Association between home smoking restrictions and changes in smoking behaviour among employed women

Tobacco Smoking and Associated Factors Among People Living With HIV in Uganda

INTRODUCTION

The prevalence of smoking among people living with HIV (PLWH) in Uganda is high.

AIMS AND METHODS

We assessed the smoking patterns, behaviors, and associated factors among PLWH in Uganda through a cross-sectional survey. Descriptive statistics were used to describe smoking patterns and behaviors. Logistic regression was used to identify factors associated with current smoking status.

RESULTS

We recruited 777 participants between October and November 2019: 387 (49.8%) current smokers and 390 (50.2%) nonsmokers. 60.9% were males, and the mean age was 40.5 (SD 10.7) years. In multivariate logistic regression, the following increased the odds of being a current smoker: being male (odds ratio [OR] 6.60 [95% confidence interval, CI = 4.34-10.04]), having at least two smokers among five closest friends (OR 3.97 [95% CI = 2.08-7.59]), living in smoking-permitted households (OR 5.83 [95% CI = 3.32-10.23]), alcohol use (OR 3.96 [95% CI = 2.34-6.71]), a higher perceived stress score (OR 2.23 [95% CI = 1.50-3.34]), and higher health-related quality of life (OR 5.25 [95% CI = 1.18-23.35]). Among smokers, the mean Fagerström Test for Nicotine Dependence score was 3.0 (SD 1.9), and 52.5% were making plans to quit. Self-efficacy to resist smoking and knowledge of the impact of smoking on PLWH's health were low.

CONCLUSIONS

Being male, having at least two smokers among five closest friends, living in smoking-permitted households, alcohol use, higher perceived stress scores, and higher health-related quality of life were associated with being a current smoker. Smokers had low to moderate nicotine dependence, high willingness to quit, and low self-efficacy.

IMPLICATIONS

Future behavioral smoking cessation interventions for PLWH should address co-consumption with alcohol and comorbid mental health conditions that are common among PLWH such as stress. In addition, they should take into account the lack of knowledge among this population of the impact of smoking on their health, and low self-efficacy. Given the relatively low levels of nicotine dependency and high levels of willingness to quit in our sample, smoking cessation interventions, if offered, are likely to support this population in achieving long-term smoking abstinence.

Increasing Home Smoking Restrictions Boosts Underserved Moms' Bioverified Quit Success

Objectives: Standard smoking cessation treatments remain relatively ineffective in vulnerable populations. This study tested whether efforts to restrict residential smoking mediated the counseling treatment - smoking cessation association in a child tobacco smoke exposure (TSE) reduction trial. Methods: Maternal smokers (N = 300) with young children from low-income minority communities were randomized to counseling or standard care control to promote child TSE reduction. Secondary mediation analyses controlled for factors associated with smoking cessation. Results: Counseling group mothers were more likely than controls to increase home smoking restrictions (OR = 1.9, 95% CI 1.1-3.4) and quit smoking (OR = 11.0, 95% CI 6.3-19.2). As hypothesized, increasing home smoking restrictions improved likelihood of bioverified quit status at end of treatment (OR = 2.5, 95% CI 1.1-5.9) and partially mediated the association between counseling intervention and quit status. Conclusions: Results suggest that among maternal smokers known to experience increased challenges to quitting smoking, encouraging efforts to protect children from TSE by increasing home smoking restrictions may be an important counseling intervention element that facilitates smoking cessation.

Correlates of attempting to quit smoking among adults in Bangladesh

Background

Quit attempts are very essential in population-based smoking cessation. Little is known about the correlates of making a quit attempt of smoking in Bangladesh. We aimed to examine correlates of making a quit attempt of smoking among adults in Bangladesh.

Methods

We used data from the 2009 Global Adult Tobacco Survey, Bangladesh. A total of 2217 adult current smokers (2141 males and 76 females) aged 15 years and older who participated in the survey were included. We compared socio-demographic, behavioral, motivational, knowledge and attitudes towards smoking, quitting methods utilized, use of social media to quit smoking, and environmental characteristics of current smokers who made an attempt to quit with those who made no quit attempt during the previous 12 months of the survey. We applied multivariable logistic regression models for analyzing the data.

Results

Among the 2217 current smokers, 1058 (47.72%) made attempt to quit. We found respondents who smoked their first cigarette within 6 to 30 min of waking up were more likely to make an attempt to quit than those who smoked their first cigarette within 5 min of waking. Moreover, among daily current smokers who smoked 10–19 manufactured cigarettes per day were less likely to make a quit attempt. We also found intention to quit smoking, smoking rules inside the home, and exposure to anti-smoking advertisements as significant correlates of making a quit attempt of smoking among adults in Bangladesh.

Conclusions

Policymakers should consider our findings when implementing tobacco control programs in Bangladesh.

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Quit attempts are very essential in population-based smoking cessation.

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Among the 2233 current smokers, 1058 individuals attempted to quit smoking.

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Smokers who don't smoke quickly after waking were more likely to make quit attempt.

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Smokers who lived in a smoke-free home were also more likely to make quit attempt.

Survey Mode and Rates of Smoke-free Homes and Support for Smoking Bans Among Single Parents in the United States in 2010-2011 and 2014-2015

National surveys are commonly used to monitor the rates of smoke-free homes and public attitudes toward smoking bans. The study explored the difference in the estimates corresponding to two survey modes-personal interviews and phone interviews-among single-parent households. Data from the Tobacco Use Supplement to the Current Population Survey administered in 2010-11 and 2014-15 were used in a stratified fashion. The rate of smoke-free homes was lower for personal interviews (79% in 2010-11 and 82% in 2014-15) than for phone interviews (85% in 2010-11 and 90% in 2014-15). Even after controlling for several factors, personal interviews corresponded to lower odds of having a smoke-free home relative to phone interviews (OR=0.7, CI=0.6:0.9 in 2010-11; OR=0.5, CI = 0.4:0.6 in 2014-15). The survey mode should be included in the analyses when estimating the rates of smoke-free homes and other smoking-related attitudes, because different survey modes could be associated with different response bias.

Passive Smoking at Home by Socioeconomic Factors in a Japanese Population: NIPPON DATA2010

BACKGROUND

Long-term passive exposure to cigarette smoke has been reported to affect the health of non-smokers. This study aims to investigate the relationships among socioeconomic factors and passive smoking at home in the non-current smokers of a representative sample from a general Japanese population.

METHODS

Data are from NIPPON DATA2010. Among 2,891 participants, 2,288 non-current smokers (1,763 never smokers and 525 past smokers) were analyzed in the present study. Cross-sectional analyses were performed on the relationships among socioeconomic factors and passive smoking at home (several times a week or more) in men and women separately. Socioeconomic factors were employment, length of education, marital status, and equivalent household expenditure. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a multivariable logistic regression model.

RESULTS

The multivariable-adjusted model showed that employed women had a higher risk of passive smoking than unemployed women (OR 1.44; 95% CI, 1.06-1.96). Women with 9 years or less of education had a higher risk of passive smoking at home than women with 13 years and more of education (OR 2.37; 95% CI, 1.49-3.78). Single women had a lower risk of passive smoking at home (OR 0.53; 95% CI, 0.37-0.77) than married women. No significant associations were observed in men.

CONCLUSIONS

An employed status, lower education, and being single were associated with passive smoking at home in the non-current smoking women of a representative Japanese population.

Household Smoking Restrictions Relate To Time To First Cigarette Smoked In The Morning

Introduction

The time a smoker waits until the first cigarette of the morning is often used as a measure of dependence with the rationale that more dependent smokers will smoke sooner upon waking than will less dependent smokers after going several hours without a cigarette overnight.

Aims

We sought to examine the relationship between time-to-first-cigarette (TTFC) and household smoking restrictions in two independent samples.

Methods

Two samples of smokers, one treatment-seeking community sample (N = 433) and one non-treatment-seeking sample of smokers with serious mental illness (i.e., Schizophrenia, Schizoaffective Disorder, or Bipolar I Disorder) (N = 94), provided information on cigarette dependence with the Fagerström Test for Nicotine Dependence and on household smoking restrictions.

Results

Half (50%) of smokers with serious mental illness and 36.7% of smokers from the general population reported that there were no limitations to smoking in their home. Household smoking restrictions were significantly and positively related to TTFC in both samples.

Conclusions

These data indicate that greater attention to TTFC may be warranted. The TTFC item is intended to measure dependence based on the premise that greater dependence should be associated with shorter TTFC. If TTFC is related to a household smoking ban, however, this item may not be assessing dependence as intended in some cases.

Factors Associated with Complete Home Smoking Ban among Chinese Parents of Young Children

(1) Background: The home environment is a major source of Environmental Tobacco Smoke (ETS) exposure among children especially in early childhood. ETS exposure is an important health risk among children and can cause severe and chronic diseases, such as asthma, bronchitis, and premature death. However, ETS exposure at home has often been neglected in the Chinese families. Identification of factors that facilitate or otherwise hamper the adoption of home smoking ban will help in the design and implementation of evidence-based intervention programs. This study identifies factors correlated with home smoking bans in Chinese families with children. (2) Methods: A cross-sectional survey of parents living in Nanning city, Guangxi Province, China with at least one smoker and a child in the household was conducted between September, 2013 and January, 2014. A Chi-square test was used to compare categorical variables differences between the parents who had home smoking bans and those with no home smoking ban. Multiple logistic regression analyses were used to identify factors correlated with home smoking bans. (3) Results: 969 completed questionnaires were collected with a response rate of 92.29% (969/1050). Of the respondents (n = 969), 14.34% had complete home smoking bans. Factors that were associated with home smoking bans were: having no other smokers in the family (OR = 2.173), attaining education up to high school (OR = 2.471), believing that paternal smoking would increase the risk of lower respiratory tract illnesses (OR = 2.755), perceiving the fact that smoking cigarettes in the presence of the child will hurt the child’s health (OR = 1.547), believing that adopting a no smoking policy at home is very important (OR = 2.816), and being confident to prevent others to smoke at home (OR = 1.950). Additionally, parents who perceived difficulty in adopting a no smoking policy at home would not have a home smoking ban (OR = 0.523). (4) Conclusions: A home smoking ban is not widely adopted by families of hospitalized children in Guangxi Province, China. To protect the health of children, there is a need to develop and test interventions to promote home smoking bans. Factors identified as predictors of home smoking ban should be considered in the design of interventions.

Social and Environmental Factors Related to Smoking Cessation among Mothers: Findings from the Geographic Research on Wellbeing (GROW) Study

OBJECTIVES

The current study examined associations between race/ethnicity and psychosocial/environmental factors with current smoking status, and whether psychosocial/environmental factors accounted for racial differences in smoking status in a population-based sample of mothers in California.

METHODS

Cross-sectional data from 542 women with a history of smoking were used. Analyses adjusted for age, partner status, and educational attainment.

RESULTS

In models adjusted for sociodemographics, black women had significantly lower odds, and Latina immigrants had significantly higher odds of being a former smoker compared to white women. Persons smoking in the home, having a majority of friends who smoke, having perceptions of their neighborhood as being somewhat or very unsafe, and experiencing food insecurity were associated with decreased odds of being a former smoker. When these variables were entered into a single model, only being a Latina immigrant and having a majority of friends who smoke were significantly associated with smoking status.

CONCLUSIONS

Black women demonstrated a notable disparity compared with white women in smoking status, accounted for by psychosocial/environmental factors. Immigrant Latinas demonstrated notable success in ever quitting smoking. Social networks may be important barriers to smoking cessation among women.

Active smoking and exposure to secondhand smoke and their relationship to depressive symptoms in the Korea national health and nutrition examination survey (KNHANES)

BACKGROUND

The relationship between tobacco smoking, including secondhand smoking, and depression has been assessed. The purpose of this study was to evaluate the association between secondhand smoking among current, former and never smokers and depressive symptoms. For secondhand smoking, gender differences and sources of exposure were examined.

METHODS

Data from 34,693 participants from the fourth and fifth Korean Health and Nutritional Examination Survey (2007-2012) were analyzed in 2014. Self-reported exposure to active (current, former or never) and secondhand smoking and depressive symptoms experienced during the past year were analyzed using logistic regression. The dose-response relationship between duration of secondhand smoke exposure and depression was assessed with stratification by gender and sources of exposure (at home only, at the workplace only or both).

RESULTS

Regardless of their smoking status, all women who had secondhand smoke exposure at home reported more depressive symptoms than non-smoking women without any exposure to secondhand cigarette smoking (OR 1.43, 95 % CI 1.04-1.96 for current smokers; OR 2.32, 95 % CI 1.04-5.16 for former smokers; OR 1.25, 95 % CI 1.08-1.43 for never smokers). There was also a significant dose-response pattern (p-trend <0.001) for the duration of secondhand smoke exposure at home among women. No significant association was found between smoking and depressive symptoms in men.

CONCLUSIONS

There was a significant association between secondhand smoke exposure at home and depressive symptoms in women. Secondhand smoke exposure at home was associated with depressive symptoms in a dose-response manner.

Spatial and temporal patterns of smoking prevalence in Ontario

BACKGROUND

Smoking prevalence varies over time and place due to various social, environmental and policy influences. However, its spatio-temporal patterns at small-area level are poorly understood. This paper attempts to describe spatio-temporal patterns of adult (age > 18) and youth (age 12-18) smoking prevalence at the municipality level in Ontario, Canada and identify potential socio-demographic, environmental, and policy factors that may affect the patterns.

METHODS

Multilevel temporal and spatio-temporal models were fitted to the Canadian Community Health Surveys (2000-2008) data. In total, approximately 160,000 respondents 12 years of age and over living in Ontario were used for this analysis.

RESULTS

The results indicate that during the time period 2003-2008, age-sex stratified smoking prevalence dropped for both the adult and youth populations in Ontario. The tendency is more obvious for youth than for adults. Smoking restriction at home is a leading factor associated with the decline of adult smoking prevalence, but does not play the same role for youth smoking. Despite the overall reduction, smoking prevalence varies considerably across the province and inequalities among municipalities have increased. Clusters of high and low smoking prevalence are both found within the study region.

CONCLUSION

The identified spatial and temporal variations help to indicate problems at the local level and suggest future research directions. Identifying these variations helps to strengthen surveillance and monitoring of smoking behaviours and the evaluation of policy and program development at the small-area level.

The meanings of smoking to women and their implications for cessation

Smoking cigarettes is a gendered activity with sex- and gender-specific uptake trends and cessation patterns. While global male smoking rates have peaked, female rates are set to escalate in the 21st century, especially in low and middle income countries. Hence, smoking cessation for women will be an ongoing issue and requires refreshed attention. Public health and health promotion messages are being challenged to be increasingly tailored, taking gender into account. Women-centred approaches that include harm-reduction, motivational interviewing and trauma-informed elements are the new frontiers in interventions to encourage smoking cessation for women. Such approaches are linked to the meanings of smoking to women, the adaptive function of, and the overall role of smoking cigarettes in the context of women’s lives. These approaches respect gender and sex-related factors that affect smoking and smoking cessation and respond to these issues, not by reinforcing destructive or negative gender norms, but with insight. This article discusses a women-centred approach to smoking cessation that could underpin initiatives in clinical, community or public health settings and could inform campaigns and messaging.

Can tobacco control be transformative? Reducing gender inequity and tobacco use among vulnerable populations

Tobacco use and exposure is unequally distributed across populations and countries and among women and men. These trends and patterns reflect and cause gender and economic inequities along with negative health impacts. Despite a commitment to gender analysis in the preamble to Framework Convention on Tobacco Control there is much yet to be done to fully understand how gender operates in tobacco control. Policies, program and research in tobacco control need to not only integrate gender, but rather operationalize gender with the goal of transforming gender and social inequities in the course of tobacco control initiatives. Gender transformative tobacco control goes beyond gender sensitive efforts and challenges policy and program developers to apply gender theory in designing their initiatives, with the goal of changing negative gender and social norms and improving social, economic, health and social indicators along with tobacco reduction. This paper outlines what is needed to progress tobacco control in enhancing the status of gendered and vulnerable groups, with a view to reducing gender and social inequities due to tobacco use and exposure.

The role of home smoking bans in limiting exposure to secondhand tobacco smoke in Hungary

Our objective was to assess how exposure to secondhand tobacco smoke occurs in Hungarian homes, particularly among non-smokers, and to examine the effectiveness of home smoking bans in eliminating exposure to secondhand smoke at home. In 2009, 2286 non-smokers and smokers aged 16-70 years, who were selected randomly from a nationally representative sample of 48 Hungarian settlements, completed paper-and-pencil self-administered questionnaires addressing tobacco-related attitudes, opinions and behaviors. Chi-square tests, one-way analysis of variance and multivariate logistic regression models were used to assess the effect of demographics, socio-economic characteristics and home smoking policies on the risk of exposure to secondhand tobacco smoke at home. Significantly higher risk of exposure was found among younger, lower educated and poorer people and among those having no or partial home smoking restrictions. There was a significant interaction between education level and home smoking policies: the effect of a smoking ban on exposure to secondhand tobacco smoke was stronger for the lower educated group than the higher educated group. The results suggest that Hungarians are making good progress in implementing home smoking bans, and that in the majority of population these bans are working. More can be done to promote the uptake of home smoking bans among poorer and less educated subpopulations.

Reshuffling and relocating: the gendered and income-related differential effects of restricting smoking locations

This study investigates secondhand smoke (SHS) exposure and management in the context of smoking location restrictions, for nonsmokers, former, and current smokers. A purposive sample of 47 low income and non-low-income men and women of varied smoking statuses was recruited to participate in a telephone interview or a focus group. Amidst general approval of increased restrictions there were gendered patterns of SHS exposure and management, and effects of SHS policies that reflect power, control, and social roles that need to be considered as policies are developed, implemented and monitored. The experience of smoking restrictions and the management of SHS is influenced by the social context (relationship with a partner, family member, or stranger), the space of exposure (public or private, worksite), the social location of individuals involved (gender, income), and differential tolerance to SHS. This confluence of factors creates differing unintended and unexpected consequences to the social and physical situations of male and female smokers, nonsmokers, and former smokers. These factors deserve further study, in the interests of informing the development of future interventions and policies restricting SHS.

Social cognitive predictors of smoking cessation intentions among smoker employees: the roles of anticipated regret and social norms

The present study assessed the effects of anticipated regret, social norms, and related social cognitions on smoking cessation intentions among indoor employees in a pro-smoking culture. Overall, 93 daily smokers completed anonymous structured questionnaires assessing attitudinal and health beliefs about tobacco use, social norms, quitting self-efficacy, and anticipated regret. Past quit attempts and tobacco dependence were also measured. Hierarchical linear regression and mediation analyses showed that attitudes toward quitting, self-efficacy and anticipated regret significantly predicted cessation intentions, over and above past quit attempts and tobacco dependence. Unlike in previous studies, tobacco dependence, descriptive norms and smoke-free policies did not directly influence quit intentions in our sample of smokers. Anticipated regret mediated the effects of attitudes and social norms on cessation intentions.

The role of worksite and home smoking bans in smoking cessation among U.S. employed adult female smokers

PURPOSE

Examine the association of work and home smoking bans with quitting behaviors among employed female smokers in the United States.

DESIGN

Secondary analyses using cross-sectional data from the 2006/2007 Tobacco Use Supplement to the Current Population Survey.

SUBJECTS

Nationally representative sample of 7610 U.S. employed female smokers, aged 18 to 64 years, who reported working indoors. Setting . N/A.

METHODS

Multivariate logistic regression analyses were conducted to examine the association of smoking ban policies (complete work and home bans, complete work ban only, complete home ban only, and no complete work or home ban) with intention to quit in the next 30 days, at least one quit attempt in the past year, and sustained abstinence of at least 3 months in the past year.

RESULTS

Twenty-nine percent of women reported complete work and home smoking bans. Smoking bans were not associated with intention to quit and were marginally associated with sustained abstinence. Regardless of intention to quit, women with complete work and home bans were significantly more likely than those without complete work and home bans to report quit attempts. Among women with no intention to quit, the odds of having a quit attempt were significantly higher among women who had a complete home ban only compared with women without complete work and home bans.

CONCLUSIONS

Efforts to promote quitting behaviors among employed female smokers may be facilitated by increasing rates of complete smoking bans at both work and home settings.

Influence of measurement setting and home smoking policy on smoking topography

While cigarette puffing style, measured by smoking topography, is highly variable between individuals, smoking behavior or style tends to vary relatively little within individuals. Recent research has demonstrated that certain situational factors may produce variation in smoking topography, including location of smoking. Smoking topography directly observed by researchers in a laboratory may differ from that indirectly observed via portable measurement devices at participants' homes. The introduction of clean indoor air laws may also influence smokers' puffing styles, as smokers modify their smoking topography to ensure a quicker, more efficient smoking style. The goal of this analysis was to examine whether directly observed laboratory measures are representative of indirectly observed smoking behavior and to examine the influence of smokers' preference for indoor or outdoor home smoking on puffing style. Overall, participants smoked more intensively in the directly observed setting than when in the indirectly observed setting in terms of total volume intake, inter-puff interval, and total time spent smoking. This difference was most pronounced among individuals who reported smoking indoors when at home. The data suggest that adherence to an indoor home smoking policy may further influence an individual's smoking behavior.

Socioeconomic variation in the prevalence, introduction, retention, and removal of smoke-free policies among smokers: findings from the International Tobacco Control (ITC) Four Country Survey

INTRODUCTION

Exposure to secondhand smoke causes premature death and disease in non-smokers and indoor smoke-free policies have become increasingly prevalent worldwide. Although socioeconomic disparities have been documented in tobacco use and cessation, the association between socioeconomic status (SES) and smoke-free policies is less well studied.

METHODS

Data were obtained from the 2006 and 2007 Waves of the International Tobacco Control Four Country Survey (ITC-4), a prospective study of nationally representative samples of smokers in Canada, the United States, the United Kingdom, and Australia. Telephone interviews were administered to 8,245 current and former adult smokers from October 2006 to February 2007. Between September 2007 and February 2008, 5,866 respondents were re-interviewed. Self-reported education and annual household income were used to create SES tertiles. Outcomes included the presence, introduction, and removal of smoke-free policies in homes, worksites, bars, and restaurants.

RESULTS

Smokers with high SES had increased odds of both having [OR: 1.54, 95% CI: 1.27-2.87] and introducing [OR: 1.49, 95% CI: 1.04-2.13] a total ban on smoking in the home compared to low SES smokers. Continuing smokers with high SES also had decreased odds of removing a total ban [OR: 0.44, 95% CI: 0.26-0.73]. No consistent association was observed between SES and the presence or introduction of bans in worksites, bars, or restaurants.

CONCLUSIONS

The presence, introduction, and retention of smoke-free homes increases with increasing SES, but no consistent socioeconomic variation exists in the presence or introduction of total smoking bans in worksites, bars, or restaurants. Opportunities exist to reduce SES disparities in smoke-free homes, while the lack of socioeconomic differences in public workplace, bar, and restaurant smoke-free policies suggest these measures are now equitably distributed in these four countries.

Second-hand smoke exposure and the factors associated with avoidance behavior among the mothers of pre-school children: a school-based cross-sectional study

BACKGROUND

Second-hand Smoke (SHS) exposure is a significant public health problem that may be responsible for serious health hazards for child. This study aimed to examine the exposure status of SHS and the factors associated with SHS avoidance behavior among the mothers of pre-school children.

METHODS

A cross-sectional study was used to obtain a sample of the mothers of pre-school children (n = 1,020) in 30 registered kindergartens in eastern Taiwan. Overall, 919 (a response rate of 90%) completed the questionnaires. Regression models were used to identify factors with respect to the avoidance behavior of SHS.

RESULTS

The prevalence of exposure to SHS was 70% and 50% for the mothers and their children, respectively. After adjusting for other variables, mothers who were current smokers (β = -0.260, p < 0.001), had spouses who smoked (β = -0.060, p < 0.05), SHS exposure (β = -0.138, p < 0.001), and/or children with exposure to SHS (β = -0.084, p < 0.05) were found to be less likely to avoid SHS, whereas mothers with a high knowledge score about SHS (β = 0.082, p < 0.01), positive attitudes (β = 0.274, p < 0.001) and a high self-efficacy level in regard to the avoidance of SHS (β = 0.397, p < 0.001) were observed to be more likely to avoid SHS. Regression analyses confirmed that the significantly factors associated with the avoidance behavior of SHS were self-efficacy, being a current smoker, and the attitude toward the avoidance of SHS to be that of 55.5% of the total variance explained (p < 0.001).

CONCLUSIONS

The high prevalence rate of exposure to SHS for mothers and their children suggests that a well-designed future intervention program should be implemented in regard to pre-school children's mothers in order to prevent these mothers and their children from SHS exposure hazards, more particularly, to strengthen the knowledge base, to enhance self-efficacy and to foster a more positive attitude toward the avoidance of SHS in the mothers.

Home and workplace smoking bans in Italy, Ireland, Sweden, France and the Czech Republic

The purpose of this study was to report predictors and prevalence of home and workplace smoking bans in five European countries. We conducted a population-based telephone survey of 4,977 females, ascertaining factors associated with smoking bans. Odds ratios and 95% confidence intervals were derived using unconditional logistic regression. A complete home smoking ban was reported by 59.5% of French, 63.5% of Irish, 61.3% of Italian, 74.4% of Czech and 87.0% of Swedish females. Home smoking bans were associated with younger age and being bothered by secondhand smoke, and among smokers, inversely associated with greater tobacco dependence. Among nonsmokers, bans were also related to believing smoking is harmful (OR 1.20, 95% CI 1.11-1.30) and having parents who smoke (OR 0.62, 95% CI 0.52-0.73). Workplace bans were reported by 92.6% of French, 96.5% of Irish, 77.9% of Italian, 79.1% of Czech and 88.1% of Swedish females. Workplace smoking bans were reported less often among those in technical positions (OR 0.64, 95% CI 0.50-0.82) and among skilled workers (OR 0.53, 95% CI 0.32-0.88) than among professional workers. Workplace smoking bans are in place for most workers in these countries. Having a home smoking ban was based on smoking behaviour, demographics, beliefs and personal preference.

Residential smoking restrictions are not associated with reduced child SHS exposure in a baseline sample of low-income, urban African Americans

Second hand smoke exposure (SHSe) relates to many chronic and acute illnesses. Low income African American (AA) maternal smokers and their children have disproportionately higher tobacco-use and child SHSe-related morbidity and mortality than other populations. While public health officials promote residential smoking restrictions to reduce SHSe and promote smoking cessation, little is known about the impact of restrictions in changing smoking behavior and SHSe in this population. Thus, the purpose of this study was to examine associations between residential smoking restrictions, maternal smoking, and young children's SHSe in the context of other factors known to influence low income AA mothers' smoking behavior. For this study, we used cross-sectional, baseline data from 307 AA maternal smokers' pre-treatment interviews completed as part of a subsequent behavioral counseling trial to reduce their young (< 4 years old) children's SHSe. Residential smoking restriction was dichotomized as 0 = no restrictions and 1 = some restrictions. Child urine cotinine provided a biomarker of SHSe. Mothers reported cigarettes/day smoked, cigarettes/day exposed to child, and intention to quit. Multivariate regressions modeled effects of restriction as the primary predictor of smoking and exposure outcomes. Maternal smoking patterns such as cigarettes per day (β = 0.52, p < 0.001) and years smoked (β = -0.11; p = 0.03) along with presence of additional smokers in the home (β = 0.10; p = 0.04), but not residential restriction (β = -0.09, p = 0.10), predicted reported SHSe. Restriction did not relate to baby cotinine or maternal intention to quit. Thus, residential smoking restrictions may contribute to efforts to reduce children's SHSe and promote maternal smoking change; but alone, may not constitute a sufficient intervention to protect children. Multi-level intervention approaches that include SHSe-reduction residential smoking policies plus support and cessation assistance for smokers may be a necessary approach to smoke-free home adoption and adherence.

Predicting home smoking restrictions among African American light smokers

OBJECTIVE

To determine home smoking restrictions (HSR) predictors among African American light smokers (smoke <or= 10 cigarettes per day).

METHODS

Data were obtained from a clinical trial testing the efficacy of nicotine gum and counseling among 755 African American light smokers.

RESULTS

Forty percent reported adopting HSR at week 26. Implementing HSR increased with higher baseline confidence to quit (P <0.0001) and female gender (P = 0.019) and decreased with older age (P = 0.016) and reduced confidence to quit between baseline and week 26 (P <0.0001).

CONCLUSIONS

Confidence to quit, gender, and age are important factors to incorporate into interventions enhancing the adoption of HSR.

Women and tobacco control policies: social-structural and psychosocial contributions to vulnerability to tobacco use and exposure

This article explores the psychosocial and social-structural vulnerability in relation to women's tobacco use, smoke exposure and responses to policy, and examines these issues in the context of women's lives and roles, describing forward looking strategies that could improve research and equity in outcomes for women. Various literatures on smoking among women and girls, and how women and sub-populations of women respond to tobacco control policies are reviewed. Specific sub-populations exhibiting more tobacco use and exposure are described, such as young pregnant and mothering women and low-income women. Emerging evidence also reveals links between smoking and experiences such as childhood sexual abuse, interpersonal violence, post-traumatic stress disorder, mental health issues and alcohol and drug dependence. Varied sub-populations of women respond in different ways to price and taxation, sales restrictions and location restrictions. However, tobacco control policies have, to date, been fashioned as broad instruments, not taking into account social context, trauma backgrounds, gendered roles such as mothering, unequal power relations affecting women in relationships and workplaces, and differences in access to resources and social support. When these issues are considered, the implications for tobacco policy development include: widening the policy purview, accounting for uneven and differential responses to policies, committing to an ethical framework, extending sex, gender and diversity based analyses, and improving research methods and approaches.

Smoke-free homes and smoking cessation and relapse in a longitudinal population of adults

INTRODUCTION

The present study reports on the prevalence of smoke-free homes, the characteristics of participants who adopted a smoke-free home policy, and the association between smoke-free homes and subsequent predictors of smoking cessation.

METHODS

Data are reported on 4,963 individuals who originally participated in the Community Intervention Trial for Smoking Cessation between 1988 and 1993 and completed follow-up surveys in 2001 and 2005. The relationship between home smoking policy and smoking behavior was examined with a multivariate regression model.

RESULTS

Among those who were smokers at the 2001 follow-up, the percentage reporting that no smoking was allowed in their home increased from 29% in 2001 to 38% in 2005. Smokers most likely to adopt smoke-free home policies between 2001 and 2005 were males, former smokers, and those who had lower levels of daily cigarette consumption (among those who continued to smoke), those with higher annual household incomes, and those with no other smokers in the household. Some 28% of smokers with smoke-free homes in 2001 reported that they had quit smoking by 2005 compared with 16% of those who allowed smoking in their homes (odds ratio [OR] = 1.7, 95% CI = 1.4-2.2), and baseline quitters with smoke-free homes also were less likely to relapse (OR = 0.6, 95% CI = 0.4-0.8).

DISCUSSION

Smoke-free homes are becoming more prevalent, and they are a powerful tool not only to help smokers stop smoking but also to help keep those who quit from relapsing back to smoking.

An examination of the relationship between adolescents' initial smoking experience and their exposure to peer and family member smoking

Sensitivity to the initial smoking experience, upon initial smoking experimentation, is associated with youth smoking. We determined the association between exposure to smoking from peers and family members on the symptoms of the initial smoking experience of adolescents. Data from a survey of 3280 high school students in the British Columbia, Canada were obtained; including information on demographics, tobacco use history, symptoms of initial smoking experience, and the smoking behaviours of peers and family member's (from which an 'exposure to smoking from peers and family members' variable was created). In multivariate logistic regression models, individuals with higher scores on the 'exposure to smoking from peers and family members' variable were more likely to report positive symptoms of initial smoking experience, even after controlling for confounding variables. Higher scores on the 'exposure to smoking from peers and family members' variable was associated with increased 'initial smoking experience' scores. Initial smoking experience scores (i.e. total number of reported initial symptoms) weakly mediated the relationship between exposure to smoking from peers and family members and current smoking. The present findings suggest that exposure to smoking from peers and family members may be an important factor to consider in understanding youths initial smoking experiences.

Special effects: tobacco policies and low socioeconomic status girls and women

Currently little is known about the specific effects of tobacco policies on low income girls and women. Research is vital on such effects both in developed and developing countries.