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Martini S, Artanti KD, Hargono A, Widati S, Ahsan A, Prabandari YS. Association between percentage of smokers and prevalence of smoking attributable morbidity in Indonesia: one decade after implementation of smoke-free area regulation. BMC Public Health 2022; 22:2202. [PMID: 36443727 PMCID: PMC9703741 DOI: 10.1186/s12889-022-14435-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/25/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND For more than ten years, Indonesia has health law, one of which states that local governments are mandated to establish Smoke Free Area (SFA). The results of 2018 National Basic Health Research shows tobacco consumption is still quite high and increasing compared to the results of 2007 and 2013 National Basic Health Research. The burden of disease in Indonesia is increasing every year. METHODS: This study aims to describe SFA regulation and analyze the relationship between the percentage of smokers and the prevalence of smoking attributable morbidity. Data from the 2018 Basic Health Research in Indonesia with the number of units of analysis were 514 districts and cities level. The design of the study was cross-sectional study. The variables analyzed were the percentage of smokers, the prevalence of diabetes, hypertension, upper respiratory tract infections (URTI), pneumonia, lung tuberculosis, asthma, and mental emotional disorders. Geographical mapping of the distribution of District/City with Smoking-Free Areas was made using QGIS 3·16. RESULTS: Around 72% of districts/cities in Indonesia already had local regulations of SFA after more than ten years implementation of the regulation of the health law. There was a significant relationship between the high percentage of smokers and the high prevalence of diabetes (p value: 0·000, PR: 1·342, 95%CI 1·135 to 1·587), hypertension (p value: 0·000, PR 1·631, 95%CI 1·252 to 2·124), and lung tuberculosis (p value: 0·008, PR 1·219, 95%CI 1·049 to 1·417) at the District/City level. However, there was no significant association between URTI, pneumonia, asthma, and mental emotional disorders. CONCLUSION The percentage of smokers in an area was associated with diabetes, hypertension, and lung tuberculosis. The implementation of Smoke Free Area should be evaluated.
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Affiliation(s)
- Santi Martini
- grid.440745.60000 0001 0152 762XDepartment of Epidemiology, Biostatistics, Population Studies and Health Promotion, Universitas Airlangga, Surabaya, Indonesia
| | - Kurnia Dwi Artanti
- grid.440745.60000 0001 0152 762XDepartment of Epidemiology, Biostatistics, Population Studies and Health Promotion, Universitas Airlangga, Surabaya, Indonesia
| | - Arief Hargono
- grid.440745.60000 0001 0152 762XDepartment of Epidemiology, Biostatistics, Population Studies and Health Promotion, Universitas Airlangga, Surabaya, Indonesia
| | - Sri Widati
- grid.440745.60000 0001 0152 762XDepartment of Epidemiology, Biostatistics, Population Studies and Health Promotion, Universitas Airlangga, Surabaya, Indonesia
| | - Abdillah Ahsan
- grid.9581.50000000120191471Faculty of Economics and Business, Universitas Indonesia, Jakarta, Indonesia
| | - Yayi Suryo Prabandari
- grid.8570.a0000 0001 2152 4506Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
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Ostrowska A, Jankowski M, Pinkas J. Public support for car smoking bans in Poland: a 2022 national cross-sectional survey. BMJ Open 2022; 12:e066247. [PMID: 36216427 PMCID: PMC9557322 DOI: 10.1136/bmjopen-2022-066247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The objectives of this study were to assess the prevalence of self-reported secondhand smoke exposure in cars among adults in Poland and to characterise public attitudes towards the implementation of the ban on smoking in cars with children. DESIGN Cross-sectional survey was carried out between 4 March 2022 and 7 March 2022 on a national sample of 1090 adult Polish residents. The questionnaire included 12 closed questions on smoking behaviours, secondhand smoke exposure as well as attitudes towards different smoke-free laws. PARTICIPANTS Data were obtained from 1090 individuals, aged 18-84 years, 52.6% were females. RESULTS Almost every fifth respondent (17.7%) declared secondhand smoke exposure in cars in the past 30 days (31.8% of smokers and 12.0% of non-smokers; p<0.001). Lack of the implementation of smoke-free home rules (aOR 2.92, 95% CI 1.99 to 4.29; p<0.001), age 18-29 years (aOR 2.06; 95% CI 1.16 to 3.67; p=0.01), current smoking (aOR 1.99, 95% CI 1.37 to 2.90; p<0.001) as well as bad financial situation (aOR 1.60, 95% CI 1.02 to 2.48; p=0.04) were significantly associated with the higher risk of secondhand smoke exposure in cars. Out of all respondents, 84.2% supported the implementation of the ban on smoking in cars with children. Out of 12 different sociodemographic factors, only the female gender (aOR 1.94, 95% CI 1.37 to 2.74) and being non-smokers (aOR 1.70. 95% CI 1.20 to 2.41; p=0.003) were significantly associated with the higher odds of supporting the implementation of the ban on smoking in cars with children. CONCLUSIONS This study showed high public support for the implementation of the ban on smoking in cars with children. Social support for smoke-free environments in Poland should be used by public health specialists and policy-makers to strengthen the national tobacco control act.
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Affiliation(s)
- Aurelia Ostrowska
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
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Song L, Luo X, Yang J. Feasibility and practicability studies of an evaluation
index system for implementation of smoke-free laws and
regulations of cities in China. Tob Induc Dis 2022; 20:13. [PMID: 35300050 PMCID: PMC8809369 DOI: 10.18332/tid/144244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 11/10/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The aim of the study is to adjust and improve the feasibility and practicability of an evaluation index system, developed for the implementation of smoke-free laws and regulations, by applying it to analyze and compare the contents and implementation of smoke-free laws and regulations in eight legislative cities in China. METHODS In regard to indicators of the established evaluation index system, data on tobacco control/smoke-free laws and regulations and their implementation in some legislative cities in China were collected, sorted, and compared, to examine and adjust the feasibility and practicality of the indicators. RESULTS The evaluation index system for implementation of smoke-free laws and regulations of cities in China has been adjusted to include 5 first-level indicators, including: 1) Simple, clear and executable legislation; 2) Careful planning and sufficient resources for law enforcement; 3) Participation of civil society; 4) Communication; and 5) Monitoring and evaluation of the implementation and impact of laws. There were 27 second-level indicators, including management department, scope of smoke-free places, requirements for non-smoking places etc. There were 27 third-level indicators, including construction of law enforcement, coordination network, work of coordination agencies, staffing situation etc. CONCLUSIONS The preliminary adjusted evaluation index system for the implementation of smoke-free laws and regulations of cities in China provides a reference and standardization for evaluating effectiveness of implementation of Chinese tobacco control laws and regulations.
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Affiliation(s)
- Lili Song
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaowei Luo
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Yang
- Chinese Center for Disease Control and Prevention, Beijing, China
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Tran LK, Morawska L, Gartner CE, Huong LTT, Le HHTC, Thai PK. Secondhand smoke in public places in Vietnam: An assessment 5 years after implementation of the tobacco control law. Tob Control 2021; 30:553-559. [PMID: 32862142 DOI: 10.1136/tobaccocontrol-2020-055753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study quantified the secondhand smoke (SHS) concentration in a sample of public places in Vietnam to determine changes in SHS levels 5 years after a public smoking ban was implemented. METHODS Two monitoring campaigns, one in 2013 (before the tobacco control law was implemented) and another in 2018 (5 years after the implementation of the law) were conducted in around 30 restaurants, cafeterias and coffee shops in major cities of Vietnam. Concentrations of PM2.5, as an indicator of SHS, were measured by portable particulate matter monitors (TSI SidePak AM510 and Air Visual Pro). RESULTS The geometric mean PM2.5 concentration of all monitored venues was 87.7 µg/m3 (83.7-91.9) in the first campaign and 55.2 µg/m3 (53.7-56.7) in the second campaign. Pairwise comparison showed the PM2.5 concentrations in the smoking observed area was triple and double those in the non-smoking area and the outdoor environment. After adjusting for sampling locations and times, the SHS concentration 5 years after the implementation of the tobacco control law reduced roughly 45%. CONCLUSION The study results indicate an improvement in air quality in public places in Vietnam via both the reduction in PM2.5 levels and the number of people observed smoking. However, greater enforcement of the free-smoke legislation is needed to eliminate SHS in public places in Vietnam.
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Affiliation(s)
- Long K Tran
- International Laboratory for Air Quality and Health, Science & Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Science & Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Coral E Gartner
- School of Public Health, University of Queensland, Herston, Queensland, Australia
- Queensland Alliance for Environmental Health Sciences, University of Queensland Faculty of Health and Behavioural Sciences, Woolloongabba, Queensland, Australia
| | - Le T T Huong
- Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Viet Nam
| | - Hong H T C Le
- Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Phong K Thai
- International Laboratory for Air Quality and Health, Science & Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
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Chen X, Gu X, Li T, Liu Q, Xu L, Peng B, Wu N. Factors influencing smoking behaviour of online ride-hailing drivers in China: a cross-sectional analysis. BMC Public Health 2021; 21:1326. [PMID: 34229627 PMCID: PMC8259384 DOI: 10.1186/s12889-021-11366-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 06/22/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Online ride-hailing is a fast-developing new travel mode. However, tobacco control policies on its drivers remain underdeveloped. This study aims to reveal the status and determine the influencing factors of ride-hailing drivers' smoking behaviour to provide a basis for the formulation of tobacco control policies. METHODS We derived our cross-sectional data from an online survey of full-time ride-hailing drivers in China. We used a survey questionnaire to collect variables, including sociodemographic and work-related characteristics, health status, health behaviour, health literacy and smoking status. Finally, we analysed the influencing factors of current smoking by conducting chi-square test and multivariate logistic regression. RESULTS A total of 8990 ride-hailing drivers have participated in the survey, in which 5024 were current smokers, accounting to 55.9%. Nearly one-third of smokers smoked in their cars (32.2%). The logistic regression analysis results were as follows: male drivers (OR = 0.519, 95% CI [0.416, 0.647]), central regions (OR = 1.172, 95% CI [1.049, 1.309]) and eastern regions (OR = 1.330, 95% CI [1.194, 1.480]), working at both daytime and night (OR = 1.287, 95% CI [1.164, 1.424]) and non-fixed time (OR = 0.847, 95% CI [0.718, 0.999]), ages of 35-54 years (OR = 0.585, 95% CI [0.408, 0.829]), current drinker (OR = 1.663, 95% CI [1.526, 1.813]), irregular eating habits (OR = 1.370, 95% CI [1.233, 1.523]), the number of days in a week of engaging in at least 10 min of moderate or vigorous exercise ≥3 (OR = 0.752, 95% CI [0.646, 0.875]), taking the initiative to acquire health knowledge occasionally (OR = 0.882, 95% CI [0.783, 0.992]) or frequently (OR = 0.675, 95% CI [0.591, 0.770]) and underweight (OR = 1.249, 95% CI [1.001, 1.559]) and overweight (OR = 0.846, 95% CI [0.775, 0.924]) have association with the prevalence of current smoking amongst online ride-hailing drivers. CONCLUSION The smoking rate of ride-hailing drivers was high. Sociodemographic and work-related characteristics and health-related factors affected their smoking behaviour. Psychological and behavioural interventions can promote smoking control management and encourage drivers to quit or limit smoking. Online car-hailing companies can also establish a complaint mechanism combined with personal credit.
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Affiliation(s)
- Xinlin Chen
- School of Public Health, Capital Medical University, No 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, China
| | - Xuefei Gu
- China National Health Development Research Center, Beijing, China
| | - Tingting Li
- China National Health Development Research Center, Beijing, China
| | - Qiaoyan Liu
- China Rehabilitation Research Center, Beijing, China
| | - Lirong Xu
- School of Public Health, Capital Medical University, No 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, China
| | - Bo Peng
- Institute of Medical Information, China Academy of Chinese Medical Sciences, Beijing, China
| | - Nina Wu
- School of Public Health, Capital Medical University, No 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, China
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Malheiro B, Teixeira PM, Alves L, Yaphe J, Correia de Sousa J. Mapping Portuguese Research on Respiratory Diseases in Primary Care: A systematic review. Pulmonology 2019; 25:186-190. [PMID: 30862427 DOI: 10.1016/j.pulmoe.2019.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 12/12/2018] [Accepted: 01/26/2019] [Indexed: 10/27/2022] Open
Affiliation(s)
- B Malheiro
- School of Medicine, University of Minho, Braga, Portugal
| | - P M Teixeira
- ICVS/3B's - PT Government Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Portugal.
| | - L Alves
- School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Portugal; St. André de Canidelo Family Health Unit, Vila Nova de Gaia, Portugal
| | - J Yaphe
- School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Portugal
| | - J Correia de Sousa
- School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Portugal; Horizonte Family Health Unit, Matosinhos, Porto, Portugal
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Wynne O, Guillaumier A, Twyman L, McCrabb S, Denham AMJ, Paul C, Baker AL, Bonevski B. Signs, Fines and Compliance Officers: A Systematic Review of Strategies for Enforcing Smoke-Free Policy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071386. [PMID: 30004425 PMCID: PMC6068603 DOI: 10.3390/ijerph15071386] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 11/16/2022]
Abstract
Background. Smoke-free environment policies limit or eliminate the use of smoke-producing tobacco in designated areas thereby reducing second hand smoke. Enforcement is perceived as critical to the successful adoption of a smoke-free policy. However, there is limited guidance available regarding effective enforcement strategies. A systematic review was conducted to examine the effectiveness of enforcement strategies at increasing compliance with and enforcement of smoke-free policies; and to determine circumstances other than enforcement strategies that are associated with compliance with smoke-free policies. Design. Medline, Medline in Process, The Cochrane Library, Embase, PsycInfo and CINAHL databases were searched using MeSH and keywords for relevant studies published between January 1980 and August 2017. A narrative synthesis and methodological quality assessment of included studies was undertaken. Results. Policy promotion and awareness-raising activities, signage, enforcement officers, and penalties for violations were the enforcement strategies most frequently cited as being associated with successful policy enforcement. Additionally, awareness of the laws, non-smoking management and lower staff smoking rates, and membership of a network guiding the policy enforcement contributed to higher compliance with smoke-free policies. Conclusions. There is weak evidence of the effectiveness of strategies associated with compliance with smoke-free policies. Given the evidence base is weak, well-designed trials utilizing appropriate evaluation designs are needed. Overall enforcement strategies associated with total smoke-free bans resulted in higher levels of compliance than strategies for policies that had only partial smoke-free bans.
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Affiliation(s)
- Olivia Wynne
- School of Medicine & Public Health, University of Newcastle, University Drive Callaghan, Callaghan, NSW 2308, Australia.
| | - Ashleigh Guillaumier
- School of Medicine & Public Health, University of Newcastle, University Drive Callaghan, Callaghan, NSW 2308, Australia.
| | - Laura Twyman
- School of Medicine & Public Health, University of Newcastle, University Drive Callaghan, Callaghan, NSW 2308, Australia.
- Tobacco Control Unit, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW 2011, Australia.
| | - Sam McCrabb
- School of Medicine & Public Health, University of Newcastle, University Drive Callaghan, Callaghan, NSW 2308, Australia.
| | - Alexandra M J Denham
- School of Medicine & Public Health, University of Newcastle, University Drive Callaghan, Callaghan, NSW 2308, Australia.
| | - Christine Paul
- School of Medicine & Public Health, University of Newcastle, University Drive Callaghan, Callaghan, NSW 2308, Australia.
| | - Amanda L Baker
- School of Medicine & Public Health, University of Newcastle, University Drive Callaghan, Callaghan, NSW 2308, Australia.
| | - Billie Bonevski
- School of Medicine & Public Health, University of Newcastle, University Drive Callaghan, Callaghan, NSW 2308, Australia.
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Female non-smokers' environmental tobacco smoking exposure by public transportation mode. Ann Occup Environ Med 2018; 30:24. [PMID: 29713477 PMCID: PMC5907694 DOI: 10.1186/s40557-018-0239-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/12/2018] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to analyze environmental tobacco smoking exposure in female nonsmokers by public transportation mode using representative data of Koreans. Methods Data from the Second Korean National Environmental Health Survey (2012–2014) were analyzed. Urine cotinine was analyzed by public transport behavior, secondhand smoke exposure, socioeconomic factors, and health-related factors. Participants were 1322 adult females; those with the top 75% urine cotinine concentrations were assigned to the high exposure group. A logistic regression analysis was performed considering appropriate weights and stratification according to the sample design of the Second Korean National Environmental Health Survey. Results The geometric mean of urine cotinine concentrations differed according to public transportation modes: subway (1.66 μg/g creatinine) bus (1.77 μg/g creatinine), and taxi (1.94 μg/g creatinine). The odds ratio [OR] was calculated for the high exposure group. The OR of the taxi (2.39; 95% confidence interval, 1.00–5.69) was statistically significantly higher than the subway value (reference), and marginally significant after adjusted with life style, sociodemographic factors and involuntary smoking frequency (2.42, 95% confidence interval, 0.97–6.04). Conclusions The odds ratio of passengers who mainly used taxis was marginally significantly higher than those of passengers who used subways and buses after adjusted with life style and sociodemographic factors. Implementation of supplementary measures and further studies on exposure to environmental tobacco smoking in taxis are warranted.
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Park EY, Lim MK, Hong SY, Oh JE, Jeong BY, Yun EH, Yang W, Lee DH. Towards smoke-free cars in the Republic of Korea: Evidence from environmental and biochemical monitoring of third-hand smoke exposure in taxis. Tob Induc Dis 2018; 16:11. [PMID: 31516411 PMCID: PMC6659503 DOI: 10.18332/tid/85089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/06/2018] [Accepted: 02/06/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION To evaluate the level of tobacco smoke exposure in taxis in Korea using tobacco specific environmental markers. METHODS From June to September 2012, cross-sectional measurements of air nicotine levels and dust nicotine-derived nitrosamine ketone (NNK) concentrations were conducted in 17 taxis in Goyang, Korea. Field investigators completed an observational questionnaire on building characteristics, smoking policies and evidence of smoking. Descriptive statistics including geometric means (GMs) ± standard deviations were produced for air nicotine levels and dust NNK concentrations. RESULTS There was no evidence of active smoking in the 17 taxis monitored, despite the fact that 10 drivers were current smokers. The overall GMs of air nicotine and dust NNK concentration were 0.42 μg/m3 and 6.78 pg/mg, respectively. These levels were 3.4-fold and 2.6-fold higher in taxis whose drivers were current smokers compared to the taxis of nonsmokers (GM of air nicotine: 0.65 μg/m3 vs 0.19 μg/m3; GM of dust NNK: 10.07 pg/mg vs 3.85 pg/mg). CONCLUSIONS The present study shows that air nicotine and dust NNK were detected in all taxis regardless of whether the taxi driver was smoking or not, which indicates the potential for exposure to SHS or THS. It suggests that an appreciable level of SHS and TSH exposure might occur if the environment is not completely smoke-free and enforcement is lacking. ABBREVIATIONS THS: third-hand smoke, SHS: second-hand smoke, FCTC: Framework Convention Alliance for Tobacco Control, NNK: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, LOD: limit of detection, GM: geometric mean, GSD: geometric standard deviation.
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Affiliation(s)
- Eun Young Park
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Min Kyung Lim
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Sun Yeol Hong
- Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang, Republic of Korea
| | - Jee Eun Oh
- Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang, Republic of Korea
| | - Bo Yoon Jeong
- Division of Health and Nutrition Survey, Korea Centers for Disease Control and Prevention, Ministry of Health and Welfare, Osong, Republic of Korea
| | - E Hwa Yun
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Wonho Yang
- Department of Occupational Health, Catholic University of Daegu, Daegu, Republic of Korea
| | - Do-Hoon Lee
- Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang, Republic of Korea
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Kuehnle D, Wunder C. The Effects of Smoking Bans on Self-Assessed Health: Evidence from Germany. HEALTH ECONOMICS 2017; 26:321-337. [PMID: 26749275 DOI: 10.1002/hec.3310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 11/09/2015] [Accepted: 12/01/2015] [Indexed: 06/05/2023]
Abstract
We examine the effects of smoking bans on self-assessed health in Germany taking into account heterogeneities by smoking status, gender and age. We exploit regional variation in the dates of enactment and dates of enforcement across German federal states. Using data from the German Socio-Economic Panel, our difference-in-differences estimates show that non-smokers' health improves, whereas smokers report no or even adverse health effects in response to bans. We find statistically significant health improvements especially for non-smokers living in households with at least one smoker. Non smokers' health improvements materialise largely with the enactment of smoking bans. Copyright © 2016 John Wiley & Sons, Ltd.
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Longitudinal Impact of the Smoking Ban Legislation in Acute Coronary Syndrome Admissions. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6956941. [PMID: 28265574 PMCID: PMC5318631 DOI: 10.1155/2017/6956941] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 12/22/2016] [Accepted: 01/17/2017] [Indexed: 02/02/2023]
Abstract
Background and Purpose. The association between smoking and CV has been proved; however smoking is still the first preventable cause of death in the EU. We aim to evaluate the potential impact of the smoke ban on the number of ACS events in the Portuguese population. In addition, we evaluate the longitudinal effects of the smoking ban several years after its implementation. Methods. We analyzed the admission rate for ACS before and after the ban using data from hospital admission. Monthly crude rate was computed, using the Portuguese population as the denominator. Data concerning the proportion of smokers among ACS patients were obtained from the NRACS. Interrupted time series were used to assess changes over time. Results. A decline of −5.8% was found for ACS crude rate after the smoking ban. The decreasing trend was observed even after years since the law. The effect of the ban was higher in men and for people over 65 years. The most significant reduction of ACS rate was found in Lisbon. Conclusions. Our results suggest that smoking ban is related to a decline in ACS admissions, supporting the importance of smoke legislation as a public health measure, contributing to the reduction of ACS rate.
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Ravara SB, Miranda N, Calheiros JM, Berteletti F, Joossens L. Tobacco control progress in Portugal: The need for advocacy and civil society leadership. REVISTA PORTUGUESA DE PNEUMOLOGIA 2014; 20:289-92. [PMID: 25310927 DOI: 10.1016/j.rppneu.2014.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 09/08/2014] [Accepted: 09/08/2014] [Indexed: 11/16/2022] Open
Affiliation(s)
- S B Ravara
- Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; CHCB University Hospital, Covilhã, Portugal.
| | - N Miranda
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - J M Calheiros
- Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; CHCB University Hospital, Covilhã, Portugal
| | | | - L Joossens
- Association of European Cancer Leagues, Belgian Foundation Against Cancer, Brussels, Belgium
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Ravara SB, Castelo-Branco M, Aguiar P, Calheiros JM. Are physicians aware of their role in tobacco control? A conference-based survey in Portugal. BMC Public Health 2014; 14:979. [PMID: 25239241 PMCID: PMC4177758 DOI: 10.1186/1471-2458-14-979] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 09/16/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The crucial role of physicians in tobacco control (TC) is widely recognized. In 2008, Portugal implemented a non-comprehensive smoke-free policy (SFP). In 2009, a conference-survey was carried out to explore Portuguese physicians' engagement in tobacco control, by evaluating the following: 1) attendance at TC training and awareness of training needs; 2) participation in TC activities; 3) attitudes and beliefs regarding SFPs. METHODS Questionnaire-based cross-sectional study conducted during two major national medical conferences targeting GPs, hospitalists, and students/recent graduates. Descriptive analysis and logistic regression were performed. RESULTS Response rate was 63.7% (605/950). Of the 605 participants, 58.3% were GPs, 32.4% hospitalists, 9.3% others; 62.6% were female; mean age was 39.0 ± 12.9 years. Smoking prevalence was 29.2% (95% CI: 23.3-35.1) in males; 15.8% (95% CI: 12.1-19.5) in females, p < 0.001. While the overwhelming majority of physicians strongly agreed that second-hand smoke (SHS) endangers health, awareness of SFP benefits and TC law was limited, p < 0.001. A significant minority (35.5%) believed that SHS can be eliminated by ventilation systems. Most physicians lacked training; only a minority (9.0%) participated regularly in TC. Training was the most consistent predictor of participation in TC. General agreement with SFP was high; but significantly lower for indoor leisure settings, outdoors bans in healthcare/schools settings and smoking restrictions in the home/car, p < 0.001. Smoking behaviour strongly predicted support for smoking restrictions in restaurants and bars/discos, healthcare outdoors and private settings. CONCLUSIONS The findings suggest that Portuguese physicians are not aware of their role in tobacco control. Poor engagement of physicians in TC may contribute to the current lack of comprehensive policies in Portugal and Europe and undermine social norm change. Medical and professional continuing education on tobacco control should be made top priorities.
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Affiliation(s)
- Sofia B Ravara
- />Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilha, Portugal
- />CHCB University Hospital, Quinta do Alvito, 6200-251 Covilha, Portugal
| | - Miguel Castelo-Branco
- />Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilha, Portugal
- />CHCB University Hospital, Quinta do Alvito, 6200-251 Covilha, Portugal
| | - Pedro Aguiar
- />National School of Public Health, New University of Lisbon, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
| | - Jose M Calheiros
- />Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilha, Portugal
- />National Institute of Health Doutor Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
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Towards a 100% smoke-free Portugal: no more delays. REVISTA PORTUGUESA DE PNEUMOLOGIA 2014; 20:282-3. [PMID: 25106112 DOI: 10.1016/j.rppneu.2014.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 06/15/2014] [Indexed: 11/23/2022] Open
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15
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Complete workplace indoor smoking ban and smoking behavior among male workers and female nonsmoking workers' husbands: a pseudo cohort study of Japanese public workers. BIOMED RESEARCH INTERNATIONAL 2014; 2014:303917. [PMID: 24783199 PMCID: PMC3982281 DOI: 10.1155/2014/303917] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 02/21/2014] [Indexed: 11/17/2022]
Abstract
A pseudo cohort study using national cross-sections (2001, 2004, 2007, and 2010) was conducted to examine differences in smoking prevalence under different smoking ban policies such as a complete workplace indoor smoking ban (early or recent implementation) and a partial smoking ban among male public workers and husbands of female nonsmoking public workers. The effectiveness of smoking bans was estimated by difference-in-differences (DID) with age group stratification. The results varied considerably by age and implementation period. Although DID estimates (positive value of DID estimate represents smoking cessation percentage) for both smoking bans on total male smoking were not significant, the over-40 age group indicated a significant DID estimate of 5.0 (95% CI: 0.2, 9.8) for the recent smoking ban. For female workers' husbands' smoking, the over-40 age group indicated positive, but not significant, DID estimates for the early and recent smoking bans of 7.2 (-4.7, 19.2) and 8.4 (-2.0, 18.7), respectively. A complete indoor workplace smoking ban, particularly one recently implemented among public office workers aged over 40, may reduce male workers' smoking and female workers' husbands' smoking compared with a partial smoking ban, but the conclusion remains tentative because of methodological weaknesses in the study.
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16
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The association of tobacco control policies and the risk of acute myocardial infarction using hospital admissions data. PLoS One 2014; 9:e88784. [PMID: 24520421 PMCID: PMC3919809 DOI: 10.1371/journal.pone.0088784] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 01/13/2014] [Indexed: 11/19/2022] Open
Abstract
Objective To evaluate the association of a nationwide comprehensive smoking ban (CSB) and tobacco tax increase (TTI) on the risk of acute myocardial infarctions (AMI) in Panama for the period of 2006 – 2010 using hospital admissions data. Methods Data of AMI cases was gathered from public and private hospitals in the country for the period of January 1, 2006 to December 31, 2010. The number of AMI cases was calculated on a monthly basis. The risk of AMI was estimated for the pre-CSB period (January 2006 to April 2008) and was used as a reference point. Three post-intervention periods were examined: (1) post-CSB from May 2008 to April 2009 (12 months); (2) post-CSB from May 2009 to November 2009 (7 months); and (3) post-TTI from December 2009 to December 2010 (13 months). Relative risks (RR) of AMI were estimated for each post intervention periods by using a Poisson regression model. Mortality registries for the country attributed to myocardial infarction (MI) were obtained from January 2001 to December 2012. The annual percentage change (APC) of the number of deaths from MI was calculated using Joinpoint regression analysis. Results A total sample size of 2191 AMI cases was selected (monthly mean number of cases 36.52±8.24 SD). Using the pre-CSB as a reference point (RR = 1.00), the relative risk of AMI during the first CSB period, the second CSB period and post-TTI were 0.982, 1.049, and 0.985, respectively. The APC of deaths from MI from January 2001 to April 2008 was 0.5%. From January 2001 to June 2010 the APC trend was 0.47% and from July 2010 to December 2012 the APC was –0.3%. Conclusions The implementation of a CSB and TTI in Panama were associated with a decrease in tobacco consumption and a reduction of the RR of AMI.
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Schoretsaniti S, Filippidis FT, Vardavas CI, Tzavara C, Dimitrakaki C, Behrakis P, Connolly GN, Tountas Y. Prevalence and determinants of SHS exposure in public and private areas after the 2010 smoke-free legislation in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2013; 24:401-411. [PMID: 24044769 DOI: 10.1080/09603123.2013.835033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The objective of the present survey was to assess the extent and socio-economic determinants of population exposure to secondhand smoke (SHS) in Greece in 2011. The national household survey Hellas Health IV was conducted in October 2011. SHS exposure was based on self-reported exposure within home, workplace and public places. Thirty-three per cent of the respondents reported living in a smoke-free home. Smokers (p < 0.001) and single individuals (p < 0.017) were less likely to prohibit smoking at home. SHS exposure at work, in restaurants and in bars/clubs/cafes was frequently mentioned by 41.6, 84.2 and 90.5%, respectively. SHS exposure in a bar/club/cafe was noted more among single individuals (p = 0.004) and those aged 18-34 years (p = 0.007). Inhabitants of rural areas were more likely to report someone smoking indoors in all the above venues. Public health education and effective enforcement of the nationwide smoke-free legislation are imperative.
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Affiliation(s)
- Sotiria Schoretsaniti
- a Department of Hygiene, Epidemiology and Medical Statistics , National and Kapodistrian University of Athens , Athens , Greece
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