Banning smoking in a children's hospital: are employees supportive?

This study surveyed 762 professional and auxiliary employees in a large urban children's hospital to assess readiness for a total ban on smoking. The prevalence of never smokers was 63.1%, former smokers was 21.1%, and current smokers was 15.1%. Among nonsmokers, 83% indicated that a children's hospital should be smoke-free. The attitudes of former smokers were almost identical to those of never smokers. Less than half of current smokers (43%) agreed with a ban on smoking which suggests some support for a smoke-free setting even among smokers. In multivariate analysis, smokers, however, were eight times less likely to agree with such a policy, independent of age, sex, and occupation. This study suggests that the majority of employees are supportive of a total ban on smoking but that special efforts to help smokers stop smoking may enhance the effectiveness of a policy banning smoking in a children's health care facility.     

A comparative evaluation of a restrictive smoking policy in a general hospital.

The impact of a restrictive smoking policy on the behavior and attitudes of smokers and non-smokers was assessed by surveying random cross-sectional samples of hospital employees before, six months after and 12 months after the policy was implemented, and comparing responses with those of employees of a hospital with no restrictive policy. Effectiveness of policy implementation was also evaluated. Results indicated that the policy was well-publicized and was approved by virtually all the non-smokers and the majority of the smokers. Following implementation, employees in the smoking policy hospital were less likely to report being bothered by smoke at their work stations than were employees of the comparison hospital. Six months and one year after the policy change, smokers reported lower smoking rates while at work, although quit smoking rates and home smoking rates were similar in both hospitals.     

Smoking prevalence and attitudes of Gwynedd Health Authority staff towards passive smoking and the Authority's non-smoking policy

In 1989, a postal survey was undertaken to investigate the smoking prevalence and attitudes of Gwynedd Health Authority employees towards the Authority's non-smoking policy, passive smoking and other related issues. The results show a smoking prevalence rate of 22% for those participating in the survey, with over half of all smokers expressing a wish to stop. Although the rate was similar for males and females, it was marginally higher amongst nursing staff and young employees. Smoking prevalence was highest among the ancillary staff, and lowest among the medical and dental professions. Most employees were in broad agreement with the Authority's non-smoking policy, and a majority thought it about right or favoured extending it. Most non-smokers and ex-smokers believed passive smoking to be a health hazard, with an increased number rating it anti-social. Attitudes towards these issues were similar for males and females, with marked differences between the groups employed in different areas of the service. Younger employees were more aware of the dangers of passive smoking, but less sympathetic towards the policy than the older ones. The findings of this study highlight the differences between smokers and non-smokers on all smoking issues. The implications for health education and the Authority's non-smoking policies are discussed.     

Behavioral, attitudinal, and physiologic characteristics of smoking and nonsmoking asbestos-exposed shipyard workers

The smoking characteristics of shipyard workers participating in an Asbestos Medical Surveillance Program (N = 3,991) were assessed. Sources of data were: (1) a self-assessment questionnaire on the smoking history and respiratory symptomatology of the 871 current smokers who participated in the smoking study, and (2) chest roentgenograms and pulmonary function test results and medical records for the entire population. The study population included 1,711 current smokers, 988 former smokers and 1,292 never smokers. The annual "quit rate" for former smokers had increased from less than 1% in 1961 to 4.2% in 1978. Of the 871 current smokers who participated in the smoking study, 19% had resumed smoking after having given up cigarettes for one year or longer. Men in the smoking study were reasonably well informed about the health consequences of smoking. While they perceived themselves to be susceptible to disease, and the disease to be serious, the benefits they saw in quitting were related more to economics and aesthetics than to health. When the results were age adjusted, no differences in rate of pulmonary function abnormalities and chest film abnormalities were found between current smokers who voluntarily participated in the smoking study and those who did not. All pulmonary function testing abnormality and chest film abnormality rates were significantly lower for former smokers and never smokers.     

Smoking habits and smoking cessation among North Carolina nurses

A 1987 questionnaire survey of a 1% random sample (n = 356) of registered nurses in North Carolina provided data on the smoking habits and smoking cessation. Fifty-six percent were never smokers; 19% were current smokers. Among the ever smokers, 31% had quit smoking for at least one year. Twenty-two percent of the former smokers had smoked less than 5 years and 39% less than 10 years before quitting. Anecdotal notes from never smokers suggested that their major deterrent to smoking was their own parents smoking. Concerns about the addictive smoking behavior and health effects of smoking observed in their parents as well as concerns about potential health risks to themselves deterred them from smoking. Concerns about the adverse consequences of smoking was the most influential factor influencing smoking cessation and reduction of cigarette smoking. Friends' and family's encouragement to stop smoking was the most influential external factor motivating nurses to quit or reduce cigarette consumption. Fifty-seven percent of the former smokers quit smoking after one or two attempts while 53 of the current smokers had tried to quit 3 or more times - 90% had tried at least once to quit smoking; however, only 18% of the current smokers had abstained for more than one year during any of their attempts to quit. Implications of the results include: (1) smoking cessation programs for nurses in the workplace may have considerable impact since the majority of nurses who smoke are tying to quit; (2) relapse prevention strategies need to be an integral part of such smoking cessation programs including involvement of family and friends to support the smokers in their cessation efforts.     

Cigarette smoking: knowledge, attitudes and behaviour in an adult population in Italy

The study explores knowledge, attitudes, and behaviour regarding cigarette smoking and related factors in an adult population. A total of 935 parents of children attending the eighth class of ten randomly selected primary schools in Catanzaro (Italy) received a questionnaire consisting of questions on demographic and socioeconomic characteristics, knowledge, behaviour and attitudes about cigarette smoking. Six hundred and sixty-nine parents returned the questionnaire, with a response rate of 71.5%. Knowledge of risk associated to smoking was significantly higher in more educated subjects and in past smokers compared to current. Current and past smokers were respectively 39.6% and 17.2%, and current smokers were younger, not married, less prone to consider smoking as a major risk for their health and more likely to live with other smokers compared to past and never smokers. Females of higher education were more likely to be current smokers, whereas male current smokers were more likely to be less educated compared to past or never smokers. The results strongly recommend the provision of accurate information about the health consequences related to smoking, with a more intensive involvement of health care providers, particularly targeted to women and younger age groups.     

Passive smoking: an environmental health risk

The supposed health risks of passive smoking are leading to increasingly restrictive legislation on smoking. Tobacco smoke is undoubtedly irritating to the eyes, nose and throat of non-smokers, but politicians wanted more spectacular facts. There is some evidence of fatal consequences of passive smoking, particularly increases in lung cancer and heart-disease mortality among non-smokers exposed to tobacco smoke. Most studies compare the non-smoking partners of smokers and non-smokers. The observed relative risks are too small to be ascertained reliably. The more than twentyfold increased risk of lung cancer among smokers and the presence of tobacco-related metabolites in non-smokers' body fluids lend support to the hypothesis that passive smoking causes lung cancer. The less than twofold increased risk of heart disease among smokers and the documented social-risk factors cast doubt on the validity of the increased risk of heart disease in non-smokers, associated with having a smoking partner. The precautionary principle regulates potential environmental health hazards: the suspicion and the hazard must be sufficiently serious to take legislative action. There is ample evidence of tobacco smoke's carcinogenicity and the accumulated knowledge strongly suggests that the legal threshold of an acceptable environmental health risk has been exceeded.     

Symptom severity in obese women with binge eating disorder as a function of smoking history

OBJECTIVE: To compare obese female former smokers with binge eating disorder (BED) to women with BED with no smoking history in the severity of binge eating and associated symptoms. METHOD: A consecutive series of 91 obese women with current diagnoses of BED were administered structured diagnostic and investigator-based interviews and self-report questionnaires to assess symptoms associated with eating disorders. Participants were classified as "never" or "former" smokers and symptom profiles were compared across smoking groups. RESULTS: Former and never-smoking groups did not differ in age, body mass index, or current binge frequency. Former smokers reported significantly higher levels of dietary restraint, rigid dieting strategies, and avoidance of eating. CONCLUSION: Former smokers were significantly more likely than never-smokers to endorse specific symptoms of eating pathology (i.e., rigid dieting strategies). Despite the average 15-year interval since smoking cessation, the former smokers in this patient group resembled current smokers with other eating disorders in terms of rigid and restrictive weight control methods. Obese patients with a smoking history may benefit from treatment to address rigid/pathological dieting and strategies.     

A multiple discriminant analysis of smoking status and health-related attitudes and behaviors

Using multiple discriminant analysis, we examined several health-related attitudes and behaviors (HABs) simultaneously across groups of university students differing by smoking status (n = 1,077). Nine HABs were considered: health responsibility, exercise, nutrition, interpersonal support, stress management, alcohol consumption, drug use, caffeine consumption, and safety practices. Overall, the findings indicated that HABs, particularly those involving substance use, differed among the smoking and nonsmoking groups. Furthermore, current smokers, former smokers, and nonsmokers represented a continuum of less healthful to more healthful attitudes and behaviors. In general, compared to men, women exhibited more positive HABs with respect to interpersonal support, health responsibility, alcohol consumption, and drug use, but less positive HABs with respect to stress management. More complex relationships emerged in comparisons of occasional and regular smokers, light and heavy smokers, and consonant and dissonant smokers. We discuss implications of the findings for smoking intervention programs.     

Cigar smoking in California: 1990-1996

BACKGROUND: Cigars have been heavily promoted in recent years. The nature and extent of the resultant increase in cigar smoking needs to be understood before the public health implications can be assessed. METHODS: Data are from population-based surveys conducted in California adults (> or = 18 years) in 1990 (n = 24,296) and 1996 (n = 24,266). Trends in current (every day or some days) cigar use are described for demographic subgroups and by cigarette smoking status. RESULTS: Current cigar use has doubled in California, from 2.5% in 1990 to 4.9% in 1996. In 1996, fewer than 5% of cigar smokers smoked cigars daily; essentially all of the increase was from nondaily use in those under 45 years of age of both genders, particularly in 18- to 24-year-olds. Among males, increased cigar use was observed in all racial/ethnic groups except Asians, and was observed in those with higher educational attainment and higher incomes. In both years, current and former cigarette smokers had higher rates of cigar use than never smokers, but the increase in current cigar smoking was observed regardless of cigarette smoking status. In 1996, daily cigar smokers were more likely to be former cigarette smokers than nondaily cigar smokers. CONCLUSION: If more people begin to smoke cigars daily, or if cigar use leads young people to initiate cigarette smoking or leads former cigarette smokers to relapse to cigarette smoking, the recent trends in cigar use may have public health implications.     

Associations of smoking and smoking cessation with CT-measured visceral obesity in 4656 Korean men

Objectives

Although obesity is shown to be less common among current smokers than never smokers, the association between visceral obesity and smoking remains uncertain.

Methods

For this cross-sectional analysis, we recruited 4656 Korean men of 19 to 79 years who received a regular checkup at a health examination center between 2008 and 2010. Computed tomography was performed to measure the area of visceral and subcutaneous adipose tissue (VAT and SAT). We compared the mean VAT by multiple regression analysis across smoking status after adjusting for confounders.

Results

Both current and former smokers had more mean VAT than never smokers. Current smokers who consumed more than 20 cigarettes per day had 11% higher mean VAT than never smokers (P < 0.01). Longer smoking duration, higher daily cigarette consumption before quitting, and shorter abstinence duration among ex-smokers were associated with increasing mean VAT (all P for trend < 0.01). The mean VAT in former smokers was highest within 2 years of abstinence. There was no significant difference of mean VAT between ex-smokers with > 20 years of abstinence duration and never smokers.

Conclusion

Both current and former smoking is associated with increased VAT. The risk of visceral obesity is proportional to the degree of exposure to cigarette smoking.     

成都市医生吸烟现状及男性医生吸烟行为影响因素研究

目的了解成都市医生的吸烟状况及男性医生吸烟的影响因素。方法采用多阶段随机抽样方法,对抽取的成都市710名医生进行吸烟现状调查,应用Logistic回归模型探讨男性医生吸烟的影响因素。结果本次调查的医生总体吸烟率为17.2%,男性医生吸烟率为37.3%;男性从不吸烟者和曾经吸现在已戒烟者的相关认知均好于吸烟者(F=3.61,P0.01;F=2.98,P0.01),从不吸烟者和曾经吸现在已戒烟者的相关态度均好于吸烟者(F=2.31,P0.01;F=2.29,P0.01);男性医生吸烟的影响因素为年龄、工龄、相关知识得分、相关态度得分和单位禁烟。结论本次调查的医生吸烟率较低,男性吸烟者吸烟相关认知差于不吸烟者,应该根据调查的相关吸烟影响因素制定医院控烟措施,进一步降低医生的吸烟率。     

Knowledge about tobacco and attitudes toward tobacco control: how different are smokers and nonsmokers?

Using data from a 1996 random-digit-dialing computer-assisted telephone survey of Ontario adults, 424 smokers and 1,340 nonsmokers were compared regarding knowledge about the health effects of tobacco use, attitudes toward restrictions on smoking and other tobacco control measures, and predictions of compliance with more restrictions. The response rate was 65%. Smokers were less knowledgeable than nonsmokers. Smokers were also less likely to support bans on smoking in specific locations, but majorities of both groups supported some restriction in most settings. Smokers were more likely than nonsmokers to predict that most smokers would comply with more restrictions, and more than three quarters indicated that they, themselves, would comply. Sizable proportions of both groups, especially smokers, failed to appreciate the effectiveness of taxation in reducing smoking. Support for other control measures also differed by smoking status. Both knowledge and smoking status were independently associated with support for more restrictions and other tobacco control policy measures.     

Sport activity and cigarette smoking among young and adult athletes from the northeastern part of Italy

Between November 1985 and October 1986, attitudes and habits towards smoking were investigated among young and adult amateur athletes of the province of Pordenone, in the northeastern part of Italy. Seventy-five percent of the athletes had never smoked and 21% were current smokers. Compared with the general population, smokers were 1/3 fewer among males and 1/5 more among females; a higher number of ex-smokers was found in both sexes. The major determinants of smoking were the kind of sport in which the athletes were engaged (percentages of current smokers among athletes of endurance sports, football and other, less exhaustive, sports were respectively 3%, 23% and 20%) and having both parents who were themselves smokers. The detrimental effects of smoking on health were underestimated by the great majority of interviewed subjects. The present study supports the view that regular phsical activity not only prevents youths from starting to smoke but also provides an incentive for stopping.     

Facial wrinkling in men and women, by smoking status.

OBJECTIVES. This study examined the association of smoking status and pack-years of smoking with facial wrinkling in men and women. METHODS. We conducted a cross-sectional study of 299 never smokers, 551 former smokers and 286 current smokers, aged 30 through 69 years, drawn from a health maintenance organization. Smoking status, pack-years of smoking, and potential confounding variables were assessed by questionnaire. Facial wrinkle category, a dichotomous variable, and facial wrinkle score, a computed continuous variable, were assessed by blinded standardized visual assessment. Wrinkling was so uncommon among 30- through 39-year-old subjects that analyses were restricted to subjects aged 40 and over (227 never smokers, 456 former smokers, and 228 current smokers). RESULTS. With age, average sun exposure, and body mass index controlled, the estimated relative risk of moderate/severe wrinkling for current smokers compared to never smokers was 2.3 (95% confidence interval [CI] = 1.2, 4.2) among men and 3.1 (95% CI = 1.6, 5.9) among women. Pack-years was positively associated with facial wrinkle score in women aged 40 through 69 years and in men aged 40 through 59 years. In both groups, the increased risk of wrinkling was equivalent to about 1.4 years of aging. CONCLUSIONS. Our results support earlier findings that risk of facial wrinkling is greater in cigarette smokers than in never smokers.     

R-rated film viewing and adolescent smoking

OBJECTIVES: As smoking is very common in R-rated films, we sought to determine if viewing R-rated films is associated with adolescent smoking. METHODS: Three annual cross-sectional surveys conducted of 88,505 Year 10 students of largely European, Maori, Asian or Pacific Islander ethnicity in secondary schools in New Zealand between 2002 and 2004. Outcomes of interest were: intention to smoke among never smokers; past experimentation with smoking among current non-smokers; current smoking status; and current frequency of smoking. RESULTS: Dose-response relationships were observed between the frequency of viewing R-rated films and all outcome measures controlling for age, gender, ethnicity, peer smoking, parental smoking, socioeconomic status, pocket money and household smoking rules. Compared to never viewing R-rated films, viewing at least weekly nearly tripled the relative risk (2.81; 95% confidence interval 2.57, 3.09) of never smokers being susceptible to smoking, and more than doubled the risk of both past experimentation (2.28; 95% CI 2.12, 2.45) and smoking>/=monthly (2.31; 95% CI 2.10, 2.54). Each of these risks was seen across all ethnic groups. CONCLUSIONS: Our results extend the association that has been demonstrated between viewing R-rated films and current smoking in American youth by demonstrating the same association in youth of different ethnic and cultural backgrounds in New Zealand.     

Smoking after the age of 65 years: a qualitative exploration of older current and former smokers' views on smoking, stopping smoking, and smoking cessation resources and services

The aim of this study was to explore older current/former smokers' views on smoking, stopping smoking, and smoking cessation resources and services. Despite the fact that older smokers have been identified as a priority group, there is currently a dearth of age-related smoking cessation research to guide practice. The study adopted a qualitative approach and used the health belief model as a conceptual framework. Twenty current and former smokers aged>or=65 years were recruited through general practices and a forum for older adults in the West of Scotland. Data were collected using a semistructured interview schedule. The audio-taped interviews were transcribed and then analysed using content analysis procedures. Current smokers reported many positive associations with smoking, which often prevented a smoking cessation attempt. The majority were aware that smoking had damaged their health; however, some were not convinced of the association. A common view was that 'the damage was done', and therefore, there was little point in attempting to stop smoking. When suggesting a cessation attempt, while some health professionals provided good levels of support, others were reported as providing very little. Some of the participants reported that they had never been advised to stop smoking. Knowledge of local smoking cessation services was generally poor. Finally, concern was voiced regarding the perceived health risks of using nicotine replacement therapy. The main reasons why the former smokers had stopped smoking were health-related. Many had received little help and support from health professionals when attempting to stop smoking. Most of the former smokers believed that stopping smoking in later life had been beneficial to their health. In conclusion, members of the primary care team have a key role to play in encouraging older people to stop smoking. In order to function effectively, it is essential that they take account of older smokers' health beliefs and that issues, such as knowledge of smoking cessation resources, are addressed.     

Public support for anti-smoking legislation varies with smoking status

Objective:  Rural Australians have higher rates of smoking than their urban counterparts, contributing to poorer health outcomes. In 2004, the Queensland Government introduced legislation to reduce the impact of environmental tobacco smoke on the community. The aims of the study were to describe smoking behaviours and associations between smoking behaviour and agreement with current anti-smoking laws.
Participants:  A total of 1208 people over the age of 18 years and living in rural, remote and very remote central Queensland participated in this telephone survey.
Results:  About 22% ( n =  130) of female and 21% of male ( n =  125) participants identified themselves as smokers. No difference existed between the mean age of smokers (47.3 years) and non-smokers (47.1 years). While there is high level of support for smoking restrictions in public places (75%), attitudes vary with smoking status. Smokers were less likely than smokers to agree that the legislation would create a healthier environment, reduce exposure to passive smoking or agree that 'it is right to ban smoking in public places'. Smokers were significantly more likely to agree that the legislation had gone too far.
Conclusion:  The gradual implementation of the anti-smoking legislation is changing social beliefs on what are acceptable smoking practices. It is likely that the legislation within Queensland and the subsequent forced changes in social conditions for smokers will continue to reduce the number of people smoking and reduce exposure to environmental tobacco smoke.     

Tobacco smoking in relation to pain in a national general population survey

BACKGROUND: We examined whether smoking status including heavy smoking (20 or more cigarettes per day) is related to the number of pain locations and intensity of pain. METHODS: A probability sample of the German national population aged 18 to 79 including 7124 participants (response proportion: 61.4%) was used. All individuals underwent a health examination between 1997 and 1999. Ordinal logistic regression analyses were performed with number of pain locations and pain intensity as dependent variables which had been assessed by questionnaire. RESULTS: Former and current heavy smokers had higher odds for greater numbers of pain locations and for moderate and intense pain than never smokers after adjustment for analgesic medicament use and behavior-related risk factors. Female former heavy smokers had an adjusted odds ratio (OR) of 1.6 (95% confidence interval, CI, 1.2-2.2) and male former heavy smokers had an adjusted OR of 1.4 (CI 1.1-1.8) for higher numbers of pain locations compared to never smoking women and men respectively (female current smokers: OR 1.4, CI 1.0-1.9; male current smokers: OR 1.3, CI 1.1-1.7). CONCLUSION: The findings suggest that former and current heavy smokers are more likely to report more pain locations and more intense pain than never smokers.