yuhangtang Road, Hangzhou, 310058, China.
| | - Ross Barnett
- Department of Geography, University of Canterbury, Christchurch, 8140, New Zealand.
| | - Sihui Peng
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Yuhangtang Road, Hangzhou, 310058, China.
| | - Lingwei Yu
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Yuhangtang Road, Hangzhou, 310058, China.
| |
Collapse
|
6
|
Rosen LJ, Tillinger E, Guttman N, Rosenblat S, Zucker DM, Stillman F, Myers V. Parental receptivity to child biomarker testing for tobacco smoke exposure: A qualitative study. PATIENT EDUCATION AND COUNSELING 2015; 98:1439-45. [PMID: 26160037 DOI: 10.1016/j.pec.2015.05.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 02/20/2015] [Accepted: 05/30/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Widespread tobacco smoke exposure (TSE) of children suggests that parents may be unaware of their children's exposure. Biomarkers demonstrate exposure and may motivate behavior change, but their acceptability is not well understood. METHODS Sixty-five in-depth interviews were conducted with parents of young children, in smoking families in central Israel. Data were analyzed using thematic analysis. RESULTS Consent to testing was associated with desire for information, for reassurance or to motivate change, and with concerns for long-term health, taking responsibility for one's child, and trust in research. Opposition to testing was associated with preference to avoid knowledge, reluctance to cause short-term discomfort, perceived powerlessness, and mistrust of research. Most parents expressed willingness to allow measurement by urine (83%), hair (88%), or saliva (93%), but not blood samples (43%); and believed that test results could motivate behavior change. CONCLUSIONS Parents were receptive to non-invasive child biomarker testing. Biomarker information could help persuade parents who smoke that their children need protection. PRACTICE IMPLICATIONS Biomarker testing of children in smoking families is an acceptable and promising tool for education, counseling, and motivation of parents to protect their children from TSE. Additionally, biomarker testing allows objective assessment of population-level child TSE.
Collapse
Affiliation(s)
- Laura J Rosen
- Dept. of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Efrat Tillinger
- Dept. of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Dept. of Sociology, Faculty of Social Sciences, Bar Ilan University, Ramat Gan, Israel
| | - Nurit Guttman
- Dept. of Communications, Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Shira Rosenblat
- Dept. of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Dept. of Communications, Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel
| | - David M Zucker
- Dept. of Statistics, Hebrew University, Jerusalem, Israel
| | - Frances Stillman
- Dept. of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Vicki Myers
- Dept. of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
7
|
Chinese Pediatrician Attitudes and Practices Regarding Child Exposure to Secondhand Smoke (SHS) and Clinical Efforts against SHS Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:5013-25. [PMID: 26006117 PMCID: PMC4454951 DOI: 10.3390/ijerph120505013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/27/2015] [Accepted: 04/28/2015] [Indexed: 11/16/2022]
Abstract
Background: Secondhand Smoke (SHS) exposure is a leading cause of childhood illness and premature death. Pediatricians play an important role in helping parents to quit smoking and reducing children’s SHS exposure. This study examined Chinese pediatricians’ attitudes and practices regarding children’s exposure to SHS and clinical efforts against SHS exposure. Methods: A cross-sectional survey of pediatricians was conducted in thirteen conveniently selected hospitals in southern China, during September to December 2013. Five hundred and four pediatricians completed self-administered questionnaires with a response rate of 92%. χ2 tests were used to compare categorical variables differences between smokers and non-smokers and other categorical variables. Results: Pediatricians thought that the key barriers to encouraging parents to quit smoking were: lack of professional training (94%), lack of time (84%), resistance to discussions about smoking (77%). 94% of the pediatricians agreed that smoking in enclosed public places should be prohibited and more than 70% agreed that smoking should not be allowed in any indoor places and in cars. Most of the pediatricians thought that their current knowledge on helping people to quit smoking and SHS exposure reduction counseling was insufficient. Conclusions: Many Chinese pediatricians did not have adequate knowledge about smoking and SHS, and many lacked confidence about giving cessation or SHS exposure reduction counseling to smoking parents. Lack of professional training and time were the most important barriers to help parents quit smoking among the Chinese pediatricians. Intensified efforts are called for to provide the necessary professional training and increase pediatricians’ participation in the training.
Collapse
|
8
|
Fischer F, Minnwegen M, Kaneider U, Kraemer A, Khan MMH. Prevalence and determinants of secondhand smoke exposure among women in Bangladesh, 2011. Nicotine Tob Res 2014; 17:58-65. [PMID: 25125322 DOI: 10.1093/ntr/ntu129] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND OBJECTIVES The population of Bangladesh is highly susceptible to secondhand smoke (SHS) exposure due to high smoking rates and low awareness about the harmful effects of SHS. This study aims to determine the prevalence of SHS exposure and highlight the essential determinants in developing successful strategies to prevent adverse health effects in Bangladesh. METHODS The analysis is based on the Bangladesh Demographic Health Survey 2011, in which 17,749 women in the reproductive age group (12-49 years) were included. The information regarding SHS exposure at home was derived from the question: "How often does anyone smoke inside your house?" The variable was recoded into 3 groups: daily exposure, low exposure (exposed weekly, monthly, or less than monthly), and no SHS exposure. We performed descriptive and bivariable analyses and multinomial logistic regression. RESULTS A total of 46.7% of the women reported high exposure to SHS at home. According to the multinomial logistic regression model, relatively lower education and lower wealth index were significantly associated with daily SHS exposure at home. The exposure differed significantly between the divisions of Bangladesh. Having children at home (vs. not) and being Islamic (compared to other religious affiliations) were protective factors. CONCLUSIONS The study indicates that women from socioeconomically disadvantaged households are more likely to experience daily exposure to SHS at home. Therefore, especially these groups have to be targeted to reduce tobacco consumption. In addition to aspects of legislation, future strategies need to focus educational aspects to improve the population's health status in Bangladesh.
Collapse
Affiliation(s)
- Florian Fischer
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Germany
| | - Martina Minnwegen
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Germany
| | - Ulrike Kaneider
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Germany
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Germany
| | - Md Mobarak Hossain Khan
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Germany
| |
Collapse
|