Achieving Smoke-Free Mental Health Services: Lessons from the Past Decade of Implementation Research

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Jonathan Campion

2013-09-01

Full Text Available The culture of smoking by patients and staff within mental health systems of care has a long and entrenched history. Cigarettes have been used as currency between patients and as a patient management tool by staff. These settings have traditionally been exempt from smoke-free policy because of complex held views about the capacity of people with mental disorder to tolerate such policy whilst they are acutely unwell, with stakeholders’ continuing fierce debate about rights, choice and duty of care. This culture has played a significant role in perpetuating physical, social and economic smoking associated impacts experienced by people with mental disorder who receive care within mental health care settings. The past decade has seen a clear policy shift towards smoke-free mental health settings in several countries. While many services have been successful in implementing this change, many issues remain to be resolved for genuine smoke-free policy in mental health settings to be realized. This literature review draws on evidence from the international published research, including national audits of smoke-free policy implementation in mental health units in Australia and England, in order to synthesise what we know works, why it works, and the remaining barriers to smoke-free policy and how appropriate interventions are provided to people with mental disorder.

Smoke-free policies in New Zealand public tertiary education institutions.

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Robertson, Lindsay A; Marsh, L

2015-04-01

The Framework Convention on Tobacco Control mandates the creation of smoke-free environments to protect non-smokers from second-hand smoke and reduce demand for tobacco. We aimed to examine the extent and nature of smoke-free campus policies at tertiary education institutions throughout New Zealand, and examine the policy development process. Stage one comprised an audit and content analysis of smoke-free policies. In stage two, semi-structured telephone interviews were conducted to investigate the process of developing and implementing policies. Qualitative content analysis was undertaken on interview notes. Policies were identified for most institutions (n = 26/29), though varied widely in nature. Only nine mandated 100% smoke-free campuses without exceptions and few prohibited the sale of tobacco on campus, or connections with the tobacco industry. During interviews (n = 22/29), cited barriers to developing a 100% smoke-free policy included enforcement challenges and anticipated opposition from staff and students. However, participants from institutions with 100% smoke-free policies reported having encountered few challenges. Varying levels of compliance with 100% smoke-free policies were reported yet, overall, these policies were viewed as being effective. Smoke-free campus policies could be strengthened to better reflect a completely tobacco-free organization. Other institutions and workplaces could use these findings to develop 100% smoke-free policies. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Inequities in coverage of smokefree space policies within the United States

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Christopher Lowrie

2017-05-01

Full Text Available Abstract Background Previous studies have found extensive geographic and demographic differences in tobacco use. These differences have been found to be reduced by effective public policies, including banning smoking in public spaces. Smokefree indoor and outdoor spaces reduce secondhand smoke exposure and denormalize smoking. Methods We evaluated regional and demographic differences in the proportion of the population covered by smokefree policies enacted in the United States prior to 2014, for both adults and children. Results Significant differences in coverage were found by ethnicity, region, income, and education (p < 0.001. Smokefree policy coverage was lower for jurisdictions with higher proportions of poor households, households with no high school diploma and the Southeast region. Increased ethnic heterogeneity was found to be a significant predictor of coverage in indoor “public spaces generally”, meaning that diversity is protective, with differential effect by region (p = 0.004 – which may relate to urbanicity. Children had a low level of protection in playgrounds and schools (~10% covered nationwide – these spaces were found to be covered at lower rates than indoor spaces. Conclusions Disparities in smokefree space policies have potential to exacerbate existing health inequities. A national increase in smokefree policies to protect children in playgrounds and schools is a crucial intervention to reduce such inequities.

One year of smokefree bars and restaurants in New Zealand: Impacts and responses

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Thomson, George; Wilson, Nick

2006-01-01

Background New Zealand introduced a smokefree bars and restaurants policy in December 2004. We reviewed the data available at December 2005 on the main public health, societal and political impacts and responses within New Zealand to the new law. Methods Data were collected from publicly available survey reports, and from government departments and interviews. This included data on smoking in bars, attitudes to smokefree bars, bar patronage, socially cued smoking, and perceived rights to smokefree workplaces. Results The proportion of surveyed bars with smoking occurring decreased from 95% to 3% during July 2004 – April 2005. Between 2004 and 2005, public support for smokefree bars rose from 56% to 69%. In the same period, support for the rights of bar workers to have smokefree workplaces rose from 81% to 91%. During the first ten months of the smokefree bars policy, there were only 196 complaints to officials about smoking in the over 9900 licensed premises. The proportion of smokers who reported that they smoked more than normal at bars, nightclubs, casinos and cafés halved between 2004 and 2005 (from 58% to 29%). Seasonally adjusted sales in bars and clubs changed little (0.6% increase) between the first three quarters of 2004 and of 2005, while café and restaurant sales increased by 9.3% in the same period. Both changes continued existing trends. Compared to the same period in 2004, average employment during the first three quarters of 2005 was up 24% for 'pubs, taverns and bars', up 9% for cafés/restaurants, and down 8% for clubs (though employment in 'pubs, taverns and bars' may have been affected by unusually high patronage around a major sports-series). The proportion of bar managers who approved of smokefree bars increased from 44% to 60% between November 2004 and May 2005. Bar managers also reported increased agreement with the rights of bar workers and patrons to smokefree environments. The main reported concerns of the national and regional

One year of smokefree bars and restaurants in New Zealand: impacts and responses.

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Thomson, George; Wilson, Nick

2006-03-14

New Zealand introduced a smokefree bars and restaurants policy in December 2004. We reviewed the data available at December 2005 on the main public health, societal and political impacts and responses within New Zealand to the new law. Data were collected from publicly available survey reports, and from government departments and interviews. This included data on smoking in bars, attitudes to smokefree bars, bar patronage, socially cued smoking, and perceived rights to smokefree workplaces. The proportion of surveyed bars with smoking occurring decreased from 95% to 3% during July 2004-April 2005. Between 2004 and 2005, public support for smokefree bars rose from 56% to 69%. In the same period, support for the rights of bar workers to have smokefree workplaces rose from 81% to 91%. During the first ten months of the smokefree bars policy, there were only 196 complaints to officials about smoking in the over 9900 licensed premises. The proportion of smokers who reported that they smoked more than normal at bars, nightclubs, casinos and cafés halved between 2004 and 2005 (from 58% to 29%). Seasonally adjusted sales in bars and clubs changed little (0.6% increase) between the first three quarters of 2004 and of 2005, while café and restaurant sales increased by 9.3% in the same period. Both changes continued existing trends. Compared to the same period in 2004, average employment during the first three quarters of 2005 was up 24% for 'pubs, taverns and bars', up 9% for cafés/restaurants, and down 8% for clubs (though employment in 'pubs, taverns and bars' may have been affected by unusually high patronage around a major sports-series). The proportion of bar managers who approved of smokefree bars increased from 44% to 60% between November 2004 and May 2005. Bar managers also reported increased agreement with the rights of bar workers and patrons to smokefree environments. The main reported concerns of the national and regional Hospitality Associations, in 2005

Impact of U.S. Smoke-free Air Laws on Restaurant and Bar Employment, 1990-2015.

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Shafer, Paul

2017-12-23

Secondhand smoke exposure is responsible for an estimated 50,000 deaths per year among nonsmokers in the U.S. Smoke-free air laws reduce secondhand smoke exposure but often encounter opposition over concerns about their economic impact. Expansion of these laws has stagnated and efforts to weaken existing laws may exacerbate existing disparities in exposure. Studies at the state and local levels have found that smoke-free air laws do not generally have an adverse effect, but there are no recent estimates of the impact of these laws nationally. Employment and sales are two measures commonly used to estimate the economic impact of smoke-free air laws. Sales data are gathered by state and local taxing authorities but not uniformly across jurisdictions. Dynamic panel models are used to estimate a population-weighted national average treatment effect of smoke-free air laws on restaurant and bar employment using data from the Quarterly Census of Employment and Wages for 1990 to 2015. A one-percentage point increase in population covered by a restaurant smoke-free air law is associated with a small increase (approximately 0.01%) in restaurant employment (b=0.0001, Plaw was not associated with bar employment. Smoke-free air laws are a powerful tool for protecting hospitality workers and patrons from the dangers of secondhand smoke. Using data over more than two decades, these results suggest that smoke-free air laws in the U.S. do not generally have any meaningful effect on restaurant and bar employment. Smoke-free air laws are associated with reductions in negative health outcomes and decreased smoking prevalence. Despite this clear public health argument and strong public support, passage of new laws has stagnated and exemptions are being used to weaken existing laws. The ability to make both a health and business case in support of existing laws may also bolster the case for expansion. This study provides an updated look at the economic impact of smoke-free air laws

Legal and political obstacles to smoke-free regulation in Minnesota regions.

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Cork, Kerry; Forman, Carolyn

2008-12-01

As communities move toward statewide smoke-free regulation, progress is often stymied by legal and political challenges that arise when multiple cities and counties share regulatory power within what is, for economic purposes, a single population center. Political challenges are exacerbated by legal inconsistencies and uncertainties, such as confusing and conflicting lawmaking power in boards of health, cities or counties, and diverse procedures and timelines for adopting and amending ordinances. Surprisingly little research is available about the legal and political obstacles communities face in regulating tobacco on a regional basis. Researchers used case study methodology to analyze legal and political challenges that seven multi-jurisdictional Minnesota regions faced in smoke-free ordinance campaigns between 2000 and 2006, to examine the approaches regulatory authorities took in each of these communities, and to identify strategies to help public health advocates, health organizations, policymakers, and legal professionals anticipate, avoid, and address these obstacles. Legal impediments included confusing rules for passing smoke-free laws via ballot measures (initiatives and referenda); distracting lawsuits; and conflicts over legal jurisdiction. Political challenges included the recurrent argument for regional consistency, protracted timelines, pending legislation and elections, and mayoral vetoes. Legal and political challenges similar to those in this study appear in smoke-free campaigns across the U.S. By recognizing the risks posed by these obstacles, advocates will be better prepared to advance smoke-free policies effectively.

Reduction of secondhand tobacco smoke in public places following national smoke-free legislation in Uruguay.

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Blanco-Marquizo, Adriana; Goja, Beatriz; Peruga, Armando; Jones, Miranda R; Yuan, Jie; Samet, Jonathan M; Breysse, Patrick N; Navas-Acien, Ana

2010-06-01

Smoke-free legislation eliminating tobacco smoke in all indoor public places and workplaces is the international standard to protect all people from exposure to secondhand smoke. Uruguay was the first country in the Americas and the first middle-income country in the world to enact a comprehensive smoke-free national legislation in March 2006. To compare air nicotine concentrations measured in indoor public places and workplaces in Montevideo, Uruguay before (November 2002) and after (July 2007) the implementation of the national legislation. Air nicotine concentrations were measured for 7-14 days using the same protocol in schools, a hospital, a local government building, an airport and restaurants and bars. A total of 100 and 103 nicotine samples were available in 2002 and 2007, respectively. Median (IQR) air nicotine concentrations in the study samples were 0.75 (0.2-1.54) microg/m(3) in 2002 compared to 0.07 (0.0-0.20) microg/m(3) in 2007. The overall nicotine reduction comparing locations sampled in 2007 to those sampled in 2002 was 91% (95% CI 85% to 94%) after adjustment for differences in room volume and ventilation. The greatest nicotine reduction was observed in schools (97% reduction), followed by the airport (94% reduction), the hospital (89% reduction), the local government building (86% reduction) and restaurants/bars (81% reduction). Exposure to secondhand smoke has decreased greatly in indoor public places and workplaces in Montevideo, Uruguay, after the implementation of a comprehensive national smoke-free legislation. These findings suggest that it is possible to successfully implement smoke-free legislations in low and middle-income countries.

After the smoke has cleared: evaluation of the impact of a new national smoke-free law in New Zealand.

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Edwards, R; Thomson, G; Wilson, N; Waa, A; Bullen, C; O'Dea, D; Gifford, H; Glover, M; Laugesen, M; Woodward, A

2008-02-01

The New Zealand 2003 Smoke-free Environments Amendment Act (SEAA) extended existing restrictions on smoking in office and retail workplaces by introducing smoking bans in bars, casinos, members' clubs, restaurants and nearly all other workplaces from 10 December 2004. To evaluate the implementation and outcomes of aspects of the SEAA relating to smoke-free indoor workplaces and public places, excluding schools and early learning centres. Data were gathered on public and stakeholder attitudes and support for smoke-free policies; dissemination of information, enforcement activities and compliance; exposure to secondhand smoke (SHS) in the workplace; changes in health outcomes linked to SHS exposure; exposure to SHS in homes; smoking prevalence and smoking related behaviours; and economic impacts. Surveys suggested growing majority support for the SEAA and its underlying principles among the public and bar managers. There was evidence of high compliance in bars and pubs, where most enforcement problems were expected. Self reported data suggested that SHS exposure in the workplace, the primary objective of the SEAA, decreased significantly from around 20% in 2003, to 8% in 2006. Air quality improved greatly in hospitality venues. Reported SHS exposure in homes also reduced significantly. There was no clear evidence of a short term effect on health or on adult smoking prevalence, although calls to the smoking cessation quitline increased despite reduced expenditure on smoking cessation advertising. Available data suggested a broadly neutral economic impact, including in the tourist and hospitality sectors. The effects of the legislation change were favourable from a public health perspective. Areas for further investigation and possible regulation were identified such as SHS related pollution in semi-enclosed outdoor areas. The study adds to a growing body of literature documenting the positive impact of comprehensive smoke-free legislation. The scientific and public

What is behind smoker support for new smokefree areas? National survey data

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Wilson Nick

2010-08-01

Full Text Available Abstract Background Some countries have started to extend indoor smokefree laws to cover cars and various outdoor settings. However, policy-modifiable factors around smoker support for these new laws are not well described. Methods The New Zealand (NZ arm of the International Tobacco Control Policy Evaluation Survey (ITC Project derives its sample from the NZ Health Survey (a national sample. From this sample we surveyed adult smokers (n = 1376. Results For the six settings considered, 59% of smokers supported at least three new completely smokefree areas. Only 2% favoured smoking being allowed in all the six new settings. Support among Maori, Pacific and Asian smokers relative to European smokers was elevated in multivariate analyses, but confidence intervals often included 1.0. Also in the multivariate analyses, "strong support" by smokers for new smokefree area laws was associated with greater knowledge of the second-hand smoke (SHS hazard, and with behaviours to reduce SHS exposure towards others. Strong support was also associated with reporting having smokefree cars (aOR = 1.68, 95% CI = 1.21 - 2.34; and support for tobacco control regulatory measures by government (aOR = 1.63, 95% CI = 1.32 - 2.01. There was also stronger support by smokers with a form of financial stress (not spending on household essentials. Conclusions Smokers from a range of population groups can show majority support for new outdoor and smokefree car laws. Some of these findings are consistent with the use of public health strategies to support new smokefree laws, such as enhancing public knowledge of the second-hand smoke hazard.

Support for smoke-free policies among smokers and non-smokers in six cities in China: ITC China Survey.

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Li, Q; Hyland, A; O'Connor, R; Zhao, G; Du, L; Li, X; Fong, G T

2010-10-01

To examine levels of support for comprehensive smoke-free policies in six large Chinese cities. Data from Wave 1 of the International Tobacco Control (ITC) China Survey (April-August 2006) were analysed. The ITC China Survey employed a multistage sampling design in Beijing, Shenyang, Shanghai, Changsha, Guangzhou and Yinchuan (none of which has comprehensive smoke-free policies in place). Face-to-face interviews were conducted with 4815 smokers and 1270 non-smokers. Multivariate logistic regression models were used to identify factors associated with support for comprehensive smoke-free policies. About one in two Chinese urban smokers and four in five non-smokers believed that secondhand smoke (SHS) causes lung cancer. The majority of respondents supported comprehensive smoke-free policies in hospitals, schools and public transport vehicles while support for smoke-free workplaces, restaurants and bars was lower. Levels of support were generally comparable between smokers and non-smokers. Support for comprehensive smoke-free policies was positively associated with knowledge about the harm of SHS. Respondents who worked in a smoke-free worksite or who frequented smoke-free indoor entertainment places were more likely to support comprehensive smoking restriction in bars and restaurants. Considerable support for smoke-free policies exists in these six large cities in China. Greater public education about the dangers of SHS may further increase support. Experiencing the benefits of smoke-free indoor entertainment places and/or workplaces increases support for these policies and suggests that some initial smoke-free policy implementation may hasten the diffusion of these public health policies.

Correlates of Persistent Smoking in Bars Subject to Smokefree Workplace Policy

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Bong Chul Chu

2009-04-01

Full Text Available This study’s goal was to characterize physical and social environments of stand-alone bars associated with indoor smoking despite California’s smokefree workplace law. In a random sample of 121 stand-alone bars in San Francisco, trained observers collected data on patrons, staff, neighborhood, indoor settings and smoking behaviors. Using bivariate (chi-square and hierarchical linear modeling analyses, we identified four correlates of patrons’ indoor smoking: 1 bars serving predominantly Asian or Irish patrons, 2 ashtrays, 3 bartender smoking, and 4 female bartenders. Public health officials charged with enforcement of smokefree bar policies may need to attend to social practices within bars, and heighten perceptions of consistent enforcement of smokefree workplace laws.

One year of smokefree bars and restaurants in New Zealand: Impacts and responses

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Wilson Nick

2006-03-01

Full Text Available Abstract Background New Zealand introduced a smokefree bars and restaurants policy in December 2004. We reviewed the data available at December 2005 on the main public health, societal and political impacts and responses within New Zealand to the new law. Methods Data were collected from publicly available survey reports, and from government departments and interviews. This included data on smoking in bars, attitudes to smokefree bars, bar patronage, socially cued smoking, and perceived rights to smokefree workplaces. Results The proportion of surveyed bars with smoking occurring decreased from 95% to 3% during July 2004 – April 2005. Between 2004 and 2005, public support for smokefree bars rose from 56% to 69%. In the same period, support for the rights of bar workers to have smokefree workplaces rose from 81% to 91%. During the first ten months of the smokefree bars policy, there were only 196 complaints to officials about smoking in the over 9900 licensed premises. The proportion of smokers who reported that they smoked more than normal at bars, nightclubs, casinos and cafés halved between 2004 and 2005 (from 58% to 29%. Seasonally adjusted sales in bars and clubs changed little (0.6% increase between the first three quarters of 2004 and of 2005, while café and restaurant sales increased by 9.3% in the same period. Both changes continued existing trends. Compared to the same period in 2004, average employment during the first three quarters of 2005 was up 24% for 'pubs, taverns and bars', up 9% for cafés/restaurants, and down 8% for clubs (though employment in 'pubs, taverns and bars' may have been affected by unusually high patronage around a major sports-series. The proportion of bar managers who approved of smokefree bars increased from 44% to 60% between November 2004 and May 2005. Bar managers also reported increased agreement with the rights of bar workers and patrons to smokefree environments. The main reported concerns of the

[Knowledge and attitudes toward smoke-free law among smoking and non-smoking medical students].

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Zielińska-Danch, Wioleta; Goniewicz, Maciej Ł; Koszowski, Bartosz; Leszczyńska, Joanna; Czogała, Jan; Szołtysek-Bołdys, Izabela; Antosiewicz, Beata; Sobczak, Andrzej

2010-01-01

Tobacco smoking is common among various social groups. There is still high prevalence of smoking among health care professionals. The aim of the study was to assess knowledge about smoke-free law in public places in Poland among smoking and nonsmoking students of selected medical university. We surveyed 50 students of one medical university aged 23 +/- 2 years. Control group consisted with 61 students of other universities located in the same region aged 23 +/- 3 years. We developed a new survey to assess students knowledge about smoke-free regulations and their implementations in various public places. Smoking status was verified with exhaled carbon monoxide levels (COex). 57% off all surveyed students declared being familiar with smoke-free law. However, we detected a significant difference between the knowledge of medical vs. nonmedical students (76% vs. 41%, p < 0.05). The knowledge about smoke-free law in Poland among students is not sufficient, especially among nonmedical students.

Second-hand smoke in public spaces: how effective has partial smoke-free legislation been in Malaysia?

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Abidin, Emilia Zainal; Hashim, Zailina; Semple, Sean

2013-01-01

This study was performed to gather data on second-hand smoke (SHS) concentrations in a range of public venues following the implementation of partial Smoke-Free Legislation in Malaysia in 2004. PM2.5 was measured as a marker of SHS levels in a total of 61 restaurants, entertainment centres, internet cafes and pubs in Kuala Lumpur, Malaysia. Under the current smoke-free laws smoking was prohibited in 42 of the 61 premises. Active smoking was observed in nearly one-third (n=12) of these. For premises where smoking was prohibited and no active smoking observed, the mean (standard deviation) indoor PM2.5 concentration was 33.4 (23.8) μg/m3 compared to 187.1 (135.1) μg/m3 in premises where smoking was observed The highest mean PM2.5 was observed in pubs [361.5 (199.3) μg/m3]. This study provides evidence of high levels of SHS across a range of hospitality venues, including about one-third of those where smoking is prohibited, despite 8 years of smoke-free legislation. Compliance with the legislation appeared to be particularly poor in entertainment centres and internet cafes. Workers and non-smoking patrons continue to be exposed to high concentrations of SHS within the hospitality industry in Malaysia and there is an urgent need for increased enforcement of existing legislation and consideration of more comprehensive laws to protect health.

Accelerated Adoption of Smoke-Free Laws After Ratification of the World Health Organization Framework Convention on Tobacco Control

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Uang, Randy; Hiilamo, Heikki

2016-01-01

Objectives. We sought to evaluate the effect of ratifying the World Health Organization Framework Convention on Tobacco Control (FCTC) on countries enacting smoke-free laws covering indoor workplaces, restaurants, and bars. Methods. We compared adoption of smoke-free indoor workplace, restaurant, and bar laws in countries that did versus did not ratify the FCTC, accounting for years since the ratification of the FCTC and for countries’ World Bank income group. Results. Ratification of the FCTC significantly (P restaurants and bars. Compared with high-income countries, upper-middle–income countries had a significantly higher probability of smoke-free indoor workplace laws. Conclusions. The FCTC accelerated the adoption of smoke-free indoor workplace, restaurant, and bar laws, with the greatest effect in the years immediately following ratification. The policy implication is that health advocates must increase efforts to secure implementation of FCTC smoke-free provisions in countries that have not done so. PMID:26562125

Impacts of smoke-free public places legislation on inequalities in youth smoking uptake: study protocol for a secondary analysis of UK survey data.

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Anyanwu, Philip Emeka; Craig, Peter; Katikireddi, Srinivasa Vittal; Green, Michael James

2018-03-27

Smoke-free public places legislation has been introduced in many countries to protect the public from the harmful effects of secondhand smoking. While evaluations of smoke-free policies have demonstrated major public health benefits, the impact on youth smoking and inequalities in smoking remains unclear. This project aims to evaluate how smoke-free public places legislation in the UK has impacted on inequalities in youth smoking uptake, and how much of any impact is via changes in parental smoking behaviour. The study will constitute secondary analyses of UK data (from the British Household Panel Survey and the Understanding Society study). Merging these datasets gives coverage of the period from 1994 to 2016. Missing data will be handled using multiple imputation. The primary outcomes are the rates and inequalities in initiation, experimentation, escalation to daily smoking and quitting among youths aged 11-15 years. Secondary outcomes include the prevalence of smoking among parents of these youths. Discrete-time event history analysis will be conducted to examine whether changes in the probability of youth smoking transitions are associated with the implementation of the smoke-free public places legislation; and whether any observed effects differ by socioeconomic position and parental smoking. A multilevel logistic regression model will be used to investigate whether there is a step change or change in trend for the prevalence of parental smoking after the policy was implemented. The models will be adjusted for relevant factors (including cigarette taxation, the change in the legal age for purchase of cigarettes and e-cigarette prevalence) that may be associated with the implementation of the legislation. This project will use anonymised survey data which have been collected following independent ethical review. The dissemination of the study findings will adopt multiple communication channels targeting both scientific and non-scientific audiences. © Article

Smoke-Free Policies in New Zealand Public Tertiary Education Institutions

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Robertson, Lindsay A.; Marsh, L.

2015-01-01

The Framework Convention on Tobacco Control mandates the creation of smoke-free environments to protect non-smokers from second-hand smoke and reduce demand for tobacco. We aimed to examine the extent and nature of smoke-free campus policies at tertiary education institutions throughout New Zealand, and examine the policy development process.…

Potential unintended consequences of smoke-free policies in public places on pregnant women in China.

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Yao, Tingting; Lee, Anita H; Mao, Zhengzhong

2009-08-01

Smoke-free policies in public places have become more common in China. Little is known, however, about the potential unintended consequences of such policies on pregnant women. The study was conducted in 2006 in Chengdu, China. Nonsmoking pregnant women (N=55) whose husband were smokers participated in a study of their knowledge about secondhand smoke and smoke-free policies, their exposure to secondhand smoke, and their husbands' smoking status at home. This study presents descriptive statistics, analyses based on family income and pregnant women's education level, and the findings of focus group discussions that examined the potential unintended consequences of the smoke-free policies on pregnant women. Exposure to secondhand smoke at home was reported by 69.1% of the pregnant women. Both family income and the education level of the pregnant women had a significant (ppolicies were: (1) increased exposure of pregnant women to secondhand smoke at home; (2) reduced work efficiency; (3) adverse effect on family harmony; and (4) poor air quality at home. Education is needed to increase knowledge of secondhand smoke among smokers and nonsmokers alike. When the smoking location is shifted from public places and workplaces to home, women, and in particular pregnant women, become the victims. Policymakers should recognize such potential unintended consequences and take necessary measures to increase awareness about the harms of secondhand smoke.

Strong advocacy led to successful implementation of smokefree Mexico City.

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Crosbie, Eric; Sebrié, Ernesto M; Glantz, Stanton A

2011-01-01

To describe the approval process and implementation of the 100% smokefree law in Mexico City and a competing federal law between 2007 and 2010. Reviewed smokefree legislation, published newspaper articles and interviewed key informants. Strong efforts by tobacco control advocacy groups and key policymakers in Mexico City in 2008 prompted the approval of a 100% smokefree law following the WHO FCTC. As elsewhere, the tobacco industry utilised the hospitality sector to block smokefree legislation, challenged the City law before the Supreme Court and promoted the passage of a federal law that required designated smoking areas. These tactics disrupted implementation of the City law by causing confusion over which law applied in Mexico City. Despite interference, the City law increased public support for 100% smokefree policies and decreased the social acceptability of smoking. In September 2009, the Supreme Court ruled in favour of the City law, giving it the authority to go beyond the federal law to protect the fundamental right of health for all citizens. Early education and enforcement efforts by tobacco control advocates promoted the City law in 2008 but advocates should still anticipate continuing opposition from the tobacco industry, which will require continued pressure on the government. Advocates should utilise the Supreme Court's ruling to promote 100% smokefree policies outside Mexico City. Strong advocacy for the City law could be used as a model of success throughout Mexico and other Latin American countries.

Smoke-free air policies: past, present and future.

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Hyland, Andrew; Barnoya, Joaquin; Corral, Juan E

2012-03-01

Smoke-free policies have been an important tobacco control intervention. As recently as 20 years ago, few communities required workplaces and hospitality venues to be smoke-free, but today approximately 11% of the world's population live in countries with laws that require these places to be smoke-free. This paper briefly summarises important milestones in the history of indoor smoke-free policies, the role of scientific research in facilitating their adoption, a framework for smoke-free policy evaluation and industry efforts to undermine regulations. At present, smoke-free policies centre on workplaces, restaurants and pubs. In addition, many jurisdictions are now beginning to implement policies in outdoor areas and in shared multiunit housing settings. The future of smoke-free policy development depends on credible scientific data that documents the health risks of secondhand smoke exposure. Over the next 20 years smoke-free policies will very likely extend to outdoor and private areas, and changes in the types of tobacco products that are consumed may also have implications for the nature and scope of the smoke-free policies of the future.

Gambling with our health: smoke-free policy would not reduce tribal casino patronage.

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Brokenleg, Isaiah Shaneequa; Barber, Teresa K; Bennett, Nancy L; Peart Boyce, Simone; Blue Bird Jernigan, Valarie

2014-09-01

Tribal sovereignty exempts tribal casinos from statewide smoking bans. To conduct a tribally-led assessment to identify the characteristics of casino patrons at Lake of the Torches Resort Casino in Lac du Flambeau WI and their preferences for a smoke-free casino. A survey was administered from April to August 2011 to a stratified random sample of 957 members of the casino players club to assess their preferences for a smoke-free casino. These members were categorized into three groups: those who reported being likely to (1) visit more; (2) visit less; or (3) visit the same if the casino prohibited smoking. They were characterized by age, education, sex, race/ethnicity, annual income, players club level, and reasons for visiting the casino. Statistical analyses were conducted on weighted data in October to December 2011. Weighted logistic regression was calculated to control for potential confounding of patron characteristics. Of the 957 surveyed patrons, 520 (54%) patrons were likely to visit more; 173 (18%) patrons to visit less; and 264 (28%) patrons were indifferent to the smoke-free status. Patrons more likely to prefer a smoke-free casino tended to be white, elderly, middle class and above, and visit the casino restaurants. Patrons within the lower tiers of the players club, almost half of the players club members, also showed a higher preference for a smoke-free casino. This tribal casino would likely realize increased patronage associated with smoke-free status while also contributing to improved health for casino workers and patrons. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Strength of smoke-free air laws and indoor air quality.

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Lee, Kiyoung; Hahn, Ellen J; Robertson, Heather E; Lee, Seongjik; Vogel, Suzann L; Travers, Mark J

2009-04-01

Smoke-free air laws have been implemented in many Kentucky communities to protect the public from the harmful effects of secondhand smoke exposure. The impact of different strengths of smoke-free air laws on indoor air quality was assessed. Indoor air quality in hospitality venues was assessed in seven communities before and after comprehensive smoke-free air laws and in two communities only after partial smoke-free air laws. One community was measured three times: before any smoke-free air law, after the initial partial law, and after the law was strengthened to cover all workplaces and public places with few exemptions. Real-time measurements of particulate matters with 2.5 mum aerodynamic diameter or smaller (PM(2.5)) were obtained. When comprehensive smoke-free air laws were implemented, indoor PM(2.5) concentrations decreased significantly from 161 to 20 microg/m3. In one community that implemented a comprehensive smoke-free law after initially passing a partial law, indoor PM(2.5) concentrations were 304 microg/m3 before the law, 338 microg/m3 after the partial law, and 9 microg/m3 after the comprehensive law. The study clearly demonstrated that partial smoke-free air laws do not improve indoor air quality. A significant linear trend indicated that PM(2.5) levels in the establishments decreased with fewer numbers of burning cigarettes. Only comprehensive smoke-free air laws are effective in reducing indoor air pollution from secondhand tobacco smoke.

Second-hand smoke: a neglected public health challenge.

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Singh, Rana J; Lal, Pranay G

2011-01-01

Exposure to secondhand smoke (SHS) causes an estimated 5% of the global burden of disease, slightly higher than the burden from direct use of tobacco. This review highlights the urgent need to address this ignored public health issue by presenting the evidence and impact of SHS on those exposed using global studies including those from the South-East Asia Region. The burden of morbidity from SHS exposure is higher in low-income countries in Southeast Asia region compared to the rest of the world. SHS exposure affects those most vulnerable, especially women and children. While several countries in the region have enacted legislation which offer protection to those exposed to SHS, most measures are partial and inadequate. As a result, implementation and compliance at national and sub-national level within the countries of the Southeast Asia region is variable. Governments must ensure that legislation mandates comprehensive smoke-free environments in order to provide public health benefit which offers universal protection to everyone and everywhere. Where comprehensive legislation exists, stringent implementation and enforcement, along with awareness building, education and monitoring through regular compliance studies must be done to sustain smokefree status of public places within jurisdictions.

Implementation of smoke-free homes in Poland

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Dorota Kaleta

2016-02-01

Full Text Available Objectives: Exposure to environmental tobacco smoke (ETS constitutes a threat to the health of many people. In order to diminish ETS exposure, countries (including Poland implemented legal restrictions of smoking in public places and worksites. Currently more attention is also paid to reduce overall and residential ETS exposure by voluntary smoke-free home policy adoption. The aim of current analysis was to evaluate the prevalence and determinants of implementing smoking bans at place of residence among economically active males and females in Poland. Material and Methods: Data from cross-sectional, household study – Global Adult Tobacco Survey (GATS 2009–2010 were analyzed. The logistic regression model was applied for appropriate calculations. Results: Out of 3696 studied subjects only 37.1% adopted total smoking ban within the home. Decreased likelihood of adopting total smoking bans was associated with current smoker status, low education attainment, lack of awareness on adverse health consequences of ETS, low level of support for tobacco control policies, and cohabitation with a smoker in both genders. Having smoke-free homes was also linked with age in women, place of residence and work smoking policy in indoor areas in men. Conclusions: Targeted activities to encourage adopting voluntary smoke-free rules among groups least likely to implement 100% smoking bans in the home and activities to decrease social acceptance of smoking in the presence of nonsmokers, children, pregnant woman are urgently needed.

Tobacco related knowledge and support for smoke-free policies among community pharmacists in Lagos state, Nigeria

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Poluyi EO

2015-03-01

Full Text Available Background: There are no safe levels of exposure to second hand smoke and smoke-free policies are effective in reducing the burden of tobacco-related diseases and death. Pharmacists, as a unique group of health professionals, might be able to play a role in the promotion of smoke-free policies. Objective: To determine the tobacco-related knowledge of community pharmacists and assess their support for smoke-free policies in Lagos state, Nigeria. Methods: A cross-sectional descriptive study design using both quantitative and qualitative methods was employed. Two hundred and twelve randomly selected community pharmacists were surveyed using a pre-tested self-administered questionnaire. In addition, one focus group discussion was conducted with ten members of the Lagos state branch of the Association of Community Pharmacists of Nigeria. Results: The quantitative survey revealed that the majority (72.1% of the respondents were aged between 20 and 40 years, predominantly male (60.8%, Yoruba (50.2% or Igbo (40.3% ethnicity and had been practicing pharmacy for ten years or less (72.2%. A majority (90.1% of respondents were aware that tobacco is harmful to health. Slightly less (75.8% were aware that second hand smoke is harmful to health. Among the listed diseases, pharmacists responded that lung (84.4% and esophageal (68.9% cancers were the most common diseases associated with tobacco use. Less than half of those surveyed associated tobacco use with heart disease (46.9%, chronic obstructive pulmonary disease (27.8%, bladder cancer (47.2%, peripheral vascular disease (35.8% and sudden death (31.1%. Only 51.9% had heard of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC. A little over half of the respondents (53.8% were aware of any law in Nigeria controlling tobacco use. The majority of respondents supported a ban on smoking in homes (83.5%, in public places (79.2%, and in restaurants, nightclubs and bars (73.6%. For

Factors associated with support for smoke-free policies among government workers in Six Chinese cities: a cross-sectional study.

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Kegler, Michelle C; Hua, Xinwei; Solomon, Madeleine; Wu, Yiqun; Zheng, Pin Pin; Eriksen, Michael

2014-11-04

A certain level of public support for smoke-free environments is a prerequisite for adoption and enforcement of policies and can be used as an indicator of readiness for legislative action. This study assessed support for comprehensive smoke-free policies in a range of settings such as hotels and colleges among government workers in China and identified factors associated with support for smoke-free policies. Understanding the extent to which government workers, a large segment of the working population in China, report a smoke-free workplace and support for smoke-free policies may be important indicators of readiness for strengthened policies given their role in formulating, implementing and enforcing regulations. Data were from an evaluation of the Tobacco Free Cities initiative of Emory University's Global Health Institute-China Tobacco Control Partnership. Self-administered surveys were completed by 6,646 workers in 160 government agencies in six Chinese cities. Multivariate logistic regression was used to identify factors associated with support for smoke-free worksites, bars, hotels, and colleges. Over half (54.6%) of participants were male. A large percentage of the male workers smoked (45.9%,) whereas very few women did (1.9%). Fewer than 50% of government workers reported smoke-free policies at work, with 19.0% reporting that smoking is allowed anywhere. Support for smoke-free policies was generally very high, with the lowest levels of support for smoke-free bars (79.0%) and hotels (82.3%), higher levels of support for restaurants (90.0%) and worksites (93.0%), and above 95% support for hospitals, schools, colleges, public transportation and religious settings. Knowledge of the harmfulness of secondhand smoke was positively associated with support for smoke-free policies. Stricter worksite smoking policies were associated with support for smoke-free workplaces and bars, but not hotels and colleges. Women and nonsmokers were more supportive of smoke-free

Key design features of a new smokefree law to help achieve the Smokefree Aotearoa.

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Delany, Louise; Thomson, George; Wilson, Nick; Edwards, Richard

2016-08-05

To design new tobacco control legislation to achieve the New Zealand Government's 2025 smokefree goal. An original analysis of the legislative options for New Zealand tobacco control. 'Business as usual' is most unlikely to achieve smoking prevalence that is less than 5% by 2025. Key components of a new Act would ideally include plans and targets with teeth, a focus on the industry, a focus on the product, reduction of supply, and a whole-of-society approach to promote consistency in policy implementation through: i) a public duty on government agencies to act consistently with smokefree law; ii) a general duty on those associated with the tobacco/nicotine industry in relation to tobacco control objectives; and iii) a principle requiring international treaties to be interpreted consistently with tobacco control objectives. Strategies such as those identified in this Viewpoint should be explored further as part of urgently needed planning to achieve the New Zealand Government's goal for Smokefree Aotearoa by 2025.

Secondhand smoke exposure is associated with smoke-free laws but not urban/rural status.

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Lee, Kiyoung; Hwang, Yunhyung; Hahn, Ellen J; Bratset, Hilarie; Robertson, Heather; Rayens, Mary Kay

2015-05-01

The objective was to determine secondhand smoke (SHS) exposure with and without smoke-free laws in urban and rural communities. The research hypothesis was that SHS exposure in public places could be improved by smoke-free law regardless of urban and rural status. Indoor air quality in hospitality venues was assessed in 53 communities (16 urban and 37 rural) before smoke-free laws; 12 communities passed smoke-free laws during the study period. Real-time measurements of particulate matter with 2.5 µm aerodynamic diameter or smaller (PM2.5) were taken 657 times from 586 distinct venues; about 71 venues had both pre- and post-law measurements. Predictors of log-transformed PM2.5 level were determined using multilevel modeling. With covariates of county-level percent minority population, percent with at least high school education, adult smoking rate, and venue-level smoker density, indoor air quality was associated with smoke-free policy status and venue type and their interaction. The geometric means for restaurants, bars, and other public places in communities without smoke-free policies were 22, 63, and 25 times higher than in those with smoke-free laws, respectively. Indoor air quality was not associated with urban status of venue, and none of the interactions involving urban status were significant. SHS exposure in public places did not differ by urban/rural status. Indoor air quality was associated with smoke-free law status and venue type. This study analyzed 657 measurements of indoor PM2.5 level in 53 communities in Kentucky, USA. Although indoor air quality in public places was associated with smoke-free policy status and venue type, it did not differ by urban and rural status. The finding supports the idea that population in rural communities can be protected with smoke-free policy. Therefore, it is critical to implement smoke-free policy in rural communities as well as urban areas.

Secondhand Smoke Exposure and Smoke-Free Policy Support Among Public Housing Authority Residents in Rural and Tribal Settings.

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Schmidt, Lisa M; Reidmohr, Alison A; Helgerson, Steven D; Harwell, Todd S

2016-12-01

Previous research has shown that multi-unit housing (MUH) residents are at risk of secondhand smoke (SHS) exposure, which can transfer between units. The purpose of this study was to determine SHS exposure and examine attitudes towards smoking policies among public housing authority (PHA) residents in rural and tribal settings. A self-administered questionnaire was completed by 895 adult tenants (41 % response rate) living in PHA multiunit buildings in Montana in 2013. Our primary outcome was tenant support of smoke-free policies; our secondary outcome was exacerbation of child asthma symptoms due to SHS exposure. In 2014, we used multiple logistic regression models to test associations between independent variables and outcomes of interest. The majority (80.6 %) of respondents supported having a smoke-free policy in their building, with support being significantly higher among nonsmokers [adjusted odds ratio (aOR) 4.2, 95 % confidence interval (CI) 1.5-11.6] and among residents living with children (aOR 2.9, 95 % CI 1.3-6.2). Tribal residents were as likely to support smoke-free policies as non-tribal residents (aOR 1.4; 95 % CI 0.5-4.0). Over half (56.5 %) of respondents reported SHS exposure in their home; residents in a building with no smoke-free policy in place were significantly more likely to report exposure (aOR 3.5, 95 % CI 2.2-5.5). SHS exposure was not significantly associated with asthma symptoms. There is a significant reduction in exposure to SHS in facilities with smoke-free policies and there is strong support for such policies by both tribal and non-tribal MUH residents. Opportunities exist for smoke-free policy initiatives in rural and tribal settings.

Secondhand Smoke Exposure 7 Years After an Indoor Smoke-Free Law.

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St Claire, Ann W; Amato, Michael S; Boyle, Raymond G; Rode, Peter; Kinney, Ann M

2018-01-01

To examine locations of secondhand smoke (SHS) exposure among nonsmokers, 7 years after a statewide smoke-free policy. Data collected via statewide, random digit dial telephone survey. Response rates were 64.7% for landline and 73.5% for cell phone. Minnesota, 2014. Representative sample of 7887 nonsmoking adults. Self-reported locations of SHS exposure and opinions on smoke-free restrictions. Descriptive statistics and logistic regression. A total of 35.5% of nonsmokers reported SHS exposure in the past 7 days. The greatest proportion of exposure occurred in community settings (31.7%) followed by cars (6.9%) and in the home (3.2%). Young adults were more likely to be exposed in a home or car than older adults. Nonsmokers living with a smoker were 39.6 (20.6-75.8) times more likely to be exposed to SHS in their home and 5.3 (4.1-6.8) times more likely to be exposed in a car, compared to those who did not live with a smoker. SHS exposure continues after comprehensive smoke-free policies restricted it from public places. Disparities in exposure rates exist for those who live with a smoker, are young, and have low incomes. Findings suggest the need for additional policies that will have the greatest public health benefit.

Smokefree cars in New Zealand: rapid research among stakeholders on attitudes and future directions.

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Tapp, Dylan; Thomson, George

2009-09-25

To conduct a rapid appraisal of the attitudes of New Zealand decision makers and tobacco control stakeholders on enacting a smokefree cars law. A media and document search was made for relevant official and other statements. In early 2008, nine semi-structured interviews were carried out involving three MPs, two officials of government health agencies and four members of NGOs with a stake in tobacco control. Interviews were audiotaped, transcribed, and analysed for themes. In official statements, and amongst the interview sample, there was general opposition to giving smokefree car legislation a current high priority. Reasons given for opposition to such a law included the suboptimal use of advocacy capital compared with other initiatives (e.g. tobacco display bans), the perceived success of relevant health marketing campaigns, and concerns over the current political will to enact legislation that targets smoker freedoms. More information on the extent of current child exposure to tobacco smoke in New Zealand cars, and on the reach and effectiveness of the New Zealand smokefree cars media campaign would help advocates and policymakers. Wider dissemination to policymakers of New Zealand public and smoker support for banning smoking in cars, and of the progress overseas on smokefree car laws, appears to be essential.

Do smoke-free environment policies reduce smoking on hospital grounds? Evaluation of a smoke-free health service policy at two Sydney hospitals.

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Poder, Natasha; Carroll, Therese; Wallace, Cate; Hua, Myna

2012-05-01

To evaluate the compliance of hospital staff, inpatients and visitors with Sydney South West Area Health Service's Smoke-free Environment Policy. Six sites were observed at two Sydney hospitals 2 weeks before implementation of the policy and at 2 weeks, 6 months, 12 months, 18 months and 2 years after implementation. There was an overall significant 36% (P≤0.05) reduction in observed smoking incidents on hospital grounds 2 years after implementation. Two years after implementation, observed smoking incidents reduced by 44% (P≤0.05) in staff, 37% (P≤0.05) in visitors and remained unchanged among inpatients. The Smoke-free Environment Policy was effective in reducing visitors and staff observed smoking on hospital grounds, but had little effect on inpatients' smoking. Identifying strategies to effectively manage nicotine addiction and promote cessation amongst hospital inpatients remains a key priority.

The road to smoke-free legislation in Ireland.

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Currie, Laura M; Clancy, Luke

2011-01-01

To describe the process through which Ireland changed its policies towards smoking in work-places and distil lessons for others implementing or extending smoke-free laws. This analysis is informed by a review of secondary sources including a commissioned media analysis, documentary analysis and key informant interviews with policy actors who provide insight into the process of smoke-free policy development. The policy analysis techniques used include the development of a time-line for policy reform, stakeholder analysis, policy mapping techniques, impact analysis through use of secondary data and a review process. The policy analysis triangle, which highlights the importance of examining policy content, context, actors and processes, will be used as an analytical framework. The importance of the political, economic, social and cultural context emerged clearly. The interaction of the context with the policy process both in identification of need for policy and its formulation demonstrated the opportunity for advocates to exert influence at all points of the process. The campaign to support the legislation had the following characteristics: a sustained consistent simple health message, sustained political leadership/commitment, a strong coalition between the Health Alliance, the Office of Tobacco Control and the Department of Health and Children, with cross-party political support and trade union support. The public and the media support clearly defined the benefit of deliberate and consistent planning and organization of a communication strategy. The Irish smoke-free legislation was a success as a policy initiative because of timing, dedication, planning, implementation and the existence of strong leadership and a powerful convinced credible political champion. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Support for smoke-free policies in the Cyprus hospitality industry.

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Lazuras, Lambros; Savva, Christos S; Talias, Michael A; Soteriades, Elpidoforos S

2015-12-01

The present study used attitudinal and behavioural indicators to measure support for smoke-free policies among employers and employees in the hospitality industry in Cyprus. A representative sample of 600 participants (95 % response rate) completed anonymous structured questionnaires on demographic variables, smoking status, exposure to second-hand smoke at work and related health beliefs, social norms, and smoke-free policy support. Participants were predominantly males (68.3 %), with a mean age of 40 years (SD = 12.69), and 39.7 % were employers/owners of the hospitality venue. Analysis of variance showed that employers and smokers were less supportive of smoke-free policies, as compared to employees and non-smokers. Linear regression models showed that attitudes towards smoke-free policy were predicted by smoking status, SHS exposure and related health beliefs, and social norm variables. Logistic regression analysis showed that willingness to confront a policy violator was predicted by SHS exposure, perceived prevalence of smoker clients, and smoke-free policy attitudes. SHS exposure and related health beliefs, and normative factors should be targeted by interventions aiming to promote policy support in the hospitality industry in Cyprus.

Compliance with smoke-free legislation and smoking behaviour: observational field study from Punjab, India.

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Goel, Sonu; Sharma, Deepak; Gupta, Rakesh; Mahajan, Vini

2017-08-10

Indian smoke-free legislation requires prohibition of smoking at public places and owners of public places to display 'no smoking' signages. The study aims to assess the compliance of public places with smoke-free legislation and determine the factors associated with active smoking in public places. This was a cross-sectional analytic observational quantitative survey conducted by a team of trained field investigators using a structured observational checklist across 6875 public places in Punjab state of India. The study was carried out over a period of 3 years. A total of 6875 public places across 22 districts of Punjab were observed. The overall compliance to smoke-free law in Punjab was 83.8%. The highest overall compliance was observed in healthcare facilities (89.6%) and least in transit stations (78.8%). Less active smoking was observed in public places where display of 'no smoking' signage compliant with smoke-free law of India was present (adjusted OR 0.6). Further, there was a positive association between active smoking and places where the owner of public places smoked (OR 5.2, CI 2.5 to 11.1). More than 80% of the public places in a jurisdiction in north India were compliant with the smoke-free legislation of India. 'No smoking' signages displayed as per legislation have an effect on curbing smoking behaviours at public places. It is recommended that policymakers should focus more on implementing the smoke-free law at transit sites and structured training sessions should be organised for owners of workplaces. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prevalence of smoke-free car and home rules in Maine before and after passage of a smoke-free vehicle law, 2007-2010.

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Murphy-Hoefer, Rebecca; Madden, Patrick; Maines, Dorean; Coles, Carol

2014-01-16

This is the first study to examine the prevalence of self-reported smoke-free rules for private cars and homes before and after the passage of a smoke-free vehicle law. Data were examined for 13,461 Maine adults aged 18 or older who participated in the Behavioral Risk Factor Surveillance System, a state-based telephone survey covering health topics. Self-reported smoke-free car and home rules, smoking behavior, and demographic variables of age, sex, education, income, and children in household were analyzed for prevalence before and after the state's smoke-free vehicle law was passed. Prevalence of smoke-free car and home rules was significantly higher after Maine's smoke-free vehicle law was passed in the state (P = .004 for car rules and P = .009 for home rules). Variations in smoking rules differed by smoking and demographic variables. People with household incomes of less than $20,000 saw an increase of 14.3% in smoke-free car rules; overall, those with annual incomes of less than $20,000 and those with less than a high school education reported a lower prevalence of smoke-free car rules both before and after the law was passed than did people with higher incomes and higher education levels. The prevalence of smoke-free home rules after the law was implemented was higher among those with 4 or more years of college education than among those with lower levels of education (P = .02). The prevalence of smoke-free car and home rules among Maine adults was significantly higher after the passage of a statewide smoke-free vehicle law. This apparent change in smoke-free rule prevalence may be indicative of changing social norms related to the unacceptability of secondhand smoke exposure.

Association between being employed in a smoke-free workplace and living in a smoke-free home: evidence from 15 low and middle income countries.

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Nazar, Gaurang P; Lee, John Tayu; Glantz, Stanton A; Arora, Monika; Pearce, Neil; Millett, Christopher

2014-02-01

To assess whether being employed in a smoke-free workplace is associated with living in a smoke-free home in 15 low and middle income countries (LMICs). Country-specific individual level analyses of cross-sectional Global Adult Tobacco Survey data (2008-2011) from 15 LMICs was conducted using multiple logistic regression. The dependent variable was living in a smoke-free home; the independent variable was being employed in a smoke-free workplace. Analyses were adjusted for age, gender, residence, region, education, occupation, current smoking, current smokeless tobacco use and number of household members. Individual country results were combined in a random effects meta-analysis. In each country, the percentage of participants employed in a smoke-free workplace who reported living in a smoke-free home was higher than those employed in a workplace not smoke-free. The adjusted odds ratios (AORs) of living in a smoke-free home among participants employed in a smoke-free workplace (vs. those employed where smoking occurred) were statistically significant in 13 of the 15 countries, ranging from 1.12 [95% CI 0.79-1.58] in Uruguay to 2.29 [1.37-3.83] in China. The pooled AOR was 1.61 [1.46-1.79]. In LMICs, employment in a smoke-free workplace is associated with living in a smoke-free home. Accelerated implementation of comprehensive smoke-free policies is likely to result in substantial population health benefits in these settings. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

The efficacy of different models of smoke-free laws in reducing exposure to second-hand smoke: a multi-country comparison.

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Ward, Mark; Currie, Laura M; Kabir, Zubair; Clancy, Luke

2013-05-01

Exposure to second-hand tobacco smoke is a serious public health concern and while all EU Member States have enacted some form of regulation aimed at limiting exposure, the scope of these regulations vary widely and many countries have failed to enact comprehensive legislation creating smoke-free workplaces and indoor public places. To gauge the effectiveness of different smoke-free models we compared fine particles from second-hand smoke in hospitality venues before and after the implementation of smoking bans in France, Greece, Ireland, Italy, Portugal, Turkey, and Scotland. Data on PM2.5 fine particle concentration levels were recorded in 338 hospitality venues across these countries before and after the implementation of smoke-free legislation. Changes in mean PM2.5 concentrations during the period from pre- to post-legislation were then compared across countries. While a reduction in PM2.5 was observed in all countries, those who had enacted and enforced more fully comprehensive smoke-free legislation experienced the greatest reduction in second-hand tobacco smoke. Comprehensive smoke-free laws are more effective than partial laws in reducing exposure to second-hand tobacco smoke. Also, any law, regardless of scope must be actively enforced in order to have the desired impact. There is continued need for surveillance of smoke-free efforts in all countries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Support for smoke-free restaurants among Massachusetts adults, 1992-1999.

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Brooks, D R; Mucci, L A

2001-02-01

The authors examined trends and predictors of public support for smoke-free restaurants in Massachusetts. Since 1992, the Massachusetts Behavioral Risk Factor Surveillance System has asked survey respondents about their attitudes toward smoking in restaurants. Analyses using data from 1992 to 1999 characterized changes over time in support for smoke-free restaurants and the role of demographic and smoking-related factors in predicting support. During 1992 to 1999, the rate of support for smoke-free restaurants increased from 37.5% to 59.8%, with similar increases among current, former, and never smokers. After adjustment for smoking status, support was associated with socioeconomic characteristics, race/ethnicity, and household smoking rules. Among current smokers, lighter smokers and those who were trying to quit were more likely to endorse smoke-free restaurants. There has been a substantial increase in support for smoke-free restaurants among both smokers and nonsmokers in Massachusetts.

Evaluation of a smoke-free law on indoor air quality and on workers' health in Portuguese restaurants.

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Madureira, Joana; Mendes, Ana; Teixeira, João Paulo

2014-01-01

Workplace bans on smoking are interventions to reduce exposure to secondhand smoke (SHS) to try to prevent harmful health effects. The Portuguese Government on January 1, 2008, introduced the first national law banning smoking in public workplaces, including restaurants. The main aim of this study was to examine the impact of this law on indoor air quality (IAQ) in restaurants and on the respiratory and sensory health of restaurant workers. Concentrations of respirable suspended particulate matter (RSP), total volatile organic compounds (TVOC), carbon monoxide (CO), and carbon dioxide (CO2) in 10 restaurants were measured and compared before and after the ban. Benzene (C6H6) concentrations were also measured in all restaurants. Fifty-two and twenty-eight restaurant workers, respectively, answered questionnaires on exposure to SHS, and respiratory and sensory symptoms in the pre- and post-ban phases. There was a statistically significant decrease in RSP, CO, TVOC, and C6H6 concentrations after the ban. Additionally, in both phases the monitored CO2 concentrations greatly exceeded 1800 mg x m(-3), suggesting inefficient ventilation of the indoor spaces. Between pre- and post-ban phases a significant reduction in self-reported workplace SHS exposure was also observed after the enforcement of the law, as well as a significant marked reduction in dry, itching, irritated, or watery eyes, nasal problems, sore or dry throat, cough, wheeze, and headache. This study provides, in a single investigation, comparison of IAQ and respiratory health in Portugal before and after the introduction of the smoke-free law, the first data reported in the literature to our knowledge. Our findings suggest that a total workplace smoking ban results in a significant reduction in indoor air pollution and an improvement in the respiratory health of restaurant workers. These observations may have implications for policymakers and legislators currently considering the nature and extent of their

Support for smoke-free policy, and awareness of tobacco health effects and use of smoking cessation therapy in a developing country

Directory of Open Access Journals (Sweden)

McNeill Ann

2011-07-01

Full Text Available Abstract Background Preventing an epidemic increase in smoking prevalence is a major challenge for developing countries. Ghana, has maintained a low smoking prevalence despite the presence of cigarette manufacturing for many decades. Some of this success may have been contributed by cultural factors and attitudes. We have studied public awareness of health risks, attitudes to smoke-free policy, tobacco advertising/promotion and other factors in a Ghanaian population sample. Methods We used two-stage cluster randomized sampling to study household members aged 14 and over in a representative household sample in the Ashanti Region of Ghana. Results 6258 people, 88% of those eligible, took part in the study. Knowledge of health risks of smoking and passive smoking was high; radio was the main source of such information. Most people work and/or spend time in places where smoking is permitted. There was very strong support (97% for comprehensive smoke-free legislation, particularly among Christians and Muslims. Despite the advertising ban, a third of respondents (35%, particularly in urban areas, had noticed advertising of tobacco or tobacco products, on the radio (72% and television (28%. Among smokers, 76% had attempted to quit in the last 6 months, with the main sources of advice being friends and spouses. Use of nicotine replacement therapy was very rare. Low levels of health awareness were seen in females compared with males (Adjusted Odds Ratio (AOR; 0.51, 95% CI 0.39-0.69, p Conclusion Awareness of health risks and support for smoke-free policy are high in Ghana. Exposure to tobacco advertising or promotion is limited and most smokers have tried to quit. Whether these findings are cause or effect of current low smoking prevalence is uncertain.

Moving toward people's needs for smoke-free restaurants: before and after a national promotion program in Taiwan, 2003-2005.

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Chen, Yi-Hua; Yeh, Ching-Ying; Chen, Ruey-Yu; Chien, Ling-Chu; Yu, Po-Tswen; Chao, Kun-Yu; Han, Bor-Cheng

2009-05-01

In Taiwan, the Smoke-Free Restaurant Program (SFRP) was implemented from 2003 to 2005 as an initial phase before the introduction of restrictive legislation promoting smoke-free restaurants (SFRs). No studies have evaluated trends in public opinion before and after a national health promotion campaign for the introduction of SFRs on a voluntary basis. The present study investigated whether public opinion with respect to eliminating environmental tobacco smoke (ETS) in restaurants changed after implementation of the SFRP. Data were obtained from four large-scale, nationally representative surveys conducted in 2003-2005 before and after implementation of the SFRP. Weighted analyses were performed to obtain nationally representative results. After a series of SFRP campaigns, reported exposure to ETS in restaurants by survey participants decreased by approximately 14%. Approximately 20% more people had heard of SFRs, and approximately 25% more had chosen to dine in a smoke-free restaurant. We found consistently high community support for SFRs (ca. 95%), and approximately 80% supported smoke-free restaurant legislation, although both rates dropped slightly in 2005. People aged 60 years or more, nonsmokers, and those who had greater knowledge of ETS hazards were more likely to support smoke-free restaurant legislation. The SFRP was effective at promoting SFRs on a voluntary basis. Strong community endorsement has major implications for legislators who are considering the nature and extent of further smoke-free restaurant legislation in Taiwan and other countries.

Smokefree environments in Latin America: on the road to real change?

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Sebrié, Ernesto M.; Schoj, Verónica; Glantz, Stanton A.

2009-01-01

Latin American countries are experiencing an increasing burden of tobacco-related diseases. Smoke free policies are cost-effective interventions to control both exposure of nonsmokers to the toxic chemicals in secondhand tobacco smoke and to reduce the prevalence of smoking and its consequent morbidity and mortality. The World Health Organization Framework Convention on Tobacco Control has created momentum in Latin America to implement meaningful tobacco control policies. As of August 2007, Uruguay, two provinces and three cities in Argentina, and one state in Venezuela, had passed, regulated, and enforced 100% smokefree legislation. The tobacco industry, working through local subsidiaries, has been the strongest obstacle in achieving this goal and has prevented progress elsewhere in the region. During the 1990s, transnational tobacco companies Philip Morris International and British American Tobacco developed voluntary initiatives (“Courtesy of Choice” and “Environmental Tobacco Smoke Consultancy” programs) to prevent effective smokefree policies. Another important barrier in the region has often been a weak and fragmented local civil society. Opportunities in the region that should be taken into account are a high public support for smokefree environments and increasing capacity building available from international collaboration on tobacco control. Policymakers and tobacco control advocates should prioritize the implementation of smokefree policies in Latin America to protect nonsmokers, reduce smoking prevalence with its economic and disease burden in the region. PMID:19578527

Influence of religious organisations' statements on compliance with a smoke-free law in Bogor, Indonesia: a qualitative study.

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Byron, M Justin; Cohen, Joanna E; Gittelsohn, Joel; Frattaroli, Shannon; Nuryunawati, Ramadhani; Jernigan, David H

2015-12-14

To explore the Bogor public's perspective on Muslim organisations' pronouncements against smoking and the effect of these pronouncements on compliance with a new smoke-free law in the context of a prosmoking social norm. Semistructured focus group discussions were conducted, transcribed, coded using ATLAS.ti software, and analysed using thematic content analysis. Photo elicitation was also used during the focus groups. Bogor, Indonesia. 11 focus groups (n=89), stratified by age, gender and smoking status, with members of the public (46 male, 43 female, ages 18-50). There was limited knowledge of and compliance with both the smoke-free law and the religious pronouncements. In most of the focus groups, smoking was described as a discouraged, but not forbidden, behaviour for Muslims. Participants described the decision of whether to follow the religious pronouncements in the context of individual choice. Some participants felt religious organisations lacked credibility to speak against smoking because many religious leaders themselves smoke. However, some non-smokers said their religion reinforced their non-smoking behaviour and some participants stated it would be useful for religious leaders to speak more about the smoke-free law. Religious organisations' pronouncements appear to have had a small effect, primarily in supporting the position of non-smokers not to smoke. Participants, including smokers, said their religious leaders should be involved in supporting the smoke-free law. These findings suggest there is potential for the tobacco control community to partner with sympathetic local Muslim leaders to promote common goals of reducing smoking and public smoke exposure. Muslim leaders' views on smoking would be perceived as more credible if they themselves followed the smoke-free law. Additionally, public health messaging that includes religious themes could be piloted and tested for effectiveness. These findings may also inform similar efforts in other Muslim

Smoke-free policies among Asian-American women: comparisons by education status.

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Tong, Elisa K; Tang, Hao; Tsoh, Janice; Wong, Candice; Chen, Moon S

2009-08-01

California has significantly decreased racial/ethnic and educational disparities in smoke-free home and indoor work policies. California's ethnic-specific surveys present an opportunity to disaggregate data and examine the impact of California's smoke-free social norm campaign for Asian-American women. The California Tobacco Use Surveys for Chinese Americans and Korean Americans were conducted in 2003 and analyzed in 2008 to compare women with lower (education status for smoke-free policy adoption and enforcement. Lower-educated and higher-educated women had similar proportions of smoke-free policies at home (58%) or indoor work (90%). However, lower-educated women were more likely than higher-educated women to report anyone ever smoking at home (OR=1.62, 95% CI=1.06, 2.48, p=0.03) and exposure during the past 2 weeks at an indoor workplace (OR=2.43, 95% CI= 1.30, 4.55, p=0.005), even after controlling for ethnicity, smoke-free policy, knowledge about the health consequences of secondhand smoke exposure, and acculturation. There was no interaction between education and knowledge about secondhand smoke health harms. The intended consequences of California's tobacco-control efforts have resulted in similar rates of smoke-free policies at home and in indoor work environments among Asian-American women across educational levels. However, an unintended consequence of this success is a disparity in enforcement by educational status, with lower-educated Asian-American women reporting greater smoke exposure despite similar rates of knowledge about the health consequences of secondhand smoke exposure. Besides establishing policies, lower-educated Asian-American women may need to be empowered to assert and enforce their right to smoke-free environments.

Use of electronic cigarettes in smoke-free environments.

Science.gov (United States)

Shi, Yuyan; Cummins, Sharon E; Zhu, Shu-Hong

2017-03-01

Although most US states prohibit cigarette smoking in public places and worksites, fewer jurisdictions regulate indoor use of electronic cigarettes (e-cigarettes). Given the dramatic increase in e-cigarette use and concern about its impact on non-users, there is a need to examine the use of e-cigarettes in smoke-free environments and related attitudes and perceptions. Recruited from a nationally representative adult panel (GfK's KnowledgePanel), 952 current users of e-cigarettes completed a cross-sectional online survey in 2014. Multivariate logistic regressions were conducted to examine the factors associated with ever using e-cigarettes in smoke-free environments. Overall, 59.5% of e-cigarette users had vaped where cigarette smoking was not allowed. Young adults (18-29 years) were most likely to do so, 74.2%. The places of first-time use most often mentioned were service venues (bar, restaurant, lounge and club), 30.7%, followed by worksites, 23.5%. Daily e-cigarette users were more likely to have vaped in smoke-free environments than non-daily users (OR=2.08, p=0.012). Only 2.5% of those who used e-cigarettes in smoke-free environments reported negative reactions from other people. Most e-cigarette users did not think e-cigarettes are harmful to themselves or to by-standers, and thus should not be banned where smoking is; those who had used e-cigarettes where smoking is banned were even more likely to hold these views. E-cigarette use in smoke-free environments was common, suggesting that most e-cigarette users do not consider smoke-free laws to apply to e-cigarettes. Explicit laws should be considered if jurisdictions want to prohibit e-cigarette use in public places. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Impact of State Preemption of Local Smoking Restrictions on Public Health Protections and Changes in Social Norms

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Paul D. Mowery

2012-01-01

Full Text Available Introduction. Preemption is a legislative or judicial arrangement in which a higher level of government precludes lower levels of government from exercising authority over a topic. In the area of smoke-free policy, preemption typically takes the form of a state law that prevents communities from adopting local smoking restrictions. Background. A broad consensus exists among tobacco control practitioners that preemption adversely impacts tobacco control efforts. This paper examines the effect of state provisions preempting local smoking restrictions in enclosed public places and workplaces. Methods. Multiple data sources were used to assess the impact of state preemptive laws on the proportion of indoor workers covered by smoke-free workplace policies and public support for smoke-free policies. We controlled for potential confounding variables. Results. State preemptive laws were associated with fewer local ordinances restricting smoking, a reduced level of worker protection from secondhand smoke, and reduced support for smoke-free policies among current smokers. Discussion. State preemptive laws have several effects that could impede progress in secondhand smoke protections and broader tobacco control efforts. Conclusion. Practitioners and advocates working on other public health issues should familiarize themselves with the benefits of local policy making and the potential impact of preemption.

Has Childhood Smoking Reduced Following Smoke-Free Public Places Legislation? A Segmented Regression Analysis of Cross-Sectional UK School-Based Surveys.

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Katikireddi, Srinivasa Vittal; Der, Geoff; Roberts, Chris; Haw, Sally

2016-07-01

Smoke-free legislation has been a great success for tobacco control but its impact on smoking uptake remains under-explored. We investigated if trends in smoking uptake amongst adolescents differed before and after the introduction of smoke-free legislation in the United Kingdom. Prevalence estimates for regular smoking were obtained from representative school-based surveys for the four countries of the United Kingdom. Post-intervention status was represented using a dummy variable and to allow for a change in trend, the number of years since implementation was included. To estimate the association between smoke-free legislation and adolescent smoking, the percentage of regular smokers was modeled using linear regression adjusted for trends over time and country. All models were stratified by age (13 and 15 years) and sex. For 15-year-old girls, the implementation of smoke-free legislation in the United Kingdom was associated with a 4.3% reduction in the prevalence of regular smoking (P = .029). In addition, regular smoking fell by an additional 1.5% per annum post-legislation in this group (P = .005). Among 13-year-old girls, there was a reduction of 2.8% in regular smoking (P = .051), with no evidence of a change in trend post-legislation. Smaller and nonsignificant reductions in regular smoking were observed for 15- and 13-year-old boys (P = .175 and P = .113, respectively). Smoke-free legislation may help reduce smoking uptake amongst teenagers, with stronger evidence for an association seen in females. Further research that analyses longitudinal data across more countries is required. Previous research has established that smoke-free legislation has led to many improvements in population health, including reductions in heart attack, stroke, and asthma. However, the impacts of smoke-free legislation on the rates of smoking amongst children have been less investigated. Analysis of repeated cross-sectional surveys across the four countries of the United Kingdom

"Accommodating" smoke-free policies: tobacco industry's Courtesy of Choice programme in Latin America.

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Sebrié, Ernesto M; Glantz, Stanton A

2007-10-01

To understand the implementation and effects of the Courtesy of Choice programme designed to "accommodate" smokers as an alternative to smoke-free policies developed by Philip Morris International (PMI) and supported by RJ Reynolds (RJR) and British American Tobacco (BAT) since the mid-1990s in Latin America. Analysis of internal tobacco industry documents, BAT "social reports", news reports and tobacco control legislation. Since the mid-1990s, PMI, BAT and RJR promoted Accommodation Programs to maintain the social acceptability of smoking. As in other parts of the world, multinational tobacco companies partnered with third party allies from the hospitality industry in Latin America. The campaign was extended from the hospitality industry (bars, restaurants and hotels) to other venues such as workplaces and airport lounges. A local public relations agency, as well as a network of engineers and other experts in ventilation systems, was hired to promote the tobacco industry's programme. The most important outcome of these campaigns in several countries was the prevention of meaningful smoke-free policies, both in public places and in workplaces. Courtesy of Choice remains an effective public relations campaign to undermine smoke-free policies in Latin America. The tobacco companies' accommodation campaign undermines the implementation of measures to protect people from second-hand smoke called for by the World Health Organization Framework Convention on Tobacco Control, perpetuating the exposure to tobacco smoke in indoor enclosed environments.

Smokers’ compliance with smoke-free policies, and non-smokers’ assertiveness for smoke-free air in the workplace: a study from the Balkans.

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Lazuras, Lambros; Zlatev, Martin; Rodafinos, Angelos; Eiser, J Richard

2012-10-01

Identify the psychosocial variables that predict smokers’ compliance with smoke-free policies at work, and non-smokers’ assertiveness for smoke-free rights in Greek and Bulgarian workplaces. Data were collected from employees in Greece and Bulgaria. The main outcome measures were smokers’ compliance with smoke-free policies, and non-smokers’ assertiveness intentions. Demographic variables, tobacco use and dependence, as well as beliefs about second-hand smoke (SHS) exposure and smoking at work were also assessed. Regression analyses showed that smokers’ compliance with smoke-free policies was predicted by age, perceived health risks of smoking, and beliefs related to the benefits of smoking at work. Non-smokers’ assertiveness was predicted by annoyance from exposure to SHS at work, and assertiveness-related social cognitions (e.g., attitudes, social norms, and self-efficacy). Interventions to promote support for tobacco control policies at work in Greece and Bulgaria may benefit from targeting smokers’ beliefs about the actual effects of tobacco use on health and job performance. Accordingly, efforts to promote non-smokers assertiveness should build stronger assertiveness-related attitudes, convey anti-smoking normative messages, and strengthen self-efficacy skills.

Using the Theory of Normative Social Behavior to Understand Compliance with a Smoke-Free Law in a Middle-Income Country

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Byron, M. J.; Cohen, J. E.; Frattaroli, S.; Gittelsohn, J.; Jernigan, D. H.

2016-01-01

Smoke-free laws, which ban smoking in public venues, can be effective in protecting public health, but it has been difficult to achieve compliance with these laws in low- and middle-income countries. This study was conducted to understand the social norms around public smoking and learn how to improve compliance in Bogor, the first Indonesian city…

Smoke-free hospital site conversations: how nurses can initiate change.

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Mackereth, Peter; Finchett, Charlotte; Holt, Melody

2016-11-24

Smoking tobacco continues to be the world's most preventable cause of death and disability with over six trillion cigarettes sold each year. Patients, visitors and health professionals who smoke on hospital sites present a challenge to the effectiveness of public health messages. Health professionals who ignore 'No smoking' hospital/clinic signage, and avoid smoking-cessation activity, help to sustain the perception that smoking is tolerated. Case studies, with a focus on lung cancer and chronic obstructive pulmonary disease (COPD), are used to illustrate how nurses can 'seed' the idea of hospitals becoming smoke-free, provide brief interventions and support patients, carers and colleagues to make that change.

Smoke-Free Policies Among Asian-American Women: Comparisons by Education Status

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Tong, Elisa K; Tang, Hao; Tsoh, Janice; Wong, Candice; Chen, Moon S.

2009-01-01

Background California has significantly decreased racial/ethnic and educational disparities in smoke-free home and indoor work policies. California's ethnic-specific surveys present an opportunity to disaggregate data and examine the impact of California's smoke-free social norm campaign for Asian-American women. Methods The California Tobacco Use Surveys for Chinese Americans and Korean Americans were conducted in 2003 and analyzed in 2008 to compare women with lower (≤ high school graduate) or higher education status for smoke-free policy adoption and enforcement. Results Lower-educated and higher-educated women had similar proportions of smoke-free policies at home (58%) or indoor work (90%). However, lower-educated women were more likely than higher-educated women to report anyone ever smoking at home (OR=1.62, 95% CI=1.06, 2.48, p=0.03) and exposure during the past 2 weeks at an indoor workplace (OR=2.43, 95% CI= 1.30, 4.55, p=0.005), even after controlling for ethnicity, smoke-free policy, knowledge about the health consequences of secondhand smoke exposure, and acculturation. There was no interaction between education and knowledge about secondhand smoke health harms. Conclusions The intended consequences of California's tobacco-control efforts have resulted in similar rates of smoke-free policies at home and in indoor work environments among Asian-American women across educational levels. However, an unintended consequence of this success is a disparity in enforcement by educational status, with lower-educated Asian-American women reporting greater smoke exposure despite similar rates of knowledge about the health consequences of secondhand smoke exposure. Besides establishing policies, lower-educated Asian-American women may need to be empowered to assert and enforce their right to smoke-free environments. PMID:19591754

Going Smokefree Matters - Multiunit Housing Infographic

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U.S. Department of Health & Human Services — Explore the Going Smokefree Matters – Multiunit Housing Infographic which outlines key facts related to the effects of secondhand smoke exposure in multiunit housing.

[Perception over smoke-free policies amongst bar and restaurant representatives in central Mexico].

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Barrientos-Gutiérrez, Tonatiuh; Gimeno, David; Thrasher, James F; Reynales-Shigematsu, Luz Myriam; Amick, Benjamin C; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

2010-01-01

To analyze the perceptions and appreciations over smoke-free environments of restaurant and bar managers from four cities in central Mexico. Managers from 219 restaurants and bars from Mexico City, Colima, Cuernavaca and Toluca were surveyed about smoke-free environments opinions and implementation. Simultaneously, environmental nicotine was monitored. The majority of surveyed managers considered public places should be smoke-free, although more than half were concerned with potential economic loses. Implementation of smoke-free environments was more frequent in Mexico City (85.4%) than in the other cities (15.3% overall), with consequently lower environmental nicotine concentrations. Managers acknowledge the need to create smoke-free environments. Concerns over economic negative effects derived from the prohibition could explain, at least partially, the rejection of this sector towards the implementation of this type of policy.

Going Smokefree Matters - Multiunit Housing Infographic

Data.gov (United States)

U.S. Department of Health & Human Services — Explore the Going Smokefree Matters – Multiunit Housing Infographic which outlines key facts related to the effects of secondhand smoke exposure in multiunit...

Building on the success of ten years of comprehensive smokefree legislation in England

Directory of Open Access Journals (Sweden)

Ailsa Rutter

2018-03-01

The success of the smokefree law has led the way in increasing public support for existing and potential tobacco control measures. It has provided the opportunity to go beyond the scope of the law by introducing new smokefree areas. Further legislation to make all private vehicles smokefree would be welcome. It has been important to place this work within an overall programme where quitting tobacco remains the goal. Overall smoking in the NE has declined by 41% in this decade.

How good is compliance with smoke-free legislation in India? Results of 38 subnational surveys.

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Kumar, Ravinder; Goel, Sonu; Harries, Anthony D; Lal, Pranay; Singh, Rana J; Kumar, Ajay M V; Wilson, Nevin C

2014-09-01

India has been implementing smoke-free legislation since 2008 prohibiting smoking in public places. This study aimed to assess the level of compliance with smoke-free legislation (defined as the presence of no-smoking signage and the absence of active smoking, smoking aids, cigarette butts/bidi ends and smoking smell) and the role of enforcement systems in Indian jurisdictions. This was a cross-sectional, retrospective review of reports and primary data sheets of surveys conducted in 38 selected jurisdictions across India in 2012-2013. Of 20 455 public places (in 38 jurisdictions), 10 377 (51%) demonstrated full compliance with smoke-free law. Educational institutions and healthcare facilities performed well at 65% and 62%, respectively, while eateries and frequently visited other public places (such as bus stands, railway stations, shopping malls, stadia, cinema halls etc.) performed poorly at 37% and 27%, respectively. Absence of no-smoking signage was the largest contributor to non-compliance across all types of public places. Enforcement systems were present in all jurisdictions, but no associations could be demonstrated between these and smoke-free compliance. Smoke-free compliance in public places in India was suboptimal and was mainly related to the absence of no-smoking signage. This warrants further pragmatic and innovative ways to improve the situation. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Did smokefree legislation in England reduce exposure to secondhand smoke among nonsmoking adults? Cotinine analysis from the Health Survey for England.

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Sims, Michelle; Mindell, Jennifer S; Jarvis, Martin J; Feyerabend, Colin; Wardle, Heather; Gilmore, Anna

2012-03-01

On 1 July 2007, smokefree legislation was implemented in England, which made virtually all enclosed public places and workplaces smokefree. We examined trends in and predictors of secondhand smoke exposure among nonsmoking adults to determine whether exposure changed after the introduction of smokefree legislation and whether these changes varied by socioeconomic status (SES) and by household smoking status. We analyzed salivary cotinine data from the Health Survey for England that were collected in 7 of 11 annual surveys undertaken between 1998 and 2008. We conducted multivariate regression analyses to examine secondhand smoke exposure as measured by the proportion of nonsmokers with undetectable levels of cotinine and by geometric mean cotinine. Secondhand smoke exposure was higher among those exposed at home and among lower-SES groups. Exposure declined markedly from 1998 to 2008 (the proportion of participants with undetectable cotinine was 2.9 times higher in the last 6 months of 2008 compared with the first 6 months of 1998 and geometric mean cotinine declined by 80%). We observed a significant fall in exposure after legislation was introduced--the odds of having undetectable cotinine were 1.5 times higher [95% confidence interval (CI): 1.3, 1.8] and geometric mean cotinine fell by 27% (95% CI: 17%, 36%) after adjusting for the prelegislative trend and potential confounders. Significant reductions were not, however, seen in those living in lower-social class households or homes where smoking occurs inside on most days. We found that the impact of England's smokefree legislation on secondhand smoke exposure was above and beyond the underlying long-term decline in secondhand smoke exposure and demonstrates the positive effect of the legislation. Nevertheless, some population subgroups appear not to have benefitted significantly from the legislation. This finding suggests that these groups should receive more support to reduce their exposure.

Exposure to secondhand smoke and voluntary adoption of smoke-free home and car rules among non-smoking South African adults.

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Ayo-Yusuf, Olalekan A; Olufajo, Olubode; Agaku, Israel T

2014-06-10

Secondhand smoke (SHS) exposure is a well-established health hazard. To determine the effectiveness of existing smoke-free policies and adoption of smoke-free rules in South Africa, we assessed exposure to SHS from several sources among non-smoking adults during 2010. Data were analyzed for 3,094 adults aged ≥16 years who participated in the 2010 South African Social Attitudes Survey. Descriptive statistics and multivariate analyses were used to assess presence of smoke-free rules among all South Africans, and prevalence and correlates of SHS exposure at work, at home, and at hospitality venues among non-smokers. Overall, 70.6% of all South African adults had 100% smoke-free rules in their private cars, 62.5% in their homes, while 63.9% worked in places with 100% smoke-free policies. Overall, 55.9% of all non-smokers reported exposure to SHS from at least one source (i.e., in the home, workplace or at a hospitality venue). By specific source of exposure, 18.4% reported being exposed to SHS at work, 25.2% at home, 33.4% in a restaurant, and 32.7% at a bar. Presence of work bans on indoor smoking conferred lower likelihood of SHS exposure at work among non-smokers (adjusted odds ratio [aOR] = 0.23; 95% CI: 0.09-0.60). Similarly, smoke-free home rules decreased the odds of being exposed to SHS at home among non-smokers (aOR =0.16; 95% CI: 0.09-0.30). Over half of South African adults reported SHS exposure in the home or at public places such as the workplace and at hospitality venues. This underscores the need for comprehensive smoke-free laws that prohibit smoking in all public indoor areas without exemptions.

Tobacco Smoke Pollution in Hospitality Venues Before and After Passage of Statewide Smoke-Free Legislation.

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Buettner-Schmidt, Kelly; Boursaw, Blake; Lobo, Marie L; Travers, Mark J

2017-03-01

In 2012, North Dakota enacted a comprehensive statewide law prohibiting smoking in enclosed public places. Disparities in tobacco control exist in rural areas. This study's objective was to determine the extent to which the passage of a comprehensive, statewide, smoke-free law in a predominantly rural state influenced tobacco smoke pollution in rural and nonrural venues. A longitudinal cohort design study comparing the levels of tobacco smoke pollution before and after passage of the statewide smoke-free law was conducted in 64 restaurants and bars statewide in North Dakota. Particulate matter with a median aerodynamic diameter of <2.5 μm (a valid atmospheric marker of tobacco smoke pollution) was assessed. A significant 83% reduction in tobacco smoke pollution levels occurred after passage of the law. Significant reductions in tobacco smoke pollution levels occurred in each of the rural categories; however, no difference by rurality was noted in the analysis after passage of the law, in contrast to the study before passage. To our knowledge, this was the largest, single, rural postlaw study globally. A comprehensive statewide smoke-free law implemented in North Dakota dramatically decreased the level of tobacco smoke pollution in bars and restaurants. © 2016 The Authors. Public Health Nursing Published by Wiley Periodicals, Inc.

Correlates of Smoke-Free Home Policies in Shanghai, China

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Pinpin Zheng

2014-01-01

Full Text Available Background. Approximately 63.7% of nonsmokers in China are exposed to secondhand smoke (SHS in their homes. The current study documents the prevalence and correlates of smoke-free home policies in Shanghai, as well as reasons for implementing such a policy and places where smoking is most commonly allowed. Methods. We conducted in-person surveys of 500 participants using a multistage proportional random sampling design in an urban and suburban district. Results. Overall, 35.3% had a smoke-free home policy. In the logistic regression, having higher income, not having smokers in the home, having children in the home, having fewer friends/relatives who permit smoking at home, and not being a current smoker were correlates of having a smoke-free home policy P<0.05. Concern about the health impact of SHS was reportedly the most important reason for establishing a smoke-free home. Among participants with no or partial bans, the most common places where smoking was allowed included the living room (64.2%, kitchen (46.1%, and bathroom (33.8%. Conclusions. Smoke-free home policies were in place for a minority of households surveyed. Establishing such a policy was influenced by personal smoking behavior and social factors. These findings suggest an urgent need to promote smoke-free home policies through tobacco control programs.

Measuring Indoor Air Quality and Engaging California Indian Stakeholders at the Win-River Resort and Casino: Collaborative Smoke-Free Policy Development

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Neil E. Klepeis

2016-01-01

Full Text Available Most casinos owned by sovereign American Indian nations allow smoking, even in U.S. states such as California where state laws restrict workplace smoking. Collaborations between casinos and public health workers are needed to promote smoke-free policies that protect workers and patrons from secondhand tobacco smoke (SHS exposure and risks. Over seven years, a coalition of public health professionals provided technical assistance to the Redding Rancheria tribe in Redding, California in establishing a smoke-free policy at the Win-River Resort and Casino. The coalition provided information to the casino general manager that included site-specific measurement of employee and visitor PM2.5 personal exposure, area concentrations of airborne nicotine and PM2.5, visitor urinary cotinine, and patron and staff opinions (surveys, focus groups, and a Town Hall meeting. The manager communicated results to tribal membership, including evidence of high SHS exposures and support for a smoke-free policy. Subsequently, in concert with hotel expansion, the Redding Rancheria Tribal Council voted to accept a 100% restriction of smoking inside the casino, whereupon PM2.5 exposure in main smoking areas dropped by 98%. A 70% partial-smoke-free policy was instituted ~1 year later in the face of revenue loss. The success of the collaboration in promoting a smoke-free policy, and the key element of air quality feedback, which appeared to be a central driver, may provide a model for similar efforts.

Measuring Indoor Air Quality and Engaging California Indian Stakeholders at the Win-River Resort and Casino: Collaborative Smoke-Free Policy Development.

Science.gov (United States)

Klepeis, Neil E; Dhaliwal, Narinder; Hayward, Gary; Acevedo-Bolton, Viviana; Ott, Wayne R; Read, Nathan; Layton, Steve; Jiang, Ruoting; Cheng, Kai-Chung; Hildemann, Lynn M; Repace, James L; Taylor, Stephanie; Ong, Seow-Ling; Buchting, Francisco O; Lee, Juliet P; Moore, Roland S

2016-01-20

Most casinos owned by sovereign American Indian nations allow smoking, even in U.S. states such as California where state laws restrict workplace smoking. Collaborations between casinos and public health workers are needed to promote smoke-free policies that protect workers and patrons from secondhand tobacco smoke (SHS) exposure and risks. Over seven years, a coalition of public health professionals provided technical assistance to the Redding Rancheria tribe in Redding, California in establishing a smoke-free policy at the Win-River Resort and Casino. The coalition provided information to the casino general manager that included site-specific measurement of employee and visitor PM2.5 personal exposure, area concentrations of airborne nicotine and PM2.5, visitor urinary cotinine, and patron and staff opinions (surveys, focus groups, and a Town Hall meeting). The manager communicated results to tribal membership, including evidence of high SHS exposures and support for a smoke-free policy. Subsequently, in concert with hotel expansion, the Redding Rancheria Tribal Council voted to accept a 100% restriction of smoking inside the casino, whereupon PM2.5 exposure in main smoking areas dropped by 98%. A 70% partial-smoke-free policy was instituted ~1 year later in the face of revenue loss. The success of the collaboration in promoting a smoke-free policy, and the key element of air quality feedback, which appeared to be a central driver, may provide a model for similar efforts.

Policy support, norms, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico city.

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Thrasher, James F; Pérez-Hernández, Rosaura; Swayampakala, Kamala; Arillo-Santillán, Edna; Bottai, Matteo

2010-09-01

We assessed attitudes and beliefs about smoke-free laws, compliance, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico City. Trends and odds of change in attitudes and beliefs were analyzed across 3 representative surveys of Mexico City inhabitants: before implementation of the policy (n=800), 4 months after implementation (n=961), and 8 months after implementation (n=761). Results indicated high and increasing support for 100% smoke-free policies, although support did not increase for smoke-free bars. Agreement that such policies improved health and reinforced rights was high before policy implementation and increased thereafter. Social unacceptability of smoking increased substantially, although 25% of nonsmokers and 50% of smokers agreed with smokers' rights to smoke in public places at the final survey wave. Secondhand smoke exposure declined generally as well as in venues covered by the law, although compliance was incomplete, especially in bars. Comprehensive smoke-free legislation in Mexico City has been relatively successful, with changes in perceptions and behavior consistent with those revealed by studies conducted in high-income countries. Normative changes may prime populations for additional tobacco control interventions.

Voluntary Smoke-Free Measures Among Oklahoma Nightlife Owners: Barriers and Facilitators.

Science.gov (United States)

Benowitz-Fredericks, Carson; McQuoid, Julia; Sheon, Nicolas; Olson, Sarah; Ling, Pamela M

2018-03-01

Smoke-free policies prevent exposure to secondhand smoke and encourage tobacco cessation. Local smoke-free policies that are more comprehensive than statewide policies are not allowed in states with preemption, including Oklahoma, which has the sixth highest smoking prevalence in the United States. In states with preemption, voluntary smoke-free measures are encouraged, but little research exists on venue owners' and managers' views of such measures, particularly in nightlife businesses such as bars and nightclubs. This article draws from semistructured interviews with 23 Oklahoma bar owners and managers, examining perceived risks and benefits of adopting voluntary smoke-free measures in their venues. No respondents expressed awareness of preemption. Many reported that smoke-free bars and nightclubs were an inevitable societal trend, particularly as younger customers increasingly expected smoke-free venues. Business benefits such as decreased operating and cleaning costs, improved atmosphere, and employee efficiency were more convincing than improved employee health. Concerns that voluntary measures created an uneven playing field among venues competing for customers formed a substantial barrier to voluntary measures. Other barriers included concerns about lost revenue and fear of disloyalty to customers, particularly older smokers. Addressing business benefits and a level playing field may increase support for voluntary smoke-free nightlife measures.

Implementation of smoke-free legislation in Malaysia: are adolescents protected from respiratory health effects?

Science.gov (United States)

Zulkifli, Aziemah; Abidin, Najihah Zainol; Abidin, Emilia Zainal; Hashim, Zailina; Rahman, Anita Abd; Rasdi, Irniza; Syed Ismail, Sharifah Norkhadijah; Semple, Sean

2014-01-01

This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation. A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire. The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8). Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.

Support for smoke-free cars when children are present: a secondary analysis of 164,819 U.S. adults in 2010/2011.

Science.gov (United States)

Agaku, Israel T; Odukoya, Oluwakemi O; Olufajo, Olubode; Filippidis, Filippos T; Vardavas, Constantine I

2014-11-01

Comprehensive smoke-free legislations prohibiting smoking in indoor areas of workplaces, bars, and restaurants have been adopted in most of the USA; however, limited efforts have focused on regulating secondhand smoke (SHS) exposure in the family car. The objective of this study was to identify the determinants and national/state-specific population support for smoke-free cars, in the presence of any occupant in general, but particularly when children are present. National data of US adults aged ≥18 years (n = 164,819) were obtained from the 2010/2011 Tobacco Use Supplement of the Current Population Survey. Among all US adults, a significantly greater proportion supported smoke-free cars when it was specified that the occupant was a child compared to when not specified (93.4 vs. 73.7 %, p race/ethnicity, gender, current tobacco use, marital status, and the existence of household smoke-free regulations all mediated population support for smoke-free cars. While differences within the US population were noted, this study however showed overwhelming support for smoke-free car policies, particularly when children are present. Policies which prohibit smoking in indoor or confined areas such as cars may benefit public health by protecting nonsmoking children and adults from involuntary SHS exposure.

CDC STATE System Tobacco Legislation - Smokefree Campus

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U.S. Department of Health & Human Services — 1995-2016. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation – Smokefree Campuses. The...

Impact of smoke-free housing policy lease exemptions on compliance, enforcement and smoking behavior: A qualitative study

Directory of Open Access Journals (Sweden)

Pamela Kaufman

2018-06-01

Full Text Available This paper investigates the impacts of smoke-free housing policies on compliance, enforcement and smoking behavior. From 2012 to 2014, we studied two affordable housing providers in Canada with comprehensive smoke-free policies: Waterloo Regional Housing that required new leases to be non-smoking and exempted existing leases, and Yukon Housing Corporation that required all leases (existing and new to be non-smoking. Focus groups and key informant interviews were conducted with 31 housing and public health staff involved in policy development and implementation, and qualitative interviews with 56 tenants. Both types of smoke-free policies helped tenants to reduce and quit smoking. However, exempting existing tenants from the policy created challenges for monitoring compliance and enforcing the policy, and resulted in ongoing tobacco smoke exposure. Moreover, some new tenants were smoking in exempted units, which undermined the policy and maintained smoking behavior. Our findings support the implementation of complete smoke-free housing policies that do not exempt existing leases to avoid many of the problems experienced by staff and tenants. In jurisdictions where exempting existing leases is still required by law, adequate staff resources for monitoring and enforcement, along with consistent and clear communication (particularly regarding balconies, patios and outdoor spaces will encourage compliance. Keywords: Smoke-free policy, Housing, Tobacco smoke pollution, Smoking cessation, Qualitative research

Going Smokefree Matters - Bars and Restaurants Infographic

Data.gov (United States)

U.S. Department of Health & Human Services — Explore the Going Smokefree Matters – Bars and Restaurants Infographic which outlines key facts related to the effects of secondhand smoke exposure in bars and...

Going Smokefree Matters - In Your Home Infographic

Data.gov (United States)

U.S. Department of Health & Human Services — Explore the Going Smokefree Matters – In Your Home Infographic which outlines key facts related to the effects of secondhand smoke exposure in the home.

"Tired of watching customers walk out the door because of the smoke": a content analysis of media coverage of voluntarily smokefree restaurants and bars.

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McDaniel, Patricia A; Offen, Naphtali; Yerger, Valerie; Forsyth, Susan; Malone, Ruth E

2015-08-08

News media are key sources of information regarding tobacco issues, and help set the tobacco control policy agenda. We examined US news coverage of voluntarily smokefree restaurants and bars in locales without mandatory policies to understand how such initiatives are perceived. We searched three online media databases (Access World News, Lexis Nexis, and Proquest) for all news items, including opinion pieces, published from 1995 to 2011. We coded retrieved items quantitatively, analyzing the volume, type, provenance, prominence, and content of news coverage. We found 986 news items, most published in local newspapers. News items conveyed unambiguous support for voluntarily smokefree establishments, regardless of venue. Mandatory policies were also frequently mentioned, and portrayed positively or neutrally. Restaurant items were more likely to mention health-related benefits of going smokefree, with bar items more likely to mention business-related benefits. Voluntary smokefree rules in bars and restaurants are regarded by news media as reasonable responses to health and business-based concerns about worker and customer exposure to secondhand smoke. As efforts continue to enact comprehensive smokefree policies to protect all in such venues, the media are likely to be supportive partners in the advocacy process, helping to generate public and policymaker support.

Going Smokefree Matters - Bars and Restaurants Infographic

Data.gov (United States)

U.S. Department of Health & Human Services — Explore the Going Smokefree Matters – Bars and Restaurants Infographic which outlines key facts related to the effects of secondhand smoke exposure in bars and...

Smoke-free laws, gender, and reduction in hospitalizations for acute myocardial infarction.

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Hahn, Ellen J; Rayens, Mary Kay; Burkhart, Patricia V; Moser, Debra K

2011-01-01

We examined gender differences in the incidence of acute myocardial infarction (AMI) after the passage of a smoke-free law in Lexington, Kentucky. The initial legislation had exemptions not covering manufacturing facilities and government buildings, which may have put men at greater risk for AMI. We examined the effect of Lexington's smoke-free public places law on hospitalizations for AMI (i.e., heart attack) among men and women 40 months prior to and 32 months after enactment of the law. We used the statewide administrative database (Comp Data) for all hospital billing records for the four health-care systems in Lexington-Fayette County. Cases were included in the analysis if (1) the patient was $35 years of age; (2) the patient had a primary discharge diagnosis of AMI, with an International Classification of Diseases, Ninth Revision code in the range of 410.00 to 410.99; and (3) the date of service was between January 1, 2001, and December 31, 2006. Among women, AMI hospitalizations declined 23% after the law took effect. The rate of AMI events among men did not change significantly. There was an overrepresentation of women in the hospitality industry and a disproportionate number of men working in manufacturing facilities and government worksites not mandated by the law. We found gender differences in the reduction of AMI hospitalizations following implementation of a smoke-free law that covered only some sectors of the workforce. Enacting smoke-free laws that cover all places of employment and strengthening existing partial laws may extend protection against AMIs to female and male workers.

CDC STATE System Tobacco Legislation - Smokefree Indoor Air

Data.gov (United States)

U.S. Department of Health & Human Services — 1995-2018. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation – Smokefree Indoor Air. The...

CDC STATE System Tobacco Legislation - Smokefree Indoor Air

Data.gov (United States)

U.S. Department of Health & Human Services — 1995-2017. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation – Smokefree Indoor Air....

Local and regional smokefree and tobacco-free action in New Zealand: highlights and directions.

Science.gov (United States)

Thomson, George; Wilson, Nick

2017-09-22

In this viewpoint we highlight and discuss some recent local and regional level advances in tobacco control in Aotearoa/New Zealand. In this country a wide range of local actors are helping drive smokefree and tobacco-free policies, with an increasing presence of businesses in this field. There has been progress in the areas of smokefree dining, large outdoor worksites and ski fields, and parts of downtown areas such as squares and streets. In 2015 and 2016, three councils (Palmerston North, Napier and Hastings) have used pavement lease policies and bylaws to start introducing an element of requirement into smokefree outdoor dining. Elsewhere (eg, Rotorua, Ashburton, Westland and Christchurch) significant smokefree outdoor dining moves have been made by, or in conjunction with, local councils. Tobacco-free retailing continues to expand, particularly in Northland. In the absence of meaningful central government action on smokefree places in the last decade (despite the Smokefree 2025 goal), local activity is leading the way. It is particularly important in providing models for smokefree outdoor hospitality areas, where smoking normalisation and relapse are significant health risks. Nevertheless, there is a need for the local smokefree and tobacco-free activity to be nationally evaluated, particularly for assessing the prevalence of smoking in areas covered by 'smokefree' policies. Action by central government could help local actors by providing a more definite legislative basis for bylaws, by minimum outdoor smokefree laws and by the funding of effective tobacco control mass media.

Clear Skies and Grey Areas: Flight Attendants’ Secondhand Smoke Exposure and Attitudes toward Smoke-Free Policy 25 Years since Smoking was Banned on Airplanes

Directory of Open Access Journals (Sweden)

Frances A. Stillman

2015-06-01

Full Text Available Our objective was to provide descriptive data on flight attendant secondhand smoke (SHS exposure in the work environment, and to examine attitudes toward SHS exposure, personal health, and smoke-free policy in the workplace and public places. Flight attendants completed a web-based survey of self-reported SHS exposure and air quality in the work environment. We assessed the frequency and duration of SHS exposure in distinct areas of the workplace, attitudes toward SHS exposure and its health effects, and attitudes toward smoke-free policy in the workplace as well as general public places. A total of 723 flight attendants participated in the survey, and 591 responded to all survey questions. The mean level of exposure per flight attendant over the past month was 249 min. The majority of participants reported being exposed to SHS always/often in outdoor areas of an airport (57.7%. Participants who worked before the in-flight smoking ban (n = 240 were more likely to support further smoking policies in airports compared to participants who were employed after the ban (n = 346 (76.7% versus 60.4%, p-value < 0.01. Flight attendants are still being exposed to SHS in the workplace, sometimes at concerning levels during the non-flight portions of their travel. Flight attendants favor smoke-free policies and want to see further restrictions in airports and public places.

Effect of smoke-free patio policy of restaurants and bars on exposure to second-hand smoke.

Science.gov (United States)

Azagba, Sunday

2015-07-01

While there is increasing support for restricting smoking in restaurant and bar patios, there is limited evidence on the effectiveness of this policy. This study examined the effect of smoke-free patio policy of restaurants and bars on adult second-hand smoke (SHS) exposure. Data were drawn from the 2005-2012 Canadian Tobacco Use Monitoring Survey (n=89,743), a repeated cross-sectional survey of youth and adult. Regression analysis, a quasi-experimental design was used to examine the effect of provincial smoke-free patio policy on self-reported exposure to SHS. Analyses suggest that exposure to SHS on patios of bars and restaurants declined following the adoption of provincial smoke-free patio policy. Relative to pre-policy SHS exposure, regression results showed a reduction in the probability of SHS exposure of up to 25% in Alberta. Similarly, in Nova Scotia, the probability of SHS exposure declined by up to 21%. Analyses stratified by smoking status found similar significant effect on both smokers and non-smokers. Findings suggest that provincial patio smoking ban on bars and restaurants had the intended effect of protecting non-smokers from SHS exposure. This study is consistent with a large body of evidence showing that a strong smoke-free legislation is an effective public health measure. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Changes in air quality and second-hand smoke exposure in hospitality sector businesses after introduction of the English Smoke-free legislation.

Science.gov (United States)

Gotz, N K; van Tongeren, M; Wareing, H; Wallace, L M; Semple, S; Maccalman, L

2008-12-01

To monitor and disseminate the short-term effects of the English Smoke-free legislation on air quality and employee exposure in businesses of the hospitality industry. Indoor particle concentrations and salivary cotinine levels were measured in businesses in the hospitality sector and non-smoking employees one month before and after the implementation of the legislation. Results were immediately released to the media to announce the improvements in air quality and employee exposure to the wider public. Measurements were collected in 49 businesses and from 75 non-smoking individuals. Indoor PM(2.5) concentrations decreased by 95% from 217 microg/m(3) at baseline to 11 microg/m(3) at follow-up (P hospitality industry sector. We believe that quick and positive feedback to the public on the effects of smoking restrictions is essential when introducing public health legislation such as the Smoke-free legislation.

What Are the Perceptions, Experiences, and Behaviors of Health Care Providers After Implementation of a Comprehensive Smoke-Free Hospital Policy?

Science.gov (United States)

Luck, Kerrie E; Doucet, Shelley

2018-01-01

The aim of this study was to explore the perceptions, experiences, and behaviors of health care providers (HCPs) after the implementation of a comprehensive smoke-free policy. This qualitative descriptive study, using semi-structured interviews, was conducted with 28 HCPs working in a Canadian hospital. Four overarching themes emerged from the analysis including (a) greater support for tobacco reduction, (b) enhanced patient care and interactions, (c) improved staff morale, and (d) some barriers still exist. The main findings suggest a comprehensive smoke-free hospital environment can strengthen the tobacco-free workplace culture within a hospital setting among HCPs where support for tobacco reduction is amplified, patient care and interactions regarding tobacco dependence are improved, and staff morale is enhanced. While there are still some challenging barriers as well as opportunities for improvements, the implementation of a comprehensive smoke-free policy heightened the call-to-action among HCPs to take a more active role in tobacco reduction.

An observational study of compliance with North Dakota's smoke-free law among retail stores that sell electronic smoking devices.

Science.gov (United States)

Buettner-Schmidt, Kelly; Miller, Donald R

2017-07-01

To determine whether retail stores selling electronic smoking devices or liquid nicotine were compliant with North Dakota's smoke-free law. During June 2015, retail stores selling electronic smoking devices or liquid nicotine (n=16), but not legally required to be licensed to sell tobacco products, were assessed for compliance with North Dakota's smoke-free law by observing for smoking or e-smoking, or evidence of such, in prohibited areas and for the presence of required no-smoking signs. Use of e-cigarettes, or evidence of use, was observed inside 8 (50%) stores required to be smoke-free. On the basis of all indicators of compliance assessed, compliance with the state's smoke-free law was low, with only 6% and 44% of stores compliant with all indoor and outdoor requirements, respectively. To the best of our knowledge, this is the first U.S. study assessing retail stores selling electronic smoking devices or liquid nicotine for compliance with the smoke-free law. The use of e-cigarettes, or evidence of use, occurred in the stores where it is prohibited by law. Overall compliance with the smoke-free law was low. These stores should be licensed by the state, as are other tobacco retailers, because this may assist in education, enforcement and compliance with the law and increase public health protection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

CDC STATE System E-Cigarette Legislation - Smokefree Indoor Air

Data.gov (United States)

U.S. Department of Health & Human Services — 1995-2018. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. E-Cigarette Legislation—Smokefree...

Attitudes of students of a health sciences university towards the extension of smoke-free policies at the university campuses of Barcelona (Spain).

Science.gov (United States)

Martínez, Cristina; Méndez, Carlos; Sánchez, María; Martínez-Sánchez, José María

To assess attitudes towards the extension of outdoor smoke-free areas on university campuses. Cross-sectional study (n=384) conducted using a questionnaire administered to medical and nursing students in Barcelona in 2014. Information was obtained pertaining to support for indoor and outdoor smoking bans on university campuses, and the importance of acting as role models. Logistic regression analyses were performed to examine agreement. Most of the students agreed on the importance of health professionals and students as role models (74.9% and 64.1%, respectively) although there were statistically significant differences by smoking status and age. 90% of students reported exposure to smoke on campus. Students expressed strong support for indoor smoke-free policies (97.9%). However, only 39.3% of participants supported regulation of outdoor smoking for university campuses. Non-smokers (OR=12.315; 95% CI: 5.377-28.204) and students ≥22 years old (OR=3.001; 95% CI: 1.439-6.257) were the strongest supporters. The students supported indoor smoke-free policies for universities. However, support for extending smoke-free regulations to outdoor areas of university campuses was limited. It is necessary to educate students about tobacco control and emphasise their importance as role models before extending outdoor smoke-free legislation at university campuses. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Smoke-free laws and direct democracy initiatives on smoking bans in Germany: a systematic review and quantitative assessment.

Science.gov (United States)

Kohler, Stefan; Minkner, Philipp

2014-01-03

Germany's 16 states regulate smoking differently within health protection principles laid down in the federal law. All state smoke-free laws in Germany have undergone at least one change since taking effect. We systematically review federal and state laws regulating smoking, as well as petitions, popular initiatives and referenda that aimed at changing statutory smoking bans. Data generated through the systematic review were correlated with state smoking rates. The protection from the dangers of secondhand smoke is the primary motive for smoking bans in Germany. The first smoke-free laws affecting smoking in pubs, restaurants and several other public places were introduced in 2007. In 2008, the Federal Constitutional Court of Germany ruled in a leading decision on the smoke-free laws of two states that some common smoking ban exemptions of the introduced smoke-free laws violate the basic right to freely exercise a profession and mandated revisions. All states but Bavaria and Saarland, whose smoking bans were more and less comprehensive than those judged by the constitutional court, respectively, needed to change the smoking ban exemptions to reconcile their smoke-free laws with the constitution. Direct democracy initiatives to change smoking bans were only successful in Bavaria in 2010, but a total of 15 initiatives by citizens' or interest groups attempted to influence non-smokers protection legislation through direct democratic procedures. Early ratification of a smoking ban in a federal state correlates with a higher reduction in the smoking rate from 2005 to 2009 (Spearman's ρ = 0.51, p = 0.04). The federal government structure and direct democratic participation in smoke-free legislation in Germany has produced a diversity of local smoking bans and exemptions.

A smoke-free medical campus in Jerusalem: data for action.

Science.gov (United States)

Feldman, Itamar; Donchin, Milka; Levine, Hagai

2016-01-01

Establishing smoke-free environments is a major component of tobacco control policy. The introduction of a smoke-free policy in medical campuses may serve as a role model for other educational and health institutions but little has been published about their prevalence or impact. In 2012, the Faculty of Medicine at Hebrew University-Hadassah in Jerusalem, Israel launched a smoke-free Medical Campus initiative. This study examined smoking behaviours, cigarette smoke exposure and attitudes towards the smoke-free campus policy among students and employees. Using a self-administered questionnaire, data was collected from medical, dental and pharmacy students, as well as employees of the school of pharmacy. We approached the entire target population in 2013 (N = 449), with a response rate of 72.5 % (N = 313). The rate of smoking was 8.3 % (95 % CI 5.5-11.9 %). Most participants reported daily exposure or exposure several times a week to cigarette smoke (65.8 %). Overall, 98.0 % had reported seeing people smoke in open campus areas and 27.2 % indoors. Most participants supported the smoking ban inside buildings (94.2 %) but fewer supported (40.8 %) a complete ban of smoking throughout the campus, including outside areas. Only 18.4 % agreed that a policy prohibiting smoking was unfair to smokers. A multivariable analysis showed that support for a complete ban on smoking on campus was higher among non-smokers than for smokers (OR = 9.5, 95 % CI 2.2-31.5, p = 0.02). The smoke-free policy does not have total compliance, despite the strong support among both students and employees for a smoke-free medical campus. The data collected will assist policy makers move towards a total smoke-free medical campus and will aid tobacco control efforts in Israel and other countries.

Smoke-free air laws and asthma prevalence, symptoms, and severity among nonsmoking youth.

Science.gov (United States)

Dove, Melanie S; Dockery, Douglas W; Connolly, Gregory N

2011-01-01

We investigated the association between smoke-free laws and asthma prevalence, symptoms, and severity among nonsmoking youth (aged 3-15 years). We examined data from the 1999-2006 National Health and Nutrition Examination Survey, a cross-sectional survey designed to monitor the health and nutritional status of the US population. Survey locations were dichotomized as having or not having at least 1 smoke-free workplace, restaurant, or bar law at the county or state level that covered the entire county population. Asthma prevalence was assessed as self-reported current asthma and as ever having asthma with current symptoms. Asthmatic symptoms included persistent wheeze, chronic night cough, and wheeze-medication use. We also examined asthma severity (asthma attack or emergency-department visit for asthma) and persistent ear infection. Smoke-free laws were not associated with current asthma but were significantly associated with lower odds of asthmatic symptoms (odds ratio [OR]: 0.67 [95% confidence interval (CI): 0.48-0.93]) among nonsmoking youth. The association between smoke-free laws and ever having asthma with current symptoms approached significance (OR: 0.74 [95% CI: 0.53-1.03]). Smoke-free laws were associated with lower odds of asthma attacks (OR: 0.66 [95% CI: 0.28-1.56]) and emergency-department visits for asthma (OR: 0.55 [95% CI: 0.27-1.13]), although these results were not statistically significant. Our results suggest that smoke-free laws reduce asthmatic symptoms, including persistent wheeze, chronic night cough, and wheeze-medication use in nonsmoking youth.

CDC STATE System Tobacco Legislation - Smokefree Indoor Air Summary

Data.gov (United States)

U.S. Department of Health & Human Services — 1995-2018. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation – Smokefree Indoor Air. The...

CDC STATE System Tobacco Legislation - Smokefree Indoor Air Summary

Data.gov (United States)

U.S. Department of Health & Human Services — 1995-2017. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation – Smokefree Indoor Air....

CDC STATE System E-Cigarette Legislation - Smokefree Indoor Air

Data.gov (United States)

U.S. Department of Health & Human Services — 1995-2016. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. E-Cigarette Legislation—Smokefree...

Economic impact of a noncomprehensive smoke-free air law.

Science.gov (United States)

Tauras, John A; Chaloupka, Frank J; Keith, Jennifer D; Brown, Deborah P; Meyer, Joy Blankley

2014-07-01

Many stakeholders were interested in the potential economic impact of Pennsylvania's 2008 Clean Indoor Air Act (CIAA). This study focused on the examination of economic change subsequent to CIAA and, because CIAA allows certain venue exemptions among eating and drinking establishments, if the allowance of exemptions influenced that impact. Policy analysis. Prais-Winsten regressions were employed to assess effects of CIAA and law exemptions on county-level quarterly taxable sales in restaurants and drinking establishments. Regressions controlled for general economic activity, trends in eating/drinking establishment sales, seasonality, and county characteristics. Across models, CIAA had no significant negative effects on taxable sales in full-/limited-service restaurants or drinking establishments and some positive effects. CIAA exemptions for drinking establishments do not offer a clear economic benefit. Restaurant and drinking establishment taxable sales were strongly related to overall economic conditions and seasonality. After controlling for confounding factors, and consistent with the weight of the evidence from literature on the economic impact of smoke-free policies, our study concludes that the Pennsylvania CIAA had no negative effects on per capita restaurant and drinking establishment taxable sales. High rates of drinking establishment exemptions were not economically beneficial. This study can inform efforts to make smoke-free laws more comprehensive. © 2014 Society for Public Health Education.

Mobile Tools | Smokefree 60+

Science.gov (United States)

These mobile resources can help you quit when you're on the go. SmokefreeTXT SmokefreeTXT is a mobile text messaging service designed for adults across the United States who are trying to quit smoking. The program offers 24/7 encouragement, advice, and tips to help smokers quit smoking and stay quit. If you are interested in signing up, fill out this form.

Creating Effective Media Messaging for Rural Smoke-free Policy.

Science.gov (United States)

Riker, Carol A; Butler, Karen M; Ricks, JaNelle M; Record, Rachael A; Begley, Kathy; Anderson, Debra Gay; Hahn, Ellen J

2015-01-01

Objectives were to (1) explore perceived effectiveness of existing smoke-free print advertisements in rural communities and (2) generate message content, characteristics, and media delivery channels that resonate with residents. Qualitative methods design. Thirty-nine rural adults recruited by community partners. Content analysis of findings from individuals in four focus groups who participated in general discussion and reviewed eight print ads related to secondhand smoke (SHS) and smoke-free policy. Six content themes were identified: smoking/SHS dangers, worker health, analogies, economic impact, rights, and nostalgia. Seven message characteristics were recognized: short/to the point, large enough to read, graphic images, poignant stories, statistics/charts/graphs, message sender, and messages targeting different groups. Four media delivery channels were considered most effective: local media, technology, billboard messages, and print materials. Seeking input from key informants is essential to reaching rural residents. Use of analogies in media messaging is a distinct contribution to the literature on effective smoke-free campaigns. Other findings support previous studies of effective messaging and delivery channels. Further research is needed to examine effectiveness of themes related to message content in smoke-free ads and delivery strategies. Effective media messaging can lead to policy change in rural communities to reduce exposure to SHS. © 2015 Wiley Periodicals, Inc.

Assessment of the smoke-free outdoor regulation in the WHO European Region.

Science.gov (United States)

Martínez, Cristina; Guydish, Joseph; Robinson, Gillian; Martínez-Sánchez, Jose María; Fernández, Esteve

2014-07-01

The aim of this study is to assess the level of protection of secondhand smoke in outdoor locations among countries belonging to the WHO European Region. This cross-sectional study measures the level of protection provided by laws in outdoor locations. A protocol to evaluate the outdoor smoke-free legislation was developed according to the recommendations provided by the WHO Guidelines for implementing smoke-free outdoor places. For each law 6 main sectors and 28 outdoor locations were evaluated. 68 laws from 48 countries were reviewed, totally assessing 1758 locations. Overall 3.1% of the locations specified 100% smoke-free outdoor regulation without exceptions, 2.5% permitted smoking in designated outdoor areas, 37.5% allowed smoking everywhere, and 56.9% did not provide information about how to deal with smoking in outdoor places. In the Education sector 17.8% of the laws specified smoke-free outdoor regulation, mainly in the primary and secondary schools. Three pioneering laws from recreational locations and two from general health facilities specified 100% outdoor smoke-free regulation. Outdoor smoke-free policies among countries belonging to the WHO European Region are limited and mainly have been passed in the primary and secondary schools, which protect minors from the hazards of secondhand smoke in educational settings. Copyright © 2014 Elsevier Inc. All rights reserved.

Failure of policy regarding smoke-free bars in the Netherlands*

OpenAIRE

Gonzalez, Mariaelena; Glantz, Stanton A.

2011-01-01

Background: Tobacco companies consistently work to prevent and undermine smoke-free laws. The tobacco industry and its allies have funded hospitality associations and other third parties to oppose smoke-free laws, argue that smoke-free laws will economically damage hospitality venues, promote ventilation and voluntary smoker ‘accommodation’ as an alternative to smoke-free laws, and to challenge smoke-free laws in court. In 2008, the Netherlands extended its smoke-free law to hospitality venue...

Smoke-Free Laws and Direct Democracy Initiatives on Smoking Bans in Germany: A Systematic Review and Quantitative Assessment

Directory of Open Access Journals (Sweden)

Stefan Kohler

2014-01-01

Full Text Available Background: Germany’s 16 states regulate smoking differently within health protection principles laid down in the federal law. All state smoke-free laws in Germany have undergone at least one change since taking effect. Methods: We systematically review federal and state laws regulating smoking, as well as petitions, popular initiatives and referenda that aimed at changing statutory smoking bans. Data generated through the systematic review were correlated with state smoking rates. Results: The protection from the dangers of secondhand smoke is the primary motive for smoking bans in Germany. The first smoke-free laws affecting smoking in pubs, restaurants and several other public places were introduced in 2007. In 2008, the Federal Constitutional Court of Germany ruled in a leading decision on the smoke-free laws of two states that some common smoking ban exemptions of the introduced smoke-free laws violate the basic right to freely exercise a profession and mandated revisions. All states but Bavaria and Saarland, whose smoking bans were more and less comprehensive than those judged by the constitutional court, respectively, needed to change the smoking ban exemptions to reconcile their smoke-free laws with the constitution. Direct democracy initiatives to change smoking bans were only successful in Bavaria in 2010, but a total of 15 initiatives by citizens’ or interest groups attempted to influence non-smokers protection legislation through direct democratic procedures. Early ratification of a smoking ban in a federal state correlates with a higher reduction in the smoking rate from 2005 to 2009 (Spearman’s ρ = 0.51, p = 0.04. Conclusions: The federal government structure and direct democratic participation in smoke-free legislation in Germany has produced a diversity of local smoking bans and exemptions.

Local smoke-free policy development in Santa Fe, Argentina.

Science.gov (United States)

Sebrié, Ernesto M; Glantz, Stanton A

2010-04-01

To describe the process of approval and implementation of a comprehensive smoke-free law in the province of Santa Fe, Argentina, between 2005 and 2009. Review of the Santa Fe smoke-free legislation, articles published in local newspapers and documentation on two lawsuits filed against the law, and interviews with key individuals in Santa Fe. Efforts to implement smoke-free policies in Santa Fe began during the 1990s without success, and resumed in 2005 when the provincial Legislature approved the first 100% smoke-free subnational law in Argentina. There was no strong opposition during the discussions within the legislature. As in other parts of the world, pro-tobacco industry interests attempted to block the implementation of the law using well known strategies. These efforts included a controversy media campaign set up, the creation of a hospitality industry association and a virtual smokers' rights group, the introduction of a counterproposal seeking modification of the law, the challenge of the law in the Supreme Court, and the proposal of a weak national bill that would 'conflict' with the subnational law. Tobacco control advocates sought media attention as a strategy to protect the law. Santa Fe is the first subnational jurisdiction in Latin America to have enacted a comprehensive smoke-free policy following the recommendations of the World Health Organization (WHO) Framework Convention on Tobacco Control. After 3 years of implementation, pro-tobacco industry forces failed to undermine the law. Other subnational jurisdictions in Argentina, as well as in Mexico and Brazil are following the Santa Fe example.

[Social marketing and public policies for health: campaign to promote smoke-free spaces in Mexico].

Science.gov (United States)

Villalobos, Víctor; Ramírez, Olivia Ortiz; Thrasher, James F; Santillán, Edna Arillo; Hernández, Rosaura Pérez; Cedillo, Claudia; González, Wendy

2010-01-01

"Porque todos respiramos lo mismo" is a mass media campaign to promote smoke-free places (SFP). The development stages were: strategic planning; formative research; message development; media plan; and impact evaluation. Development involved formation of a coalition of key actors in various sectors. The target population was smokers and nonsmokers, with the aim of changing social norms around SFP. Nonsmokers were targeted because they comprised the majority and were most likely to appreciate the benefits of SFPs. Campaign materials were aired on television, radio, print and on billboards. One key limitation was the lack of evidence for previous campaigns, which increased the importance of formative research and of including a rigorous evaluation for this one. The campaign evaluation indicates a significant impact, which suggests that future campaigns use similar strategies in their development.

Smoke-free legislation and charitable gaming in Kentucky.

Science.gov (United States)

Pyles, M K; Hahn, E J

2009-02-01

To determine the effect of municipal smoke-free laws in Kentucky on gross and/or net revenues from charitable gaming activities. Between January 2000 and June 2007, 13 Kentucky communities implemented smoke-free legislation; only three specifically exempted charitable gaming facilities and compliance in several communities was not consistent. Kentucky is a tobacco-growing state that has the highest smoking rate in the United States. A fixed-effects time series design to estimate the impact of municipal smoke-free laws on charitable gaming. 13 Kentucky counties that implemented smoke-free laws during the study period of January 2000 through June 2007. All charitable gaming facilities in 13 counties in which a smoke-free ordinance was enacted during the study period. Gross and net revenues from charitable gaming activities in each county for each quarter of the study period, obtained from the Kentucky Department of Charitable Gaming. When controlling for economic variables, county-specific effects and time trends using a robust statistical framework, there was no significant relation between smoke-free laws and charitable gaming revenues. Municipal smoke-free legislation had no effect on charitable gaming revenues. No significant harm to charitable gaming revenues was associated with the smoke-free legislation during the 7.5-year study period, despite the fact that Kentucky is a tobacco-producing state with higher-than-average smoking rates.

Impact of a smoke-free policy in a large psychiatric hospital on staff attitudes and patient behavior.

Science.gov (United States)

Voci, Sabrina; Bondy, Susan; Zawertailo, Laurie; Walker, Louise; George, Tony P; Selby, Peter

2010-01-01

The objectives of this work were to examine changes over time in degree of staff support for the implementation of a smoke-free policy in Canada's largest public mental health and addiction teaching hospital and to assess the impact of the policy on patient behavior. Staff completed an anonymous survey, which assessed views toward the smoke-free policy and perceived change in patient behavior, 2-7 and 31-33 months after an indoor smoke-free policy was implemented (September 21, 2005). Objective indicators of patient behavior were also collected in the form of number of emergency code whites (aggressive behavior) and that of code reds (fire) called 1 year prior to and 2 years following policy implementation. Survey response rates were 19.0% (n=481) and 18.1% (n=500) at 2-7 and 31-33 months, respectively. The proportion of staff who supported the policy increased from pre-implementation (82.6%) to post-implementation (89.1%), and a high level of support was maintained 2 years after policy enactment (90.1%). The number of emergency codes did not significantly change after policy implementation, and staff did not perceive a change in most forms of patient behavior. A smoke-free policy can be implemented in a large psychiatric hospital with a high degree of support from staff and no substantial negative impact on patient behavior. Copyright © 2010 Elsevier Inc. All rights reserved.

Effect of Smoke-Free Legislation on Adult Smoking Behaviour in England in the 18 Months following Implementation

OpenAIRE

Lee, John Tayu; Glantz, Stanton A.; Millett, Christopher

2011-01-01

Background Comprehensive smoke-free legislation covering all enclosed public places and workplaces was implemented in England on 1 July 2007. This study examines the impact of this legislation on smoking prevalence, number of cigarettes smoked and location of smoking, controlling for secular trends through the end of 2008. Method and Findings Repeat cross sectional survey using nationally representative data from the Health Survey for England (HSE). In total there are 54,333 respondents from ...

Smoke-free medical students' meetings

DEFF Research Database (Denmark)

Brown, Colin; Rudkjøbing, Andreas

2005-01-01

Medical students of the world have signalled their commitment to health promotion by prohibiting smoking at the semiannual general assembly meetings of the International Federation of Medical Students' Associations (IFMSA). Although initially adopted in 2000, the smoke-free bylaw took 5 years...... to come into force. This year finally saw compliance with the bylaw on March 1, 2005, at the IFMSA General Assembly in Antalya, Turkey, when medical students who wanted to smoke had to do so outside....

Smoke-Free School Policy and Exposure to Secondhand Smoke: A Quasi-Experimental Analysis.

Science.gov (United States)

Azagba, Sunday; Kennedy, Ryan David; Baskerville, Neill Bruce

2016-02-01

Tobacco control prevention efforts are important to protect people from exposure to dangerous tobacco smoke, support cessation, and reduce tobacco-use initiation. While smoke-free laws have been a widespread tobacco control strategy, little work has been done to examine the impact of smoke-free school policies. The objective of this study is to evaluate the impact of provincial smoke-free school ground policies on youth-reported exposure to secondhand smoke (SHS) on school property. This study used a nationally representative sample of 20 388 youth aged 15-18 from the 2005-2012 Canadian Tobacco Use Monitoring Survey. A quasi-experimental design was used to evaluate the impact of smoke-free school policies on SHS exposure. Approximately over half (52%) of respondents reported SHS exposure on a school property in the past month. Smoke-free school policy had a statistically significant effect on SHS exposure. Specifically, the adoption of smoke-free school reduced the probability of SHS exposure by about 8 percentage points. Respondents who were smokers were more likely to report being exposed to SHS than nonsmokers. Likewise, those living in urban areas had higher probability of being exposed to SHS than those living in rural parts of Canada. Reported exposure to tobacco smoke did decrease after the introduction of smoke-free ground policies; however, almost half of high-school aged youth report exposure in the last month. Across Canada, provincial health authorities as well as school administers may need to assess the implementation of these smoke-free policies and improve enforcement strategies to further reduce exposure to dangerous SHS. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

Smoke-Free Rules and Secondhand Smoke Exposure in Vehicles among U.S. Adults-National Adult Tobacco Survey, 2009-2010 and 2013-2014.

Science.gov (United States)

Kruger, Judy; Jama, Amal; Kegler, Michelle; Baker Holmes, Carissa; Hu, Sean; King, Brian

2016-10-26

In the United States (U.S.), secondhand smoke (SHS) exposure causes more than 41,000 deaths among nonsmoking adults annually. Adoption of smoke-free laws in public areas has increased, but private settings such as vehicles remain a source of SHS exposure. This study assessed change in voluntary smoke-free vehicle rules and SHS exposure in personal vehicles among U.S. adults between two periods, 2009-2010 and 2013-2014, using data from the National Adult Tobacco Survey (NATS). NATS is a national landline and cellular telephone survey of non-institutionalized adults aged ≥18 years in the 50 U.S. states and the District of Columbia. We assessed percentage change in the prevalence of smoke-free vehicle rules among all adults and SHS exposure in vehicles among nonsmoking adults, overall, by sociodemographic factors (sex, age, race/ethnicity, education, marital status, annual household income, U.S. region), and by cigarette smoking status. During 2009-2010 to 2013-2014, the percentage of adults with a 100% smoke-free vehicle rule increased from 73.6% to 79.5% (% change = +8.0%; p exposure in vehicles in the previous 7 days decreased from 9.2% to 8.2% (% change = -10.9%; p Smoke-free rules in private settings such as vehicles, in coordination with comprehensive smoke-free policies in indoor public settings, can help reduce SHS exposure and promote smoke-free norms.

Maori challenges and crown responsibilities: Maori policymaker ideas on smokefree policy options.

Science.gov (United States)

Gifford, Heather; Parata, Kiri; Thomson, George

2010-11-26

To determine obstacles/opportunities within policy processes, for smokefree interventions appropriate to Maori. In particular, to explore Maori policymakers' ideas on how to achieve progress on smokefree homes, cars and community property. Documents and interviews with 16 senior Maori officials and Members of Parliament, and nine interviews in two case studies, were used to explore Maori policymakers' ideas for (i) Progress, within relevant policy processes, on smoking in homes, cars and community property; (ii) Particular interventions that the interviewees felt were most and least effective, practical, sustainable, politically feasible or desirable in some way; (iii) The context, and obstacles and opportunities for such interventions. The case studies were of a Maori health service and a group of Maori District Health Board managers. Several key themes emerged from the research including, (i) children as drivers for change, (ii) strong national and local indigenous leadership needed for change, (iii) delivering smokefree messages as part of wider healthy living approaches, (iv) targeting of the messages for greatest impact for Maori, (v) need for a Maori approach, not a general approach, (vi) central and local government having a significant role in the prevention of tobacco harm, (vii) ideas on how tobacco tax revenue should be spent on tobacco control, and (viii) the rights of children to smokefree environments. Results indicate that indigenous specific approaches and indigenous leadership are critical for Maori tobacco-free advances. Harnessing indigenous values and principles related to health, family and children was the preferred method of these Maori policymakers for delivering social marketing messages.

National and State-Specific Attitudes toward Smoke-Free Parks among U.S. Adults

Directory of Open Access Journals (Sweden)

Judy Kruger

2016-08-01

Full Text Available 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.

National and State-Specific Attitudes toward Smoke-Free Parks among U.S. Adults

Science.gov (United States)

Kruger, Judy; Jama, Amal; Kegler, Michelle; Marynak, Kristy; King, Brian

2016-01-01

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. PMID:27589779

Legislating tolerance: Spain's national public smoking law.

Science.gov (United States)

Muggli, Monique E; Lockhart, Nikki J; Ebbert, Jon O; Jiménez-Ruiz, Carlos A; Riesco Miranda, Juan Antonio; Hurt, Richard D

2010-02-01

While Spain's national tobacco control legislation prohibits smoking in many indoor public places, the law provides for an exception to the prohibition of smoking by allowing separate seating sections and ventilation options in certain public places such as bars and restaurants, hotels and airports. Accordingly, Spain's law is not aligned with Article 8 Guidelines of the World Health Organization's Framework Convention on Tobacco Control, which requires parties to ensure universal protection against secondhand smoke exposure in all enclosed public places, workplaces and on all means of public transport. Spain's law is currently being promoted by the tobacco companies in other countries as a model for smoke-free legislation. In order to prevent weakening of smoke-free laws in other countries through industry-supported exceptions, we investigated the tactics used by the tobacco companies before the implementation of the new law and assessed the consequences of these actions in the hospitality sector. Internal tobacco industry documents made public through US litigation settlements dating back to the 1980s were searched in 2008-9. Documents show that tobacco companies sought to protect hospitality venues from smoking restrictions by promoting separate seating for smokers and ineffective ventilation technologies, supporting an unenforceable voluntary agreement between the Madrid local government and the hospitality industry, influencing ventilation standards setting and manipulating Spanish media. The Spanish National Assembly should adopt comprehensive smoke-free legislation that does not accommodate the interests of the tobacco industry. In doing so, Spain's smoke-free public places law would be better aligned with the Framework Convention on Tobacco Control.

The impact of the 2010 Polish smoke-free legislation on the popularity and sales of electronic cigarettes.

Science.gov (United States)

Goniewicz, Maciej L; Kosmider, Leon; Delijewski, Marcin; Knysak, Jakub; Ochota, Patryk; Sobczak, Andrzej

2014-06-01

Electronic cigarettes, also called e-cigarettes or electronic nicotine delivery systems (ENDS), have become widely available globally, particularly via the Internet. They are considered by many users as a safe alternative to regular cigarettes, and some use them for smoking cessation. We investigated whether the implementation of new tobacco control legislation in Poland affected the popularity and sales of ENDS. This study monitored Google searches and online sales before and after the implementation of new tobacco control legislation in November 2010. The study demonstrated that the implementation of the smoke-free legislation was associated with only a temporary increase in ENDS online popularity in Poland. In longer time frames, there was decrease in ENDS online popularity and sales in Poland after implementation of the smoke-free policy. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Clear Skies and Grey Areas: Flight Attendants' Secondhand Smoke Exposure and Attitudes toward Smoke-Free Policy 25 Years since Smoking was Banned on Airplanes.

Science.gov (United States)

Stillman, Frances A; Soong, Andrea; Zheng, Laura Y; Navas-Acien, Ana

2015-06-04

Our objective was to provide descriptive data on flight attendant secondhand smoke (SHS) exposure in the work environment, and to examine attitudes toward SHS exposure, personal health, and smoke-free policy in the workplace and public places. Flight attendants completed a web-based survey of self-reported SHS exposure and air quality in the work environment. We assessed the frequency and duration of SHS exposure in distinct areas of the workplace, attitudes toward SHS exposure and its health effects, and attitudes toward smoke-free policy in the workplace as well as general public places. A total of 723 flight attendants participated in the survey, and 591 responded to all survey questions. The mean level of exposure per flight attendant over the past month was 249 min. The majority of participants reported being exposed to SHS always/often in outdoor areas of an airport (57.7%). Participants who worked before the in-flight smoking ban (n=240) were more likely to support further smoking policies in airports compared to participants who were employed after the ban (n=346) (76.7% versus 60.4%, p-valuesmoke-free policies and want to see further restrictions in airports and public places.

'It's about the smoke, not the smoker': messages that motivate rural communities to support smoke-free policies.

Science.gov (United States)

Kostygina, Ganna; Hahn, Ellen J; Rayens, Mary Kay

2014-02-01

Rural residents are exposed to sophisticated tobacco advertising and tobacco growing represents an economic mainstay in many rural communities. There is a need for effective health messages to counter the pro-tobacco culture in these communities. To determine relevant cultural themes and key message features that affect receptivity to pro-health advertisements among rural residents, 11 exploratory focus groups and surveys with community advocates (N = 82) in three rural Kentucky counties were conducted. Participants reviewed and rated a collection of print media advertisements and branding materials used by rural communities to promote smoke-free policies. Findings reveal that negative emotional tone, loss framing, appeals to religiosity, and shifting focus away from smokers are effective strategies with rural audiences. Potential pitfalls were identified. Attacks on smokers may not be a useful strategy. Health risk messages reinforced beliefs of secondhand smoke harm but some argued that the messages needed to appeal to smokers and emphasize health hazards to smokers, rather than to non-smokers only. Messages describing ineffectiveness of smoking sections were understood but participants felt they were only relevant for restaurants and not all public spaces. Emphasis on religiosity and social norms shows promise as a culturally sensitive approach to promoting smoke-free environments in rural communities.

Hospital admissions for acute myocardial infarction before and after implementation of a comprehensive smoke-free policy in Uruguay

Science.gov (United States)

Sebrié, Ernesto Marcelo; Sandoya, Edgardo; Hyland, Andrew; Bianco, Eduardo; Glantz, Stanton A; Cummings, K Michael

2012-01-01

Background Stimulated by the WHO Framework Convention on Tobacco Control, many countries in Latin America adopted comprehensive smoke-free policies. In March 2006, Uruguay became the first Latin American country to adopt 100% smoke-free national legislation, which ended smoking in all indoor public places and workplaces, including restaurants and bars. The objective of this study was to evaluate trends in hospital admissions for cardiovascular disease 2 years before and 2 years after the policy was implemented in Uruguay. Methods Reports of hospital admissions for acute myocardial infarction (AMI) (International Classification of Disease-10 I21) from 37 hospitals (79% of all hospital admissions in the country), representing the period 2 years before and 2 years after the adoption of a nationwide smoke-free policy in Uruguay (between 1 March 2004 and 29 February 2008), were reviewed. A time series analysis was undertaken to compare the average monthly number of events of hospital admission for AMI before and after the smoke-free law. Results A total of 7949 hospital admissions for AMI were identified during the 4-year study period. Two years after the smoke-free policy was enacted, hospital admissions for AMI fell by 22%. The same pattern and roughly the same magnitude of reduction in AMI admissions were observed for patients seen in public and private hospitals, men, women and people aged 40–65 years and older than 65 years. Conclusions The national smoke-free policy implemented in Uruguay in 2006 was associated with a significant reduction in hospital admissions for AMI. PMID:22337557

Hospital admissions for acute myocardial infarction before and after implementation of a comprehensive smoke-free policy in Uruguay.

Science.gov (United States)

Sebrié, Ernesto Marcelo; Sandoya, Edgardo; Hyland, Andrew; Bianco, Eduardo; Glantz, Stanton A; Cummings, K Michael

2013-05-01

Stimulated by the WHO Framework Convention on Tobacco Control, many countries in Latin America adopted comprehensive smoke-free policies. In March 2006, Uruguay became the first Latin American country to adopt 100% smoke-free national legislation, which ended smoking in all indoor public places and workplaces, including restaurants and bars. The objective of this study was to evaluate trends in hospital admissions for cardiovascular disease 2 years before and 2 years after the policy was implemented in Uruguay. Reports of hospital admissions for acute myocardial infarction (AMI) (International Classification of Disease-10 I21) from 37 hospitals (79% of all hospital admissions in the country), representing the period 2 years before and 2 years after the adoption of a nationwide smoke-free policy in Uruguay (between 1 March 2004 and 29 February 2008), were reviewed. A time series analysis was undertaken to compare the average monthly number of events of hospital admission for AMI before and after the smoke-free law. A total of 7949 hospital admissions for AMI were identified during the 4-year study period. Two years after the smoke-free policy was enacted, hospital admissions for AMI fell by 22%. The same pattern and roughly the same magnitude of reduction in AMI admissions were observed for patients seen in public and private hospitals, men, women and people aged 40-65 years and older than 65 years. The national smoke-free policy implemented in Uruguay in 2006 was associated with a significant reduction in hospital admissions for AMI.

[Response of the tobacco industry to the creation of smoke-free environments in Brazil].

Science.gov (United States)

Bialous, Stella Aguinaga; Presman, Sabrina; Gigliotti, Analice; Muggli, Monique; Hurt, Richard

2010-04-01

To document the response of the tobacco industry to the regulation of smoking in public places in Brazil starting in 1996. The Legacy Tobacco Documents Library (legacy.library.ucsf.edu/) and the British American Tobacco (BAT) Company Documents (bat.library.ucsf.edu/) were searched. The following key words were used: Brasil/Brazil; Souza Cruz; fumo passivo, tabagismo passivo/passive smoking; fumo de segunda mão/secondhand smoking; convivência em harmonia/courtesy of choice; along with the names of institutions, politicians, and individuals associated with tobacco control. We also searched the websites of cigarette manufacturers and hospitality industry organizations and businesses, news websites, and online newspapers and magazines. The search was limited to the period from 1995 to 2005. The text of the first law restricting smoking in Brazil (no. 9 294, of 1996) benefited the industry by stating that smokers and nonsmokers could share the same space provided that specific areas were designated as smoking and nonsmoking. As in other countries, the tobacco industry established partnerships with hotel, bar, and restaurant associations to prevent the passing of laws creating 100% smoke-free environments, as recommended by the World Health Organization. However, local state and city laws in major cities and states (such as Rio de Janeiro and São Paulo) have been successful in ensuring the creation of 100% smoke-free places. It is essential that Brazil recognize the damage caused by smoking and revise its federal law regulating smoking in closed environments. The knowledge concerning the strategies employed by the industry may be useful for politicians and health care professionals to prepare arguments opposing measures that can be detrimental to public health.

Environmental Tobacco Smoke Exposure and Smoke-Free Rules in Homes among Socially-Disadvantaged Populations in Poland

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Katarzyna Milcarz

2017-04-01

Full Text Available This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed in the Piotrkowski District were used, which was part of the “Reducing Social Inequalities in Health” program. Overall, 19.4% of the respondents declared exposure to ETS at home. In the non-smokers group, 15.5%, including 6.6% males and 18.3% females, were exposed to ETS in their place of residence (p < 0.0001. Complete smoke-free rules were adopted by 22.1% of the study participants. Two factors, smoker status and lack of ETS-associated health risk awareness, were found to be significantly associated with no adoption of total smoking bans at home. Socially-disadvantaged non-smokers, especially females from rural areas in Poland, still constitute a large population exposed to ETS in their homes—a challenge from the perspective of public health. Focused efforts are required to address social norms around exposing others to ETS.

Courtesy and the challenges of implementing smoke-free policies in Japan.

Science.gov (United States)

Bialous, Stella Aguinaga; Mochizuki-Kobayashi, Yumiko; Stillman, Frances

2006-04-01

For decades, the tobacco companies have developed a worldwide campaign to oppose the creation of smoke-free environments. Public health efforts to promote clean indoor air have been uneven throughout the world, and in few places have such efforts faced as many challenges as in Japan. The Japanese market is dominated by Japan Tobacco, which is partly owned by the government, and Philip Morris International is also present in Japan. Japan Tobacco and Philip Morris International have developed campaigns promoting courtesy and tolerance that, until recently, seem to have resonated well with the public. The companies also have supported research promoting ventilation and have funded consultants to act as experts in the area of second-hand smoke exposure. Japan is a critical country to study, partly because of the strength of Japan Tobacco in the country and the growth of Japan Tobacco International in Southeast Asia and the rest of the world, and partly because of Japan's ratification of the World Health Organization Framework Convention on Tobacco Control. This paper uses tobacco industry documents to provide an overview of the tobacco industry's scientific and political efforts to stifle the development of clean indoor measures in Japan. Learning past industry strategies may assist policymakers and advocates in the development of future public health activities.

Beneficial impacts of a national smokefree environments law on an indigenous population: a multifaceted evaluation

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Thomson George

2009-04-01

�ori responded to the new law with increased calls to the national Quitline service. Conclusion The New Zealand Smokefree Environments Amendment Act had a range of positive effects, including reducing SHS exposure among Māori communities. If the experience is replicated in other countries with indigenous populations, it suggests that comprehensive smokefree environments legislation will have beneficial effects on the health of indigenous groups and could contribute to reducing inequalities in health within societies.

Beneficial impacts of a national smokefree environments law on an indigenous population: a multifaceted evaluation

Science.gov (United States)

Edwards, Richard; Gifford, Heather; Waa, Andrew; Glover, Marewa; Thomson, George; Wilson, Nick

2009-01-01

increased calls to the national Quitline service. Conclusion The New Zealand Smokefree Environments Amendment Act had a range of positive effects, including reducing SHS exposure among Māori communities. If the experience is replicated in other countries with indigenous populations, it suggests that comprehensive smokefree environments legislation will have beneficial effects on the health of indigenous groups and could contribute to reducing inequalities in health within societies. PMID:19405964

Beneficial impacts of a national smokefree environments law on an indigenous population: a multifaceted evaluation.

Science.gov (United States)

Edwards, Richard; Gifford, Heather; Waa, Andrew; Glover, Marewa; Thomson, George; Wilson, Nick

2009-04-30

national Quitline service. The New Zealand Smokefree Environments Amendment Act had a range of positive effects, including reducing SHS exposure among Māori communities. If the experience is replicated in other countries with indigenous populations, it suggests that comprehensive smokefree environments legislation will have beneficial effects on the health of indigenous groups and could contribute to reducing inequalities in health within societies.

The impact of a 100% smoke-free law on the health of hospitality workers from the city of Neuquén, Argentina.

Science.gov (United States)

Schoj, Veronica; Alderete, Mariela; Ruiz, Ernesto; Hasdeu, Santiago; Linetzky, Bruno; Ferrante, Daniel

2010-04-01

The objective of this study was to evaluate the impact of 100% smoke-free environment legislation on respiratory and sensory irritation symptoms and respiratory function among bar and restaurant workers from the city of Neuquén, Argentina. Pre-ban and post-ban studies without a comparison group in an Argentinean city were conducted. A baseline survey and spirometric measurements were performed with a total of 80 bar and restaurant workers 1 month before (October 2007) and 3 months after (March 2008) the implementation of the new 100% smoke-free legislation. A significant reduction in secondhand smoke exposure was observed after the enactment and enforcement of the new legislation, and an important reduction in respiratory symptoms (from a pre-ban level of 57.5% to a post-ban level of only 28.8%). The reduction of sensory irritation symptoms was even higher. From 86.3% of workers who reported at least one sensory irritation symptom in October 2007, only 37.5% reported the same symptoms in March 2008. Also, data obtained by spirometry showed a significant forced vital capacity increase. Consistent with other studies, 100% smoke-free legislation improved short-term health outcomes in the sample and should be implemented nationwide. Furthermore, undertaking this study has been highly important in promoting 100% smoke-free environment legislation at the workplace as a legitimate right of hospitality workers, and in reducing social acceptance of designated smoking areas in bars and restaurants.

The impact of a 100% smoke-free law on the health of hospitality workers from the city of Neuquén, Argentina

Science.gov (United States)

Alderete, Mariela; Ruiz, Ernesto; Hasdeu, Santiago; Linetzky, Bruno; Ferrante, Daniel

2010-01-01

Objectives The objective of this study was to evaluate the impact of 100% smoke-free environment legislation on respiratory and sensory irritation symptoms and respiratory function among bar and restaurant workers from the city of Neuquén, Argentina. Methods Pre-ban and post-ban studies without a comparison group in an Argentinean city were conducted. A baseline survey and spirometric measurements were performed with a total of 80 bar and restaurant workers 1 month before (October 2007) and 3 months after (March 2008) the implementation of the new 100% smoke-free legislation. Results A significant reduction in secondhand smoke exposure was observed after the enactment and enforcement of the new legislation, and an important reduction in respiratory symptoms (from a pre-ban level of 57.5% to a post-ban level of only 28.8%). The reduction of sensory irritation symptoms was even higher. From 86.3% of workers who reported at least one sensory irritation symptom in October 2007, only 37.5% reported the same symptoms in March 2008. Also, data obtained by spirometry showed a significant forced vital capacity increase. Conclusions Consistent with other studies, 100% smoke-free legislation improved short-term health outcomes in the sample and should be implemented nationwide. Furthermore, undertaking this study has been highly important in promoting 100% smoke-free environment legislation at the workplace as a legitimate right of hospitality workers, and in reducing social acceptance of designated smoking areas in bars and restaurants. PMID:20378587

The economic impact of Mexico City's smoke-free law.

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López, Carlos Manuel Guerrero; Ruiz, Jorge Alberto Jiménez; Shigematsu, Luz Myriam Reynales; Waters, Hugh R

2011-07-01

To evaluate the economic impact of Mexico City's 2008 smoke-free law--The Non-Smokers' Health Protection Law on restaurants, bars and nightclubs. We used the Monthly Services Survey of businesses from January 2005 to April 2009--with revenues, employment and payments to employees as the principal outcomes. The results are estimated using a differences-in-differences regression model with fixed effects. The states of Jalisco, Nuevo León and México, where the law was not in effect, serve as a counterfactual comparison group. In restaurants, after accounting for observable factors and the fixed effects, there was a 24.8% increase in restaurants' revenue associated with the smoke-free law. This difference is not statistically significant but shows that, on average, restaurants did not suffer economically as a result of the law. Total wages increased by 28.2% and employment increased by 16.2%. In nightclubs, bars and taverns there was a decrease of 1.5% in revenues and an increase of 0.1% and 3.0%, respectively, in wages and employment. None of these effects are statistically significant in multivariate analysis. There is no statistically significant evidence that the Mexico City smoke-free law had a negative impact on restaurants' income, employees' wages and levels of employment. On the contrary, the results show a positive, though statistically non-significant, impact of the law on most of these outcomes. Mexico City's experience suggests that smoke-free laws in Mexico and elsewhere will not hurt economic productivity in the restaurant and bar industries.

Attitudes of students of a health sciences university towards the extension of smoke-free policies at the university campuses of Barcelona (Spain

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Cristina Martínez

2017-03-01

Conclusions: The students supported indoor smoke-free policies for universities. However, support for extending smoke-free regulations to outdoor areas of university campuses was limited. It is necessary to educate students about tobacco control and emphasise their importance as role models before extending outdoor smoke-free legislation at university campuses.

Population support before and after the implementation of smoke-free laws in the United States: trends from 1992-2007.

Science.gov (United States)

Nagelhout, Gera E; Wolfson, Tanya; Zhuang, Yue-Lin; Gamst, Anthony; Willemsen, Marc C; Zhu, Shu-Hong

2015-03-01

Several states implemented comprehensive smoke-free laws in workplaces (14 states), restaurants (17 states), and bars (13 states) between 2002 and 2007. We tested the hypothesis that public support for smoke-free laws increases at a higher rate in states that implemented smoke-free laws between 2002 and 2007 (group A) than in states that implemented smoke-free laws after that time or not at all (group B). The period before the implementation (1992-2001) was also considered. Data was used from the Current Population Survey (CPS) Tobacco Use Supplements (TUS), which is representative for the U.S. adult population. Respondents were asked whether they thought smoking should not be allowed in indoor work areas, restaurants, and bars and cocktail lounges. Differences in trends were analyzed with binomial mixed effects models. Population support for smoke-free restaurants and bars was higher among group A than among group B before 2002. After 2002, support for smoke-free restaurants and bars increased at a higher rate among group A than among group B. Population support for smoke-free workplaces did not differ between group A and B, and the increase in support for smoke-free workplaces also did not differ between these groups. The positive association between the implementation of smoke-free restaurant and bar laws and the rate of increase in support for these laws partly supported the hypothesis. The implementation of the laws may have caused support to increase, but also states that have higher support may have been more likely to implement smoke-free laws. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

‘It’s about the smoke, not the smoker’: messages that motivate rural communities to support smoke-free policies

Science.gov (United States)

Kostygina, Ganna; Hahn, Ellen J.; Rayens, Mary Kay

2014-01-01

Rural residents are exposed to sophisticated tobacco advertising and tobacco growing represents an economic mainstay in many rural communities. There is a need for effective health messages to counter the pro-tobacco culture in these communities. To determine relevant cultural themes and key message features that affect receptivity to pro-health advertisements among rural residents, 11 exploratory focus groups and surveys with community advocates (N = 82) in three rural Kentucky counties were conducted. Participants reviewed and rated a collection of print media advertisements and branding materials used by rural communities to promote smoke-free policies. Findings reveal that negative emotional tone, loss framing, appeals to religiosity, and shifting focus away from smokers are effective strategies with rural audiences. Potential pitfalls were identified. Attacks on smokers may not be a useful strategy. Health risk messages reinforced beliefs of secondhand smoke harm but some argued that the messages needed to appeal to smokers and emphasize health hazards to smokers, rather than to non-smokers only. Messages describing ineffectiveness of smoking sections were understood but participants felt they were only relevant for restaurants and not all public spaces. Emphasis on religiosity and social norms shows promise as a culturally sensitive approach to promoting smoke-free environments in rural communities. PMID:23969628

Smoke-Free Rules and Secondhand Smoke Exposure in Vehicles among U.S. Adults—National Adult Tobacco Survey, 2009–2010 and 2013–2014

Science.gov (United States)

Kruger, Judy; Jama, Amal; Kegler, Michelle; Baker Holmes, Carissa; Hu, Sean; King, Brian

2016-01-01

In the United States (U.S.), secondhand smoke (SHS) exposure causes more than 41,000 deaths among nonsmoking adults annually. Adoption of smoke-free laws in public areas has increased, but private settings such as vehicles remain a source of SHS exposure. This study assessed change in voluntary smoke-free vehicle rules and SHS exposure in personal vehicles among U.S. adults between two periods, 2009–2010 and 2013–2014, using data from the National Adult Tobacco Survey (NATS). NATS is a national landline and cellular telephone survey of non-institutionalized adults aged ≥18 years in the 50 U.S. states and the District of Columbia. We assessed percentage change in the prevalence of smoke-free vehicle rules among all adults and SHS exposure in vehicles among nonsmoking adults, overall, by sociodemographic factors (sex, age, race/ethnicity, education, marital status, annual household income, U.S. region), and by cigarette smoking status. During 2009–2010 to 2013–2014, the percentage of adults with a 100% smoke-free vehicle rule increased from 73.6% to 79.5% (% change = +8.0%; p exposure in vehicles in the previous 7 days decreased from 9.2% to 8.2% (% change = −10.9%; p Smoke-free rules in private settings such as vehicles, in coordination with comprehensive smoke-free policies in indoor public settings, can help reduce SHS exposure and promote smoke-free norms. PMID:27792208

Smoke-Free Universities Help Students Avoid Establishing Smoking by Means of Facilitating Quitting

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Tatiana I Andreeva

2015-12-01

Full Text Available Background: This study aimed to clarify whether smoke-free policies affect the initiation or the quit­ting of smoking among young adults. Methods: In this natural quasi-experiment study, three universities with different enforcement of smoke-free policies were considered in Kazan City, Russian Federation. Exposure data were collected in 2008-2009 through measurement of particulate matter concentrations in typical sets of premises in each university to distinguish smoke-free universities (SFU and those not smoke-free (NSFU. All present third year students were surveyed in class in April-June 2011. Number of valid questionnaires equaled 635. The questionnaire was adapted from the Health Professions Students Survey and con­tained questions on smoking initiation, current tobacco use, willingness to quit, quit attempts, percep­tion of smoke-free policies enforcement, and the demographic data. Results: Among students of SFU, the percentage of current smokers was smaller than in NSFU: 42% vs. 64% in men and 32% vs. 43% in women. Prevalence of daily smoking was 11-12% in SFU, 26% in NSFU overall and 42% among male students. No advantage of SFU in limiting smoking initiation was found. Percentage of former smokers in SFU was 33% vs. 10% in NSFU. Among current smokers, 57% expressed willingness to quit in SFU and only 28% in NSFU. About 60% of current smokers in SFU attempted to quit within a year and only 36% did so in NSFU with 23% vs. 3% having done three or more attempts. Conclusion: Smoke-free universities help young adults to avoid establishing regular smoking by means of facilitating quitting smoking.

Smoking cessation interventions from health care providers before and after the national smoke-free law in France.

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Kennedy, Ryan David; Behm, Ilan; Craig, Lorraine; Thompson, Mary E; Fong, Geoffrey T; Guignard, Romain; Beck, Francois

2012-02-01

Smoking cessation advice from health care providers (HCP) is well-known to be associated with increased quitting. This study sought to understand the extent to which smokers in France who visited a HCP around the time of the implementation of the national ban on smoking received encouragement to quit from a HCP and what kinds of intervention were provided. HCP may have a unique opportunity during the implementation phase of smoke-free laws to address their patients' smoking behaviours to increase the likelihood of success at a time when smokers' readiness and interest in quitting may be higher. Telephone interviews were conducted among adult smokers (n = 1067) before and after the two-phase (2007 and 2008) national ban on indoor smoking as part of the International Tobacco Control (ITC) France Survey. In the survey, smokers were asked whether they had visited a HCP in the past 6 months and, if so, whether they had received cessation encouragement, and/or other interventions to support quitting such as prescriptions for stop-smoking medication. Most smokers (61%) reported visiting a HCP in the 6 months prior to the first phase of the national smoke-free ban, and 58% after the time of the hospitality ban. Of these, most reported they did not receive any assistance from a HCP before (54%) or after (64%) the smoke-free law. Among those who reported an intervention, the most common were only encouragement to quit (58% in Wave 1 and 49% in Wave 2), or receiving both encouragement and a pamphlet (31% in both Wave 1 and 2). The combination of prescriptions for stop-smoking medicine and encouragement to quit increased from 8% in 2007 to 22% in 2008. The smokers who received an intervention were more likely (OR 1.9, 95% CI: 1.2-2.9) to report that they were thinking about quitting. This study demonstrates that HCP in France are well positioned to provide smoking cessation encouragement and other interventions to a majority of smokers and thus the importance of taking

Relationship of secondhand smoke exposure with sociodemographic factors and smoke-free legislation in the European Union.

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Filippidis, Filippos T; Agaku, Israel T; Girvalaki, Charis; Jiménez-Ruiz, Carlos; Ward, Brian; Gratziou, Christina; Vardavas, Constantine I

2016-04-01

To explore whether exposure to secondhand smoke (SHS) among non-smokers in the European Union (EU) showed any association with sociodemographic factors and/or the extent of national tobacco control policies. A secondary analysis was performed on data from 26 751 individuals ≥15 years old from 27 EU member states (EU MS), collected during the 2012 Special Eurobarometer survey (wave 77.1). Respondents were asked whether they had been exposed to SHS in eating or drinking establishments during the past 6 months, and/or in their workplace. Data on smoke-free policies were extracted from the European Tobacco Control Status Report and the European Tobacco Control Scale (TCS) in 2013. In total, 29.0% of non-smoking participants reported being exposed to SHS in indoor areas. Males (vs. females) as well as individuals with difficulties to pay bills (vs. those with no difficulties), had significantly greater odds of being exposed to SHS in bars, restaurants and workplaces. For every unit increase of a country's score on the Smoke-free Component of the TCS (indicating greater adherence to smoke-free legislations) the odds ratio of reporting exposure to SHS was 0.82 in bars, 0.85 in restaurants and 0.94 in workplaces. Differences in exposure to SHS clearly exist between and within EU MS, despite the fact that they all have signed the Framework Convention on Tobacco Control, with the burden found to disproportionally affect younger people and individuals with financial difficulties. Moreover, enforcement of smoke-free legislation was inversely associated with SHS exposure, highlighting the importance of enforcing comprehensive smoking bans. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Views about secondhand smoke and smoke-free policies among North Carolina restaurant owners before passage of a law to prohibit smoking.

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Linnan, Laura A; Weiner, Bryan J; Bowling, J Michael; Bunger, Erin M

2010-01-01

This study examined the knowledge, attitudes, and beliefs about secondhand smoke and smoke-free policies among North Carolina restaurant owners and managers before passage of House Bill 2, which prohibited smoking in most restaurants and bars. A random sample of North Carolina restaurants was selected to participate. A 15-minute telephone survey was completed by 523 restaurant owners and managers (one per participating restaurant) who spoke English and operated a restaurant that had seating for guests and was not a corporate headquarters for a restaurant chain (response rate, 36.7%). Bivariable analyses using chi2 tests of association were conducted. Multivariable modeling with logistic regression was used to examine relationships among several predictor variables and current smoking policies at participating restaurants, support among owners and managers for a statewide ban on smoking in restaurants, and beliefs among owners and managers about the economic impact of smoke-free policies. Restaurant owners and managers were aware that secondhand smoke causes cancer and asthma (79% and 73% or respondents, respectively) but were less aware that it causes heart attacks (56%). Sixty-six percent of restaurants did not permit any smoking indoors. Sixty percent of owners and managers supported a statewide smoke-free law. Owners and managers who were current smokers, those who worked at a restaurant with an employee smoking prevalence of more than 25%, and those who worked in a restaurant without a 700% smoke-free policy were significantly less likely to support a statewide law requiring smoke-free public places. Only owner and manager smoking status and no current smoke-free indoor policy were significant independent predictors of the belief that instituting a smoke-free policy would have negative economic consequences for the restaurant. Although participating establishments were a representative sample of North Carolina restaurants, an overall survey response rate of 36

Relapse to smoking following release from smoke-free correctional facilities in Queensland, Australia.

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Puljević, Cheneal; de Andrade, Dominique; Coomber, Ross; Kinner, Stuart A

2018-06-01

Smoke-free prison policies are increasingly common, but few studies have investigated relapse to smoking after release from prison. This study investigated return to tobacco smoking and correlates of smoking at reduced levels after release among adults recently released from smoke-free prisons in Queensland, Australia. A cross-sectional survey of 114 people at parole offices within two months of release from prison was used. The survey measured health, social, and criminological factors related to tobacco smoking. We used logistic regression to identify factors associated with reduced post-release smoking levels compared to pre-incarceration levels. 94% of participants relapsed to smoking within two months of release; 72% relapsed on the day of release. 62% of participants smoked significantly less per day after compared with before incarceration. Living with a partner (Odds Ratio (OR) 2.77, 95%CI 1.02-7.52), expressing support for smoke-free prison policies (OR 2.44, 95%CI 1.12-5.32), intending to remain abstinent post-release (OR 4.29, 95%CI 1.88-9.82), and intending to quit in the future (OR 3.88, 95%CI 1.66-9.07) were associated with reduced smoking post-release. Use of illicit drugs post-release was negatively associated with reduced smoking post-release (OR 0.27, 95%CI 0.09-0.79). In multivariate analyses, pre-release intention to remain smoke-free was associated with reduced smoking post-release (AOR 2.69, 95%CI 1.01-7.14). Relapse to smoking after release from smoke-free prisons is common, but many who relapse smoke less than before incarceration, suggesting that smoke-free prison policies may reduce post-release tobacco smoking. There is a need for tailored, evidence-based tobacco cessation interventions for people recently released from prison. Copyright © 2018 Elsevier B.V. All rights reserved.

An examination of smoking behavior and opinions about smoke-free environments in a large sample of sexual and gender minority community members.

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McElroy, Jane A; Everett, Kevin D; Zaniletti, Isabella

2011-06-01

The purpose of this study is to more completely quantify smoking rate and support for smoke-free policies in private and public environments from a large sample of self-identified sexual and gender minority (SGM) populations. A targeted sampling strategy recruited participants from 4 Missouri Pride Festivals and online surveys targeted to SGM populations during the summer of 2008. A 24-item survey gathered information on gender and sexual orientation, smoking status, and questions assessing behaviors and preferences related to smoke-free policies. The project recruited participants through Pride Festivals (n = 2,676) and Web-based surveys (n = 231) representing numerous sexual and gender orientations and the racial composite of the state of Missouri. Differences were found between the Pride Festivals sample and the Web-based sample, including smoking rates, with current smoking for the Web-based sample (22%) significantly less than the Pride Festivals sample (37%; p times more likely to be current smokers compared with the study's heterosexual group (n = 436; p = .005). Statistically fewer SGM racial minorities (33%) are current smokers compared with SGM Whites (37%; p = .04). Support and preferences for public and private smoke-free environments were generally low in the SGM population. The strategic targeting method achieved a large and diverse sample. The findings of high rates of smoking coupled with generally low levels of support for smoke-free public policies in the SGM community highlight the need for additional research to inform programmatic attempts to reduce tobacco use and increase support for smoke-free environments.

Before and after study of bar workers' perceptions of the impact of smoke-free workplace legislation in the Republic of Ireland

Directory of Open Access Journals (Sweden)

Mullally Bernie J

2007-06-01

Full Text Available Abstract Background Objectives: To compare support for, and perceptions of, the impacts of smoke-free workplace legislation among bar workers in the Republic of Ireland (ROI pre- and post-implementation, and to identify predictors of support for the legislation. Methods Setting: Public houses (pubs in three areas of the ROI. Design: Comparisons pre- and post-implementation of smoke-free workplace legislation. Participants: From a largely non-random selection, 288 bar workers volunteered for the baseline survey; 220 were followed up one year later (76.4%. Outcome measures: Level of support for the legislation, attitude statements concerning potential impacts of the law and modelled predictors of support for the legislation. Results Pre-implementation 59.5% of participants supported the legislation, increasing to 76.8% post-implementation. Support increased among smokers by 27.3 percentage points from 39.4% to 66.7% (p Pre-legislation three-quarters of participants agreed that the legislation would make bars more comfortable and was needed to protect workers' health. Post-legislation these proportions increased to over 90% (p Conclusion Smoke-free legislation had the support of three-quarters of a large sample of bar workers in the ROI. However, this group holds complex sets of both positive and negative perspectives on the legislation. Of particular importance is that negative economic perceptions did not diminish the widely held perception that the ban is needed to protect workers' health.

Sociodemographic Disparities in Local Smoke-Free Law Coverage in 10 States.

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Huang, Jidong; King, Brian A; Babb, Stephen D; Xu, Xin; Hallett, Cynthia; Hopkins, Maggie

2015-09-01

We assessed sociodemographic disparities in local 100% smoke-free laws prohibiting smoking in all indoor areas of nonhospitality worksites, restaurants, and bars in 10 states. We obtained data on local 100% smoke-free laws (US Tobacco Control Laws Database) and subcounty characteristics (2006-2010 American Community Survey) for Alabama, Alaska, Indiana, Kentucky, Mississippi, Missouri, North Dakota, South Carolina, Texas, and West Virginia. Outcomes included (1) 100% smoke-free law covering restaurants, bars, and workplaces; (2) 100% smoke-free law covering restaurants, bars, or workplaces; and (3) number of venue types covered by 100% smoke-free laws (0-3). Sociodemographics included total population, urban status, percentage racial/ethnic minority, per capita income, percentage with high-school diploma, percentage with blue-collar jobs, and percentage of workers who live and work in the same locality. Across states, localities with less-educated residents, smaller proportions of workers living and working in the same locality, or both generally had lower odds of being covered by 100% smoke-free laws. Coverage varied across states for other sociodemographics. Disparities exist in local smoke-free law coverage. Identifying patterns in coverage can inform state efforts to address related disparities.

Public health in New York City, 2002-2007: confronting epidemics of the modern era.

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Frieden, Thomas R; Bassett, Mary T; Thorpe, Lorna E; Farley, Thomas A

2008-10-01

Long after the leading causes of death in the United States shifted from infectious diseases to chronic diseases, many public health agencies have not established effective policies and programmes to prevent current health problems. Starting in 2002, the New York City health department, an agency with a long history of innovation, undertook initiatives to address chronic disease prevention and control, as well as to modernize methods to address persistent health problems. All the initiatives relied on an expansive use of epidemiology; actions to prevent disease were based on policy change to create health-promoting environments as well as engagement with the health care system to improve its focus on prevention. Examples of policy-based initiatives are: a multi-component tobacco control programme that included a tax increase, a comprehensive smoke-free air law, hard-hitting anti-tobacco advertising and cessation services; elimination of trans fats from restaurants and a mandate that restaurants post-calorie information on menu boards. Examples of health care initiatives are public health 'detailing' to primary care providers, creation of a city-wide diabetes registry and development of a public health-oriented electronic health record. The infrastructure needed by local health departments to prevent chronic diseases and other modern health problems includes strong information technology systems, skillful epidemiology, expertise in communications using modern media, policy-making authority and, most importantly, political support.

"You Want Your Guests to Be Happy in This Business": Hoteliers' Decisions to Adopt Voluntary Smoke-Free Guest-Room Policies.

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McDaniel, Patricia A; Malone, Ruth E

2018-01-01

To explore why some hotels have implemented 100% smoke-free policies voluntarily, the perceived consequences of doing so, and media responses. Qualitative study of hotel management and quantitative content analysis of media coverage of smoke-free hotels. Hotels and media based in the United States. Eleven representatives of 5 independent and 4 chain hotels. Other data included 265 news items about smoke-free hotels. We conducted 30-minute semi-structured interviews with hotel representatives and analyzed the data using qualitative content analysis. We also searched 3 online news databases for news items about hotels in our study, and collaboratively coded retrieved items; we analyzed the content and slant of news items. Business considerations, including guest requests, competitor action, and cost savings, were the primary motivations for implementing 100% smoke-free guest-room policies. Health concerns played a minimal role. Hotels received positive feedback from customers and employees. Media coverage was favorable, emphasizing positive aspects of going smoke-free; the overall slant of news items was positive or neutral. However, few hotels marketed the change. Since hotel customers and employees are likely to experience long periods of smoke exposure and smoke-free hotels appear to be so well received, it may be timely to pursue policies making all hotels smoke-free.

Effect of smoke-free policies on the behaviour of social smokers.

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Philpot, S J; Ryan, S A; Torre, L E; Wilcox, H M; Jalleh, G; Jamrozik, K

1999-01-01

To test the hypothesis that proposed amendments to the Occupational Safety and Health Act making all enclosed workplaces in Western Australia smoke free would result in a decrease in cigarette consumption by patrons at nightclubs, pubs, and restaurants without adversely affecting attendance. Cross sectional structured interview survey. Patrons of several inner city pubs and nightclubs in Perth were interviewed while queuing for admission to these venues. Current social habits, smoking habits; and how these might be affected by the proposed regulations. Persons who did not smoke daily were classified as "social smokers." Half (50%) of the 374 patrons interviewed were male, 51% currently did not smoke at all, 34.3% smoked every day, and the remaining 15.7% smoked, but not every day. A clear majority (62.5%) of all 374 respondents anticipated no change to the frequency of their patronage of hospitality venues if smoke-free policies became mandatory. One in five (19.3%) indicated that they would go out more often, and 18.2% said they would go out less often. Half (52%) of daily smokers anticipated no change to their cigarette consumption, while 44.5% of daily smokers anticipated a reduction in consumption. A majority of social smokers (54%) predicted a reduction in their cigarette consumption, with 42% of these anticipating quitting. One in nine (11.5%) of smokers say that adoption of smoke-free policies would prompt them to quit smoking entirely without a significant decrease in attendance at pubs and nightclubs. There can be few other initiatives as simple, cheap, and popular that would achieve so much for public health.

Perspectives of Chinese American smoker and nonsmoker household pairs about the creating smokefree living together program.

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Saw, Anne; Paterniti, Debora A; Fung, Lei-Chun; Tsoh, Janice Y; Tong, Elisa K

2018-04-01

Chinese men smoke at high rates, and this puts household members at risk for tobacco-related diseases. Culturally responsive interventions that provide education and support are needed to promote smokefree living and reduce smoke exposure, particularly for US immigrants who experience changes in smokefree social norms. This qualitative study examines perspectives of Chinese American smoker and nonsmoker household pairs in the Creating Smokefree Living Together program. Four focus groups were conducted with 30 Chinese American participants (15 smokers and 15 nonsmokers) who, in household pairs, completed smokefree education interventions of either brief or moderate intensity. Nearly three-quarters of the smokers continued to smoke after the intervention at the time of focus group participation. All smokers were male, and most household nonsmokers were female spouses. All participants had limited English proficiency. Focus group meetings were recorded, and the recordings were translated and transcribed. Transcripts and field notes were thematically analyzed. The following themes, shared by smokers and nonsmokers across interventions, were identified: 1) there was a preference for dyadic and group interventions because of the support offered, 2) increased knowledge of the health harms of smoke exposure within a pair improved the nonsmoker's support for smokefree living, 3) learning communication strategies improved household relationships and assertiveness for smokefree environments, 4) biochemical feedback was useful but had short-term effects, and 5) project magnets provided cues to action. Involving household partners is critical to smokefree interventions. Simple reminders at home appear to be more powerful than personal biochemical feedback of smoke exposure for sustaining motivation and engagement in ongoing behavioral changes within the household. Cancer 2018;124:1599-606. © 2018 American Cancer Society. © 2018 American Cancer Society.

Public health foundations and the tobacco industry: lessons from Minnesota

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Ibrahim, J; Tsoukalas, T; Glantz, S

2004-01-01

Objective: To investigate whether private foundations can be created in a way that will insulate them from attacks by the tobacco industry, using the Minnesota Partnership for Action Against Tobacco (MPAAT) as a case study. Design: Information was collected from internal tobacco industry documents, court documents, newspapers, and interviews with health advocates and elected officials. Results: The creation of MPAAT as an independent foundation did not insulate it from attacks by tobacco industry allies. During 2001–2002, MPAAT was repeatedly attacked by Attorney General Mike Hatch and major media, using standard tobacco industry rhetoric. This strategy of attack and demands for information were reminiscent of previous attacks on Minnesota's Plan for Nonsmoking and Health and the American Stop Smoking Intervention Study (ASSIST). MPAAT was ultimately forced to restructure its programme to abandon effective community norm change interventions around smoke-free policies and replace them with less effective individual cessation interventions. Neither MPAAT nor other health advocates mounted an effective public response to these attacks, instead relying on the insider strategy of responding in court. Conclusion: It is not possible to avoid attacks by the tobacco industry or its political allies. Like programmes administered by government agencies, tobacco control foundations must be prepared for these attacks, including a proactive plan to educate the public about the principles of community based tobacco control. Public health advocates also need to be willing to take prompt action to defend these programmes and hold public officials who attack tobacco control programmes accountable for their actions. PMID:15333877

Passing a smoke-free law in a pro-tobacco culture: a multiple streams approach.

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Greathouse, Lisa W; Hahn, Ellen J; Okoli, Chizimuzo T C; Warnick, Todd A; Riker, Carol A

2005-08-01

This article describes a case study of the policy development and political decision-making process involved in the enactment of Lexington, Kentucky's smoke-free law. The multiple streams framework is used to analyze the development of the law in a seemingly unlikely and challenging political environment. Proponents developed a dissemination research plan targeted at policy makers and the public to demonstrate the need for a comprehensive law. The existence of a strong coalition of health care providers and health care systems including the board of health, as well as long-standing tobacco control expertise and a strong legal team, were essential ingredients for success. A deliberate strategy to expose the tobacco industry was effective in preparing policy makers for the opponents' policy arguments. As expected, a hospitality industry association was formed to oppose the ordinance, resulting in a legal challenge that delayed enactment of the law.

Attitudes of business people to proposed smokefree shopping streets.

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Patel, Vimal; Thomson, George; Wilson, Nick

2013-01-01

To investigate the attitudes of business people toward a possible smokefree policy along a route of major shopping streets, the "Golden Mile" (GM) in central Wellington, New Zealand. Businesses on the GM (n = 303) were visited in June-July 2011. Either the owner or manager from each business was surveyed. A response rate of 65.6% (n = 198) was achieved, with 13.3% declining to participate, and further contact not being productive for 21.2%. Support for making the GM smokefree was 43.4% (95% CI = 36.7%-50.4%), with the remainder opposed. There was significantly higher support among business people who were nonsmokers versus smokers (relative risk = 2.95; 95% CI = 1.48-5.89). Overall, 83.3% (95% CI = 77.0%-88.0%) of respondents stated that a smokefree GM would have either a positive or negligible impact on their business (nonconcern), compared with a negative impact (at 16.7%). Nonconcern about the business impact of a smokefree GM was significantly greater for nonfood businesses (89.9%) versus food businesses (64.0%; p business people may reflect the negligible promotion of the idea in this setting. Nevertheless, the likely business impact of a smokefree streets policy was not a concern for the large majority of these business people, so this may not be a significant barrier to policy development. This type of study can contribute to the process for developing smokefree streets and other outdoor areas, by gauging sector support.

Association between clean indoor air laws and voluntary smokefree rules in homes and cars.

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Cheng, Kai-Wen; Okechukwu, Cassandra A; McMillen, Robert; Glantz, Stanton A

2015-03-01

This study examines the influence that smokefree workplaces, restaurants and bars have on the adoption of smokefree rules in homes and cars, and whether there is an association with adopting smokefree rules in homes and cars. Bivariate probit models were used to jointly estimate the likelihood of living in a smokefree home and having a smokefree car as a function of law coverage and other variables. Household data were obtained from the nationally representative Social Climate Survey of Tobacco Control 2001, 2002 and 2004-2009; clean indoor air law data were from the American Nonsmokers' Rights Foundation Tobacco Control Laws Database. 'Full coverage' and 'partial coverage' smokefree legislation is associated with an increased likelihood of having voluntary home and car smokefree rules compared with 'no coverage'. The association between 'full coverage' and smokefree rule in homes and cars is 5% and 4%, respectively, and the association between 'partial coverage' and smokefree rules in homes and cars is 3% and 4%, respectively. There is a positive association between the adoption of smokefree rules in homes and cars. Clean indoor air laws provide the additional benefit of encouraging voluntary adoption of smokefree rules in homes and cars. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Impact of National Smoke-Free Legislation on Educational Disparities in Smoke-Free Homes: Findings from the SIDRIAT Longitudinal Study.

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Gorini, Giuseppe; Carreras, Giulia; Cortini, Barbara; Verdi, Simona; Petronio, Maria Grazia; Sestini, Piersante; Chellini, Elisabetta

2015-07-24

Families with lower socioeconomic status are less likely to adopt household smoking bans (HSB). The aim of this study was to determine whether socioeconomic disparities in HSB prevalence in Italy decreased 7-9 years after the introduction of the Italian ban on smoking in public places. A longitudinal, 12-year, two-wave study was conducted on a sample of 3091 youths aged 6-14 years in 2002; 1763 (57%) were re-interviewed in 2012-2014. A Poisson regression with a robust error variance was used to assess the association between socioeconomic disparities and HSB prevalence. The adoption of HSBs significantly increased from 60% in 2002 to 75% in 2012-2014, with the increase recorded in youths with ≥1 smoking parent only (from 22% at baseline to 46% at follow-up). The presence of HSBs at baseline was more likely in families with ≥1 graduate parent compared to those with no graduate parents (prevalence ratio (PR) = 1.34, 95% confidence interval (CI) = 1.15-1.57), either in families with ≥1 smoking parent (PR = 1.36, 95% CI = 1.17-1.58) or in families with non-smoking parents (PR = 1.61, 95% CI = 1.01-2.56). Conversely, at follow-up socioeconomic disparities dropped since families with no graduate parents were 1.5-fold more likely to introduce a HSB between the two waves. The Italian ban on smoking in public places may have increased the adoption of smoke-free homes in families with smoking and non-graduate parents, causing the drop of the socioeconomic gap in smoke-free homes.

If you build (and moderate) it, they will come: the Smokefree Women Facebook page.

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Post, Samantha D; Taylor, Shani C; Sanders, Amy E; Goldfarb, Jeffrey M; Hunt, Yvonne M; Augustson, Erik M

2013-12-01

This analysis explores the impact of modifying the Smokefree Women Facebook social media strategy, from primarily promoting resources to encouraging participation in communications about smoking cessation by posting user-generated content. Analyses were performed using data from the Smokefree Women Facebook page to assess the impact of the revised strategy on reach and engagement. Fan engagement increased 430%, and a strong and statistically significant correlation (P Facebook page, providing an example of an approach that may prove useful for reaching and engaging users in online communities. Additional research is needed to assess the association between engagement in virtual communities and health behavior outcomes.

Attitudes and experiences with secondhand smoke and smoke-free policies among subsidised and market-rate multiunit housing residents living in six diverse communities in the USA.

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Gentzke, Andrea S; Hyland, Andrew; Kiviniemi, Marc; Travers, Mark J

2018-03-01

Given that higher smoking rates persist among lower socioeconomic populations, multiunit housing (MUH) environments may result in higher secondhand smoke (SHS) exposures among subsidised MUH residents. This cross-sectional assessment compares experiences with SHS and smoke-free policies among subsidised and market-rate MUH residents living in six US communities. MUH residents (n=1565) were surveyed regarding their smoke-free rules (home and building), SHS exposures and preferences towards smoke-free policies. Binary logistic regression identified predictors of each outcome, focusing on differences by subsidised housing status (subsidised vs market rate). Among residents enforcing smoke-free home rules (76%, overall), 50% reported SHS incursions into their unit. Only 23% reported living in a smoke-free building; 56% of those living in smoking-allowable buildings reported preferences towards smoke-free building policies. Among market-rate housing residents, smoke-free home (OR=4.18) and building (OR=2.26) rules were significantly higher when children were present. Smoke-free building rules reduced the odds of SHS incursions among market-rate housing residents (OR=0.50), but no association was observed among subsidised housing residents. Non-smoking subsidised housing residents exhibited stronger preferences for smoke-free policies compared with those in market-rate housing. Smoke-free home rules may not protect MUH residents from SHS exposures, particularly in subsidised MUH. Although strong preferences towards smoke-free policies were present overall, subsidised MUH residents may have fewer alternative smoke-free housing options available. Therefore, all publicly funded housing should be smoke free to protect these vulnerable populations. However, continued efforts to encourage privately owned MUH operators to adopt smoke-free policies are also necessary. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights

Smoke-free cafe in an unregulated European city: highly welcomed and economically successful.

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Künzli, N; Mazzoletti, P; Adam, M; Götschi, T; Mathys, P; Monn, C; Brändli, O

2003-09-01

In a unique setting with two identical cafes, which only differed in their smoking ordinances, this study assessed the influence of smoking policies on the choice of the cafe, investigated regulatory preferences among customers, and evaluated the claim that smoking cafes have better sales performance in a city without smoking bans. In a parallel assessment, customers of both cafes answered a questionnaire. Sales were compared and air pollutants were measured to confirm air quality differences. The two customer groups (n = 177) differed only with regard to smoking status (p cafes for this reason. Two thirds stated that all cafe/restaurants should offer the opportunity of a smoke-free environment. However, almost half stated that mandatory regulations are not needed and that customers should make individual arrangements based on tolerance and courtesy. Those who were informed about the health effects of secondhand smoke were more likely to call for clear policies. Whereas sales showed no differences, tips were 22% (p cafe. In a generation raised in smoking friendly environments, customers paradoxically ask for a landmark shift towards smoke-free opportunities, while substantially adhering to the tobacco industry paradigm of promoting "tolerance" rather than smoke-free policies. Given the clear preference of a large number of customers, hospitality businesses could, however, greatly profit from offering smoke-free environments even in the absence of regulatory policies.

Ashtrays and signage as determinants of a smoke-free legislation's success.

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Vardavas, Constantine I; Agaku, Israel; Patelarou, Evridiki; Anagnostopoulos, Nektarios; Nakou, Chrysanthi; Dramba, Vassiliki; Giourgouli, Gianna; Argyropoulou, Paraskevi; Antoniadis, Antonis; Gourgoulianis, Konstantinos; Ourda, Despoina; Lazuras, Lambros; Bertic, Monique; Lionis, Christos; Connolly, Gregory; Behrakis, Panagiotis

2013-01-01

Successful smoke-free legislation is dependent on political will, enforcement and societal support. We report the success and pitfalls of a non-enforced nationwide smoke-free legislation in Greece, as well as ways in which compliance and enforcement-related factors, including ashtrays and signage, may impact indoor secondhand smoke (SHS) concentrations. A follow-up study of venues (n=150, at baseline, n=75 at 2-year follow-up) in Greece assessed indoor particulate matter with a diameter less than 2.5 micrometers (PM 2.5 ) concentrations attributable to SHS smoke every six months for two years (n=455 venue/measurements). Following the implementation of the 2010 smoke-free legislation, mean PM2.5 concentrations attributable to SHS fell from 175.3 µg/m(3) pre-ban to 84.52 µg/m(3) immediately post-ban, increasing over subsequent waves (103.8 µg/m(3) and 158.2 µg/m(3) respectively). Controlling for potential influential factors such as ventilation, time of day, day of week, city and venue type, all post-ban measurements were still lower than during the pre-ban period (Wave 2 beta: -118.7, Wave 3 beta: -87.6, and Wave 4 beta: -69.9). Outdoor or indoor signage banning smoking was not found to affect SHS concentrations (beta: -10.9, p=0.667 and beta: -18.1, p=0.464 respectively). However, ashtray or ashtray equivalents were strong determinants of the existence of indoor SHS (beta: +67 µg/m(3), p=0.017). While the public may be supportive of smoke-free legislation, adherence may decline rapidly if enforcement is limited or nonexistent. Moreover, enforcement agencies should also focus on the comprehensive removal of ashtray equivalents that could act as cues for smoking within a venue.

Ashtrays and signage as determinants of a smoke-free legislation's success.

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Constantine I Vardavas

Full Text Available INTRODUCTION: Successful smoke-free legislation is dependent on political will, enforcement and societal support. We report the success and pitfalls of a non-enforced nationwide smoke-free legislation in Greece, as well as ways in which compliance and enforcement-related factors, including ashtrays and signage, may impact indoor secondhand smoke (SHS concentrations. METHODS: A follow-up study of venues (n=150, at baseline, n=75 at 2-year follow-up in Greece assessed indoor particulate matter with a diameter less than 2.5 micrometers (PM 2.5 concentrations attributable to SHS smoke every six months for two years (n=455 venue/measurements. RESULTS: Following the implementation of the 2010 smoke-free legislation, mean PM2.5 concentrations attributable to SHS fell from 175.3 µg/m(3 pre-ban to 84.52 µg/m(3 immediately post-ban, increasing over subsequent waves (103.8 µg/m(3 and 158.2 µg/m(3 respectively. Controlling for potential influential factors such as ventilation, time of day, day of week, city and venue type, all post-ban measurements were still lower than during the pre-ban period (Wave 2 beta: -118.7, Wave 3 beta: -87.6, and Wave 4 beta: -69.9. Outdoor or indoor signage banning smoking was not found to affect SHS concentrations (beta: -10.9, p=0.667 and beta: -18.1, p=0.464 respectively. However, ashtray or ashtray equivalents were strong determinants of the existence of indoor SHS (beta: +67 µg/m(3, p=0.017. CONCLUSIONS: While the public may be supportive of smoke-free legislation, adherence may decline rapidly if enforcement is limited or nonexistent. Moreover, enforcement agencies should also focus on the comprehensive removal of ashtray equivalents that could act as cues for smoking within a venue.

Impact of a smoke-free hospital campus policy on employee and consumer behavior.

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Wheeler, J Gary; Pulley, LeaVonne; Felix, Holly C; Bursac, Zoran; Siddiqui, Nadia J; Stewart, M Kathryn; Mays, Glen P; Gauss, C Heath

2007-01-01

Although smoke-free hospital campuses can provide a strong health message and protect patients, they are few in number due to employee retention and public relations concerns. We evaluated the effects of implementing a clean air policy on employee attitudes, recruitment, and retention; hospital utilization; and consumer satisfaction in 2003 through 2005. We conducted research at a university hospital campus with supplemental data from an affiliated hospital campus. Our evaluation included (1) measurement of employee attitudes during the year before and year after policy implementation using a cross-sectional, anonymous survey; (2) focus group discussions held with supervisors and security personnel; and (3) key informant interviews conducted with administrators. Secondary analysis included review of employment records and exit interviews, and monitoring of hospital utilization and patient satisfaction data. Employee attitudes toward the policy were supportive (83.3%) at both institutions and increased significantly (89.8%) at post-test at the university hospital campus. Qualitatively, administrator and supervisor attitudes were similarly favorable. There was no evidence on either campus of an increase in employee separations or a decrease in new hiring after the policy was implemented. On neither campus was there a change in bed occupancy or mean daily census. Standard measures of consumer satisfaction were also unchanged at both sites. A campus-wide smoke-free policy had no detrimental effect on measures of employee or consumer attitudes or behaviors.

Public policy: effective treatment for tobacco disease.

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Scheg, K E

1996-01-01

Public policy initiatives offer greater promise than other strategies for reducing the major public health problem of death and disease due to smoking. Three of the most critical public policy areas today are smoke-free environments, youth access, and advertising. While earlier laws separated smokers and nonsmokers into separate sections, the focus now is on smoke-free environments. Various places, however, most notably restaurants, often remain polluted with tobacco smoke and put women at heightened risk of disease and death. Restricting youth access to tobacco products has also gained momentum in the 1990s. The recently proposed Food and Drug Administration regulations designed to reduce smoking by minors by 50% over seven years are the most significant national public policy initiatives ever to address the problem of children smoking. Measures to counter the tobacco industry's massive advertising and promotion campaigns have also increased. The federal government has begun enforcing the prohibition on cigarette advertising on television, and local jurisdictions have restricted tobacco billboards and point-of-sale advertising.

Recall and Effectiveness of Messages Promoting Smoke-Free Policies in Rural Communities

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Butler, Karen M.; Wiggins, Amanda T.; Kostygina, Ganna; Langley, Ronald E.; Hahn, Ellen J.

2016-01-01

Abstract Introduction: Low-cost media campaigns increase demand for smoke-free policies in underserved rural areas. The study examined the impact of loss- and gain-framed smoke-free print ads on recall and perceived effectiveness in rural communities, controlling for personal characteristics. Methods: Following 6- to 9-month print media campaigns in three rural counties, recall and perceived effectiveness of loss-framed (ie, targeting dangers of secondhand smoke [SHS]) and gain-framed (ie, highlighting positive aspects of smoke-free air) ads were assessed using random-digit-dial phone surveys. Respondents were asked if they remembered each ad, whether they liked it, whether they were prompted to contact a smoke-free coalition, whether the ad made them think, and whether it prompted emotion. Mixed modeling assessed whether personal factors predicted ad recall or perceived effectiveness. Results: Loss-framed ads were less likely to be recalled but more likely to prompt emotion. For ads of both frame types, females reported greater recall and perceived effectiveness than males. Those with less education reported higher perceived effectiveness of the ads but lower recall. Nonsmokers were more likely than smokers to perceive the ads as effective. Knowledge of SHS risk and support for smoke-free workplaces were positively associated with recall and effectiveness. Conclusions: Ad recall and perceived effectiveness were associated with framing and demographic and personal characteristics. Smoke-free efforts in rural areas may be bolstered by continuing to promote benefits of smoke-free workplace policies and educate on SHS risks. Rural areas may need to provide a combination of ad types and framing strategies to appeal to a wide audience. Implications: Rural communities are disproportionately affected by SHS and less likely to be protected by smoke-free policies. This study adds evidence-based guidance for tailoring rural smoke-free media campaigns using different framing

Smokefree signage at children's playgrounds: Field observations and comparison with Google Street View.

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Thomson, George; Wilson, Nick

2017-01-01

Although there is global growth in outdoor smokefree areas, little is known about the associated smokefree signage. We aimed to study smokefree signage at playgrounds and to compare field observations with images from Google Street View (GSV). We randomly selected playgrounds in 21 contiguous local government areas in the lower North Island of New Zealand, all of which had smokefree playground policies. Field data were collected on smokefree signage along with dog control signage to allow for comparisons. The sensitivity and specificity of using GSV for data collection were calculated. Out of the 63 playgrounds studied, only 44% (95% CI: 33%-57%) had any smokefree signage within 10 m of the playground equipment. The mean number of such signs was 0.8 per playground (range: 0 to 6). Sign size varied greatly from 42 cm 2 up to 2880 cm 2 ; but was typically fairly small (median = 600 cm 2 ; ie, as per a 20 × 30 cm rectangle). Qualitatively the dog signs appeared to use clearer images and were less wordy than the smokefree signs. Most playground equipment (82%), could be seen on GSV, but for these settings the sensitivity for identifying smokefree signs was poor at 16%. Yet specificity was reasonable at 96%. The presence and quality of smokefree signage was poor in this sample of children's playgrounds in this developed country setting. There appears to be value in comparing smokefree signage with other types of signage (eg, dog control signage). Google Street View was not a sensitive tool for studying such signage.

Smoke-free policies and non-smokers’ reactions to SHS exposure in small and medium enterprises

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Calliopi Sivri

2013-12-01

Full Text Available Introduction: Non-smoker employees can significantly improve the existing smoke-free policies in the workplace by asserting their right for smoke-free air and confronting smoker colleagues. The aim of the study was to assess the psychological and social drivers of non-smokers' readiness to assert their right for smoke-free air in the workplace. Materials and Methods: Twenty-six small-and-medium enterprises (SME with diverse background were randomly selected, and 284 employees agreed to participate in the study. Our study focused on the responses of 85 non-smokers (M age = 34 years, SD = 7.98, 84.2% worked in indoor offices. A cross-sectional design was used and participants completed a structured anonymous questionnaire assessing background and demographic characteristics, and psychosocial predictors of assertiveness intentions. Results: Although more than half of non-smokers reported they were often/almost always bothered by exposure to SHS, roughly one third of them reported having asked their colleagues not to smoke at work. Regression analysis showed that the effects of distal predictors (i.e. annoyance due to SHS exposure were mediated by past behaviour, attitudes (protection motivation beliefs, social norms, and self-efficacy. Conclusions: Health beliefs related to SHS exposure, and concerns about workplace health and job performance, social norms and self-efficacy can increase the assertiveness of non-smokers in workplace settings. Related campaigns should focus on communicating normative messages and self-efficacy training to empower non-smoker employees to act assertively towards protecting their smoke-free rights.

Environmental and economic evaluation of the Massachusetts Smoke-Free Workplace Law.

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Alpert, Hillel R; Carpenter, Carrie M; Travers, Mark J; Connolly, Gregory N

2007-08-01

An environmental and economic evaluation of the smoke-free law in Massachusetts provides a broad appreciation of how a state-wide smoking ban affects the health of patrons and workers as well as the industries that are commonly concerned about the effects of smoking bans on business. The aim of this study is to evaluate environmental and economic effects of the statewide Massachusetts statewide Smoke-Free Workplace Law. Before and after the smoking ban, air quality testing was conducted in a sample (n = 27) of hospitality venues and state-wide economic changes were assessed. Compliance, in terms of patronage was measured by person-counts. Environmental outcomes were respirable suspended particles (RSP) less than 2.5 microns in diameter (PM2.5). Economic outcomes were meals tax collections, employment in the food services and drinking places and accommodations industries. On average, levels of respirable suspended particles (RSPs) less than 2.5 microns in diameter (PM2.5) decreased 93% in these venues after the Massachusetts Smoke-free Workplace Law went into effect. No statistically significant changes were observed among the economic indicators. This evaluation demonstrates that the state-wide Massachusetts law has effectively improved indoor air quality in a sample of Massachusetts venues and has not negatively affected several economic indicators.

Toward smoke-free homes: A community-based study on initiatives of rural Indian women.

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Mittal, Srabani; Das, Samiran

2011-05-01

Since the home is the primary source of exposure of children to second-hand smoke (SHS), measures to restrict smoking at home should be introduced to protect children from its adverse health consequences. Objectives of the study were to assess the level of awareness of rural Indian women on the health impacts of SHS on children and to look into the strategies they used to reduce children's exposure to SHS at home. A community-based cross-sectional study was conducted among 438 rural women using a survey questionnaire. Information on socio-demographic characteristics, knowledge on specific health effects of SHS on children, and attitude toward having a smoke-free home were collected. The perceived reasons that made it difficult to have smoke-free homes were also explored. A total of 75.8% of women agreed that SHS was a serious health risk for children. Knowledge on health impacts of SHS on children identified asthma as the most common problem. Smoking by husbands (89.7%) was the major source of exposure to SHS at home. While 67.6% of women reported having taken measures to limit SHS exposure in their homes, only 12.8% of them had tried to introduce a complete ban on smoking at home. On a five-point evaluation scale, 73.3% of the women indicated a failure of their initiatives to have smoke-free homes. Women's initiatives to introduce restrictions on smoking at home had very limited success and did not produce an appreciable change in smoking behavior at home. Lack of empowerment of women in rural India probably rendered the interventional measures ineffective.

Toward smoke-free homes: A community-based study on initiatives of rural Indian women

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Srabani Mittal

2011-01-01

Full Text Available Context: Since the home is the primary source of exposure of children to second-hand smoke (SHS, measures to restrict smoking at home should be introduced to protect children from its adverse health consequences. Aims: Objectives of the study were to assess the level of awareness of rural Indian women on the health impacts of SHS on children and to look into the strategies they used to reduce children′s exposure to SHS at home. Materials and Methods: A community-based cross-sectional study was conducted among 438 rural women using a survey questionnaire. Information on socio-demographic characteristics, knowledge on specific health effects of SHS on children, and attitude toward having a smoke-free home were collected. The perceived reasons that made it difficult to have smoke-free homes were also explored. Results: A total of 75.8% of women agreed that SHS was a serious health risk for children. Knowledge on health impacts of SHS on children identified asthma as the most common problem. Smoking by husbands (89.7% was the major source of exposure to SHS at home. While 67.6% of women reported having taken measures to limit SHS exposure in their homes, only 12.8% of them had tried to introduce a complete ban on smoking at home. On a five-point evaluation scale, 73.3% of the women indicated a failure of their initiatives to have smoke-free homes. Conclusions: Women′s initiatives to introduce restrictions on smoking at home had very limited success and did not produce an appreciable change in smoking behavior at home. Lack of empowerment of women in rural India probably rendered the interventional measures ineffective.

Study of secondhand smoke exposure in St. Louis City and County suggests need for comprehensive smoke-free Missouri law adoption.

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Moreland-Russell, Sarah; Cyr, Julianne; Benson, Peter; Colditz, Graham; Pulley, Deren; Barnoya, Joaquin

2012-01-01

This cross-sectional study provides information about secondhand smoke exposure across the St. Louis metro area and perceptions and attitudes about tobacco and health within the local hospitality industry. Results from this study support the need for passage and implementation of comprehensive smoke-free laws throughout Missouri, particularly in St. Louis City and County where efforts to pass comprehensive smoke-free laws have been unsuccessful.

Smoke-Free Rules and Secondhand Smoke Exposure in Homes and Vehicles Among US Adults, 2009–2010

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Dube, Shanta R.; Homa, David M.

2013-01-01

Introduction An increasing number of US states and localities have implemented comprehensive policies prohibiting tobacco smoking in all indoor areas of public places and worksites. However, private settings such as homes and vehicles remain a major source of exposure to secondhand smoke (SHS) for many people. This study assessed the prevalence and correlates of voluntary smoke-free rules and SHS exposure in homes and vehicles among US adults. Methods We obtained data from the 2009–2010 National Adult Tobacco Survey, a landline and cellular-telephone survey of adults aged 18 years or older residing in the 50 US states or the District of Columbia. We calculated national and state estimates of smoke-free rules and past-7-day SHS exposure in homes and vehicles and examined national estimates by sex, age, race/ethnicity, and education. Results The national prevalence of voluntary smoke-free home rules was 81.1% (state range, 67.9%–92.9%), and the prevalence of household smoke-free vehicle rules was 73.6% (state range, 58.6%–85.8%). Among nonsmokers, the prevalence of SHS exposure was 6.0% in homes (state range, 2.4%–13.0%) and 9.2% in vehicles (state range, 4.8%–13.7%). SHS exposure among nonsmokers was greatest among men, younger adults, non-Hispanic blacks, and those with a lower level of education. Conclusion Most US adults report having voluntary smoke-free home and vehicle rules; however, millions of people remain exposed to SHS in these environments. Disparities in exposure also exist among certain states and subpopulations. Efforts are needed to warn about the dangers of SHS and to promote voluntary smoke-free home and vehicle rules. PMID:23680508

Smokefree signage at New Zealand racecourses and sports facilities with outdoor stands.

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Thomson, George; Wilson, Nick

2017-10-27

Smokefree signage is crucial to the implementation of smokefree policies for outdoor venues and for facilitating smoking denormalisation. Such signage helps to communicate the expected norms for not smoking at venues. Therefore, we aimed to identify such signage at racecourses and sports facilities that had outdoor stands. We surveyed the entrances of 25 racecourse and 25 sport facilities with outdoor stands, across New Zealand. There were smokefree signs at the main entrances of 40% of the sports facilities with outdoor stands, and at 16% of the 25 other entrances. None of the horse/greyhound racecourses had smokefree signage at any of their entrances.

Recall and Effectiveness of Messages Promoting Smoke-Free Policies in Rural Communities.

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Rayens, Mary Kay; Butler, Karen M; Wiggins, Amanda T; Kostygina, Ganna; Langley, Ronald E; Hahn, Ellen J

2016-05-01

Low-cost media campaigns increase demand for smoke-free policies in underserved rural areas. The study examined the impact of loss- and gain-framed smoke-free print ads on recall and perceived effectiveness in rural communities, controlling for personal characteristics. Following 6- to 9-month print media campaigns in three rural counties, recall and perceived effectiveness of loss-framed (ie, targeting dangers of secondhand smoke [SHS]) and gain-framed (ie, highlighting positive aspects of smoke-free air) ads were assessed using random-digit-dial phone surveys. Respondents were asked if they remembered each ad, whether they liked it, whether they were prompted to contact a smoke-free coalition, whether the ad made them think, and whether it prompted emotion. Mixed modeling assessed whether personal factors predicted ad recall or perceived effectiveness. Loss-framed ads were less likely to be recalled but more likely to prompt emotion. For ads of both frame types, females reported greater recall and perceived effectiveness than males. Those with less education reported higher perceived effectiveness of the ads but lower recall. Nonsmokers were more likely than smokers to perceive the ads as effective. Knowledge of SHS risk and support for smoke-free workplaces were positively associated with recall and effectiveness. Ad recall and perceived effectiveness were associated with framing and demographic and personal characteristics. Smoke-free efforts in rural areas may be bolstered by continuing to promote benefits of smoke-free workplace policies and educate on SHS risks. Rural areas may need to provide a combination of ad types and framing strategies to appeal to a wide audience. Rural communities are disproportionately affected by SHS and less likely to be protected by smoke-free policies. This study adds evidence-based guidance for tailoring rural smoke-free media campaigns using different framing: gain-framed messages (ie, benefits of smoke-free environments) to

Secondhand smoke in outdoor settings: smokers’ consumption, non-smokers’ perceptions, and attitudes towards smoke-free legislation in Spain

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Sureda, Xisca; Fernández, Esteve; Martínez-Sánchez, Jose M; Fu, Marcela; López, María J; Martínez, Cristina; Saltó, Esteve

2015-01-01

Objective To describe where smokers smoke outdoors, where non-smokers are exposed outdoors to secondhand smoke (SHS), and attitudes towards smoke-free outdoor areas after the implementation of national smoke-free legislation. Design This cross-sectional study was conducted between June 2011 and March 2012 (n=1307 participants). Setting Barcelona, Spain. Participants Representative, random sample of the adult (≥16 years) population. Primary and secondary outcomes Proportion of smoking and prevalence of exposure to SHS in the various settings according to type of enclosure. Percentages of support for outdoor smoke-free policies according to smoking status. Results Smokers reported smoking outdoors most in bars and restaurants (54.8%), followed by outdoor places at work (46.8%). According to non-smokers, outdoor SHS exposure was highest at home (42.5%) and in bars and restaurants (33.5%). Among non-smoking adult students, 90% claimed exposure to SHS on university campuses. There was great support for banning smoking in the majority of outdoor areas, which was stronger among non-smokers than smokers. Over 70% of participants supported smoke-free playgrounds, school and high school courtyards, and the grounds of healthcare centres. Conclusions Extending smoking bans to selected outdoor settings should be considered in further tobacco control interventions to protect non-smokers from SHS exposure and to establish a positive model for youth. The majority of public support for some outdoor smoke-free areas suggests that it is feasible to extend smoking bans to additional outdoor settings. PMID:25854974

Effect of smoke-free legislation on Ticino gastronomy revenue.

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Schulz, Peter J; Hartung, Uwe; Fiordelli, Maddalena

2012-12-01

To provide evidence on the effects of smoke-free laws on gastronomy revenue in a European setting based on objective data. Damage to gastronomy revenue is a widely used argument against smoke-free legislation. Gastronomy revenue in Ticino is compared with the rest of Switzerland before and after Ticino banned smoking from gastronomy in April 2007, being the first (and at the time of the study only) Swiss canton to do that. The study uses breakdowns by cantons of taxable revenue of gastronomy branches and retailers (for comparison) provided by the Swiss tax authorities for the years 2005-2008. Revenues of restaurants and bars were not damaged by the Ticino smoke-free law. Decreases in Ticino happened before the smoke-free law came into effect. Evidence for night clubs is inconclusive. The absence of detrimental effects on restaurant and bar revenue corroborates the gist of research on the subject from other countries. The argument that the decline of bar and restaurant sales prior to the implementation of the ban might have occurred in anticipation of the new regulation is not considered tenable.

Children's exposure to secondhand smoke at home before and after smoke-free legislation in Taiwan.

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Wang, Ying-Ting; Tsai, Yi-Wen; Tsai, Tzu-I; Chang, Po-Yin

2017-11-01

In January 2009, Taiwan broadened smoke-free legislation, requiring mass transportation systems, indoor public areas and indoor workplaces with 3 or more people, to become smoke-free. We investigated the secondhand smoke (SHS) exposure at home for children aged 3-11 years in Taiwan before and after the implantation of the legislation. We studied 7911 children from the 2005, 2009 and 2013 National Health Interview Surveys (cross-sectional, nationally representative household surveys). Logistic regression modelling estimated adjusted ORs (AOR) and 95% CIs for children's SHS exposure at home in 2009 and 2013 (2005 as reference) for the overall sample and for each category of household socioeconomic status (SES) and household composition. Prevalence of children SHS exposure at home decreased from 51% (2005) to 32% (2009) and 28% (2013). Compared to 2005, children in 2009 and 2013 had lower likelihoods of SHS exposure at home with AOR of 0.45 (95% CI 0.41 to 0.51) and 0.41 (95% CI 0.36 to 0.46), respectively. All children had reduced SHS exposure at home after the legislation, irrespective of household SES and compositions. Low household income, low parental education level, living with grandparents or living with other adults was individually associated with increased SHS exposure. The proportion of children exposed to SHS at home in Taiwan declined substantially from 2005 to 2009 after smoke-free legislation, and fell further by 2013, irrespective of SES and household compositions. Still, inequality in SHS exposure at home by SES and household composition warrants future research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Ashtrays and Signage as Determinants of a Smoke-Free Legislation’s Success

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Vardavas, Constantine I.; Agaku, Israel; Patelarou, Evridiki; Anagnostopoulos, Nektarios; Nakou, Chrysanthi; Dramba, Vassiliki; Giourgouli, Gianna; Argyropoulou, Paraskevi; Antoniadis, Antonis; Gourgoulianis, Konstantinos; Ourda, Despoina; Lazuras, Lambros; Bertic, Monique; Lionis, Christos; Connolly, Gregory; Behrakis, Panagiotis

2013-01-01

Introduction Successful smoke-free legislation is dependent on political will, enforcement and societal support. We report the success and pitfalls of a non-enforced nationwide smoke-free legislation in Greece, as well as ways in which compliance and enforcement-related factors, including ashtrays and signage, may impact indoor secondhand smoke (SHS) concentrations. Methods A follow-up study of venues (n = 150, at baseline, n = 75 at 2-year follow-up) in Greece assessed indoor particulate matter with a diameter less than 2.5 micrometers (PM2.5) concentrations attributable to SHS smoke every six months for two years (n = 455 venue/measurements). Results Following the implementation of the 2010 smoke-free legislation, mean PM2.5 concentrations attributable to SHS fell from 175.3 µg/m3 pre-ban to 84.52 µg/m3 immediately post-ban, increasing over subsequent waves (103.8 µg/m3 and 158.2 µg/m3 respectively). Controlling for potential influential factors such as ventilation, time of day, day of week, city and venue type, all post-ban measurements were still lower than during the pre-ban period (Wave 2 beta: −118.7, Wave 3 beta: −87.6, and Wave 4 beta: −69.9). Outdoor or indoor signage banning smoking was not found to affect SHS concentrations (beta: −10.9, p = 0.667 and beta: −18.1, p = 0.464 respectively). However, ashtray or ashtray equivalents were strong determinants of the existence of indoor SHS (beta: +67 µg/m3, p = 0.017). Conclusions While the public may be supportive of smoke-free legislation, adherence may decline rapidly if enforcement is limited or nonexistent. Moreover, enforcement agencies should also focus on the comprehensive removal of ashtray equivalents that could act as cues for smoking within a venue. PMID:24023795

The study protocol of women′s education to create smoke-free home on the basis of family ties in Isfahan, Iran

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Ahmadreza Zamani

2013-01-01

Full Text Available Background: Tobacco smoke is the leading cause of preventable death world-wide. Unfortunately, the risk is not limited to smokers. It is dangerous for non-smokers particularly women, kids and elderly. Despite the remarkable reduction of tobacco exposure in public places, it is still continuing at homes as the most common places. Interventions to create a smoke-free home are needed, but little is known about them. The aim of this study is to explain the field randomized controlled trial that is designed to examine the role of non-smoker women to create a smoke-free home through establishing complete agreement on ban smoking at home. Methods: In this field randomized controlled trial, the effectiveness of women′s education will be evaluated in primary health-care centers. A total of 136 non-smoker women who exposed to second-hand smoke by their husbands at home will be included (68 intervention/non-intervention group. The intervention arm will receive an educational package including a consultation visit individually, a peer group session, a booklet, a "no smoking" sign. The primary outcome is the frequency of smoke-free home (no exposure to second-hand smoke at home. Mediator outcomes include a complete agreement to ban smoking at home, second-hand smoke exposure rate and self-assertiveness rate. All measurements will be conducted on baseline, 1 and 3 months after intervention. Conclusions: Outcomes will present the effects of implementing multi-component women′s education intervention program to ban smoking at home. If the effectiveness of the trial is confirmed, it will be suggested to merge this package to routine care in primary health-care centers.

Legislation on smoking in enclosed public places in Scotland: how will we evaluate the impact?

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Haw, Sally J; Gruer, Laurence; Amos, Amanda; Currie, Candace; Fischbacher, Colin; Fong, Geoffrey T; Hastings, Gerard; Malam, Sally; Pell, Jill; Scott, Calum; Semple, Sean

2006-03-01

From 26 March 2006, smoking will be prohibited in wholly and substantially enclosed public places in Scotland, and it will be an offence to permit smoking or to smoke in no-smoking premises. We anticipate that implementation of the smoke-free legislation will result in significant health gains associated with reductions in exposure to both environmental tobacco smoke (ETS) and personal tobacco consumption as well as other social and economic impacts. Health Scotland in conjunction with the Information Services Division (ISD) Scotland and the Scottish Executive have developed a comprehensive evaluation strategy to assess the expected short-term, intermediate and long-term outcomes. Using routine health, behavioural and economic data and commissioned research, we will assess the impact of the smoke-free legislation in eight key outcome areas--knowledge and attitudes, ETS exposure, compliance, culture, smoking prevalence and tobacco consumption, tobacco-related morbidity and mortality, economic impacts on the hospitality sector and health inequalities. The findings from this evaluation will make a significant contribution to the international understanding of the health effects of exposure to ETS and the broader social, cultural and economic impacts of smoke-free legislation.

Stuck in Neutral: Stalled Progress in Statewide Comprehensive Smoke-Free Laws and Cigarette Excise Taxes, United States, 2000–2014

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King, Brian A.; Babb, Stephen D.

2016-01-01

Introduction Increasing tobacco excise taxes and implementing comprehensive smoke-free laws are two of the most effective population-level strategies to reduce tobacco use, prevent tobacco use initiation, and protect nonsmokers from secondhand smoke. We examined state laws related to smoke-free buildings and to cigarette excise taxes from 2000 through 2014 to see how implementation of these laws from 2000 through 2009 differs from implementation in more recent years (2010–2014). Methods We used legislative data from LexisNexis, an online legal research database, to examine changes in statewide smoke-free laws and cigarette excise taxes in effect from January 1, 2000, through December 31, 2014. A comprehensive smoke-free law was defined as a statewide law prohibiting smoking in all indoor areas of private work sites, restaurants, and bars. Results From 2000 through 2009, 21 states and the District of Columbia implemented comprehensive smoke-free laws prohibiting smoking in work sites, restaurants, and bars. In 2010, 4 states implemented comprehensive smoke-free laws. The last state to implement a comprehensive smoke-free law was North Dakota in 2012, bringing the total number to 26 states and the District of Columbia. From 2000 through 2009, 46 states and the District of Columbia implemented laws increasing their cigarette excise tax, which increased the national average state excise tax rate by $0.92. However, from 2010 through 2014, only 14 states and the District of Columbia increased their excise tax, which increased the national average state excise tax rate by $0.20. Conclusion The recent stall in progress in enacting and implementing statewide comprehensive smoke-free laws and increasing cigarette excise taxes may undermine tobacco prevention and control efforts in the United States, undercutting efforts to reduce tobacco use, exposure to secondhand smoke, health disparities, and tobacco-related illness and death. PMID:27309417

Potential for smoke-free policies in social venues to prevent smoking uptake and reduce relapse: a qualitative study.

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Wakefield, Melanie; Cameron, Melissa; Murphy, Michael

2009-01-01

The purpose of this article is to better understand the utility of smoking in pubs/bars and nightclubs and explore perceptions of how smoke-free policies might influence smoking behavior. Qualitative focus group methodology was used involving young social smokers and older regular smokers. Pubs/bars and nightclubs were valued as the few remaining indoor public places where people could relax and smoke. These venues were perceived to provide encouragement for smoking more cigarettes by increasing smoking rate and facilitating smoking relapse. For young social smokers, smoking provided an opportunity to be part of a "cool" in-group. Older regular smokers felt pubs/bars provided strong cues for smoking relapse. Smokers felt they would adapt to smoke-free policies and expected these policies to reduce their smoking or assist quitting. Smoke-free policies in pubs/bars and nightclubs may assist smokers to quit and make it less likely that young social smokers will progress to regular smoking.

Clearing the Air: Smoke-Free Housing Policies, Smoking, and Secondhand Smoke Exposure Among Affordable Housing Residents in Minnesota, 2014-2015.

Science.gov (United States)

Kingsbury, John H; Reckinger, Dawn

2016-08-18

During the past 30 years, local and state tobacco use control laws in the United States have helped reduce smoking prevalence and exposure to secondhand smoke, but progress among low socioeconomic populations has been slow. Implementing smoke-free housing policies in affordable housing may help address this issue. The purpose of our study was to assess how such policies affect smoking rates and exposure to secondhand smoke among residents of affordable housing. We conducted a pretest-posttest longitudinal study of 180 residents from 8 affordable housing properties in Minnesota. Participating properties agreed to adopt a smoke-free housing policy covering indoor grounds, and 3 of these properties also prohibited smoking on all outdoor grounds. Policies were implemented with assistance from local public health departments and the Statewide Health Improvement Program. Participants completed surveys one month before policy implementation and 6 months postimplementation. Surveys assessed smoking, quit attempts, and indoor and outdoor secondhand smoke exposure. Results indicated a significant reduction in nonsmokers' indoor exposure to secondhand smoke (F1,144 = 22.69, P exposure to secondhand smoke from Time 1 (pretest) to Time 2 (posttest) (F1,140 = 2.17, P = .14). However, when examining sites that only prohibited smoking indoors, we observed an increase in outdoor secondhand smoke exposure that approached significance (F1,118 = 3.76, P = .055). Results showed no change in quit attempts over time, but 77% of residents who smoked at pretest reported reducing the amount that they smoked at posttest, and an additional 5% reported that they had quit. Smoke-free housing policies may be an effective strategy to reduce exposure to indoor secondhand exposure and promote decreased cigarette smoking among residents of affordable housing.

A controlled community-based trial to promote smoke-free policy in rural communities.

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Hahn, Ellen J; Rayens, Mary Kay; Adkins, Sarah; Begley, Kathy; York, Nancy

2015-01-01

Rural, tobacco-growing areas are disproportionately affected by tobacco use, secondhand smoke, and weak tobacco control policies. The purpose was to test the effects of a stage-specific, tailored policy-focused intervention on readiness for smoke-free policy, and policy outcomes in rural underserved communities. A controlled community-based trial including 37 rural counties. Data were collected annually with community advocates (n = 330) and elected officials (n = 158) in 19 intervention counties and 18 comparison counties over 5 years (average response rate = 68%). Intervention communities received policy development strategies from community advisors tailored to their stage of readiness and designed to build capacity, build demand, and translate and disseminate science. Policy outcomes were tracked over 5 years. Communities receiving the stage-specific, tailored intervention had higher overall community readiness scores and better policy outcomes than the comparison counties, controlling for county-level smoking rate, population size, and education. Nearly one-third of the intervention counties adopted smoke-free laws covering restaurants, bars, and all workplaces compared to none of the comparison counties. The stage-specific, tailored policy-focused intervention acted as a value-added resource to local smoke-free campaigns by promoting readiness for policy, as well as actual policy change in rural communities. Although actual policy change and percent covered by the policies were modest, these areas need additional resources and efforts to build capacity, build demand, and translate and disseminate science in order to accelerate smoke-free policy change and reduce the enormous toll from tobacco in these high-risk communities. © 2014 National Rural Health Association.

Development and evaluation of the See Me Smoke-Free multi-behavioral mHealth app for women smokers.

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Gordon, Judith S; Armin, Julie; D Hingle, Melanie; Giacobbi, Peter; Cunningham, James K; Johnson, Thienne; Abbate, Kristopher; Howe, Carol L; Roe, Denise J

2017-06-01

Women face particular challenges when quitting smoking, especially those with weight concerns. A multi-behavioral smoking cessation intervention addressing these concerns and incorporating guided imagery may assist women to engage in healthy lifestyle behaviors. An mHealth app can easily disseminate such an intervention. The goals of this pilot study were to develop and test the feasibility and potential of the See Me Smoke-Free ™ mHealth app to address smoking, diet, and physical activity among women smokers. We used pragmatic, direct-to-consumer methods to develop and test program content, functionality, and the user interface and conduct a pre-/post-test, 90-day pilot study. We enrolled 151 participants. Attrition was 52%, leaving 73 participants. At 90 days, 47% of participants reported 7-day abstinence and significant increases in physical activity and fruit consumption. Recruitment methods worked well, but similar to other mHealth studies, we experienced high attrition. This study suggests that a guided imagery mHealth app has the potential to address multiple behaviors. Future research should consider different methods to improve retention and assess efficacy.

Exposure to secondhand smoke and voluntary adoption of smoke-free home and car rules among non-smoking South African adults

OpenAIRE

Ayo-Yusuf, Olalekan A; Olufajo, Olubode; Agaku, Israel T

2014-01-01

Background: Secondhand smoke (SHS) exposure is a well-established health hazard. To determine the effectiveness of existing smoke-free policies and adoption of smoke-free rules in South Africa, we assessed exposure to SHS from several sources among non-smoking adults during 2010. Methods: Data were analyzed for 3,094 adults aged ≥16 years who participated in the 2010 South African Social Attitudes Survey. Descriptive statistics and multivariate analyses were used to assess presence of smoke-f...

No association of smoke-free ordinances with profits from bingo and charitable games in Massachusetts

OpenAIRE

Glantz, S; Wilson-Loots, R

2003-01-01

Background: Because it is widely played, claims that smoking restrictions will adversely affect bingo games is used as an argument against these policies. We used publicly available data from Massachusetts to assess the impact of 100% smoke-free ordinances on profits from bingo and other gambling sponsored by charitable organisations between 1985 and 2001.

Noncompliance to smoke-free law: which hospitality premises are more prone?

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Ay, P; Evrengil, E; Guner, M; Dagli, E

2016-12-01

In Turkey, smoking has been banned in hospitality establishments since July 2009. The objective of this study was to determine noncompliance to the smoke-free law and its change in 2 consecutive years in enclosed spaces of hospitality venues and also to evaluate the factors associated with noncompliance. This is an observational study. Hospitality venues in Istanbul were visited, and data were collected through direct observation and interviews. Observation of smoking, cigarette butts or existence of ashtrays were defined as noncompliance. The survey was repeated in 2 consecutive years; the venues were visited both in 2013 and 2014. Logistic regression was used to evaluate factors associated with noncompliance. In 2013, 450 establishments were visited, and in the next year, 367 (81.6%) were revisited. Noncompliance for 2013 and 2014 were 49.0% and 29.7%, respectively. The highest violation was observed in bars and traditional coffeehouses. There was a significant decrease in noncompliance from 2013 to 2014 among restaurants and cafés, while such a change was not observed among bars and traditional coffeehouses. In the multivariate analysis, venues other than restaurants, venues that did not have no-smoking signs and venues which had been issued fines previously had increased probability of noncompliance. While compliance to smoke-free law had increased significantly within 1 year, almost one third of the venues were still violating the law in 2014. The venues which were issued fines continued to violate the law. There is a need to strengthen enforcement efforts and revise the methods of enforcement and penalties in hospitality establishments. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Clearing the Air: Smoke-Free Housing Policies, Smoking, and Secondhand Smoke Exposure Among Affordable Housing Residents in Minnesota, 2014–2015

Science.gov (United States)

Reckinger, Dawn

2016-01-01

Introduction During the past 30 years, local and state tobacco use control laws in the United States have helped reduce smoking prevalence and exposure to secondhand smoke, but progress among low socioeconomic populations has been slow. Implementing smoke-free housing policies in affordable housing may help address this issue. The purpose of our study was to assess how such policies affect smoking rates and exposure to secondhand smoke among residents of affordable housing. Methods We conducted a pretest–posttest longitudinal study of 180 residents from 8 affordable housing properties in Minnesota. Participating properties agreed to adopt a smoke-free housing policy covering indoor grounds, and 3 of these properties also prohibited smoking on all outdoor grounds. Policies were implemented with assistance from local public health departments and the Statewide Health Improvement Program. Participants completed surveys one month before policy implementation and 6 months postimplementation. Surveys assessed smoking, quit attempts, and indoor and outdoor secondhand smoke exposure. Results Results indicated a significant reduction in nonsmokers’ indoor exposure to secondhand smoke (F 1,144 = 22.69, P secondhand smoke from Time 1 (pretest) to Time 2 (posttest) (F 1,140 = 2.17, P = .14). However, when examining sites that only prohibited smoking indoors, we observed an increase in outdoor secondhand smoke exposure that approached significance (F 1,118 = 3.76, P = .055). Results showed no change in quit attempts over time, but 77% of residents who smoked at pretest reported reducing the amount that they smoked at posttest, and an additional 5% reported that they had quit. Conclusions Smoke-free housing policies may be an effective strategy to reduce exposure to indoor secondhand exposure and promote decreased cigarette smoking among residents of affordable housing. PMID:27536903

Before and after study of bar workers' perceptions of the impact of smoke-free workplace legislation in the Republic of Ireland.

LENUS (Irish Health Repository)

Pursell, Lisa

2007-01-01

BACKGROUND: Objectives: To compare support for, and perceptions of, the impacts of smoke-free workplace legislation among bar workers in the Republic of Ireland (ROI) pre- and post-implementation, and to identify predictors of support for the legislation. METHODS: Setting: Public houses (pubs) in three areas of the ROI. Design: Comparisons pre- and post-implementation of smoke-free workplace legislation. Participants: From a largely non-random selection, 288 bar workers volunteered for the baseline survey; 220 were followed up one year later (76.4%). Outcome measures: Level of support for the legislation, attitude statements concerning potential impacts of the law and modelled predictors of support for the legislation. RESULTS: Pre-implementation 59.5% of participants supported the legislation, increasing to 76.8% post-implementation. Support increased among smokers by 27.3 percentage points from 39.4% to 66.7% (p < 0.001) and among non-smokers by 12.4% percentage points from 68.8% to 81.2% (p = 0.003).Pre-legislation three-quarters of participants agreed that the legislation would make bars more comfortable and was needed to protect workers\\' health. Post-legislation these proportions increased to over 90% (p < 0.001). However, negative perceptions also increased, particularly for perceptions that the legislation has a negative impact on business (from 50.9% to 62.7%, p = 0.008) and that fewer people would visit pubs (41.8% to 62.7%, p < 0.001). After adjusting for relevant covariates, including responses to the attitude statements, support for the ban increased two to three-fold post-implementation. Regardless of their views on the economic impact, most participants agreed, both pre- and post-implementation, that the legislation was needed to protect bar workers\\' health. CONCLUSION: Smoke-free legislation had the support of three-quarters of a large sample of bar workers in the ROI. However, this group holds complex sets of both positive and negative

Characterization of urinary cotinine in non-smoking residents in smoke-free homes in the Korean National Environmental Health Survey (KoNEHS

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Jeonghoon Kim

2016-07-01

Full Text Available Abstract Background The objectives of this study were to determine urinary cotinine concentrations in non-smoking residents of smoke-free homes and to establish the relationship of urinary cotinine with housing type and other socio-demographic and secondhand smoke (SHS exposure factors. Methods We used data from the Korean National Environmental Health Survey I (2009–2011. The study included 814 non-smoking adult residents living in apartments, attached, and detached housing. Residents who lived with smokers were excluded. Urinary cotinine concentration was used as a biomarker for SHS exposure. The factors associated with urinary cotinine levels in non-smoking residents were determined using multivariate regression analysis. Results Urinary cotinine was detected in 88 % of the 814 non-smoking residents of smoke-free homes. The urinary cotinine concentrations of residents living in attached [1.18 ng/mg creatinine (Cr] and detached housing (1.23 ng/mg Cr were significantly higher than those of residents who lived in apartments (0.69 ng/mg Cr. Urinary cotinine concentrations were significantly higher in residents who were men, those with a household income ≤1000 USD/month, those who were former smokers with >1 year and ≤1 year of not smoking, and those who experienced SHS odor every day. In the multivariate regression analysis, housing type, sex, former smoking status, and frequency of experiencing SHS odor were associated with urinary cotinine concentrations (R 2 = 0.14. Conclusions The majority of non-smoking residents of smoke-free homes had detectable urinary cotinine. Housing type, sex, former smoking status, and frequency of experiencing SHS odor were predictors for urinary cotinine concentrations in the study participants.

Secondhand smoke in outdoor settings: smokers' consumption, non-smokers' perceptions, and attitudes towards smoke-free legislation in Spain.

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Sureda, Xisca; Fernández, Esteve; Martínez-Sánchez, Jose M; Fu, Marcela; López, María J; Martínez, Cristina; Saltó, Esteve

2015-04-08

To describe where smokers smoke outdoors, where non-smokers are exposed outdoors to secondhand smoke (SHS), and attitudes towards smoke-free outdoor areas after the implementation of national smoke-free legislation. This cross-sectional study was conducted between June 2011 and March 2012 (n=1307 participants). Barcelona, Spain. Representative, random sample of the adult (≥16 years) population. Proportion of smoking and prevalence of exposure to SHS in the various settings according to type of enclosure. Percentages of support for outdoor smoke-free policies according to smoking status. Smokers reported smoking outdoors most in bars and restaurants (54.8%), followed by outdoor places at work (46.8%). According to non-smokers, outdoor SHS exposure was highest at home (42.5%) and in bars and restaurants (33.5%). Among non-smoking adult students, 90% claimed exposure to SHS on university campuses. There was great support for banning smoking in the majority of outdoor areas, which was stronger among non-smokers than smokers. Over 70% of participants supported smoke-free playgrounds, school and high school courtyards, and the grounds of healthcare centres. Extending smoking bans to selected outdoor settings should be considered in further tobacco control interventions to protect non-smokers from SHS exposure and to establish a positive model for youth. The majority of public support for some outdoor smoke-free areas suggests that it is feasible to extend smoking bans to additional outdoor settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pilot Study Results from a Brief Intervention to Create Smoke-Free Homes

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Michelle C. Kegler

2012-01-01

Full Text Available Very few community-based intervention studies have examined how to effectively increase the adoption of smoke-free homes. A pilot study was conducted to test the feasibility, acceptability, and short-term outcomes of a brief, four-component intervention for promoting smoke-free home policies among low-income households. We recruited forty participants (20 smokers and 20 nonsmokers to receive the intervention at two-week intervals. The design was a pretest-posttest with follow-up at two weeks after intervention. The primary outcome measure was self-reported presence of a total home smoking ban. At follow-up, 78% of participants reported having tried to establish a smoke-free rule in their home, with significantly more nonsmokers attempting a smoke-free home than smokers (P=.03. These attempts led to increased smoking restrictions, that is, going from no ban to a partial or total ban, or from a partial to a total ban, in 43% of the homes. At follow-up, 33% of the participants reported having made their home totally smoke-free. Additionally, smokers reported smoking fewer cigarettes per day. Results suggest that the intervention is promising and warrants a rigorous efficacy trial.

A new national smokefree law increased calls to a national quitline.

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Wilson, Nick; Sertsou, Gabriel; Edwards, Richard; Thomson, George; Grigg, Michele; Li, Judy

2007-05-08

A law making all indoor workplaces including bars and restaurants smokefree became operational in New Zealand in December 2004. New Zealand has a national free-phone Quitline Service which has been operational since 1999. Previous work has shown that the number of calls to the Quitline are influenced by marketing of the service through media campaigns. We set out to investigate if the smokefree law increased calls to the Quitline. For 24 months prior to the law, and 12 months after the law, data were collected on: (i) Quitline caller registrations and the issuing of nicotine replacement therapy (NRT) vouchers by the Quitline Service; (ii) expenditure on Quitline-related television advertising; (iii) expenditure on other smokefree television advertising; and (iv) print media coverage of smoking in major New Zealand newspapers. These data were inputs to a time series analysis using a Box-Jenkins transfer function model. This used the law change as the intervention variable, with the response series being the monthly Quitline caller rates and monthly first time NRT voucher issue rates. The monthly rates of Quitline caller registrations and NRT voucher issues were observed to increase in the months after the law change. The increase in both these outcomes was even greater when considered in terms of per level of Quitline advertising expenditure (though these patterns may have partly reflected marked reductions in advertising expenditure at the time of the law change and hence are of limited validity). In the more robust time series analyses, the law change (intervention variable) had a significant effect (p = 0.025) on increasing the monthly caller registration rate in December 2004. This was after adjusting for the possible effects of Quitline advertising expenditure, print media coverage, and other smoking-related advertising expenditure. The new national smokefree law resulted in increased quitting-related behaviour. This would suggest there is an extra opportunity

A new national smokefree law increased calls to a national quitline

Science.gov (United States)

Wilson, Nick; Sertsou, Gabriel; Edwards, Richard; Thomson, George; Grigg, Michele; Li, Judy

2007-01-01

Background A law making all indoor workplaces including bars and restaurants smokefree became operational in New Zealand in December 2004. New Zealand has a national free-phone Quitline Service which has been operational since 1999. Previous work has shown that the number of calls to the Quitline are influenced by marketing of the service through media campaigns. We set out to investigate if the smokefree law increased calls to the Quitline. Methods For 24 months prior to the law, and 12 months after the law, data were collected on: (i) Quitline caller registrations and the issuing of nicotine replacement therapy (NRT) vouchers by the Quitline Service; (ii) expenditure on Quitline-related television advertising; (iii) expenditure on other smokefree television advertising; and (iv) print media coverage of smoking in major New Zealand newspapers. These data were inputs to a time series analysis using a Box-Jenkins transfer function model. This used the law change as the intervention variable, with the response series being the monthly Quitline caller rates and monthly first time NRT voucher issue rates. Results The monthly rates of Quitline caller registrations and NRT voucher issues were observed to increase in the months after the law change. The increase in both these outcomes was even greater when considered in terms of per level of Quitline advertising expenditure (though these patterns may have partly reflected marked reductions in advertising expenditure at the time of the law change and hence are of limited validity). In the more robust time series analyses, the law change (intervention variable) had a significant effect (p = 0.025) on increasing the monthly caller registration rate in December 2004. This was after adjusting for the possible effects of Quitline advertising expenditure, print media coverage, and other smoking-related advertising expenditure. Conclusion The new national smokefree law resulted in increased quitting-related behaviour. This would

A new national smokefree law increased calls to a national quitline

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Thomson George

2007-05-01

Full Text Available Abstract Background A law making all indoor workplaces including bars and restaurants smokefree became operational in New Zealand in December 2004. New Zealand has a national free-phone Quitline Service which has been operational since 1999. Previous work has shown that the number of calls to the Quitline are influenced by marketing of the service through media campaigns. We set out to investigate if the smokefree law increased calls to the Quitline. Methods For 24 months prior to the law, and 12 months after the law, data were collected on: (i Quitline caller registrations and the issuing of nicotine replacement therapy (NRT vouchers by the Quitline Service; (ii expenditure on Quitline-related television advertising; (iii expenditure on other smokefree television advertising; and (iv print media coverage of smoking in major New Zealand newspapers. These data were inputs to a time series analysis using a Box-Jenkins transfer function model. This used the law change as the intervention variable, with the response series being the monthly Quitline caller rates and monthly first time NRT voucher issue rates. Results The monthly rates of Quitline caller registrations and NRT voucher issues were observed to increase in the months after the law change. The increase in both these outcomes was even greater when considered in terms of per level of Quitline advertising expenditure (though these patterns may have partly reflected marked reductions in advertising expenditure at the time of the law change and hence are of limited validity. In the more robust time series analyses, the law change (intervention variable had a significant effect (p = 0.025 on increasing the monthly caller registration rate in December 2004. This was after adjusting for the possible effects of Quitline advertising expenditure, print media coverage, and other smoking-related advertising expenditure. Conclusion The new national smokefree law resulted in increased quitting

The impact of smokefree legislation in Scotland: results from the Scottish ITC Scotland/UK longitudinal surveys

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Hassan, Louise M.; Higbee, Cheryl; Boudreau, Christian; Fong, Geoffrey T.; Borland, Ron; Cummings, K. Michael; Yan, Mi; Thompson, Mary E.; Hastings, Gerard

2009-01-01

Background: To evaluate how Scotland's smokefree law impacted self-reported secondhand smoke (SHS) exposure in hospitality venues, workplaces and in people's homes. In addition, we examine changes in support for the law, pub and restaurant patronage, smoking cessation indicators and whether any observed changes varied by socioeconomic status. Methods: A quasi-experimental longitudinal telephone survey of nationally representative samples of smokers and non-smokers interviewed before the Scottish law (February to March 2006) and 1 year later after the law (March 2007) in Scotland (n = 705 smokers and n = 417 non-smokers) and the rest of the UK (n = 1027 smokers and n = 447 non-smokers) where smoking in public places was not regulated at the time. Results: Dramatic declines in the observance of smoking in pubs, restaurants and workplaces were found in Scotland relative to the rest of the UK. The change in the percent of smokers reporting a smokefree home and number of cigarettes smoked inside the home in the evening was comparable in Scotland and the rest of the UK. Support for smokefree policies increased to a greater extent in Scotland than in the rest of the UK. Self-reported frequency of going to pubs and restaurants was generally comparable between Scotland and the rest of the UK; however, non-smokers in Scotland were more likely to frequent pubs more often. No differences in smoking cessation indicators were observed between countries. Conclusion: The Scottish smokefree law has been successful in decreasing secondhand smoke exposure while causing none of the hypothesized negative outcomes. PMID:19151105

Tobacco Control and Health Advocacy in the European Union: Understanding Effective Coalition-Building.

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Weishaar, Heide; Collin, Jeff; Amos, Amanda

2016-02-01

Coalitions of supporters of comprehensive tobacco control policy have been crucial in achieving policy success nationally and internationally, but the dynamics of such alliances are not well understood. Qualitative semi-structured, narrative interviews with 35 stakeholders involved in developing the European Council Recommendation on smoke-free environments. These were thematically analyzed to examine the dynamics of coalition-building, collaboration and leadership in the alliance of organizations which successfully called for the development of comprehensive European Union (EU) smoke-free policy. An alliance of tobacco control and public health advocacy organizations, scientific institutions, professional bodies, pharmaceutical companies, and other actors shared the goal of fighting the harms caused by second-hand smoke. Alliance members jointly called for comprehensive EU smoke-free policy and the protection of the political debates from tobacco industry interference. The alliance's success was enabled by a core group of national and European actors with long-standing experience in tobacco control, who facilitated consensus-building, mobilized allies and synchronized the actions of policy supporters. Representatives of Brussels-based organizations emerged as crucial strategic leaders. The insights gained and identification of key enablers of successful tobacco control advocacy highlight the strategic importance of investing into tobacco control at European level. Those interested in effective health policy can apply lessons learned from EU smoke-free policy to build effective alliances in tobacco control and other areas of public health. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

Knowledge and attitude toward smoke-free legislation and second-hand smoking exposure among workers in indoor bars, beer parlors and discotheques in Osun State of Nigeria.

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Onigbogi, Olanrewaju Olusola; Odukoya, Oluwakemi; Onigbogi, Modupe; Sekoni, Oluwakemi

2015-04-01

One of the requirements of the Osun State smoke-free legislation is to ensure smoke-free enclosed and partially enclosed workplaces. This survey was conducted to assess the knowledge and attitude of workers in indoor bars, beer parlors and discotheques to smoke-free legislation in general and the Osun State smoke-free law in particular. A convenience sampling of 36 hospitality centers was conducted. Interviewer-administered questionnaires were used to elicit responses about the objectives from non-smoking workers. The questionnaires had sections on knowledge of the Osun State smoke-free law, attitude toward the law and smoke-free legislation in general and exposure to second-hand tobacco smoke by the workers. Questions were also asked about the second-hand tobacco smoking status of these workers. The data were analyzed using SPSS version 15.0. We had 154 participants recruited into the study. There were 75 males (48.0%) and 79 females (52.0%). On the overall, respondents had a good knowledge of the effects of second-hand smoke on health (70.2%) with 75.0% of them being aware of the general smoke-free law and 67.3% being aware of the Osun State smoke-free law although none of them had ever seen a copy of the law. A high proportion (60.0%) was in support of the Osun smoke-free law although all of them think that the implementation of the law could reduce patronage and jeopardize their income. Attitude toward second-hand smoking was generally positive with 72.0% of them having no tolerance for second-hand tobacco smoke in their homes. Most participants (95.5%) had been exposed to tobacco smoke in the workplace within the past week. Despite the high level of awareness of the respondents about the dangers of second hand smoke and their positive attitude to smoke-free laws, nearly all were constantly being exposed to second hand smoke at work. This calls for policy level interventions to improve the implementation of the smoke-free law.

Knowledge and Attitude toward Smoke-Free Legislation and Second-Hand Smoking Exposure among Workers in Indoor Bars, Beer Parlors and Discotheques in Osun State of Nigeria

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Olanrewaju Olusola Onigbogi

2015-04-01

Full Text Available Background One of the requirements of the Osun State smoke-free legislation is to ensure smoke-free enclosed and partially enclosed workplaces. This survey was conducted to assess the knowledge and attitude of workers in indoor bars, beer parlors and discotheques to smoke-free legislation in general and the Osun State smoke-free law in particular. Methods A convenience sampling of 36 hospitality centers was conducted. Interviewer-administered questionnaires were used to elicit responses about the objectives from non-smoking workers. The questionnaires had sections on knowledge of the Osun State smoke-free law, attitude toward the law and smoke-free legislation in general and exposure to second-hand tobacco smoke by the workers. Questions were also asked about the secondhand tobacco smoking status of these workers. The data were analyzed using SPSS version 15.0. Results We had 154 participants recruited into the study. There were 75 males (48.0% and 79 females (52.0%. On the overall, respondents had a good knowledge of the effects of second-hand smoke on health (70.2% with 75.0% of them being aware of the general smoke-free law and 67.3% being aware of the Osun State smoke-free law although none of them had ever seen a copy of the law. A high proportion (60.0% was in support of the Osun smoke-free law although all of them think that the implementation of the law could reduce patronage and jeopardize their income. Attitude toward second-hand smoking was generally positive with 72.0% of them having no tolerance for second-hand tobacco smoke in their homes. Most participants (95.5% had been exposed to tobacco smoke in the workplace within the past week. Conclusion Despite the high level of awareness of the respondents about the dangers of second hand smoke and their positive attitude to smoke-free laws, nearly all were constantly being exposed to second hand smoke at work. This calls for policy level interventions to improve the implementation of

Smoke-Free Legislation in Spain and Prematurity.

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Simón, Lorena; Pastor-Barriuso, Roberto; Boldo, Elena; Fernández-Cuenca, Rafael; Ortiz, Cristina; Linares, Cristina; Medrano, María José; Galán, Iñaki

2017-06-01

Spain implemented a partial smoking ban in 2006 followed by a comprehensive ban in 2011. The objective was to examine the association between these smoke-free policies and different perinatal complications. Cross-sectional study including all live births between 2000 and 2013. Selected adverse birth outcomes were: preterm births (birth weight (2000 to 2005 (preban), 2006 to 2010 (partial ban), and 2011 to 2013 (comprehensive ban). Models were adjusted for maternal sociodemographics, health care during the delivery, and smoking prevalence during pregnancy. The comprehensive ban was associated with preterm birth rate reductions of 4.5% (95% confidence interval [CI]: 2.9%-6.1%) and 4.1% (95% CI: 2.5%-5.6%) immediately and 1 year after implementation, respectively. The low birth weight rate also dropped immediately (2.3%; 95% CI: 0.7%-3.8%) and 1 year after the comprehensive ban implementation (3.5%; 95% CI: 2.1%-5.0%). There was an immediate reduction in the SGA rate at the onset of the partial ban (4.9%; 95% CI: 3.5%-6.2%), which was sustained 1 year postimplementation. Although not associated with the comprehensive ban at the onset, the SGA rate declined by 1.7% (95% CI: 0.3%-3.1%) 1 year postimplementation. The implementation of the Spanish smoke-free policies was associated with a risk reduction for preterm births and low birth weight infants, especially with the introduction of the more restrictive ban. Copyright © 2017 by the American Academy of Pediatrics.

Smoke-free restaurants in Shanghai: should it be mandatory and is it acceptable?

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Zheng, Pinpin; Fu, Hua; Li, Guangyao

2009-02-01

This study aims to describe secondhand smoke (SHS) exposure in restaurants in Shanghai and to explore the impact on the health of restaurant workers. Attitude to smoke-free restaurants among restaurant workers and customers was also determined in this study. A random sample of 242 workers, 284 customers, and 46 restaurant owners participated in face-to-face questionnaire interviews. A total of 219 (90.7%) restaurant workers surveyed were found to be exposed to SHS during working hours with 24.2+/-18.6h of exposure on average per week. Exposure time each week was significantly associated with the symptoms of dyspnea and irritated eyes. Among the customers surveyed 73.9% supported the concept of a 100% smoke-free law in restaurants and 49.6% expressed that they would be more likely to eat in restaurants if smoking was banned in restaurants. And 58.6% of the restaurant owners surveyed regarded smoke-free laws banning smoking in restaurant as feasible and 56.5% estimated such bans would decrease the profit. Both restaurant workers and customers are substantially exposed to SHS. Although some restaurant owners are concerned about a decrease in profits, the fear of losing business is not supported by the response among customers. Therefore, introducing a law-banning smoking in restaurants appears to be feasible and acceptable in Shanghai.

Immediate impact of smoke-free laws on indoor air quality.

Science.gov (United States)

Lee, Kiyoung; Hahn, Ellen J; Riker, Carol; Head, Sara; Seithers, Peggy

2007-09-01

Smoke-free laws significantly impact indoor air quality. However, the temporal effects of these laws on indoor air pollution have not been determined. This paper assesses the temporal impact of one smoke-free law on indoor air quality. This quasi-experimental study compared the indoor air quality of nine hospitality venues and one bingo hall in Georgetown, Kentucky, before and after implementation of a 100% smoke-free workplace law. We made real-time measurements of particulate matter with 2.5 microm aerodynamic diameter or smaller (PM2.5). Among the nine Georgetown hospitality venues, the average indoor PM2.5 concentration was 84 microg/m3 before the law took effect. The average indoor PM2.5 concentrations in nine compliant venues significantly decreased to 18 microg/m3 one week after the law took effect. Three venues having 82 microg/m3 before the law had significantly lower levels from the first day the law was implemented, and the low level was maintained. Compliance with the law is critical to achieving clean indoor air. Indoor air pollution in the bingo hall was not reduced until the establishment decided to comply with the law. The smoke-free law showed immediate impact on indoor air quality.

Environmental Tobacco Smoke Exposure and Smoke-Free Rules in Homes among Socially-Disadvantaged Populations in Poland.

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Milcarz, Katarzyna; Bak-Romaniszyn, Leokadia; Kaleta, Dorota

2017-04-21

This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed in the Piotrkowski District were used, which was part of the "Reducing Social Inequalities in Health" program. Overall, 19.4% of the respondents declared exposure to ETS at home. In the non-smokers group, 15.5%, including 6.6% males and 18.3% females, were exposed to ETS in their place of residence ( p smoker status and lack of ETS-associated health risk awareness, were found to be significantly associated with no adoption of total smoking bans at home. Socially-disadvantaged non-smokers, especially females from rural areas in Poland, still constitute a large population exposed to ETS in their homes-a challenge from the perspective of public health. Focused efforts are required to address social norms around exposing others to ETS.

Evaluating the Effectiveness of France's Indoor Smoke-Free Law 1 Year and 5 Years after Implementation: Findings from the ITC France Survey.

Directory of Open Access Journals (Sweden)

Geoffrey T Fong

Full Text Available France implemented a comprehensive smoke-free law in two phases: Phase 1 (February 2007 banned smoking in workplaces, shopping centres, airports, train stations, hospitals, and schools; Phase 2 (January 2008 banned smoking in hospitality venues (bars, restaurants, hotels, casinos, nightclubs. This paper evaluates France's smoke-free law based on the International Tobacco Control Policy Evaluation Project in France (the ITC France Project, which conducted a cohort survey of approximately 1,500 smokers and 500 non-smokers before the implementation of the laws (Wave 1 and two waves after the implementation (Waves 2 and 3. Results show that the smoke-free law led to a very significant and near-total elimination of observed smoking in key venues such as bars (from 94-97% to 4% and restaurants (from 60-71% to 2-3% at Wave 2, which was sustained four years later (6-8% in bars; 1-2% in restaurants. The reduction in self-reported smoking by smoking respondents was nearly identical to the effects shown in observed smoking. Observed smoking in workplaces declined significantly after the law (from 41-48% to 18-20%, which continued to decline at Wave 3 (to 14-15%. Support for the smoke-free laws increased significantly after their implementation and continued to increase at Wave 3 (p<.001 among smokers for bars and restaurants; p<.001 among smokers and p = .003 for non-smokers for workplaces. The findings demonstrate that smoke-free policies that are implemented in ways consistent with the Guidelines for Article 8 of the WHO Framework Convention on Tobacco Control (WHO FCTC lead to substantial and sustained reductions in indoor smoking while also leading to high levels of support by the public. Moreover, contrary to arguments by opponents of smoke-free laws, smoking in the home did not increase after the law was implemented and prevalence of smoke-free homes among smokers increased from 23.2% before the law to 37.2% 5 years after the law.

Tobacco industry manipulation of the hospitality industry to maintain smoking in public places

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Dearlove, J; Bialous, S; Glantz, S

2002-01-01

Objective: To describe how the tobacco industry used the "accommodation" message to mount an aggressive and effective worldwide campaign to recruit hospitality associations, such as restaurant associations, to serve as the tobacco industry's surrogate in fighting against smoke-free environments. Methods: We analysed tobacco industry documents publicly available on the internet as a result of litigation in the USA. Documents were accessed between January and November 2001. Results: The tobacco industry, led by Philip Morris, made financial contributions to existing hospitality associations or, when it did not find an association willing to work for tobacco interests, created its own "association" in order to prevent the growth of smoke-free environments. The industry also used hospitality associations as a vehicle for programmes promoting "accommodation" of smokers and non-smokers, which ignore the health risks of second hand smoke for employees and patrons of hospitality venues. Conclusion: Through the myth of lost profits, the tobacco industry has fooled the hospitality industry into embracing expensive ventilation equipment, while in reality 100% smoke-free laws have been shown to have no effect on business revenues, or even to improve them. The tobacco industry has effectively turned the hospitality industry into its de facto lobbying arm on clean indoor air. Public health advocates need to understand that, with rare exceptions, when they talk to organised restaurant associations they are effectively talking to the tobacco industry and must act accordingly. PMID:12034999

Restaurant volatility and the Iowa City, Iowa, smoke-free restaurant ordinance.

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Sheffer, Megan A; Squier, Christopher A; Gilmore, Gary D

2013-01-01

To determine the economic impact of the Iowa City, Iowa, smoke-free restaurant ordinance (IC-SFRO) using an immediate and novel approach. In this retrospective study, food permit licensure served as the measure to assess the IC-SFRO impact. The Iowa City experience provided an excellent experimental setting, as the ordinance was enacted March 1, 2002, and repealed May 7, 2003, because of preemption. The city of Coralville served as a natural control, as it is contiguous to Iowa City, has similar population demographics, and has never enacted a smoke-free restaurant ordinance. Food permit licensure data for all Iowa City and Coralville restaurants were obtained from the Johnson County Health Department. Differences in restaurant volatility were assessed using Fisher's exact probability test. The number of restaurants increased in both Iowa City and Coralville throughout the ordinance period. The ratio of the total number of restaurants in Iowa City to the total number of restaurants in the Iowa City-Coralville metropolitan area remained stable. The proportion of restaurants for each city did not differ significantly during the preordinance, ordinance, and postordinance periods. The IC-SFRO did not adversely impact the restaurant industry in terms of restaurant closures. The Iowa legislature was urged to draft evidence-based legislation, such as amending preemption of the IC-SFRO, to protect and promote the health of its communities.

Changes in the SF-8 scores among healthy non-smoking school teachers after the enforcement of a smoke-free school policy: a comparison by passive smoke status.

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Kiyohara, Kosuke; Itani, Yuri; Kawamura, Takashi; Matsumoto, Yoshitaka; Takahashi, Yuko

2010-04-28

The effects of the enforcement of a smoke-free workplace policy on health-related quality of life (HRQOL) among a healthy population are poorly understood. The present study was undertaken to examine the effects of the enforcement of a smoke-free school policy on HRQOL among healthy non-smoking schoolteachers with respect to their exposure to passive smoke. Two self-reported questionnaire surveys were conducted, the first before and the second after the enforcement of a total smoke-free public school policy in Nara City. A total of 1534 teachers were invited from 62 schools, and their HRQOL was assessed using six domains extracted from the Medical Outcomes Survey Short Form-8 questionnaire (SF-8): general health perception (GH), role functioning-physical (RP), vitality (VT), social functioning (SF), mental health (MH), and role functioning-emotional (RE). The participants were divided into two groups according to their exposure to environmental tobacco smoke (ETS) at baseline: participants not exposed to ETS at school (non-smokers), and participants exposed to ETS at school (passive smokers). Changes in each SF-8 score were evaluated using paired t-tests for each group, and their inter-group differences were evaluated using multiple linear regression analyses adjusted for sex, age, school type, managerial position, and attitude towards a smoke-free policy. After ineligible subjects were excluded, 689 teachers were included in the analyses. The number of non-smokers and passive smokers was 447 and 242, respectively. Significant changes in SF-8 scores were observed for MH (0.9; 95% confidence interval [CI], 0.2-1.5) and RE (0.7; 95% CI, 0.0-1.3) in non-smokers, and GH (2.2; 95% CI, 1.2-3.1), VT (1.8; 95% CI, 0.9-2.7), SF (2.7; 95% CI, 1.6-3.8), MH (2.0; 95% CI, 1.0-2.9), and RE (2.0; 95% CI, 1.2-2.8) in passive smokers. In the multiple linear regression analyses, the net changes in the category scores of GH (1.8; 95% CI, 0.7-2.9), VT (1.4, 95% CI, 0.3-2.5), SF (2

Attitudes of School Administrators and Teachers towards the "Smoke-Free Air Zone" Policy in Turkish Schools

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Banoglu, Köksal

2013-01-01

Objective: Schools are likely to be better able to achieve compliance with smoke-free regulations if principals and teachers perceive the importance of a smoke-free policy. The purpose of this study was to measure teacher and administrator attitudes towards the smoke-free policy in Turkish schools, which promotes a total smoking ban. Method: The…

Economic effects of smoke-free laws on rural and urban counties in Kentucky and Ohio.

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Pyles, Mark K; Hahn, Ellen J

2012-01-01

Numerous empirical studies have examined the influence of smoke-free legislation on economic activity, with most finding a null effect. The influence could possibly differ in rural areas relative to urban areas due to differing rates of smoking prevalence and access to prevention and treatment programs. Furthermore, the discussion of the effectiveness of smoke-free laws has been extended to consider local ordinances relative to statewide laws. This study examines these issues using 21 local laws in Kentucky and the Ohio statewide smoke-free law. The number of employees, total wages paid, and number of reporting establishments in all hospitality and accommodation services in Kentucky and Ohio counties were documented, beginning the first quarter 2001 and ending the last quarter of 2009. A generalized estimating equation time-series design is used to estimate the impact of local and state smoke-free laws in Kentucky and Ohio rural and urban counties. There is no evidence that the economies in Kentucky counties were affected in any way from the implementation of local smoke-free laws. There was also no evidence that total employment or the number of establishments was influenced by the statewide law in Ohio, but wages increased following the implementation of the law. Furthermore, there is no evidence that either rural or urban counties experienced a loss of economic activity following smoke-free legislation. The study finds no evidence that local or state smoke-free legislation negatively influences local economies in either rural or urban communities.

Association between Smokefree Legislation and Hospitalizations for Cardiac, Cerebrovascular and Respiratory Diseases: A Meta-Analysis

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Tan, Crystal E.; Glantz, Stanton A.

2012-01-01

Background Secondhand smoke causes cardiovascular and respiratory disease. Smokefree legislation is associated with a lower risk of hospitalization and death from these diseases. Methods and Results Random effects meta-analysis was conducted by law comprehensiveness to determine the relationship between smokefree legislation and hospital admission or death from cardiac, cerebrovascular, and respiratory diseases. Studies were identified using a systematic search for studies published before November 30, 2011 using Science Citation Index, Google Scholar, PubMed, and Embase and references in identified papers. Change in hospital admissions (or deaths) in the presence of a smokefree law, duration of follow-up, and law comprehensiveness (workplaces only; workplaces and restaurants; or workplaces, restaurants, and bars) were recorded. Forty-five studies of 33 smokefree laws with median follow-up of 24 months (range 2–57 months) were included. Comprehensive smokefree legislation was associated with significantly lower rates of hospital admissions (or deaths) for all 4 diagnostic groups: coronary events (RR .848, 95% CI .816–.881), other heart disease (RR .610, 95% CI .440–.847), cerebrovascular accidents (RR .840, 95% CI .753–.936), and respiratory disease (RR .760, 95% CI .682–.846). The difference in risk following comprehensive smokefree laws does not change with longer follow-up. More comprehensive laws were associated with larger changes in risk. Conclusions Smokefree legislation was associated with a lower risk of smoking-related cardiac, cerebrovascular, and respiratory diseases, with more comprehensive laws associated with greater changes in risk. PMID:23109514

Comparative impact of smoke-free legislation on smoking cessation in three European countries

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Nagelhout, G.E.; de Vries, H.; Boudreau, C.; Allwright, S.; McNeill, A.; van den Putte, B.; Fong, G.T.; Willemsen, M.C.

2012-01-01

Background: Little is known about the differential impact of comprehensive and partial smoke-free legislation on smoking cessation. This study aimed to examine the impact of comprehensive smoke-free workplace legislation in Ireland and England, and partial hospitality industry legislation in the

Indoor particulate matter measurement as a tool in the process of the implementation of smoke-free hospitals.

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Nardini, S; Cagnin, R; Invernizzi, G; Ruprecht, A; Boffi, R; Formentini, S

2004-01-01

There are International and National standards that requires hospitals and health premises to be smoke-free. According to recent data from Italy and other European Countries, smoking is a widespread habit in hospitals. To get smoke-free hospitals in an Italian region, we have adopted the European Code for smoke-free hospitals, which sets standards and provides instruments for its implementation. According to the Code, whenever possible, each step towards a smoke-free hospital, should be shared by all staff. As a mean for achieving this goal, in our region the certification of single units as smoke-free units has been chosen. For getting the certification, besides implementing the Code, we planned to use ETS (Environmental Tobacco Smoke) monitoring, as ETS should not be present in hospitals. As a marker of ETS we have chosen Particulate Matter (PM), as it can easily be measured in real-time with a portable instrument and, when other even outdoor--sources of combustion can be ruled out, it is an accurate detector of cigarette smoke. Here the first experience of measuring PM in hospitals for monitoring ETS and certificating smoke-free health premises, is described. PM measurements were carried out without any previous notification in different areas of two Network hospitals of the Veneto Region, during a single working day. A real time laser-operated aerosol mass analyser was used. Several classes of PM (PM1, PM2.5, PM7, PM10, TSP Total Suspended Particles) were measured. Outdoor PM levels were found to be repeatedly lower than the annual official limits of 65 mcg/m3 and around the 24 hour official limits of 15 mcg/m3 [15 to 20 mcg/m3, with an overall mean (+/-SD) of 17.8 (1.9)] throughout the whole day. Very good indoor air quality was found in the operating theaters and isolation department, where PM2.5 concentrations were much lower than outdoor levels [1.6 (0.9) and 5.9 (0.6) mcg/m3, respectively]. No increase in PM pollution was found in the surveyed medical

Do Partial Home Smoking Bans Signal Progress toward a Smoke-Free Home?

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Kegler, Michelle C.; Haardörfer, Regine; Bundy, Lucja T.; Escoffery, Cam; Berg, Carla J.; Fernandez, Maria; Williams, Rebecca; Hovell, Mel

2016-01-01

Understanding who establishes partial home smoking bans, what these bans cover, and whether they are an intermediate step in going smoke-free would help to inform smoke-free home interventions. Participants were recruited from United Way of Greater Atlanta's 2-1-1 contact center. Data were collected at baseline, 3 and 6 months via telephone…

Smoke-Free Workplaces Are Associated with Protection from Second-Hand Smoke at Homes in Nigeria: Evidence for Population-Level Decisions

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Dorota Kaleta

2015-01-01

Full Text Available The evidence suggests that smoke-free workplace policies may change social norms towards exposing others to second-hand smoke at home. The aim of the study was to assess whether being employed in a smoke-free workplace (SFWP is associated with living in a smoke-free home (SFH. We used the data from the Global Adult Tobacco Survey conducted in Nigeria in 2012, in which 9,765 individuals were interviewed including 1,856 persons who worked indoors. The percentage of Nigerians employed in SFWP that reported living in a SFH was higher compared to those employed in a workplace where smoking occurred (95% versus 73%. Working in a SFWP was associated with a significantly higher likelihood of living in a SFH (OR = 5.3; p<0.001. Urban inhabitants indicated more frequently that they lived in SFH compared to rural residents (OR = 2.0; p=0.006. The odds of living in a SFH were significantly higher among nonsmokers and nonsmokeless tobacco users compared to smokers and smokeless tobacco users (OR = 28.8; p<0.001; OR = 7.0; p<0.001. These findings support the need for implementation of comprehensive smoke-free policies in Nigeria that result in substantial health benefits.

If You Build (and Moderate) It, They Will Come: The Smokefree Women Facebook Page

Science.gov (United States)

2013-01-01

This analysis explores the impact of modifying the Smokefree Women Facebook social media strategy, from primarily promoting resources to encouraging participation in communications about smoking cessation by posting user-generated content. Analyses were performed using data from the Smokefree Women Facebook page to assess the impact of the revised strategy on reach and engagement. Fan engagement increased 430%, and a strong and statistically significant correlation (P < .05) between the frequency of moderator posts and community engagement was observed. The reach of the page also increased by 420%. Our findings indicate that the strategy shift had a statistically significant and positive effect on the frequency of interactions on the Facebook page, providing an example of an approach that may prove useful for reaching and engaging users in online communities. Additional research is needed to assess the association between engagement in virtual communities and health behavior outcomes. PMID:24395993

Impact of Scotland's comprehensive, smoke-free legislation on stroke.

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Daniel F Mackay

Full Text Available Previous studies have reported a reduction in acute coronary events following smoke-free legislation. Evidence is lacking on whether stroke is also reduced. The aim was to determine whether the incidence of stroke, overall and by sub-type, fell following introduction of smoke-free legislation across Scotland on 26 March 2006.A negative binomial regression model was used to determine whether the introduction of smoke-free legislation resulted in a step and/or slope change in stroke incidence. The model was adjusted for age-group, sex, socioeconomic deprivation quintile, urban/rural residence and month. Interaction tests were also performed. Routine hospital administrative data and death certificates were used to identify all hospital admissions and pre-hospital deaths due to stroke (ICD10 codes I61, I63 and I64 in Scotland between 2000 and 2010 inclusive. Prior to the legislation, rates of all stroke, intracerebral haemorrhage and unspecified stroke were decreasing, whilst cerebral infarction was increasing at 0.97% per annum. Following the legislation, there was a dramatic fall in cerebral infarctions that persisted for around 20 months. No visible effect was observed for other types of stroke. The model confirmed an 8.90% (95% CI 4.85, 12.77, p<0.001 stepwise reduction in cerebral infarction at the time the legislation was implemented, after adjustment for potential confounders.Following introduction of national, comprehensive smoke-free legislation there was a selective reduction in cerebral infarction that was not apparent in other types of stroke.

Impact of tobacco prices and smoke-free policy on smoking cessation, by gender and educational group: Spain, 1993-2012.

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Regidor, Enrique; Pascual, Cruz; Giráldez-García, Carolina; Galindo, Silvia; Martínez, David; Kunst, Anton E

2015-12-01

To evaluate the effect of tobacco prices and the implementation of smoke-free legislation on smoking cessation in Spain, by educational level, across the period 1993-2012. National Health Surveys data for the above two decades were used to calculate smoking cessation in people aged 25-64 years. The relationship between tobacco prices and smoking quit-ratio was estimated using multiple linear regression adjusted for time and the presence of smoke-free legislation. The immediate as well as the longer-term impact of the 2006 smoke-free law on quit-ratio was estimated using segmented linear regression analysis. The analyses were performed separately in men and women with high and low education, respectively. No relationship was observed between tobacco prices and smoking quit-ratio, except in women having a low educational level, among whom a rise in price was associated with a decrease in quit-ratio. The smoke-free law altered the smoking quit-ratio in the short term and altered also pre-existing trends. Smoking quit-ratio increased immediately after the ban - though this increase was significant only among women with a low educational level - and then decreased in subsequent years except among men with a high educational level. A clear relationship between tobacco prices and smoking quit-ratio was not observed in a recent period. After the implementation of smoke-free legislation the trend in the quit ratio in most of the socio-economic groups was different from the trend observed before implementation, so existing inequalities in smoking quit-ratio were not widened or narrowed. Copyright © 2015 Elsevier B.V. All rights reserved.

A Qualitative Examination of Smoke-Free Policies and Electronic Cigarettes Among Sheltered Homeless Adults.

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Vijayaraghavan, Maya; Hurst, Samantha; Pierce, John P

2017-05-01

To examine attitudes toward smoke-free policies and perceptions of e-cigarette use among homeless adults. A cross-sectional qualitative study was conducted. Study setting comprised seven transitional homeless shelters with indoor smoke-free policies in San Diego County; facilities differed in outdoor restrictions on smoking. Sixty-six current or former smokers were the study participants. Participants completed a questionnaire on smoking behaviors, perceived antitobacco norms, and attitudes toward smoke-free policies, and attended a focus group interview that explored these topics. We used a directed content analysis approach to analyze the focus group transcripts. Clients in facilities with outdoor restrictions on smoking had stronger perceived antitobacco norms than those in facilities without such restrictions. We identified the following major themes: attitudes toward smoke-free policies, the use of e-cigarettes, the addictive potential of cigarettes, vulnerability to tobacco industry marketing, and interest in smoking cessation. The consensus was that smoke-free policies were important because they limited secondhand smoke exposure to nonsmokers and children. All were curious about e-cigarettes, particularly if they could be smoked in areas where smoking was prohibited and/or used as a cessation aid. In this study of homeless adults, there was strong support for indoor and outdoor smoke-free policies. However, misperceptions that e-cigarettes could be used indoors could threaten antitobacco norms, highlighting opportunities to educate about the potential risks of e-cigarette use among homeless individuals.

Evaluation of a social marketing campaign to support Mexico City's comprehensive smoke-free law.

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Thrasher, James F; Huang, Liling; Pérez-Hernández, Rosaura; Niederdeppe, Jeff; Arillo-Santillán, Edna; Alday, Jorge

2011-02-01

We aimed to assess the level of awareness and impact of a social marketing campaign to promote Mexico City's 2008 comprehensive smoke-free law. Four months after the smoke-free law was implemented but before the campaign launch, we collected data from a population-based, random sample of 961 inhabitants of Mexico City. We analyzed data from 786 respondents who completed follow-up at the end of the campaign to determine campaign exposure and the association between campaign exposure and changes in campaign-targeted knowledge and attitudes. Recall of any of the 5 campaign materials was 69%, with a uniform distribution of exposure to 1, 2, and 3 or more campaign materials (25%, 25%, and 19%, respectively). Exposure to a greater number of campaign materials was associated in a monotonic relation with campaign-targeted knowledge of ammonia and arsenic in cigarette smoke. In models assessing support for, perceived benefits of, and perceived right to smoke-free places, campaign exposure accounted for a positive change in half of the indicators within each of these domains. Social marketing campaigns can reinforce knowledge and attitudes that favor smoke-free laws, thereby helping to establish smoke-free norms.

A persisting secondhand smoke hazard in urban public places: results from fine particulate (PM2.5) air sampling.

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Wilson, Nick; Edwards, Richard; Parry, Rhys

2011-03-04

To assess the need for additional smokefree settings, by measuring secondhand smoke (SHS) in a range of public places in an urban setting. Measurements were made in Wellington City during the 6-year period after the implementation of legislation that made indoor areas of restaurants and bars/pubs smokefree in December 2004, and up to 20 years after the 1990 legislation making most indoor workplaces smokefree. Fine particulate levels (PM2.5) were measured with a portable real-time airborne particle monitor. We collated data from our previously published work involving random sampling, purposeful sampling and convenience sampling of a wide range of settings (in 2006) and from additional sampling of selected indoor and outdoor areas (in 2007-2008 and 2010). The "outdoor" smoking areas of hospitality venues had the highest particulate levels, with a mean value of 72 mcg/m3 (range of maximum values 51-284 mcg/m3) (n=20 sampling periods). These levels are likely to create health hazards for some workers and patrons (i.e., when considered in relation to the WHO air quality guidelines). National survey data also indicate that these venues are the ones where SHS exposure is most frequently reported by non-smokers. Areas inside bars that were adjacent to "outdoor" smoking areas also had high levels, with a mean of 54 mcg/m3 (range of maximum values: 18-239 mcg/m3, for n=13 measurements). In all other settings mean levels were lower (means: 2-22 mcg/m3). These other settings included inside traditional style pubs/sports bars (n=10), bars (n=18), restaurants (n=9), cafes (n=5), inside public buildings (n=15), inside transportation settings (n=15), and various outdoor street/park settings (n=22). During the data collection in all settings made smokefree by law, there was only one occasion of a person observed smoking. The results suggest that compliance in pubs/bars and restaurants has remained extremely high in this city in the nearly six years since implementation of the

The impact of smoke-free legislation on reducing exposure to secondhand smoke: differences across gender and socioeconomic groups.

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Tsai, Yi-Wen; Chang, Li-Chuan; Sung, Hai-Yen; Hu, Teh-Wei; Chiou, Shu-Ti

2015-01-01

On 11 January 2009, Taiwan expanded its smoke-free legislation to all indoor public places and workplaces. This study examined the impact of this policy on secondhand smoke (SHS) exposure in adult non-smokers, across gender and socioeconomic status groups (SES). An annual sample of about 13,000-14,000 non-smokers was drawn from cross-sectional nationwide data of Taiwan Adult Tobacco Behavior Surveys during 2005-2011. Logistic regressions were used to analyse the aggregate data to estimate the association between the 2009 smoke-free legislation and SHS exposures in homes and workplaces. Interaction terms were used to examine the impact of the 2009 smoke-free policy on reducing differences in SHS exposure across gender, education and income groups. The 2009 policy reduced the odds of SHS exposure in homes in 2009 (OR=0.76, 95% CI 0.68 to 0.84) and in workplaces (year 2009: OR=0.49, 95% CI 0.39 to 0.62; year 2010: OR=0.79, 95% CI 0.66 to 0.95). The model with interaction terms showed that men were more likely than women to be exposed to workplace SHS (OR=2.02, 95% CI 1.80 to 2.27) but were less likely to be exposed to home SHS (OR=0.79, 95% CI 0.73 to 0.86). SHS exposure in homes was significantly related to lower socioeconomic status, but the 2009 smoke-free policy reduced the difference in SHS exposure across education levels. The 2009 smoke-free policy reduced the SHS exposure for non-smokers. However, this impact on home SHS did not persist after 2009, and the effect of protection was unequal across gender and SES groups. Thus, further enforcement of smoking restrictions would be needed to reduce the risk of SHS exposure and improve protection against SHS risk among parts of the population with lower socioeconomic status. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Correlates of compliance with national comprehensive smoke-free laws.

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Peruga, Armando; Hayes, Luminita S; Aguilera, Ximena; Prasad, Vinayak; Bettcher, Douglas W

2017-12-05

To explore correlates of high compliance with smoking bans in a cross-sectional data set from the 41 countries with national comprehensive smoke-free laws in 2014 and complete data on compliance and enforcement. Outcome variable: compliance with a national comprehensive smoke-free law in each country was obtained for 2014 from the WHO global report on the global tobacco epidemic. Explanatory variables: legal enforcement requirements, penalties, infrastructure and strategy were obtained through a separate survey of governments. Also, country socioeconomic and demographic characteristics including the level of corruption control were included. an initial bivariate analysis determined the significance of each potentially relevant explanatory variable of high compliance. Differences in compliance were tested using the exact logistic regression. High compliance with the national comprehensive smoke-free law was associated with the involvement of the local jurisdictions in providing training and/or guidance for inspections (OR=10.3, 95% CI 1.7 to 117.7) and a perception of high corruption control efforts in the country (OR=7.2, 95% CI 1.1 to 85.8). The results show the importance of the depth of the enforcement infrastructure and effort represented by the degree to which the local government is involved in enforcement. They also show the significance of fighting corruption in the enforcement process, including the attempts of the tobacco industry to undermine the process, to achieve high levels of compliance with the law. The results point out to the need to invest minimal but essential enforcement resources given that national comprehensive smoke-free laws are self-enforcing in many but not all countries and sectors.

Myocardial infarction and sudden cardiac death in Olmsted County, Minnesota, before and after smoke-free workplace laws.

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Hurt, Richard D; Weston, Susan A; Ebbert, Jon O; McNallan, Sheila M; Croghan, Ivana T; Schroeder, Darrell R; Roger, Véronique L

2012-11-26

Reductions in admissions for myocardial infarction (MI) have been reported in locales where smoke-free workplace laws have been implemented, but no study has assessed sudden cardiac death in that setting. In 2002, a smoke-free restaurant ordinance was implemented in Olmsted County, Minnesota, and in 2007, all workplaces, including bars, became smoke free. To evaluate the population impact of smoke-free laws, we measured, through the Rochester Epidemiology Project, the incidence of MI and sudden cardiac death in Olmsted County during the 18-month period before and after implementation of each smoke-free ordinance. All MIs were continuously abstracted and validated, using rigorous standardized criteria relying on biomarkers, cardiac pain, and Minnesota coding of the electrocardiogram. Sudden cardiac death was defined as out-of-hospital deaths associated with coronary disease. Comparing the 18 months before implementation of the smoke-free restaurant ordinance with the 18 months after implementation of the smoke-free workplace law, the incidence of MI declined by 33% (P trends in other risk factors do not appear explanatory, smoke-free workplace laws seem to be ecologically related to these favorable trends. Secondhand smoke exposure should be considered a modifiable risk factor for MI. All people should avoid secondhand smoke to the extent possible, and people with coronary heart disease should have no exposure to secondhand smoke.

The Effect of Local Smokefree Regulations on Birth Outcomes and Prenatal Smoking.

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Bartholomew, Karla S; Abouk, Rahi

2016-07-01

Objectives We assessed the impact of varying levels of smokefree regulations on birth outcomes and prenatal smoking. Methods We exploited variations in timing and regulation restrictiveness of West Virginia's county smokefree regulations to assess their impact on birthweight, gestational age, low birthweight, very low birthweight, preterm birth, and prenatal smoking. We conducted regression analysis using state Vital Statistics individual-level data for singletons born to West Virginia residents between 1995-2010 (N = 293,715). Results Only more comprehensive smokefree regulations were associated with statistically significant favorable effects on birth outcomes in the full sample: Comprehensive (workplace/restaurant/bar ban) demonstrated increased birthweight (29 grams, p workplace/restaurant ban) demonstrated a small decrease in very low birthweight (-0.2 %, p workplace ban) was associated with a 23 g (p < 0.01) decrease in birthweight; Limited (partial ban) had no effect. Comprehensive's improvements extended to most maternal groups, and were broadest among mothers 21+ years, non-smokers, and unmarried mothers. Prenatal smoking declined slightly (-1.7 %, p < 0.01) only among married women with Comprehensive. Conclusions Regulation restrictiveness is a determining factor in the impact of smokefree regulations on birth outcomes, with comprehensive smokefree regulations showing promise in improving birth outcomes. Favorable effects on birth outcomes appear to stem from reduced secondhand smoke exposure rather than reduced prenatal smoking prevalence. This study is limited by an inability to measure secondhand smoke exposure and the paucity of data on policy implementation and enforcement.

[Health services research for the public health service (PHS) and the public health system].

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Hollederer, A; Wildner, M

2015-03-01

There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.

Evaluation of community and organizational characteristics of smoke-free ordinance campaigns in 15 Wisconsin cities.

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Ahrens, David; Uebelher, Paul; Remington, Patrick L

2005-07-01

Smoke-free restaurant ordinance campaigns were conducted in 15 Wisconsin cities during 1992 through 2002. Community and health coalition organizational characteristics varied with each campaign; nine campaigns were successful in enacting ordinances, and six campaigns failed. Data on community and coalition characteristics were analyzed. Community characteristics included adjusted gross income, percentage of Democratic voters in recent elections, and county smoking prevalence. Coalition characteristics included the number of supporters identified, leadership experience, level of print news media coverage, and editorial position of local newspaper. Successful campaigns were more likely to have leadership with high levels of political experience; eight of nine successful campaigns had leadership with high levels of experience, and two of six unsuccessful campaigns had leadership with high levels of experience. Every successful campaign had high levels of newspaper coverage and strong editorial support. None of the unsuccessful campaigns had high levels of news coverage or strong editorial support. Characteristics controlled or influenced by coalitions are associated with successful outcomes. Community characteristics were not associated with outcomes. These results should assist communities planning to implement smoke-free ordinances or other health policy campaigns.

State preemption of local smoke-free laws in government work sites, private work sites, and restaurants - United States, 2005-2009.

Science.gov (United States)

2010-02-05

Smoke-free policies (i.e., policies that completely eliminate smoking in indoor workplaces and public places) result in health benefits, including preventing heart attacks. Preemptive legislation at the state level prohibits localities from enacting laws that vary from state law or are more stringent. A Healthy People 2010 objective (27-19) is to eliminate state laws that preempt stronger local tobacco control laws. A 2005 CDC review found that little progress was being made toward reducing the number of state laws preempting local smoking restrictions in three indoor settings: government work sites, private-sector work sites, and restaurants. These three settings were selected for analysis because they are settings that often are addressed by state and local smoking restrictions and because they are major settings where nonsmoking workers and patrons are exposed to secondhand smoke. This report updates the previous analysis and summarizes changes that occurred from December 31, 2004, to December 31, 2009, in state laws that preempt local smoke-free laws for the same three settings. During that period, the number of states preempting local smoking restrictions in at least one of these three settings decreased from 19 to 12. In contrast with the 2005 findings, this decrease indicates progress toward achieving the goal of eliminating state laws preempting local smoking restrictions. Further progress could result in additional reductions in secondhand smoke exposure.

Economic effects of Ohio's smoke-free law on Kentucky and Ohio border counties.

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Pyles, Mark K; Hahn, Ellen J

2011-01-01

To determine if the Ohio statewide smoke-free law is associated with economic activity in Ohio or Kentucky counties that lie on the border between the two states. In November 2006, Ohio implemented a comprehensive statewide smoke-free law for all indoor workplaces. A feasible generalised least squares (FLGS) time series design to estimate the impact of the Ohio smoke-free law on Kentucky and Ohio border counties. Six Kentucky and six Ohio counties that lie on the border between the two states. All reporting hospitality and accommodation establishments in all Kentucky and Ohio counties including but not limited to food and drinking establishments, hotels and casinos. Total number of employees, total wages paid and number of reported establishments in all hospitality and accommodation services, 6 years before Ohio's law and 1 year after. There is no evidence of a disproportionate change in economic activity in Ohio or Kentucky border counties relative to their non-border counterparts. There was no evidence of a relation between Ohio's smoke-free law and economic activity in Kentucky border counties. The law generated a positive influence on wages and number of establishments in Ohio border counties. The null result cannot be explained by low test power, as minimum changes necessary in the dependent variables to detect a significant influence are very reasonable in size. Our data add to the large body of evidence that smoke-free laws are neutral with respect to the hospitality business across jurisdictions with and without laws.

Government and public health responses to e-cigarettes in New Zealand: vapers' perspectives.

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Fraser, Trish; Glover, Marewa; Truman, Penelope

2018-04-05

The New Zealand (NZ) government is to lift the ban on the sale of nicotine for use in electronic cigarettes (e-cigarettes). Using a naturalistic approach, we sought to understand how the current law was experienced by e-cigarette users (vapers). Twenty-nine vapers were interviewed by telephone, between May and September 2016, using a semi-structured interview schedule. Open-ended questions covered: initiating vaping, the experience of stopping smoking, technical problems encountered, reasons for vaping, acceptability of vaping, addiction to vaping and advice given to smokers about vaping. The audio recordings were transcribed and then independently coded using a general inductive thematic analysis. This paper presents the main theme which was that vapers employed a range of reactionary strategies to the ban on the sale of nicotine e-liquid in NZ. These included lobbying government, spreading the word, establishing vaper support groups, helping people stop smoking by switching to vaping and advocating for e-cigarettes to be incorporated into smoking cessation practice. Vapers' experience and observations form a popular or lay epidemiology--one that identified that e-cigarettes were helping people stop smoking and could thus deliver public health benefits. Public health researchers and workers, and government fears about vaping, and proposals to strengthen restrictions contributed to the growth of the vaper community who reacted by forming self-help groups and providing alternative cessation support to smokers. For a significant switch from smoking to vaping to occur, the health sector needs to have a change of attitude towards vaping that is positive, and the public needs evidence-based information on vaping. A first step could be for the health sector to collaborate with the vaping community to reorient current tobacco control and cessation practice to encourage smokers to switch to less harmful smoke-free alternatives to smoking.

Individual, social, and environmental factors associated with support for smoke-free housing policies among subsidized multiunit housing tenants.

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Hood, Nancy E; Ferketich, Amy K; Klein, Elizabeth G; Wewers, Mary Ellen; Pirie, Phyllis

2013-06-01

Mandatory smoke-free policies in subsidized, multiunit housing (MUH) may decrease secondhand smoke exposure in households with the highest rates of exposure. Ideally, policies should be based on a strong understanding of factors affecting support for smoke-free policies in the target population to maximize effectiveness. A face-to-face survey was conducted from August to October 2011 using a stratified random sample of private subsidized housing units in Columbus, OH, without an existing smoke-free policy (n = 301, 64% response rate). Lease holders were asked to report individual, social, and environmental factors hypothesized to be related to support for smoke-free policies. Multiple logistic regression models were used to identify factors independently associated with policy support. Most tenants supported smoke-free policies in common areas (82.7%), half supported policies inside units (54.5%), and one third supported a ban outside the building (36.3%). Support for smoke-free policies in units and outdoors was more common among nonsmokers than smokers (71.5% vs. 35.7%, p social, but no environmental, factors were independently associated with policy support. Smokers who intended to quit within 6 months or less were more likely than other smokers to support in-unit policies (45.3% vs. 21.1%; p = .003). More than half of subsidized MUH tenants supported smoke-free policies inside their units. Strategies to address individual- and social-level barriers to behavior change should be implemented in parallel with smoke-free policies. Policies should be evaluated with objective measures to determine their effectiveness.

Public health emergencies and the public health/managed care challenge.

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Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

2002-01-01

The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

Training public health superheroes: five talents for public health leadership.

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Day, Matthew; Shickle, Darren; Smith, Kevin; Zakariasen, Ken; Moskol, Jacob; Oliver, Thomas

2014-12-01

Public health leaders have been criticized for their policy stances, relationships with governments and failure to train the next generation. New approaches to the identification and training of public health leaders may be required. To inform these, lessons can be drawn from public health 'superheroes'; public health leaders perceived to be the most admired and effective by their peers. Members and Fellows of the UK Faculty of Public Health were contacted via e-newsletter and magazine and asked to nominate their 'Public Health Superhero'. Twenty-six responses were received, nominating 40 different people. Twelve semi-structured interviews were conducted. Thematic analysis, based on 'grounded theory', was conducted. Five leadership 'talents' for public health were identified: mentoring-nurturing, shaping-organizing, networking-connecting, knowing-interpreting and advocating-impacting. Talent-based approaches have been effective for leadership development in other sectors. These talents are the first specific to the practice of public health and align with some aspects of existing frameworks. An increased focus on identifying and developing talents during public health training, as opposed to 'competency'-based approaches, may be effective in strengthening public health leadership. Further research to understand the combination and intensity of talents across a larger sample of public health leaders is required. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Restaurant smoking sections in South Africa and the perceived impact of the proposed smokefree laws: Evidence from a nationally representative survey

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M Little

2018-03-01

Full Text Available Background. The South African Minister of Health announced in 2016 that he intends to introduce tobacco control legislation that will prohibit smoking in restaurants. This will substantially strengthen the Tobacco Products Control Act (1993, as amended, which currently allows restaurants to have a dedicated, enclosed indoor smoking area.Objectives. To analyse current smoking policies of restaurants, whether and how these policies have changed over the past decade, and restaurateurs’ attitudes to the proposed legislative changes.Methods. From a population of nearly 12 000 restaurants, derived from four websites, we sampled 2 000 restaurants, stratifying by province and type (independent v. chain and disproportionately sampling small strata to ensure meaningful analysis. We successfully surveyed 741 restaurants, mostly by phone. We also surveyed 60 franchisors from a population of 82 franchisors.Results. Of the restaurants sampled, 44% were 100% smoke-free, 44% had smoking sections outside, 11% had smoking sections inside, and 1% allowed smoking anywhere. Smoking areas were more common in independent restaurants (62% than franchised restaurants (43%. Of the restaurants with a smoking section, 33% reported that the smoking sections were busier than the non-smoking sections. Twenty-three percent of restaurants had made changes to their smoking policies in the past 10 years, mostly removing or reducing the size of the smoking sections. Customer requests (39%, compliance with the law (35% and cost and revenue pressures (14% were the main reasons for changing smoking policies. Of the restaurant respondents 91% supported the current legislation, while 63% supported the proposed legislative changes; 68% of respondents who were aware of the proposed legislation supported it, compared with 58% of respondents who were not aware of the proposed legislation.Conclusions. In contrast to the vehement opposition to the 1999 legislation, which resulted

Smokefree signage at children’s playgrounds: Field observations and comparison with Google Street View

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George Thomson

2017-08-01

The presence and quality of smokefree signage was poor in this sample of children’s playgrounds in this developed country setting. There appears to be value in comparing smokefree signage with other types of signage (eg, dog control signage. Google Street View was not a sensitive tool for studying such signage.

Association between smoke-free legislation and hospitalizations for cardiac, cerebrovascular, and respiratory diseases: a meta-analysis.

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Tan, Crystal E; Glantz, Stanton A

2012-10-30

Secondhand smoke causes cardiovascular and respiratory disease. Smoke-free legislation is associated with a lower risk of hospitalization and death from these diseases. Random-effects meta-analysis was conducted by law comprehensiveness to determine the relationship between smoke-free legislation and hospital admission or death from cardiac, cerebrovascular, and respiratory diseases. Studies were identified by using a systematic search for studies published before November 30, 2011 with the use of the Science Citation Index, Google Scholar, PubMed, and Embase and references in identified articles. Change in hospital admissions (or deaths) in the presence of a smoke-free law, duration of follow-up, and law comprehensiveness (workplaces only; workplaces and restaurants; or workplaces, restaurants, and bars) were recorded. Forty-five studies of 33 smoke-free laws with median follow-up of 24 months (range, 2-57 months) were included. Comprehensive smoke-free legislation was associated with significantly lower rates of hospital admissions (or deaths) for all 4 diagnostic groups: coronary events (relative risk, 0.848; 95% confidence interval 0.816-0.881), other heart disease (relative risk, 0.610; 95% confidence interval, 0.440-0.847), cerebrovascular accidents (relative risk, 0.840; 95% confidence interval, 0.753-0.936), and respiratory disease (relative risk, 0.760; 95% confidence interval, 0.682-0.846). The difference in risk following comprehensive smoke-free laws does not change with longer follow-up. More comprehensive laws were associated with larger changes in risk. Smoke-free legislation was associated with a lower risk of smoking-related cardiac, cerebrovascular, and respiratory diseases, with more comprehensive laws associated with greater changes in risk.

[Public health services between "new public health" and "new public management"].

Science.gov (United States)

Oppen, M

1996-04-01

Today, a substantial reorientation of the Public Health services in the Federal Republic of Germany is broadly seen necessary. Patterns of functional and organisational restructuring of Public Health services on the regional and the communal level are closely linked with concepts of prevention and health promotion. Hence, a number of agencies have already adopted new tasks and functions like comprehensive and transorganizational planning, coordination and evaluation as well as the establishment of new reporting systems. Presently, the transformation process from the bureaucratic mode of administering matters of health to a new Public Health orientation receives new impacts from the international "New Public Management" movement. Comparatively late, with the beginning of the 1990s, a growing number of German municipalities has introduced new concepts of administration. Local government administrations, of which the Public Health services are a part, follow the model of modern service organizations producing services in a more efficient, professionalized and consumer-oriented way. Specific elements of economising modernisation programmes like re-distribution of tasks, de-centralisation, extension of managerial capacities, setting of stimulating working conditions that provide employees with greater independence of action as well as career opportunities, are at the same time prerequisites for innovative strategies of health protection and coordination policies of Public Health services.

Smokefree implementation in Colombia: Monitoring, outside funding, and business support

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Randy Uang

2017-03-01

Full Text Available Objective. To analyze successful national smokefree policy implementation in Colombia, a middle income country. Materials and methods. Key informants at the national and local levels were interviewed and news sources and government ministry resolutions were reviewed. Results.Colombia’s Ministry of Health coordinated local implementation practices, which were strongest in larger cities with supportive leadership. Nongovernmental organizations provided technical assistance and highlighted noncompliance. Organizations outside Colombia funded some of these efforts. The bar owners’ association provided concerted education campaigns. Tobacco interests did not openly challenge implementation. Conclusions. Health organization monitoring, external funding, and hospitality industry support contributed to effective implementation, and could be cultivated in other low and middle income countries.

Knowledge, opinions and compliance related to the 100% smoke-free law in hospitality venues in Kampala, Uganda: cross-sectional results from the KOMPLY Project.

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Gravely, Shannon; Nyamurungi, Kellen Namusisi; Kabwama, Steven Ndugwa; Okello, Gabriel; Robertson, Lindsay; Heng, Kelvin Khow Chuan; Ndikum, Achiri Elvis; Oginni, Adeniyi Samuel; Rusatira, Jean Christophe; Kakoulides, Socrates; Huffman, Mark D; Yusuf, Salim; Bianco, Eduardo

2018-01-05

This study evaluated knowledge, opinions and compliance related to Uganda's comprehensive smoke-free law among hospitality venues in Kampala Uganda. This multi-method study presents cross-sectional findings of the extent of compliance in the early phase of Uganda's comprehensive smoke-free law (2 months postimplementation; pre-enforcement). Bars, pubs and restaurants in Kampala Uganda. A two-stage stratified cluster sampling procedure was used to select hospitality sites stratified by all five divisions in Kampala. A total of 222 establishments were selected for the study. One hospitality representative from each of the visited sites agreed to take part in a face-to-face administered questionnaire. A subsample of hospitality venues were randomly selected for tobacco air quality testing (n=108). Data were collected between June and August 2016. Knowledge and opinions of the smoke-free law among hospitality venue staff and owners. The level of compliance with the smoke-free law in hospitality venues through: (1) systematic objective observations (eg, active smoking, the presence of designated smoking areas, 'no smoking' signage) and (2) air quality by measuring the levels of tobacco particulate matter (PM 2.5 ) in both indoor and outdoor venues. Active smoking was observed in 18% of venues, 31% had visible 'no smoking' signage and 47% had visible cigarette remains. Among interviewed respondents, 57% agreed that they had not been adequately informed about the smoke-free law; however, 90% were supportive of the ban. Nearly all respondents (97%) agreed that the law will protect workers' health, but 32% believed that the law would cause financial losses at their establishment. Indoor PM 2.5 levels were hazardous (267.6 µg/m 3 ) in venues that allowed smoking and moderate (29.6 µg/m 3 ) in smoke-free establishments. In the early phase of Uganda's smoke-free law, the level of compliance in hospitality venues settings in Kampala was suboptimal. Civil society and the

Opportunistic insights into occupational health hazards associated with waterpipe tobacco smoking premises in the United Kingdom.

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Al-Bakri, Ali; Jawad, Mohammed; Salameh, Pascale; al'Absi, Mustafa; Kassim, Saba

2015-01-01

Smokefree laws aim to protect employees and the public from the dangers of secondhand smoke. Waterpipe premises have significantly increased in number in the last decade, with anecdotal reports of poor compliance with the smokefree law. The literature is bereft of information pertaining to waterpipe premise employees. This study aimed to opportunistically gather knowledge about the occupational health hazards associated with working in waterpipe premises in London, England. Employees from seven convenience-sampled, smokefree-compliant waterpipe premises in London were observed for occupational activities. Opportunistic carbon monoxide (CO) measurements were made among those with whom a rapport had developed. Observations were thematically coded and analysed. Occupational hazards mainly included environmental smoke exposure. Waterpipe-serving employees were required to draw several puffs soon after igniting the coals, thereby providing quality assurance of the product. Median CO levels were 27.5 ppm (range 21-55 ppm) among these employees. Self-reported employee health was poor, with some suggestion that working patterns and smoke exposure was a contributory factor. The smokefree law in England does not appear to protect waterpipe premise employees from high levels of CO. Continued concerns surrounding chronic smoke exposure may contribute to poor self-reported physical and mental wellbeing.

Impact of tobacco control policies in hospitals: Evaluation of a national smoke-free campus ban in Spain

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Xisca Sureda

2014-01-01

Conclusions: After the law, particulate matter < 2.5 µm concentrations were much below the values obtained before the law and below the annual guideline value recommended by the World Health Organization for outdoor settings (10 μg/m3. Our data showed the feasibility of implementing a smoke-free campus ban and its positive effects.

Leprosy: International Public Health Policies and Public Health Eras

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Niyi Awofeso

2011-09-01

Full Text Available Public health policies continue to play important roles in national and international health reforms. However, the influence and legacies of the public health eras during which such policies are formulated remain largely underappreciated. The limited appreciation of this relationship may hinder consistent adoption of public health policies by nation-states, and encumber disinvestment from ineffective or anachronistic policies. This article reviews seven public health eras and highlights how each era has influenced international policy formulation for leprosy control—“the fertile soil for policy learning”. The author reiterates the role of health leadership and health activism in facilitating consistency in international health policy formulation and implementation for leprosy control.

Impact of tobacco prices and smoke-free policy on smoking cessation, by gender and educational group: Spain, 1993-2012

NARCIS (Netherlands)

Regidor, Enrique; Pascual, Cruz; Giráldez-García, Carolina; Galindo, Silvia; Martínez, David; Kunst, Anton E.

2015-01-01

To evaluate the effect of tobacco prices and the implementation of smoke-free legislation on smoking cessation in Spain, by educational level, across the period 1993-2012. National Health Surveys data for the above two decades were used to calculate smoking cessation in people aged 25-64 years. The

Effect of Uruguay’s National 100% Smokefree Law on Emergency Visits for Bronchospasm

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Kalkhoran, Sara; Sebrié, Ernesto M; Sandoya, Edgardo; Glantz, Stanton A.

2014-01-01

Introduction Implementation of smokefree laws is followed by drops in hospital admissions for cardiovascular diseases and asthma. The impact of smokefree laws on use of non-hospital medical services has not been assessed. The purpose of this study is to evaluate the impact of Uruguay’s national 100% smokefree legislation on non-hospital emergency care visits and hospitalizations for bronchospasm and bronchodilator use. Methods The monthly number of non-hospital emergency care visits and hospitalizations for bronchospasm, as well as monthly puffs of bronchodilators (total and per person), from 3 years prior to the adoption of the 100% smokefree policy on March 1, 2006 through 5 years after the policy were assessed using interrupted time series negative binomial regression. Data analysis was conducted in 2014. Results The incidence of non-hospital emergency visits for bronchospasm decreased by 15% (incidence rate ratio [IRR]=0.85, 95% CI=0.76, 0.94) following implementation of the law. Hospitalizations for bronchospasm did not change significantly (IRR=0.89, 95% CI=0.66, 1.21). Total monthly puffs of salbutamol and ipratropium administered in the non-hospital emergency setting decreased by 224 (95% CI= −372, −76) and 179 (95% CI= −340, −18.6), respectively, from means of 1,222 and 1,007 before the law. Conclusions Uruguay’s 100% smokefree law was followed by fewer emergency visits for bronchospasm and less need for treatment, supporting adoption of such policies in low- and middle-income countries to reduce the disease burden and healthcare costs associated with smoking. PMID:25997906

Smoke-free law associated with higher-than-expected taxable retail sales for bars and taverns in Washington State.

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Boles, Myde; Dilley, Julia; Maher, Julie E; Boysun, Michael J; Reid, Terry

2010-07-01

Continued progress in implementing smoke-free laws throughout the United States would benefit from documenting positive economic effects, particularly for the hospitality industry. This study describes changes in sales revenue in bars and taverns since December 2005, when a statewide smoke-free law in Washington State went into effect. Using 24 quarters of inflation-adjusted taxable retail sales data from 2002 through 2007, we fitted a regression model to estimate the effect of the smoke-free law on sales revenue, controlling for seasonality and other economic factors. We found no immediate change in bar revenues in the first quarter of 2006, but taxable retail sales grew significantly through the fourth quarter of 2007. In the 2 years after the smoke-free law was implemented, sales revenues were $105.5 million higher than expected for bars and taverns in Washington State. The higher-than-expected revenue from taxable sales in bars and taverns after the implementation of smoke-free laws in Washington State provided extra funds to the state general fund. Potential increases in revenue in other jurisdictions that implement smoke-free indoor air policies could provide funds to benefit residents of those jurisdictions.

Smoke-Free Child Care = Proyecto de Cuidado Diurno Para Ninos Donde "No se Fuma."

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Massachusetts State Dept. of Public Health, Boston.

This packet of materials on smoke-free child care contains: (1) "Smoke Free Child Care," a booklet warning child care providers about the dangers of second-hand smoke and the fact that children often imitate adult behaviors, such as smoking; (2) "Smoke-Free Child Care: A Booklet for Family Day Care Providers," warning about the…

Tobacco smoke exposure in public places and workplaces after smoke-free policy implementation: a longitudinal analysis of smoker cohorts in Mexico and Uruguay

Science.gov (United States)

Thrasher, James F.; Nayeli Abad-Vivero, Erika; Sebrié, Ernesto M.; Barrientos-Gutierrez, Tonatiuh; Boado, Marcelo; Yong, Hua Hie; Arillo-Santillán, Edna; Bianco, Eduardo

2013-01-01

Objective: To determine the prevalence, correlates and changes in secondhand smoke (SHS) exposure over the period after comprehensive smoke-free policy implementation in two Latin American countries. Methods: Data were analysed from population-based representative samples of adult smokers and recent quitters from the 2008 and 2010 waves of the International Tobacco Control Policy Evaluation Survey in Mexico (n = 1766 and 1840, respectively) and Uruguay (n = 1379 and 1411, respectively). Prevalence of SHS exposure was estimated for regulated venues, and generalized estimating equations were used to determine correlates of SHS exposure. Results: Workplace SHS exposure in the last month was similar within and across countries (range: Mexico 20–25%; Uruguay 14–29%). At the most recent restaurant visit, SHS exposure was lower where comprehensive smoke-free policies were implemented (range: Uruguay 6–9%; Mexico City 5–7%) compared with Mexican cities with weaker policies, where exposure remained higher but decreased over time (32–17%). At the most recent bar visit, SHS exposure was common (range: Uruguay 8–36%; Mexico City 23–31%), although highest in jurisdictions with weaker policies (range in other Mexican cities: 74–86%). In Uruguay, males were more likely than females to be exposed to SHS across venues, as were younger compared with older smokers in Mexico. Conclusions: Comprehensive smoke-free policies are more effective than weaker policies, although compliance in Mexico and Uruguay is not as high as desired. PMID:23172895

Greater gains from smoke-free legislation for non-smoking bar staff in Belfast.

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Bannon, Finian; Devlin, Anne; McElwee, Gerry; Gavin, Anna

2009-12-01

In April 2007, smoke-free legislation was enacted in workplaces throughout N. Ireland. The effects of this legislation on bar workers' health and their exposure to second-hand smoke at home, work and social environment, and their attitudes to the legislation before and after its implementation remain to be documented. A self-completed questionnaire of bar staff in 35 Belfast bars, before (March 2007, n = 110) and after the legislation (July 2007, n = 110). Smokers (excluding 'social smokers') made up 41.6% of respondents. After the introduction of the smoke-free legislation, the reductions in the proportion of bar workers reporting various respiratory symptoms ranged from 1.3% to 18.6% for smokers and from 21.9% to 33.2% for non-smokers. Likewise, the reductions for various sensory symptoms ranged from 7.3% to 17.7% for smokers and from 29.6% to 46.8% for non-smokers. Reduction in wheeze, cough and throat symptoms after the legislation were much greater for non-smokers than smokers. The proportion of bar staff who reported satisfaction with the legislation remained unchanged across the surveys. Decreases in perceived exposure to second-hand smoke occurred at work, home and in social settings. After the legislation's enactment, a majority of bar workers felt the workplace was healthier (98%). These first findings show reduced reported symptoms among bar workers, both smokers and non-smokers, after the introduction of smoke-free legislation in N. Ireland, though greater among non-smokers. There was also a reported fall in the hours of second-hand smoke exposure in the home for this group of workers which has a high prevalence of smokers.

Changes in Smoking-Related Norms in Bars Resulting from California's Smoke-Free Workplace Act

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Satterlund, Travis D.; Lee, Juliet P.; Moore, Roland S.

2012-01-01

California's Smoke-Free Workplace Act--CA Labor Code Sec. 6404.5(a)--was extended to bars in 1998. This article analyzes changes in normative beliefs and behaviors related to bar smoking in the decade following the adoption of the Act. In a series of studies evaluating the smoke-free workplace law in bars, researchers conducted extensive…

Knowledge and opinion about smoke-free laws and second-hand smoke among hospitality venue managers in Gujarat and Andhra Pradesh, India.

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Gupta, Vinay K; Arora, Monika; Sharma, Indrani; Nazar, Gaurang P; Modi, Bhavesh; Singh, Deepti; Millett, Christopher; Reddy, K Srinath

2013-01-01

India's Smoke-Free Law (SFL) was implemented in 2004 and reinforced on 2nd October 2008. This research attempts to understand the knowledge and opinion of hospitality venue (HV) managers about second-hand smoke (SHS) and SFL as well as self-reported compliance with SFL in two Indian states. A survey was conducted among 804 randomly sampled HVs from project STEPS (Strengthening of tobacco control efforts through innovative partnerships and strategies) in Gujarat and Andhra Pradesh, India. Four hundred and three HVs from two districts in Gujarat and 401 HVs from six districts in Andhra Pradesh were selected. The owner, manager or supervisor of each HV was interviewed using a pre-tested structured interview schedule. Association of opinion scales with respondents' background characteristics was assessed through the analysis of variance (ANOVA) method. Out of the 403 respondents in Gujarat and 401 in Andhra Pradesh, 56.1% and 84.3% had knowledge about SFL respectively. Compliance of HVs with SFL was 21.8% in Gujarat and 31.2% in Andhra Pradesh as reported by the managers. Knowledge about SHS was noted among 39.7% of respondents in Gujarat and 25.4% in Andhra Pradesh. Bivariate results indicated that more educated HV managers showed higher support for smoke-free public places (P < 0.001) and were more concerned about the health effects of SHS exposure (P = 0.002). Complete self-reported compliance with, and knowledge of SFL as well as SHS was not found in Gujarat and Andhra Pradesh. The education level of HV managers is an important determinant to ensure compliance with SFL in public places.

Use of Internet Viral Marketing to Promote Smoke-Free Lifestyles among Chinese Adolescents

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Ip, Patrick; Lam, Tai-Hing; Chan, Sophia Siu-Chee; Ho, Frederick Ka-Wing; Lo, Lewis A.; Chiu, Ivy Wing-Sze; Wong, Wilfred Hing-Sang; Chow, Chun-Bong

2014-01-01

Purpose Youth smoking is a global public health concern. Health educators are increasingly using Internet-based technologies, but the effectiveness of Internet viral marketing in promoting health remains uncertain. This prospective pilot study assessed the efficacy of an online game-based viral marketing campaign in promoting a smoke-free attitude among Chinese adolescents. Methods One hundred and twenty-one Hong Kong Chinese adolescents aged 10 to 24 were invited to participate in an online multiple-choice quiz game competition designed to deliver tobacco-related health information. Participants were encouraged to refer others to join. A zero-inflated negative binomial model was used to explore the factors contributing to the referral process. Latent transition analysis utilising a pre- and post-game survey was used to detect attitudinal changes toward smoking. Results The number of participants increased almost eightfold from 121 to 928 (34.6% current or ex-smokers) during the 22-day campaign. Participants exhibited significant attitudinal change, with 73% holding negative attitudes toward smoking after the campaign compared to 57% before it. The transition probabilities from positive to negative and neutral to negative attitudes were 0.52 and 0.48, respectively. It was also found that attempting every 20 quiz questions was associated with lower perceived smoking decision in future (OR  = 0.95, p-value non-smoking participants and changing their attitudes toward smoking. It constitutes a promising practical and cost-effective model for engaging young smokers and promulgating smoking-related health information among Chinese adolescents. PMID:24911010

Use of Internet viral marketing to promote smoke-free lifestyles among Chinese adolescents.

Science.gov (United States)

Ip, Patrick; Lam, Tai-Hing; Chan, Sophia Siu-Chee; Ho, Frederick Ka-Wing; Lo, Lewis A; Chiu, Ivy Wing-Sze; Wong, Wilfred Hing-Sang; Chow, Chun-Bong

2014-01-01

Youth smoking is a global public health concern. Health educators are increasingly using Internet-based technologies, but the effectiveness of Internet viral marketing in promoting health remains uncertain. This prospective pilot study assessed the efficacy of an online game-based viral marketing campaign in promoting a smoke-free attitude among Chinese adolescents. One hundred and twenty-one Hong Kong Chinese adolescents aged 10 to 24 were invited to participate in an online multiple-choice quiz game competition designed to deliver tobacco-related health information. Participants were encouraged to refer others to join. A zero-inflated negative binomial model was used to explore the factors contributing to the referral process. Latent transition analysis utilising a pre- and post-game survey was used to detect attitudinal changes toward smoking. The number of participants increased almost eightfold from 121 to 928 (34.6% current or ex-smokers) during the 22-day campaign. Participants exhibited significant attitudinal change, with 73% holding negative attitudes toward smoking after the campaign compared to 57% before it. The transition probabilities from positive to negative and neutral to negative attitudes were 0.52 and 0.48, respectively. It was also found that attempting every 20 quiz questions was associated with lower perceived smoking decision in future (OR = 0.95, p-value online game-based viral marketing programme was effective in reaching a large number of smoking and non-smoking participants and changing their attitudes toward smoking. It constitutes a promising practical and cost-effective model for engaging young smokers and promulgating smoking-related health information among Chinese adolescents.

Effect of smoke-free legislation on adult smoking behaviour in England in the 18 months following implementation.

Directory of Open Access Journals (Sweden)

John Tayu Lee

Full Text Available Comprehensive smoke-free legislation covering all enclosed public places and workplaces was implemented in England on 1 July 2007. This study examines the impact of this legislation on smoking prevalence, number of cigarettes smoked and location of smoking, controlling for secular trends through the end of 2008.Repeat cross sectional survey using nationally representative data from the Health Survey for England (HSE. In total there are 54,333 respondents from 2003-2008. Logit and linear regression models were used to examine the effect of the legislation on smoking prevalence and the number of cigarettes smoked daily among continuing smokers which took the underlying trend into account. Our finding suggest that smoking prevalence (current smoker decreased from 25% in 2003 to 21% in 2008 (AOR = 0.96 per year, 95% CI = 0.95-0.98, P<0.01 and the mean number of cigarettes consumed daily by smokers decreased from 14.1 in 2003 to 13.1 in 2008 (coefficient for time trend = -0.28±0.06 SE cig/day per year, P<0.01. After adjusting for these trends the introduction of smoke-free legislation was not associated with additional reductions in smoking prevalence (AOR = 1.02, 95% CI = 0.94-1.11, P = 0.596 or daily cigarette use in smokers (0.42±0.28 SE; P = 0.142. The percentage of respondents reporting smoking 'at work' and 'inside pubs or bars' decreased significantly from 14% to 2% (p<0.001 and from 34% to 2% (p<0.001, respectively, after the legislation. The percentage reporting smoking 'inside restaurants, cafes, or canteens' decreased significantly from 9% to 1% (p<0.001 and 'inside their home' decreased significantly from 65% to 55% (p<0.01.There is widespread compliance with the smoke-free legislation in England, which has led to large drops in indoor smoking in all venues, including at home. Declines in smoking prevalence and consumption continued along existing trends; they did not accelerate during the 18 months

Partners in Public Health: Public Health Collaborations With Schools of Pharmacy, 2015.

Science.gov (United States)

DiPietro Mager, Natalie A; Ochs, Leslie; Ranelli, Paul L; Kahaleh, Abby A; Lahoz, Monina R; Patel, Radha V; Garza, Oscar W; Isaacs, Diana; Clark, Suzanne

To collect data on public health collaborations with schools of pharmacy, we sent a short electronic survey to accredited and preaccredited pharmacy programs in 2015. We categorized public health collaborations as working or partnering with local and/or state public health departments, local and/or state public health organizations, academic schools or programs of public health, and other public health collaborations. Of 134 schools, 65 responded (49% response rate). Forty-six (71%) responding institutions indicated collaborations with local and/or state public health departments, 34 (52%) with schools or programs of public health, and 24 (37%) with local and/or state public health organizations. Common themes of collaborations included educational programs, community outreach, research, and teaching in areas such as tobacco control, emergency preparedness, chronic disease, drug abuse, immunizations, and medication therapy management. Interdisciplinary public health collaborations with schools of pharmacy provide additional resources for ensuring the health of communities and expose student pharmacists to opportunities to use their training and abilities to affect public health. Examples of these partnerships may stimulate additional ideas for possible collaborations between public health organizations and schools of pharmacy.

No association of smoke-free ordinances with profits from bingo and charitable games in Massachusetts.

Science.gov (United States)

Glantz, S A; Wilson-Loots, R

2003-12-01

Because it is widely played, claims that smoking restrictions will adversely affect bingo games is used as an argument against these policies. We used publicly available data from Massachusetts to assess the impact of 100% smoke-free ordinances on profits from bingo and other gambling sponsored by charitable organisations between 1985 and 2001. We conducted two analyses: (1) a general linear model implementation of a time series analysis with net profits (adjusted to 2001 dollars) as the dependent variable, and community (as a fixed effect), year, lagged net profits, and the length of time the ordinance had been in force as the independent variables; (2) multiple linear regression of total state profits against time, lagged profits, and the percentage of the entire state population in communities that allow charitable gaming but prohibit smoking. The general linear model analysis of data from individual communities showed that, while adjusted profits fell over time, this effect was not related to the presence of an ordinance. The analysis in terms of the fraction of the population living in communities with ordinances yielded the same result. Policymakers can implement smoke-free policies without concern that these policies will affect charitable gaming.

Formative research on creating smoke-free homes in rural communities.

Science.gov (United States)

Escoffery, Cam; Kegler, Michelle Crozier; Butler, Susan

2009-02-01

The home is a significant place for exposure to secondhand smoke for children and non-smoking adults. This study explored factors that would convince families to adopt household smoking bans and actions to create and maintain smoke-free homes. Interviews were conducted with adults in 102 households in rural Georgia. Participating families had a young adolescent and included households with a mix of smokers and non-smokers and smoking ban status. Families reported they would consider a total ban to protect children from secondhand smoke and protect family members if they got sick. Few described difficulties in enforcement with over half of smokers accepting the rules. Situations that made it hard to enforce restrictions were if there was a visitor who smoked, a smoker who had cravings, and bad weather outside when the smoker desired to smoke. Smokers explained that family members could assist them in quitting by talking to them, not purchasing cigarettes for them, not smoking around them, and supporting them. Ideas for promoting smoke-free homes were having a no smoking sign, saying no to visitors who want to smoke, removing ashtrays, and creating a place outside for smokers. These findings can inform interventions designed to create and maintain smoke-free households.

Undergraduate Public Health Majors: Why They Choose Public Health or Medicine?

Science.gov (United States)

Hilton, Warren

2013-01-01

This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a public health major, and their desire to pursue graduate training in public health and subsequently, public health careers. The study highlighted the current public health workforce shortage and…

Keeping the "public" in schools of public health.

Science.gov (United States)

Freudenberg, Nicholas; Klitzman, Susan; Diamond, Catherine; El-Mohandes, Ayman

2015-03-01

In this article, we compared the characteristics of public and private accredited public health training programs. We analyzed the distinct opportunities and challenges that publicly funded schools of public health face in preparing the nation's public health workforce. Using our experience in creating a new, collaborative public school of public health in the nation's largest urban public university system, we described efforts to use our public status and mission to develop new approaches to educating a workforce that meets the health needs of our region and contributes to the goal of reducing health inequalities. Finally, we considered policies that could protect and strengthen the distinct contributions that public schools of public health make to improving population health and reducing health inequalities.

Effects of a smoke-free law on hair nicotine and respiratory symptoms of restaurant and bar workers.

Science.gov (United States)

Hahn, Ellen J; Rayens, Mary Kay; York, Nancy; Okoli, Chizimuzo T C; Zhang, Mei; Dignan, Mark; Al-Delaimy, Wael K

2006-09-01

Bar and restaurant workers' exposure to secondhand smoke (SHS) was compared before and 3 and 6 months after implementation of a smoke-free ordinance. Hair nicotine, self-reported exposure to SHS, and respiratory symptoms were assessed on 105 smoking and nonsmoking workers from randomly selected establishments in Lexington, Kentucky. Thirty-eight percent were current smokers with more than half smoking 10 or fewer cigarettes per day. Workers provided a hair sample at baseline and at the 3-month interview. There was a significant decline in hair nicotine 3 months postlaw when controlling for cigarettes smoked per day. Bar workers showed a significantly larger decline in hair nicotine compared with restaurant workers. The only significant decline in SHS exposure was in the workplace and other public places. Regardless of smoking status, respiratory symptoms declined significantly postlaw. Hospitality workers demonstrated significant declines in hair nicotine and respiratory symptoms after the law. Comprehensive smoke-free laws can provide the greatest protection to bar workers who are the most vulnerable to SHS exposure at work.

The effect of smoke-free policies on hospitality industry revenues in Cyprus: an econometric approach.

Science.gov (United States)

Talias, Michael A; Savva, Christos S; Soteriades, Elpidoforos S; Lazuras, Lambros

2015-10-01

Smoke-free policies aiming to improve quality of indoor air and significantly reduce exposure to secondhand smoke in the hospitality industry are faced with strong opposition from the tobacco industry and hospitality venue owners claiming that they lead to reductions of revenues. The objective of our study was to examine the impact of a recently introduced smoke-free legislation on the revenues of the hospitality industry in Cyprus. Anonymous information on revenues was obtained from the Cyprus government value added tax office for the entire hospitality industry in Cyprus including hotels, bars, restaurants and cafeterias between 2005 and 2011. Panel data methodology was used to examine the effect of a smoke-free legislation, on tourism, businesses' revenues adjusting for gross domestic product, inflation, unemployment rate, tourists' arrivals, seasonal variation and the economic crisis. Our study showed that the implementation of the smoke-free policy did not have negative effects on the hospitality industry profitability. We conclude that even in regions with relatively high smoking rates, pro-smoking societal attitudes and weak social norms against tobacco control, and even during periods of economic crisis, smoke-free legislation does not impact negatively on hospitality industry revenues and if anything may lead to a small positive increase. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Smoke-free policies and the social acceptability of smoking in Uruguay and Mexico: findings from the International Tobacco Control Policy Evaluation Project.

Science.gov (United States)

Thrasher, James F; Boado, Marcelo; Sebrié, Ernesto M; Bianco, Eduardo

2009-06-01

Little research has been conducted to determine the psychosocial and behavioral impacts of smoke-free policies in middle-income countries. Cross-sectional data were analyzed from the 2006 waves of the International Tobacco Control Policy Evaluation. Survey comparing adult smokers in Mexico (n = 1,080), where smoke-free legislation at that time was weak, and Uruguay (n = 1,002), where comprehensive smoke-free legislation was implemented. Analyses aimed to determine whether exposure to smoke-free policies and perceived antismoking social norms were associated with smokers' receiving cues about the bothersome nature of secondhand smoke (SHS), with smokers' reactance against such cues, and with smokers' level of support for smoke-free policies in different venues. In bivariate analyses, Uruguayan smokers were more likely than Mexican smokers to experience verbal anti-SHS cues, lower reactance against anti-SHS cues, stronger antismoking societal norms, and stronger support for 100% smoke-free policies in enclosed workplaces, restaurants, and bars. In multivariate models for both countries, the strength of voluntary smoke-free policies at home was independently associated with support for smoke-free policies across all venues queried, except for in bars among Uruguayans. Perceived strength of familial antismoking norms was consistently associated with all indicators of the social acceptability of smoking in Uruguay but only with the frequency of receiving anti-SHS verbal cues in Mexico. These results are generally consistent with previous research indicating that comprehensive smoke-free policies are likely to increase the social unacceptability of smoking and that resistance against such policies is likely to diminish once such policies are in place.

The economic impact of a smoke-free bylaw on restaurant and bar sales in Ottawa, Canada.

Science.gov (United States)

Luk, Rita; Ferrence, Roberta; Gmel, Gerhard

2006-05-01

On 1 August 2001, the City of Ottawa (Canada's Capital) implemented a smoke-free bylaw that completely prohibited smoking in work-places and public places, including restaurants and bars, with no exemption for separately ventilated smoking rooms. This paper evaluates the effects of this bylaw on restaurant and bar sales. DATA AND MEASURES: We used retail sales tax data from March 1998 to June 2002 to construct two outcome measures: the ratio of licensed restaurant and bar sales to total retail sales and the ratio of unlicensed restaurant sales to total retail sales. Restaurant and bar sales were subtracted from total retail sales in the denominator of these measures. We employed an interrupted time-series design. Autoregressive integrated moving average (ARIMA) intervention analysis was used to test for three possible impacts that the bylaw might have on the sales of restaurants and bars. We repeated the analysis using regression with autoregressive moving average (ARMA) errors method to triangulate our results. Outcome measures showed declining trends at baseline before the bylaw went into effect. Results from ARIMA intervention and regression analyses did not support the hypotheses that the smoke-free bylaw had an impact that resulted in (1) abrupt permanent, (2) gradual permanent or (3) abrupt temporary changes in restaurant and bar sales. While a large body of research has found no significant adverse impact of smoke-free legislation on restaurant and bar sales in the United States, Australia and elsewhere, our study confirms these results in a northern region with a bilingual population, which has important implications for impending policy in Europe and other areas.

Use of Internet viral marketing to promote smoke-free lifestyles among Chinese adolescents.

Directory of Open Access Journals (Sweden)

Patrick Ip

Full Text Available PURPOSE: Youth smoking is a global public health concern. Health educators are increasingly using Internet-based technologies, but the effectiveness of Internet viral marketing in promoting health remains uncertain. This prospective pilot study assessed the efficacy of an online game-based viral marketing campaign in promoting a smoke-free attitude among Chinese adolescents. METHODS: One hundred and twenty-one Hong Kong Chinese adolescents aged 10 to 24 were invited to participate in an online multiple-choice quiz game competition designed to deliver tobacco-related health information. Participants were encouraged to refer others to join. A zero-inflated negative binomial model was used to explore the factors contributing to the referral process. Latent transition analysis utilising a pre- and post-game survey was used to detect attitudinal changes toward smoking. RESULTS: The number of participants increased almost eightfold from 121 to 928 (34.6% current or ex-smokers during the 22-day campaign. Participants exhibited significant attitudinal change, with 73% holding negative attitudes toward smoking after the campaign compared to 57% before it. The transition probabilities from positive to negative and neutral to negative attitudes were 0.52 and 0.48, respectively. It was also found that attempting every 20 quiz questions was associated with lower perceived smoking decision in future (OR = 0.95, p-value <0.01. CONCLUSIONS: Our online game-based viral marketing programme was effective in reaching a large number of smoking and non-smoking participants and changing their attitudes toward smoking. It constitutes a promising practical and cost-effective model for engaging young smokers and promulgating smoking-related health information among Chinese adolescents.

The effect of a smoke-free law on restaurant business in South Australia.

Science.gov (United States)

Wakefield, Melanie; Siahpush, Mohammad; Scollo, Michelle; Lal, Anita; Hyland, Andrew; McCaul, Kieran; Miller, Caroline

2002-08-01

Despite evidence to the contrary from overseas research, the introduction of smoke-free legislation in South Australia (SA), which required all restaurants to go smoke-free in January 1999, sparked concerns among the hospitality industry about loss of restaurant business. This study aimed to determine whether the law had a detrimental impact on restaurant business in SA. Using time series analysis, we compared the ratio of monthly restaurant turnover from restaurants and cafés in SA to (a) total retail tumover in SA (minus restaurants) for the years 1991 to 2001 and (b) Australian restaurant tumover (minus SA, Westem Australia and the Australian Capital Territory) for the years 1991-2000. There was no decline in the ratio of (a) SA restaurant turnover to SA retail turnover or (b) SA restaurant tumover to Australian restaurant turnover. The introduction of a smoke-free law applying to restaurants in SA did not adversely affect restaurant business in SA.

Smoke-free homes among single-parent families: Differences associated with parental race/ethnicity and smoking behaviors.

Science.gov (United States)

Mai, Yujiao; Leonardo, Selena; Soulakova, Julia N

2018-03-01

We assessed differences in the rates of smoke-free homes among single-parent households with regard to parental race/ethnicity and smoking status. We identified two cohorts representative of the U.S. single-parent households with underage children (children under the age of 18) based on the Tobacco Use Supplement to the Current Population Survey: 2010-11 ( n  = 6474) and 2014-15 ( n  = 6114). The interviews were conducted by phone and in-person. Statistical analysis was performed in 2017. The overall rate of smoke-free homes was 82% in 2010-11 and 86% in 2014-15. The rate of a smoke-free home was highest for Non-Hispanic (NH) Asian (94%) and Hispanic (92%) parents and lowest for NH Multiracial (77% in 2010-11 and 82% in 2014-15) in both survey periods. However, 2014-15 model-based comparisons relative to NH Whites indicated only one significant difference: the rate was lower for NH Blacks (OR = 0.46, 99% CI = 0.32:0.66). The smoke-free homes were least prevalent among daily smokers, followed by occasional smokers, followed by former smokers, and most prevalent among never smokers in each survey period. The 2010-11 and 2014-15 rates were 45% and 54% for daily, 64% and 72% for occasional, 89% and 91% for former, and 93% and 94% for never smokers. The gap in the rates of smoke-free homes for diverse parental racial/ethnic groups observed in 2010-11 decreased by 2014-15. While smoke-free homes became more prevalent in 2014-15, the rates remain drastically different among families with different parental smoking behaviors. Exposure to secondhand smoke at home remains common among single-parent households where the parent smokes.

Smoke-free homes among single-parent families: Differences associated with parental race/ethnicity and smoking behaviors

Directory of Open Access Journals (Sweden)

Yujiao Mai

2018-03-01

Full Text Available We assessed differences in the rates of smoke-free homes among single-parent households with regard to parental race/ethnicity and smoking status. We identified two cohorts representative of the U.S. single-parent households with underage children (children under the age of 18 based on the Tobacco Use Supplement to the Current Population Survey: 2010–11 (n=6474 and 2014–15 (n=6114. The interviews were conducted by phone and in-person. Statistical analysis was performed in 2017. The overall rate of smoke-free homes was 82% in 2010–11 and 86% in 2014–15. The rate of a smoke-free home was highest for Non-Hispanic (NH Asian (94% and Hispanic (92% parents and lowest for NH Multiracial (77% in 2010–11 and 82% in 2014–15 in both survey periods. However, 2014–15 model-based comparisons relative to NH Whites indicated only one significant difference: the rate was lower for NH Blacks (OR=0.46, 99% CI=0.32:0.66. The smoke-free homes were least prevalent among daily smokers, followed by occasional smokers, followed by former smokers, and most prevalent among never smokers in each survey period. The 2010–11 and 2014–15 rates were 45% and 54% for daily, 64% and 72% for occasional, 89% and 91% for former, and 93% and 94% for never smokers. The gap in the rates of smoke-free homes for diverse parental racial/ethnic groups observed in 2010–11 decreased by 2014–15. While smoke-free homes became more prevalent in 2014–15, the rates remain drastically different among families with different parental smoking behaviors. Exposure to secondhand smoke at home remains common among single-parent households where the parent smokes. Keywords: Involuntary exposure to secondhand smoke, Single mother, Single father, Healthy home environment

Compliance and Support for Smoke-Free School Policies

Science.gov (United States)

Trinidad, D. R.; Gilpin, E. A.; Pierce, J. P.

2005-01-01

Our objective was to examine factors associated with compliance and support for a smoke-free campus before and after a 1995 campus-wide smoking ban for everyone, including teachers and visitors, in California. Adolescent (12-17 years) data from the 1993, 1996, 1999 and 2002 (N approximately 6000 each year) California Tobacco Surveys…

Assessing the National Cancer Institute's SmokefreeMOM Text-Messaging Program for Pregnant Smokers: Pilot Randomized Trial.

Science.gov (United States)

Abroms, Lorien C; Chiang, Shawn; Macherelli, Laura; Leavitt, Leah; Montgomery, Margaret

2017-10-03

Automated text messages on mobile phones have been found to be effective for smoking cessation in adult smokers. This study aims to test the acceptability and feasibility of SmokefreeMOM, a national smoking cessation text-messaging program for pregnant smokers. Participants were recruited from prenatal care and randomized to receive SmokefreeMOM (n=55), an automated smoking cessation text-messaging program, or a control text message quitline referral (n=44). Participants were surveyed by phone at baseline and at 1 month and 3 months after enrollment. Results indicate that the SmokefreeMOM program was highly rated overall and rated more favorably than the control condition in its helpfulness at 3-month follow-up (Pmessaging at both 1-month and 3-month follow-ups (Pmessages, and few participants unsubscribed from the program. There were no significant differences between groups on the use of extra treatment resources or on smoking-related outcomes. However, at the 3-month follow-up, some outcomes favored the intervention group. SmokefreeMOM is acceptable for pregnant smokers. It is recommended that SmokefreeMOM be further refined and evaluated. Clinicaltrials.gov NCT02412956; https://clinicaltrials.gov/ct2/show/NCT02412956 (Archived by WebCite at http://www.webcitation.org/6tcmeRnbC). ©Lorien C Abroms, Shawn Chiang, Laura Macherelli, Leah Leavitt, Margaret Montgomery. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 03.10.2017.

The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice

Science.gov (United States)

Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

2015-01-01

The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall. PMID:26066925

Understanding the impact of the Smoke-Free Ontario Act on hospitality establishments' outdoor environments: a survey of restaurants and bars.

Science.gov (United States)

Kennedy, Ryan David; Elton-Marshall, Tara; Mutti, Seema; Dubray, Jolene; Fong, Geoffrey T

2010-04-01

The Smoke-Free Ontario Act (SFOA) came into effect in May 2006 and included restrictions to outdoor hospitality areas by only permitting smoking on a patio if the area had no roof. (1) To assess the impact of the SFOA on the prevalence of smoke-free patios in Ontario and (2) to determine the proportion of venues where structural alterations were made rather than going smoke-free in order to achieve compliance with the SFOA. A telephone survey of 403 hospitality sector operators/owners in four clustered samples of Ontario, Canada. Based on completed surveys, the SFOA resulted in an increase in prevalence of smoke-free patios, from 5% (n=21) to 25% (n=99). Of the patios where smoking was permitted before the SFOA (n=382), 42% (n=161) had physical structures that would make smoking not permissible under the new act. Operators of half of these venues (n=80) made their patios smoke-free, with most indicating they had no choice given the costs or physical limitations to changing their outdoor environment. The other half (n=81) reported making physical changes, including removing roof structures to achieve compliance. The SFOA resulted in greater protection from outdoor secondhand smoke; however, most patios still permitted smoking. Half of the venues that complied with the SFOA by going smoke-free did so involuntarily because of structural and/or financial limitations. The majority of venue operators preferred to permit smoking on their patios, and only made their patios smoke-free when they were required to do so by law.

[Brazilian bibliographical output on public oral health in public health and dentistry journals].

Science.gov (United States)

Celeste, Roger Keller; Warmling, Cristine Maria

2014-06-01

The scope of this paper is to describe characteristics of the scientific output in the area of public oral health in journals on public health and dentistry nationwide. The Scopus database of abstracts and quotations was used and eight journals in public health, as well as ten in dentistry, dating from 1947 to 2011 were selected. A research strategy using key words regarding oral health in public health and key words about public health in dentistry was used to locate articles. The themes selected were based on the frequency of key words. Of the total number of articles, 4.7% (n = 642) were found in oral health journals and 6.8% (n = 245) in public health journals. Among the authors who published most, only 12% published in both fields. There was a percentile growth of public oral health publications in dentistry journals, though not in public health journals. In dentistry, only studies indexed as being on the topic of epidemiology showed an increase. In the area of public health, planning was predominant in all the phases studied. Research to evaluate the impact of research and postgraduate policies in scientific production is required.

Opportunities for Public Relations Research in Public Health.

Science.gov (United States)

Wise, Kurt

2001-01-01

Considers how communication researchers have developed a solid body of knowledge in the health field but know little about the activities of public relations practitioners in public health bodies. Suggests that public relations scholarship and practice have much to offer the field of public health in helping public health bodies meet their…

Effect of the Smoke-Free Illinois Act on casino admissions and revenue.

Science.gov (United States)

Tauras, John A; Chaloupka, Frank J; Moor, Gregg; Henderson, Patricia Nez; Leischow, Scott J

2018-01-19

As part of the Smoke-Free Illinois Act, smoking on the gambling floors of all commercial casinos in Illinois became prohibited. This study examined the effects of the Smoke-Free Illinois Act on casino admissions per-capita and real per-capita adjusted gross receipts using 18 years of data (10 years before and 8 years after the Illinois law went into effect). We employed a difference-in-difference regression technique using monthly data for the states of Illinois, Indiana, Iowa and Missouri and control for numerous determinants expected to affect casino admissions and revenue. The Smoke-free Illinois Act was found not to be a statistically significant determinant of per-capita casino admissions and of real per-capita gross adjusted receipts in all the models we estimated. The estimates from this study clearly indicated that the Illinois law that banned smoking in casinos has had no significant negative economic consequences for casinos in terms of per-capita admissions or revenues. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ethics in public health research: privacy and public health at risk: public health confidentiality in the digital age.

Science.gov (United States)

Myers, Julie; Frieden, Thomas R; Bherwani, Kamal M; Henning, Kelly J

2008-05-01

Public health agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core public health functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people. Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Public health professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information. Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of public health agencies.

[Terrorism, public health and health services].

Science.gov (United States)

Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

2009-01-01

Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

Genetics, health care, and public policy: an introduction to public health genetics

National Research Council Canada - National Science Library

Stewart, Alison

2007-01-01

... initiative About this book Further reading and resources Principles of public health The emergence of public health genetics The human genome project and 'genomic medicine' Community genetics Current developments in public health genetics Genomics and global health 2 Genetic science and technology Basic molecular genetics Genes and the geno...

Towards a public health profession

DEFF Research Database (Denmark)

Foldspang, Anders

2015-01-01

in the theoretical as well as the practical potential of the public health professional. Thus, he and she must be able to perform, what WHO Europe has developed as Essential Public Health Operations (EPHOs).3 This, in turn, implies that the public health professional possesses the set of intellectual (knowledge...... endorsed by WHO Europe’s member states as the basis for the public health education in Europe.5 The sections of the lists include: Public health methods; Population health and: Its social and economic determinants, and: Its material environmental determinants; Man-made interventions and systems, namely...... Health policy, health economics, organizational theory, health legislation, and public health leadership and management; Health promotion—health education, health protection, disease prevention; public health ethics. This should form the central part of the basis for all public health professionals...

Pigs in Public Health

DEFF Research Database (Denmark)

Svendsen, Mette N.

2017-01-01

of public health, made me re-evaluate both what ‘public’ and what ‘health’ means in public health. In this commentary I provide a short personal account of that intellectual journey. I argue that entanglements between species make it urgent that public health scholars investigate the moral, socio......Animals are rare topics in public health science texts and speech despite the fact that animal bodies and lives are woven into the health of human populations, and vice versa. Years of ethnographic and documentary research – following pigs and their humans in and out of biomedical research – made......-economic, material, and bacterial passages between humans and animals that constitute the various publics of public health and profoundly shape the health of human and animal populations in a globalized world....

Profile of Public Health Leadership.

Science.gov (United States)

Little, Ruth Gaskins; Greer, Annette; Clay, Maria; McFadden, Cheryl

2016-01-01

Public health leaders play pivotal roles in ensuring the population health for our nation. Since 2000, the number of schools of public health has almost doubled. The scholarly credentials for leaders of public health in academic and practice are important, as they make decisions that shape the future public health workforce and important public health policies. This research brief describes the educational degrees of deans of schools of public health and state health directors, as well as their demographic profiles, providing important information for future public health leadership planning. Data were extracted from a database containing information obtained from multiple Web sites including academic institution Web sites and state government Web sites. Variables describe 2 sets of public health leaders: academic deans of schools of public health and state health directors. Deans of schools of public health were 73% males and 27% females; the PhD degree was held by 40% deans, and the MD degree by 33% deans. Seventy percent of deans obtained their terminal degree more than 35 years ago. State health directors were 60% males and 40% females. Sixty percent of state health directors had an MD degree, 4% a PhD degree, and 26% no terminal degree at all. Sixty-four percent of state health directors received their terminal degree more than 25 years ago. In addition to terminal degrees, 56% of deans and 40% of state health directors held MPH degrees. The findings call into question competencies needed by future public health professionals and leadership and the need to clarify further the level of public health training and degree type that should be required for leadership qualifications in public health.

Public Health Departments

Data.gov (United States)

Department of Homeland Security — State and Local Public Health Departments in the United States Governmental public health departments are responsible for creating and maintaining conditions that...

Smoke-Free Homes and Home Exposure to Secondhand Smoke in Shanghai, China

Directory of Open Access Journals (Sweden)

Pinpin Zheng

2014-11-01

Full Text Available Few studies have examined home exposure to secondhand smoke (SHS in China. This study aimed to document: (1 the prevalence and correlates of exposure to SHS in homes (in adult non-smokers in Shanghai, and (2 enforcement of rules, harm reduction behaviors, and self-efficacy for maintaining smoke-free homes in Shanghai. A total of 500 participants were recruited using a multistage proportional random sampling design in an urban and suburban district to complete a survey. Among the total 355 nonsmokers, 127 (35.8% participants reported being exposed to SHS in the past 7 days. Participants living with smokers in the home, with no smoking restriction at home, and having children younger than 18 were more likely to be exposed to SHS at home. Higher self-efficacy in maintaining a smoke-free home was negatively associated with home SHS exposure. Having visitors who smoke was the greatest policy enforcement challenge. Ineffective measures such as opening windows were more commonly used in homes with partial bans. Educational initiatives to protect against SHS exposure in the home should promote smoke-free homes, address challenges to implementing such policies, and address misconceptions regarding the effectiveness of supposed harm reduction behaviors.

Exposure to environmental tobacco smoke and health effects among hospitality workers in Sweden--before and after the implementation of a smoke-free law.

Science.gov (United States)

Larsson, Matz; Boëthius, Göran; Axelsson, Sara; Montgomery, Scott M

2008-08-01

This study attempted to identify changes in exposure to environmental tobacco smoke, as well as symptoms and attitudes among hospitality workers after the introduction of extended smoke-free workplace legislation. A total of 37 volunteers working in bingo halls and casinos (gaming workers) and 54 bars and restaurant employees (other workers) in nine Swedish communities participated in the study. Altogether 71 of 91 persons (14 daily smokers and 57 nonsmokers) participated in both the pre-ban baseline survey and the follow-up 12 months after the ban. Exposure to environmental tobacco smoke, smoking habits, respiratory and sensory symptoms, and attitudes towards the ban were recorded, and spirometry was carried out. The frequency of reported respiratory and sensory symptoms was approximately halved among the nonsmokers in both occupational groups after the introduction of the ban. Initially 87% had exposure to environmental tobacco smoke that was over the nicotine cut-off level chosen to identify possible health risk ( <0.5 microg/m3) while, after the ban, it was only 22%, a relative risk of 0.25 (95% confidence interval 0.15-0.41). The risk decreased in both occupational groups, but gaming workers experienced the highest pre-ban exposure levels. Attitudes towards the legislation were largely positive, particularly after the ban. However, there was no notable change in lung function, and there was no notable reduction in the number of cigarettes consumed by smokers. The introduction of smoke-free legislation was associated with a substantial reduction in respiratory and sensory symptoms, as well as reduced exposure to environmental tobacco smoke at work, particularly among gaming workers.

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths.

Science.gov (United States)

Lister, Cameron; Payne, Hannah; Hanson, Carl L; Barnes, Michael D; Davis, Siena F; Manwaring, Todd

2017-01-01

Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths

Directory of Open Access Journals (Sweden)

Cameron Lister

2017-08-01

Full Text Available Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

Feminism and public health nursing: partners for health.

Science.gov (United States)

Leipert, B D

2001-01-01

It is a well-known fact that nursing and feminism have enjoyed an uneasy alliance. In recent years, however, nursing has begun to recognize the importance of feminism. Nevertheless, the literature still rarely addresses the relevance of feminism for public health nursing. In this article, I articulate the relevance of feminism for public health nursing knowledge and practice. First, I define and describe feminism and public health nursing and then I discuss the importance of feminism for public health nursing practice. The importance of feminism for the metaparadigm concepts of public health nursing is then reviewed. Finally, I examine several existing challenges relating to feminism and public health nursing research, education, and practice. The thesis of this article is that feminism is vitally important for the development of public health nursing and for public health care.

Manager Factor Associated to the Compliance of Local Smoke-Free Regulation among Star Hotels in Badung District

Directory of Open Access Journals (Sweden)

Ni Luh Putu Devhy

2015-04-01

Full Text Available Background and purpose: Smoke-free area regulation has been issued recently in Bali Province and Badung District. This study aimed to identify factors associated to the compliance of local smoke-free regulation in star hotel. Methods: This study was a cross-sectional analytic study conducted in Badung District from March to May 2014. Samples of numbered 104 hotels and the managers that selected using systematic random sampling. Compliance data collected through observation using the observation form and the data of managers through interviews using a structured questionnaire. Data were analyzed using chi-square test and poisson regression. Result: The results shows that the compliance of star hotel to local smoke-free regulation was low (15.4%. The concrete support of hotel managers was significantly associated with the compliance to smoke free regulation (PR=4.25; 95%CI: 1.03-17.58. The factors that not significantly associated to the compliance were the knowledge (PR=2.0; 95%CI: 0.8-4.9, attitude (PR=2.5; 95%CI: 0.8-8.2, and organization support (PR=1.8; 95%CI: 0.7-4.5. Furthermore the hotel compliance of managers who have smoking behavior was 0% while the managers without smoking behavior, the compliance was 19.5%. Conclusion: The compliance of star hotels in Badung District on the implementation of local smoke-free regulation was relatively low and the compliance was associated with the presence of concrete support of the hotel managers. Keywords: compliance, local smoke-free legislation, star hotel

Applying the Theory of Planned Behavior to Explore the Relation between Smoke-Free Air Laws and Quitting Intentions

Science.gov (United States)

Macy, Jonathan T.; Middlestadt, Susan E.; Seo, Dong-Chul; Kolbe, Lloyd J.; Jay, Stephen J.

2012-01-01

Smoke-free air policies have been shown to reduce smoking, but the mechanism of behavior change is not well understood. The authors used structural equation modeling to conduct a theory of planned behavior analysis with data from 395 smokers living in seven Texas cities, three with a comprehensive smoke-free air law and four without a…

Tax revenue in Mississippi communities following implementation of smoke-free ordinances: an examination of tourism and economic development tax revenues.

Science.gov (United States)

McMillen, Robert; Shackelford, Signe

2012-10-01

There is no safe level of exposure to tobacco smoke. More than 60 Mississippi communities have passed smoke-free ordinances in the past six years. Opponents claim that these ordinances harm local businesses. Mississippi law allows municipalities to place a tourism and economic development (TED) tax on local restaurants and hotels/motels. The objective of this study is to examine the impact of these ordinances on TED tax revenues. This study applies a pre/post quasi-experimental design to compare TED tax revenue before and after implementing ordinances. Descriptive analyses indicated that inflation-adjusted tax revenues increased during the 12 months following implementation of smoke-free ordinances while there was no change in aggregated control communities. Multivariate fixed-effects analyses found no statistically significant effect of smoke-free ordinances on hospitality tax revenue. No evidence was found that smoke-free ordinances have an adverse effect on the local hospitality industry.

The next public health revolution: public health information fusion and social networks.

Science.gov (United States)

Khan, Ali S; Fleischauer, Aaron; Casani, Julie; Groseclose, Samuel L

2010-07-01

Social, political, and economic disruptions caused by natural and human-caused public health emergencies have catalyzed public health efforts to expand the scope of biosurveillance and increase the timeliness, quality, and comprehensiveness of disease detection, alerting, response, and prediction. Unfortunately, efforts to acquire, render, and visualize the diversity of health intelligence information are hindered by its wide distribution across disparate fields, multiple levels of government, and the complex interagency environment. Achieving this new level of situation awareness within public health will require a fundamental cultural shift in methods of acquiring, analyzing, and disseminating information. The notion of information "fusion" may provide opportunities to expand data access, analysis, and information exchange to better inform public health action.

Feminism and public health ethics.

Science.gov (United States)

Rogers, W A

2006-06-01

This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health.

Public health and Plowshare

Energy Technology Data Exchange (ETDEWEB)

Terrill, Jr, J G [Consumer Protection and Environmental Health Service, U.S. PubIic Health Service, Washington, DC (United States)

1969-07-01

The protection of public health and safety is a principal area of concern in any application of nuclear energy. A health and safety analysis must be conducted and reviewed by appropriate agencies and the final results made available to interested agencies and groups, both public and private, prior to the application. This is especially important for the Plowshare Program - the peaceful uses of nuclear explosives - where the public is to be the ultimate beneficiary. Because public health must be a primary concern in the Plowshare Program, it is essential that the potential risk be weighed against the expected benefits to the public. Public health agencies must play an increasingly important role in the planning and operational stages of the peaceful applications of nuclear explosives and in the final stage of consumer use of Plowshare-generated products. There are many long term and long distance ramifications of the Plowshare Program, such a the potential radiological contamination of consumer products that may reach the consumer at long times after the event or at great distances from the site of the event. Criteria for evaluating public exposure to radiation from these products need to be developed based on sound scientific research. Standards for radioactivity in consumer products must be developed in relation to potential exposure of the public. Above all, a clear benefit to the public with a minimum of risk must be shown. The major purpose of this Symposium on the Public Health Aspects of Peaceful Uses of Nuclear-Explosives is to focus attention on the health and safety aspects, present the results of safety analyses accomplished to date and other information necessary to an understanding of the public health aspects, and to identify areas where additional research is required. A general overview of the total symposium content is presented with emphasis on the relationship of the topics to public health. (author)

Public health and Plowshare

International Nuclear Information System (INIS)

Terrill, J.G. Jr.

1969-01-01

The protection of public health and safety is a principal area of concern in any application of nuclear energy. A health and safety analysis must be conducted and reviewed by appropriate agencies and the final results made available to interested agencies and groups, both public and private, prior to the application. This is especially important for the Plowshare Program - the peaceful uses of nuclear explosives - where the public is to be the ultimate beneficiary. Because public health must be a primary concern in the Plowshare Program, it is essential that the potential risk be weighed against the expected benefits to the public. Public health agencies must play an increasingly important role in the planning and operational stages of the peaceful applications of nuclear explosives and in the final stage of consumer use of Plowshare-generated products. There are many long term and long distance ramifications of the Plowshare Program, such a the potential radiological contamination of consumer products that may reach the consumer at long times after the event or at great distances from the site of the event. Criteria for evaluating public exposure to radiation from these products need to be developed based on sound scientific research. Standards for radioactivity in consumer products must be developed in relation to potential exposure of the public. Above all, a clear benefit to the public with a minimum of risk must be shown. The major purpose of this Symposium on the Public Health Aspects of Peaceful Uses of Nuclear-Explosives is to focus attention on the health and safety aspects, present the results of safety analyses accomplished to date and other information necessary to an understanding of the public health aspects, and to identify areas where additional research is required. A general overview of the total symposium content is presented with emphasis on the relationship of the topics to public health. (author)

Do smoke-free laws affect revenues in pubs and restaurants?

Science.gov (United States)

Melberg, Hans Olav; Lund, Karl E

2012-02-01

In the debate about laws regulating smoking in restaurants and pubs, there has been some controversy as to whether smoke-free laws would reduce revenues in the hospitality industry. Norway presents an interesting case for three reasons. First, it was among the first countries to implement smoke-free laws, so it is possible to assess the long-term effects. Second, it has a cold climate so if there is a negative effect on revenue one would expect to find it in Norway. Third, the data from Norway are detailed enough to distinguish between revenue from pubs and restaurants. Autoregressive integrated moving average (ARIMA) intervention analysis of bi-monthly observations of revenues in restaurants and pubs show that the law did not have a statistically significant long-term effect on revenue in restaurants or on restaurant revenue as a share of personal consumption. Similar analysis for pubs shows that there was no significant long-run effect on pub revenue.

Gambling and the Health of the Public: Adopting a Public Health Perspective.

Science.gov (United States)

Korn, David A.; Shaffer, Howard J.

1999-01-01

During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the major public health issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

Development of an online tool for public health: the European Public Health Law Network.

Science.gov (United States)

Basak, P

2011-09-01

The European Public Health Law Network was established in 2007 as part of the European Union (EU) co-funded Public Health Law Flu project. The aims of the website consisted of designing an interactive network of specialist information and encouraging an exchange of expertise amongst members. The website sought to appeal to academics, public health professionals and lawyers. The Public Health Law Flu project team designed and managed the website. Registered network members were recruited through publicity, advertising and word of mouth. Details of the network were sent to health organizations and universities throughout Europe. Corresponding website links attracted many new visitors. Publications, news, events and a pandemic glossary became popular features on the site. Although the website initially focused only on pandemic diseases it has grown into a multidisciplinary website covering a range of public health law topics. The network contains over 700 publications divided into 28 public health law categories. News, events, front page content, legislation and the francophone section are updated on a regular basis. Since 2007 the website has received over 15,000 views from 156 countries. Newsletter subscribers have risen to 304. There are now 723 followers on the associated Twitter site. The European Public Health Law Network has been a successful and innovative site in the area of public health law. Interest in the site continues to grow. Future funding can contribute to a bigger site with interactive features and pages in a wider variety of languages to attract a wider global audience. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Public health and peace.

Science.gov (United States)

Laaser, Ulrich; Donev, Donco; Bjegović, Vesna; Sarolli, Ylli

2002-04-01

The modern concept of public health, the New Public Health, carries a great potential for healthy and therefore less aggressive societies. Its core disciplines are health promotion, environmental health, and health care management based on advanced epidemiological methodologies. The main principles of living together in healthy societies can be summarized as four ethical concepts of the New Public Health essential to violence reduction equity, participation, subsidiarity, and sustainability. The following issues are discussed as violence determinants: the process of urbanization; type of neighborhood and accommodation, and consequent stigmatization; level of education; employment status; socialization of the family; women's status; alcohol and drug consumption; availability of the firearms; religious, ethnic, and racial prejudices; and poverty. Development of the health systems has to contribute to peace, since aggression, violence, and warfare are among the greatest risks for health and the economic welfare. This contribution can be described as follows: 1) full and indiscriminate access to all necessary services, 2) monitoring of their quality, 3) providing special support to vulnerable groups, and 4) constant scientific and public accountability of the evaluation of the epidemiological outcome. Violence can also destroy solidarity and social cohesion of groups, such as family, team, neighborhood, or any other social organization. Durkheim coined the term anomie for a state in which social disruption of the community results in health risks for individuals. Health professionals can make a threefold contribution to peace by 1) analyzing the causal interrelationships of violence phenomena, 2) curbing the determinants of violence according to the professional standards, and 3) training professionals for this increasingly important task. Because tolerance is an essential part of an amended definition of health, monitoring of the early signs of public intolerance is

Public Health's Falling Share of US Health Spending.

Science.gov (United States)

Himmelstein, David U; Woolhandler, Steffie

2016-01-01

We examined trends in US public health expenditures by analyzing historical and projected National Health Expenditure Accounts data. Per-capita public health spending (inflation-adjusted) rose from $39 in 1960 to $281 in 2008, and has fallen by 9.3% since then. Public health's share of total health expenditures rose from 1.36% in 1960 to 3.18% in 2002, then fell to 2.65% in 2014; it is projected to fall to 2.40% in 2023. Public health spending has declined, potentially undermining prevention and weakening responses to health inequalities and new health threats.

Five Years After the Hawai‘i Smoke-free Law: Tourism and Hospitality Economic Indicators Appear Unharmed

Science.gov (United States)

Rivard, Cheryl; Lipsher, Julian; Hyland, Andrew

2013-01-01

Opponents of Hawai‘i's smoke-free law argued that such a law would lead to a decrease in tourism. The purpose of this study is to determine if there is evidence of an adverse impact of Hawai‘i's smoke-free law on tourism utilizing data obtained from Hawai‘i's Department of Business, Economic Development & Tourism website for tourists from the United States. Descriptive statistics were reported before and after the law and linear regression was used to assess the relationship between the implementation of the law and changes in indicators of tourism while adjusting for underlying economic factors. The most pronounced fluctuations observed with all tourism indicators occurred around the time the US entered the recession (December 2007), with steady increases following the end of the US recession. While controlling for economic and seasonal trends, the presence of the smoke-free law was associated with an increase in arrivals (β= 42847.9; 95% CI: 16303.3, 69392.5), accommodation employees (β= 969.0; 95% CI: 351.1, 1586.8) and food services & beverage places employees (β=3390.8; 95% CI: 2326.9, 4454.7). Fluctuations in tourism indicators are likely to be associated with greater economic forces, such as decreasing GDP and consumer confidence in the United States and greater global economic trends, rather than the smoke-free law. PMID:24167770

Five years after the Hawai'i smoke-free law: tourism and hospitality economic indicators appear unharmed.

Science.gov (United States)

Dobson Amato, Katharine A; Rivard, Cheryl; Lipsher, Julian; Hyland, Andrew

2013-10-01

Opponents of Hawai'i's smoke-free law argued that such a law would lead to a decrease in tourism. The purpose of this study is to determine if there is evidence of an adverse impact of Hawai'i's smoke-free law on tourism utilizing data obtained from Hawai'i's Department of Business, Economic Development & Tourism website for tourists from the United States. Descriptive statistics were reported before and after the law and linear regression was used to assess the relationship between the implementation of the law and changes in indicators of tourism while adjusting for underlying economic factors. The most pronounced fluctuations observed with all tourism indicators occurred around the time the US entered the recession (December 2007), with steady increases following the end of the US recession. While controlling for economic and seasonal trends, the presence of the smoke-free law was associated with an increase in arrivals (β= 42847.9; 95% CI: 16303.3, 69392.5), accommodation employees (β= 969.0; 95% CI: 351.1, 1586.8) and food services & beverage places employees (β=3390.8; 95% CI: 2326.9, 4454.7). Fluctuations in tourism indicators are likely to be associated with greater economic forces, such as decreasing GDP and consumer confidence in the United States and greater global economic trends, rather than the smoke-free law.

Restaurant employment before and after the New York City Smoke-Free Air Act.

Science.gov (United States)

Hyland, A; Cummings, K M

1999-01-01

The purpose of this study was to observe trends in the number of restaurants and restaurant employees two years before and two years after the New York City Smoke-Free Air Act took effect in April, 1995. Between April 1993 and April 1997, New York City added 19,347 new restaurant jobs (18% increase) while the rest of the state outside the immediate metropolitan area added 7,423 new jobs (5% increase). The rate of growth in the number of restaurants was comparable among New York City, neighboring counties, and the rest of the state. The data suggest that the New York City Smoke-Free Air Act did not result in job losses for the city's restaurant industry.

Transportation and public health.

Science.gov (United States)

Litman, Todd

2013-01-01

This article investigates various ways that transportation policy and planning decisions affect public health and better ways to incorporate public health objectives into transport planning. Conventional planning tends to consider some public health impacts, such as crash risk and pollution emissions measured per vehicle-kilometer, but generally ignores health problems resulting from less active transport (reduced walking and cycling activity) and the additional crashes and pollution caused by increased vehicle mileage. As a result, transport agencies tend to undervalue strategies that increase transport system diversity and reduce vehicle travel. This article identifies various win-win strategies that can help improve public health and other planning objectives.

Parental Practices and Attitudes Related to Smoke-Free Rules in Homes, Cars, and Outdoor Playgrounds in US Households With Underage Children and Smokers, 2010-2011.

Science.gov (United States)

Zhang, Xiao; Martinez-Donate, Ana; Rhoads, Natalie

2015-06-18

A smoke-free environment protects children from exposure to involuntary smoke and also can reduce or prevent future smoking behavior. The purpose of this study was to examine levels and correlates of parental behavior and attitudes related to voluntary smoke-free rules in homes, cars, and outdoor children's play areas among US households with underage children and 1 or more smoking parents. We used data from the 2010-2011 Tobacco Use Supplement to the Current Population Survey and logistic regressions to model behavior and attitudes related to voluntary smoke-free rules in 3 settings. Overall, 60.1% of households with children and at least 1 smoking parent had voluntary smoke-free home rules. Approximately 84.6% and 71.5% of parents thought that smoking should not be allowed inside cars with children present and in outdoor play areas, respectively. Positive parental behavior and attitudes related to voluntary smoke-free rules were more likely among households with 2 parents, parents of higher education and household income, Hispanic parents, and parents of infants (P prevention efforts are needed to promote the voluntary adoption of smoke-free rules in homes, private cars, and outdoor children's play areas. Most parents from smoker households with underage children were supportive of smoke-free laws for cars and outdoor children's play areas, providing evidence and encouragement to policy makers to take action to restrict smoking in these locations.

Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

Science.gov (United States)

Guyon, Ak'ingabe; Perreault, Robert

2016-10-20

Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

Results from unannounced visits to check compliance with smoke-free regulations in three types of indoor places in Beijing

Directory of Open Access Journals (Sweden)

Shuyan Wu

2018-03-01

Full Text Available Background Beijing Tobocco control regulation come into force in 2015. According to the regulation, all indoor areas are smoke free. To assess compliance with the Beijing Regulations, identify weaknesses and problems, and provide scientific evidence for policy making by the government and other authorities. Methods on site, unannounced visits. We conducted unannounced visits to a sample of 821 places in three types of places across the sixteen districts of Beijing, including medical and health facilities (including health and family planning commissions, CDCs, health inspection institutes and a variety of hospitals, colleges (including vocational schools and taxis (including Shouqi Group vehicles booked online. Results Among medical and health facilities, all posted smoke-free signage, and no cigarette end or smoking paraphernalia was found indoors, except in private hospitals, community health service centers and few maternal and child care centers. Among colleges, 96.9% of them posted smoke-free signage, cigarette end was found indoors in 9.9% of colleges, smell of smoking was detected indoors in 1.9% of colleges, and ashtray was found indoors in 0.6% of colleges. Among taxies, 6% of drivers of online booked vehicles permit passengers to smoke inside their car, and no smell of smoking, container of cigarette ends/ashes, or driver smoking was detected in these online booked vehicles. Among the conventional cruising taxis, 48.4% of taxi drivers permit passengers to smoke inside their car, smell of smoking was found in 9.6% of taxies, and 1.6% of taxi drivers smoke in their car. Conclusions Smoking in violation of the Regulations is serious in the taxi sector, and targeted stronger supervision and administration are needed.

Barriers Associated with Implementing a Campus-Wide Smoke-Free Policy

Science.gov (United States)

Harbison, Philip Adam; Whitman, Marilyn V.

2008-01-01

Purpose: The purpose of this study is to review the barriers associated with implementing a campus-wide smoke-free policy as perceived by the American Cancer Society's Colleges against Cancer (CAC) Program chapter representatives. Design/methodology/approach: Four focus group sessions were conducted at the annual CAC National Leadership Summit in…

Economic evaluation of a 100% smoke-free law on the hospitality industry in an Argentinean province.

Science.gov (United States)

Candioti, Carlos; Rossini, Gustavo; Depetris de Guiguet, Edith; Costa, Oscar; Schoj, Verónica

2012-06-01

To assess the economic impact of a 100% smoke-free law on bars and restaurants in an Argentinean province. We conducted a time series analysis of restaurant and bar revenues in the province of Santa Fe 31 months before and 29 months after the implementation of the 100% smoke-free environment law. The neighboring province of Entre Rios without smoking restrictions at the time of this study, was used as the control province. Average taxable revenues post-legislation in the province of Santa Fe as a whole and in the two most important cities were higher when compared to the total provincial revenue pre-legislation. No significant differences were observed with the total revenue from the province of Entre Rios. We found no statistically significant evidence that the 100% smoke-free environment legislation in the province of Santa Fe, Argentina, had a negative impact on the revenues of local bars and restaurants.

Transitions in state public health law: comparative analysis of state public health law reform following the Turning Point Model State Public Health Act.

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Meier, Benjamin Mason; Hodge, James G; Gebbie, Kristine M

2009-03-01

Given the public health importance of law modernization, we undertook a comparative analysis of policy efforts in 4 states (Alaska, South Carolina, Wisconsin, and Nebraska) that have considered public health law reform based on the Turning Point Model State Public Health Act. Through national legislative tracking and state case studies, we investigated how the Turning Point Act's model legal language has been considered for incorporation into state law and analyzed key facilitating and inhibiting factors for public health law reform. Our findings provide the practice community with a research base to facilitate further law reform and inform future scholarship on the role of law as a determinant of the public's health.

Clearing the air: improving smoke-free policy compliance at the national oncology hospital in Armenia.

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Movsisyan, Narine K; Petrosyan, Varduhi; Harutyunyan, Arusyak; Petrosyan, Diana; Stillman, Frances

2014-12-13

Smoke-free policies shown to reduce population exposure to secondhand smoke (SHS) are the norm in hospitals in many countries around the world. Armenia, a transition economy in the South Caucasus, has one of the highest male smoking rates in the European region. Although smoking in healthcare facilities has been banned since 2005, compliance with this ban has been poor due to lack of implementation and enforcement mechanisms and social acceptability of smoking. The study aimed to develop and test a model intervention to address the lack of compliance with the de jure smoking ban. The national oncology hospital was chosen as the intervention site. This study used employee surveys and objective measurements of respirable particles (PM2.5) and air nicotine as markers of indoor air pollution before and after the intervention. The intervention developed in partnership with the hospital staff included an awareness campaign on SHS hazards, creation of no-smoking environment and building institutional capacity through training of nursing personnel on basics of tobacco control. The survey analysis included paired t-test and McNemar's test. The log-transformed air nicotine and PM2.5 data were analyzed using paired t-test. The survey showed significant improvement in the perceived quality of indoor air, reduced worksite exposure to SHS and increased employees' awareness of the smoke-free policy. The number of employees reporting compliance with the hospital smoke-free policy increased from 36.0% to 71.9% (p Armenia that have failed to implement the adopted smoke-free policies.

Educating the future public health workforce: do schools of public health teach students about the private sector?

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Rutkow, Lainie; Traub, Arielle; Howard, Rachel; Frattaroli, Shannon

2013-01-01

Recent surveys indicate that approximately 40% of graduates from schools of public health are employed within the private sector or have an employer charged with regulating the private sector. These data suggest that schools of public health should provide curricular opportunities for their students--the future public health workforce--to learn about the relationship between the private sector and the public's health. To identify opportunities for graduate students in schools of public health to select course work that educates them about the relationship between the private sector and public health. We systematically identified and analyzed data gathered from publicly available course titles and descriptions on the Web sites of accredited schools of public health. Data were collected in the United States. The sample consisted of accredited schools of public health. Descriptions of the number and types of courses that schools of public health offer about the private sector and identification of how course descriptions frame the private sector relative to public health. We identified 104 unique courses with content about the private sector's relationship to public health. More than 75% of accredited schools of public health offered at least 1 such course. Nearly 25% of identified courses focused exclusively on the health insurance industry. Qualitative analysis of the data revealed 5 frames used to describe the private sector, including its role as a stakeholder in the policy process. Schools of public health face a curricular gap, with relatively few course offerings that teach students about the relationship between the private sector and the public's health. By developing new courses or revising existing ones, schools of public health can expose the future public health workforce to the varied ways public health professionals interact with the private sector, and potentially influence students' career paths.

Why Do People Work in Public Health? Exploring Recruitment and Retention Among Public Health Workers.

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Yeager, Valerie A; Wisniewski, Janna M; Amos, Kathleen; Bialek, Ron

2016-01-01

The public health workforce is critical to the functioning of the public health system and protection of the population's health. Ensuring a sufficient workforce depends on effectively recruiting and retaining workers. This study examines factors influencing decisions to take and remain in jobs within public health, particularly for workers employed in governmental public health. This cross-sectional study employed a secondary data set from a 2010 national survey of US public health workers. Survey respondents were included in this study if they responded to at least 1 survey item related to recruitment and retention. A total of 10 859 survey responses fit this criterion. Data examined demographics of public health workers and factors that influenced decisions to take jobs in and remain in public health. Job security (β = 0.42; 95% confidence interval [CI], 0.28-0.56) and competitive benefits (β = 0.49; 95% CI, 0.28-0.70) were significantly and positively associated with governmental employees' decisions to take positions with their current employers compared with public health workers employed by other types of organizations. The same finding held with regard to retention: job security (β = 0.40; 95% CI, 0.23-0.57) and competitive benefits (β = 0.53; 95% CI, 0.24-0.83). Two personal factors, personal commitment to public service (β = 0.30; 95% CI, 0.17-0.42) and wanted a job in the public health field (β = 0.44; 95% CI, 0.18-0.69), were significantly and positively related to governmental employees deciding to remain with their current employers. It is important to recognize the value of competitive benefits for both current and potential employees. Public health agencies should maintain these if possible and make the value of these benefits known to policy makers or other agencies setting these benefit policies. Job security associated with governmental public health jobs also appears to offer public health an advantage in recruiting and retaining employees.

Public mental health.

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Lindert, Jutta; Bilsen, Johan; Jakubauskiene, Marija

2017-10-01

Public mental health (PMH) is a major challenge for public health research and practice. This article is organized in six parts. First, we will highlight the significance of PMH; second, we will define mental health and mental disorders; third, we identify and describe determinants of mental health and mental disorders on which we worked in the past 10 years since the establishment of the PMH section such as social determinants and violence. Fourth, we will describe the development of the EUPHA PMH section and provide details on vulnerable groups in the field of PMH, on violence as a main determinant and on suicide as an outcome which affects all countries in the European region. Fifth, we describe policy and practice implications of the development of PMH and highlight the European dimension of PMH. We will conclude this article by providing an outlook on potential further development of PMH as regards research and policy and practice. Finally, we hope that the EUPHA PMH section will contribute to public health in the next 25 years and we can contribute to improvement of PMH in Europe. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Social media in public health.

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Kass-Hout, Taha A; Alhinnawi, Hend

2013-01-01

While social media interactions are currently not fully understood, as individual health behaviors and outcomes are shared online, social media offers an increasingly clear picture of the dynamics of these processes. Social media is becoming an increasingly common platform among clinicians and public health officials to share information with the public, track or predict diseases. Social media can be used for engaging the public and communicating key public health interventions, while providing an important tool for public health surveillance. Social media has advantages over traditional public health surveillance, as well as limitations, such as poor specificity, that warrant additional study. Social media can provide timely, relevant and transparent information of public health importance; such as tracking or predicting the spread or severity of influenza, west nile virus or meningitis as they propagate in the community, and, in identifying disease outbreaks or clusters of chronic illnesses. Further work is needed on social media as a valid data source for detecting or predicting diseases or conditions. Also, whether or not it is an effective tool for communicating key public health messages and engaging both, the general public and policy-makers.

Protecting workers from secondhand smoke in North Carolina.

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Plescia, Marcus; Malek, Sally Herndon; Shopland, Donald R; Anderson, Christy M; Burns, David M

2005-01-01

Exposure to job-related secondhand smoke represents a significant, but entirely preventable occupational health risk to non-smoking workers. This article examines trends in smoke-free workplace policies in North Carolina. We also examine whether workers comply with such policies. Data from the Census Bureau's Current Population Survey were analyzed from 1992 through 2002. Trends for North Carolina workers are compared with workers nationally and trends are presented by age, race, gender, and type of worker. North Carolina ranks 35th in the proportion of its workforce reporting a smoke-free place of employment. The proportion of workers reporting such a policy doubled between 1992 and 2002. Females were more likely to reporta smoke-free work environment (72.0%, CI +/- 2.6) than males (61.2%, CI +/- 4.6%). Blue-collar (55.6%, CI +/- 5.5) and service workers (61.2%, CI +/- 8.4), especially males, were less likely to report a smoke-free worksite than white-collar workers (73.4%, CI +/- 2.6). Compliance with a smoke-free policy does not appear to be an issue, only 3.2% of workers statewide reported someone had violated their company's nonsmoking policy While some progress has been made in North Carolina to protect workers from secondhand smoke, significant disparities exist. Smoke-free policies can make a significant difference in reducing exposure to airborne toxins and their associated diseases, and these protective public health policies have not been shown to reduce business revenues. Much has been done to assure the health and safety of workers through public health policy However, opportunities to protect North Carolina workers from the health effects of secondhand smoke are limited by a preemptive state law.

Assessing the public health impact of using poison center data for public health surveillance.

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Wang, Alice; Law, Royal; Lyons, Rebecca; Choudhary, Ekta; Wolkin, Amy; Schier, Joshua

2017-12-13

The National Poison Data System (NPDS) is a database and surveillance system for US poison centers (PCs) call data. The Centers for Disease Control and Prevention (CDC) and American Association of Poison Control Centers (AAPCC) use NPDS to identify incidents of potential public health significance. State health departments are notified by CDC of incidents identified by NPDS to be of potential public health significance. Our objective was to describe the public health impact of CDC's notifications and the use of NPDS data for surveillance. We described how NPDS data informed three public health responses: the Deepwater Horizon incident, national exposures to laundry detergent pods, and national exposures to e-cigarettes. Additionally, we extracted survey results of state epidemiologists regarding NPDS incident notification follow-up from 1 January 2015 to 31 December 2016 to assess current public health application of NPDS data using Epi Info 7.2 and analyzed data using SAS 9.3. We assessed whether state health departments were aware of incidents before notification, what actions were taken, and whether CDC notifications contributed to actions. NPDS data provided evidence for industry changes to improve laundry detergent pod containers safety and highlighted the need to regulate e-cigarette sale and manufacturing. NPDS data were used to improve situational awareness during the 2010 Deepwater Horizon oil spill. Of 59 health departments and PCs who responded to CDC notifications about anomalies (response rate = 49.2%), 27 (46%) reported no previous awareness of the incident, and 20 (34%) said that notifications contributed to public health action. Monitoring NPDS data for anomalies can identify emerging public health threats and provide evidence-based science to support public health action and policy changes.

Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis.

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Rando-Matos, Yolanda; Pons-Vigués, Mariona; López, María José; Córdoba, Rodrigo; Ballve-Moreno, José Luis; Puigdomènech-Puig, Elisa; Benito-López, Vega Estíbaliz; Arias-Agudelo, Olga Lucía; López-Grau, Mercè; Guardia-Riera, Anna; Trujillo, José Manuel; Martin-Cantera, Carlos

2017-01-01

The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose) among all populations. Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1) original scientific studies about smokefree legislation, 2) Data before and after legislation were collected, and 3) Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment. A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers). Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months). Four (50%) of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1-36%) than for asthma (5-31%). Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46%) of the studies. Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms) and, to a lesser degree, rates of hospitalization for asthma.

Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Yolanda Rando-Matos

Full Text Available The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose among all populations.Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1 original scientific studies about smokefree legislation, 2 Data before and after legislation were collected, and 3 Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment.A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers. Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months. Four (50% of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1-36% than for asthma (5-31%. Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46% of the studies.Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms and, to a lesser degree, rates of hospitalization for

The impact of globalization on public health: implications for the UK Faculty of Public Health Medicine.

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Lee, K

2000-09-01

There has been substantial discussion of globalization in the scholarly and popular press yet limited attention so far among public health professionals. This is so despite the many potential impacts of globalization on public health. Defining public health broadly, as focused on the collective health of populations requiring a range of intersectoral activities, globalization can be seen to have particular relevance. Globalization, in turn, can be defined as a process that is changing the nature of human interaction across a wide range of spheres and along at least three dimensions. Understanding public health and globalization in these ways suggests the urgent need for research to better understand the linkages between the two, and effective policy responses by a range of public health institutions, including the UK Faculty of Public Health Medicine. The paper is based on a review of secondary literature on globalization that led to the development of a conceptual framework for understanding potential impacts on the determinants of health and public health. The paper then discusses major areas of public health in relation to these potential impacts. It concludes with recommendations on how the UK Faculty of Public Health Medicine might contribute to addressing these impacts through its various activities. Although there is growing attention to the importance of globalization to public health, there has been limited research and policy development in the United Kingdom. The UK Faculty of Public Health Medicine needs to play an active role in bringing relevant issues to the attention of policy makers, and encourage its members to take up research, teaching and policy initiatives. The potential impacts of globalization support a broader understanding and practice of public health that embraces a wide range of health determinants.

The public health leadership certificate: a public health and primary care interprofessional training opportunity.

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Matson, Christine C; Lake, Jeffrey L; Bradshaw, R Dana; Matson, David O

2014-03-01

This article describes a public health leadership certificate curriculum developed by the Commonwealth Public Health Training Center for employees in public health and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Public health employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited public health in Virginia.

Factors associated with smoke-free homes in NSW: results from the 1998 NSW Health Survey.

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Merom, D; Rissel, C

2001-08-01

To examine the sociodemographic characteristics associated with smoke-free homes (SFHs) in NSW and specify high-risk groups with a low prevalence of household smoking restrictions. Data were drawn from the 1998 NSW Health Survey, a computer-assisted telephone interview survey of 17,494 randomly selected respondents aged > or = 16 years across NSW (response rate = 70%). Logistic regression analyses, stratified by smoking status, were used. Overall, 72% of adults reported having a SFH; 87% of never-smokers, 81% of ex- and 35% of current smokers. The highest percentages of SFHs were reported in households with young children (78%) and with older children (72%) or with adults only (72%). For smokers, SFHs were independently associated with the presence of young children (OR=3.8, 95% CI 3.1-4.7) compared with those who lived alone, but the odds of living in a SFH were only slightly increased for smokers living with older children (aged 6-15) and for those living with adults only (OR=1.9, OR=1.8 respectively). Speaking a language other than English at home, having more than 10 years' education, and being homes have restrictions on smoking inside, but more than half the households with children and at least one smoker adult are not smoke free. Interventions to shape parents' smoking behaviour around older children are warranted. Strategies need to address never-smokers in communities with high prevalence of smoking and adults with lower levels of education. A continued commitment to workplace smoking bans is important as they may affect household smoking restrictions.

Changes of Attitudes and Patronage Behaviors in Response to a Smoke-Free Bar Law

Science.gov (United States)

Tang, Hao; Cowling, David W.; Lloyd, Jon C.; Rogers, Todd; Koumjian, Kristi L.; Stevens, Colleen M.; Bal, Dileep G.

2003-01-01

Objectives. We examined patron responses to a California smoke-free bar law. Methods. Three telephone surveys measured attitudes and behavior changes after implementation of the law. Results. Approval of the law rose from 59.8% to 73.2% (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.58, 2.40). Self-reported noncompliance decreased from 24.6% to 14.0% (OR = 0.50; 95% CI = 0.30, 0.85). Likelihood of visiting a bar or of not changing bar patronage after the law was implemented increased from 86% to 91% (OR = 1.76; 95% CI = 1.29, 2.40). Conclusions. California bar patrons increasingly support and comply with the smoke-free bar law. PMID:12660206

Developing an academia-based public health observatory: the new global public health observatory with emphasis on urban health at Johns Hopkins Bloomberg School of Public Health

Directory of Open Access Journals (Sweden)

Carlos Castillo-Salgado

2015-11-01

Full Text Available Abstract Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.

Developing an academia-based public health observatory: the new global public health observatory with emphasis on urban health at Johns Hopkins Bloomberg School of Public Health.

Science.gov (United States)

Castillo-Salgado, Carlos

2015-11-01

Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH) in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.

Advances in dental public health.

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Holt, R D

2001-07-01

Dental public health has been defined as 'the science and art of preventing oral diseases, promoting oral health and improving the quality of life through the organised efforts of society'. Dental practitioners most often have the oral health of individual patients as their primary focus but the aim of public health is to benefit populations. Early developments in dental public health were concerned largely with demonstrating levels of disease and with treatment services. With greater appreciation of the nature of oral health and disease, and of their determinants has come recognition of the need for wider public health action if the effects of prevention and oral health promotion are to be maximized.

Health needs and public health functions addressed in scientific publications in Francophone sub-Saharan Africa.

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Benie-Bi, J; Cambon, L; Grimaud, O; Kivits, J; Alla, F

2013-09-01

To describe the reporting of public health research in Francophone sub-Saharan Africa (FSA). A bibliometric research study of scientific public health publications in FSA, which includes 24 countries and approximately 260 million people. Two researchers analysed original articles published in 2007 in the medical or social sciences fields and indexed in Scopus. At least one co-author of articles had to be based in FSA. The analysis focused on research field, public health function (WHO classification), FSA country author's affiliation, language, journal type and global burden of disease (WHO classification). Of 1047 articles retrieved by the search, 212 were from the public health field. The number of articles per country varied from 0 to 36. Public health functions examined were health service research (24.5%), health monitoring (27.4%), prevention (15%) and legislation (0.5%). The distribution of health needs described in the articles was close to that of the WHO data for Africa for 2004: infectious and parasitic diseases (70% vs 54%), maternal and perinatal conditions (15% vs 17%), non-communicable diseases (15.6% vs 21%), and injuries (0.5% vs 8%). The areas reported in published articles from sub-Saharan Africa reflect the health needs distribution in Africa; however, the number of publications is low, particularly for prevention. In light of the current focus on evidence-based public health, this study questions whether the international scientific community adequately considers the expertise and perspectives of African researchers and professionals. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Assessing entrepreneurship in governmental public health.

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Jacobson, Peter D; Wasserman, Jeffrey; Wu, Helen W; Lauer, Johanna R

2015-04-01

We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Ongoing PHE activity has the potential to reduce LHDs' reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs' current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative.

Public health educational comprehensiveness: The strategic rationale in establishing networks among schools of public health.

Science.gov (United States)

Otok, Robert; Czabanowska, Katarzyna; Foldspang, Anders

2017-11-01

The establishment and continuing development of a sufficient and competent public health workforce is fundamental for the planning, implementation, evaluation, effect and ethical validity of public health strategies and policies and, thus, for the development of the population's health and the cost-effectiveness of health and public health systems and interventions. Professional public health strategy-making demands a background of a comprehensive multi-disciplinary curriculum including mutually, dynamically coherent competences - not least, competences in sociology and other behavioural sciences and their interaction with, for example, epidemiology, biostatistics, qualitative methods and health promotion and disease prevention. The size of schools and university departments of public health varies, and smaller entities may run into problems if seeking to meet the comprehensive curriculum challenge entirely by use of in-house resources. This commentary discusses the relevance and strength of establishing comprehensive curriculum development networks between schools and university departments of public health, as one means to meet the comprehensiveness challenge. This commentary attempts to consider a two-stage strategy to develop complete curricula at the bachelor and master's as well as PhD levels.

42 CFR 90.9 - Public health advisory.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of a...

Four-year follow-up of smoke exposure, attitudes and smoking behaviour following enactment of Finland's national smoke-free work-place law.

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Heloma, Antero; Jaakkola, Maritta S

2003-08-01

This study evaluated the possible impact of national smoke-free work-place legislation on employee exposure to environmental tobacco smoke (ETS), employee smoking habits and attitudes on work-place smoking regulations. Repeated cross-sectional questionnaire surveys and indoor air nicotine measurements were carried out before, and 1 and 3 years after the law had come into effect. Industrial, service sector and office work-places from the Helsinki metropolitan area, Finland. A total of 880, 940 and 659 employees (response rates 70%, 75% and 75%) in eight work-places selected from a register kept by the Uusimaa Regional Institute of Occupational Health to represent various sectors of public and private work-places. Reported exposure to ETS, smoking habits, attitudes on smoking at work and measurements of indoor air nicotine concentration. Employee exposure to ETS for at least 1 hour daily decreased steadily during the 4-year follow-up, from 51% in 1994 to 17% in 1995 and 12% in 1998. Respondents' daily smoking prevalence and tobacco consumption diminished 1 year after the enforcement of legislation from 30% to 25%, and remained at 25% in the last survey 3 years later. Long-term reduction in smoking was confined to men. Both smokers' and non-smokers' attitudes shifted gradually towards favouring a total ban on smoking at work. Median indoor airborne nicotine concentrations decreased from 0.9 micro g/m3 in 1994-95 to 0.1 micro g/m3 in 1995-96 and 1998. This is the first follow-up study on a nationally implemented smoke-free work-place law. We found that such legislation is associated with steadily reducing ETS exposure at work, particularly at work-places, where the voluntary smoking regulations have failed to reduce exposure. The implementation of the law also seemed to encourage smokers to accept a non-smoking work-place as the norm.

GIS and Public Health

Directory of Open Access Journals (Sweden)

Stefania Bertazzon

2014-06-01

Full Text Available This Special Issue on GIS and public health is the result of a highly selective process, which saw the participation of some 20 expert peer-reviewers and led to the acceptance of one half of the high-quality submissions received over the past year. Many threads link these papers to each other and, indeed, to our original call for papers, but the element that most clearly emerges from these works is the inextricable connection between public health and the environment. Indeed, GIS analysis of public health simply cannot disregard the geospatial dimension of environmental resources and risks. What consistently emerges from these analyses is that current geospatial research can only scratch the surface of the complex interactions of spatial resources, risks, and public health. In today’s world, or at least in the developed world, researchers and practitioners can count on virtually endless data, on inexpensive computational power, and on seamless connectivity. In this research environment, these papers point to the need for improved analytical tools, covering concepts, representation, modeling and reliability. These works are important contributions that help us to identify what advances in geospatial analysis can better address the complex interactions of public health with our physical and cultural environment, and bridge research and practice, so that geospatial analyses can inform public health policy making. [...

Mental health in prisons: A public health agenda.

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Fraser, A

2009-01-01

Mental illness affects the majority of prisoners. Mental health issues are beginning to take a central position in the development of prison health services, reflecting this burden of disease. This change in focus is not before time. But prison mental health services cannot exist in isolation. Public health systems should lead provision of care for patients with acute and severe illness. A whole prison approach to health and, specifically, mental health will offer the greatest likelihood that offenders will thrive, benefit from imprisonment, and lead law-abiding lives after release. Public awareness of the scale and commitment of prisons to mental health and illness, and understanding of prisons' role in society, are necessary developments that would protect and enhance public mental health, as well as creating a healthier and safer society. This article draws on recent reviews, information and statements to set out a public health agenda for mental health in prisons.

Academic dental public health diplomates: their distribution and recommendations concerning the predoctoral dental public health faculty.

Science.gov (United States)

Kaste, L M; Sadler, Z E; Hayes, K L; Narendran, S; Niessen, L C; Weintraub, J A

1998-01-01

The purpose of this study was to assess the representation of academically based diplomates of the American Board of Dental Public Health (ABDPH) and to identify their perceptions on the training of dental public health predoctoral faculty. Data were collected by a mailed, self-administered, 13-item questionnaire. The population was the 48 diplomates of the ABDPH as of March 1997 associated with academic institutions. Twenty of the 55 US dental schools had a diplomate of the ABDPH with a mean of 1.8 diplomates per school with a diplomate. An average of 4.5 full-time faculty members per school were associated with teaching dental public health. A master's degree in public health (MPH) was the most frequently suggested educational requirement for dental public health faculty. Continuing education courses were training needs perceived for dental public health faculty. The lack of time, money, and incentives, along with perceived rigidity of requirements for board certification, were reported as major barriers for faculty becoming dental public health board certified. Numerous challenges confront the development of a strong dental public health presence in US dental schools. These challenges include, among others, insufficient numbers of academic dental public health specialists and insufficient motivations to encourage promising candidates to pursue specialty status.

Utility and justice in public health.

Science.gov (United States)

MacKay, Kathryn

2017-12-11

Many public health practitioners and organizations view themselves as engaged in the promotion or achievement of equity. However, discussions around public health frequently assume that practitioners and policy-makers take a utilitarian approach to this work. I argue that public health is better understood as a social justice endeavor. I begin by presenting the utility view of public health and then discuss the equity view. This is a theoretical argument, which should help public health to justify interventions for communicable and non-communicable diseases equally, and which contributes to breaking down the 'old/new' public health divide. This argument captures practitioners' views of the work they are engaged in and allows for the moral and policy justification of important interventions in communicable and non-communicable diseases. Systemic interventions are necessary to remedy high rates of disease among certain groups and, generally, to improve the health of entire populations. By viewing diseases as partly the result of failures of health protective systems in society, public health may justify interventions in communicable and non-communicable diseases equally. Public health holds a duty to improve the health of the worst-off in society; by prioritizing this group, the health of the whole community may improve. © The Author(s) 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Public health

NARCIS (Netherlands)

Berg, van den A.E.

2007-01-01

Agnes van den Berg wrote an essay about human health and nature, establishing that subject as an important policy argument in developing (urban) nature in the Netherlands. She studied the public balance of fear and fascination for nature, summarising benefits on human health. In this chapter, she

Critical perspectives in public health

National Research Council Canada - National Science Library

Green, Judith; Labonte, Ronald N

2008-01-01

... the contemporary roles of 'critical voices' in public health research and practice from a range of disciplines and contexts. The book covers many of the pressing concerns for public health practitioners and researchers, including: * * * * * the implications of new genetic technologies for public health; the impact of globalisation on local practice...

Development of Systematic Knowledge Management for Public Health: A Public Health Law Ontology

Science.gov (United States)

Keeling, Jonathan

2012-01-01

The Institute of Medicine has stated that legal structures and the authority vested in health agencies and other partners within the public health system are essential to improving the public's health. Variation between the laws of different jurisdictions within the United States allows for natural experimentation and research into their…

Public health leadership education in North America

OpenAIRE

Uno, Hideo; Zakariasen,Kenneth

2010-01-01

Hideo Uno, Kenneth ZakariasenDepartment of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, AB, CanadaAbstract: Public health leadership is one of the priority disciplines public health professionals need to learn well if they are to deal with demanding public health issues effectively and efficiently. This article looks at the trends in public health leadership education by reviewing the literature and using the Internet to explore the public health leadershi...

Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives

OpenAIRE

Orvik, Arne

2016-01-01

The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutio...

Qualitative Assessment of Smoke-Free Policy Implementation in Low-Income Housing: Enhancing Resident Compliance.

Science.gov (United States)

Anthony, Jodi; Goldman, Roberta; Rees, Vaughan W; Frounfelker, Rochelle L; Davine, Jessica; Keske, Robyn R; Brooks, Daniel R; Geller, Alan C

2018-01-01

As public housing agencies and other low-income housing providers adopt smoke-free policies, data are needed to inform implementation approaches that support compliance. Focused ethnography used including qualitative interviews with staff, focus groups with residents, and property observations. Four low-income housing properties in Massachusetts, 12 months postpolicy adoption. Individual interviews (n = 17) with property staff (managers, resident service coordinators, maintenance, security, and administrators) and focus groups with resident smokers (n = 28) and nonsmokers (n = 47). Informed by the social-ecological model: intrapersonal, interpersonal, organizational, and community factors relating to compliance were assessed. Utilized MAXQDA in a theory-driven immersion/crystallization analytic process with cycles of raw data examination and pattern identification until no new themes emerged. Self-reported secondhand smoke exposure (SHSe) was reduced but not eliminated. Challenges included relying on ambivalent maintenance staff and residents to report violations, staff serving as both enforcers and smoking cessation counsellors, and inability to enforce on nights and weekends. Erroneous knowledge of the policy, perception that SHSe is not harmful to neighbors, as well as believing that smokers were losing their autonomy and being unfairly singled out when other resident violations were being unaddressed, hindered policy acceptance among resident smokers. The greatest challenge to compliance was the lack of allowable outdoor smoking areas that may have reduced the burden of the policy on smokers. Smoke-free policy implementation to support compliance could be enhanced with information about SHSe for smokers and nonsmokers, cessation support from external community partners, discussion forums for maintenance staff, resident inclusion in decision-making, and framing the policy as part of a broader wellness initiative.

PPACA and public health: creating a framework to focus on prevention and wellness and improve the public's health.

Science.gov (United States)

Majette, Gwendolyn Roberts

2011-01-01

PPACA epitomizes comprehensive health care reform legislation. Public health, disease prevention, and wellness were integral considerations in its development. This article reveals the author's personal experiences while working on the framework for health care reform in the United States Senate and reviews activity in the United States House of Representatives. This insider's perspective delineates PPACA's positive effect on public health by examining the infrastructure Congress designed to focus on prevention, wellness, and public health, with a particular focus on the National Prevention, Health Promotion and Public Health Council; the National Prevention, Health Promotion, Public Health, and Integrative Health Care Strategy; and the Prevention and Public Health Fund. The Council, strategy, and fund are especially important because they reflect compliance with some of the Institute of Medicine's recommendations to improve public health in the United States, as well as international health and human rights norms that protect the right to health. © 2011 American Society of Law, Medicine & Ethics, Inc.

Lack of sustainable prevention effect of the "Smoke-Free Class Competition" on German pupils.

Science.gov (United States)

Schulze, Alexander; Mons, Ute; Edler, Lutz; Pötschke-Langer, Martina

2006-01-01

This study examines the effectiveness of the school-based campaign "Smoke-Free Class Competition" as a means of preventing young non-smokers from taking up smoking. Based on two measurements of the Heidelberg Children's Panel Study (1998 and 2000), a longitudinal sample of 1704 pupils was examined: 948 in the intervention group and 756 in the control group. In order to evaluate the effects of the intervention, we compared the smoking behavior in the intervention and the control group at two points in time, shortly before, and 18 months after the intervention, on an individual case basis. (1) Stabilization of never-smoking rates: the proportion of pupils remaining a never-smoker at the follow-up is 62.1% in the intervention group and 61.5% in the control group (OR 1.02, 95% CI: 0.83-1.24); (2) Lowering of relapse rates among ex-smokers: the proportion of former smokers who had not started smoking again in the follow-up is 45.1% in the intervention group and 41.4% in the control group (OR 1.07, 95% CI: 0.77-1.49). The "Smoke-Free Class Competition" did not prevent smoking among adolescents and does not appear to be an effective substitute to the complete ban of tobacco advertising, the abolition of vending machines and the creation of smoke-free environments in German schools.

One Health Perspectives on Emerging Public Health Threats

Directory of Open Access Journals (Sweden)

Sukhyun Ryu

2017-11-01

Full Text Available Antimicrobial resistance and emerging infectious diseases, including avian influenza, Ebola virus disease, and Zika virus disease have significantly affected humankind in recent years. In the premodern era, no distinction was made between animal and human medicine. However, as medical science developed, the gap between human and animal science grew deeper. Cooperation among human, animal, and environmental sciences to combat emerging public health threats has become an important issue under the One Health Initiative. Herein, we presented the history of One Health, reviewed current public health threats, and suggested opportunities for the field of public health through better understanding of the One Health paradigm.

Climate Change and Public Health.

Science.gov (United States)

Ciesielski, Timothy

2017-05-01

It is clear that the public health community is concerned about the human health impacts of climate change, but are we inadvertently underestimating the scope of the problem and obfuscating potentially useful interventions by using a narrow intellectual frame in our discussions with policy makers? If we take a more holistic approach, we see that the public health impacts of climate change are only one subset of the enormous public health impacts of fossil fuel burning. This broader perspective can provide a more accurate and comprehensive assessment that is more useful for decision making in public policy settings.

New Public Health research in Ukraine and other countries

Directory of Open Access Journals (Sweden)

Andreeva, Tatiana

2012-07-01

Full Text Available This issue of the journal Tobacco Control and Public Health in Eastern Europe (TCPHEE covers studies presented at the Second conference ‘Economics, Sociology, Theory, and Practice of Public Health’. Compared to the content of the same conference last year (Andreeva 2011, in 2012, wider range of participants took part in the conference, both geographically and institutionally.The presented materials are partly concentrated around particular health outcomes, including mortality (Krasovsky 2012; Tigova et al. 2012, some diseases, mostly infectious ones, such as tuberculosis (Baranovska and Doroshenko 2012; Besieda and Semigina 2012 and HIV-infection (Dumchev et al. 2012; Klymenko and Semigina 2012; Shulga 2012; Vasylyeva et al. 2012b; Zhabenko and Zhabenko 2012 and some of the non-communicable diseases including diabetes (Bondarenko and Danyliv 2012 and cancers (Fomenko and Stepurko 2012; Khryshchuk 2012.The presented studies also discuss those determinants of health which contribute to the existing disease burden including structural factors on macro-level related to health policies (Besieda and Semigina 2012; Klymenko and Semigina 2012; Krasovsky 2012; Semigina 2012; Tigova et al. 2012 and health systems (Akbirov 2012; Fomenko and Stepurko 2012; Melnyk et al. 2012; Raminashvili et al. 2012; Salo and Yakovlev 2012b, a; Zenchenko et al. 2012; Kozlova and Gryga 2012. Two papers are devoted to the attitudes and perceptions of health workers in particular (Kozlova and Gryga 2012; Zhabenko and Zhabenko 2012. One study has analyzed the quality of reported clinical trials of a particular group of medicines (Akbirov 2012. Three studies are related to the reforms of health systems (Raminashvili et al. 2012; Salo and Yakovlev 2012b, a. Four studies are related to payments and other financial issues (Baranovska and Doroshenko 2012; Bondarenko and Danyliv 2012; Fomenko and Stepurko 2012; Melnyk et al. 2012. Another group of studies focuses on individual

Liberalism and Public Health Ethics.

Science.gov (United States)

Rajczi, Alex

2016-02-01

Many public health dilemmas involve a tension between the promotion of health and the rights of individuals. This article suggests that we should resolve the tension using our familiar liberal principles of government. The article considers the common objections that (i) liberalism is incompatible with standard public health interventions such as anti-smoking measures or intervention in food markets; (2) there are special reasons for hard paternalism in public health; and (3) liberalism is incompatible with proper protection of the community good. The article argues that we should examine these critiques in a larger methodological framework by first acknowledging that the right theory of public health ethics is the one we arrive at in reflective equilibrium. Once we examine the arguments for and against liberalism in that light, we can see the weaknesses in the objections and the strength of the case for liberalism in public health. © 2015 John Wiley & Sons Ltd.

Enhancing crisis leadership in public health emergencies.

Science.gov (United States)

Deitchman, Scott

2013-10-01

Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives

DEFF Research Database (Denmark)

Orvik, Arne

The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing...... as the disintegration of such values. Possible implications for public health management and leadership include four different forms. The application of the conceptual model can potentially draw attention to value conflicts and help to clarify contradictory, institutional logics. It can also potentially support health...... workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutional theory. It includes five dimensions and defines organizational health in terms of how an organization...

Surfing the net for public health resources.

Science.gov (United States)

Angell, C; Hemingway, A; Hartwell, H

2011-08-01

To identify public health open educational resources (OER) available online, map the identified OER to The Public Health Skills and Career Framework (PHSCF), and triangulate these findings with public health practitioners. Systematic online search for public health OER. An online search was undertaken using a pre-defined set of search terms and inclusion/exclusion criteria. Public health OER were then mapped against the UK PHSCF. The findings of the search were discussed with public health specialists to determine whether or not they used these resources. A number of public health OER were identified, located on 42 websites from around the world. Mapping against the UK PHSCF demonstrated a lack of coverage in some areas of public health education. It was noted that many of the OER websites identified were not those generally used in practice, and those sites preferred by public health specialists were not identified by the online search. Public health OER are available from a number of providers, frequently universities and government organizations. However, these reflect a relatively small pool of original OER providers. Tagging of websites does not always identify their public health content. In addition, users of public health OER may not use search engines to identify resources but locate them using other means. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Intercultural competency in public health: a call for action to incorporate training into public health education

Directory of Open Access Journals (Sweden)

Julia eFleckman

2015-09-01

Full Text Available Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultural roles needs to be included in all processes of planning, implementation and evaluation. In focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt and strengthen intercultural competence education in public health educational institutions.

The State Public Health Laboratory System.

Science.gov (United States)

Inhorn, Stanley L; Astles, J Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M; Wilcke, Burton W; White, Vanessa A

2010-01-01

This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the goal of which is to promote public-private collaboration to assure quality laboratory services and public health surveillance. To enhance the realization of the NLS, the Association of Public Health Laboratories (APHL) launched in 2004 a State Public Health Laboratory System Improvement Program. In the same year, APHL developed a Comprehensive Laboratory Services Survey, a tool to measure improvement through the decade to assure that essential PHL services are provided.

Economic Impact of Smoke-Free Legislation: Did the Spanish Tobacco Control Law Affect the Economic Activity of Bars and Restaurants?

Science.gov (United States)

García-Altés, Anna; Pinilla, Jaime; Marí-Dell'Olmo, Marc; Fernández, Esteve; López, Maria José

2015-11-01

The potential of smoke-free bans to negatively impact the hospitality business has been an argument of the hospitality and tobacco industry against such legislation. A partial smoke-free legislation was introduced in Spain in 2006 allowing smoking in most bars and restaurants due to the pressure of the hospitality sector. However, this partial ban was later amended in 2011 to include all the hospitality premises without exceptions. The stepped Spanish process permits to evaluate whether the entry into force of the smoke-free legislation had any effect on the economic activity of the hospitality sector. We employed a pooled time series cross-sectional design, with national data over 6 years (2006-2011). The dependent variable used was the total number of bars and restaurants per 100,000 inhabitants. The explanatory variables used were the average amount of spending per household in bars and restaurants, and the total unemployment rate in Spain by regions. For every 1% increase in the unemployment rate there was a 0.05% decrease in the number of bars and restaurants. In 2007, the number of bars and restaurants was significantly reduced by 13.06% (all others factors being held constant), 4.87% in 2008, and 10.42% in 2009. No statistically significant effect of the smoke-free legislation emerged from 2010 (6.76%) to 2011 (7.69%). The new Spanish smoke-free legislation had no effect on the number of bars and restaurants. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ethics in public health: call for shared moral public health literacy.

Science.gov (United States)

Maeckelberghe, Els L M; Schröder-Bäck, Peter

2017-10-01

Public Health (PH) in Europe has become much more vocal about its moral understandings since 1992. The rising awareness that PH issues were inseparable from issues of human rights and social justice almost self-evidently directed the agenda of EUPHA and the European Public Health (EPH)-conferences. Problems of cultural and behavioural change, and environmental issues on a global scale were also added. The Section Ethics in PH invited the EPH community to join in 'arm chair thinking': coming together at conferences not only to share the 'how' and 'what' of PH research, practices and policies but also the 'why'. Time has been reserved to genuinely discuss what moral values are at stake in the work of PH and to actively develop a moral language and framework for PH Ethics. The challenge for the next decades is to find ways to involve the general public in the cultivation of a shared moral PH literacy. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Intercultural Competency in Public Health: A Call for Action to Incorporate Training into Public Health Education.

Science.gov (United States)

Fleckman, Julia M; Dal Corso, Mark; Ramirez, Shokufeh; Begalieva, Maya; Johnson, Carolyn C

2015-01-01

Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in public health educational institutions.

Conventional and ecological public health.

Science.gov (United States)

Rayner, G

2009-09-01

This paper suggests that current models of public health are no longer sufficient as a means for understanding the health challenges of the anthropogenic age, and argues for an alternative based upon an ecological model. The roots of this perspective originated within the Victorian era, although it found only limited expression at that time. Ecological thinking in public health has only been revived relatively recently. Derived from an analysis of obesity, this paper proposes the development of an approach to ecological public health based on four dimensions of existence: the material, the physiological, the social and the cultural-cognitive. The implications for public policy are considered.

Evaluating the Effectiveness of France's Indoor Smoke-Free Law 1 Year and 5 Years after Implementation: Findings from the ITC France Survey.

Science.gov (United States)

Fong, Geoffrey T; Craig, Lorraine V; Guignard, Romain; Nagelhout, Gera E; Tait, Megan K; Driezen, Pete; Kennedy, Ryan David; Boudreau, Christian; Wilquin, Jean-Louis; Deutsch, Antoine; Beck, François

2013-01-01

France implemented a comprehensive smoke-free law in two phases: Phase 1 (February 2007) banned smoking in workplaces, shopping centres, airports, train stations, hospitals, and schools; Phase 2 (January 2008) banned smoking in hospitality venues (bars, restaurants, hotels, casinos, nightclubs). This paper evaluates France's smoke-free law based on the International Tobacco Control Policy Evaluation Project in France (the ITC France Project), which conducted a cohort survey of approximately 1,500 smokers and 500 non-smokers before the implementation of the laws (Wave 1) and two waves after the implementation (Waves 2 and 3). Results show that the smoke-free law led to a very significant and near-total elimination of observed smoking in key venues such as bars (from 94-97% to 4%) and restaurants (from 60-71% to 2-3%) at Wave 2, which was sustained four years later (6-8% in bars; 1-2% in restaurants). The reduction in self-reported smoking by smoking respondents was nearly identical to the effects shown in observed smoking. Observed smoking in workplaces declined significantly after the law (from 41-48% to 18-20%), which continued to decline at Wave 3 (to 14-15%). Support for the smoke-free laws increased significantly after their implementation and continued to increase at Wave 3 (plaws, smoking in the home did not increase after the law was implemented and prevalence of smoke-free homes among smokers increased from 23.2% before the law to 37.2% 5 years after the law.

Why feminism in public health?

Science.gov (United States)

Hammarström, A

1999-12-01

The issues raised in this editorial and exemplified within a number of the studies reported in this issue indicate new directions for public health, directions which take feminist scholarship, both outside and within the medical framework, into account. The changing potential of feminist public health, as derived from the articles in this issue, can be summarised within the following issues: new research areas, positioning women as actors, development of theoretical frameworks, reflexive theory of science, interplay between sex and gender, gender-sensitive methods, diversities among women/men, pro-feminist research on men's health and using the results for change. Thus, feminist public health represents a shift towards the new public health, with holistic and multidisciplinary activities, based on theoretical pluralism, multiple perspectives and collective actions with the aim of improving the health of gender-subordinated groups.

Education Improves Public Health and Promotes Health Equity.

Science.gov (United States)

Hahn, Robert A; Truman, Benedict I

2015-01-01

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health - an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. © The Author(s) 2015.

Applications of health information exchange information to public health practice.

Science.gov (United States)

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-01-01

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US' investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health.

41 CFR 102-74.351 - If a state or local government has a smoke-free ordinance that is more strict than the smoking...

Science.gov (United States)

2010-07-01

... government has a smoke-free ordinance that is more strict than the smoking policy for Federal facilities... REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Smoking § 102-74.351 If a state or local government has a smoke-free ordinance that is more strict than the smoking policy for Federal facilities...

Public health emergencies in urban India

Directory of Open Access Journals (Sweden)

Bhabani Prasad Acharya

2018-03-01

Full Text Available Public health emergencies in urban India can be caused by natural or man-made disasters. Occurrence of a public health emergency adds to the already stretched health system. This paper looks into the public health emergency conditions in urban India, and our preparedness to tackle them. To address this composite threat to nation’s health and development, a concerted public health response is needed, that can ensure efficient delivery in emergency situations Public health emergency is an occurrence or eminent threat of an illness or health condition caused by bio-terrorism, epidemic or pandemic disease, or novel and highly fatal infectious agent or biological toxin, that possess a substantial risk of a significant number of human facilities or incidents or permanent or long–term disability (1. It is a condition that requires the government to declare a state of public health emergency. The declaration of a state of public health emergency permits the government to suspend state regulations,and change the functions of state agencies (2. Term “Urban” refers to perplexing variety of environments.  Health circumstances of small cities and town differ in many ways from larger cities and metros. Within cities, change in lifestyle of residents is observed. The urban system is often present with full array of health providers ranging from traditional healer, street drug seller to highly –trained surgeons (3.

Influencing public health without authority.

Science.gov (United States)

Suresh, K

2012-01-01

This paper analyzes the present processes, products and needs of post-graduate public health education for the health programming, implementation and oversight responsibilities at field level and suggests some solutions for the institutes to adopt or adapt for improving the quality of their scholars. Large number of institutions has cropped up in India in the recent years to meet the growing demand of public health specialists/practitioners in various national health projects, international development partners, national and international NGOs. Throwing open MPH courses to multi-disciplinary graduate's is a new phenomenon in India and may be a two edged sword. On one hand it is advantageous to produce multi-faceted Public health postgraduates to meet the multi tasking required, on the other hand getting all of them to a common basic understanding, demystifying technical teaching and churning out products that are acceptable to the traditional health system. These Institutions can and must influence public health in the country through producing professionals of MPH/ MD degree with right attitude and skill-mix. Engaging learners in experimentation, experience sharing projects, stepping into health professionals' roles and similar activities lead to development of relatively clear and permanent neural traces in the brain. The MPH institutes may not have all efficient faculties, for which they should try to achieve this by inviting veterans in public health and professionals from corporate health industry for interface with students on a regular basis. The corporate and public health stalwarts have the capacities to transmit the winning skills and knowledge and also inspire them to adopt or adapt in order to achieve the desired goals.

Twitter and Public Health (Part 1): How Individual Public Health Professionals Use Twitter for Professional Development.

Science.gov (United States)

Hart, Mark; Stetten, Nichole E; Islam, Sabrina; Pizarro, Katherine

2017-09-20

The use of social networking sites is increasingly being adopted in public health, in part, because of the barriers to funding and reduced resources. Public health professionals are using social media platforms, specifically Twitter, as a way to facilitate professional development. The objective of this study was to identify public health professionals using Twitter and to analyze how they use this platform to enhance their formal and informal professional development within the context of public health. Keyword searches were conducted to identify and invite potential participants to complete a survey related to their use of Twitter for public health and professional experiences. Data regarding demographic attributes, Twitter usage, and qualitative information were obtained through an anonymous Web-based survey. Open-response survey questions were analyzed using the constant comparison method. "Using Twitter makes it easier to expand my networking opportunities" and "I find Twitter useful for professional development" scored highest, with a mean score of 4.57 (standard deviation [SD] 0.74) and 4.43 (SD 0.76) on a 5-point Likert scale. Analysis of the qualitative data shows the emergence of the following themes for why public health professionals mostly use Twitter: (1) geography, (2) continuing education, (3) professional gain, and (4) communication. For public health professionals in this study, Twitter is a platform best used for their networking and professional development. Furthermore, the use of Twitter allows public health professionals to overcome a series of barriers and enhances opportunities for growth. ©Mark Hart, Nichole E Stetten, Sabrina Islam, Katherine Pizarro. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 20.09.2017.

Public health terminology: Hindrance to a Health in All Policies approach?

Science.gov (United States)

Synnevåg, Ellen S; Amdam, Roar; Fosse, Elisabeth

2018-02-01

National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms 'public health' and 'public health work' are suitable when implementing an HiAP approach. A qualitative case study based on analyses of interviews and planning documents was performed in three Norwegian municipalities. The results present dilemmas associated with using public health terminology when implementing an HiAP approach. On the one hand, the terms are experienced as wide, complex, advanced and unnecessary. On the other hand, the terms are experienced as important for a systematic approach towards understanding public health ideology and cross-sectional responsibility. One municipality used alternative terminology. This paper promotes debate about the appropriateness of using the terms 'public health' and 'public health work' at the local level. It suggests that adaptation is suitable and necessary, unless it compromises knowledge, responsibility and a systematic approach. This study concludes that the use of terminology is a central factor when implementing the Norwegian Public Health Act at the local level.

Public health challenges in sun protection.

Science.gov (United States)

Eide, Melody J; Weinstock, Martin A

2006-01-01

Sunscreens are a popular choice for protection from ultraviolet radiation, and hence, important components in the public health campaign to reduce the burden of skin cancer. Public health messages in skin cancer prevention have been used effectively in educational campaigns. The benefits of sunscreen extend beyond skin cancer prevention into other aspects of health and disease prevention: sunscreen decreases the risk for sunburn during physical activity outdoors and seems not to increase the risk for osteoporosis. Public health efforts have laid a solid foundation on which to face the continuing challenge of promoting and developing effective public health campaigns and health policies that encourage sunscreen use, sun protection, and the primary prevention of skin cancer. In this article, the controversies, concerns, and challenges of sunscreen use as it relates to public health are discussed.

Periodontal health and global public health

DEFF Research Database (Denmark)

Petersen, Poul E; Baehni, Pierre C

2012-01-01

Chronic diseases are a growing burden to people, to health-care systems and to societies across the world. The rapid increase in the burden of chronic diseases is particularly prevalent in the developing countries. Periodontal disease is one of the two most important oral diseases contributing...... to the global burden of chronic disease. In addition to social determinants, periodontal health status is related to several proximal factors. Modifiable risk factors, such as tobacco use, excessive alcohol consumption, poor diet and nutrition, obesity, psychological stress and insufficient personal....../oral hygiene, are important and these principal risk factors for periodontal disease are shared by other chronic diseases. The present monograph is devoted to the existing evidence on the practice of public health related to periodontal health. Public health is defined as the process of mobilizing and engaging...

Public Health Autonomy: A Critical Reappraisal.

Science.gov (United States)

Zimmerman, Frederick J

2017-11-01

The ethical principle of autonomy is among the most fundamental in ethics, and it is particularly salient for those in public health, who must constantly balance the desire to improve health outcomes by changing behavior with respect for individual freedom. Although there are some areas in which there is a genuine tension between public health and autonomy-childhood vaccine mandates, for example-there are many more areas where not only is there no tension, but public health and autonomy come down to the same thing. These areas of overlap are often rendered invisible by a thin understanding of autonomy. Better integrating newer theoretical insights about autonomy into applied ethics can make discussions of public health ethics more rigorous, incisive, and effective. Even more importantly, bringing modern concepts of autonomy into public health ethics can showcase the many areas in which public health and autonomy have the same goals, face the same threats, and can be mutually advanced by the same kinds of solutions. This article provides a schema for relational autonomy in a public health context and gives concrete examples of how autonomy can be served through public-health interventions. It marshals insights from sociology, psychology, and philosophy to advance a theory of autonomy and coercion that recognizes three potential threats to autonomy: threats to choice sets, threats to knowledge, and threats to preferences. © 2017 The Hastings Center.

(Public) Health and Human Rights in Practice.

Science.gov (United States)

Annas, George J; Mariner, Wendy K

2016-02-01

Public health's reliance on law to define and carry out public activities makes it impossible to define a set of ethical principles unique to public health. Public health ethics must be encompassed within--and consistent with--a broader set of principles that define the power and limits of governmental institutions. These include human rights, health law, and even medical ethics. The human right to health requires governments not only to respect individual human rights and personal freedoms, but also, importantly, to protect people from harm from external sources and third parties, and to fulfill the health needs of the population. Even if human rights are the natural language for public health, not all public health professionals are comfortable with the language of human rights. Some argue that individual human rights--such as autonomy and privacy--unfairly limit the permissible means to achieve the goal of health protection. We argue that public health should welcome and promote the human rights framework. In almost every instance, this will make public health more effective in the long run, because the goals of public health and human rights are the same: to promote human flourishing. Copyright © 2016 by Duke University Press.

Primary health care and public health: foundations of universal health systems.

Science.gov (United States)

White, Franklin

2015-01-01

The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

Chiropractic care and public health

DEFF Research Database (Denmark)

Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre

2012-01-01

The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...... disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession...

Public health medicine: the constant dilemma.

Science.gov (United States)

Eskin, Frada

2002-03-01

There is a well-known quotation by the nineteenth-century sociologist Virchow (quoted in Ref. 1) that aptly captures the dilemma that has confronted public health medicine since the specialty was created as a discrete entity in 1848. Virchow said: 'Medicine is politics and social medicine is politics writ large!' What does this mean in relation to effective public health medicine practice and how is it likely to affect its future? There is increasingly limited freedom of expression within the current context of political correctness, central control and a rapidly burgeoning litigious climate. The purpose of this paper is to explore these issues and to propose a means of maintaining public health medicine integrity within a working environment where action is becoming rapidly constrained by political rigidity. An additional factor to be included in the dialogue is the current context within which public health physicians work. Because the majority of public health doctors are employed within the National Health Service (NHS), they are finding themselves being expected to take on tasks and responsibilities marginal to their essential purpose and function. For example, public health physicians spend a great deal of time involved in detailed deliberations about health service provision. Although there is a great deal of evidence to show that good quality health care provision positively affects the health of the individual, there is no evidence to show that this activity has any effect on the population's health status. The essence of public health medicine practice is the prevention of ill-health and the promotion of the health of the population and, consequently, attention needs to be focused on the root causes of disease. However, as these are outside the aegis of the NHS, public health medicine involvement in such issues as education, nutrition, housing, transport and poverty is regarded as marginal to the NHS corporate agenda.

77 FR 17065 - Proposed Data Collections Submitted for Public Comment and Recommendations

Science.gov (United States)

2012-03-23

... a voluntary basis through changes in leasing agreements and advertising, however, smoking... measured and will quantify how exposure changes when smoke-free policies are implemented. In addition, the... cost-effectiveness of these policies. CDC is authorized to conduct this investigation by the Public...

Child public health

National Research Council Canada - National Science Library

Blair, Mitch

2010-01-01

"Despite children making up around a quarter of the population, the first edition of this book was the first to focus on a public health approach to the health and sickness of children and young people...

[Survey on public health nursing education-in the comparison of nursing education courses, universities, advanced courses for public health nurse with junior nursing colleges, and public health nursing school].

Science.gov (United States)

Hirano, Kayoko; Ikeda, Nobuko; Kanagawa, Katuko; Shiomi, Sigeki; Suzuki, Akira; Hirayama, Tomoko; Furuya, Akie; Ymazaki, Kyoko; Yasumura, Seiji

2005-08-01

Changes in public health nursing education have been consideration. Theses changes include a dramatic increase in the number of public health nurses (PHNs) who have enrolled for nursing courses at university. This study was conducted to assess the current status and future of public health nursing education as perceived by teachers and students at three types of schools: universities offering nursing courses, advanced courses for PHNs with junior nursing colleges, and public health nursing schools. Questionnaires were distributed to teachers and students by mail. The questions that were sent to teachers asked which subjects were required to become a certified PHN, which lecture methods were employed to teach public health-particularly community health assessment methods, and what was the level of awareness of the activities of PHNs. Students were asked about their motivation to be a PHN, their understanding of public health, their views of public health activities and their images of PHNs. Responses were analyzed and differences between questionnaires from different schools were noted. These included the number of subjects and the total number of hours spent doing practical training and field experience in universities and the other types of schools, and the number of teachers. Differences also were noted among students at three types of schools about their age, methods of public health activities, knowledge about activities undertaken by PHNs, and their images of PHNs. No differences were observed among the schools with respect to the students' conceptual understanding of public health. Student age, practical training and field experience were found to contribute to their level of understanding of public health and public health nursing. It is thus necessary to consider the teaching methods employed by universities that administer nursing courses and the effectiveness of courses offered by graduate schools.

Protecting Health and Saving Lives: The Part-Time/Internet-Based Master of Public Health Program at the Johns Hopkins Bloomberg School of Public Health