Secondhand smoke in Geneva, 1996-2006: changes in exposure, opinions, and workplace smoking bans in the absence of national legislation

Public support for smoke-free air strategies among smokers and nonsmokers, New York City, 2010-2012

INTRODUCTION

From 2010 through 2012, the New York City Department of Health and Mental Hygiene engaged in multiple smoke-free-air activities in collaboration with community, institution, and government partners. These included implementing a law prohibiting smoking in all parks and beaches as well as working to increase compliance with existing Smoke-free Air Act provisions.

METHODS

We investigated trends in awareness of existing smoke-free rules publicized with new signage and public support for new smoke-free air strategies by using 3 waves of survey data from population-based samples of smoking and nonsmoking adults in New York City (2010-2012). Analyses adjusted for the influence of sociodemographic characteristics.

RESULTS

Among both smokers and nonsmokers, we observed increased awareness of smoke-free regulations in outdoor areas around hospital entrances and grounds and in lines in outdoor waiting areas for buses and taxis. Regardless of smoking status, women, racial/ethnic minorities, and adults aged 25 to 44 years were more likely than men, non-Hispanic whites, and adults aged 65 years or older to support smoke-free air strategies.

CONCLUSION

New signage was successful in increasing population-wide awareness of rules. Our analysis of the association between demographic characteristics and support for tobacco control over time provide important contextual information for community education efforts on secondhand smoke and smoke-free air strategies.

Protecting the world from secondhand tobacco smoke exposure: where do we stand and where do we go from here?

INTRODUCTION

Article 8 of the Framework Convention on Tobacco Control mandates all signatory countries to "protect citizens from exposure to tobacco smoke in workplaces, public transport and indoor public places." Even though there has been great progress in the implementation of Article 8, still most of the world population remains exposed to secondhand smoke (SHS). In this article, we sought to summarize the research that supports Article 8, where do we stand, and current research gaps and future directions.

DISCUSSION

Secondhand smoke is an established cause of heart disease and several types of cancer. Additional research is needed to reach final conclusions for diseases where evidence is only suggestive of causality. The only solution to SHS exposure in public places is banning smoking indoors. Research on the gaming industry and nightclubs, particularly in developing countries, needs to be disseminated to support their inclusion in smoke-free laws. Aside from indoor bans, additional research is needed for outdoor and multiunit housing bans and in support of measures that protect children and other vulnerable populations. The impact of smoke-free laws on other health outcomes, besides heart disease and respiratory outcomes, is another area where further research is needed. Thirdhand smoke assessment and health effects are also likely to be a topic of further research. As new tobacco products emerge, evaluating SHS exposure and effects will be vital.

CONCLUSIONS

Furthering research in support of Article 8 can contribute to reach the final goal of protecting everyone from SHS exposure.

Secondhand smoke at work

PURPOSE OF REVIEW

Secondhand smoke (SHS) exposure in the workplace remains common and has important acute and chronic health effects. The present study reviews the recent evidence linking workplace SHS exposure with poor health and the benefits of smoke-free workplace legislation.

RECENT FINDINGS

Workplace SHS exposure continues to occur in many parts of the United States and around the world. Occupational SHS exposure has been linked to serious chronic health effects including lung cancer, cardiovascular disease, chronic obstructive pulmonary disease, and poor general health. Smoke-free workplace laws rapidly reduce workplace SHS exposure and improve respiratory health including symptoms and lung function. Smoke-free workplace legislation is also expected to reduce the chronic health effects of passive smoking, including cardiopulmonary disease and lung cancer.

SUMMARY

Occupational exposure to SHS has serious negative health consequences and will shorten lifespan. Smoke-free workplace legislation should be universally adopted around the world.

Smoking prevalence, cigarette consumption and advice received from physicians: Change between 1996 and 2006 in Geneva, Switzerland

OBJECTIVE

To assess change between 1996 and 2006 in smoking prevalence, cigarette consumption, quit attempts, motivation to quit and advice received from physicians in Geneva, Switzerland.

METHODS

Postal surveys in cross-sectional, representative samples of the general population of Geneva in 1996 and 2006.

RESULTS

There were 742 participants in 1996 (response rate 75%) and 1487 in 2006 (response rate 76%). Smoking prevalence remained stable between 1996 (28.0%, 95% confidence interval: 24.7 to 31.3%) and 2006 (26.5%, 24.3 to 28.7%, p=0.46). Among smokers, cigarette consumption fell from 15 to 13 cig./day between 1996 and 2006 (p=0.003). However, tobacco dependence, as measured by the Heaviness of Smoking Index, remained stable (mean=1.9 vs. 1.7, p=0.18). The proportion of smokers who made a 24-hour quit attempt in the previous year remained stable (29.2% in 1996, 32.1% in 2006, p=0.52), but more smokers reported that they intended to quit in the next 6 months in 2006 (39.6%) than in 1996 (29.1%, p=0.045). The association between smoking prevalence and income was stronger in 2006 (chi(2)=53.7, p<0.001) than in 1996 (chi(2)=10.9, p=0.012). In 2006 (no change since 1996), few smokers reported that, during their last medical visit, their physician told them to quit smoking (27.3%) or offered them help to quit (13.3%).

CONCLUSIONS

Over these 10 years, smoking prevalence, nicotine dependence levels and the frequency of quit attempts remained stable, but smokers' motivation to quit increased. We observed a growing social gap in smoking prevalence and cigarette consumption. Smoking cessation advice was seldom received during medical visits.