The Association Between Household Smoking Restrictions and Smoking Abstinence: Does Age Matter?

Smokefree home rules and cigarette smoking intensity among smokers in different stages of smoking cessation from 20 low-and-middle income countries

Smokefree environment created by smokefree policies is associated with smoking reduction; however, there is paucity of literature on the relationship between smokefree home rules and smoking intensity in low-and-middle income countries (LMICs), and how smokefree policy affects smoking behavior of smokers at different stages of smoking cessation. This study examined the relationship between smokefree home rules and average number of cigarettes smoked per day (CPD) among daily smokers at different stages of the transtheoretical model (TTM) of change. Data from 18,718 current daily cigarette smokers from the Global Adult Tobacco Survey (GATS) conducted from 2011 to 2017 in 20 LMICs were analyzed. Weighted multivariable linear regression analyses were conducted using the log of CPD as the outcome variable with smokefree home rules as the exposure variable, controlling for selected covariates. Approximately 15% of the participants were in precontemplation, 5% were in preparation, 15% lived in partial smokefree homes, and 30% lived in complete smokefree homes. The average number of CPD was 12.3, 12.0, and 10.6 among participants living in homes where smoking was allowed, partial smokefree homes, and complete smokefree homes, respectively. Compared to living in homes where smoking was allowed, living in complete smokefree homes were associated with 22.5% (95%CI = 18.4%-26.5%), 17.9% (95%CI = 8.4%-27.3%), and 29.3% (95% CI = 17.1%-41.5%) fewer CPD among participants in precontemplation, contemplation, and preparation stages, respectively. These findings suggest that complete smokefree home policy will benefit smokers in LMICs irrespective of their intention to quit smoking in addition to protecting non-smokers from secondhand smoke exposure.

Health Warnings, Smoking Rules, and Smoking Status: A Cross-National Comparison of Turkey and the United States

OBJECTIVES

This study aimed to compare the prevalence of smoking status (i.e., current, former and never) between the United States and Turkey in terms of age and gender, and examine how smoking rules and health warnings are associated with smoking status within and between the two countries.

METHODS

The study used data from the 2012-2013 National Adult Tobacco Survey (U.S. sample, N = 60,196) and the 2012 Global Adult Tobacco Survey (Turkey sample, N = 9,581). SAS PROC SURVEYLOGISTIC with a weighted variable was used to examine the associations between demographics (age, gender and education), smoking rules, health warnings, and smoking status within and between the two countries.

RESULTS

There was an 18% current smoking prevalence among U.S. sample, compared to 27% of the Turkey sample. The U.S. sample had a higher rate of former smoking compared to the Turkey sample (25% vs. 22%). In both countries, being older and male gender predicted former smoking while being younger and female gender predicted never smoking. Having seen a health warning, and not allowing smoking in the vehicle and home positively predicted former and never smoking status. Higher education predicted both smoking statuses in the U.S. only.

CONCLUSIONS

It is important to work with partners particularly in low- and middle-income countries (e.g., Turkey) to combat the global tobacco epidemic. In both counties, cessation endeavors should emphasize a comprehensive understanding of smoking status in terms of smoking rules in personal spaces and health warnings.

Smoke-free homes, smoking susceptibility and familial smoking among never-smoking high school students: a cross-sectional analysis

BACKGROUND

Research has shown that living in a smoke-free home has a positive effect on adolescents' perceived acceptance of smoking. However, the relationship between smoke-free homes and adolescent smoking behaviours remains unclear. The aim of this study was to examine the association between smoke-free homes and smoking susceptibility among high school students, and to determine whether these associations persist when analyses are stratified by familial smoking status.

METHODS

We conducted a random cross-sectional survey (2012/2013 Youth Smoking Survey) of primary, junior and high school students in Canada (n = 47 203). Multivariable logistic regression analyses were used to examine the associations between smoke-free homes and susceptibility to smoking among never-smoking high school students, with and without stratification by familial smoking.

RESULTS

Analyses showed that adolescents living in a smoke-free home had reduced odds of being susceptible to smoking (odds ratio [OR] 0.582, 95% confidence interval [CI] 0.428-0.791) compared with their peers living in households where smoking was permitted. When adolescents had other family members who were smokers, having a smoke-free home was not significantly associated with reduced smoking susceptibility (OR 0.878, 95% CI 0.721-1.071).

INTERPRETATION

Our results suggest that smoke-free homes may influence future smoking initiation. Optimal success in preventing youth smoking uptake necessitates having a coherent antismoking message between the home smoking environment and familial smoking behaviour.

Correlates of former smoking in patients with cerebrovascular disease: a cross-sectional study

OBJECTIVE

To identify multilevel correlates of former smoking in patients with cerebrovascular disease.

DESIGN

Secondary data analysis of the Canadian Community Health Survey.

METHODS

We used data from the 2007-2008 Canadian Community Health Survey (CCHS). Smoking status (former smoking vs smoker) was described by multilevel correlates of former smoking. A multilevel approach for variable selection for this study was used to understand how multiple levels in society can have an impact on former smoking. The study sample was selected from those respondents of the CCHS that reported they suffered from stroke symptoms. Logistic regression was used to predict former smoking in patients with cerebrovascular disease while controlling for multilevel confounders. Proportions were weighted to reflect the Canadian population.

RESULTS

There were 172 355 respondents who reported to suffer from stroke. From this sample, 36.5% were smokers and 63.5% were former smokers. Age groups 55-69 and 70-80 and higher education (secondary education +) were positively related to former smoking. Household and vehicle smoking restrictions significantly predicted former smoking. Counselling advice from a physician and having access to a general practitioner were correlates of former smoking. Finally, the use of buproprion was positively related to former smoking.

CONCLUSIONS

There are multilevel correlates of former smoking in smokers with reported stroke symptoms. These correlates include older age groups, higher education, household and vehicle smoking restrictions, pharmacotherapy use (bupropion), access to a general practitioner and counselling advice from a physician.