On the relationship between smoking bans and incidence of acute myocardial infarction

During the last few years several studies have reported a substantial reduction of acute myocardial infarction (AMI) in the general population few months after the enforcement of comprehensive smoking bans. We reviewed the consistency and plausibility of this association, investigating the effect of the Italian law, entered into force on January 10, 2005. We compared the AMI incidence on the first year after the ban with the period before (2000–2004) in the Tuscany population aged 30–64 years. The analysis was performed with a Poisson model of the monthly time-series, adjusting for seasonality and comparing different models with linear and non-linear long-term trends. While the model with linear time trend estimated a decrease of 5.4% (RR 0.95; 95% CI: 0.89–1.00), this effect completely disappeared once the linearity assumption was relaxed (RR 1.01; 95% CI: 0.93–1.10). The model with non-linear terms showed a significantly improved fit (P-value = 0.01). The estimate of the effect of the ban seems to be highly sensitive to the model specification and to the effects of unaccounted factors which could modify the trend of AMI incidence, such as changes in the prevalence of other risk factors or the modification of diagnostic criteria. Several arguments which are put forward to inspect the causal relation between smoking bans and AMI indicate that the plausible effects could be lower than the estimates reported so far.     

The effect of the tobacco settlement and smoking bans on alcohol consumption

In the last few years, the price of cigarettes has increased considerably in the USA. In addition, a number of states have also imposed smoking bans. These increases in the cost and barriers to smoking have created a natural experiment to study relationships between smoking and drinking behaviors. In this study, we employ data from the first six waves of the Health and Retirement Survey (HRS) to analyze the effects of smoking bans and cigarette prices on alcohol consumption. We also test if past cigarette and alcohol consumption affect current alcohol consumption as predicted by co-addiction models. We estimate dynamic panel models using GMM estimators. Our approach allows us to obtain consistent estimates irrespective of the number of time periods. The three main findings of this study are: (1) there is positive reinforcement effect of past cigarette consumption on current alcohol consumption, (2) smoking bans reduce alcohol consumption and (3) there is a positive effect of cigarette prices on alcohol consumption.     

Tobacco use behaviors and household smoking bans among Chinese Americans

PURPOSE: To assess the relationship between household smoking restrictions and smoking patterns among Chinese American adults. DESIGN: This is a cross-sectional analysis based on a National Institutes of Health-funded population-based household and telephone survey of 2537 Chinese American adults. SETTING: Two communities in New York City. SUBJECTS: The analyses focused on male current smokers (N = 600). MEASURES: Demographic characteristics, smoking status, household smoking restrictions, cigarettes smoked per day, and past quit attempts were based on self-reported data. RESULTS: Among current smokers, 37% reported living in a home with a complete smoking ban. Smokers with a full household smoking ban smoked fewer cigarettes on weekdays and weekends than smokers with no household smoking ban (p < or = .05) and were 3.4 times (p < .01) more likely to report having at least one quit attempt in the past 12 months. Smokers with knowledge of the dangers of environmental tobacco smoke (ETS) exposure were 2.8 times (p < or = .01) more likely to have at least one quit attempt in the last 12 months compared with those who were unaware of the danger of ETS and more likely to live in a smoke-free household. CONCLUSIONS: Smoke-free home policies and interventions to raise awareness among smokers of the dangers of ETS have the potential to significantly reduce tobacco use and exposure to household ETS among this immigrant population.     

Socioeconomic determinants of children's environmental tobacco smoke exposure and family's home smoking policy

Background: Few studies have analysed the impact of differentsocioeconomic indicators on the prevalence of children's environmentaltobacco smoke (ETS) exposure at several indoor environmentsand on family's home smoking policy. Methods: Dataon 12 422 pre-school children (48% female) from two cross-sectionalsurveys conducted during 2004–06 in Germany were analysed.Exposure assessment was based on parental report. Independenteffects of socioeconomic indicators were determined by mutuallyadjustment in logistic regression analyses. Results: Lowparental education, unemployment, low household equivalent income,non-German nationality, single-parent family and family sizewere independently associated with children's ETS exposure athome and in cars. The strongest associations were observed forlow parental education [at home: adjusted odds ratio (OR) 3.94;95% confidence interval (CI) 3.46–4.49; in cars: 5.00;3.84–6.50]. Indicators of material living conditions (relativepoverty: 0.48; 0.39–0.57, parental unemployment: 0.55;0.46–0.65), as well as single-parent family, non-Germannationality and family size, but not parental education, wereindependently associated with ETS exposure at hospitality venues.Smoking households with low parental education, unemployment,poverty, single-parent family and non-German nationality wereless likely to have the rule of exclusively smoking on the balconyor terrace. Low parental education and unemployment were negativelyassociated with no smoking in presence of the child in householdswith smoking inside the flat. Conclusion: Severaldimensions of socioeconomic position have to be considered inexplanations of social inequalities in children's ETS exposureand family's home smoking policy as well as in development oftargeted interventions.     

College student reactions to smoking bans in public, on campus and at home

We examined college student reactions to a statewide public smoke-free policy, campus policies and private restrictions through an online survey among 2260 students at a 2-year college and a university and 12 focus groups among smokers. Among survey participants, 34.6% smoked in the past month (35.0% daily, 65.0% non-daily). Correlates of receptivity to public policies included attending the university, not living with smokers and non-smoker status (versus daily and non-daily smoking). Correlates of receptivity to outdoor campus policies included being a university student, unmarried, without children, from homes where parents banned indoor smoking and a non-smoker. Correlates of having home restrictions included not living with smokers, no children, parents banning indoor smoking and non-smoker status. Correlates of having car restrictions included attending the university, not living with smokers, having children, parents banning indoor smoking and non-smoker status. Qualitative findings indicated support for smoke-free policies in public (albeit greater support for those in restaurants versus bars) and on campus. Participants reported concern about smokers' and bar/restaurant owners' rights, while acknowledging several benefits. Overall, 2-year college students and smokers (non-daily and daily) were less supportive of smoke-free policies.     

The effect of comprehensive state tobacco control programs on adult cigarette smoking

This study is the second to use national survey data to assess the effect of comprehensive state tobacco control programs on adult cigarette smoking. Data are drawn from the Behavioral Risk Factor Surveillance System (1991-2006) and reveal consistent evidence that these programs have a statistically significant effect to reduce prevalence of cigarette smoking among adults. Simulations indicate that had all states spent the CDC recommended level of funding from 1991 to 2006 then cigarette smoking prevalence would have been 1.40-8.07% lower in 2006, translating to between 635,000 and 3.7 million fewer adult cigarette smokers.     

The association between workplace smoking bans and self-perceived,work-related stress among smoking workers

Background  

There is substantial empirical evidence on the benefits of smoking bans; however, the unintended consequences of this anti-smoking measure have received little attention. This paper examines whether workplace smoking bans (WSB's) are associated with higher self-perceived, work-related stress among smoking workers.     

大学生童年期不良经历暴露与非自杀性自伤行为的关联

目的 探讨童年期不良经历(ACEs)暴露类型和时相与大学生非自杀性自伤(NSSI)行为的关联,为大学生NSSI行为防控提供参考.方法 2019年10-11月,整群选取安徽省2所不同城市的医学院校一、二年级在校学生,了解社会人口学指标、童年期不良经历和NSSI行为发生等信息,建立多因素logistics回归模型,分析AC...     

Characterizing the spatial relationship between smoking status and tobacco retail exposure: Implications for policy development and evaluation

Tobacco retail density and smoking prevalence remain elevated in marginalized communities, underscoring the need for strategies to address these place-based disparities. The spatial variation of smokers and tobacco retailers is often measured by aggregating them to area-level units (e.g., census tracts), but spatial statistical methods that use point-level data, such as spatial intensity and K-functions, can better describe their geographic patterns. We applied these methods to a case study in New Castle County, DE to characterize the cross-sectional spatial relationship between tobacco retailers and smokers, finding that current smokers experience greater tobacco retail exposure and clustering relative to former smokers. We discuss how analysis at different geographic scales can provide complementary insights for tobacco control policy.     

家长参与家庭控烟程度对初中生吸烟行为影响

目的探讨家长参与家庭控烟程度对初中生吸烟行为的影响。方法采用随机抽样方法从广州市黄埔区20所中学中抽取3所学校,对在校初中生的家长以自填式结构问卷进行调查,内容包括家长的一般情况、家长参与家庭控烟程度以及其子女吸烟行为等。采用多元协方差分析法分析家长参与家庭控烟的程度对子女吸烟行为的影响。结果2 019份有效问卷中,初中生尝试吸烟率为5.60%（男生10.05%,女生2.25%）;偶尔吸烟率为4.41%（男生8.47%,女生1.32%）;规律吸烟率为1.19%（男生1.58%,女生0.93%）。母亲参与家庭控烟程度高于父亲,男生家长参与程度高于女生家长。家长参与控烟的程度越高,其子女吸烟越少。结论家长在家庭内进行烟草控制可减少和（或）延缓青少年吸烟。     

青岛市成人戒烟现况及影响因素分析

目的 分析青岛市成人戒烟状况和戒烟意愿的影响因素。方法 采取多阶段分层随机抽样的方法,在青岛市抽取5 000名15岁及以上的居民,采取入户调查的方式进行问卷调查。根据2010年第六次普查人口加权计算,采用戒烟率、尝试戒烟次数、医生戒烟建议等指标描述戒烟行为,采用复杂抽样Logistic单因素和多因素分析,探讨吸烟者戒烟意愿的影响因素。结果 青岛市成年吸烟者戒烟率为20.2%;吸烟者尝试戒烟和意愿戒烟的比例分别为24.8%和13.5%,54.6%的尝试戒烟者在过去12个月尝试戒烟2次以上;就诊的吸烟者中有66.8%的人接受过医生的戒烟建议。多因素分析显示,在控制其它影响因素后,只有烟草危害知识知晓情况和是否尝试过戒烟会影响戒烟意愿。结论 青岛市人群目前尝试戒烟率较低,应提高戒烟服务的专业性和可及性,促进吸烟者尝试戒烟,同时制定针对性的控烟宣传策略,提高未来戒烟意愿。     

Stigmatizing smokers: public sentiment toward cigarette smoking and its relationship to smoking behaviors

Public sentiment in the United States has been evolving against cigarette smoking. Providing support for stronger tobacco control legislation, unfavorable public sentiment has contributed to the decrease in the size of the smoking population in this country. The present study hypothesizes that the unfavorable public sentiment may also discourage cigarette smoking by creating an unfavorable "smoking climate" in which smoking is socially rejected as a deviant behavior. Analyses of several secondary data-sets provided evidence that smoking rates are lower in the states where the public holds relatively unfavorable sentiment toward cigarette smoking. The relationship between public sentiment and smoking rates was significant even after controlling for the effects of state-level tobacco control measures, such as cigarette taxes and smoking restrictions in private workplaces and restaurants. We also found that smokers who have experienced unfavorable public sentiment are more willing to quit smoking than those who have not, supporting the hypothesized effects of antismoking public sentiment on smoking behaviors.     

Parent reported home smoking bans and toddler (18–30 month) smoke exposure: a cross-sectional survey

Parent reported home smoking bans and toddler (18–30 month) smoke exposure: a cross-sectional survey . Spencer N. , Blackburn C. , Bonas S. , Coe C. , Dolan A. ( 2005 ) Archives of Disease in Childhood , 90 , 670 – 674 .     

Restaurant and bar owners' exposure to secondhand smoke and attitudes regarding smoking bans in five Chinese cities

Despite the great progress made towards smoke-free environments, only 9% of countries worldwide mandate smoke-free restaurants and bars. Smoking was generally not regulated in restaurants and bars in China before 2008. This study was designed to examine the public attitudes towards banning smoking in these places in China. A convenience sample of 814 restaurants and bars was selected in five Chinese cities and all owners of these venues were interviewed in person by questionnaire in 2007. Eighty six percent of current nonsmoking subjects had at least one-day exposure to secondhand smoke (SHS) at work in the past week. Only 51% of subjects knew SHS could cause heart disease. Only 17% and 11% of subjects supported prohibiting smoking completely in restaurants and in bars, respectively, while their support for restricting smoking to designated areas was much higher. Fifty three percent of subjects were willing to prohibit or restrict smoking in their own venues. Of those unwilling to do so, 82% thought smoking bans would reduce revenue, and 63% thought indoor air quality depended on ventilation rather than smoking bans. These results showed that there was support for smoking bans among restaurant or bar owners in China despite some knowledge gaps. To facilitate smoking bans in restaurants and bars, it is important to promote health education on specific hazards of SHS, provide country-specific evidence on smoking bans and hospitality revenues, and disseminate information that restricting smoking and ventilation alone cannot eliminate SHS hazards.     

Attitudes towards smoking policies and tobacco control measures in relation to smoking status and smoking behaviour

BACKGROUND: To examine support for various smoking policies and tobacco control measures among lifetime smokers in a country with weak anti-smoking legislation and an underdeveloped anti-smoking climate. METHODS: Current (n = 624) and former smokers (n = 131) from a general population survey filled in the 30-item Smoking Policy Index (SPI). Structural equation modelling was used to confirm the SPI factorial structure and to test whether smoking status and smoking behaviour variables were related to the six dimensions of the SPI. RESULTS: The dimension with the highest support was penalties for sales to minors. Sanctions against smokers had the lowest support. Current smokers compared with former smokers showed lower support on the taxes/fees, public education, and environmental restrictions dimensions while controlling for gender, age, and social status. Within current smokers, unfavourable smoking behaviours were associated with lower support. CONCLUSION: Even in a country with poor tobacco control conditions, lifetime smokers including smokers with highly unfavourable smoking behaviours strongly support smoking policies and tobacco control measures concerning penalties and advertising/promotion. These measures should be used to promote anti-smoking legislation, and strict law enforcement of these measures is expected to be accepted by all smokers. For measures that are not supported by all lifetime smokers, interventions may be useful to increase acceptability. A limitation of the present study is the absence of never-smokers as a comparison group.     

Second-hand smoke exposure and household smoking bans in Chinese families: a qualitative study

As workplace smoking restrictions spread, smoking in the home is becoming the predominant source of exposure to second-hand smoke (SHS) among children and other non-smokers in the household. This study explored issues around children's exposure to SHS. Focus group discussions (FGDs) and in-depth interviews (IDI) were conducted among 31 Chinese households in urban Shanghai, China. All FGDs/IDIs were audio recorded and analysed thematically. The findings suggest that there are gaps in knowledge of the health consequences of smoking and SHS among the participants. Although there was a lack of knowledge about the health risk of exposure to SHS, most were willing to protect their child from the SHS exposure. In 16/31 households, families had partial home-smoking restrictions; there were no complete restrictions in any of the smokers' homes. Many families do not openly discuss smoking or smoking restrictions at home. Barriers to adopting a smoke-free home included the social acceptability of smoking (22/31), hosting social gatherings at home, which would involve smoking (12/31), authoritative attitudes of the husband or father-in-law (10/31), and difficulties with visitors who smoke (7/31). Most (28/31) participants stated they would accept a counselling intervention to reduce SHS exposure to children and suggested various measures to implement it. The findings from this intervention have implications for designing intervention strategies to reduce SHS exposure at home among children in China.