1
|
Boderie NW, Ennissay S, Ijzelenberg W, van Lenthe FJ, Baars J, Been JV. Public support for smoke-free private indoor and public outdoor areas in the Netherlands: A trend analysis from 2018-2022. Tob Induc Dis 2024; 22:TID-22-12. [PMID: 38235256 PMCID: PMC10792619 DOI: 10.18332/tid/176141] [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: 09/27/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION In addition to smoke-free policies in indoor public and workplaces, governments increasingly implement smoke-free policies at beaches, in parks, playgrounds and private cars ('novel smoke-free policies'). An important element in the implementation of such policies is public support. In the context of the ambition of the Netherlands to reach a smoke-free generation by 2040, we investigated temporal changes in public support for novel smoke-free policies. METHODS We analyzed annual cross-sectional questionnaires in a representative sample of the Dutch population from 2018 to 2022. Multivariable logistic regression was applied to model public support for each smoke-free policy area as a function of time (calendar year), smoking status, gender, and socioeconomic status. Interaction terms were added for time with smoking status and with socioeconomic status. RESULTS A total of 5582 participant responses were included. Between 2018 and 2022, support increased most for smoke-free policies regarding train platforms (+16%), theme parks (+12%), beaches (+10%), and terraces (+10%). In 2022, average support was higher than 65% for all categories of smoke-free places and highest for private cars with children (91%). Regression analyses indicated significant increases in support over time within each category of smoke-free places (adjusted odds ratio, AOR between 1.09 and 1.17 per year), except smoke-free private cars with children (AOR=0.97; 95% CI: 0.89-1.05). Regardless of smoking status, support was high for places where children often go. CONCLUSIONS Support for novel smoke-free places in the Netherlands is high and increasing, in particular for places frequented by children. This indicates the potential to implement such measures in the Netherlands.
Collapse
Affiliation(s)
- Nienke W. Boderie
- Department of Public Health, Erasmus MC Rotterdam, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sabri Ennissay
- Department of Public Health, Erasmus MC Rotterdam, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wilhelmina Ijzelenberg
- Amsterdam Public Health Research Institute, Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank J. van Lenthe
- Department of Public Health, Erasmus MC Rotterdam, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jessica Baars
- Health Funds for a Smokefree Netherlands, Utrecht, the Netherlands
| | - Jasper V. Been
- Department of Public Health, Erasmus MC Rotterdam, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Obstetrics and Gynaecology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
| |
Collapse
|
2
|
Boderie NW, Sheikh A, Lo E, Sheikh A, Burdorf A, van Lenthe FJ, Mölenberg FJ, Been JV. Public support for smoke-free policies in outdoor areas and (semi-)private places: a systematic review and meta-analysis. EClinicalMedicine 2023; 59:101982. [PMID: 37256097 PMCID: PMC10225670 DOI: 10.1016/j.eclinm.2023.101982] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 06/01/2023] Open
Abstract
Background Smoke-free policies are essential to protect people against tobacco smoke exposure. To successfully implement smoke-free policies that go beyond enclosed public places and workplaces, public support is important. We undertook a comprehensive systematic review of levels and determinants of public support for indoor (semi-)private and outdoor smoke-free policies. Methods In this systematic review and meta-analysis, six electronic databases were searched for studies (published between 1 January 2004 and 19 January 2022) reporting support for (semi-)private and outdoor smoke-free policies in representative samples of at least 400 respondents aged 16 years and above. Two reviewers independently extracted data and assessed risk of bias of individual reports using the Mixed Methods Appraisal Tool. The primary outcome was proportion support for smoke-free policies, grouped according to location covered. Three-level meta-analyses, subgroup analyses and meta-regression were performed. Findings 14,749 records were screened, of which 107 were included; 42 had low risk of bias and 65 were at moderate risk. 99 studies were included in the meta-analyses, reporting 326 measures of support from 896,016 individuals across 33 different countries. Support was pooled for indoor private areas (e.g., private cars, homes: 73%, 95% confidence interval (CI): 66-79), indoor semi-private areas (e.g., multi-unit housing: 70%, 95% CI: 48-86), outdoor hospitality areas (e.g., café and restaurant terraces: 50%, 95% CI: 43-56), outdoor non-hospitality areas (e.g., school grounds, playgrounds, parks, beaches: 69%, 95% CI: 64-73), outdoor semi-private areas (e.g., shared gardens: 67%, 95% CI: 53-79) and outdoor private areas (e.g., private balconies: 41%, 95% CI: 18-69). Subcategories showed highest support for smoke-free cars with children (86%, 95% CI: 81-89), playgrounds (80%, 95% CI: 74-86) and school grounds (76%, 95% CI: 69-83). Non-smokers and ex-smokers were more in favour of smoke-free policies compared to smokers. Support generally increased over time, and following implementation of each smoke-free policy. Interpretation Our findings suggested that public support for novel smoke-free policies is high, especially in places frequented by children. Governments should be reassured about public support for implementation of novel smoke-free policies. Funding Dutch Heart Foundation, Lung Foundation Netherlands, Dutch Cancer Society, Dutch Diabetes Research Foundation and Netherlands Thrombosis Foundation.
Collapse
Affiliation(s)
- Nienke W. Boderie
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Asiyah Sheikh
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - Erika Lo
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Alex Burdorf
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Frank J. van Lenthe
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Famke J.M. Mölenberg
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Jasper V. Been
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Division of Neonatology, Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Obstetrics and Gynaecology, Erasmus MC Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
| |
Collapse
|
3
|
Farley SM, Jasek J, Debchoudhury I, Van Beck K, Talati A, Perlman SE, Thorpe LE. Housing type and secondhand tobacco smoke exposure among non-smoking New York City adults, 2004 and 2013–14. Prev Med Rep 2022; 27:101805. [PMID: 35656213 PMCID: PMC9152802 DOI: 10.1016/j.pmedr.2022.101805] [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: 12/11/2021] [Revised: 03/09/2022] [Accepted: 04/18/2022] [Indexed: 11/27/2022] Open
Abstract
Assessed association between housing type and cotinine level among non-smokers. Secondhand smoke exposure among New York City non-smokers has declined overtime. Odds of elevated cotinine doubled when living in multiunit housing in 2013/14.
Secondhand tobacco smoke (SHS) exposure has declined due to smoking reductions, expanding workplace and public smoke-free air laws, and smoke-free housing policy promotion. Population-based studies examining objective SHS exposure biomarkers have documented reductions over time, however non-smoking urban adults are more likely to have elevated cotinine (a metabolite of nicotine) compared with national averages. Evidence suggests residential housing type may impact urban SHS exposure risk. Direct associations between multiunit housing (MUH) and elevated cotinine have been identified among children but not yet examined among adults. We used data from the cross-sectional 2004 and 2013/14 New York City Health and Nutrition Examination Surveys to investigate associations between MUH (single-family versus 2; 3–99; and 100 + units) and likelihood of elevated serum cotinine among nonsmoking adults (2004: n = 1324; 2013/14: n = 946), adjusting for socio-demographics (sex, age, race/ethnicity, education, income) and self-reported SHS exposure variables. Combined and single-year adjusted multivariable regressions were conducted. Elevated cotinine was defined as a serum level of ≥ 0.05 ng/ml. Combined year adjusted multivariable regression analyses found no difference in elevated cotinine by housing type among non-smoking adults. By survey year, elevated cotinine did not vary by housing type in 2004, while non-smoking adults in 3–99 unit buildings were twice as likely to have elevated cotinine compared with single family residents in 2013/14 (adjusted Odds Ratio = 2.55 (1.13, 5.79)). While SHS exposure has declined, relative burden may be increasing among MUH residents. In urban settings with extensive MUH, attention to housing-based policies and programmatic interventions is critical to reducing SHS exposure.
Collapse
Affiliation(s)
- Shannon M. Farley
- New York City Department of Health and Mental Hygiene, New York, NY, USA
- Corresponding author at: Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, 42-09 28th St, Long Island City, NY 11101, USA.
| | - John Jasek
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | | | - Kellie Van Beck
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Achala Talati
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Sharon E. Perlman
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | | |
Collapse
|
4
|
Blake KD, Gaysynsky A, Mayne RG, Seidenberg AB, Kaufman A, D'Angelo H, Roditis M, Vollinger RE. U.S. public opinion toward policy restrictions to limit tobacco product placement and advertising at point-of-sale and on social media. Prev Med 2022; 155:106930. [PMID: 34954242 PMCID: PMC8896313 DOI: 10.1016/j.ypmed.2021.106930] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 02/03/2023]
Abstract
The Family Smoking Prevention and Tobacco Control Act granted the U.S. Food and Drug Administration authority to regulate tobacco advertising and promotion, including at the retail level, and preserved state, tribal, and local tobacco advertising and promotion authorities. Public health experts have proposed prohibiting point-of-sale tobacco advertisements and product displays, among other tobacco advertising restrictions. We examined the prevalence and correlates of public support, opposition, and neutrality toward proposed tobacco product placement and advertising restrictions at point-of-sale and on social media utilizing the National Cancer Institute's 2020 Health Information National Trends Survey (HINTS) (N = 3865), a cross-sectional, probability-based postal survey of U.S. addresses conducted from Feb 24, 2020 to June 15, 2020 (Bethesda, MD). Frequencies and unadjusted, weighted proportions were calculated for support, neutrality, and opposition toward the three policies under study, and weighted, adjusted multivariable logistic regression was employed to examine predictors of neutrality and opposition. Tests of significance were conducted at the p < 0.05 level. Sixty-two percent of U.S. adults supported a policy prohibiting tobacco product advertising on social media; 55% supported a policy restricting the location of tobacco product advertising at point-of-sale; and nearly 50% supported a policy to keep tobacco products out of view at the checkout counter. Neutrality and opposition varied by sociodemographic characteristics including age, sex, education, rurality, and presence of children in the household. Understanding public opinion toward tobacco product placement and advertising restrictions may inform policy planning and implementation.
Collapse
Affiliation(s)
- Kelly D Blake
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
| | - Anna Gaysynsky
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA; ICF Next, Rockville, MD, USA
| | - Rachel Grana Mayne
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Andrew B Seidenberg
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Annette Kaufman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Heather D'Angelo
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Maria Roditis
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Robert E Vollinger
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| |
Collapse
|
5
|
Grunseit AC, Howse E, Bohn-Goldbaum E, Mitchell J, Bauman AE. Changes in Australian community perceptions of non-communicable disease prevention: a greater role for government? BMC Public Health 2021; 21:2094. [PMID: 34781923 PMCID: PMC8591602 DOI: 10.1186/s12889-021-12159-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/02/2021] [Indexed: 12/03/2022] Open
Abstract
Background Monitoring trends in community opinion can identify critical opportunities to implement upstream health policies or interventions. Our study examines change and demographic modifiers of change in community perceptions of government intervention for prevention of lifestyle-related chronic disease across two time points in Australia. Methods Data were drawn from the 2016 (n = 2052) and 2018 (n = 2601) waves of a nationally representative cross-sectional telephone survey, ‘AUSPOPS’. Survey questions gauged perceptions of government intervention for health in general, peoples’/organizations’ role in maintaining health (e.g., parents, government) and support for specific health interventions (e.g., taxing soft drink). Bivariate and multivariate regression models tested for change between the two surveys, adjusted for demographic characteristics. Models with interactions between survey wave and demographic variables tested for differential change. One-tailed variance ratio tests examined whether opinions had become more polarized in 2018 compared with 2016. Results The large, significant increase observed in the perceived size of the role that government has in maintaining people’s health was uniform across demographic subpopulations. The role for employers and private health insurers was also perceived to be larger in 2018 compared with 2016, but the degree of change varied by gender, age and/or socioeconomic status. Support for some government interventions (e.g., taxing soft drinks) increased among specific demographic subgroups whilst exhibiting no overall change. Opinion was more polarized on general attitudes to government intervention for population health in 2018 compared to 2016, despite little change in central tendency. Conclusions Opportunities may exist to implement government health-promoting policies (e.g., taxing soft drinks), although advocacy may be needed to address the concerns of less supportive subpopulations. Attitudes on government intervention in general may be becoming more polarized; future research examining the association of such changes with exposure to different information sources could inform communication strategies for future health policy change. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12159-9.
Collapse
Affiliation(s)
- Anne C Grunseit
- The Australian Prevention Partnership Centre, Prevention Research Collaboration, Sydney School of Public Health, Level 6, Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Eloise Howse
- The Australian Prevention Partnership Centre, The Sax Institute, Level 3, 30C Wentworth St, Glebe, NSW, 2037, Australia
| | - Erika Bohn-Goldbaum
- The Australian Prevention Partnership Centre, Prevention Research Collaboration, Sydney School of Public Health, Level 6, Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Jo Mitchell
- The Australian Prevention Partnership Centre, The Sax Institute, Level 3, 30C Wentworth St, Glebe, NSW, 2037, Australia
| | - Adrian E Bauman
- The Australian Prevention Partnership Centre, Prevention Research Collaboration, Sydney School of Public Health, Level 6, Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia
| |
Collapse
|
6
|
Honeycutt A, Bradley C, Khavjou O, Yarnoff B, Soler R, Orenstein D. Simulated impacts and potential cost effectiveness of Communities Putting Prevention to Work: Tobacco control interventions in 21 U.S. communities, 2010-2020. Prev Med 2019; 120:100-106. [PMID: 30659909 DOI: 10.1016/j.ypmed.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 12/24/2018] [Accepted: 01/15/2019] [Indexed: 10/27/2022]
Abstract
In 2010, the Centers for Disease Control and Prevention (CDC) funded communities to implement policy, systems, and environmental (PSE) changes under the Communities Putting Prevention to Work (CPPW) program to make it easier for people to make healthier choices to prevent chronic disease. Twenty-one of 50 funded communities implemented interventions intended to reduce tobacco use. To examine the potential cost-effectiveness of tobacco control changes implemented under CPPW from a healthcare system perspective, we compared program cost estimates with estimates of potential impacts. We used an existing simulation model, the Prevention Impacts Simulation Model (PRISM), to estimate the potential cumulative impact of CPPW tobacco interventions on deaths and medical costs averted through 2020. We collected data on the costs to implement CPPW tobacco interventions from 2010 to 2013. We adjusted all costs to 2010 dollars. CPPW tobacco interventions cost $130.5 million across all communities, with an average community cost of $6.2 million. We found $735 million in potentially averted medical costs cumulatively from 2010 through 2020 because of the CPPW-supported interventions. If the CPPW tobacco control PSE changes are sustained through 2020 without additional funding after 2013, we find that medical costs averted will likely exceed program costs by $604 million. Our results suggest that the medical costs averted through 2020 may more than offset the initial investment in CPPW tobacco control interventions, implying that such interventions may be cost saving, especially over the long term.
Collapse
Affiliation(s)
| | | | - Olga Khavjou
- RTI International, Research Triangle Park, NC, USA
| | | | - Robin Soler
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Diane Orenstein
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
7
|
Laverty AA, Filippidis FT, Fernandez E, Vardavas CI. E-cigarette use and support for banning e-cigarette use in public places in the European Union. Prev Med 2017; 105:10-14. [PMID: 28823683 DOI: 10.1016/j.ypmed.2017.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/26/2017] [Accepted: 08/14/2017] [Indexed: 10/19/2022]
Abstract
We investigated the factors associated with support for banning e-cigarette use in public places in the European Union (EU) and how this varies by socio-demographic determinants, use of tobacco, ever use of e-cigarettes and their perceived harm. Data are from the representative Special Eurobarometer for Tobacco survey performed in 2014 (n=27,801) in 28 EU member states. Analyses were conducted separately by tobacco use status (never, current, and former smokers) and e-cigarette experimentation status. 70.9% of never smokers, 63.1% of former smokers and 45.7% of current smokers in the EU supported a ban on the use of e-cigarettes in public places. In all groups, support for banning e-cigarettes in public places was lower among those who had experimented with e-cigarettes (adjusted odds ratios (aOR) 0.43 vs. 0.50 vs. 0.61, among never, current and former smokers respectively) and higher among those who perceived e-cigarettes as harmful (aORs 2.49 vs 2.35 vs. 2.40, among never, current and former smokers respectively). 40.5% of those who had experimented with e-cigarettes supported a ban on use in public places, although levels of support were lower among those who started using e-cigarettes in order to circumvent existing smoking bans (aOR 0.54, 95% Confidence Interval 0.45-0.64). Bans of e-cigarette use in public places in Europe have high levels of public support even among former and current tobacco smokers, although this does vary across population groups. As legislators consider approaches to e-cigarette use, public opinion is likely to become more important to the passing and enforcement of any legislation.
Collapse
Affiliation(s)
- Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, United Kingdom.
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom
| | - Esteve Fernandez
- Tobacco Control Unit, WHO Collaborating Center for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Catalonia, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Catalonia, Barcelona, Spain
| | | |
Collapse
|
8
|
Mader EM, Lapin B, Cameron BJ, Carr TA, Morley CP. Update on Performance in Tobacco Control: A Longitudinal Analysis of the Impact of Tobacco Control Policy and the US Adult Smoking Rate, 2011-2013. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 22:E29-35. [PMID: 26618847 PMCID: PMC5035147 DOI: 10.1097/phh.0000000000000358] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
CONTEXT Tobacco use remains the leading cause of preventable death in the United States. States and municipalities have instituted a variety of tobacco control measures (TCMs) to address the significant impact tobacco use has on population health. The American Lung Association annually grades state performance of tobacco control using the State of Tobacco Control grading framework. OBJECTIVE To gain an updated understanding of how recent efforts in tobacco control have impacted tobacco use across the United States, using yearly State of Tobacco Control TCM assessments. DESIGN The independent TCM variables of smoke-free air score, cessation score, excise tax, and percentage of recommended funding were selected from the American Lung Association State of Tobacco Control reports. Predictors of adult smoking rates were determined by a mixed-effects model. SETTING/PARTICIPANTS The 50 US states and District of Columbia. MAIN OUTCOME MEASURE Adult smoking rate in each state from 2011 to 2013. RESULTS The average adult smoking rate decreased significantly from 2011 to 2013 (21.3% [SD: 3.5] to 19.3% [SD: 3.5], P = .016). All forms of TCMs varied widely in implementation levels across states. Excise taxes (β = -.812, P = .006) and smoke-free air regulations (β = -.057, P = .008) were significant, negative predictors of adult smoking. Cessation services (β = .015, P = .46) did not have a measurable effect on adult smoking. CONCLUSION Tobacco control measures with the strongest influence on adult smoking include the state excise tax and state smoke-free air regulations. The lack of robust funding for tobacco cessation services across the majority of US states highlights an important shortfall in current tobacco control policy.
Collapse
Affiliation(s)
- Emily M. Mader
- Departments of Family Medicine (Mss Mader and Cameron and Dr Morley), Public Health and Preventive Medicine (Ms Cameron and Dr Morley), and Psychiatry (Dr Morley), SUNY Upstate Medical University, Syracuse, New York; Research Institute, Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, Illinois (Dr Lapin); and American Lung Association National Headquarters, Washington, District of Columbia (Mr Carr)
| | - Brittany Lapin
- Departments of Family Medicine (Mss Mader and Cameron and Dr Morley), Public Health and Preventive Medicine (Ms Cameron and Dr Morley), and Psychiatry (Dr Morley), SUNY Upstate Medical University, Syracuse, New York; Research Institute, Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, Illinois (Dr Lapin); and American Lung Association National Headquarters, Washington, District of Columbia (Mr Carr)
| | - Brianna J. Cameron
- Departments of Family Medicine (Mss Mader and Cameron and Dr Morley), Public Health and Preventive Medicine (Ms Cameron and Dr Morley), and Psychiatry (Dr Morley), SUNY Upstate Medical University, Syracuse, New York; Research Institute, Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, Illinois (Dr Lapin); and American Lung Association National Headquarters, Washington, District of Columbia (Mr Carr)
| | - Thomas A. Carr
- Departments of Family Medicine (Mss Mader and Cameron and Dr Morley), Public Health and Preventive Medicine (Ms Cameron and Dr Morley), and Psychiatry (Dr Morley), SUNY Upstate Medical University, Syracuse, New York; Research Institute, Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, Illinois (Dr Lapin); and American Lung Association National Headquarters, Washington, District of Columbia (Mr Carr)
| | - Christopher P. Morley
- Departments of Family Medicine (Mss Mader and Cameron and Dr Morley), Public Health and Preventive Medicine (Ms Cameron and Dr Morley), and Psychiatry (Dr Morley), SUNY Upstate Medical University, Syracuse, New York; Research Institute, Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, Illinois (Dr Lapin); and American Lung Association National Headquarters, Washington, District of Columbia (Mr Carr)
| |
Collapse
|
9
|
National and State-Specific Attitudes toward Smoke-Free Parks among U.S. Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13090864. [PMID: 27589779 PMCID: PMC5036697 DOI: 10.3390/ijerph13090864] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 07/31/2016] [Accepted: 08/26/2016] [Indexed: 11/17/2022]
Abstract
Outdoor places, such as parks, remain a source of secondhand smoke (SHS) exposure. We assessed attitudes toward smoke-free parks among U.S. adults. Data came from the 2009-2010 National Adult Tobacco Survey, a landline and cellular telephone survey of noninstitutionalized adults aged ≥18 in the 50 U.S. states and D.C. Descriptive statistics and logistic regression were used to assess the prevalence and sociodemographic correlates of attitudes toward smoke-free parks, overall and by current tobacco use. Overall, 38.5% of adults reported favorable attitudes toward complete smoke-free parks; prevalence ranged from 29.2% in Kentucky to 48.2% in Maine. Prevalence of favorable attitudes toward smoke-free parks was higher among nonusers of tobacco (44.6%) and noncombustible-only users (30.0%) than any combustible users (21.3%). The adjusted odds of having a favorable attitude were higher among: women; Hispanics and Black non-Hispanics, American Indian and Alaska Native non-Hispanics, and other non-Hispanics; those with an unspecified sexual orientation; and those with children aged ≤17 in the household, relative to each characteristics respective referent group. Odds were lower among: any combustible tobacco and noncombustible-only tobacco users; adults aged 45-64; and those with some college or an undergraduate degree. Opportunities exist to educate the public about the benefits of smoke-free outdoor environments.
Collapse
|
10
|
Thomson G, Wilson N, Collins D, Edwards R. Attitudes to smoke-free outdoor regulations in the USA and Canada: a review of 89 surveys. Tob Control 2015; 25:506-16. [DOI: 10.1136/tobaccocontrol-2015-052426] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/25/2015] [Indexed: 11/03/2022]
|
11
|
Agaku IT, Filippidis FT, Vardavas CI. Effectiveness of text versus pictorial health warning labels and predictors of support for plain packaging of tobacco products within the European Union. Eur Addict Res 2015; 21:47-52. [PMID: 25402440 DOI: 10.1159/000366019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 07/17/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Tobacco product warning labels are a key health communication medium with plain packaging noted as the next step in the evolution of tobacco packaging. We assessed the self-reported impact of text versus pictorial health warnings and the determinants of support for plain packaging of tobacco products in the European Union (EU). METHODS The Special Eurobarometer 385 survey was analyzed for 26,566 adults from 27 EU countries in 2012. The self-reported impact of warning labels (text or pictorial) and determinants of EU-wide support for plain packaging were assessed using multivariate logistic regression. RESULTS Current smokers in countries where cigarette pictorial warnings were implemented had higher odds of reporting that health warning labels had any effect on their smoking behavior (making a quit attempt or reducing number of cigarettes smoked per day) compared to respondents in countries with text-only warning labels (adjusted odds ratio, aOR = 1.31; 95% confidence interval, 95% CI: 1.10-1.56). Population support for plain packaging of tobacco packs was higher in countries where cigarette pictorial warnings already existed (aOR = 1.17; 95% CI: 1.07-1.28). CONCLUSIONS These findings indicate that the implementation of pictorial warnings at an EU level may have a positive behavioral impact among smokers and pave the way for population support for plain packaging in the EU.
Collapse
Affiliation(s)
- Israel T Agaku
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Mass., USA
| | | | | |
Collapse
|