浅析控烟协会在控烟工作中的重要作用

随着科学的进步和人民群众思想文化素质的提高 ,吸烟对健康的危害已越来越被人们所认识。自 1979年以来 ,国家及有关部委相继颁布有关控烟的法令、法规 ,如《烟草专卖法》、《广告法》、《未成年人保护法》、《公共场所卫生管理条例》、《公共交通工具上禁止吸烟》等 ,在这些法规中 ,对有关控烟问题都作了相应的规定。湖北省吸烟与健康协会本着组织协调全省的控烟工作 ,发挥协会在宣传烟草危害、减少吸烟相关疾病、提高人民群众的健康水平方面的积极作用。1　总体策划作用控烟协会的主要任务就是向政府有关部门及新闻传播媒介提供国内外有关…     

开展控烟教育 净化就医环境

吸烟有害健康,是不争的事实,并早已为医学科学调查所证实。尤其是近十年来,市民的健康意识不断提高,主管部门、社区及有关媒体开展的控烟宣传及公共场所禁止吸烟的活动声势浩大,许多地区的立法机构或政府部门还制订了有关法规或法规性文件。但据有关资料报道,我国烟民的总数仍在不断上升。因此,如何摆脱烟草的危害,尤其是从事医疗保健工作的医疗卫生机构的控烟问题,是医院健康教育工作的重点和难点之一。我院领导十分重视医院健康教育工作,特别是在控烟宣传教育方面极为重视,并取得了一定的成效。我们着重抓了以下几个方面的工作。     

南宁市控烟现状调查分析

目的了解南宁市控烟现状,开展控烟需求评估、控烟活动效果评估,创建无烟环境、降低被动吸烟的危害。方法根据“迈向无烟中国”项目组“项目基线调查方案”制订南宁市“迈向无烟中国”项目基线调查方案”,对南宁市控烟政策、控烟能力、网络现状,六种场所不同人群控烟知识知晓率,以及烟草企业现状进行调查。结果公共场所禁烟规定有着良好的群众基础,控烟网络建设有待完善,公众对被动吸烟健康危害的认识及对部分公共场所禁烟政策的支持尚有待提高。结论南宁市控烟工作基础薄弱,应积极促使公共场所禁止吸烟相关法规的出台和实施,整合控烟力量。建立控烟网络,创建无烟环境。努力提高南宁市的控烟能力,最终减少被动吸烟的暴露。     

发挥相关部门作用 做好控烟干预工作

1995年起 ,我市在创建卫生城市、文明城市等活动中 ,注意发挥相关部门作用 ,采用综合干预的方法做好控烟工作 ,收效良好。1　发挥政府的组织协调作用控烟工作仅仅依靠健康教育工作者的努力是难以奏效的 ,它首先需要政府政策上的支持。为此 ,我市于 1995年出台了《太仓市公共场所控烟规定》 ,1998年转发了《苏州市公共场所禁止吸烟管理办法》 ,公共场所控烟工作从此逐步走上了规范化、法制化之路。据此 ,我市加强了对文化娱乐场所、商场、会议室等公共场所的控烟执法活动 ,且对执行不力者进行了监督、处罚。目前 ,我市购物、休闲场所空气清新…     

柳州社区控烟效果分析及社区控烟对策设想

社区控烟活动以动员全社会积极参与为宗旨。 1 995～ 1 999年间 ,柳州市爱卫办在全市范围开展了社区控烟研究。方　　法1 实施控烟法规　①开展爱国卫生先进单位及无烟先进单位的评比活动。将控烟工作纳入“柳州市爱国卫生先进单位”标准中。②实施“柳州市公共场所禁止吸烟的暂行规定”(1 996年 ,柳州市政府出台 )。2 营造控烟环境　在全市范围内开展戒烟竞赛 ,给戒烟者营造一个良好的戒烟环境。利用大众传媒。有关部门及社会团体向市民开展宣传 ,营造控烟氛围。3 开展健康教育　①利用大众传播媒体对全市进行健康教育。在电视台播放控烟…     

上海市医疗卫生机构2010—2014年度控烟监管状况分析

《上海市公共场所控制吸烟条例》^[1]（以下简称《条例》）于2010年3月1日起在上海全面实施。《条例》是在1994年《上海市公共场所禁止吸烟规定》的基础上,为进一步推进上海控烟工作而出台的地方性法规。上海市卫生计生行政部门按照《条例》的要求,对医疗卫生机构、机关办事场所、商场、超市、金融服务场所等控烟场所开展监督执法。到2015的2月28日,该《条例》已经实施了5年。其中,医疗卫生机构的控烟工作由于管理对象及对控烟     

学校控烟健康教育有关问题探讨

当前 ,青少年吸烟已成为人们日益关注的问题。在中国3.2亿烟民中 ,很多是在青少年时期即开始使用烟草的 ,1/ 3至 1/ 2的青少年尝试吸烟后养成吸烟习性并成瘾。因此 ,在学校开展控烟健康教育显得尤其重要 ,是落实《教育法》和《未成年人保护法》的具体体现。控烟活动的开展将大大有利于提高全民族的人口素质 ,提高青少年的身心素质 ,有利于为社会培养更多的高素质的健康、文明的有用之才。通过近几年在湖北省几所学校开展的控烟健康教育试点活动 ,对学校控烟健康教育有关问题进行探讨。1　学校控烟教育需要有领导支持环境学校控烟的成效如何…     

宜昌市居民吸烟状况及对控烟措施态度的调查

据报道,我国的吸烟人数及吸烟人数增加量均名列世界第一,现有吸烟人数已超过3亿。我国对此已采取了若干措施,使吸烟率逐渐下降。宜昌市人民政府于1996年10月颁布了《宜昌市部分公共场所禁止吸烟规定》。为了解实施该规定后市民对吸烟与控烟的认识,探索影响吸烟行为的有关因素,为进一步的控烟活动提供依据,对宜昌市城区6500名居民的吸烟状况、吸烟有害健康知识的知晓程度及对控烟措施的态度等进行了调查,其结果如下。     

控烟专栏

正2006年我国加入《烟草控制框架公约》后,中办和国办联合发布了《关于领导干部带头在公共场所禁烟有关事项的规定》,目前有北京等10几个有立法权的城市出台了地方控烟法规,国务院《公共场所控制吸烟条例》草案面向社会广泛征求意见。在控烟实践工作中,控烟立法和执法是两个重要方面的工作。来自中     

“史上最严控烟令”以严取胜？

近日，国务院法制办公布了国家卫生计生委起草的《公共场所控制吸烟条例（送审稿）》，并公开征求意见。这是我国首次拟制定行政法规在全国范围全面控烟。根据该送审稿，所有室内公共场所一律禁止吸烟。同时，以未成年人为主要活动人群的公共场所，如托幼机构、学校等，其室外区域，高等学校的室外教学区域，妇幼保健机构、儿童医院的室外区域等候区域等也全面禁止吸烟。     

上海市居民吸烟、戒烟及被动吸烟现状

目的 了解上海市15岁及以上居民的吸烟、戒烟和被动吸烟的流行水平,为有针对性的制定控烟措施提供基础资料.方法 利用2007年上海市慢性病及其危险因素监测调查数据,对17174名(男性8072人,女性9102人)15岁及以上居民的吸烟、戒烟和被动吸烟状况进行描述性分析,指标包括吸烟率、现在吸烟率、常吸烟率、重型吸烟率、戒烟率、成功戒烟率、被动吸烟率.结果 男性居民的吸烟率、现在吸烟率、常吸烟率、重型吸烟率分别为61.8%,54.8%,48.5%,28.3%,女性分别为1.2%,1.0%,0.7%和0.2%.人群的戒烟率、成功戒烟率分别为11.3%和8.6%.非吸烟者的被动吸烟率为43.1%,暴露场所主要是工作场所和家中.结论 上海市居民吸烟率、被动吸烟率处于较高水平,戒烟率较低,烟草控制面临巨大挑战.     

Smoking Cessation

Smoking accounts for significant morbidity and mortality and has major economic consequences for healthcare delivery throughout the world. Government policy such as increasing taxes and restricting advertising go some way to reduce smoking, but the social and economic factors that affect target populations will impact on the success of any strategy.Public health interventions can also contribute to increasing cessation rates. The most successful interventions appear to be those characterised by personalised advice and assistance, repeated in different forms over the longest feasible period of time. Pharmacological aids, which are important components of a cessation programme, include nicotine replacement therapy in the form of chewing gum, patches, nasal spray, oral inhaler or sublingual tablets; bupropion (amfebutamone) has been approved for use in some countries. As the community pharmacy is the major point of supply of such products, the pharmacist is in a key position to encourage and support clients who wish to stop smoking.A number of studies have examined the role of the community pharmacist in assisting smokers through the so-called ‘cycle of change’. These studies have utilised a model that offers individualised advice through a motivational technique to encourage a change in behaviour; nicotine replacement therapy is optional. Follow-up is an essential part of these programmes to monitor progress and to provide additional support. Evaluations of these pharmacy-based initiatives have confirmed the importance of a multifaceted approach in achieving success in smoking cessation, i.e. behaviour modification, nicotine replacement therapy and client support.     

深圳市常住居民吸烟、戒烟与被动吸烟现状分析

目的 了解深圳市15岁以上常住居民吸烟、戒烟与被动吸烟的分布和流行情况,为控制烟草使用、创建无烟环境提供依据.方法 采用多阶段整群随机抽样的方法,对深圳市8 782名15岁以上常住居民进行问卷调查.结果 调查人群吸烟率为16.47％,现在吸烟率为16.34％,常吸烟率为14.30％,重型吸烟率为7.74％,被动吸烟率为...     

Smoking cessation

We estimate that more than 80% of tobacco-smokers hope that they will stop smoking one day. The major obstacle is the psychologic and pharmacologic dependence generated by the cigarette. Different weaning methods have been tried, but their rate of success remains low. The nicotinic sustitution by transdermic track (patch) will give good results providing it is prescribed within the framework of a medical help to wean away from smoking tobacco.     

The Effect of Household Smoking Bans on Household Smoking

Objectives. Because household smoking levels and adoption of domestic smoking rules may be endogenously related, we estimated a nonrecursive regression model to determine the simultaneous relationship between home smoking restrictions and household smoking.Methods. We used data from a May–June 2012 survey of Philadelphia, Pennsylvania, households with smokers (n = 456) to determine the simultaneous association between smoking levels in the home and the presence of home restrictions on smoking.Results. We found that home smoking rules predicted smoking in the home but smoking in the home had no effect on home smoking restrictions.Conclusions. Absent in-home randomized experiments, a quasi-experimental causal inference suggesting that home smoking rules result in lower home smoking levels may be plausible.Secondhand smoke (also known as “passive smoking” or “environmental tobacco smoke”) is a health hazard for children and adults.1–5 Institutional, city, or national smoking restrictions reduce smoking prevalence and the average consumption of smokers while naturally limiting exposure to secondhand smoke.6–11 At the household level, the research focus has been on the efficacy of household bans on indoor smoking to reduce nonsmokers’ and children’s exposure.12–18 Many studies have found that smokers in households with smoking bans or restrictive smoking rules smoke fewer cigarettes than smokers in households with no bans or rules.19–23 This relationship appears to suggest that household smoking restrictions are effective in reducing household smoking. But do household bans really reduce household smoking? Unfortunately, this situation is not the same as when smoking bans are implemented in bars,24,25 hospitals,26 prisons,27 schools,28 or countries.29,30 In all of these examples, the bans are introduced independently of the prevalent smoking levels of the institution, city, or country because passive smoking exposure is seen as an important health hazard that requires an administrative or legislative response.In households, this analogy does not necessarily hold. Household smoking could be negatively related to household smoking bans because smokers who smoke fewer cigarettes or households with little smoking may implement a household smoking ban whereas heavier smokers or households with multiple smokers could not do so.23,31 In this situation, household smoking bans are endogenous32 relative to household smoking, which implies that household smoking levels cause the smoking ban, not the reverse. To determine which explanation is correct, an experiment that implemented a household ban randomly in regard to household smoking levels would be appropriate.14,33,34 Under experimental conditions, the ban would be independent of household smoking levels and the effect of implementing a household smoking ban on smoking could be unambiguously estimated.     

Association Between Neighborhood-Level Smoking and Individual Smoking Risk: Maternal Smoking Among Latina Women in Pennsylvania

Objective

We examined whether or not high maternal smoking rates at the neighborhood level increase the likelihood of individual smoking by Latina women in the three months prior to and during pregnancy, independent of other individual and neighborhood factors.

Methods

This study was observational in nature, using linked vital statistics records for 24,443 Latina women in Pennsylvania (2009–2010) and U.S. Census data for 2,398 census tracts. We used multilevel logistic regression models to determine the individual odds of self-reported maternal smoking given different census tract-level rates of maternal smoking in the previous three years (2006–2008), adjusting for maternal and census-tract characteristics, including ethnic density, population density, and poverty.

Results

Higher levels of maternal smoking at the census-tract level were associated with increased individual odds of smoking among Latina mothers. In the fully adjusted model, a 10% increase in the neighborhood smoking rate was associated with a 1.28 (95% confidence interval 1.22, 1.34) increase in the individual odds of smoking.

Conclusion

Latina women living in census tracts where more women have smoked during or immediately prior to pregnancy are themselves at higher risk of smoking during this period.Tobacco control is a U.S. public health priority and maternal smoking is of particular importance.¹ Maternal smoking is associated with premature birth and low birthweight, birth defects, sudden infant death syndrome, and the exacerbation of childhood asthma and other respiratory disorders.² Furthermore, parental smoking increases the risk that children themselves will smoke as adults.³ In the United States, one in every seven women is estimated to smoke during pregnancy.⁴ Although women of Latina heritage are less likely to smoke than women from other ethnic/racial groups, Latina women account for approximately 23% of U.S. births each year.^5,6 A 1% absolute decrease in maternal smoking among Latina women would impact the health and well-being of more than 9,000 infants and mothers of Latina origin annually.Individual risk factors for prenatal and maternal smoking among Latina women in the United States include poverty, lower education levels, younger age, English language preference, and U.S. nativity.^7–9 Smoking behaviors also have been found to be contingent upon neighborhood characteristics, meaning the physical, demographic, or social characteristics of the relatively small geographic area surrounding one''s residential address. This research has predominantly focused on smoking among the general adult and adolescent populations.^10–14 For example, Xue et al. found that high co-ethnic density (i.e., a neighborhood characteristic defined at the level of census block groups) decreased the risk of tobacco use by African American adolescents independent of individual characteristics such as age, socioeconomic status (SES), and exposure to parental substance use.¹⁰ Similarly, Kandula et al. found that Asian American women living in “Asian enclaves” (i.e., census tracts with ≥50% Asian residents) in California were less likely to smoke than women not living in Asian enclaves, even after taking into account individual characteristics such as age, marital status, education, income, emotional well-being, duration of U.S. residency, and language spoken at home. Notably, neighborhood SES (a composite measure comprising concentrated affluence, concentrated poverty, percentage of college-educated residents, and percentage of home ownership) was not associated with increased or decreased odds of smoking in this minority population.¹⁵A limited but evolving literature has focused on neighborhood-level factors associated with smoking during pregnancy. Studies examining neighborhood-level associates of maternal smoking in Sweden, South Carolina, and California have found that neighborhood poverty is independently associated with risk of tobacco use during pregnancy.^16,17 In a nationwide analysis of U.S. natality files, Shoff and Yang found that after adjusting for individual-level characteristics such as age, education, and race/ethnicity, a one-unit increase in county-level SES (a composite measure comprising various county-level statistics for educational attainment, income, occupation, and household composition) was associated with a 21% decrease in the individual likelihood of smoking during pregnancy. They also found that women in rural counties were less likely than women in non-rural areas to smoke during pregnancy.¹⁸ Shaw et al. also found that as county-level co-ethnic density increases, Latina women are substantially less likely to smoke during pregnancy. For example, Latina women in U.S. counties with <1% Latino residents compared with Latina women in counties with 15% to <50% Latino residents had an adjusted odds ratio for smoking during pregnancy of 0.35 (95% confidence interval [CI] 0.28, 0.42). Among Latina women living in counties with ≥50% Latino residents, the adjusted odds ratio was 0.11 (95% CI 0.07, 0.17).¹⁹The relationships between neighborhood measures and individual behavior may be mediated by structural, spatially correlated factors, such as the availability of tobacco products and exposure to tobacco advertising. They may also be mediated by social factors, such as decreased chronic stress in neighborhoods in which high co-ethnic density results in greater social connectedness, support, or cohesion for members of the dominant ethnic group. It is also possible that this association is due to differences in social norms (i.e., shared beliefs about how people should behave).^20–22 In general, Latina women who live in neighborhoods with a high proportion of Latino residents are also living in neighborhoods where maternal smoking is infrequent. This environment may reinforce a perceived social norm—that women do not smoke during preconception or pregnancy (or smoke at all)—that may be a more important determinant of individual maternal smoking behavior than the neighborhood''s ethnic composition. This potential social norm that exists in Latino neighborhoods is suggested by an analysis completed by Shaw and Pickett, who demonstrated that non-Latina women living in U.S. counties with ≥50% Latino residents are also much less likely to smoke during pregnancy than women who live in less Latino-dense areas, independent of individual characteristics such as age, marital status, and education.²³ Shoff and Yang also found that the individual odds of smoking during pregnancy were lower for women living in counties with a higher proportion of Latino residents compared with women living in neighborhoods with lower proportions of Latino residents, adjusting for maternal race/ethnicity.¹⁸We sought to advance this literature by examining the relationship between peer smoking rates at the census-tract level and the individual-level probability of smoking in the three months prior to or during any trimester of pregnancy. We hypothesize that Latina women living in census tracts where more women smoke immediately prior to or during pregnancy will themselves be more likely to smoke prior to or during pregnancy, independent of other individual and census tract-level risk factors. Because residential Latino ethnic density has a strong relationship with maternal smoking, and because maternal smoking behaviors differ significantly among racial/ethnic groups, we focused our analysis on Latina women.^5,24