Understanding motivation to implement smoking bans among mothers with a hospitalized infant.

PubMed

Stotts, Angela L; Klawans, Michelle R; Northrup, Thomas F; Villarreal, Yolanda; Hovell, Melbourne F

2016-07-01

Secondhand smoke exposure (SHSe) poses risks to hospitalized children upon discharge and no uniformly effective interventions have been identified. Understanding change-related processes and social-contextual factors related to motivation for implementing home and car smoking bans may inform interventions to reduce infant SHSe among mothers with a hospitalized infant. In this cross-sectional, secondary analysis, mothers of neonatal ICU infants who reported smoking or living with a smoker (N=205) were assigned to stages of change (pre-contemplation, contemplation, preparation, or action) based on behaviors and intentions for establishing smoking bans in their homes and cars. Processes of change (POC) for SHSe reduction practices, self-efficacy, depressive symptoms, generalized anxiety, and social support for not smoking in the home were examined across all four stages. The majority of mothers were in the action stage for having a home smoking ban in place (55%); only 35% of participants were in action for a car smoking ban. POC use differed across the stages of change for having a home ban (p=0.004) and car ban (p=0.02), with earlier stages using fewer overall and relatively fewer cognitive/affective processes. Earlier stage women also reported lower self-efficacy to change, less familial and partner support for in-home smoking bans, and more depressive symptoms. Novel intervention targets were identified, including cognitive/affective change processes, mental health, and familial/social contingencies for implementing SHSe protective practices. Creative ways in which to affect change at the individual and household level are needed in order to fully address the complexity of child SHSe. Copyright © 2016 Elsevier Ltd. All rights reserved.

Smoking Restrictions in Homes After Implementation of a Smoking Ban in Public Places

PubMed Central

Lasnier, Benoit; Mihaylova, Tsvetelina; Montreuil, Annie; Cohen, Joanna E.

2015-01-01

Introduction: This Canadian study examines the prevalence of smoking restrictions in homes before and after the implementation of a public smoking ban, and their relation to tobacco use and cessation among a cohort of smokers. Methods: Data were from a longitudinal cohort study of 1,058 smokers in the province of Québec, Canada. Baseline data were collected through a population-based survey conducted 1 month before the implementation of the smoking ban with a representative sample of smokers. Follow-up data were collected 18 months after the ban with a response rate of 68%. Logistic regressions, paired t tests and chi-square statistics were used to examine the factors associated with smoking restrictions in homes, cigarette consumption, and quit attempts. Results: Many smokers imposed partial or full smoking restrictions in their homes but proportions of smoke-free homes did not change significantly between baseline and follow-up. The presence of young children and nonsmokers significantly predicted full smoking restriction in the home. Knowledge about risks associated with exposure to secondhand smoke (SHS) and skepticism about the efficacy of methods to reduce exposure in the home also predicted maintenance of voluntary smoking restrictions in homes. The uptake of smoke-free homes was not associated with the quantity of cigarettes smoked or quit attempts. Conclusions: No significant change in home smoking bans was found 18 months after implementation of a public smoking ban. There remains a need for efforts to better inform smokers about health risks from exposure to SHS in homes and the reality that strategies other than a total smoking ban inside the home are ineffective. PMID:25140045

When You Smoke, They Smoke: Children's Rights and Opinions about Vehicular Smoking Bans

NASA Astrophysics Data System (ADS)

Tymko, Morgan Anne

International law guarantees every person the highest attainable standard of health, and this should include protection from the health risks of environmental tobacco smoke. As knowledge of these risks has increased, there has been an incremental expansion of smoking bans in public space. Since 2007, they have extended to the private space of the motor vehicle in an attempt to protect child passengers. This thesis aimed to understand the views and interests of children and youth on vehicular smoking bans, and the extent to which these have been sought after and considered in previous discussions of this policy initiative in Canada. A print media analysis found a lack of concern for children's perspectives. Rights, when considered, were generally those of adults. In focus groups, children discussed the unfairness of exposure to smoke in any space, but especially within the motor vehicle, and articulated a desire for increased participation in decision-making. Keywords: Smoking, smoking bans, rights, children's opinions, vehicles, Canada.

Smoking restrictions in homes after implementation of a smoking ban in public places.

PubMed

Kairouz, Sylvia; Lasnier, Benoit; Mihaylova, Tsvetelina; Montreuil, Annie; Cohen, Joanna E

2015-01-01

This Canadian study examines the prevalence of smoking restrictions in homes before and after the implementation of a public smoking ban, and their relation to tobacco use and cessation among a cohort of smokers. Data were from a longitudinal cohort study of 1,058 smokers in the province of Québec, Canada. Baseline data were collected through a population-based survey conducted 1 month before the implementation of the smoking ban with a representative sample of smokers. Follow-up data were collected 18 months after the ban with a response rate of 68%. Logistic regressions, paired t tests and chi-square statistics were used to examine the factors associated with smoking restrictions in homes, cigarette consumption, and quit attempts. Many smokers imposed partial or full smoking restrictions in their homes but proportions of smoke-free homes did not change significantly between baseline and follow-up. The presence of young children and nonsmokers significantly predicted full smoking restriction in the home. Knowledge about risks associated with exposure to secondhand smoke (SHS) and skepticism about the efficacy of methods to reduce exposure in the home also predicted maintenance of voluntary smoking restrictions in homes. The uptake of smoke-free homes was not associated with the quantity of cigarettes smoked or quit attempts. No significant change in home smoking bans was found 18 months after implementation of a public smoking ban. There remains a need for efforts to better inform smokers about health risks from exposure to SHS in homes and the reality that strategies other than a total smoking ban inside the home are ineffective. © 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.

[Acceptance of a total smoking ban in schools: students' attitudes].

PubMed

Morgenstern, M; Wiborg, G; Hanewinkel, R

2008-06-01

The purpose of this study was to measure students' attitudes towards a total smoking ban in schools and towards impositions in cases of violation. Cross-sectional survey of 1 738 students of 12 public schools in Schleswig-Holstein (grades 7-13, age 11-20 years). Data were collected by means of written questionnaires administered during class time. The following variables were assessed: attitude towards smoking ban, attitude towards impositions, age, sex, citizenship, perceived school climate, current smoking, lifetime smoking; for smokers, and additionally, the "Heaviness of Smoking Index". 76.5% of all students agreed with a total smoking ban, 66.4% agreed with the punishment of violations. Higher acceptance rates were found among girls, young students (11-15 years of age), for never-smokers, and for students who feel comfortable at school. Acceptance of the smoking ban is closely related to current smoking status: 93% of the non-smoking students, but only 14% of the daily smoking students agreed with the regulations. Refusal of the ban increased with increasing physical dependence. The intensification of the smoking ban in public schools meets approval by the majority of students. Smoking students should be more strongly involved in the implementation process, e.g., by supplemental cessation programmes.

Thirdhand Smoke in the Homes of Medically Fragile Children: Assessing the Impact of Indoor Smoking Levels and Smoking Bans

PubMed Central

Matt, Georg E.; Hovell, Melbourne F.; Khan, Amir M.; Stotts, Angela L.

2016-01-01

Abstract Introduction: Thirdhand smoke (THS) residue results from secondhand smoke, and is emerging as a distinct public health hazard, particularly for medically fragile pediatric patients living with smokers. THS is difficult to remove and readily reacts with other pollutants to form carcinogens and ultrafine particles. This study investigated THS found in homes of high-risk infants admitted to a neonatal intensive care unit and their association with characteristics (eg, number of household smokers) hypothesized to influence THS. Methods: Baseline data from 141 hospitalized infants’ homes were analyzed, along with follow-up data ( n = 22) to explore household smoking characteristics and THS changes in response to indoor smoking ban policies. Results: Households with an indoor ban, in which not more than 10 cigarettes/d were smoked, had the lowest levels of THS contamination compared to homes with no ban ( P < .001) and compared to homes with an indoor ban in which greater numbers of cigarettes were smoked ( P < .001). Importantly, homes with an indoor ban in which at least 11 cigarettes/d were smoked were not different from homes without a ban. The follow-up sample of 22 homes provided initial evidence indicating that, unless a ban was implemented, THS levels in homes continued to increase over time. Conclusions: Preliminary longitudinal data suggest that THS may continue to accumulate in homes over time and household smoking bans may be protective. However, for homes with high occupant smoking levels, banning indoor smoking may not be fully adequate to protect children from THS. Unless smoking is reduced and bans are implemented, medically fragile children will be exposed to the dangers of THS. PMID:26315474

Direct health costs of environmental tobacco smoke exposure and indirect health benefits due to smoking ban introduction.

PubMed

Hauri, Dimitri D; Lieb, Christoph M; Rajkumar, Sarah; Kooijman, Cornelis; Sommer, Heini L; Röösli, Martin

2011-06-01

Introducing comprehensive smoke-free policies to public places is expected to reduce health costs. This includes prevented health damages by avoiding environmental tobacco smoke (ETS) exposure as well as indirect health benefits from reduced tobacco consumption. The aim of this study was to estimate direct health costs of ETS exposure in public places and indirect health benefits from reduced tobacco consumption. We calculated attributable hospital days and years of life lost (YLL), based on the observed passive smoking and disease rates in Switzerland. The exposure-response associations of all relevant health outcomes were derived by meta-analysis from prospective cohort studies in order to calculate the direct health costs. To assess the indirect health benefits, a meta-analysis of smoking ban studies on hospital admissions for acute myocardial infarction was conducted. ETS exposure in public places in Switzerland causes 32,000 preventable hospital days (95% CI: 10,000-61,000), 3000 YLL (95% CI: 1000-5000), corresponding to health costs of 330 Mio CHF. The number of hospital days for ischaemic heart disease attributable to passive smoking is much larger if derived from smoking ban studies (41,000) than from prospective cohort studies (3200), resulting in additional health costs of 89 Mio CHF, which are attributed to the indirect health benefits of a smoking ban introduction. The example of smoking ban studies on ischaemic heart disease hospitalization rates suggests that total health costs that can be prevented with smoking bans are considerably larger than the costs arising from the direct health impact of ETS exposure in public places.

Effects of Enactment of Legislative (Public) Smoking Bans on Voluntary Home Smoking Restrictions: A Review

PubMed Central

Arsenault, Nicole

2017-01-01

Introduction: The positive effects of worldwide increases in enactment of legislative bans on smoking in public areas have been well documented. Relatively little is known about the effects of such bans on voluntary home smoking behavior. Meanwhile, private spaces, such as homes, have replaced public spaces as the primary milieu of secondhand smoke exposure. Methods: A systematic search of peer-reviewed articles was conducted using multiple databases including Cochrane Library, Cinahl, Embase, Global Health, Health Star, Joanna Briggs, MEDLINE, PsycINFO, PAIS International, PubMed, and Web of Science. We examined peer-reviewed studies that considered the impact of legislation-based public smoking bans on enactment of private home smoking restrictions. Results: Sixteen articles published between 2002 and 2014 were identified and included. Our results suggest overall positive effects post-legislative ban with the majority of studies demonstrating significant increases in home smoking restrictions. Studies focusing on smoking and nonsmoking samples as well as child populations are discussed in depth. Conclusions: Existing evidence indicates an overall significant positive effect post-legislative ban on voluntary home smoking restrictions. While disentangling these effects over space and time remains a challenge, scientific research has converged in dispelling any notion of significant displacement of smoking into the home. Policy makers, especially those in countries without existing public smoking legislation, can rest assured that these types of bans contribute to the minimization of tobacco-related harm. Implications: Findings converge in dispelling notions of displacement of smoking into the home as a consequence of legislative bans that prohibit smoking in public spaces. Evidence from the studies reviewed suggests that through their influence on social norms, legislative bans on smoking in public places may encourage citizens to establish voluntary home smoking

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

ERIC Educational Resources Information Center

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…

14 CFR 252.5 - Smoking ban: foreign air carriers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Smoking ban: foreign air carriers. 252.5... PROCEEDINGS) ECONOMIC REGULATIONS SMOKING ABOARD AIRCRAFT § 252.5 Smoking ban: foreign air carriers. (a) Foreign air carriers shall prohibit smoking on all scheduled passenger flight segments: (1) Between points...

14 CFR 252.5 - Smoking ban: foreign air carriers.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Smoking ban: foreign air carriers. 252.5... PROCEEDINGS) ECONOMIC REGULATIONS SMOKING ABOARD AIRCRAFT § 252.5 Smoking ban: foreign air carriers. (a) Foreign air carriers shall prohibit smoking on all scheduled passenger flight segments: (1) Between points...

14 CFR 252.5 - Smoking ban: foreign air carriers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Smoking ban: foreign air carriers. 252.5... PROCEEDINGS) ECONOMIC REGULATIONS SMOKING ABOARD AIRCRAFT § 252.5 Smoking ban: foreign air carriers. (a) Foreign air carriers shall prohibit smoking on all scheduled passenger flight segments: (1) Between points...

14 CFR 252.5 - Smoking ban: foreign air carriers.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Smoking ban: foreign air carriers. 252.5... PROCEEDINGS) ECONOMIC REGULATIONS SMOKING ABOARD AIRCRAFT § 252.5 Smoking ban: foreign air carriers. (a) Foreign air carriers shall prohibit smoking on all scheduled passenger flight segments: (1) Between points...

14 CFR 252.5 - Smoking ban: foreign air carriers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Smoking ban: foreign air carriers. 252.5... PROCEEDINGS) ECONOMIC REGULATIONS SMOKING ABOARD AIRCRAFT § 252.5 Smoking ban: foreign air carriers. (a) Foreign air carriers shall prohibit smoking on all scheduled passenger flight segments: (1) Between points...

The Impact of Smoking Bans on Smoking and Consumer Behavior: Quasi-Experimental Evidence from Switzerland.

PubMed

Boes, Stefan; Marti, Joachim; Maclean, Johanna Catherine

2015-11-01

In this paper, we exploit the progressive implementation of smoking bans in public venues at the state level in Switzerland to evaluate both the direct effects on smoking and the potential unintended consequences of these legislations on consumer behaviors as measured by visiting restaurants/bars and discos ('going out'). Our results indicate that public venue smoking bans in Switzerland reduce smoking rates, but the findings do not emerge until 1 year following the ban. This pattern of results is consistent with delays in ban enforcement on the part of business owners, difficulties in changing addictive behaviors such as smoking, and/or learning on the part of smokers. We find evidence that smoking bans influence going-out behavior and there is substantial heterogeneity across venue and consumer characteristics. Copyright © 2014 John Wiley & Sons, Ltd.

Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption.

PubMed

Frazer, Kate; Callinan, Joanne E; McHugh, Jack; van Baarsel, Susan; Clarke, Anna; Doherty, Kirsten; Kelleher, Cecily

2016-02-04

Smoking bans have been implemented in a variety of settings, as well as being part of policy in many jurisdictions to protect the public and employees from the harmful effects of secondhand smoke (SHS). They also offer the potential to influence social norms and the smoking behaviour of those populations they affect. Since the first version of this review in 2010, more countries have introduced national smoking legislation banning indoor smoking. To assess the effects of legislative smoking bans on (1) morbidity and mortality from exposure to secondhand smoke, and (2) smoking prevalence and tobacco consumption. We searched the Cochrane Tobacco Addiction Group Specialised Register, MEDLINE, EMBASE, PsycINFO, CINAHL and reference lists of included studies. We also checked websites of various organisations. Date of most recent search; February 2015. We considered studies that reported legislative smoking bans affecting populations. The minimum standard was having an indoor smoking ban explicitly in the study and a minimum of six months follow-up for measures of smoking behaviour. Our search included a broad range of research designs including: randomized controlled trials, quasi-experimental studies (i.e. non-randomized controlled studies), controlled before-and-after studies, interrupted time series as defined by the Cochrane Effective Practice and Organisation of Care Group, and uncontrolled pre- and post-ban data. One author extracted characteristics and content of the interventions, participants, outcomes and methods of the included studies and a second author checked the details. We extracted health and smoking behaviour outcomes. We did not attempt a meta-analysis due to the heterogeneity in design and content of the studies included. We evaluated the studies using qualitative narrative synthesis. There are 77 studies included in this updated review. We retained 12 studies from the original review and identified 65 new studies. Evidence from 21 countries is

Perceptions and influences of a state prison smoking ban.

PubMed

Thibodeau, Laura; Seal, David W; Jorenby, Douglas E; Corcoran, Kerri; Sosman, James M

2012-10-01

Prison smoking bans are increasingly common. It is important to consider how those who are incarcerated respond to these bans and to the subsequent development of contraband tobacco markets. Since there are high rates of smoking in individuals who become incarcerated, along with high rates of chronic illnesses that are exacerbated by smoking, it is critical to examine whether there are health promoting changes in perceptions of and intentions toward smoking and other health behaviors that can be maintained on release to the community. Interviews with incarcerated men experiencing a prison smoking ban revealed their responses to being smoke-free, reactions to the presence of contraband smoking, and the influences of this experience on their intentions to smoke following release.

Outdoor smoking ban at a cancer center: attitudes and smoking behavior among employees and patients.

PubMed

Unrod, Marina; Oliver, Jason A; Heckman, Bryan W; Simmons, Vani Nath; Brandon, Thomas H

2012-01-01

Policies restricting indoor worksite tobacco use began being implemented more than a decade ago. More recently, the scope of these policies has been expanding to outdoors, with hospitals leading the trend in restricting smoking throughout their grounds. However, research on the effects such bans have on employees is scarce. The purpose of the current study was to examine the impact of a campus-wide smoking ban on employees and patients at a cancer center. Employees completed anonymous questionnaires during the months before (n = 607; 12% smokers) and 3 months after the ban implementation (n = 511; 10% smokers). Patients (n = 278; 23% smokers) completed an anonymous questionnaire preban. Results showed that 86% of nonsmokers, 20% of employees who smoke, and 57% of patients who smoke supported the ban. More than 70% of smokers were planning or thinking about quitting at both time points and nearly one-third were interested in cessation services following the ban. Before the ban, 32% expected the ban to have a negative effect on job performance and 41% thought their smoking before and after work would increase. Postban, 22% reported a negative impact on job performance, 35% increased smoking before and after work, and 7% quit. Overall, these data revealed an overwhelming support for an outdoor smoking ban by nonsmoker employees and patients. Although a majority of employee smokers opposed the ban, a significant proportion was interested in cessation. Compared with preban expectations, a lower proportion experienced negative effects postban. Findings suggest a need for worksite cessation programs to capitalize on the window of opportunity created by tobacco bans, while also addressing concerns about effects on work performance.

Teenage smoking behaviour following a high-school smoking ban in Chile: interrupted time-series analysis.

PubMed

Feigl, Andrea B; Salomon, Joshua A; Danaei, Goodarz; Ding, Eric L; Calvo, Esteban

2015-07-01

To evaluate the effect of a smoking ban in high schools on smoking behaviour among Chilean students. We conducted an interrupted time-series analysis, using repeated cross-sectional data from Chile's school population survey (2000-2011) for high-school students aged 12-18 years and a control group of persons aged 19-24 years. Poisson regression models were used to assess trends in smoking behaviour before and after the policy changes. The outcome measures were self-reported smoking prevalence (any smoking in the past month) and high frequency of smoking (smoking 15 days or more per month). From 2005 to 2011, the prevalence of smoking declined among high-school students by 6.8% per year compared with 3.6% decline per year in the control group. The decline in the target group was 2.9% (95% confidence interval, CI: 0.18 to 5.00) greater. We estimated that 5-6 years after enforcing the law, smoking prevalence among high-school students was 13.7% lower as a result of the ban. The impact of the smoking ban was primarily driven by declines in smoking prevalence among students in grades 8 to 10. The smoking ban did not significantly alter the frequency of smoking. The 2005 school smoking ban reduced smoking prevalence among younger high-school students in Chile. Further interventions targeting older individuals and frequent smokers may be needed.

Thank you for not smoking: evidence from the Italian smoking ban.

PubMed

Buonanno, Paolo; Ranzani, Marco

2013-02-01

By 2030, tobacco is expected to be the cause of about 10 million deaths per year worldwide. In Italy tobacco smoking is still a pervasive and relevant phenomenon. Using data from a national health survey, we investigate how individuals react to the introduction of a public smoking ban in Italy. Our estimates suggest that the Italian smoking ban in private places open to the public reduced smoking prevalence by 1.3% and daily cigarettes consumption by 8%. We find heterogeneous effects by gender, marital status, and region of residence. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The Impact of a City-Wide Indoor Smoking Ban on Smoking and Drinking Behaviors Across Emerging Adulthood

PubMed Central

Talley, Anna E.; Fromme, Kim

2016-01-01

Introduction: Almost one-third of college students report recent cigarette use, primarily as “social smoking,” and often in conjunction with alcohol use. While city-wide indoor smoking bans effectively reduce the number of social opportunities to smoke (eg, bars and music clubs), little is known about how these bans may impact the smoking behaviors of college students. Furthermore, nothing is known about how indoor smoking bans may impact students’ drinking behaviors. The current study aims to determine the impact of a city-wide comprehensive indoor smoking ban on smoking and alcohol behaviors among a longitudinal sample of emerging adults. Methods: Data are from a 6-year longitudinal study (10 waves of data collection) that began the summer before college enrollment. Participants (N = 2244; 60% female) reported on their past 3-month smoking and drinking behaviors using Internet-based surveys at each wave. Piecewise linear growth modeling was used to determine how a city-wide comprehensive indoor smoking ban (implemented in the Fall of 2005 between Waves 4 and 5) impacted smoking frequency, cigarette quantity, drinking frequency, and number of binge drinking episodes. Results: Smoking and alcohol use increased from the summer before college through the semester before implementation of the city-wide smoking ban. While smoking frequency (P < .001) and cigarette quantity (P < .05) declined after the ban, drinking frequency increased (P < .001) and the number of binge drinking episodes remained stable. Conclusions: Current findings suggest that comprehensive indoor smoking bans can influence the smoking behaviors of emerging adults, whereas trajectories of drinking are relatively unchanged. PMID:25744964

Teenage smoking behaviour following a high-school smoking ban in Chile: interrupted time-series analysis

PubMed Central

Salomon, Joshua A; Danaei, Goodarz; Ding, Eric L; Calvo, Esteban

2015-01-01

Abstract Objective To evaluate the effect of a smoking ban in high schools on smoking behaviour among Chilean students. Methods We conducted an interrupted time-series analysis, using repeated cross-sectional data from Chile’s school population survey (2000–2011) for high-school students aged 12–18 years and a control group of persons aged 19–24 years. Poisson regression models were used to assess trends in smoking behaviour before and after the policy changes. The outcome measures were self-reported smoking prevalence (any smoking in the past month) and high frequency of smoking (smoking 15 days or more per month). Findings From 2005 to 2011, the prevalence of smoking declined among high-school students by 6.8% per year compared with 3.6% decline per year in the control group. The decline in the target group was 2.9% (95% confidence interval, CI: 0.18 to 5.00) greater. We estimated that 5–6 years after enforcing the law, smoking prevalence among high-school students was 13.7% lower as a result of the ban. The impact of the smoking ban was primarily driven by declines in smoking prevalence among students in grades 8 to 10. The smoking ban did not significantly alter the frequency of smoking. Conclusion The 2005 school smoking ban reduced smoking prevalence among younger high-school students in Chile. Further interventions targeting older individuals and frequent smokers may be needed. PMID:26170504

[Smoking ban in restaurants and respiratory symptoms among employees].

PubMed

Skogstad, Marit; Kjærheim, Kristina; Fladseth, Geir; Molander, Pål

2011-11-01

Along with the introduction of a smoking ban in restaurants in 2004, respiratory symptoms, urinary cotinine and lung function among employees in 13 different bars and restaurants were studied before and after the ban came into force. At the same time measurements of air quality were taken at the respective restaurants and bars. The purpose of this study was to compare self-respiratory symptoms before and after the smoking ban among the staff at the establishments. The study included 93 men and women. These were followed during a work-shift before the smoking ban and three to eight months later. Initially 86 of the participants answered a questionnaire about respiratory tract symptoms , while 67 did so at follow-up. Before the ban 39 of the subjects (45.3%) reported wheezing in the chest and 28 (32.6%) said they had recently had an upper respiratory tract infection. 43.3% of the participants reported fewer symptoms and 20.9% more symptoms after the ban, while 35.8% reported no change. The corresponding figures among smokers were 47.5%, 15.0% and 37.5%. This study shows that the introduction of a smoking ban in restaurants contributes to a reduction in reported respiratory symptoms among employees, and may therefore be advantageous for the health of this group.

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

PubMed

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.

Quitting smoking: The importance of non-smoker identity in predicting smoking behaviour and responses to a smoking ban.

PubMed

Meijer, Eline; Gebhardt, Winifred A; Dijkstra, Arie; Willemsen, Marc C; Van Laar, Colette

2015-01-01

We examined how 'smoker' and 'non-smoker' self- and group-identities and socio-economic status (SES) may predict smoking behaviour and responses to antismoking measures (i.e., the Dutch smoking ban in hospitality venues). We validated a measure of responses to the smoking ban. Longitudinal online survey study with one-year follow-up (N = 623 at T1 in 2011; N = 188 at T2 in 2012) among daily smokers. Intention to quit, quit attempts and 'rejecting', 'victimizing', 'socially conscious smoking' and 'active quitting' responses to the smoking ban. Non-smoker identities are more important than smoker identities in predicting intention to quit, quit attempts and responses to the smoking ban, even when controlling for other important predictors such as nicotine dependence. Smokers with stronger non-smoker identities had stronger intentions to quit, were more likely to attempt to quit between measurements, and showed less negative and more positive responses to the smoking ban. The association between non-smoker self-identity and intention to quit was stronger among smokers with lower than higher SES. Antismoking measures might be more effective if they would focus also on the identity of smokers, and help smokers to increase identification with non-smoking and non-smokers.

The Impact of a City-Wide Indoor Smoking Ban on Smoking and Drinking Behaviors Across Emerging Adulthood.

PubMed

Cance, Jessica Duncan; Talley, Anna E; Fromme, Kim

2016-02-01

Almost one-third of college students report recent cigarette use, primarily as "social smoking," and often in conjunction with alcohol use. While city-wide indoor smoking bans effectively reduce the number of social opportunities to smoke (eg, bars and music clubs), little is known about how these bans may impact the smoking behaviors of college students. Furthermore, nothing is known about how indoor smoking bans may impact students' drinking behaviors. The current study aims to determine the impact of a city-wide comprehensive indoor smoking ban on smoking and alcohol behaviors among a longitudinal sample of emerging adults. Data are from a 6-year longitudinal study (10 waves of data collection) that began the summer before college enrollment. Participants (N = 2244; 60% female) reported on their past 3-month smoking and drinking behaviors using Internet-based surveys at each wave. Piecewise linear growth modeling was used to determine how a city-wide comprehensive indoor smoking ban (implemented in the Fall of 2005 between Waves 4 and 5) impacted smoking frequency, cigarette quantity, drinking frequency, and number of binge drinking episodes. Smoking and alcohol use increased from the summer before college through the semester before implementation of the city-wide smoking ban. While smoking frequency (P < .001) and cigarette quantity (P < .05) declined after the ban, drinking frequency increased (P < .001) and the number of binge drinking episodes remained stable. Current findings suggest that comprehensive indoor smoking bans can influence the smoking behaviors of emerging adults, whereas trajectories of drinking are relatively unchanged. © 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.

Does the workplace-smoking ban eliminate differences in risk for environmental tobacco smoke exposure at work?

PubMed

Verdonk-Kleinjan, Wendy M I; Knibbe, Ronald A; Tan, Frans E S; Willemsen, Marc C; de Groot, Henk N; de Vries, Hein

2009-10-01

A workplace-smoking ban in the Netherlands was introduced on January 1, 2004. Before the ban male and low educated employees were at higher risk for exposure to environmental tobacco smoke (ETS). Effective implementation of the ban should result not only in an overall decline of exposure, but also in the disappearance of systematic differences in exposure between subgroups of employees. Data from a Dutch continuous Internet survey were used. From July 2003 through June 2005, 200 respondents were randomly selected each week. The sample consisted of 11,291 non-smoking, working respondents, aged 16-65 years. ETS exposure decreased among all employees and among subgroups at higher risk before the ban. However, also after the ban, males and low educated employees were still most likely to be exposed to ETS. The workplace-smoking ban was effective in reducing ETS exposure among employees. However, after the ban still 52.2% of non-smoking workers reported to be exposed. We did not find the expected stronger effect among employees who were at higher risk. Both before and after implementation of the ban, males and lower educated employees were about two times more likely to be exposed to ETS.

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

PubMed Central

Kohler, Stefan; Minkner, Philipp

2014-01-01

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. PMID:24394216

A citywide smoking ban reduced maternal smoking and risk for preterm births: a Colorado natural experiment.

PubMed

Page, Robert Lee; Slejko, Julia F; Libby, Anne M

2012-06-01

Few reports exist on the association of a public smoking ban with fetal outcomes and maternal smoking in the United States. We sought to evaluate the effect of a citywide smoking ban in comparison to a like municipality with no such ban in Colorado on maternal smoking and subsequent fetal birth outcomes. A citywide smoking ban in Colorado provided a natural experiment. The experimental citywide smoking ban site was implemented in Pueblo, Colorado. A comparison community was chosen that had no smoking ban, El Paso County, with similar characteristics of population, size, and geography. The two sites served as their own controls, as each had a preban and postban retrospective observation period: preban was April 1, 2001, to July 1, 2003; postban was April 1, 2004, to July 1, 2006. Outcomes were maternal smoking (self-report), low birth weight (LBW) (defined as <2500 g or as <3000 g), and preterm births (<37 weeks gestation) in singleton births from mothers residing in these cities and reported to the State Department of Public Health. A difference-in-differences estimator was used to account for site and temporal trends in multivariate models. Compared to El Paso County preban, the odds of maternal smoking and preterm births were, respectively, 38% (p<0.05) and 23% (p<0.05) lower in Pueblo. The odds for LBW births decreased by 8% for <3000 g and increased by 8.4% for <2500 g; however, neither was significant. This is the first evidence in the United States that population-level intervention using a smoking ban improved maternal and fetal outcomes, measured as maternal smoking and preterm births.

Cardiorespiratory hospitalisation and mortality reductions after smoking bans in Switzerland.

PubMed

Vicedo-Cabrera, Ana M; Röösli, Martin; Radovanovic, Dragana; Grize, Leticia; Witassek, Fabienne; Schindler, Christian; Perez, Laura

2017-01-19

Smoking bans are considered one of the most effective policies to reduce population exposure to tobacco smoke and prevent adverse health outcomes. However, evidence on the effect of contextual variables on the effectiveness of smoking bans is still lacking. The patchwork of cantonal smoke-free laws in Switzerland was used as a quasi-experimental setting to assess changes after their introduction in: hospitalisations and mortality due to cardiorespiratory diseases in adults; total hospitalisations and hospitalisations due to respiratory disorders in children; and the modifying effects of contextual factors and the effectiveness of the laws. Using hospital and mortality registry data for residents in Switzerland (2005-2012), we conducted canton-specific interrupted time-series analyses followed by random effects meta-analyses to obtain nationwide smoking ban estimates by subgroups of age, sex and causes of hospitalisation or death. Heterogeneity of the impact caused by strictness of the ban and other smoking-related characteristics of the cantons was explored through meta-regression. Total hospitalisation rates due to cardiovascular and respiratory diseases did not significantly change after the introduction of the ban. Post-ban changes were detected in ischaemic heart disease hospitalisations, with a 2.5% reduction (95% confidence interval [CI)] -6.2 to 1.3%) for all ages and 5.5% (95% CI -10.8 to -0.2%) in adults 35-64 years old. Total mortality due to respiratory diseases decreased by 8.2% (95% CI -15.2 to -0.6%) over all ages, and chronic obstructive pulmonary disease mortality decreased by 14.0% (95% CI -22.3 to -4.5%) in adults ≥65 years old. Cardiovascular mortality did not change after the introduction of the ban, but there was an indication of post-ban reductions in mortality due to hypertensive disorders (-5.4%, 95% CI -12.6 to 2.3%), and congestive heart failure (-6.0%, 95% CI -14.5 to 3.4%). No benefits were observed for hospitalisations due to

Complete home smoking bans and antitobacco contingencies: a natural experiment.

PubMed

Hovell, Melbourne F; Adams, Marc A; Hofstetter, C Richard; Martínez-Donate, Ana P; González-Pérez, Guillermo J; Rovniak, Liza S; Boman-Davis, Marie C

2014-02-01

The California antitobacco culture may have influenced home smoking bans in Mexico. Based on the Behavioral Ecological Model, exposure to socially reinforcing contingencies or criticism may explain adoption of home smoking bans in Tijuana, Mexico, approximating rates relative to San Diego, California, and higher than those in Guadalajara, Mexico. A representative cross-sectional population survey of Latinos (N = 1,901) was conducted in San Diego, Tijuana, and Guadalajara between June 2003 and September 2004. Cities were selected to represent high-, medium-, and low-level exposure to antitobacco social contingencies of reinforcement in a quasiexperimental analysis of possible cultural influences across borders. Complete home smoking ban prevalence was 91% in San Diego, 66% in Tijuana, and 38% in Guadalajara (p < .001). Sample cluster-adjusted logistic regression showed significantly lower odds of complete home smoking bans in Guadalajara (odds ratio [OR] = .048) and in Tijuana (OR = .138) compared to San Diego after control for demographics. Odds of complete home smoking bans in both Guadalajara and Tijuana in comparison with San Diego were weakened when mediators for bans were controlled in predictive models. Direction of association was consistent with theory. When theoretical mediators were explored as possible moderators, weak and nonsignificant associations were obtained for all interaction terms. Bootstrap analyses demonstrated that our multivariable logistic regression results were reliable. Results suggest that California antismoking social contingencies mediate complete home smoking bans in all 3 cities and may account for the greater effects in Tijuana contrasted with Guadalajara.

Socioeconomic Inequalities in Smoking and Smoking Cessation Due to a Smoking Ban: General Population-Based Cross-Sectional Study in Luxembourg.

PubMed

Tchicaya, Anastase; Lorentz, Nathalie; Demarest, Stefaan

2016-01-01

This study aimed to measure changes in socioeconomic inequalities in smoking and smoking cessation due to the 2006 smoking ban in Luxembourg. Data were derived from the PSELL3/EU-SILC (Panel Socio-Economique Liewen Zu Letzebuerg/European Union--Statistic on Income and Living Conditions) survey, which was a representative survey of the general population aged ≥16 years conducted in Luxembourg in 2005, 2007, and 2008. Smoking prevalence and smoking cessation due to the 2006 smoking ban were used as the main smoking outcomes. Two inequality measures were calculated to assess the magnitude and temporal trends of socioeconomic inequalities in smoking: the prevalence ratio and the disparity index. Smoking cessation due to the smoking ban was considered as a positive outcome. Three multiple logistic regression models were used to assess social inequalities in smoking cessation due to the 2006 smoking ban. Education level, income, and employment status served as proxies for socioeconomic status. The prevalence of smoking decreased by 22.5% between 2005 and 2008 (from 23.1% in 2005 to 17.9% in 2008), but socioeconomic inequalities in smoking persisted. Smoking prevalence decreased by 24.2% and 20.2% in men and women, respectively; this difference was not statistically significant. Smoking cessation in daily smokers due to the 2006 smoking ban was associated with education level, employment status, and income, with higher percentages of quitters among those with a lower socioeconomic status. The decrease in smoking prevalence after the 2006 law was also associated with a reduction in socioeconomic inequalities, including differences in education level, income, and employment status. Although the smoking ban contributed to a reduction of such inequalities, they still persist, indicating the need for a more targeted approach of smoke-free policies directed toward lower socioeconomic groups.

Socioeconomic Inequalities in Smoking and Smoking Cessation Due to a Smoking Ban: General Population-Based Cross-Sectional Study in Luxembourg

PubMed Central

Tchicaya, Anastase; Lorentz, Nathalie; Demarest, Stefaan

2016-01-01

This study aimed to measure changes in socioeconomic inequalities in smoking and smoking cessation due to the 2006 smoking ban in Luxembourg. Data were derived from the PSELL3/EU-SILC (Panel Socio-Economique Liewen Zu Letzebuerg/European Union—Statistic on Income and Living Conditions) survey, which was a representative survey of the general population aged ≥16 years conducted in Luxembourg in 2005, 2007, and 2008. Smoking prevalence and smoking cessation due to the 2006 smoking ban were used as the main smoking outcomes. Two inequality measures were calculated to assess the magnitude and temporal trends of socioeconomic inequalities in smoking: the prevalence ratio and the disparity index. Smoking cessation due to the smoking ban was considered as a positive outcome. Three multiple logistic regression models were used to assess social inequalities in smoking cessation due to the 2006 smoking ban. Education level, income, and employment status served as proxies for socioeconomic status. The prevalence of smoking decreased by 22.5% between 2005 and 2008 (from 23.1% in 2005 to 17.9% in 2008), but socioeconomic inequalities in smoking persisted. Smoking prevalence decreased by 24.2% and 20.2% in men and women, respectively; this difference was not statistically significant. Smoking cessation in daily smokers due to the 2006 smoking ban was associated with education level, employment status, and income, with higher percentages of quitters among those with a lower socioeconomic status. The decrease in smoking prevalence after the 2006 law was also associated with a reduction in socioeconomic inequalities, including differences in education level, income, and employment status. Although the smoking ban contributed to a reduction of such inequalities, they still persist, indicating the need for a more targeted approach of smoke-free policies directed toward lower socioeconomic groups. PMID:27100293

Restaurant and Bar Owners’ Exposure to Secondhand Smoke and Attitudes Regarding Smoking Bans in Five Chinese Cities

PubMed Central

Liu, Ruiling; Hammond, S. Katharine; Hyland, Andrew; Travers, Mark J.; Yang, Yan; Nan, Yi; Feng, Guoze; Li, Qiang; Jiang, Yuan

2011-01-01

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. PMID:21655134

UK news media representations of smoking, smoking policies and tobacco bans in prisons.

PubMed

Robinson, Amy; Sweeting, Helen; Hunt, Kate

2018-02-19

Prisoner smoking rates remain high, resulting in secondhand smoke exposures for prison staff and non-smoker prisoners. Several jurisdictions have introduced prison smoking bans with little evidence of resulting disorder. Successful implementation of such bans requires staff support. As news media representations of health and other issues shape public views and as prison smoking bans are being introduced in the UK, we conducted content analysis of UK news media to explore representations of smoking in prisons and smoke-free prisons. We searched 64 national and local newspapers and 5 broadcast media published over 17 months during 2015-2016, and conducted thematic analysis of relevant coverage in 106 articles/broadcasts. Coverage was relatively infrequent and lacked in-depth engagement with the issues. It tended to reinforce a negative view of prisoners, avoid explicit concern for prisoner or prison staff health and largely ignore the health gains of smoke-free policies. Most coverage failed to discuss appropriate responses or support for cessation in the prison context, or factors associated with high prisoner smoking rates. Half the articles/broadcasts included coverage suggesting smoke-free prisons might lead to unrest or instability. Negative news media representations of prisoners and prison smoking bans may impact key stakeholders' views (eg, prison staff, policy-makers) on the introduction of smoke-free prison policies. Policy-makers' communications when engaging in discussion around smoke-free prison policies should draw on the generally smooth transitions to smoke-free prisons to date, and on evidence on health benefits of smoke-free environments and smoking cessation. © 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.

Transitions in Smoking Behavior During Emerging Adulthood: A Longitudinal Analysis of the Effect of Home Smoking Bans

PubMed Central

Stigler, Melissa H.; Erickson, Darin J.; Perry, Cheryl L.; Forster, Jean L.

2014-01-01

Objectives. We studied the effect of home smoking bans on transitions in smoking behavior during emerging adulthood. Methods. We used latent transition analysis to examine movement between stages of smoking from late adolescence (ages 16–18 years) to young adulthood (ages 18–20 years) and the effect of a home smoking ban on these transitions. We used data from the Minnesota Adolescent Community Cohort study collected in 2004 to 2006. Results. Overall, we identified 4 stages of smoking: (1) never smokers, (2) experimental smokers, (3) light smokers, and (4) daily smokers. Transition probabilities varied by stage. Young adults with a home ban during late adolescence were less likely to be smokers and less likely to progress to higher use later. Furthermore, the protective effect of a home smoking ban on the prevalence of smoking behavior was evident even in the presence of parental smoking. However, this effect was less clear on transitions over time. Conclusions. In addition to protecting family members from exposure to secondhand smoke, home smoking bans appear to have the additional benefit of reducing initiation and escalation of smoking behavior among young adults. PMID:24524528

Smoking ban policies and their influence on smoking behaviors among current California smokers: a population-based study.

PubMed

Zablocki, Rong W; Edland, Steven D; Myers, Mark G; Strong, David R; Hofstetter, C Richard; Al-Delaimy, Wael K

2014-02-01

To assess whether smoking ban policies are associated with smoking reduction and quit attempts among California smokers. Data were examined for 1718 current smokers from follow-up telephone interviews conducted in 2011 of persons previously identified as smokers in a representative sample of the adult population of California. Population weighted logistic regressions controlling for demographic and other variables were used to evaluate the association between smoking ban policies (home, work, and town) and changes in tobacco use (past year quit attempt or reduction in smoking rate). Living in a home with a total ban was significantly associated with smoking reduction (adjusted odds ratio, AOR: 2.4, 95% CI: 1.4-4.2) and making a quit attempt (AOR: 2.3, 95% CI: 1.3-3.9) compared to living in a home with no home ban. Self-reported perception of an outdoor ban in one's city/town was associated with smoking reduction (AOR: 1.7, 95% CI: 1.02-2.7) and making a quit attempt (AOR: 1.8, 95% CI: 1.05-2.9). These results indicate that smoking bans not only protect nonsmokers from the harms of secondhand smoke, but are also associated with smoking reduction and cessation. Copyright © 2013 Elsevier Inc. All rights reserved.

Complete Home Smoking Bans and Antitobacco Contingencies: A Natural Experiment

PubMed Central

2014-01-01

Introduction: The California antitobacco culture may have influenced home smoking bans in Mexico. Based on the Behavioral Ecological Model, exposure to socially reinforcing contingencies or criticism may explain adoption of home smoking bans in Tijuana, Mexico, approximating rates relative to San Diego, California, and higher than those in Guadalajara, Mexico. Methods: A representative cross-sectional population survey of Latinos (N = 1,901) was conducted in San Diego, Tijuana, and Guadalajara between June 2003 and September 2004. Cities were selected to represent high-, medium-, and low-level exposure to antitobacco social contingencies of reinforcement in a quasiexperimental analysis of possible cultural influences across borders. Results: Complete home smoking ban prevalence was 91% in San Diego, 66% in Tijuana, and 38% in Guadalajara (p < .001). Sample cluster-adjusted logistic regression showed significantly lower odds of complete home smoking bans in Guadalajara (odds ratio [OR] = .048) and in Tijuana (OR = .138) compared to San Diego after control for demographics. Odds of complete home smoking bans in both Guadalajara and Tijuana in comparison with San Diego were weakened when mediators for bans were controlled in predictive models. Direction of association was consistent with theory. When theoretical mediators were explored as possible moderators, weak and nonsignificant associations were obtained for all interaction terms. Bootstrap analyses demonstrated that our multivariable logistic regression results were reliable. Conclusions: Results suggest that California antismoking social contingencies mediate complete home smoking bans in all 3 cities and may account for the greater effects in Tijuana contrasted with Guadalajara. PMID:23999652

Factors Associated with Complete Home Smoking Ban among Chinese Parents of Young Children

PubMed Central

Huang, Kaiyong; Chen, Hailian; Liao, Jing; Nong, Guangmin; Yang, Li; Winickoff, Jonathan P.; Zhang, Zhiyong; Abdullah, Abu S.

2016-01-01

(1) Background: The home environment is a major source of Environmental Tobacco Smoke (ETS) exposure among children especially in early childhood. ETS exposure is an important health risk among children and can cause severe and chronic diseases, such as asthma, bronchitis, and premature death. However, ETS exposure at home has often been neglected in the Chinese families. Identification of factors that facilitate or otherwise hamper the adoption of home smoking ban will help in the design and implementation of evidence-based intervention programs. This study identifies factors correlated with home smoking bans in Chinese families with children. (2) Methods: A cross-sectional survey of parents living in Nanning city, Guangxi Province, China with at least one smoker and a child in the household was conducted between September, 2013 and January, 2014. A Chi-square test was used to compare categorical variables differences between the parents who had home smoking bans and those with no home smoking ban. Multiple logistic regression analyses were used to identify factors correlated with home smoking bans. (3) Results: 969 completed questionnaires were collected with a response rate of 92.29% (969/1050). Of the respondents (n = 969), 14.34% had complete home smoking bans. Factors that were associated with home smoking bans were: having no other smokers in the family (OR = 2.173), attaining education up to high school (OR = 2.471), believing that paternal smoking would increase the risk of lower respiratory tract illnesses (OR = 2.755), perceiving the fact that smoking cigarettes in the presence of the child will hurt the child’s health (OR = 1.547), believing that adopting a no smoking policy at home is very important (OR = 2.816), and being confident to prevent others to smoke at home (OR = 1.950). Additionally, parents who perceived difficulty in adopting a no smoking policy at home would not have a home smoking ban (OR = 0.523). (4) Conclusions: A home smoking ban

Factors Associated with Complete Home Smoking Ban among Chinese Parents of Young Children.

PubMed

Huang, Kaiyong; Chen, Hailian; Liao, Jing; Nong, Guangmin; Yang, Li; Winickoff, Jonathan P; Zhang, Zhiyong; Abdullah, Abu S

2016-01-26

(1) BACKGROUND: The home environment is a major source of Environmental Tobacco Smoke (ETS) exposure among children especially in early childhood. ETS exposure is an important health risk among children and can cause severe and chronic diseases, such as asthma, bronchitis, and premature death. However, ETS exposure at home has often been neglected in the Chinese families. Identification of factors that facilitate or otherwise hamper the adoption of home smoking ban will help in the design and implementation of evidence-based intervention programs. This study identifies factors correlated with home smoking bans in Chinese families with children. (2) METHODS: A cross-sectional survey of parents living in Nanning city, Guangxi Province, China with at least one smoker and a child in the household was conducted between September, 2013 and January, 2014. A Chi-square test was used to compare categorical variables differences between the parents who had home smoking bans and those with no home smoking ban. Multiple logistic regression analyses were used to identify factors correlated with home smoking bans. (3) RESULTS: 969 completed questionnaires were collected with a response rate of 92.29% (969/1050). Of the respondents (n = 969), 14.34% had complete home smoking bans. Factors that were associated with home smoking bans were: having no other smokers in the family (OR = 2.173), attaining education up to high school (OR = 2.471), believing that paternal smoking would increase the risk of lower respiratory tract illnesses (OR = 2.755), perceiving the fact that smoking cigarettes in the presence of the child will hurt the child's health (OR = 1.547), believing that adopting a no smoking policy at home is very important (OR = 2.816), and being confident to prevent others to smoke at home (OR = 1.950). Additionally, parents who perceived difficulty in adopting a no smoking policy at home would not have a home smoking ban (OR = 0.523). (4) CONCLUSIONS: A home smoking ban is

Problems with cigarette smoking and attitudes towards the ban of smoking in Shantou, China.

PubMed

Au, W W; Ma, W; Zhu, Q; Chen, H; Tang, L

2016-05-01

To investigate the extent of cigarette smoking, knowledge of health hazards and attitudes towards the ban of smoking in Shantou, China, as causes for failure to control smoking. Environmental monitoring and population survey. Particulate matter (PM2.5) measurements were conducted in randomly selected public places (restaurants, non-alcoholic drink shops and internet bars) and exposure-related health hazards were evaluated. University students and adult citizens were randomly selected to determine their extent of cigarette smoking, knowledge of health hazards and attitude towards the ban of smoking in public places. The collected data were used to evaluate possible causes and solutions to the smoking problem. From PM2.5 measurements, the average indoor to outdoor concentrations in non-smoking restaurants were 33.4 vs. 30.6 μg/m(3), P > 0.05; average indoor of smoking restaurants was 350.0% higher, P < 0.05; internet bars was 395.7% higher, P < 0.05; and non-alcoholic drink shops was 650.2% higher, P > 0.001. From our survey of 1100 university students: 1) 17.5% and 7.5% were active male and female smokers, respectively; and 2) 57.5% of students would accept a smoke-ban policy. From 502 adult citizens: 1) 27.5% were active male smokers; 2) Approximately 40 and 60% had inadequate knowledge of health hazards from smoking and second-hand smoke exposure; and 3) >90% of them would accept a smoke-ban policy. Our data indicate that failure to ban smoking was not caused by resistance from smokers but inadequate (national and local) government effort to educate the public and to enforce existing policy. The data suggest that development of a citizen-based approach, in collaboration with willing officials, may be highly successful in the control of cigarette smoking in China. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Short-run economic effects of the Scottish smoking ban.

PubMed

Adda, Jérôme; Berlinski, Samuel; Machin, Stephen

2007-02-01

We estimated the short-run economic impacts of the Scottish smoking ban on public houses. Previous findings on the effect of smoking bans on the hospitality sector have mainly focused on the United States. These studies have mostly found no negative economic effects of such legislation on the hospitality sector in the long run. However, differences in the social use of public houses in Great Britain in comparison with the United States may lead to different findings. We used a quasi-experimental research design that compared the sales and number of customers in public houses located in Scotland before and after the Scottish smoking ban was introduced, relative to a control group of establishments across the English border where no ban was imposed. To perform this analysis, we collected data on 2724 pubs, 1590 in Scotland and 1134 in Northern England by phone interviews using quota sampling. We found that the Scottish ban led to a 10% decrease in sales [P = 0.02, 95% confidence interval (CI) -19% to -2%] and a 14% decrease in customers (P = 0.02, 95% CI -26% to -2%). Our study suggests that the Scottish smoking ban had a negative economic impact on public houses, at least in the short run, due in part to a drop in the number of customers.

Prevalence of second-hand smoke exposure after introduction of the Italian smoking ban: the Florence and Belluno survey.

PubMed

Gorini, Giuseppe; Gasparrini, Antonio; Tamang, Elizabeth; Nebot, Manel; Lopez, Maria José; Albertini, Marco; Marcolina, Daniela; Fernandez, Esteve

2008-01-01

A law banning smoking in enclosed public places was implemented in Italy on January 10, 2005. The aim of this paper is to present a cross-sectional survey on two representative samples of non-smokers of two Italian towns (Florence and Belluno), conducted one year after the introduction of the ban, in order to assess prevalence of second-hand smoke exposure, to record the attitudes towards the ban, and the perception about its compliance in a representative sample of non-smokers. Computer-assisted telephone interviews were carried out in March 2006, from a random sample of households from telephone registries. Respondents were 402 non-smokers from Belluno and 1,073 from Florence. About 12% of Florentines and 7% of Belluno respondents were exposed at home; 39% and 19%, respectively, at work; 10% and 5% in hospitality venues; 20% and 10% in cars. The smoke-free law was almost universally supported (about 98%) even if a smaller proportion of people (about 90%) had the perception that the ban was observed. Second-hand smoke exposure at home and in hospitality premises has dropped to < or = 10%, whereas exposure at work remained higher. These results suggest the need for more controls in workplaces other than hospitality venues.

Home and workplace smoking bans in Italy, Ireland, Sweden, France, and the Czech Republic

PubMed Central

Heck, Julia E.; Stücker, Isabelle; Allwright, Shane; Gritz, Ellen R.; Haglund, Margaretha; Healton, Cheryl G.; Králíková, Eva; Del Mazo, Sara Sanchez; Tamang, Elizabeth; Dresler, Carolyn M.; Hashibe, Mia

2015-01-01

The purpose of this study was to report predictors and prevalence of home and workplace smoking bans in 5 European countries. We conducted a population-based telephone survey of 4977 women, ascertaining factors associated with smoking bans. Odds ratios (ORs) and 95% confidence intervals (CI) were derived using unconditional logistic regression. A complete home smoking ban was reported by 59.5% of French, 63.5% of Irish, 61.3% of Italian, 74.4% of Czech, and 87.0% of Swedish women. Home smoking bans were associated with younger age and being bothered by secondhand smoke, and among smokers, inversely associated with greater tobacco dependence. Among nonsmokers, bans were also related to believing smoking is harmful (OR=1.20, CI: 1.11, 1.30) and having parents who smoke (OR=0.62, CI: 0.52, 0.73). Workplace bans were reported by 92.6% of French, 96.5% of Irish, 77.9% of Italian, 79.1% of Czech, and 88.1% of Swedish women. Workplace smoking bans were reported less often among those in technical positions (OR=0.64, CI: 0.50, 0.82) and among skilled workers (OR=0.53, CI: 0.32, 0.88) than among professional workers. Workplace smoking bans are in place for most workers in these countries. Having a home smoking ban was based on smoking behavior, demographics, beliefs, and personal preference. PMID:19926747

Assessing the impact of the national smoking ban in indoor public places in china: evidence from quit smoking related online searches.

PubMed

Huang, Jidong; Zheng, Rong; Emery, Sherry

2013-01-01

Despite the tremendous economic and health costs imposed on China by tobacco use, China lacks a proactive and systematic tobacco control surveillance and evaluation system, hampering research progress on tobacco-focused surveillance and evaluation studies. This paper uses online search query analyses to investigate changes in online search behavior among Chinese Internet users in response to the adoption of the national indoor public place smoking ban. Baidu Index and Google Trends were used to examine the volume of search queries containing three key search terms "Smoking Ban(s)," "Quit Smoking," and "Electronic Cigarette(s)," along with the news coverage on the smoking ban, for the period 2009-2011. Our results show that the announcement and adoption of the indoor public place smoking ban in China generated significant increases in news coverage on smoking bans. There was a strong positive correlation between the media coverage of smoking bans and the volume of "Smoking Ban(s)" and "Quit Smoking" related search queries. The volume of search queries related to "Electronic Cigarette(s)" was also correlated with the smoking ban news coverage. To the extent it altered smoking-related online searches, our analyses suggest that the smoking ban had a significant effect, at least in the short run, on Chinese Internet users' smoking-related behaviors. This research introduces a novel analytic tool, which could serve as an alternative tobacco control evaluation and behavior surveillance tool in the absence of timely or comprehensive population surveillance system. This research also highlights the importance of a comprehensive approach to tobacco control in China.

Compliance with the smoking ban in Italy 8 years after its application.

PubMed

Minardi, Valentina; Gorini, Giuseppe; Carreras, Giulia; Masocco, Maria; Ferrante, Gianluigi; Possenti, Valentina; Quarchioni, Elisa; Spizzichino, Lorenzo; Galeone, Daniela; Vasselli, Stefania; Salmaso, Stefania

2014-06-01

The aim of this paper is to report compliance with the smoking ban and the spread of smoke-free homes after 3-8 years since the Italian smoking ban implementation, according to the ongoing Italian surveillance system for behavioural risk factors (PASSI). PASSI is based on representative annual samples of the Italian population aged 18-69 years. We considered questions on smoking habits, self-reported compliance with the ban, and on smoke-free homes of 176,236 interviews conducted in 2008-2012. Ninety percent of respondents in 2012 reported that the smoking ban was enforced in hospitality premises (HPs), with a significant 3% increase from 2008. Similarly, 91.3% in 2012 reported a high compliance in workplaces other than HPs, with a significant 5% increase. Perception of compliance did not change among smokers and non-smokers. Seventy-eight percent of respondents in 2012 reported smoke-free homes, with a significant increase from 2008 to 2012. The high compliance with the ban that is still increasing even after 8 years since its implementation may partially have caused the concurrent increase in smoke-free homes.

Secondhand smoke exposure in bars and restaurants in Guatemala City: before and after smoking ban evaluation.

PubMed

Barnoya, Joaquin; Arvizu, Mariel; Jones, Miranda R; Hernandez, Juan C; Breysse, Patrick N; Navas-Acien, Ana

2011-01-01

In February 2009, Guatemala implemented a comprehensive smoking ban. We assessed air nicotine levels in bars and restaurants 6 months after the ban (post-ban) and compared them with levels found in 2006 (pre-ban). Exposure was estimated by passive sampling of vapor-phase nicotine using samplers (n=50) placed for 7 working days in 10 bars and 11 restaurants in Guatemala City. Air nicotine was measured by gas chromatography, and the time-weighted average concentration in μg/m(3) was estimated. Employees answered a survey about smoke-free workplaces (n = 32) and compared with pre-ban (n = 37) results. Nicotine was detectable in all bars pre- and post-ban. In restaurants, it was detectable in all pre- and 73% post-ban. Median nicotine concentrations in bars significantly decreased from 4.58 μg/m(3) (IQR, 1.71, 6.45) pre-ban to 0.28 μg/m(3) (IQR 0.17, 0.66) post-ban (87% decrease). In restaurants, concentrations significantly decreased from 0.58 μg/m(3) (IQR, 0.44, 0.71) to 0.04 μg/m(3) (IQR 0.01, 0.11) (95% decrease). Employees' support for a smoke-free workplace increased in the post-ban survey (from 32 to 81%, p < 0.001). Six months after the implementation of a smoke-free law in Guatemala, nicotine levels were significantly decreased in bars and restaurants and workers' support for the law substantially increased.

Do provincial policies banning smoking in cars when children are present impact youth exposure to secondhand smoke in cars?

PubMed

Elton-Marshall, Tara; Leatherdale, Scott T; Driezen, Pete; Azagba, Sunday; Burkhalter, Robin

2015-09-01

To examine youth exposure to smoking in cars following 7 provincial bans on smoking in cars with children in Canada. Repeated cross-sectional data from the 2004-2012 Youth Smoking Survey (n=91,800) were examined. Using a quasi-experimental design, contrasts of the interaction of survey year and province included in the logistic regression analyses were used to test whether exposure significantly declined pre-post implementation of a ban on smoking in cars relative to control provinces not implementing a ban. Exposure across all provinces declined from 26.5% in 2004 to 18.2% of youth in 2012. Exposure declined significantly from pre to post implementation of a ban on smoking in cars with children in Ontario at time 1 post ban (Pre-Ban=20.4% T1post=10.3%, OR=0.45), time 2 post ban (12.1%, OR=0.61) and time 3 post ban (11.6%, OR=0.58) relative to control provinces that did not implement a ban. In British Columbia exposure to smoking in cars declined significantly at pre-post ban time 3 compared to the control group (Pre-Ban=21.2%, T3post=9.6%, OR=0.51). No other provinces had a significant change in exposure pre-post ban relative to the control provinces. Although rates declined, significant differences were only found in Ontario relative to control provinces in the immediate and long term. Copyright © 2015 Elsevier Inc. All rights reserved.

Full and home smoking ban adoption after a randomized controlled trial targeting secondhand smoke exposure reduction.

PubMed

Nicholson, Jody S; McDermott, Michael J; Huang, Qinlei; Zhang, Hui; Tyc, Vida L

2015-05-01

The current study examined home and full (i.e., home plus car) smoking ban adoption as secondary outcomes to a randomized controlled trial targeting reduced secondhand smoke exposure (SHSe) for children under treatment for cancer. Families with at least 1 adult smoker who reported SHSe for their children (n = 119) were randomized to control or intervention conditions and followed for 1 year with 5 assessments. Both groups were advised of the negative health outcomes associated with SHSe; the intervention group provided more in-depth counseling from baseline to 3 months. Parents reported on household and car smoking behavior, demographic, psychosocial, and medical/treatment-related information. Regardless of group assignment, there was an increase in home (odds ration [OR] = 1.16, p = .074) and full (OR = 1.37, p = .001) smoking ban adoption across time. Families in the intervention group were more likely to adopt a full ban by 3 months, but this difference was nonsignificant by 12 months. Married parents (OR = 2.33, p = .006) and those with higher self-efficacy for controlling children's SHSe (OR = 1.11, p = .023) were more likely to have a home smoking ban; parents who reported smoking fewer cigarettes were more likely to adopt a home (OR = 1.62, p < .0001) or full (OR = 7.32, p = .038) ban. Smoking bans are in-line with Healthy People 2020's tobacco objectives and may be more feasible for parents with medically compromised children for immediate SHSe reduction. Furthermore, interventions targeting full smoking bans may be a more effective for comprehensive elimination of SHSe. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Complying with the smoking ban by students before and after introducing legislative intervention.

PubMed

Rzeźnicki, Adam; Stelmach, Iwona; Kowalska, Alina; Krakowiak, Jan; Żebrowski, Michał; Stelmach, Włodzimierz

2015-01-01

More and more countries introduce a total ban on smoking tobacco in public places. The aim of this work was to evaluate the effectiveness of "The Act of 8 April 2010 on amendment of the act on protection of health against the consequences of consumption of tobacco and tobacco products and act on National Sanitary Inspectorate" and assess the frequency of complying with the smoking bans by the students of the Medical University of Lodz, Poland. Between 2007-2011, at the Social Medicine Institute of the Medical University of Lodz, a study using random survey was carried out involving students who were starting their studies at the Health Department of the Medical University of Lodz. The analysis of the collected material showed that 1038 people reported being smokers at the time of the study. Among that group, 530 students were included in the study prior to, and 508 after the introduction of the amendment. In order to verify their compliance with the smoking ban, the respondents were asked whether they smoked only in designated areas or wherever they wanted to. The ratio of people claiming they smoked anywhere they wanted to, disregarding the smoking ban, was 60% (N = 318) and after the amendment had been introduced, this ratio was 62.2% (N = 316), it increased by 2.2 percentage points. The observed difference was statistically irrelevant (Chi² = 0.530, p > 0.05). The Act "On amendment of the act on protection of health against the consequences of consumption of tobacco and tobacco products and Act on National Sanitary Inspectorate" in Poland did not result in the expected changes in the frequency of complying with the smoking ban by the 1st year students. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Factors influencing adoption of and adherence to indoor smoking bans among health disparity communities.

PubMed

Rees, Vaughan W; Keske, Robyn R; Blaine, Kevin; Aronstein, David; Gandelman, Ediss; Lora, Vilma; Savage, Clara; Geller, Alan C

2014-10-01

We assessed current home smoking behaviors and secondhand smoke (SHS) levels among parents of children in low-income, racial/ethnic minority communities in Massachusetts. We used a cross-sectional design to assess home smoking rules, smoking status, cigarettes smoked in the home, and barriers and benefits to attaining a smoke-free home among 138 caregivers (mean age=30.0 years; 92% women) of children aged 0 to 6 years, between April 2010 and September 2012. Indoor SHS was assessed using a nicotine dosimeter. Households with no ban reported a higher weekly mean number of cigarettes smoked in the home (114 cigarettes/week) than homes with partial (71 cigarettes/week) or complete (30 cigarettes/week) bans (P<.01). Smoking occurred outside more than inside homes with partial or complete bans. Air nicotine levels were positively associated with no household smoking ban, current smoking by the caregiver, and smoking indoors. Strategies to reduce home SHS should focus on a "complete" home smoking ban and smoking cessation. SHS mitigation strategies such as smoking outside were associated with lower SHS among participants unable to maintain a complete ban, and might enhance the likelihood of longer term success while immediately reducing home SHS.

Beliefs associated with intention to ban smoking in households with smokers.

PubMed

Hennessy, Michael; Bleakley, Amy; Mallya, Giridhar; Romer, Dan

2014-01-01

Smoking in homes exposes family members to secondhand smoke, an exposure that is harmful to children and adults. This study identifies barriers to instituting household smoking bans and beliefs that are positively and negatively related to smoking bans in households with smokers. A telephone survey of parents living in Philadelphia with at least 1 smoker and a child under the age of 13 years in the household was conducted in 2012. Using the reasoned action model, the survey assessed beliefs regarding attitudes, norms, and self-efficacy/control predictors of intention to ban household smoking. Forty-seven percent of households reported high intention to not allow smoking in the home. Regression analysis to identify the reasoned action predictors associated with intention to restrict smoking in the home showed that all 3 of the predictors of intention (attitude, normative pressure, and control) were significantly related to intention. Important underlying beliefs related to intention included beliefs about the health effects of secondhand smoke on children's health, norms regarding those restrictions, and barriers to enforcing such restrictions. Messages that increase concern about the health effects of secondhand smoke on children, that contrast the rights of smokers with negative health effects, and that suggest alternative locations to smoke are promising strategies to motivate smokers to implement indoor smoking bans.

Longitudinal Impact of the Smoking Ban Legislation in Acute Coronary Syndrome Admissions.

PubMed

Abreu, D; Sousa, P; Matias-Dias, C; Pinto, F J

2017-01-01

Background and Purpose . The association between smoking and CV has been proved; however smoking is still the first preventable cause of death in the EU. We aim to evaluate the potential impact of the smoke ban on the number of ACS events in the Portuguese population. In addition, we evaluate the longitudinal effects of the smoking ban several years after its implementation. Methods . We analyzed the admission rate for ACS before and after the ban using data from hospital admission. Monthly crude rate was computed, using the Portuguese population as the denominator. Data concerning the proportion of smokers among ACS patients were obtained from the NRACS. Interrupted time series were used to assess changes over time. Results . A decline of -5.8% was found for ACS crude rate after the smoking ban. The decreasing trend was observed even after years since the law. The effect of the ban was higher in men and for people over 65 years. The most significant reduction of ACS rate was found in Lisbon. Conclusions . Our results suggest that smoking ban is related to a decline in ACS admissions, supporting the importance of smoke legislation as a public health measure, contributing to the reduction of ACS rate.

Global Evidence on the Association between POS Advertising Bans and Youth Smoking Participation.

PubMed

Shang, Ce; Huang, Jidong; Cheng, Kai-Wen; Li, Qing; Chaloupka, Frank J

2016-03-09

Point-of-sale (POS) tobacco advertising has been linked to youth smoking susceptibility and experimental smoking. However, there is limited evidence of the association between POS advertising bans and youth smoking participation. This study aims to examine how such bans are associated with current smoking, daily smoking, and regular smoking (≥ 1 cigarettes per day) participation among youth. one to two waves (primarily one wave) of the Global Youth Tobacco Survey were conducted in 130 countries between 2007 and 2011. These surveys were linked to the WHO "MPOWER" data using country and year identifiers to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and smoking participation in the past month. Weighted logistic regressions were employed to analyze this association while controlling for age, gender, parents' smoking status, 6 MPOWER policy scores, and GDP per capita. We find that in countries with POS advertising bans, current smoking (OR = 0.73, p ≤ 0.1), daily smoking (OR = 0.70, p ≤ 0.1), and regular smoking (OR = 0.75, p ≤ 0.05) participation in the past month is significantly lower, suggesting that POS promotion bans can potentially reduce youth smoking. This study provides evidence to support the implementation of POS promotion regulations by the US FDA and implementation of the WHO FCTC guidelines regarding restrictions on tobacco POS promotion.

Bans on electronic cigarette sales to minors and smoking among high school students.

PubMed

Abouk, Rahi; Adams, Scott

2017-07-01

Many states have banned electronic cigarette sales to minors under the rationale that using e-cigarettes leads to smoking traditional combustion cigarettes. Such sales bans would be counterproductive, however, if e-cigarettes and traditional cigarettes are substitutes, as bans might push teenagers back to smoking the more dangerous combustion cigarettes. We provide evidence that these sales bans reduce the incidence of smoking conventional cigarettes among high school seniors. Moreover, we provide evidence suggesting that sales bans reduced e-cigarette usage as well. This evidence suggests that not only are e-cigarettes and smoking regular cigarettes positively related and not substitutes for young people, banning retail sales to minors is an effective policy tool in reducing tobacco use. Copyright © 2017 Elsevier B.V. All rights reserved.

Tobacco Smoke Exposure in Non-smoking Hospitality Workers Before and After a State Smoking Ban

PubMed Central

Jensen, Joni A.; Schillo, Barbara A.; Moilanen, Molly M.; Lindgren, Bruce R.; Murphy, Sharon; Carmella, Steven; Hecht, Stephen S.; Hatsukami, Dorothy K.

2010-01-01

Secondhand smoke exposure is estimated to account for 3000 cancer deaths per year. While several countries and states in the U.S. have passed comprehensive smoke-free laws to protect all employees, a significant number of workers are still not protected. The purpose of this study was to determine the effects of passing a comprehensive smoking ban that included bars and restaurants on biomarkers of nicotine and carcinogen exposure. The urines of non-smoking employees (N=24) of bars and restaurants that allowed smoking prior to the smoke-free law were analyzed before and after the law was passed in Minnesota. The results showed significant reductions in both total cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) (free plus glucuronidated) after the ban was instituted. These results provide further support for the importance of protecting employees working in all venues. PMID:20354127

Are Statewide Restaurant and Bar Smoking Bans Associated With Reduced Cigarette Smoking Among Those With Mental Illness?

PubMed Central

2014-01-01

Background: Smoke-free air laws have effectively reduced cigarette consumption at the population level; however, the influence of these policies on smoking among those with mental illness is unclear. We examined whether associations between statewide restaurant/bar smoking bans and cigarette smoking varied by psychiatric diagnoses and gender. Methods: We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, Wave 1: 2001–2002; Wave 2: 2004–2005; n = 7,317 smokers). All analyses were stratified by gender. We examined whether tobacco cessation was associated with the interaction between ban implementation and Wave 1 psychiatric diagnoses (alcohol use disorder [AUD], anxiety disorder [AD], or mood disorder), adjusting for relevant covariates. Among those who continued to use tobacco at Wave 2, we examined associations between Wave 2 cigarettes per day (CPD) and the diagnoses × ban interactions, controlling for Wave 1 CPD and other relevant covariates. Results: Among men with an AUD and women with an AD, ban implementation was associated with 6% and 10% greater probability of tobacco cessation at Wave 2, respectively. Among men in the overall sample, ban implementation was associated with smoking 0.8 fewer CPD at Wave 2. Associations with CPD were nonsignificant among women. Interactions between ban implementation and psychiatric diagnoses were also nonsignificant when examining CPD, suggesting consistent reductions in CPD among men but not among women. Conclusions: This study provided the first evidence that statewide restaurant/bar smoking bans may be associated with reduced smoking among those with select psychiatric conditions. PMID:24566280

Attitudes and experiences of restaurateurs regarding smoking bans in Adelaide, South Australia.

PubMed

Jones, K; Wakefield, M; Turnbull, D A

1999-01-01

To determine compliance with a voluntary code of practice (VCP) for restricting smoking in restaurants and to canvass the attitudes of restaurateurs towards tougher smoking restrictions. Cross-sectional survey conducted in 1996 using a telephone questionnaire. Metropolitan restaurants and cafes in Adelaide, South Australia. 276 (86.8%) of a sample of randomly selected owners and managers. Restaurant non-smoking policies, reported and anticipated change in business, and restaurateurs' attitudes towards smoking restrictions. 26.8% of restaurants had a total smoking ban; 40.6% restricted smoking some other way; and 32.6% permitted unrestricted smoking. Only 15.1% of restaurants with a ban or restrictions had used the VCP to guide the development of their policy, and only half of these were complying with it. Although 78.4% of those with bans and 84.4% of those with restrictions reported that their non-smoking policy had been associated with either no change or a gain in business, only 33.3% of those allowing unrestricted smoking expected that this would be the case, if they were to limit smoking. A total of 50.4% of restaurateurs, including 45.3% of those with no restrictions, agreed that the government should ban smoking in all restaurants. The VCP made an insignificant contribution to adoption of non-smoking policies, and compliance with the code was poor. Despite concerns about loss of business, there was considerable support for legislation which would ban smoking in all dining establishments.

Factors Influencing Adoption of and Adherence to Indoor Smoking Bans Among Health Disparity Communities

PubMed Central

Keske, Robyn R.; Blaine, Kevin; Aronstein, David; Gandelman, Ediss; Lora, Vilma; Savage, Clara; Geller, Alan C.

2014-01-01

Objectives. We assessed current home smoking behaviors and secondhand smoke (SHS) levels among parents of children in low-income, racial/ethnic minority communities in Massachusetts. Methods. We used a cross-sectional design to assess home smoking rules, smoking status, cigarettes smoked in the home, and barriers and benefits to attaining a smoke-free home among 138 caregivers (mean age = 30.0 years; 92% women) of children aged 0 to 6 years, between April 2010 and September 2012. Indoor SHS was assessed using a nicotine dosimeter. Results. Households with no ban reported a higher weekly mean number of cigarettes smoked in the home (114 cigarettes/week) than homes with partial (71 cigarettes/week) or complete (30 cigarettes/week) bans (P < .01). Smoking occurred outside more than inside homes with partial or complete bans. Air nicotine levels were positively associated with no household smoking ban, current smoking by the caregiver, and smoking indoors. Conclusions. Strategies to reduce home SHS should focus on a “complete” home smoking ban and smoking cessation. SHS mitigation strategies such as smoking outside were associated with lower SHS among participants unable to maintain a complete ban, and might enhance the likelihood of longer term success while immediately reducing home SHS. PMID:25208003

A second reporter matters: agreement between parents' and children's reports of smoking bans in families.

PubMed

Ding, Ding; Wahlgren, Dennis R; Liles, Sandy; Matt, Georg E; Oliver, McKenzie; Jones, Jennifer A; Hovell, Melbourne F

2011-05-01

Home and car smoking bans implemented by caregivers are important approaches to reducing children's secondhand smoke (SHS) exposure and attendant health risks. Such private smoking bans are usually informal and are subject to individuals' interpretation, observation, and recall. Relying on a single reporter may lead to misclassification of bans in families. To determine (1) proportion of families with discordant reports of bans; (2) association between parent-child report agreement and SHS exposure; and (3) whether including a second reporter of bans improves prediction of child SHS exposure. In each of 386 participating families a preteen and a parent reported separately on their home and car smoking bans, and agreement was determined. ANOVA, chi-square, and multiple linear regression were used to determine relationships between SHS exposure (measured by urine cotinine and reported exposure) and home/car smoking bans reported by preteens and parents. In 19% of families, reports disagreed for home smoking bans; 30%, for car smoking bans. Families who agreed on the presence of a ban had the lowest exposure, families who agreed on the absence of a ban had the highest exposure, and intermediate exposure for those who disagreed. Parent and child reports of bans each explained significant, unique variance in child SHS exposure. Due to relatively high prevalence of discordant reporting, a more accurate classification of home/car smoking bans may result from including multiple reporters. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

[The changes in smoking related behaviours and second hand smoke after the smoking ban in Izmir].

PubMed

Turan, Pakize Ayşe; Ergör, Gül; Turan, Onur; Doğanay, Sinem; Kilinç, Oğuz

2014-01-01

The aim of the study is to determine the views about law, change of second hand smoke (SHS) quantity, people's smoking related behaviours after the publishment of law which prohibits use of tobacco products in closed public areas. Questionnaire including 47 questions was performed to 600 people, who were selected by Turkey Statistics Instutition to present population of Izmir. 53.7% of participants were female and 46.3% was male; the mean age was 41.5 ± 15.6. 98% of all participants were aware of the law and 91.5% of them were supporting it. 42% of participants who succeeded in quitting had managed it after the ban. Restriction of areas, rise of prices and effects of SHS were the most popular reasons of reducing/quitting smoking after the law. Non-smokers were exposed to SHS at homes; 35.1%, at vehicles: 14.9%, at work places: 14.4%. The number of smoking cigarettes was reduced by 3.19 cigarettes/day. The rate of violation of the ban was 32.3%; only 21.3% of violators were warned. 96.4% of law supporters found law successful and sufficient. A big amount of participants thinks about quitting in Izmir; law is thought to have important effect on this decision. SHS has reduced mostly in public areas with ban, but law must be enlarged to prevent SHS at private areas such as houses, vehicles and workplaces. As a result; the ban encouraged smokers to quit and reduced SHS at public areas. We believe that paying more attention for law sanction and extending the borders of law and reviewing the ban, will make our country more smoke free from now.

Implementation of a workplace smoking ban in bars: the limits of local discretion.

PubMed

Montini, Theresa; Bero, Lisa A

2008-12-08

In January 1998, the California state legislature extended a workplace smoking ban to bars. The purpose of this study was to explore the conditions that facilitate or hinder compliance with a smoking ban in bars. We studied the implementation of the smoking ban in bars by interviewing three sets of policy participants: bar employers responsible for complying with the law; local government officials responsible for enforcing the law; and tobacco control activists who facilitated implementation. We transcribed the interviews and did a qualitative analysis of the text. The conditions that facilitated bar owners' compliance with a smoking ban in bars included: if the cost to comply was minimal; if the bars with which they were in competition were in compliance with the smoking ban; and if there was authoritative, consistent, coordinated, and uniform enforcement. Conversely, the conditions that hindered compliance included: if the law had minimal sanctions; if competing bars in the area allowed smoking; and if enforcement was delayed or inadequate. Many local enforcers wished to forfeit their local discretion and believed the workplace smoking ban in bars would be best implemented by a state agency. The potential implication of this study is that, given the complex nature of local politics, smoking bans in bars are best implemented at a broader provincial or national level.

Implementation of a workplace smoking ban in bars: The limits of local discretion

PubMed Central

Montini, Theresa; Bero, Lisa A

2008-01-01

Background In January 1998, the California state legislature extended a workplace smoking ban to bars. The purpose of this study was to explore the conditions that facilitate or hinder compliance with a smoking ban in bars. Methods We studied the implementation of the smoking ban in bars by interviewing three sets of policy participants: bar employers responsible for complying with the law; local government officials responsible for enforcing the law; and tobacco control activists who facilitated implementation. We transcribed the interviews and did a qualitative analysis of the text. Results The conditions that facilitated bar owners' compliance with a smoking ban in bars included: if the cost to comply was minimal; if the bars with which they were in competition were in compliance with the smoking ban; and if there was authoritative, consistent, coordinated, and uniform enforcement. Conversely, the conditions that hindered compliance included: if the law had minimal sanctions; if competing bars in the area allowed smoking; and if enforcement was delayed or inadequate. Conclusion Many local enforcers wished to forfeit their local discretion and believed the workplace smoking ban in bars would be best implemented by a state agency. The potential implication of this study is that, given the complex nature of local politics, smoking bans in bars are best implemented at a broader provincial or national level. PMID:19063716

Social Norms and Smoking Bans on Campus: Interactions in the Canadian University Context

ERIC Educational Resources Information Center

Procter-Scherdtel, Amy; Collins, Damian

2013-01-01

Smoking bans offer practical protection against environmental tobacco smoke and highlight the decreasing normative status of smoking. At Canadian universities, indoor smoking is now completely prohibited, but regulations vary with respect to outdoor smoking. The purpose of this research was to conceptualize the interactions of smoking bans on…

What can public endorsement for a smoking ban policy mean? Preliminary findings from a qualitative study.

PubMed

Borowiec, Agnieszka; Lignowska, Izabella; Makowska, Marta

2013-09-01

The aim of the study is to describe attitudes which underlie Pole's declarations of support for a smoking ban in public places. The qualitative study using semi-structured individual in-depth interviews was conducted. The 30 IDI-s (in depth interviews) being a part of a larger research project entitled 'Lay meanings of health and life orientation of Polish society versus prevention and health promotion attitudes' were realized between 2007-2009. People belonging to all key socio-demographic categories identified by variables such as sex, age, education, and place of domicile were interviewed. The resulting material was subjected to content analysis. In the study the structural concept of 'attitude' was adopted. In order to identify the attitudes towards smoking bans in public places statements related to all three components of attitudes were analysed, but the typology of attitudes was constructed mainly on the basis of the emotional-evaluative component. The study identified as many as four attitudes behind the declared support for a smoking ban in public places. Those attitudes were labelled 'supportive', 'accepting', 'conditionally accepting', and 'ambivalent'. They differ as regards degree of acceptance for the ban, conviction about harmfulness of passive smoking, setting great store by other regulators of smoking like cultural norms or healthy consciousness, and propensity to observe and execute the smoking ban. The 'supportive' attitude can be characterized not only by total support for the smoking ban in public places but also by insistence on the need for its extension. The 'accepting' attitude means approval for the smoking ban, and the 'conditionally accepting' attitude is distinguished from the others by the stress put on the right of smokers to have an access to places where smoking is permitted. The 'ambivalent' attitude can be typified by underlining other than legal ways of influencing smoking in public places. The study suggests that the attitudes

An exploratory analysis of the impact of a university campus smoking ban on staff and student smoking habits in Japan.

PubMed

Ohmi, Hiroki; Okizaki, Toshiyuki; Meadows, Martin; Terayama, Kazuyuki; Mochizuki, Yoshikatsu

2013-09-15

Smoking bans in public places have been shown to have an impact on smoking habits, however the potential influence of a university smoking ban on faculty and staff smoking habits remains elusive. This cross sectional study was implemented in Nayoro City, Japan in 2011, among the faculty and students of the Nayoro City University. Five years after the declaration of a total ban on smoking on a university campus, the smoking characteristics of all students, teachers and office workers, and the policy's impact on smokers were investigated. The survey was conducted through an anonymous, self-administered, multiple-choice questionnaire. Information was gathered on the characteristics and smoking characteristics of respondents, and the smokers attitudes toward smoking. The recovery rate was 62.1%. Among respondents, smoking prevalence was 17.9% in teachers and office workers, and 4.0% in students. Among all smokers, 46.4% did not abstain from smoking while at the university and they indicated their smoking areas were "on the streets next to the campus": 16 and "outdoors on campus": 3, respectively. As for smokers, 29.6% of them reduced the number of cigarettes smoked per day as a result of the smoking ban. None of the ex-smokers replied that their principal motivation for quitting smoking was the smoking ban. The ban on smoking served a motivator for smokers to reduce in smoking, but not serve as an effective motivator to quit smoking.

Global Evidence on the Association between POS Advertising Bans and Youth Smoking Participation

PubMed Central

Shang, Ce; Huang, Jidong; Cheng, Kai-Wen; Li, Qing; Chaloupka, Frank J.

2016-01-01

Background: Point-of-sale (POS) tobacco advertising has been linked to youth smoking susceptibility and experimental smoking. However, there is limited evidence of the association between POS advertising bans and youth smoking participation. This study aims to examine how such bans are associated with current smoking, daily smoking, and regular smoking (≥1 cigarettes per day) participation among youth. Methods: one to two waves (primarily one wave) of the Global Youth Tobacco Survey were conducted in 130 countries between 2007 and 2011. These surveys were linked to the WHO “MPOWER” data using country and year identifiers to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and smoking participation in the past month. Weighted logistic regressions were employed to analyze this association while controlling for age, gender, parents’ smoking status, 6 MPOWER policy scores, and GDP per capita. Results and Conclusions: We find that in countries with POS advertising bans, current smoking (OR = 0.73, p ≤ 0.1), daily smoking (OR = 0.70, p ≤ 0.1), and regular smoking (OR = 0.75, p ≤ 0.05) participation in the past month is significantly lower, suggesting that POS promotion bans can potentially reduce youth smoking. This study provides evidence to support the implementation of POS promotion regulations by the US FDA and implementation of the WHO FCTC guidelines regarding restrictions on tobacco POS promotion. PMID:27005651

Acute respiratory and cardiovascular admissions after a public smoking ban in Geneva, Switzerland.

PubMed

Humair, Jean-Paul; Garin, Nicolas; Gerstel, Eric; Carballo, Sebastian; Carballo, David; Keller, Pierre-Frédéric; Guessous, Idris

2014-01-01

Many countries have introduced legislations for public smoking bans to reduce the harmful effects of exposure to tobacco smoke. Smoking bans cause significant reductions in admissions for acute coronary syndromes but their impact on respiratory diseases is unclear. In Geneva, Switzerland, two popular votes led to a stepwise implementation of a state smoking ban in public places, with a temporary suspension. This study evaluated the effect of this smoking ban on hospitalisations for acute respiratory and cardiovascular diseases. This before and after intervention study was conducted at the University Hospitals of Geneva, Switzerland, across 4 periods with different smoking legislations. It included 5,345 patients with a first hospitalisation for acute coronary syndrome, ischemic stroke, acute exacerbation of chronic obstructive pulmonary disease, pneumonia and acute asthma. The main outcomes were the incidence rate ratios (IRR) of admissions for each diagnosis after the final ban compared to the pre-ban period and adjusted for age, gender, season, influenza epidemic and secular trend. Hospitalisations for acute exacerbation of chronic obstructive pulmonary disease significantly decreased over the 4 periods and were lowest after the final ban (IRR=0.54 [95%CI: 0.42-0.68]). We observed a trend in reduced admissions for acute coronary syndromes (IRR=0.90 [95%CI: 0.80-1.00]). Admissions for ischemic stroke, asthma and pneumonia did not significantly change. A legislative smoking ban was followed by a strong decrease in hospitalisations for acute exacerbation of chronic obstructive pulmonary disease and a trend for reduced admissions for acute coronary syndrome. Smoking bans are likely to be very beneficial for patients with chronic obstructive pulmonary disease.

Acute Respiratory and Cardiovascular Admissions after a Public Smoking Ban in Geneva, Switzerland

PubMed Central

Humair, Jean-Paul; Garin, Nicolas; Gerstel, Eric; Carballo, Sebastian; Carballo, David; Keller, Pierre-Frédéric; Guessous, Idris

2014-01-01

Background Many countries have introduced legislations for public smoking bans to reduce the harmful effects of exposure to tobacco smoke. Smoking bans cause significant reductions in admissions for acute coronary syndromes but their impact on respiratory diseases is unclear. In Geneva, Switzerland, two popular votes led to a stepwise implementation of a state smoking ban in public places, with a temporary suspension. This study evaluated the effect of this smoking ban on hospitalisations for acute respiratory and cardiovascular diseases. Methods This before and after intervention study was conducted at the University Hospitals of Geneva, Switzerland, across 4 periods with different smoking legislations. It included 5,345 patients with a first hospitalisation for acute coronary syndrome, ischemic stroke, acute exacerbation of chronic obstructive pulmonary disease, pneumonia and acute asthma. The main outcomes were the incidence rate ratios (IRR) of admissions for each diagnosis after the final ban compared to the pre-ban period and adjusted for age, gender, season, influenza epidemic and secular trend. Results Hospitalisations for acute exacerbation of chronic obstructive pulmonary disease significantly decreased over the 4 periods and were lowest after the final ban (IRR = 0.54 [95%CI: 0.42–0.68]). We observed a trend in reduced admissions for acute coronary syndromes (IRR = 0.90 [95%CI: 0.80–1.00]). Admissions for ischemic stroke, asthma and pneumonia did not significantly change. Conclusions A legislative smoking ban was followed by a strong decrease in hospitalisations for acute exacerbation of chronic obstructive pulmonary disease and a trend for reduced admissions for acute coronary syndrome. Smoking bans are likely to be very beneficial for patients with chronic obstructive pulmonary disease. PMID:24599156

Survey of staff attitudes to the smoking ban in a medium secure unit.

PubMed

Garg, Shruti; Shenoy, Suraj; Badee, May; Varghese, Joe; Quinn, Patrick; Kent, John

2009-10-01

The aim of this survey was to explore staff attitudes to the indoor smoking ban in a medium secure unit and to ascertain if they had experienced any difficulties in imposing the ban in the four months after its introduction. All staff members available on duty who agreed to participate in the survey were interviewed using a semi-structured questionnaire. The response rate was 65%. Sixty-four percent of the staff supported the smoking ban. Forty-three percent reported experiencing patient management problems with the majority complaining of increased patient aggression, increased use of staff time in supervising patients smoking. Additionally, supervising staff were still being exposed to passive smoking. Sixty-five percent reported positive effects due to the ban with the majority reporting that patients were sleeping at night due to the smoking area being closed at night. A significant proportion of the staff is still opposed to the smoking ban. Changing staff attitudes through educational programmes will be important in ensuring success of a possible future total ban in psychiatric units. 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine.

Smoke-free homes and attitudes towards banning smoking in vehicles carrying children in Spain (2016).

PubMed

Díez-Izquierdo, Ana; Lidón-Moyano, Cristina; Martín-Sánchez, Juan Carlos; Matilla-Santander, Nuria; Cassanello-Peñarroya, Pia; Balaguer, Albert; Martínez-Sánchez, Jose M

2017-10-01

To describe the voluntary adoption of smoke-free homes and social attitudes in Spain towards banning smoking in vehicles in which children are present. Cross-sectional study of a representative sample of the adult Spanish population age range, 18-75 years (n=1036). The field work was conducted via a computer-assisted telephone survey in March and April 2016. Survey respondents answered questions about smoking rules at home and attitudes towards a smoking ban in cars with or without children. Home smoking rules were defined as complete (smoking not allowed anywhere in the house), partial (smoking allowed in some areas inside the house) or absent (smoking allowed everywhere). Most (83.0%) of the surveyed population had some type of smoking restriction in place at home (45.6% complete and 37.5% partial). There were significant differences between groups according to age group (the highest prevalence was 86.1% from 66 to 75 years and the lowest prevalence was 77.8% from 46 to 65 years) and smoking status (the highest prevalence was 89.4% in people who had never been smokers and the lowest prevalence was 75.0% in current smokers) with regards to the prevalence of smoke-free homes (p<0.05), with partial bans more prevalent in smoking households (49.0%). Most (61.6%) of the population favored banning smoking in cars, and 90.1% supported a ban in cars carrying minors. Attitudes towards smoking regulation in cars (with or without children) varied significantly by age group (the highest prevalence was 81.9% from 66 to 75 years and the lowest prevalence was 54.5% from 18 to 45 years) and smoking status (the highest prevalence was 71.4% in people who had never been smokers and the lowest prevalence was 46.0% in current smokers). However, no significant differences were found with regard to attitudes towards smoking regulation in cars carrying children, regardless of sex, age, social class, or smoking status. Approximately half of the adult population in Spain have implemented

Design of prospective study of acute coronary syndrome hospitalization after smoking ban in public places in Hyogo prefecture: comparison with Gifu, a prefecture without a public smoking ban.

PubMed

Sato, Yukihito; Minatoguchi, Shinya; Nishigaki, Kazuhiko; Hirata, Ken-ichi; Masuyama, Tohru; Furukawa, Yutaka; Uematsu, Masaaki; Yoshikawa, Junichi; Otsuji, Satoru; Iida, Mami; Fujiwara, Hisayoshi

2014-02-01

Hyogo is the second prefecture, after Kanagawa, to enact a smoking ban in public places in Japan. The effect of this smoking ban on acute coronary syndrome (ACS) has not been evaluated. Changes in the annual number of ACS hospital cases in Hyogo Prefecture, before and after the enactment of the prefectural legislative ban on smoking in public places, are to be compared with those in Gifu Prefecture, where there is no smoking-ban legislation. Consecutive Hyogo residents with ACS, admitted to 33 major hospitals in the Hanshin-Awaji-Kobe district, which covers 56% of the population, during the 12 months before implementation of the legislation (April 2012 through March 2013) and during the same 24 months thereafter (April 2013 through March 2015) will be enrolled. Consecutive patients with ACS, who are Gifu residents, treated at the 20 major hospitals in Gifu Prefecture will be enrolled as geographical controls. The primary endpoint is the change in number of ACS admissions from April 2012 through March 2015, considering the periods before and after the smoking-ban legislation in Hyogo prefecture. Our study has certain strengths: (1) This is the first large Japanese study of ACS registry with smoking-ban legislation. (2) Major hospitals in the Hanshin-Awaji-Kobe district are included. (3) The data will cover 3 years including 1 year before legislation enactment. (4) The data will be compared with those of Gifu Prefecture, where smoking-ban legislation will not be enacted. (5) The very large database makes possible analysis of subgroups based on age and gender. Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Applying a contingency model of strategic decision making to the implementation of smoking bans: a case study.

PubMed

Willemsen, M C; Meijer, A; Jannink, M

1999-08-01

A model of strategic decision making was applied to study the implementation of worksite smoking policy. This model assumes there is no best way of implementing smoking policies, but that 'the best way' depends on how decision making fits specific content and context factors. A case study at Wehkamp, a mail-order company, is presented to illustrate the usefulness of this model to understand how organizations implement smoking policies. Interview data were collected from representatives of Wehkamp, and pre- and post-ban survey data were collected from employees. After having failed to solve the smoking problem in a more democratic way, Wehkamp's top management choose a highly confrontational and decentralized decision-making approach to implement a complete smoking ban. This resulted in an effective smoking ban, but was to some extent at the cost of employees' satisfaction with the policy and with how the policy was implemented. The choice of implementation approach was contingent upon specific content and context factors, such as managers' perception of the problem, leadership style and legislation. More case studies from different types of companies are needed to better understand how organizational factors affect decision making about smoking bans and other health promotion innovations.

Assessing the Impact of the National Smoking Ban in Indoor Public Places in China: Evidence from Quit Smoking Related Online Searches

PubMed Central

Huang, Jidong; Zheng, Rong; Emery, Sherry

2013-01-01

Background Despite the tremendous economic and health costs imposed on China by tobacco use, China lacks a proactive and systematic tobacco control surveillance and evaluation system, hampering research progress on tobacco-focused surveillance and evaluation studies. Methods This paper uses online search query analyses to investigate changes in online search behavior among Chinese Internet users in response to the adoption of the national indoor public place smoking ban. Baidu Index and Google Trends were used to examine the volume of search queries containing three key search terms “Smoking Ban(s),” “Quit Smoking,” and “Electronic Cigarette(s),” along with the news coverage on the smoking ban, for the period 2009–2011. Findings Our results show that the announcement and adoption of the indoor public place smoking ban in China generated significant increases in news coverage on smoking bans. There was a strong positive correlation between the media coverage of smoking bans and the volume of “Smoking Ban(s)” and “Quit Smoking” related search queries. The volume of search queries related to “Electronic Cigarette(s)” was also correlated with the smoking ban news coverage. Interpretation To the extent it altered smoking-related online searches, our analyses suggest that the smoking ban had a significant effect, at least in the short run, on Chinese Internet users’ smoking-related behaviors. This research introduces a novel analytic tool, which could serve as an alternative tobacco control evaluation and behavior surveillance tool in the absence of timely or comprehensive population surveillance system. This research also highlights the importance of a comprehensive approach to tobacco control in China. PMID:23776504

Complete workplace indoor smoking ban and smoking behavior among male workers and female nonsmoking workers' husbands: a pseudo cohort study of Japanese public workers.

PubMed

Tabuchi, Takahiro; Hoshino, Takahiro; Hama, Hitomi; Nakata-Yamada, Kayo; Ito, Yuri; Ioka, Akiko; Nakayama, Tomio; Miyashiro, Isao; Tsukuma, Hideaki

2014-01-01

A pseudo cohort study using national cross-sections (2001, 2004, 2007, and 2010) was conducted to examine differences in smoking prevalence under different smoking ban policies such as a complete workplace indoor smoking ban (early or recent implementation) and a partial smoking ban among male public workers and husbands of female nonsmoking public workers. The effectiveness of smoking bans was estimated by difference-in-differences (DID) with age group stratification. The results varied considerably by age and implementation period. Although DID estimates (positive value of DID estimate represents smoking cessation percentage) for both smoking bans on total male smoking were not significant, the over-40 age group indicated a significant DID estimate of 5.0 (95% CI: 0.2, 9.8) for the recent smoking ban. For female workers' husbands' smoking, the over-40 age group indicated positive, but not significant, DID estimates for the early and recent smoking bans of 7.2 (-4.7, 19.2) and 8.4 (-2.0, 18.7), respectively. A complete indoor workplace smoking ban, particularly one recently implemented among public office workers aged over 40, may reduce male workers' smoking and female workers' husbands' smoking compared with a partial smoking ban, but the conclusion remains tentative because of methodological weaknesses in the study.

Complete Workplace Indoor Smoking Ban and Smoking Behavior among Male Workers and Female Nonsmoking Workers' Husbands: A Pseudo Cohort Study of Japanese Public Workers

PubMed Central

Hoshino, Takahiro; Hama, Hitomi; Nakata-Yamada, Kayo; Ito, Yuri; Ioka, Akiko; Nakayama, Tomio; Miyashiro, Isao; Tsukuma, Hideaki

2014-01-01

A pseudo cohort study using national cross-sections (2001, 2004, 2007, and 2010) was conducted to examine differences in smoking prevalence under different smoking ban policies such as a complete workplace indoor smoking ban (early or recent implementation) and a partial smoking ban among male public workers and husbands of female nonsmoking public workers. The effectiveness of smoking bans was estimated by difference-in-differences (DID) with age group stratification. The results varied considerably by age and implementation period. Although DID estimates (positive value of DID estimate represents smoking cessation percentage) for both smoking bans on total male smoking were not significant, the over-40 age group indicated a significant DID estimate of 5.0 (95% CI: 0.2, 9.8) for the recent smoking ban. For female workers' husbands' smoking, the over-40 age group indicated positive, but not significant, DID estimates for the early and recent smoking bans of 7.2 (−4.7, 19.2) and 8.4 (−2.0, 18.7), respectively. A complete indoor workplace smoking ban, particularly one recently implemented among public office workers aged over 40, may reduce male workers' smoking and female workers' husbands' smoking compared with a partial smoking ban, but the conclusion remains tentative because of methodological weaknesses in the study. PMID:24783199

Implementing smoking bans in American hospitals: results of a national survey

PubMed Central

Longo, D.; Feldman, M.; Kruse, R.; Brownson, R.; Petroski, G.; Hewett, J.

1998-01-01

OBJECTIVES—To determine how well hospitals complied with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) tobacco control standards, which required banning smoking in hospital buildings; to explore issues involved in developing and implementing smoking bans; and to ascertain the perceived success of the policies.
DESIGN—Postal survey conducted January through June 1994.
PARTICIPANTS—Stratified random sample of American hospitals surveyed by JCAHO (n = 1055).
MAIN OUTCOME MEASURES—Enacting smoking policies more restrictive than the JCAHO standard; the respondent's judgment of the relative success of the hospital's smoking policy.
RESULTS—More than 96% of hospitals complied with the smoking ban standard; 41.4% enacted policies that were more restrictive than required by JCAHO. Several characteristics were associated with exceeding JCAHO requirements: location in a "non-tobacco state"; having fewer than 100 beds; location in a metropolitan statistical area; having unionised employees; and having no psychiatric or substance abuse unit, favour having the same tobacco policy in psychiatry and substance abuse units as the rest of the hospital. More than 95% of respondents viewed their hospital's policy as successful. The JCAHO requirements and concern for employees' health were the major forces influencing hospitals to go smoke-free. Negative employee morale and lack of acceptance by visitors and patients were the most commonly cited barriers to overcome when implementing smoke-free policies.
CONCLUSIONS—Smoking bans were successfully implemented in American hospitals, with many restricting smoking beyond the JCAHO standard. Other industries wishing to follow hospitals' lead would be most likely to succeed in the context of a social norm favouring a smoking ban and regulation by an outside agency.


Keywords: smoke-free worksites; hospitals; United States PMID:9706754

Associations of Bar and Restaurant Smoking Bans With Smoking Behavior in the CARDIA Study: A 25-Year Study.

PubMed

Mayne, Stephanie L; Auchincloss, Amy H; Tabb, Loni Philip; Stehr, Mark; Shikany, James M; Schreiner, Pamela J; Widome, Rachel; Gordon-Larsen, Penny

2018-06-01

Indoor smoking bans have often been associated with reductions in smoking prevalence. However, few studies have evaluated their association with within-person changes in smoking behaviors. We linked longitudinal data from 5,105 adults aged 18-30 years at baseline from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-2011) to state, county, and local policies mandating 100% smoke-free bars and restaurants by census tract. We used fixed-effects models to examine the association of smoking bans with within-person change in current smoking risk, smoking intensity (smoking ≥10 cigarettes/day on average vs. <10 cigarettes/day), and quitting attempts, using both linear and nonlinear adjustment for secular trends. In models assuming a linear secular trend, smoking bans were associated with a decline in current smoking risk and smoking intensity and an increased likelihood of a quitting attempt. The association with current smoking was greatest among participants with a bachelor's degree or higher. In models with a nonlinear secular trend, pooled results were attenuated (confidence intervals included the null), but effect modification results were largely unchanged. Findings suggest that smoking ban associations may be difficult to disentangle from other tobacco control interventions and emphasize the importance of evaluating equity throughout policy implementation.

Children's exposure to second-hand smoke before and after the smoking ban in Bavaria-a multiple cross-sectional study.

PubMed

Liang, Linda A; Weber, Alisa; Herr, Caroline; Hendrowarsito, Lana; Meyer, Nicole; Bolte, Gabriele; Nennstiel-Ratzel, Uta; Kolb, Stefanie

2016-12-01

The federal state of Bavaria, Germany enforced a comprehensive smoking ban across all enclosed public areas in 2008 to protect non-smokers from second-hand smoke (SHS). Evidence against displacement of smoking to homes is abundant, however long-term assessments are few. We aim to report prevalence of children's SHS exposure before and after the ban, parental smoking behaviour and exposure risk factors. Cross-sectional data of children aged 5-6 years old in Bavaria (n = 22 944) were collected in 2004/5 and 2005/6 (S1 and S2) before the ban and after in 2008/9 and 2012/13 (S4 and S6). Parents reported their child's home SHS exposure, in enclosed public areas and private cars. Adjusted multivariable logistic regression assessed changes across time and predicted risk factors. Children's home SHS exposure before the ban was 14.3% (S1), 14.1% (S2) and 12.8% (S4) directly after the ban to 7.2% (S6) (P<0.0001). The proportion of homes where at least one parent smoked significantly reduced from 12.78% (S1) to 4.94% (S6) (P<0.0001) and homes with voluntary smoke-free rules increased. Exposure in cafes, restaurants and private cars also decreased. No significant changes in the proportion of parents that ceased smoking due to the ban were found. Among others, low parental education, crowding and unemployment were risk factors for higher SHS exposure. Since the smoking ban, no long-term displacement of SHS to homes was observed. Social smoking norms appear to have shifted in favour of the ban. Social inequalities still exist and should be addressed to further minimise SHS exposure. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Trends in Home Smoking Bans in the U.S., 1995–2007: Prevalence, Discrepancies, and Disparities

PubMed Central

Zhang, Xiao; Martinez-Donate, Ana P.; Kuo, Daphne; Jones, Nathan R.; Palmersheim, Karen A.

2017-01-01

Background Home smoking bans significantly reduce the likelihood of secondhand smoke exposure among children and non-smoking adults. The purpose of this study was to examine national trends in a) the adoption of home smoking bans; b) discrepancies in parental smoking ban reports; and c) household and parental correlates of home smoking bans among households with underage children from 1995 to 2007. Methods We used data from the 1995/1996, 1998/1999, 2001/2002, 2003 and 2006/2007 Tobacco Use Supplement of the U.S. Current Population Survey to estimate prevalence rates and logistic regression models of parental smoking ban reports by survey period. Results Overall, the prevalence of a complete home smoking bans increased from 58.1% to 83.8% (p<0.01), while discrepancies in parental reports decreased from 12.5% to 4.6% (p<0.01) from 1995 to 2007. Households with single parent, low income, one or two current smokers, parents with less than a college education, or without infants were consistently less likely to report a home smoking ban over this period (p<0.05). Conclusion Despite general improvements in the adoption of home smoking bans and a reduction on parental discrepancies, disparities in the level of protection from secondhand smoke have persisted over time. Children living in households with single parents, low income, current smoker parents, less educated parents, or without infants are less likely to be protected by a home smoking ban. These groups are in need of interventions promoting the adoption of home smoking bans to reduce disparities in tobacco-related diseases. PMID:21813487

Effects of a complete smoking ban on inpatients at an intermediate to long-term psychiatric facility.

PubMed

Smith, Philip H; Homish, Gregory G; Kozlowski, Lynn T; Spacone, Celia; Trigoboff, Eileen; Joffe, Susan

2013-04-01

The majority of research on reactions to smoking bans in psychiatric facilities focuses on staff feedback in acute inpatient settings. The purpose of this pilot study was to assess inpatient attitudes about a complete smoking ban in an intermediate to long-term psychiatric facility. One hundred inpatients were surveyed via questionnaire. Inpatients reported changes in smoking and improvements in health as a result of the ban, despite evidence of non-compliant smoking at the facility. There was evidence that inpatients perceived others' attitudes about the ban to be worse than reality. The findings from this pilot study suggest that consequences of smoking bans in psychiatric facilities are not as negative as some perceive. Smoking bans in intermediate to long-term settings may result in improvements in health among both smoking and non-smoking patients.

The influence of a smoking ban on the profitability of Belgian restaurants.

PubMed

De Schoenmaker, Sofie; Van Cauwenberge, Philippe; Vander Bauwhede, Heidi

2013-05-01

To examine whether the nationwide smoking ban, imposed in 2007, had an impact on the profitability of Belgian restaurants. Objective financial reporting data on 1613 restaurants were analysed with return on assets as the outcome measure. The data were collected from the Belfirst database and cover the period 2004-2009. To assess the impact of the smoking ban, a differences-in-differences estimation method was used, with bars serving as the control group. The regression model was estimated, while controlling for firm-specific characteristics and unobserved firm-level heterogeneity. The variable of interest is the interaction between the smoking ban dummy and the dummy for the treatment group. The coefficient of this variable is insignificant. The adoption of the nationwide smoking ban did not affect the profitability of Belgian restaurants.

Air pollution in Boston bars before and after a smoking ban.

PubMed

Repace, James L; Hyde, James N; Brugge, Doug

2006-10-27

We quantified the air quality benefits of a smoke-free workplace law in Boston Massachusetts, U.S.A., by measuring air pollution from secondhand smoke (SHS) in 7 pubs before and after the law, comparing actual ventilation practices to engineering society (ASHRAE) recommendations, and assessing SHS levels using health and comfort indices. We performed real-time measurements of respirable particle (RSP) air pollution and particulate polycyclic aromatic hydrocarbons (PPAH), in 7 pubs and outdoors in a model-based design yielding air exchange rates for RSP removal. We also assessed ventilation rates from carbon dioxide concentrations. We compared RSP air pollution to the federal Air Quality Index (AQI) and the National Ambient Air Quality Standard (NAAQS) to assess health risks, and assessed odor and irritation levels using published SHS-RSP thresholds. Pre-smoking-ban RSP levels in 6 pubs (one pub with a non-SHS air quality problem was excluded) averaged 179 microg/m3, 23 times higher than post-ban levels, which averaged 7.7 microg/m3, exceeding the NAAQS for fine particle pollution (PM2.5) by nearly 4-fold. Pre-smoking ban levels of fine particle air pollution in all 7 of the pubs were in the Unhealthy to Hazardous range of the AQI. In the same 6 pubs, pre-ban indoor carcinogenic PPAH averaged 61.7 ng/m3, nearly 10 times higher than post-ban levels of 6.32 ng/m3. Post-ban particulate air pollution levels were in the Good AQI range, except for 1 venue with a defective gas-fired deep-fat fryer, while post-ban carcinogen levels in all 7 pubs were lower than outdoors. During smoking, although pub ventilation rates per occupant were within ASHRAE design parameters for the control of carbon dioxide levels for the number of occupants present, they failed to control SHS carcinogens or RSP. Nonsmokers' SHS odor and irritation sensory thresholds were massively exceeded. Post-ban air pollution measurements showed 90% to 95% reductions in PPAH and RSP respectively, differing

Exposure to ultrafine particles in hospitality venues with partial smoking bans.

PubMed

Neuberger, Manfred; Moshammer, Hanns; Schietz, Armin

2013-01-01

Fine particles in hospitality venues with insufficient smoking bans indicate health risks from passive smoking. In a random sample of Viennese inns (restaurants, cafes, bars, pubs and discotheques) effects of partial smoking bans on indoor air quality were examined by measurement of count, size and chargeable surface of ultrafine particles (UFPs) sized 10-300 nm, simultaneously with mass of particles sized 300-2500 nm (PM2.5). Air samples were taken in 134 rooms unannounced during busy hours and analyzed by a diffusion size classifier and an optical particle counter. Highest number concentrations of particles were found in smoking venues and smoking rooms (median 66,011 pt/cm(3)). Even non-smoking rooms adjacent to smoking rooms were highly contaminated (median 25,973 pt/cm(3)), compared with non-smoking venues (median 7408 pt/cm(3)). The particle number concentration was significantly correlated with the fine particle mass (P<0.001). We conclude that the existing tobacco law in Austria is ineffective to protect customers in non-smoking rooms of hospitality premises. Health protection of non-smoking guests and employees from risky UFP concentration is insufficient, even in rooms labeled "non-smoking". Partial smoking bans with separation of smoking rooms failed.

Response to ban on smoking in public places--a cross-sectional study.

PubMed

Hussain, Abrar; Mohan, Anjana; Sathiyasekaran, B W C

2009-07-01

Smoking has become an important global problem that poses serious health hazards. Today even teenagers have got trapped by this addictive habit. To curb this menace, the Government of Tamilnadu has proposed a ban on smoking in public places by introducing the Bill "Tamilnadu Prohibition of Smoking and Spitting 2002". A study was conducted in the month of February, 2003 to find out the response to this proposed ban among health providers. One hundred and twenty-seven hospital employees were studied using a one page questionnaire. The prevalence of smoking was found to be 12.6% (95% CI 6.9 to 18.3). The response of the study group to the proposed ban was recorded by asking them about their awareness, acceptability and their personal opinion about the ban. It was found that 94% of the smokers and 83% of the non-smokers were aware of the proposed ban and 50% of the smokers and 69% of non-smokers wanted the ban to be implemented. It was also found that 43.8% of the smokers and 52.3% of the non-smokers were confident that the ban on smoking in public places will be effective. They were also of the opinion that awareness had to be increased and the penalties had to be implemented strictly. Further studies on other population groups may have to be taken upto know about the impact of this important Act after it comes into effect.

Perceptions of parental smoking and sociodemographic factors associated with the adoption of home smoking bans among parents of school-aged children.

PubMed

Chen, Yu-Ting; Chen, Ping-Ling

2014-08-01

Although public smoking restrictions have been implemented, children are still exposed to household smoking. Parental smoking is the main source of children's exposure to secondhand smoke. This study was conducted to examine the factors associated with parents' adoption of home smoking bans. A cross-sectional study was conducted using a self-administered questionnaire to collect data from 768 parents of school-aged children in Taiwan. The home smoking restriction status, parents' perceptions of smoking in the presence of children and its influences, and parents' sociodemographic characteristics were assessed. Hierarchical logistic regression analysis was used to determine the best-fit model. More than 80% of the parents agreed with home smoking bans, whereas only approximately 26% of the parents actually restricted smoking at home completely. The crude odds ratios showed that parents who perceived the influence of parental smoking on children to be negative were more likely to adopt home smoking bans. Hierarchical logistic regression revealed factors associated with the adoption of home smoking bans, including a higher education level and older age of parents, a family composed of nonparent adults, and opposition to parental smoking in the presence of children. Children's health is a major concern for parents considering home smoking bans. Helping parents clarify misunderstandings regarding parental smoking, emphasizing the adverse effects of children's exposure to parental smoking, suggesting healthy substitutes for smoking, and providing effective strategies for maintaining a smoke-free home can motivate families to adopt home smoking bans. © 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.

Compliance and enforcement of a partial smoking ban in Lisbon taxis: an exploratory cross-sectional study.

PubMed

Ravara, Sofia B; Castelo-Branco, Miguel; Aguiar, Pedro; Calheiros, Jose M

2013-02-14

Research evaluating enforcement and compliance with smoking partial bans is rather scarce, especially in countries with relative weak tobacco control policies, such as Portugal. There is also scarce evidence on specific high risk groups such as vehicle workers. In January 2008, Portugal implemented a partial ban, followed by poor enforcement. The purpose of this study was to explore the effectiveness of a partial smoking ban in a pro-smoking environment, specifically transportation by taxi in the city of Lisbon. Ban effectiveness was generally defined by ban awareness and support, compliance and enforcement. Exploratory cross-sectional study; purposive sampling in selected Lisbon streets. Structured interviews were conducted by trained researchers while using taxi services (January 2009-December 2010). 250 taxi drivers (98.8% participation rate). Chi-square, McNemar, Man Whitney tests and multiple logistic regression were performed. Of the participants, 249 were male; median age was 53.0 years; 43.6% were current smokers. Most participants (82.8%) approved comprehensive bans; 84.8% reported that clients still asked to smoke in their taxis; 16.8% allowed clients to smoke. Prior to the ban this value was 76.9% (p < 0.001). The major reason for not allowing smoking was the legal ban and associated fines (71.2%). Of the smokers, 66.1% admitted smoking in their taxi. Stale smoke smells were detected in 37.6% of the cars. None of the taxi drivers did ever receive a fine for non-compliance. Heavy smoking, night-shift and allowing smoking prior the ban predicted non-compliance. Despite the strong ban support observed, high smoking prevalence and poor enforcement contribute to low compliance. The findings also suggest low compliance among night-shift and vehicle workers. This study clearly demonstrates that a partial and poorly-enforced ban is vulnerable to breaches, and highlights the need for clear and strong policies.

Exposure to tobacco smoke before and after a partial smoking ban in prison: indoor air quality measures.

PubMed

Ritter, Catherine; Huynh, Cong Khanh; Etter, Jean-François; Elger, Bernice S

2012-09-01

Although exposure to secondhand smoke (SHS) is reportedly high in prison, few studies have measured this in the prison environment, and none have done so in Europe. We measured two indicators of SHS exposure (particulate matter PM10 and nicotine) in fixed locations before (2009) and after (2010) introduction of a partial smoking ban in a Swiss prison. Access to smoking cessation support was available to detainees throughout the study. To measure SHS before and after the introduction of a partial smoking ban. Assessment of particulate matter PM10 (suspended microparticles of 10 μm) and nicotine in ambient air, collected by real-time aerosol monitor and nicotine monitoring devices. The authors observed a significant improvement of nicotine concentrations in the air after the introduction of the smoking ban (before: 7.0 μg/m(3), after: 2.1 μg/m(3), difference 4.9 μg/m(3), 95% CI for difference: 0.52 to 9.8, p=0.03) but not in particulate matter PM10 (before: 0.11 mg/m(3), after: 0.06 mg/m(3), difference 0.06 mg/m(3), 95% CI for difference of means: -0.07 to 0.19, p=0.30). The partial smoking ban was followed by a decrease in nicotine concentrations in ambient air. These improvements can be attributed to the introduction of the smoking ban since no other policy change occurred during this period. Although this shows that concentrations of SHS decreased significantly, protection was still incomplete and further action is necessary to improve indoor air quality.

Patient Management and Psychopharmacological Treatment Associated to Smoking Ban in an Acute Psychiatric Unit.

PubMed

Bergé, Daniel; Mané, Anna; Fonseca, Francina; Toll, Alba; Merino, Ana; Pérez, Victor; Bulbena, Antoni

2015-08-01

This study investigates differences in terms of clinical and treatment management in psychiatric hospitalization associated to smoking ban. We collected data regarding medication, socio-demographic and admission characteristics from all patients admitted to an acute psychiatric hospital before and after a smoking ban was in force. We also assessed a limited sample of patients before and after the ban regarding nicotine dependence, motivation to quit smoking and attitudes towards the ban. More number of leaves of absence and movement restrictions during the ban period occurred in comparison to the pre-ban period. On the contrary a lack of significant differences in terms of hospital stay (duration, rate of voluntary admissions and voluntary discharges), use of sedatives and doses of antipsychotics was found. A period of adjustment regarding the deal with leave of access and facilitate nicotine replacement treatment may help future psychiatric facilities planning smoking free policies.

Tobacco smoke exposure in nonsmoking hospitality workers before and after a state smoking ban.

PubMed

Jensen, Joni A; Schillo, Barbara A; Moilanen, Molly M; Lindgren, Bruce R; Murphy, Sharon; Carmella, Steven; Hecht, Stephen S; Hatsukami, Dorothy K

2010-04-01

Secondhand smoke exposure is estimated to account for 3,000 cancer deaths per year. Although several countries and states in the United States have passed comprehensive smoke-free laws to protect all employees, a significant number of workers are still not protected. The purpose of this study was to determine the effects of passing a comprehensive smoking ban that included bars and restaurants on biomarkers of nicotine and carcinogen exposure. The urines of nonsmoking employees (n = 24) of bars and restaurants that allowed smoking before the smoke-free law were analyzed before and after the law was passed in Minnesota. The results showed significant reductions in both total cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (free plus glucuronidated) after the ban was instituted. These results provide further support for the importance of protecting employees working in all venues.

Banning Cigarette Smoking on US Navy Submarines: A Case Study

PubMed Central

Lando, Harry A.; Michaud, Mark. E.; Poston, Walker S.C.; Jahnke, Sara A.; Williams, Larry; Haddock, Christopher K.

2014-01-01

Background The military has had a long pro-tobacco tradition. Despite official policy discouraging smoking, tobacco still is widely seen as part of military culture. While active smoking has presented a particular challenge for the military, in recent years there also has been increasing concern with secondhand smoke. This is especially true in closed environments and submarines may be deployed for months at a time. The current case study describes the successful implementation by the Navy of a comprehensive ban on smoking aboard submarines. Methods The authors searched documents on the Internet, popular media, military-based news outlets, and the scientific literature. We also conducted interviews with Navy officers who were instrumental in policy implementation. Findings Data demonstrating substantial exposure of nonsmokers to tobacco smoke aboard submarines had major impact on successful adoption of the policy. A systematic and extended roll out of the ban included establishing a working group, soliciting input and active engagement from submarine personnel, and offering cessation assistance. Support was enlisted from Chief Petty Officers who could have been strongly opposed but who became strong proponents. Fewer problems were encountered than had been expected. In contrast to a previous unsuccessful attempt by a Navy captain to ban smoking on his ship, the ban was adopted without apparent tobacco industry interference. Conclusions Lessons learned included the importance of strong empirical support, effective framing of the issue, setting a realistic timeline, soliciting support from key personnel, and providing appropriate resources. These lessons have implications for those considering further tobacco policy changes in the military and elsewhere. PMID:25163466

Correlates of household smoking bans in low-income families of children with and without asthma.

PubMed

Wamboldt, Frederick S; Balkissoon, Ronald C; Rankin, Allison E; Szefler, Stanley J; Hammond, S Katharine; Glasgow, Russell E; Dickinson, W Perry

2008-03-01

Exposure to secondhand smoke (SHS) harms all children's health, especially children with asthma. Yet, children with asthma are as likely to live with smokers as healthy children. Household smoking bans are being advocated to reduce children's harm from SHS. To measure the effect of household smoking bans on child SHS exposure and to examine correlates of strict smoking bans in a low-income, diverse sample, 91 children with asthma were matched to 91 healthy children. All had at least one smoker living in their homes. Nicotine dosimeters, child cotinine assays, and maternal reports quantified child SHS exposures. Maternal reports of household smoking rules, behaviors, and beliefs, and other family characteristics were also gathered. The presence of a strict household smoking ban vastly reduced children's SHS exposures and was associated with fewer cigarettes smoked by the mother and by other family members, the belief that SHS was a personal health risk, having children with asthma, and living in a single-family home. Many children are exposed to high levels of SHS at home. Strict household smoking bans greatly decrease, but do not eliminate children's SHS exposure. Even in disadvantaged families, mutable factors were associated with strict smoking bans. Increased dissemination and use of established public health strategies are needed to reduce children's SHS exposures.

Effects of a smoking ban on clozapine plasma concentrations in a nonsecure psychiatric unit.

PubMed

Gee, Siobhan H; Taylor, David M; Shergill, Sukhwinder S; Flanagan, Robert; MacCabe, James H

2017-02-01

Tobacco smoke is known to affect plasma levels of some drugs, including the antipsychotic clozapine. The effects of suddenly stopping smoking on patients who take clozapine can be severe, as plasma concentrations are expected to rapidly rise, potentially leading to toxicity. A ban on smoking at South London and the Maudsley NHS Foundation Trust (SLaM) was implemented in 2014, and this was expected to affect the plasma concentrations of clozapine for inpatients at the time. This study aimed to determine whether plasma concentrations of clozapine were affected, and additionally, in line with observations from other authors, whether levels of reported violence would also be affected. The smoking habits of all patients at SLaM who smoked and were prescribed clozapine were recorded both before and after the ban. The Glasgow Antipsychotic Side Effect Scale for Clozapine (GASS-C) scale was used to evaluate side-effect burden. Clozapine doses and plasma concentrations were also collected. In total, 31 patients were included in this study. The mean clozapine dose before the ban was 502 mg/day, and this did not change significantly after the ban. Similarly, there were no significant changes in clozapine or norclozapine plasma concentrations, or in GASS-C scores. There was no change in the amount of tobacco patients reported smoking before or after the ban. A modest but statistically significant reduction in violent incidences was observed. Our data suggest that a ban on smoking for patients taking clozapine on open wards at inpatient hospital sites had little impact on clozapine plasma concentrations, because patients continued to smoke tobacco if allowed to leave. Smoking bans may result in a reduction in violent incidences.

Impact of Smoking Ban on Passive Smoke Exposure in Pregnant Non-Smokers in the Southeastern United States.

PubMed

Schechter, Julia C; Fuemmeler, Bernard F; Hoyo, Cathrine; Murphy, Susan K; Zhang, Junfeng Jim; Kollins, Scott H

2018-01-06

Prenatal passive smoke exposure raises risk for negative birth outcomes. Legislation regulating public smoking has been shown to impact exposure levels, though fewer studies involving pregnant women have been conducted within the U.S. where bans are inconsistent across regions. This study examined the effect of a ban enacted in the southeastern U.S. on pregnant women's cotinine levels. Additional analyses compared self-reported exposure to cotinine and identified characteristics associated with passive exposure. Pregnant women ( N = 851) were recruited prospectively between 2005 and 2011 in North Carolina. Sociodemographic and health data were collected via surveys; maternal blood samples were assayed for cotinine. Among non-active smokers who provided self-report data regarding passive exposure ( N = 503), 20% were inconsistent with corresponding cotinine. Among all non-smokers ( N = 668), being unmarried, African American, and less educated were each associated with greater passive exposure. Controlling for covariates, mean cotinine was higher prior to the ban compared to after, F (1, 640) = 24.65, p < 0.001. Results suggest that banning smoking in public spaces may reduce passive smoke exposure for non-smoking pregnant women. These data are some of the first to examine the impact of legislation on passive smoke exposure in pregnant women within the U.S. using a biomarker and can inform policy in regions lacking comprehensive smoke-free legislation.

Impact of Smoking Ban on Passive Smoke Exposure in Pregnant Non-Smokers in the Southeastern United States

PubMed Central

Schechter, Julia C.; Fuemmeler, Bernard F.; Hoyo, Cathrine; Murphy, Susan K.; Zhang, Junfeng (Jim); Kollins, Scott H.

2018-01-01

Prenatal passive smoke exposure raises risk for negative birth outcomes. Legislation regulating public smoking has been shown to impact exposure levels, though fewer studies involving pregnant women have been conducted within the U.S. where bans are inconsistent across regions. This study examined the effect of a ban enacted in the southeastern U.S. on pregnant women’s cotinine levels. Additional analyses compared self-reported exposure to cotinine and identified characteristics associated with passive exposure. Pregnant women (N = 851) were recruited prospectively between 2005 and 2011 in North Carolina. Sociodemographic and health data were collected via surveys; maternal blood samples were assayed for cotinine. Among non-active smokers who provided self-report data regarding passive exposure (N = 503), 20% were inconsistent with corresponding cotinine. Among all non-smokers (N = 668), being unmarried, African American, and less educated were each associated with greater passive exposure. Controlling for covariates, mean cotinine was higher prior to the ban compared to after, F(1, 640) = 24.65, p < 0.001. Results suggest that banning smoking in public spaces may reduce passive smoke exposure for non-smoking pregnant women. These data are some of the first to examine the impact of legislation on passive smoke exposure in pregnant women within the U.S. using a biomarker and can inform policy in regions lacking comprehensive smoke-free legislation. PMID:29316617

Indoor air quality in a bar/restaurant before and after the smoking ban in Athens, Greece.

PubMed

Konstantopoulou, Sophia S; Behrakis, Panagiotis K; Lazaris, Andreas C; Nicolopoulou-Stamati, Polyxeni

2014-04-01

In this study we compared indoor air pollutant concentrations in a bar/restaurant in Greece before and after the enactment of a smoking ban legislation of 2008. This was done to investigate whether the separation of the venue into smoking and non-smoking areas will have an impact on workers and customers from secondhand smoke (SHS) exposure (null hypothesis). The study was completed within an 8-month period beginning in March 2010 and ending on November 2010. We compared the average of the measured PM0.1 concentrations in the smoking zones between the pre-ban and post-ban periods. Overall reduction in the number of particles was 18% between pre-ban and post-ban periods. The mean of the 36 total CO2 measurements for the pre- and the post-ban period was 611ppm. We calculated the ventilation rates per occupant (Vo in l/s/occ) and found it to be higher in the post-ban period (19.4l/s/occ), thus complying with the ASHARAE standard for Vo of 15l/s/occ at maximum occupancy, than in the pre-ban period (10.7l/s/occ). The mean of the 36 total CO measurements for the pre-ban period was 2 ppm. CO measurements in the post-ban period were less than the detection limit of 1 ppm. Emissions of nitrogen dioxide and formaldehyde weren't detected in any of the zones. It was observed there was about 50% distribution of pollutants from the smoking zones to the smoke-free zones. The smoking ban effect on the occupancy levels was initially reduced by 16%, but based on other similar studies this transition period will be followed by an increase in the occupancy. Passive smoking and associated risks were significantly reduced but not totally eliminated, indicating the need for stronger enforcement or complete partition between smoking and non-smoking areas. Copyright © 2013 Elsevier B.V. All rights reserved.

Compliance and enforcement of a partial smoking ban in Lisbon taxis: an exploratory cross-sectional study

PubMed Central

2013-01-01

Background Research evaluating enforcement and compliance with smoking partial bans is rather scarce, especially in countries with relative weak tobacco control policies, such as Portugal. There is also scarce evidence on specific high risk groups such as vehicle workers. In January 2008, Portugal implemented a partial ban, followed by poor enforcement. The purpose of this study was to explore the effectiveness of a partial smoking ban in a pro-smoking environment, specifically transportation by taxi in the city of Lisbon. Ban effectiveness was generally defined by ban awareness and support, compliance and enforcement. Methods Exploratory cross-sectional study; purposive sampling in selected Lisbon streets. Structured interviews were conducted by trained researchers while using taxi services (January 2009-December 2010). Participants: 250 taxi drivers (98.8% participation rate). Chi-square, McNemar, Man Whitney tests and multiple logistic regression were performed. Results Of the participants, 249 were male; median age was 53.0 years; 43.6% were current smokers. Most participants (82.8%) approved comprehensive bans; 84.8% reported that clients still asked to smoke in their taxis; 16.8% allowed clients to smoke. Prior to the ban this value was 76.9% (p < 0.001). The major reason for not allowing smoking was the legal ban and associated fines (71.2%). Of the smokers, 66.1% admitted smoking in their taxi. Stale smoke smells were detected in 37.6% of the cars. None of the taxi drivers did ever receive a fine for non-compliance. Heavy smoking, night-shift and allowing smoking prior the ban predicted non-compliance. Conclusions Despite the strong ban support observed, high smoking prevalence and poor enforcement contribute to low compliance. The findings also suggest low compliance among night-shift and vehicle workers. This study clearly demonstrates that a partial and poorly-enforced ban is vulnerable to breaches, and highlights the need for clear and strong

“How Is Smoking Handled in Your Home?”: Agreement Between Parental Reports on Home Smoking Bans in the United States, 1995–2007

PubMed Central

Zhang, Xiao; Kuo, Daphne; Jones, Nathan R.

2012-01-01

Introduction: Home smoking bans significantly reduce secondhand smoke exposure among children, but parents may offer discordant reports on whether there is a home smoking ban. The purpose of this study was to examine national trends in (a) parental discordance/concordance in the reporting of home smoking bans and (b) correlates of discordant/concordant reports among two-parent households with underage children from 1995 to 2007. Methods: Data from the 1995/1996, 1998/1999, 2001/2002, 2003, and 2006/2007 Tobacco Use Supplement of the U.S. Current Population Survey were used to estimate prevalence rates and multinomial logistic regression models of discordant/concordant parental smoking ban reports by survey period. Results: Overall, the percentage of households in which the 2 parents gave discordant reports on a complete home smoking ban decreased significantly from 12.7% to 2.8% from 1995 to 2007 (p < .001). Compared with households where both parents reported a complete smoking ban, discordant reports were more likely to be obtained from households with current smokers (p < .01) across survey periods. Compared with households where both parents reported the lack of a complete home smoking ban, discordant reports were more likely among households with college graduates, no current smokers, and parents with Hispanic ethnicity (p < .05). Conclusions: Parental concordance on the existence of a home smoking ban increased from 1995 to 2007. This suggests estimates of home smoking bans based on just one parent may be more reliable now than they were in the past. Interventions to improve the adoption and enforcement of home smoking bans should target households with current smoker parents. PMID:22377935

An international smoking ban-how many lives will be saved?

PubMed

Kelleher, Cecily C; Frazer, Kate

2014-06-01

Multicomponent tobacco control strategies are crucial to combat the ongoing global smoking challenge. In the twenty-first century, many countries have signed up to the World Health Organization Framework Convention on Tobacco Control, and in recent years a mounting number of countries and regions have implemented partial or complete smoking bans to protect the general public from passive smoke exposure. There is substantial evidence that workers, particularly in the hospitality sector, benefit from reduced exposure. More recently, several reports have appeared from different countries showing a temporal relationship between the introduction of a smoking ban and reduced hospital admissions for cardiovascular, respiratory and maternity outcomes. This will have a measurable benefit for public health, saving many lives. Multicomponent strategies could also reduce active smoking significantly if successfully implemented worldwide.

Sustainability of outdoor school ground smoking bans at secondary schools: a mixed-method study

PubMed Central

Rozema, A D; Mathijssen, J J P; Jansen, M W J; van Oers, J A M

2018-01-01

Abstract Background Although increasing numbers of countries are implementing outdoor school ground smoking bans at secondary schools, less attention is paid to the post-implementation period even though sustainability of a policy is essential for long-term effectiveness. Therefore, this study assesses the level of sustainability and examines perceived barriers/facilitators related to the sustainability of an outdoor school ground smoking ban at secondary schools. Methods A mixed-method design was used with a sequential explanatory approach. In phase I, 438 online surveys were conducted and in phase II, 15 semi-structured interviews were obtained from directors of relevant schools. ANOVA (phase I) and a thematic approach (phase II) were used to analyze data. Results Level of sustainability of an outdoor school ground smoking ban was high at the 48% Dutch schools with an outdoor smoking ban. Furthermore, school size was significantly associated with sustainability. The perceived barriers/facilitators fell into three categories: (i) smoking ban implementation factors (side-effects, enforcement, communication, guidelines and collaboration), (ii) school factors (physical environment, school culture, education type and school policy) and (iii) community environment factors (legislation and social environment). Conclusions Internationally, the spread of outdoor school ground smoking bans could be further promoted. Once implemented, the ban has become ‘normal’ practice and investments tend to endure. Moreover, involvement of all staff is important for sustainability as they function as role models, have an interrelationship with students, and share responsibility for enforcement. These findings are promising for the sustainability of future tobacco control initiatives to further protect against the morbidity/mortality associated with smoking. PMID:29016786

Improved health of hospitality workers after a Swiss cantonal smoking ban.

PubMed

Durham, André-Dante; Bergier, Samuel; Morisod, Xavier; Locatelli, Isabella; Zellweger, Jean-Pierre; Huynh, Cong Khanh; Cornuz, Jacques

2011-12-22

Hospitality workers are a population particularly at risk from the noxious effects of environmental tobacco smoke (ETS). The Canton of Vaud, Switzerland banned smoking in public places in September 2009. This prospective study addresses the impact of the ban on the health of hospitality workers. ETS exposure was evaluated using a passive sampling device that measures airborne nicotine; lung function was assessed by spirometry; health-related quality of life, ETS exposure symptoms and satisfaction were measured by questionnaire. 105 participants (smokers and non-smokers) were recruited initially and 66 were followed up after one year. ETS exposure was significantly lower after the ban. Hospitality workers had lower pre-ban forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) values than expected. FEV1 remained stable after the ban, with a near-significant increase in the subgroup of asthmatics only. FVC increased at one year follow-up from 90.42% to 93.05% (p = 0.02) in the entire cohort; women, non-smokers and older participants gained the greatest benefit. The health survey showed an increase in physical wellbeing after the ban, the greatest benefit being observed in non-smokers. ETS exposure symptoms were less frequent after the ban, especially red and irritated eyes and sneezing. The new law was judged useful and satisfactory by the vast majority of employees, including smokers. The recent cantonal ban on smoking in public places brought about an improvement in lung function, physical well-being and ETS symptoms of hospitality workers, including smokers.

Independent and Interactive Effects of Smoking Bans and Tobacco Taxes on a Cohort of US Young Adults.

PubMed

Vuolo, Mike; Kelly, Brian C; Kadowaki, Joy

2016-02-01

We examined the mutual effects of smoking bans and taxes on smoking among a longitudinal cohort of young adults. We combined a repository of US tobacco policies at the state and local level with the nationally representative geocoded National Longitudinal Survey of Youth 1997 (2004-2011) from ages 19 to 31 years and Census data, to examine the impact of tobacco policies on any current and daily pack smoking. The analytic sample amounts to 19,668 observations among 4341 individuals within 487 cities. For current smoking, we found significant effects for comprehensive smoking bans, but not excise taxes. We also found an interaction effect, with bans being most effective in locales with no or low taxes. For daily pack smoking, we found significant effects for taxes, but limited support for bans. Social smoking among young adults is primarily inhibited by smoking bans, but excise taxes only deter such smoking in the absence of a ban. Heavy smokers are primarily deterred by taxes. Although both policies have an impact on young adult smoking behaviors, their dual presence does not intensify each policy's efficacy.

Italy and Austria before and after study: second-hand smoke exposure in hospitality premises before and after 2 years from the introduction of the Italian smoking ban.

PubMed

Gorini, G; Moshammer, H; Sbrogiò, L; Gasparrini, A; Nebot, M; Neuberger, M; Tamang, E; Lopez, M J; Galeone, D; Serrahima, E

2008-08-01

The aim of this paper was to compare nicotine concentration in 28 hospitality premises (HPs) in Florence and Belluno, Italy, where a smoking ban was introduced in 2005, and in 19 HPs in Vienna, Austria, where no anti-smoking law entered into force up to now. Airborne nicotine concentrations were measured in the same HPs in winter 2002 or 2004 (pre-ban measurements) and winter 2007 (post-ban measurements). In Florence and Belluno, medians decreased significantly (P < 0.001) from 8.86 [interquartile range (IQR): 2.41-45.07)] before the ban to 0.01 microg/m3 (IQR: 0.01-0.41) afterwards. In Austria (no smoking ban) the medians collected in winters 2004 and 2007 were, respectively, 11.00 (IQR: 2.53-30.38) and 15.76 microg/m3 (IQR: 2.22-31.93), with no significant differences. Measurements collected in winter 2007 in 28 HPs located in Naples, Turin, Milan (0.01 microg/m3; IQR: 0.01-0.16) confirmed post-ban results in Florence and Belluno. The medians of nicotine concentrations in Italy and Austria before the Italian ban translates, using the risk model of Repace and Lowery, into a lifetime excess lung cancer mortality risk for hospitality workers of 11.81 and 14.67 per 10,000, respectively. Lifetime excess lung cancer mortality risks for bar and disco-pub workers were 10-20 times higher than that calculated for restaurant workers, both in Italy and Austria. In winter 2007, it dropped to 0.01 per 10,000 in Italy, whereas in Austria it remained at the same levels. The drop of second-hand smoke exposure indicates a substantial improvement in air quality in Italian HPs even after 2 years from the ban. The nation-wide smoking ban introduced in Italy on January 10, 2005, resulted in a drop in second-hand smoke exposure in hospitality premises, whereas in Austria, where there is no similar nation-wide smoking ban, the exposure to second-hand smoke in hospitality premises remains high. Given that second-hand smoke is considered a group 1 carcinogen according to the International

Effect of a smoking ban on respiratory health in nonsmoking hospitality workers: a prospective cohort study.

PubMed

Rajkumar, Sarah; Stolz, Daiana; Hammer, Jürg; Moeller, Alexander; Bauer, Georg F; Huynh, Cong Khanh; Röösli, Martin

2014-10-01

The aim of this study was to examine the effect of a smoking ban on lung function, fractional exhaled nitric oxide, and respiratory symptoms in nonsmoking hospitality workers. Secondhand smoke exposure at the workplace, spirometry, and fractional exhaled nitric oxide were measured in 92 nonsmoking hospitality workers before as well as twice after a smoking ban. At baseline, secondhand smoke-exposed hospitality workers had lung function values significantly below the population average. After the smoking ban, the covariate-adjusted odds ratio for cough was 0.59 (95% confidence interval, 0.36 to 0.93) and for chronic bronchitis 0.75 (95% confidence interval, 0.55 to 1.02) compared with the preban period. The below-average lung function before the smoking ban indicates chronic damages from long-term exposure. Respiratory symptoms such as cough decreased within 12 months after the ban.

Implementing an indoor smoking ban in prison: enforcement issues and effects on tobacco use, exposure to second-hand smoke and health of inmates.

PubMed

Lasnier, Benoit; Cantinotti, Michael; Guyon, Louise; Royer, Ann; Brochu, Serge; Chayer, Lyne

2011-01-01

To describe the issues encountered during the implementation of an indoor smoking ban in prison and its effects on self-reported tobacco use, perceived exposure to second-hand smoke (SHS) and perceived health status of inmates in Quebec's provincial correctional facilities. Quantitative data were obtained from 113 inmates in three provincial correctional facilities in the province of Quebec, Canada. Qualitative data were obtained from 52 inmates and 27 staff members. Participants were recruited through a self-selection process. Particular efforts were made to enrol proportions of men, women, smokers and non-smokers similar to those generally found among correctional populations. Despite the indoor smoking ban, 93% of inmates who declared themselves smokers reported using tobacco products inside the correctional facilities and 48% did not report any reduction in their tobacco use. Only 46% of smokers declared having been caught smoking inside the facility, and more than half of them (58%) reported no disciplinary consequences to their smoking. A majority of inmates incarcerated before the implementation of the ban (66%) did not perceive a reduction of their exposure to SHS following the indoor ban. Enforcement issues were encountered during the implementation of the indoor ban, notably because of the amendment made to the original regulation (total smoking ban) and tolerance from smokers in the staff towards indoor smoking. They were also related to perceptions that banning indoor smoking is complex and poses management problems. This study's findings emphasize the importance of considering organizational and environmental factors when planning the implementation of an indoor smoking ban in correctional facilities.

Smoking, occupancy and staffing levels in a selection of Dublin pubs pre and post a national smoking ban, lessons for all.

PubMed

McCaffrey, M; Goodman, P G; Kelleher, K; Clancy, L

2006-01-01

On the 29th March 2004 the Irish government introduced a comprehensive workplace smoking ban to protect the health of workers. This study evaluates the impact the ban had on staffing levels, customer numbers and smoking rates in a sample of 38 public houses in Dublin. A total of 38 public houses were visited prior to the introduction of the ban, each visit lasted at least three hours, and the number of staff, customers and the number of people smoking was recorded each hour. Follow-up visits were conducted exactly one year later, on the same day of the week and at the same time of day, allowing controlling for seasonal and weekday effects. There was a decrease (8.82%) in average staff levels while customer numbers increased by 11% and there was a dramatic reduction in numbers smoking on a visit to a pub (77.8%). The hospitality industry predicted major job losses as a consequence of the introduction of the smoking ban; this work has shown that there was no significant decrease in the number of staff employed or in customer numbers. There was full compliance, with no customers smoking inside the public houses following the introduction of the ban. The ban has been good for the industry, staff, and customers.

Sustainability of outdoor school ground smoking bans at secondary schools: a mixed-method study.

PubMed

Rozema, A D; Mathijssen, J J P; Jansen, M W J; van Oers, J A M

2018-02-01

Although increasing numbers of countries are implementing outdoor school ground smoking bans at secondary schools, less attention is paid to the post-implementation period even though sustainability of a policy is essential for long-term effectiveness. Therefore, this study assesses the level of sustainability and examines perceived barriers/facilitators related to the sustainability of an outdoor school ground smoking ban at secondary schools. A mixed-method design was used with a sequential explanatory approach. In phase I, 438 online surveys were conducted and in phase II, 15 semi-structured interviews were obtained from directors of relevant schools. ANOVA (phase I) and a thematic approach (phase II) were used to analyze data. Level of sustainability of an outdoor school ground smoking ban was high at the 48% Dutch schools with an outdoor smoking ban. Furthermore, school size was significantly associated with sustainability. The perceived barriers/facilitators fell into three categories: (i) smoking ban implementation factors (side-effects, enforcement, communication, guidelines and collaboration), (ii) school factors (physical environment, school culture, education type and school policy) and (iii) community environment factors (legislation and social environment). Internationally, the spread of outdoor school ground smoking bans could be further promoted. Once implemented, the ban has become 'normal' practice and investments tend to endure. Moreover, involvement of all staff is important for sustainability as they function as role models, have an interrelationship with students, and share responsibility for enforcement. These findings are promising for the sustainability of future tobacco control initiatives to further protect against the morbidity/mortality associated with smoking. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association.

Smoking habits in Italian pregnant women: any changes after the ban?

PubMed

Charrier, Lorena; Serafini, Paola; Giordano, Livia; Zotti, Carla Maria

2010-04-01

A reduction in the prevalence of smoking and tobacco consumption was noted after the enactment in 2005 of new smoking regulations in Italy. To determine the impact of the smoking ban on pregnant women, we compared the results of two retrospective studies on two samples of 300 women, who recently delivered, conducted before and after the regulations went into effect. The comparison showed a marked drop in passive exposure to smoke in the workplace but not in the family environment; however, passive exposure and smoking were associated before and during pregnancy. Nearly all women agreed that the ban on smoking in public was reasonable and stated it had influenced their smoking habit or exposure. Despite this lip service, both studies highlighted that smoking in pregnancy remains a problem for many women, as about 10 per cent did not quit and over 50 per cent relapsed after delivery.

Exposure to secondhand smoke in Italian non-smokers 5 years after the Italian smoking ban.

PubMed

Martínez-Sánchez, Jose M; Gallus, Silvano; Zuccaro, Piergiorgio; Colombo, Paolo; Fernández, Esteve; Manzari, Marco; La Vecchia, Carlo

2012-10-01

No data on secondhand smoke (SHS) exposure are available on a national level in Italy. To assess the prevalence of exposure to SHS in indoor public places, home and cars in non-smoking Italian population, we conducted a survey 5 years after the national smoking ban. In 2010, we conducted a survey on a representative sample of the Italian population aged≥15 years. Analyses were conducted on 2365 non-smokers. Current (during the previous week) self-reported exposure to SHS was assessed in public places, at home and in private cars. The prevalence of SHS exposure in any setting (excluding workplaces) was 31.2%. SHS exposure was 10.2% in public places, 15.6% at home and 17.9% in cars. The corresponding estimates among the young (15-24 years) were 54.2% in any setting, 21.4% in public places, 27.1% at home and 32.9% in cars. By multivariate analysis, males, the young, subjects from southern Italy and former smokers were more frequently exposed in any setting. The Italian smoking ban substantially decreased SHS exposure. However, specific subpopulations, including the young, are still frequently exposed both in public and private places. We observed a relatively high SHS exposure in private vehicles. Thus, further control to improve compliance with the smoking ban and an extension of the smoke-free legislation to motor vehicles are needed.

Prison staff and prisoner views on a prison smoking ban: evidence from the Tobacco in Prisons Study.

PubMed

Brown, Ashley; Sweeting, Helen; Logan, Greig; Demou, Evangelia; Hunt, Kate

2018-05-15

In jurisdictions permitting prisoner smoking, rates are high (c75%), with smoking embedded in prison culture, leading to secondhand smoke exposures among staff and prisoners and challenges for smoking cessation. Momentum is building to ban smoking in prisons, but research on staff and prisoner views is lacking. We address this gap, providing evidence on staff and prisoner views throughout all Scottish prisons. Data were collected prior to announcement of a (November 2018) prison smoking ban throughout Scotland. Mixed methods were used: surveys of staff (online, N=1,271, ~27%) and prisoners (questionnaire, N=2,512, ~34%); 17 focus groups and two paired interviews with staff in 14 prisons. Staff were more positive than prisoners about bans and increased smoking restrictions, although prisoner views were more favourable should e-cigarettes be permitted. Non-smokers were more positive than smokers. Whilst 74% staff and 22% prisoners agreed bans were a good idea, both groups acknowledged implementation and enforcement challenges. Staff views were influenced by beliefs about: acceptability of the policy in principle; and whether/how bans could be achieved. Although some voiced doubts about smoke-free policies, staff likened a ban to other operational challenges. Staff raised concerns around needs for appropriate measures, resources and support, adequate lead-in time, and effective communication prior to a ban. We recommend that regular and open opportunities for dialogue within and between different stakeholder groups are created when preparing for prison smoking bans, and that specific measures to address staff and prisoner concerns are incorporated into plans to create and maintain smoke-free environments. To our knowledge, this study is the first to research staff and prisoner views across a whole prison system prior to implementation of smoke-free policies. The results highlight potential challenges and suggest measures which might help to maximise the success of

Independent and Interactive Effects of Smoking Bans and Tobacco Taxes on a Cohort of US Young Adults

PubMed Central

Kelly, Brian C.; Kadowaki, Joy

2016-01-01

Objectives. We examined the mutual effects of smoking bans and taxes on smoking among a longitudinal cohort of young adults. Methods. We combined a repository of US tobacco policies at the state and local level with the nationally representative geocoded National Longitudinal Survey of Youth 1997 (2004–2011) from ages 19 to 31 years and Census data, to examine the impact of tobacco policies on any current and daily pack smoking. The analytic sample amounts to 19 668 observations among 4341 individuals within 487 cities. Results. For current smoking, we found significant effects for comprehensive smoking bans, but not excise taxes. We also found an interaction effect, with bans being most effective in locales with no or low taxes. For daily pack smoking, we found significant effects for taxes, but limited support for bans. Conclusions. Social smoking among young adults is primarily inhibited by smoking bans, but excise taxes only deter such smoking in the absence of a ban. Heavy smokers are primarily deterred by taxes. Although both policies have an impact on young adult smoking behaviors, their dual presence does not intensify each policy’s efficacy. PMID:26691133

Banning cigarette smoking on US Navy submarines: a case study.

PubMed

Lando, Harry A; Michaud, Mark E; Poston, Walker S C; Jahnke, Sara A; Williams, Larry; Haddock, Christopher K

2015-10-01

The military has had a long pro-tobacco tradition. Despite official policy discouraging smoking, tobacco still is widely seen as part of military culture. While active smoking has presented a particular challenge for the military, in recent years there also has been increasing concern with secondhand smoke. This is especially true in closed environments and submarines may be deployed for months at a time. The current case study describes the successful implementation by the Navy of a comprehensive ban on smoking aboard submarines. The authors searched documents on the internet, popular media, military-based news outlets and the scientific literature. We also conducted interviews with Navy officers who were instrumental in policy implementation. Data demonstrating substantial exposure of non-smokers to tobacco smoke aboard submarines had major impact on successful adoption of the policy. A systematic and extended roll out of the ban included establishing a working group, soliciting input and active engagement from submarine personnel, and offering cessation assistance. Support was enlisted from Chief Petty Officers who could have been strongly opposed but who became strong proponents. Fewer problems were encountered than had been expected. In contrast to a previous unsuccessful attempt by a Navy captain to ban smoking on his ship, the ban was adopted without apparent tobacco industry interference. Lessons learned included the importance of strong empirical support, effective framing of the issue, setting a realistic timeline, soliciting support from key personnel and providing appropriate resources. These lessons have implications for those considering further tobacco policy changes in the military and elsewhere. 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.

Estimating the Smoking Ban Effects on Smoking Prevalence, Quitting and Cigarette Consumption in a Population Study of Apprentices in Italy.

PubMed

Pieroni, Luca; Muzi, Giacomo; Quercia, Augusto; Lanari, Donatella; Rundo, Carmen; Minelli, Liliana; Salmasi, Luca; dell'Omo, Marco

2015-08-13

We evaluated the effects of the Italian 2005 smoking ban in public places on the prevalence of smoking, quitting and cigarette consumption of young workers. The dataset was obtained from non-computerized registers of medical examinations for a population of workers with apprenticeship contracts residing in the province of Viterbo, Italy, in the period 1996-2007. To estimate the effects of the ban, a segmented regression approach was used, exploiting the discontinuity introduced by the application of the law on apprentices' smoking behavior. It is estimated that the Italian smoking ban generally had no effect on smoking prevalence, quitting ratio, or cigarette consumption of apprentices. However, when the estimates were applied to subpopulations, significant effects were found: -1% in smoking prevalence, +2% in quitting, and -3% in smoking intensity of apprentices with at least a diploma.

[Secondhand smoke in hospitality venues. Exposure, body burden, economic and health aspects in conjunction with smoking bans].

PubMed

Fromme, H; Kuhn, J; Bolte, G

2009-04-01

Secondhand smoke was classified by national and international organisations as a known cause of cancer in humans and has many adverse health effects, especially cardiovascular diseases and lung tumours. Global studies have clearly shown that hospitality venues have the highest levels of indoor air pollution containing different substances that are clearly carcinogenic--such as tobacco-related chemicals--compared with other, smoke-free indoor spaces. Data from the human biomonitoring of non-smoking employees in the food service industry confirm this high exposure level. Non-smokers exposed to secondhand smoke in these environments are at increased risk for adverse health effects. The consistent protection of non-smokers in public places such as restaurants and bars through a smoking ban results in a significant reduction of the pollutants in the air (mostly > 90%) and clearly reduces the internal body burden for users and employees. Furthermore, health complaints by non-smoking employees are reduced and the higher risk for lung tumours of employees in the food service industry compared with the general population can be effectively reduced as well. According to current standards of knowledge, other measures such as spatial separation of smoking areas or the use of mechanical venting systems do not achieve a comparably high and effective pollutant reduction under field conditions. Studies concerning the economic effects of prohibiting smoking in public places conducted in various countries have shown that beverage-focused gastronomic enterprises experience a short-term down trend but that food-focused gastronomic enterprises do not experience any negative or even positive effects. The positive effects of a ban on smoking in public places on the general population are a decline in cigarette consumption and the reduction of secondhand smoke exposure by non-smokers. Smoking bans in hospitality venues are not necessarily linked with a shift of the tobacco consumption to

Impact of a smoking ban in public places: a rapid assessment in the Seychelles.

PubMed

Viswanathan, Bharathi; Plumettaz, Chloé; Gedeon, Jude; Bovet, Pascal

2011-11-01

We assessed the impact of a smoking ban in hospitality venues in the Seychelles 9 months after legislation was implemented. Survey officers observed compliance with the smoking ban in 38 most popular hospitality venues and administered a structured questionnaire to two customers, two workers and one manager in each venue. Virtually no customers or workers were seen smoking in the indoor premises. Patrons, workers and managers largely supported the ban. The personnel of the hospitality venues reported that most smokers had no difficulty refraining from smoking. However, a third of workers did not systematically request customers to stop smoking and half of them did not report adequate training. Workers reported improved health. No substantial change in the number of customers was noted. A ban on public smoking was generally well implemented in hospitality venues but some less than optimal findings suggest the need for adequate training of workers and strengthened enforcement measures. The simple and inexpensive methodology used in this rapid survey may be a useful approach to evaluate the implementation and impact of clean air policy in low and middle-income countries.

Smoking ban and small-for-gestational age births in Ireland.

PubMed

Kabir, Zubair; Daly, Sean; Clarke, Vanessa; Keogan, Sheila; Clancy, Luke

2013-01-01

Ireland introduced a comprehensive workplace smoke-free legislation in March, 2004. Smoking-related adverse birth outcomes have both health care and societal cost implications. The main aim of this study was to determine the impact of the Irish smoke-free legislation on small-for-gestationa- age (SGA) births. We developed a population-based birthweight (BW) percentile curve based on a recent study to compute SGA (BW <5(th) percentile) and very SGA (vSGA - BW<3(rd) percentile) for each gestational week. Monthly births born between January 1999 and December 2008 were analyzed linking with monthly maternal smoking rates from a large referral maternity university hospital. We ran individual control and CUSUM charts, with bootstrap simulations, to pinpoint the breakpoint for the impact of ban implementation ( = April 2004). Monthly SGA rates (%) before and after April 2004 was considered pre and post ban period births, respectively. Autocorrelation was tested using Durbin Watson (DW) statistic. Mixed models using a random intercept and a fixed effect were employed using SAS (v 9.2). A total of 588,997 singleton live-births born between January 1999 and December 2008 were analyzed. vSGA and SGA monthly rates declined from an average of 4.7% to 4.3% and from 6.9% to 6.6% before and after April 2004, respectively. No auto-correlation was detected (DW = ~2). Adjusted mixed models indicated a significant decline in both vSGA and SGA rates immediately after the ban [(-5.3%; 95% CI -5.43% to -5.17%, p<0.0001) and (-0.45%; 95% CI: -0.7% to -0.19%, p<0.0007)], respectively. Significant gradual effects continued post the ban periods for vSGA and SGA rates, namely, -0.6% (p<0.0001) and -0.02% (p<0.0001), respectively. A significant reduction in small-for-gestational birth rates both immediately and sustained over the post-ban period, reinforces the mounting evidence of the positive health effect of a successful comprehensive smoke-free legislation in a vulnerable population group

The potential of smoking cessation programmes and a smoking ban in public places: comparing gain in life expectancy and cost effectiveness.

PubMed

Højgaard, Betina; Olsen, Kim Rose; Pisinger, Charlotta; Tønnesen, Hanne; Gyrd-Hansen, Dorte

2011-12-01

Interventions aimed at reducing the number of smokers are generally believed to be cost effective. However as the cost of the interventions should be paid up front whereas the gains in life years only appear in the future--the budgetary consequences might be a barrier to implementing such interventions. The aim of the present paper was to assess the long-term cost effectiveness as well as the short-term (10 years) budget consequences of cessation programmes and a smoking ban in enclosed public places. We develop a population-based Markov model capable of analyzing both interventions and assess long-term costs effectiveness as well as short-term budgetary consequences and outcome gains. The smoking cessation programme model was based on data from the Danish National Smoking Cessation Database (SCDB), while the model of the smoking ban was based on effect estimates found in the literature. On a population level the effect of a smoking ban has the largest potential compared with the effect of smoking cessation programmes. Our results suggest that smoking cessation programmes are cost saving and generate life-years, whereas the costs per life-year gained by a smoking ban are 40,645 to 64,462 DKK (100 DKK = €13.4). These results are conservative as they do not include the healthcare cost saving related to reduced passive smoking. Our results indicate that smoking cessation programmes and a smoking ban in enclosed public places both in the short term and the long term are cost-effective strategies compared with the status quo.

Estimating the Smoking Ban Effects on Smoking Prevalence, Quitting and Cigarette Consumption in a Population Study of Apprentices in Italy

PubMed Central

Pieroni, Luca; Muzi, Giacomo; Quercia, Augusto; Lanari, Donatella; Rundo, Carmen; Minelli, Liliana; Salmasi, Luca; dell’Omo, Marco

2015-01-01

Objectives: We evaluated the effects of the Italian 2005 smoking ban in public places on the prevalence of smoking, quitting and cigarette consumption of young workers. Data and Methods: The dataset was obtained from non-computerized registers of medical examinations for a population of workers with apprenticeship contracts residing in the province of Viterbo, Italy, in the period 1996–2007. To estimate the effects of the ban, a segmented regression approach was used, exploiting the discontinuity introduced by the application of the law on apprentices’ smoking behavior. Results: It is estimated that the Italian smoking ban generally had no effect on smoking prevalence, quitting ratio, or cigarette consumption of apprentices. However, when the estimates were applied to subpopulations, significant effects were found: −1% in smoking prevalence, +2% in quitting, and −3% in smoking intensity of apprentices with at least a diploma. PMID:26287220

Smoking in Correctional Settings Worldwide: Prevalence, Bans, and Interventions.

PubMed

Spaulding, Anne C; Eldridge, Gloria D; Chico, Cynthia E; Morisseau, Nancy; Drobeniuc, Ana; Fils-Aime, Rebecca; Day, Carolyn; Hopkins, Robyn; Jin, Xingzhong; Chen, Junyu; Dolan, Kate A

2018-06-01

Smoking tobacco contributes to 11.5% of deaths worldwide and, in some countries, more hospitalizations than alcohol and drugs combined. Globally in 2015, 25% of men and 5% of women smoked. In the United States, a higher proportion of people in prison smoke than do community-dwelling individuals. To determine smoking prevalence in prisons worldwide, we systematically reviewed the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines; we also examined whether prisons banned smoking or treated smokers. We searched databases for articles published between 2012 and 2016 and located 85 relevant articles with data representing 73.5% of all incarcerated persons from 50 countries. In 35 of 36 nations (97%) with published prevalence data, smoking for the incarcerated exceeded community rates 1.04- to 62.6-fold. Taking a conservative estimate of a 2-fold increase, we estimated that, globally, 14.5 million male and 26,000 female smokers pass through prisons annually. Prison authorities' responses include permitting, prohibiting, or treating tobacco use. Bans may temporarily improve health and reduce in-prison health care costs but have negligible effect after prison release. Evidence-based interventions for smoking cessation effective outside prisons are effective inside; effects persist after release. Because smoking prevalence is heightened in prisons, offering evidence-based interventions to nearly 15 million smokers passing through yearly would improve global health.

Reduced admissions for acute myocardial infarction associated with a public smoking ban: matched controlled study.

PubMed

Seo, Dong-Chul; Torabi, Mohammad R

2007-01-01

There has been no research linking implementation of a public smoking ban and reduced incidence of acute myocardial infarction (AMI) among nonsmoking patients. An ex post facto matched control group study was conducted to determine whether there was a change in hospital admissions for AMI among nonsmoking patients after a public smoking ban was implemented in Monroe County compared with Delaware County, Indiana without such a ban. Poisson analysis was conducted for 44 months of hospital admissions. A significant drop occurred in the number of admissions among nonsmoking patients in Monroe County after the ban whereas a nonsignificant decrease in the number of admissions occurred in Delaware County. The changes in the number of smoking-patient admissions before and after the ban were not significant.

Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: A cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban

PubMed Central

2011-01-01

Background Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC) attitudes before the national ban came into force in January 2008. Methods Questionnaire-based cross-sectional study, including all eligible staff. Sample: 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR) was performed to identify factors associated with smoking status and TC attitudes. Results Smoking prevalence was 40.5% (95% CI: 33.6-47.4) in males, 23.5% (95% CI: 19.2-27.8) in females (p < 0.001); 43.2% in auxiliaries, 26.1% in nurses, 18.9% among physicians, and 34.7% among other non-health professionals (p = 0.024). The findings showed a very high level of agreement with smoking bans, even among smokers, despite the fact that 70.3% of the smokers smoked on the premises and 76% of staff reported being frequently exposed to second-hand smoke (SHS). In addition 42.8% reported that SHS was unpleasant and 28.3% admitted complaining. MLR showed that smoking behaviour was the most important predictor of TC attitudes. Conclusions Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low

Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: a cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban.

PubMed

Ravara, Sofia B; Calheiros, Jose M; Aguiar, Pedro; Barata, Luis Taborda

2011-09-23

Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC) attitudes before the national ban came into force in January 2008. Questionnaire-based cross-sectional study, including all eligible staff. 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR) was performed to identify factors associated with smoking status and TC attitudes. Smoking prevalence was 40.5% (95% CI: 33.6-47.4) in males, 23.5% (95% CI: 19.2-27.8) in females (p < 0.001); 43.2% in auxiliaries, 26.1% in nurses, 18.9% among physicians, and 34.7% among other non-health professionals (p = 0.024). The findings showed a very high level of agreement with smoking bans, even among smokers, despite the fact that 70.3% of the smokers smoked on the premises and 76% of staff reported being frequently exposed to second-hand smoke (SHS). In addition 42.8% reported that SHS was unpleasant and 28.3% admitted complaining. MLR showed that smoking behaviour was the most important predictor of TC attitudes. Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low participation on smoking cessation activities. Smoking

Socioeconomic differentials in the immediate mortality effects of the national Irish smoking ban.

PubMed

Stallings-Smith, Sericea; Goodman, Pat; Kabir, Zubair; Clancy, Luke; Zeka, Ariana

2014-01-01

Consistent evidence has demonstrated that smoking ban policies save lives, but impacts on health inequalities are uncertain as few studies have assessed post-ban effects by socioeconomic status (SES) and findings have been inconsistent. The aim of this study was to assess the effects of the national Irish smoking ban on ischemic heart disease (IHD), stroke, and chronic obstructive pulmonary disease (COPD) mortality by discrete and composite SES indicators to determine impacts on inequalities. Census data were used to assign frequencies of structural and material SES indicators to 34 local authorities across Ireland with a 2000-2010 study period. Discrete indicators were jointly analysed through principal component analysis to generate a composite index, with sensitivity analyses conducted by varying the included indicators. Poisson regression with interrupted time-series analysis was conducted to examine monthly age and gender-standardised mortality rates in the Irish population, ages ≥35 years, stratified by tertiles of SES indicators. All models were adjusted for time trend, season, influenza, and smoking prevalence. Post-ban mortality reductions by structural SES indicators were concentrated in the most deprived tertile for all causes of death, while reductions by material SES indicators were more equitable across SES tertiles. The composite indices mirrored the results of the discrete indicators, demonstrating that post-ban mortality decreases were either greater or similar in the most deprived when compared to the least deprived for all causes of death. Overall findings indicated that the national Irish smoking ban reduced inequalities in smoking-related mortality. Due to the higher rates of smoking-related mortality in the most deprived group, even equitable reductions across SES tertiles resulted in decreases in inequalities. The choice of SES indicator was influential in the measurement of effects, underscoring that a differentiated analytical approach

The Role of Home Smoking Bans in Limiting Exposure to Secondhand Tobacco Smoke in Hungary

ERIC Educational Resources Information Center

Paulik, Edit; Maroti-Nagy, A.; Nagymajtenyi, L.; Rogers, T.; Easterling, D.

2013-01-01

Our objective was to assess how exposure to secondhand tobacco smoke occurs in Hungarian homes, particularly among non-smokers, and to examine the effectiveness of home smoking bans in eliminating exposure to secondhand smoke at home. In 2009, 2286 non-smokers and smokers aged 16-70 years, who were selected randomly from a nationally…

Public smoking ban and socioeconomic inequalities in smoking prevalence and cessation: a cross-sectional population-based study in Geneva, Switzerland (1995-2014).

PubMed

Sandoval, José Luis; Leão, Teresa; Cullati, Stéphane; Theler, Jean-Marc; Joost, Stéphane; Humair, Jean-Paul; Gaspoz, Jean-Michel; Guessous, Idris

2018-01-26

Smoking bans were suggested to reduce smoking prevalence and increase quit ratio but their equity impact remains unclear. We aimed to characterise the socioeconomic status (SES)-related inequalities in smoking prevalence and quit ratio before and after the implementation of a public smoking ban. We included data from 17 544 participants in the population-based cross-sectional Bus Santé study in Geneva, Switzerland, between 1995 and 2014. We considered educational attainment (primary, secondary and tertiary) as a SES indicator. Outcomes were smoking prevalence (proportion of current smokers) and quit ratio (ex-smokers to ever-smokers ratio). We used segmented linear regression to assess the overall impact of smoking ban on outcome trends. We calculated the relative (RII) and slope (SII, absolute difference) indexes of inequality, quantifying disparities between educational groups in outcomes overall (1995-2014), before and after ban implementation (November 2009). Least educated participants displayed higher smoking prevalence (RII=2.04, P<0.001; SII=0.15, P<0.001) and lower quit ratio (RII=0.73, P<0.001; SII=-0.18, P<0.001). As in other studies, smoking ban implementation coincided with a temporary reduction of smoking prevalence (P=0.003) and increase in quit ratio (P=0.02), with a progressive return to preban levels. Inequalities increased (P<0.05) in relative terms for smoking prevalence (RII before =1.84, P<0.001 and RII after =3.01, P<0.001) and absolute terms for both outcomes (smoking prevalence: SII before =0.14, P<0.001 and SII after =0.19, P<0.001; quit ratio: SII before =-0.15, P<0.001 and SII after =-0.27, P<0.001). Implementation of a public smoking ban coincided with a short-lived decrease in smoking prevalence and increase in quit ratio but also with a widening in SES inequalities in smoking-related outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No

Effects of a workplace-smoking ban in combination with tax increases on smoking in the Dutch population.

PubMed

Verdonk-Kleinjan, Wendy M I; Candel, Math J J M; Knibbe, Ronald A; Willemsen, Marc C; de Vries, Hein

2011-06-01

In the Netherlands, between 2003 and 2005, 3 tobacco control measures were implemented: a workplace-smoking ban and 2 tax increases on tobacco products. This study explores how the combination of measures influences the smoking behavior of the general population divided into subpopulations with and without paid work (all aged 16-65 years). Data from the Dutch Continuous Survey of Smoking Habits were used. The total sample consisted of 32,014 respondents (27,150 with paid work and 4,864 without paid work) aged 16-65 years. Analyses were done by linear and logistic regression, controlling for relevant factors. For respondents with paid work, the combination of a smoking ban and 2 tax increases led to a decrease in the number of cigarettes per day and in the prevalence of daily smoking. For respondents without paid work, there was no significant effect on any of the outcome parameters. In both groups, there was no evidence that the effect of the measures on smoking was moderated by the respondent's gender, age, or level of education. The combination of policy measures has influenced the smoking behavior of respondents with paid work in a positive way. Compared with most other studies, the effect of the workplace-smoking ban alone is smaller. However, the effect of the combined interventions is higher than the that of tax increases in other studies. Among respondents without paid work who were exposed to tax increases only, no significant effects were found.

Tobacco Use Documenting Policy and Its Association with Pupils' Smoking and Their Perception of the Enforcement of School Smoking Bans in Finland

ERIC Educational Resources Information Center

Saaristo, Vesa; Kulmala, Jenni; Raisamo, Susanna; Rimpelä, Arja; Ståhl, Timo

2014-01-01

Finnish national data sets on schools (N = 496) and pupils (N = 74,143; 14-16 years) were used to study whether a systematic documenting policy for the violations of school smoking bans was associated with pupils' smoking and their perceptions on the enforcement of smoking bans. Attending a school with a systematic documenting policy was…

Communicating contentious health policy: lessons from Ireland's workplace smoking ban.

PubMed

Fahy, Declan; Trench, Brian; Clancy, Luke

2012-05-01

The Irish workplace smoking ban has been described as possibly a tipping point for public health worldwide. This article presents the first analysis of the newspaper coverage of the ban over the duration of the policy formation process. It adds to previous studies by analyzing how health communication strategists engaged, over time, with a newsworthy topic, viewed as being culturally controversial. It analyzes a sample of media content (n = 1,154) and firsthand accounts from pro-ban campaigners and journalists (n = 10). The analysis shows that the ban was covered not primarily as a health issue: Economic, political, social, democratic, and technical aspects also received significant attention. It shows how coverage followed controversy and examines how pro-ban campaigners countered effectively the anti-ban communication efforts of influential social actors in the economic and political spheres. The analysis demonstrates that medical-political sources successfully defined the ban's issues as centrally concerned with public health.

Tourists' attitudes towards ban on smoking in air-conditioned hotel lobbies in Thailand.

PubMed

Viriyachaiyo, V; Lim, A

2009-06-01

Thailand is internationally renowned for its stringent tobacco control measures. In Thailand, a regulation banning smoking in air-conditioned hotel lobbies was issued in late 2006, causing substantial apprehension within the hospitality industry. A survey of tourists' attitudes toward the ban was conducted. A cross-sectional survey of 5550 travellers staying in various hotels in Bangkok, Surat Thani, Phuket, Krabi and Songkhla provinces, October 2005 to December 2006. Travellers aged 15 years or older with a check-in duration of at least one day and willing to complete the questionnaire were requested by hotel staff to fill in the 5-minute questionnaire at check-in or later at their convenience. Secondhand cigarette smoke was recognised as harmful to health by 89.7% of respondents. 47.8% of travellers were aware of the Thai regulation banning smoking in air-conditioned restaurants. 80.9% of the respondents agreed with the ban, particularly female non-smokers. 38.6% of survey respondents indicated that they would be more likely to visit Thailand again because of the regulation, 53.4% that the regulation would not affect their decision and 7.9% that they would be less likely to visit Thailand again. Banning smoking in air-conditioned hotel lobbies in Thailand is widely supported by tourists. Enforcement of the regulation is more likely to attract tourists than dissuade them from holidaying in Thailand.

Attitudes towards a smoking ban in restaurants of managers, employees and customers in Kunming City, China.

PubMed

Jiang, Li; Sriplung, Hutcha; Chongsuvivatwong, Virasakdi; Li, Tao; Xiao, Yize

2010-09-01

The objective of this study was to investigate the attitudes of restaurant managers, employees and customers towards a total smoking ban policy in restaurants. A restaurant based survey in an urban area of Kunming City, China, was carried out from May to August 2009. One hundred managers, 1,055 employees and 5,213 customers aged 15 years or above were interviewed using a structured questionnaire. The percentage of respondents supporting a total smoking ban in restaurants was 17% among managers, 13.4% among employees, and 16.6% among customers. Multilevel analysis confirmed respondents who did not smoke, who were educated, and who worked or dined at a restaurant with fewer than 200 seats were more likely to support a total smoking ban. A total smoking ban in restaurants is unlikely to be supported by people involved in the restaurant business in the study area. This coincides with poor awareness of the harms of smoking.

[Application and effects of smoking ban in bars and restaurants of Rome].

PubMed

Fontana, L; Di Martino, T; Iavicoli, I

2007-01-01

Both active and passive tobacco smoke is carcinogenic. In the last years the most important countries of European Community developed and passed smoke-free public places and smoke-free workplace legislations. The aim of this study was to investigate the real application of smoking ban in bars and restaurants of Rome and to value social, economic and health effects caused by the application of the law. The study was carried out in 200 public places (100 restaurants and 100 bars) with an inspection of the sites and the administration of a questionnaire to the managers of the public places. Results demonstrate that smoking ban in public places is widely respected and that the application of the law had a very positive impact on the quality of life and health of workers and general population.

Smoking ban and health at birth: Evidence from Hungary.

PubMed

Hajdu, Tamás; Hajdu, Gábor

2018-06-13

In 2012, smoking restrictions were extended to hospitality venues in Hungary. Women working in bars and restaurants were primarily affected by the intervention. In this research, we analyze the effect of this smoking ban on the outcomes of their pregnancies. Using individual live birth, fetal loss, and infant mortality registry data, we examine the probability of live birth, indicators of health at birth, and the probability of death in the first year of life. We apply a difference-in-differences framework and show that the smoking ban has improved health at birth. We observed birth weight to increase by 56 g (95% CI: 4.2 to 106.8) and gestation length by 0.19 weeks (95% CI: 0.02 to 0.36). Due to the ban, the probability of being born with very low and low birth weight has decreased by 1.2 and 2.2 percentage points, respectively (95% CI: -0.2 to -2.2 and 0.06 to -4.4), and we see a 0.9 percentage points reduction in the chance of being born very preterm (95% CI: -0.03 to -1.9). We also observe a decrease in the probability of being born with a low Ponderal index (decrease of 4.1 percentage points, 95% CI: -0.7 to -7.5). Performing a series of robustness and placebo tests, we provide evidence that supports the causal interpretation of our results. We also show that the ban was more beneficial for newborns of parents with low educational attainment and at the bottom of the fetal health endowment distribution. Copyright © 2018 Elsevier B.V. All rights reserved.

The opinion of catering sector about the smoking ban and the evaluation of establishments.

PubMed

Doruk, Sibel; Çelik, Deniz; İnönü Köseoğlu, Handan; Etikan, Ilker; Çetin, İlhan

2014-01-01

We aimed to evaluate the knowledge and perspective of employees/employers in the catering sector in our city regarding the smoking ban, as well as to determine the changes in the number of customers and income after the bans implementation. In this two phased cross-sectional study 337 and 310 adults were evaluated respectively. Before the smoking ban was implemented we visited 84 workplaces in city center, after 18 months later 97 workplaces were visited in the same region. In both phases, the participants' opinions about the necessity/applicability of the ban were evaluated. In the second phase, they were also asked whether they had any changes in their income. In both phases, participants' general characteristics were similar. When all participants were evaluated, we determined that their knowledge and belief in the necessity/applicability of the ban did not change over time. It was determined that non-smokers more strongly believed in the necessity/applicability of the ban. Thirty-eight participants were included in both phases; 44.7% of them reported a decrease in the number of customers, and 60% of employers reported an increase in their income. The smokers were less convinced about the applicability/necessity of this ban than non-smokers. According to our results it could be said that smoking can also adversely affect implementation of the related ban. Employers should be informed that the ban will not affect their income.

Socioeconomic Differentials in the Immediate Mortality Effects of the National Irish Smoking Ban

PubMed Central

Stallings-Smith, Sericea; Goodman, Pat; Kabir, Zubair; Clancy, Luke; Zeka, Ariana

2014-01-01

Background Consistent evidence has demonstrated that smoking ban policies save lives, but impacts on health inequalities are uncertain as few studies have assessed post-ban effects by socioeconomic status (SES) and findings have been inconsistent. The aim of this study was to assess the effects of the national Irish smoking ban on ischemic heart disease (IHD), stroke, and chronic obstructive pulmonary disease (COPD) mortality by discrete and composite SES indicators to determine impacts on inequalities. Methods Census data were used to assign frequencies of structural and material SES indicators to 34 local authorities across Ireland with a 2000–2010 study period. Discrete indicators were jointly analysed through principal component analysis to generate a composite index, with sensitivity analyses conducted by varying the included indicators. Poisson regression with interrupted time-series analysis was conducted to examine monthly age and gender-standardised mortality rates in the Irish population, ages ≥35 years, stratified by tertiles of SES indicators. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results Post-ban mortality reductions by structural SES indicators were concentrated in the most deprived tertile for all causes of death, while reductions by material SES indicators were more equitable across SES tertiles. The composite indices mirrored the results of the discrete indicators, demonstrating that post-ban mortality decreases were either greater or similar in the most deprived when compared to the least deprived for all causes of death. Conclusions Overall findings indicated that the national Irish smoking ban reduced inequalities in smoking-related mortality. Due to the higher rates of smoking-related mortality in the most deprived group, even equitable reductions across SES tertiles resulted in decreases in inequalities. The choice of SES indicator was influential in the measurement of effects, underscoring

Smoking habits and attitudes toward tobacco bans among United Kingdom hospital staff and students.

PubMed

Lewis, K E; Shin, D; Davies, G

2011-08-01

A group of United Kingdom (UK) hospitals. To estimate the current smoking habits of health care professionals (HCPs) in a country with active tobacco control measures, and to record their attitudes to national and hospital tobacco bans. A cross-sectional survey of 500 HCPs. HCPs reported a lower rate of current smoking (7%) than the general population (24%). Doctors (2.6%) and medical students (3.8%) were less likely to be current smokers than both nurses (8.7%) and allied health professionals (10.9%, P < 0.001). The vast majority felt national legislation had been effective (88%) and well complied with (82%). Around a third of respondents believed the ban had led to a reduction in admissions for acute coronary syndrome. Almost all respondents were in favour of restrictions on smoking in health care premises. A higher proportion of UK doctors (69%) than nurses (52%) favoured a complete ban (odds ratio 2.01, 95% confidence interval 1.14-3.56). Self-reported smoking patterns in UK health professionals are lower than previously and compared to other industrialised and developing countries. Support for bans is very high, but differences remain in behaviour and especially attitudes to local bans according to professional status, although this gap is also narrowing.

Attitudes towards smoking restrictions and tobacco advertisement bans in Georgia.

PubMed

Bakhturidze, George D; Mittelmark, Maurice B; Aarø, Leif E; Peikrishvili, Nana T

2013-11-25

This study aims to provide data on a public level of support for restricting smoking in public places and banning tobacco advertisements. A nationally representative multistage sampling design, with sampling strata defined by region (sampling quotas proportional to size) and substrata defined by urban/rural and mountainous/lowland settlement, within which census enumeration districts were randomly sampled, within which households were randomly sampled, within which a randomly selected respondent was interviewed. The country of Georgia, population 4.7 million, located in the Caucasus region of Eurasia. One household member aged between 13 and 70 was selected as interviewee. In households with more than one age-eligible person, selection was carried out at random. Of 1588 persons selected, 14 refused to participate and interviews were conducted with 915 women and 659 men. Respondents were interviewed about their level of agreement with eight possible smoking restrictions/bans, used to calculate a single dichotomous (agree/do not agree) opinion indicator. The level of agreement with restrictions was analysed in bivariate and multivariate analyses by age, gender, education, income and tobacco use status. Overall, 84.9% of respondents indicated support for smoking restrictions and tobacco advertisement bans. In all demographic segments, including tobacco users, the majority of respondents indicated agreement with restrictions, ranging from a low of 51% in the 13-25 age group to a high of 98% in the 56-70 age group. Logistic regression with all demographic variables entered showed that agreement with restrictions was higher with age, and was significantly higher among never smokers as compared to daily smokers. Georgian public opinion is normatively supportive of more stringent tobacco-control measures in the form of smoking restrictions and tobacco advertisement bans.

Is nonsmoking dangerous to the health of restaurants? The effect of California's indoor smoking ban on restaurant revenues.

PubMed

Stolzenberg, Lisa; D'Alessio, Stewart J

2007-02-01

The state of California passed the Smoke-Free Workplace Act on January 1, 1995. This legislation effectively banned indoor smoking in all public and private workplaces including restaurants. Many restaurant owners, especially owners of restaurants that served alcohol, opposed the ban for fear that their businesses would be affected adversely because of the loss of patrons who smoked. Using an interrupted times-series autoregressive integrative moving average study design, the authors assess the effect of California's indoor smoking ban on revenue rates for all restaurants, for non-alcohol-serving restaurants, and for alcohol-serving restaurants. Results showed that revenues for alcohol-serving restaurants dropped by about 4% immediately following the establishment of the indoor smoking ban. However, this reduction was temporary because revenues for alcohol-serving restaurants quickly returned to normal levels. Findings also revealed that the indoor smoking ban had little observable impact on the revenue rate for restaurants overall and for non-alcohol-serving restaurants.

Reductions in cardiovascular, cerebrovascular, and respiratory mortality following the national irish smoking ban: interrupted time-series analysis.

PubMed

Stallings-Smith, Sericea; Zeka, Ariana; Goodman, Pat; Kabir, Zubair; Clancy, Luke

2013-01-01

Previous studies have shown decreases in cardiovascular mortality following the implementation of comprehensive smoking bans. It is not known whether cerebrovascular or respiratory mortality decreases post-ban. On March 29, 2004, the Republic of Ireland became the first country in the world to implement a national workplace smoking ban. The aim of this study was to assess the effect of this policy on all-cause and cause-specific, non-trauma mortality. A time-series epidemiologic assessment was conducted, utilizing Poisson regression to examine weekly age and gender-standardized rates for 215,878 non-trauma deaths in the Irish population, ages ≥35 years. The study period was from January 1, 2000, to December 31, 2007, with a post-ban follow-up of 3.75 years. All models were adjusted for time trend, season, influenza, and smoking prevalence. Following ban implementation, an immediate 13% decrease in all-cause mortality (RR: 0.87; 95% CI: 0.76-0.99), a 26% reduction in ischemic heart disease (IHD) (RR: 0.74; 95% CI: 0.63-0.88), a 32% reduction in stroke (RR: 0.68; 95% CI: 0.54-0.85), and a 38% reduction in chronic obstructive pulmonary disease (COPD) (RR: 0.62; 95% CI: 0.46-0.83) mortality was observed. Post-ban reductions in IHD, stroke, and COPD mortalities were seen in ages ≥65 years, but not in ages 35-64 years. COPD mortality reductions were found only in females (RR: 0.47; 95% CI: 0.32-0.70). Post-ban annual trend reductions were not detected for any smoking-related causes of death. Unadjusted estimates indicate that 3,726 (95% CI: 2,305-4,629) smoking-related deaths were likely prevented post-ban. Mortality decreases were primarily due to reductions in passive smoking. The national Irish smoking ban was associated with immediate reductions in early mortality. Importantly, post-ban risk differences did not change with a longer follow-up period. This study corroborates previous evidence for cardiovascular causes, and is the first to demonstrate reductions in

Benefits of smoking bans on preterm and early-term births: a natural experimental design in Switzerland.

PubMed

Vicedo-Cabrera, Ana M; Schindler, Christian; Radovanovic, Dragana; Grize, Leticia; Witassek, Fabienne; Dratva, Julia; Röösli, Martin; Perez, Laura

2016-12-01

Birth outcomes are relevant for future children's heath. Capitalising on a natural experimental design in Switzerland, we evaluated how regional smoking bans introduced at different time points affected birth outcomes, including preterm and early-term births. We used birth registry data of all singleton neonates born in Switzerland (2007-2012). We developed canton-specific interrupted time-series followed by random meta-analysis to evaluate the benefits of smoking bans on preterm (<37 gestational weeks) and early-term (37-38 gestational weeks) births. Heterogeneity across type of ban and contextual characteristics was explored through metaregression. A time-to-event approach was used for evaluating duration of pregnancy under the smoking bans and effects, taking into account individual maternal factors. We observed a decrease in the risk of preterm birth of 3.6% (95% CI, -9.3% to 2.5%), and early-term birth of 5.0% (95% CI -7.5% to -2.5%). Results showed a clear dose-response relationship. Greater risk reductions were obtained for preterm births in areas with more comprehensive bans (-6.8%; 95% CI -12.1% to 0.1%), and for pregnancies with the longest gestational time under smoking bans (HR, 0.991; 95% CI 0.984 to 0.997 per 10% increase in duration). Benefits were unequal across outcomes and characteristics of cantons and mothers. Smoking bans resulted in improved birth outcomes in Switzerland with cantons that adopted more comprehensive smoking bans achieving greater benefits. Early-term births constitute a previously ignored though important group. 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/.

Tourists’ attitudes towards ban on smoking in air-conditioned hotel lobbies in Thailand

PubMed Central

Viriyachaiyo, V; Lim, A

2009-01-01

Background: Thailand is internationally renowned for its stringent tobacco control measures. In Thailand, a regulation banning smoking in air-conditioned hotel lobbies was issued in late 2006, causing substantial apprehension within the hospitality industry. A survey of tourists’ attitudes toward the ban was conducted. Methods: A cross-sectional survey of 5550 travellers staying in various hotels in Bangkok, Surat Thani, Phuket, Krabi and Songkhla provinces, October 2005 to December 2006. Travellers aged 15 years or older with a check-in duration of at least one day and willing to complete the questionnaire were requested by hotel staff to fill in the 5-minute questionnaire at check-in or later at their convenience. Results: Secondhand cigarette smoke was recognised as harmful to health by 89.7% of respondents. 47.8% of travellers were aware of the Thai regulation banning smoking in air-conditioned restaurants. 80.9% of the respondents agreed with the ban, particularly female non-smokers. 38.6% of survey respondents indicated that they would be more likely to visit Thailand again because of the regulation, 53.4% that the regulation would not affect their decision and 7.9% that they would be less likely to visit Thailand again. Conclusion: Banning smoking in air-conditioned hotel lobbies in Thailand is widely supported by tourists. Enforcement of the regulation is more likely to attract tourists than dissuade them from holidaying in Thailand. PMID:19364754

Hospital Admissions for Acute Myocardial Infarction, Angina, Stroke, and Asthma After Implementation of Arizona's Comprehensive Statewide Smoking Ban

PubMed Central

Walsh, Michele E.

2011-01-01

Objectives. We examined the impact of Arizona's May 2007 comprehensive statewide smoking ban on hospital admissions for diagnoses for which there is evidence of a causal relationship with secondhand smoke (SHS) exposure (acute myocardial infarction [AMI], angina, stroke, and asthma). Methods. We compared monthly hospital admissions from January 2004 through May 2008 for these primary diagnoses and 4 diagnoses not associated with SHS (appendicitis, kidney stones, acute cholecystitis, and ulcers) for Arizona counties with preexisting county or municipal smoking bans and counties with no previous bans. We attributed reductions in admissions to the statewide ban if they occurred only in diagnoses associated with SHS and if they were larger in counties with no previous bans. We analyzed the data with Poisson regressions, controlling for seasonality and admissions trends. We also estimated cost savings. Results. Statistically significant reductions in hospital admissions were seen for AMI, angina, stroke, and asthma in counties with no previous bans over what was seen in counties with previous bans. No ban variable coefficients were statistically significant for diagnoses not associated with SHS. Conclusions. Arizona's statewide smoking ban decreased hospital admissions for AMI, stroke, asthma, and angina. PMID:20466955

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

PubMed

Azagba, Sunday; Sharaf, Mesbah F

2012-02-13

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. A longitudinal representative sample of 3,237 individuals from the Canadian National Population Health Survey from 2000 to 2008 is used. Work-related stress is derived from a 12-item job questionnaire. Two categories of WSB's, full and partial, are included in the analysis, with no ban being the reference category. Analysis also controls for individual socio-demographic characteristics, health status, provincial and occupational fixed-effects. We use fixed-effects linear regression to control for individual time-invariant confounders, both measured and unmeasured, which can affect the relationship between WSB's and work-related stress. To examine the heterogeneous effects of WSB's, the analysis is stratified by gender and age. We check the robustness of our results by re-estimating the baseline specification with the addition of different control variables and a separate analysis for non-smokers. Multivariate analysis reveals a positive and statistically significant association between full (β = 0.75, CI = 0.19-1.32) or partial (β = 0.69, CI = 0.12-1.26) WSB's, and the level of self-perceived, work-related stress among smoking workers compared to those with no WSB. We also find that this association varies by gender and age. In particular, WSB's are significantly associated with higher work stress only for males and young adults (aged 18-40). No statistically significant association is found between WSB's and the level of self-perceived work-related stress among non-smoking workers. The results of this study do not imply that WSB's are the main determinant of self-perceived, work-related stress among smokers but provides suggestive evidence that these

Impact of national smoke-free legislation on home smoking bans: findings from the International Tobacco Control Policy Evaluation Project Europe Surveys.

PubMed

Mons, Ute; Nagelhout, Gera E; Allwright, Shane; Guignard, Romain; van den Putte, Bas; Willemsen, Marc C; Fong, Geoffrey T; Brenner, Hermann; Pötschke-Langer, Martina; Breitling, Lutz P

2013-05-01

To measure changes in prevalence and predictors of home smoking bans (HSBs) among smokers in four European countries after the implementation of national smoke-free legislation. Two waves of the International Tobacco Control Policy Evaluation Project Europe Surveys, which is a prospective panel study. Pre- and post-legislation data were used from Ireland, France, Germany and the Netherlands. Two pre-legislation waves from the UK were used as control. 4634 respondents from the intervention countries and 1080 from the control country completed both baseline and follow-up and were included in the present analyses. Multiple logistic regression models to identify predictors of having or of adopting a total HSB, and Generalised Estimating Equation models to compare patterns of change after implementation of smoke-free legislation to a control country without such legislation. Most smokers had at least partial smoking restrictions in their home, but the proportions varied significantly between countries. After implementation of national smoke-free legislation, the proportion of smokers with a total HSB increased significantly in all four countries. Among continuing smokers, the number of cigarettes smoked per day either remained stable or decreased significantly. Multiple logistic regression models indicated that having a young child in the household and supporting smoking bans in bars were important correlates of having a pre-legislation HSB. Prospective predictors of imposing a HSB between survey waves were planning to quit smoking, supporting a total smoking ban in bars and the birth of a child. Generalised Estimating Equation models indicated that the change in total HSB in the intervention countries was greater than that in the control country. The findings suggest that smoke-free legislation does not lead to more smoking in smokers' homes. On the contrary, our findings demonstrate that smoke-free legislation may stimulate smokers to establish total smoking bans in

The Association between Point-of-Sale Advertising Bans and Youth Experimental Smoking: Findings from the Global Youth Tobacco Survey (GYTS).

PubMed

Shang, Ce; Huang, Jidong; Li, Qing; Chaloupka, Frank J

while existing research has demonstrated a positive association between exposure to point-of-sale (POS) tobacco advertising and youth smoking, there is limited evidence on the relationship between POS advertising restrictions and experimental smoking among youth. This study aims to fill this research gap by analyzing the association between POS advertising bans and youths' experimental smoking. Global Youth Tobacco Surveys from 130 countries during 2007-2011 were linked to the WHO "MPOWER" tobacco control policy measures to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and experimental smoking using weighted logistic regressions. All analyses were clustered at the country level and controlled for age, parents' smoking status, GDP per capita, and country-level tobacco control scores in monitoring tobacco use, protecting people from smoke, offering help to quit, warning about the dangers of tobacco, enforcing promotion/advertising bans, and raising taxes on tobacco. The results suggest that a POS advertising ban is significantly associated with reduced experimental smoking among youth (OR = 0.63, p < 0.01), and that this association is seen for both genders (boys OR = 0.74, p < 0.1; girls OR = 0.52, p < 0.001). POS advertising bans are significantly associated with reduced experimental smoking among youth. Adopting POS advertising bans has the potential to reduce tobacco use among their youth in countries currently without such bans.

[High time for a total ban on smoking in the hotel, restaurant and catering industry: the arguments are mounting].

PubMed

Hassink, R J; Franke, L J A

2007-02-24

Active and passive smoking are well-known causes of disease, including respiratory and cardiovascular disease and cancer. In 2004 the Dutch government introduced new legislation to regulate smoking in the workplace. However, smoking is still allowed in hotels, bars and restaurants, despite the fact that two-thirds of the Dutch population support a total ban on smoking in public places. Several other European countries and American states have banned smoking in public places. Studies performed in these regions show that the new smoking regulations have had no negative economic effects. Moreover, various studies have shown that smoking bans have a positive impact on public health, even in the short-term, including a significant decrease in respiratory and cardiovascular disease. There is therefore no reason to continue to exclude hotels, bars and restaurants from the smoking ban in all public places in The Netherlands.

Challenges for the smoking ban in Israeli pubs and bars: analysis guided by the behavioral ecological model

PubMed Central

2012-01-01

Background The latest amendment to the ban on smoking in public places in Israel was implemented in 2007, adding pubs and bars (P&B) to the list of public places in which smoking is prohibited. However, smoking in most P&B continued. The aim of the study was to identify the theoretically plausible reasons for the partial success of a public ban on smoking in P&B settings. Explanations provided by P&B owners were interpreted as probable causal factors based on the Behavioral Ecological Model (BEM). Methods Qualitative interviews were performed with 36 P&B owners in Tel-Aviv and 18 Israeli towns and cities of various population size. Results P&B owners reported a variety of situational factors (i.e., contingencies) and reinforcers as likely explanations of the partial failure of the legislated ban on smoking in public places, particularly P&B. The major reinforcers for non-adherence with the law were no or low frequency of inspections and low penalties from authorities. P&B owners also feared loss of customers and revenue if bans were enforced in their own establishment but not in competing establishments. Finally, owners reported social norms prevailing among some Israeli patrons supporting smoking in P&B settings, in part to express opposition to the new law. Conclusions Qualitative assessment can uncover probable social situations that operate to prevent greater adherence to smoking bans. The results warrant confirmation by quantitative analyses. Policies with mandated inspections and penalty requirements that are implemented in all bars without prejudice could lead to greater adherence to smoking bans. Positive reinforcing consequences that encourage adherence (such as publicity and support from non-smokers) would be more likely to generate both greater adherence to the policy and good will toward the government. Principles of behavior outlined in the BEM offer guidance for designing quantitative confirmation analyses of future bans. PMID:22913392

Support and correlates of support for banning smoking in cars with children: findings from the ITC Four Country Survey.

PubMed

Hitchman, Sara C; Fong, Geoffrey T; Zanna, Mark P; Hyland, Andrew; Bansal-Travers, Maansi

2011-06-01

Since 2006, banning smoking in cars with children has become a rapidly growing tobacco control policy. However, to date, there have been few studies examining support and correlates of support for car smoking bans, and none of the existing studies have been international in nature. We conducted such a study among smokers in four countries. 6716 adult current smokers from the 2007 Wave of the International Tobacco Control Four Country Survey, a nationally representative, longitudinal cohort telephone survey of smokers in the USA, Canada, UK and Australia. Controlling for demographics, heaviness of smoking, smoking health knowledge/beliefs and quit intentions, we compared support and correlates of support for banning smoking in cars with children across the four countries. The majority of smokers supported banning smoking in cars with children. Support was highest in Australia (83%), followed by the UK (75%) and Canada (74%); support was lower-but still high-in the USA (60%). Support was highest among smokers who: had stronger quit intentions, were lighter smokers, had lower education, had no children in the home, believed that cigarette smoke is dangerous to non-smokers and could cause asthma in children, and were concerned about modelling smoking to children. These findings indicate that a majority of smokers in the four countries support banning smoking in cars with children, and lend support to banning smoking in cars with children. Additionally, they suggest that support may be increased by educating smokers about the dangers of cigarette smoke exposure.

Can a smoking ban save your heart?

PubMed

Mazzonna, Fabrizio; Salari, Paola

2018-06-04

This paper evaluates the causal effect of environmental tobacco exposure on health by exploiting the time and geographical variation in public-place smoking bans implemented in Switzerland between 2007 and 2011. We use administrative data on hospitalizations for acute myocardial infarction, which allow to measure the short-run effects of the policy on an objective metric of health. We show that the incidence of acute myocardial infarction decreases by approximately 8% immediately after implementation of the law with large heterogeneity across regions. Our results indicate that the policy was effective in reducing the negative externality of smoking with potential spillovers on health inequality. Copyright © 2018 John Wiley & Sons, Ltd.

[Evaluation of the knowledge and manner of workers of workplaces in Tokat about the ban on restriction of indoor smoking].

PubMed

Doruk, Sibel; Celik, Deniz; Etikan, Ilker; Inönü, Handan; Yılmaz, Ayşe; Seyfikli, Zehra

2010-01-01

To evaluate the knowledge and manner of cafe, pub and restaurant (with/without alcohol) workers in our city center about the ban on restriction of indoor smoking. To determine the preparation about the ban, smoking characteristics of workers, the knowledge on passive smoking. A questionnaire was performed to workers. The type of workplace, the number of workers, existence of a restriction of indoor smoking, any preparation about the ban were asked. The job of worker, whether the worker has a knowledge on the ban or not, the idea of the workers on the necessity and practicability of the ban were asked. Smoking history and the knowledge about passive smoking of workers were recorded. Fagerstrom nicotine dependent test (FNDT) was performed to smokers. Eighty four work places with 568 workers included in the study. The questionnaire was performed to 337 workers whose mean age was 29.1/years. 292 of workers were male. 190 of cases were current smokers. 166 of cases (49.3%) know the meaning of passive smoking. Alcohol offering was made at 8 of workplaces. Smoking was forbidden in 20 of workplaces. A preparation was performed about the ban in 30 of (46.9%) other workplaces. 88.4% of workers have knowledge on the ban, 64.7% of them know the punishment of the noncompliance of the ban. 81.3% of the workers believe the necessity and 45.7% of them believe the practicability of the ban. Smokers and especially who's FNBT > 5 have a stronger belief on the necessity and practicability of the ban. We determined that the preparation about the ban was inadequate although there was an little time for the put into practice the law. So we think that the controls of workplaces should be happened frequent.

Changes in hospitalization rates for acute coronary syndrome after a two-phase comprehensive smoking ban.

PubMed

Séguret, Fabienne; Ferreira, Christelle; Cambou, Jean-Pierre; Carrière, Isabelle; Thomas, Daniel

2014-12-01

The impact of a comprehensive stepwise smoking ban (2007 and 2008) was assessed by analysing the hospitalization rate for acute coronary syndrome (ACS) in France, between 2003 and 2009. Between 2003 and 2009, 867,164 hospitalizations for ACS were observed among about 23 million administrative reports. The age-and gender-standardized hospitalization rates were calculated and their variation before and after the smoking ban implementation was investigated by Poisson regression that included the ACS seasonal variations and the historical trend. The hospitalization rate decreased by 12.8% (from 269 to 235/100,000) with a significant historical trend reduction (p < 0.10(-3)) in all groups, but in young women. After adjusting for linear trend, reductions linked to the ban remained not significant in all groups: relative risk (RR) from 0.96 (95% CI 0.91-1.01) in men older than 55 years to 0.99 (95% CI 0.93-1.04) in men aged 55 years or less after the first phase, and from 0.96 (95% CI 0.89-1.04) in men older than 55 years to 1.03 (95% CI 0.94-1.12) in women older than 65 years after the second phase of the ban. This study did not demonstrate a significant effect of a two-phases smoking ban on ACS hospitalization rate. A steadily decrease of this rate over the 7-year period, the past preventive measures in France leading to low levels of passive smoking, and the significant increase in active smoking during the studied period may explain this result. Our study highlights the difficulty of proving an effect of smoking bans in a country with an already low ACS incidence. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Reduced Admissions for Acute Myocardial Infarction Associated with a Public Smoking Ban: Matched Controlled Study

ERIC Educational Resources Information Center

Seo, Dong-Chul; Torabi, Mohammad R.

2007-01-01

There has been no research linking implementation of a public smoking ban and reduced incidence of acute myocardial infarction (AMI) among nonsmoking patients. An ex post facto matched control group study was conducted to determine whether there was a change in hospital admissions for AMI among nonsmoking patients after a public smoking ban was…

Reductions in Cardiovascular, Cerebrovascular, and Respiratory Mortality following the National Irish Smoking Ban: Interrupted Time-Series Analysis

PubMed Central

Stallings-Smith, Sericea; Zeka, Ariana; Goodman, Pat; Kabir, Zubair; Clancy, Luke

2013-01-01

Background Previous studies have shown decreases in cardiovascular mortality following the implementation of comprehensive smoking bans. It is not known whether cerebrovascular or respiratory mortality decreases post-ban. On March 29, 2004, the Republic of Ireland became the first country in the world to implement a national workplace smoking ban. The aim of this study was to assess the effect of this policy on all-cause and cause-specific, non-trauma mortality. Methods A time-series epidemiologic assessment was conducted, utilizing Poisson regression to examine weekly age and gender-standardized rates for 215,878 non-trauma deaths in the Irish population, ages ≥35 years. The study period was from January 1, 2000, to December 31, 2007, with a post-ban follow-up of 3.75 years. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results Following ban implementation, an immediate 13% decrease in all-cause mortality (RR: 0.87; 95% CI: 0.76–0.99), a 26% reduction in ischemic heart disease (IHD) (RR: 0.74; 95% CI: 0.63–0.88), a 32% reduction in stroke (RR: 0.68; 95% CI: 0.54–0.85), and a 38% reduction in chronic obstructive pulmonary disease (COPD) (RR: 0.62; 95% CI: 0.46–0.83) mortality was observed. Post-ban reductions in IHD, stroke, and COPD mortalities were seen in ages ≥65 years, but not in ages 35–64 years. COPD mortality reductions were found only in females (RR: 0.47; 95% CI: 0.32–0.70). Post-ban annual trend reductions were not detected for any smoking-related causes of death. Unadjusted estimates indicate that 3,726 (95% CI: 2,305–4,629) smoking-related deaths were likely prevented post-ban. Mortality decreases were primarily due to reductions in passive smoking. Conclusions The national Irish smoking ban was associated with immediate reductions in early mortality. Importantly, post-ban risk differences did not change with a longer follow-up period. This study corroborates previous evidence for cardiovascular

Impact of a national smoking ban on hospital admission for acute coronary syndromes: a longitudinal study.

PubMed

Cronin, Edmond M; Kearney, Patricia M; Kearney, Peter P; Sullivan, Patrick; Perry, Ivan J

2012-04-01

A ban on smoking in the workplace was introduced in Ireland on March 29, 2004. As exposure to secondhand smoke has been implicated in the development of coronary disease, this might impact the incidence of acute coronary syndromes (ACS). The smoking ban was associated with a decreased rate of hospital admissions for ACS. We analyzed data collected in a registry of all patients admitted to hospital with ACS in the southwest of Ireland, catchment population 620 525, from March 2003 until March 2007. In the year following implementation of the ban, there was a significant 12% reduction in ACS admissions (177.9 vs 205.9/100,000; 95% confidence interval [CI]: 164.0-185.1, P = 0.002). This reduction was due to fewer events occurring among men (281.5 vs 233.5, P = 0.0011) and current smokers (408 vs 302 admissions, P < 0.0001). There was no change in the rate of admissions for ACS in the following year (174.3/100,000; 95% CI: 164.0-185.1, P > 0.1). However, a further 13% reduction was observed between March 2006 and March 2007 (149.2; 95% CI: 139.7-159.2). Variation in admissions with time as a continuous variable also demonstrated a reduction on implementation of the smoking ban. A national ban on smoking in public places was associated with an early significant decrease in hospital admissions for ACS, suggesting a rapid effect of banning smoking in public places on ACS. A further reduction of similar magnitude 2 years after implementation of the ban is consistent with a longer-term effect that should be further examined in long-term studies. © 2012 Wiley Periodicals, Inc.

Impact of a smoking ban in hospitality venues on second hand smoke exposure: a comparison of exposure assessment methods

PubMed Central

2013-01-01

Background In May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector. While the law leaves room for exceptions in some cantons, it is comprehensive in others. This longitudinal study uses different measurement methods to examine airborne nicotine levels in hospitality venues and the level of personal exposure of non-smoking hospitality workers before and after implementation of the law. Methods Personal exposure to second hand smoke (SHS) was measured by three different methods. We compared a passive sampler called MoNIC (Monitor of NICotine) badge, to salivary cotinine and nicotine concentration as well as questionnaire data. Badges allowed the number of passively smoked cigarettes to be estimated. They were placed at the venues as well as distributed to the participants for personal measurements. To assess personal exposure at work, a time-weighted average of the workplace badge measurements was calculated. Results Prior to the ban, smoke-exposed hospitality venues yielded a mean badge value of 4.48 (95%-CI: 3.7 to 5.25; n = 214) cigarette equivalents/day. At follow-up, measurements in venues that had implemented a smoking ban significantly declined to an average of 0.31 (0.17 to 0.45; n = 37) (p = 0.001). Personal badge measurements also significantly decreased from an average of 2.18 (1.31-3.05 n = 53) to 0.25 (0.13-0.36; n = 41) (p = 0.001). Spearman rank correlations between badge exposure measures and salivary measures were small to moderate (0.3 at maximum). Conclusions Nicotine levels significantly decreased in all types of hospitality venues after implementation of the smoking ban. In-depth analyses demonstrated that a time-weighted average of the workplace badge measurements represented typical personal SHS exposure at work more reliably than personal exposure measures such as salivary cotinine and nicotine. PMID:23731820

Impact of a smoking ban in hospitality venues on second hand smoke exposure: a comparison of exposure assessment methods.

PubMed

Rajkumar, Sarah; Huynh, Cong Khanh; Bauer, Georg F; Hoffmann, Susanne; Röösli, Martin

2013-06-04

In May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector. While the law leaves room for exceptions in some cantons, it is comprehensive in others. This longitudinal study uses different measurement methods to examine airborne nicotine levels in hospitality venues and the level of personal exposure of non-smoking hospitality workers before and after implementation of the law. Personal exposure to second hand smoke (SHS) was measured by three different methods. We compared a passive sampler called MoNIC (Monitor of NICotine) badge, to salivary cotinine and nicotine concentration as well as questionnaire data. Badges allowed the number of passively smoked cigarettes to be estimated. They were placed at the venues as well as distributed to the participants for personal measurements. To assess personal exposure at work, a time-weighted average of the workplace badge measurements was calculated. Prior to the ban, smoke-exposed hospitality venues yielded a mean badge value of 4.48 (95%-CI: 3.7 to 5.25; n = 214) cigarette equivalents/day. At follow-up, measurements in venues that had implemented a smoking ban significantly declined to an average of 0.31 (0.17 to 0.45; n = 37) (p = 0.001). Personal badge measurements also significantly decreased from an average of 2.18 (1.31-3.05 n = 53) to 0.25 (0.13-0.36; n = 41) (p = 0.001). Spearman rank correlations between badge exposure measures and salivary measures were small to moderate (0.3 at maximum). Nicotine levels significantly decreased in all types of hospitality venues after implementation of the smoking ban. In-depth analyses demonstrated that a time-weighted average of the workplace badge measurements represented typical personal SHS exposure at work more reliably than personal exposure measures such as salivary cotinine and nicotine.

Agreement between self-reports and on-site inspections of compliance with a workplace smoking ban.

PubMed

Verdonk-Kleinjan, Wendy M I; Rijswijk, Pieter C P; Candel, Math J J M; de Vries, Hein; Knibbe, Ronald A

2012-09-01

This study compares self-reports on compliance with a workplace smoking ban with on-site inspections of the same workplace, in the Netherlands, to assess the validity of self-reported compliance by employees. A total of 360 companies had participated in the telephone survey (in October and November 2006) and were also visited by inspectors directly after the survey to establish compliance. The sampling frame included companies with 5 or more employees, stratified according to the number of employees and type of economic activity. We calculated the agreement, the under- or overestimation and the predictive values, and explored nonresponse research. The percent agreement on compliance between the two measures was 77.5%, the McNemar test was not significant, and the agreement coefficient with first order correction was .68, indicating moderately strong agreement. Furthermore, the results indicate a slight overestimation of compliance. Concerning the predictive values, we found most variance among the self-reported noncompliance: 55.2% of those reporting noncompliance did in fact comply. This study allows to conclude that self-reports on compliance with a workplace smoking ban are largely valid and that social desirability is negligible. For agencies enforcing the workplace smoking ban, these results indicate that a strategy to identify noncompliance among responding companies might be useful. Moreover, such a strategy reduces the burden of inspecting among complying companies.

The Association between Point-of-Sale Advertising Bans and Youth Experimental Smoking: Findings from the Global Youth Tobacco Survey (GYTS)

PubMed Central

Shang, Ce; Huang, Jidong; Li, Qing; Chaloupka, Frank J.

2015-01-01

Background and Objectives: while existing research has demonstrated a positive association between exposure to point-of-sale (POS) tobacco advertising and youth smoking, there is limited evidence on the relationship between POS advertising restrictions and experimental smoking among youth. This study aims to fill this research gap by analyzing the association between POS advertising bans and youths' experimental smoking. Methods: Global Youth Tobacco Surveys from 130 countries during 2007–2011 were linked to the WHO “MPOWER” tobacco control policy measures to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and experimental smoking using weighted logistic regressions. All analyses were clustered at the country level and controlled for age, parents' smoking status, GDP per capita, and country-level tobacco control scores in monitoring tobacco use, protecting people from smoke, offering help to quit, warning about the dangers of tobacco, enforcing promotion/advertising bans, and raising taxes on tobacco. Results: The results suggest that a POS advertising ban is significantly associated with reduced experimental smoking among youth (OR = 0.63, p < 0.01), and that this association is seen for both genders (boys OR = 0.74, p < 0.1; girls OR = 0.52, p < 0.001). Conclusions: POS advertising bans are significantly associated with reduced experimental smoking among youth. Adopting POS advertising bans has the potential to reduce tobacco use among their youth in countries currently without such bans. PMID:27294172

Temporal changes in the attitude towards smoking bans in public arenas among adults in the Capital Region of Denmark from 2007 to 2010.

PubMed

Lykke, Maja; Helbech, Bodil; Glümer, Charlotte

2014-07-01

The population's attitude towards smoking bans in public arenas is important for their passing, implementation and compliance. Smoking bans are believed to reduce the social acceptability of smoking, and once people experience them, public support increases--also among pre-ban sceptics. This study aimed to examine the temporal changes in public attitude towards smoking bans in public arenas from 2007 to 2010 and whether these changes differed across educational attainment, smoking status and intention to quit among smokers. Data from two surveys among adults (aged 25-79 years) in 2007 and 2010 in the Capital Region of Denmark (n=36,472/42,504, response rate = 52.3) was linked with data on sex, age and educational attainment from central registers. Age-standardised prevalence of supportive attitude towards smoking bans was estimated. Temporal changes in supportive attitude were explored in workplaces, restaurants and bars using logistic regression models. The prevalence of supportive attitude towards smoking bans increased significantly in all arenas from 2007 to 2010. Positive temporal changes in supportive attitude towards smoking bans were seen across educational attainment, smoking status and intention to quit smoking in restaurants and across smoking status for smoking bans in workplaces and bars. The results of this study show that the public's attitude towards smoking in public arenas has changed after the implementation of a comprehensive smoking ban. This change in attitude can support implementation of future legislation on smoking and may lead to positive changes in smoking norms. © 2014 the Nordic Societies of Public Health.

Support and correlates of support for banning smoking in cars with children: findings from the ITC Four Country Survey*

PubMed Central

Fong, Geoffrey T.; Zanna, Mark P.; Hyland, Andrew; Bansal-Travers, Maansi

2011-01-01

Background: Since 2006, banning smoking in cars with children has become a rapidly growing tobacco control policy. However, to date, there have been few studies examining support and correlates of support for car smoking bans, and none of the existing studies have been international in nature. We conducted such a study among smokers in four countries. Methods: 6716 adult current smokers from the 2007 Wave of the International Tobacco Control Four Country Survey, a nationally representative, longitudinal cohort telephone survey of smokers in the USA, Canada, UK and Australia. Controlling for demographics, heaviness of smoking, smoking health knowledge/beliefs and quit intentions, we compared support and correlates of support for banning smoking in cars with children across the four countries. Results: The majority of smokers supported banning smoking in cars with children. Support was highest in Australia (83%), followed by the UK (75%) and Canada (74%); support was lower—but still high—in the USA (60%). Support was highest among smokers who: had stronger quit intentions, were lighter smokers, had lower education, had no children in the home, believed that cigarette smoke is dangerous to non-smokers and could cause asthma in children, and were concerned about modelling smoking to children. Conclusions: These findings indicate that a majority of smokers in the four countries support banning smoking in cars with children, and lend support to banning smoking in cars with children. Additionally, they suggest that support may be increased by educating smokers about the dangers of cigarette smoke exposure. PMID:20630910

The Effect of a Smoking Ban on Hospitalization Rates for Cardiovascular and Respiratory Conditions in Prince Edward Island, Canada

PubMed Central

Gaudreau, Katherine; Sanford, Carolyn J.; Cheverie, Connie; McClure, Carol

2013-01-01

Background This is the first study to have examined the effect of smoking bans on hospitalizations in the Atlantic Canadian socio-economic, cultural and climatic context. On June 1, 2003 Prince Edward Island (PEI) enacted a province-wide smoking ban in public places and workplaces. Changes in hospital admission rates for cardiovascular (acute myocardial infarction, angina, and stroke) and respiratory (chronic obstructive pulmonary disease and asthma) conditions were examined before and after the smoking ban. Methods Crude annual and monthly admission rates for the above conditions were calculated from April 1, 1995 to December 31, 2008 in all PEI acute care hospitals. Autoregressive Integrated Moving Average time series models were used to test for changes in mean and trend of monthly admission rates for study conditions, control conditions and a control province after the comprehensive smoking ban. Age- and sex-based analyses were completed. Results The mean rate of acute myocardial infarctions was reduced by 5.92 cases per 100,000 person-months (P = 0.04) immediately after the smoking ban. The trend of monthly angina admissions in men was reduced by −0.44 cases per 100,000 person-months (P = 0.01) in the 67 months after the smoking ban. All other cardiovascular and respiratory admission changes were non-significant. Conclusions A comprehensive smoking ban in PEI reduced the overall mean number of acute myocardial infarction admissions and the trend of angina hospital admissions. PMID:23520450

The effect of a smoking ban on hospitalization rates for cardiovascular and respiratory conditions in Prince Edward Island, Canada.

PubMed

Gaudreau, Katherine; Sanford, Carolyn J; Cheverie, Connie; McClure, Carol

2013-01-01

This is the first study to have examined the effect of smoking bans on hospitalizations in the Atlantic Canadian socio-economic, cultural and climatic context. On June 1, 2003 Prince Edward Island (PEI) enacted a province-wide smoking ban in public places and workplaces. Changes in hospital admission rates for cardiovascular (acute myocardial infarction, angina, and stroke) and respiratory (chronic obstructive pulmonary disease and asthma) conditions were examined before and after the smoking ban. Crude annual and monthly admission rates for the above conditions were calculated from April 1, 1995 to December 31, 2008 in all PEI acute care hospitals. Autoregressive Integrated Moving Average time series models were used to test for changes in mean and trend of monthly admission rates for study conditions, control conditions and a control province after the comprehensive smoking ban. Age- and sex-based analyses were completed. The mean rate of acute myocardial infarctions was reduced by 5.92 cases per 100,000 person-months (P = 0.04) immediately after the smoking ban. The trend of monthly angina admissions in men was reduced by -0.44 cases per 100,000 person-months (P = 0.01) in the 67 months after the smoking ban. All other cardiovascular and respiratory admission changes were non-significant. A comprehensive smoking ban in PEI reduced the overall mean number of acute myocardial infarction admissions and the trend of angina hospital admissions.

The Politics of Smoking in Federal Buildings: An Executive Order Case Study

PubMed Central

Bero, Lisa A.

2009-01-01

Executive orders are important presidential tools for health policymaking that are subject to less public scrutiny than are legislation and regulatory rulemaking. President Bill Clinton banned smoking in federal government buildings by executive order in 1997, after the administration of George H. W. Bush had twice considered and abandoned a similar policy. The 1991 and 1993 Bush proposals drew objections from agency heads and labor unions, many coordinated by the tobacco industry. We analyzed internal tobacco industry documents and found that the industry engaged in extensive executive branch lobbying and other political activity surrounding the Clinton smoking ban. Whereas some level of stakeholder politics might have been expected, this policy also featured jockeying among various agencies and the participation of organized labor. PMID:19608948

The politics of smoking in federal buildings: an executive order case study.

PubMed

Cook, Daniel M; Bero, Lisa A

2009-09-01

Executive orders are important presidential tools for health policymaking that are subject to less public scrutiny than are legislation and regulatory rulemaking. President Bill Clinton banned smoking in federal government buildings by executive order in 1997, after the administration of George H. W. Bush had twice considered and abandoned a similar policy. The 1991 and 1993 Bush proposals drew objections from agency heads and labor unions, many coordinated by the tobacco industry. We analyzed internal tobacco industry documents and found that the industry engaged in extensive executive branch lobbying and other political activity surrounding the Clinton smoking ban. Whereas some level of stakeholder politics might have been expected, this policy also featured jockeying among various agencies and the participation of organized labor.

Evaluation of the Impact of Indoor Smoking Bans on Air Quality in Australian Licensed Clubs

NASA Astrophysics Data System (ADS)

Davidson, Margaret Elissa

The quality of indoor air in Australian buildings is unknown due to limited published data. The assessment of indoor air quality (IAQ) in hospitality environments is of special concern because they are frequented by sensitive populations such as the elderly, children, and people with pre-existing health conditions, who may be at risk of developing adverse health reactions if the IAQ is poor. As of 2010, all Australian states and territories have introduced legalisation banning smoking in enclosed public places, including licensed clubs. This project has evaluated the impact of indoor smoking bans on air quality inside and outside of Australian licensed clubs. In doing this it has identified emerging IAQ issues in post smoking ban environments, and documented the airborne concentrations of previously unstudied air contaminants such as particulate matter with a 50% cut-point diameter of 1.0 ?m (PM1.0) and particulate polycyclic aromatic hydrocarbons (PPAH) in the indoor smoking areas of Australian licensed clubs. The study involved collecting approximately 400 hours of air quality data, of which 200 hours was collected before bans and 200 hrs was collected after smoking bans were introduced in licensed clubs located within two local government districts of South Eastern Australia. Clubs 1 to 7 were located in the one district and Clubs 8 to 11 in the other district. Club 4 dropped out following the pre ban monitoring, and the results were omitted from analysis. The air quality parameters measured inside include particulate matter with a 50% cut-point diameter of 2.5 mum (PM2.5), PPAH, carbon monoxide (CO), carbon dioxide mu(CO2), temperature and humidity. The air quality parameters measured outside were PM2.5, CO2, temperature and humidity. Each of the parameters were monitored for 4 hour periods on 4 occasions in each club both before, and after the introduction of indoor smoking bans. Additional monitoring of indoor concentrations of PM1.0, nicotine and PM2

Systematic review and meta-analysis of the economic impact of smoking bans in restaurants and bars.

PubMed

Cornelsen, Laura; McGowan, Yvonne; Currie-Murphy, Laura M; Normand, Charles

2014-05-01

To review systematically the literature on the economic impact of smoking bans in bars and restaurants and provide an estimate of the impact size using meta-analysis. Studies were identified by systematic database searches and screening references of reviews and relevant studies. Google and web-pages of tobacco control agencies were also searched. The review identified 56 studies using absolute sales, sales ratio or employment data and employing regression methods to evaluate the impact of smoking bans in the United States, Australia or in countries in South America or Europe. The meta-analysis included 39 comparable studies, with 129 cases identified based on the outcome measure, scope of the ban, type of establishment and geographical location. Methodological quality was assessed based on four pre-determined criteria. Study and case selection and data extraction were conducted independently by two researchers. Random-effects meta-analysis of all cases showed no associations between smoking bans and changes in absolute sales or employment. An increase in the share of bar and restaurant sector sales in total retail sales was associated with smoking bans [0.23 percentage-points; 95% confidence interval (CI) 0.08-0.375]. When cases were separated by business type (bars or restaurants or wider hospitality including bars and restaurants), some differential impacts emerged. Meta-analysis of the economic impact of smoking bans in hospitality sector showed overall no substantial economic gains or losses. Differential impacts were observed across individual business types and outcome variable, but at aggregate level these appear to balance out. © 2014 Society for the Study of Addiction.

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

PubMed Central

2012-01-01

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. Methods A longitudinal representative sample of 3,237 individuals from the Canadian National Population Health Survey from 2000 to 2008 is used. Work-related stress is derived from a 12-item job questionnaire. Two categories of WSB's, full and partial, are included in the analysis, with no ban being the reference category. Analysis also controls for individual socio-demographic characteristics, health status, provincial and occupational fixed-effects. We use fixed-effects linear regression to control for individual time-invariant confounders, both measured and unmeasured, which can affect the relationship between WSB's and work-related stress. To examine the heterogeneous effects of WSB's, the analysis is stratified by gender and age. We check the robustness of our results by re-estimating the baseline specification with the addition of different control variables and a separate analysis for non-smokers. Results Multivariate analysis reveals a positive and statistically significant association between full (β = 0.75, CI = 0.19-1.32) or partial (β = 0.69, CI = 0.12-1.26) WSB's, and the level of self-perceived, work-related stress among smoking workers compared to those with no WSB. We also find that this association varies by gender and age. In particular, WSB's are significantly associated with higher work stress only for males and young adults (aged 18-40). No statistically significant association is found between WSB's and the level of self-perceived work-related stress among non-smoking workers. Conclusion The results of this study do not imply that WSB's are the main determinant of self-perceived, work-related stress among smokers but

Association of restaurant smoking ban and the incidence of acute myocardial infarction in Finland.

PubMed

Sipilä, Jussi Olli Tapani; Gunn, Jarmo Mikael; Kauko, Tommi; Rautava, Päivi; Kytö, Ville

2016-01-29

To describe the changes in nationwide acute myocardial infarction (AMI) incidence following the implementation of a law banning smoking indoors in restaurants on 1 June 2007. Retrospective registry study of all hospitalisations for AMI in Finland. All 34,887 hospitalisations for AMI between 1 June 2005 and 31 May 2009 were identified from the Care Register for Health Care (CRHC) and statistics for tobacco consumption were obtained from the National Institute for Health and Welfare. Comorbidities for individual hospitalisations were searched from the CRHC. The incidence rate of AMI was reduced by 6.3% (95% CI 4.1% to 8.6%; p<0.0001) in the latter half of the study period following the smoking ban when adjusted for age, gender and overall population prevalence of smoking. Short-term incidence of AMI (6-month prior vs 6 months after the smoking ban) was also reduced (4.5%, 95% CI 0.2% to 9.0%; p=0.0399) and was largest in the working middle-aged group (40-50 years) but observed also in the oldest age group (>70 years). The incidence rates declined similarly for men and women. Banning indoor tobacco smoking in restaurants was associated with a mild additional reduction in AMI incidence on a nationwide level in Finland. 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/

Impact of the 2011 Spanish smoking ban in hospitality venues: indoor secondhand smoke exposure and influence of outdoor smoking.

PubMed

López, María J; Fernández, Esteve; Pérez-Rios, Mónica; Martínez-Sánchez, Jose M; Schiaffino, Anna; Galán, Iñaki; Moncada, Albert; Fu, Marcela; Montes, Agustín; Saltó, Esteve; Nebot, Manel

2013-05-01

The Spanish tobacco control law of 2006 was modified in January 2011, banning smoking in all hospitality venues. The objective of the study was to assess the impact of the 2011 Spanish smoking ban on secondhand smoke (SHS) exposure in hospitality venues, and to analyze the potential impact of outdoor smokers close to entrances on indoor SHS levels after the law came into force. Before-and-after evaluation study with repeated measures. The study was carried out in three regions of Spain (Catalonia, Galicia, and Madrid) and included a random sample of 178 hospitality venues. We measured vapor-phase nicotine and particulate matter 2.5 micrometers or less in diameter (PM2.5) as SHS markers at baseline (November-December 2010) and at follow-up (April-June 2011). We also recorded tobacco consumption variables such as the presence of butts, ashtrays, and smokers. In the posttest assessment, we also recorded the number of outdoor smokers close to the entrance. A total of 351 nicotine and 160 PM2.5 measurements were taken. Both nicotine and PM2.5 concentrations decreased by more than 90% (nicotine from 5.73 to 0.57 µg/m(3), PM2.5 from 233.38 to 18.82 µg/m(3)). After the law came into force, both nicotine and PM2.5 concentrations were significantly higher in venues with outdoor smokers close to the entrance than in those without outdoor smokers. All the observational tobacco consumption variables significantly decreased (p < .001). SHS exposure in hospitality venues dramatically decreased after the 2011 Spanish smoking ban. SHS from outdoor smokers close to entrances seems to drift inside venues. Smoking control legislation should consider outdoor restrictions to ensure complete protection against SHS.

Impact of national smoke-free legislation on home smoking bans – Findings from the International Tobacco Control (ITC) Policy Evaluation Project Europe Surveys

PubMed Central

Mons, Ute; Nagelhout, Gera E.; Allwright, Shane; Guignard, Romain; van den Putte, Bas; Willemsen, Marc C.; Fong, Geoffrey T.; Brenner, Hermann; Pötschke-Langer, Martina; Breitling, Lutz P.

2014-01-01

Objectives To measure changes in prevalence and predictors of home smoking bans (HSB) among smokers in four European countries after the implementation of national smoke-free legislation. Design Two waves of the International Tobacco Control (ITC) Policy Evaluation Project Europe Surveys, which is a prospective panel study. Pre- and post-legislation data was used from Ireland, France, Germany, and the Netherlands. Two pre-legislation waves from UK were used as control. Participants 4,634 respondents from the intervention countries and 1,080 from the control country completed both baseline and follow-up, and were included in the present analyses. Methods Multiple logistic regression models to identify predictors of having or of adopting a total HSB, and Generalised Estimating Equation (GEE) models to compare patterns of change after implementation of smoke-free legislation to a control country without such legislation. Results Most smokers had at least partial smoking restrictions in their home, but the proportions varied significantly between countries. After implementation of national smoke-free legislation, the proportion of smokers with a total HSB increased significantly in all four countries. Among continuing smokers the number of cigarettes smoked per day either remained stable or decreased significantly. Multiple logistic regression models indicated that having a young child in the household and supporting smoking bans in bars were important correlates of having a pre-legislation HSB. Prospective predictors of imposing a HSB between survey waves were planning to quit smoking, supporting a total smoking ban in bars, and the birth of a child. GEE models indicated that the change in total HSB in the intervention countries was greater than in the control country. Conclusions The findings suggest that smoke-free legislation does not lead to more smoking in smokers’ homes. On the contrary, our findings demonstrate that smoke-free legislation may stimulate

A smoking ban in public places increases the efficacy of bupropion and counseling on cessation outcomes at 1 year.

PubMed

Grassi, M Caterina; Enea, Domenico; Ferketich, Amy K; Lu, Bo; Nencini, Paolo

2009-09-01

Legal restrictions have contributed to the decline in smoking prevalence in several European countries. We investigated the impact of the Italian 2005 indoor smoking ban on the efficacy of counseling alone or in combination with bupropion for smoking cessation. Before and after the introduction of the ban (2001-2006), 550 smokers were enrolled in the smoking cessation program in Rome and were asked to choose between a 6-week group counseling therapy (GCT) given alone or in combination with 7 weeks of daily bupropion. Follow-up was completed 12, 26, and 52 weeks after the quit day. Due to the observational nature of the study, we used propensity scores to match 138 and 290 subjects (pre-/postban) in the bupropion- and GCT-only groups, respectively. Covariate balance in the two matched samples was adequate for all variables except "coffee consumption" in the GCT-only group. The regression adjusted odds ratios indicated that the introduction of the ban resulted in 52% reduced odds of continued smoking at 12 months among the GCT + bupropion group and 41% reduced odds in the GCT-only group. We observed that the ban was associated with both increased 12-month abstinence rates and motivation to quit. In a mediation analysis, we determined that the total effect of the smoking ban on the abstinence rate was reduced after controlling for motivation, which confirmed that motivation was a partial mediator. The introduction of an indoor smoking ban improved the efficacy of smoking cessation treatments by possibly providing a setting that increased the level of motivation to stop smoking.

Impact of an Outdoor Smoking Ban at Secondary Schools on Cigarettes, E-Cigarettes and Water Pipe Use among Adolescents: An 18-Month Follow-Up

PubMed Central

Hiemstra, Marieke; Mathijssen, Jolanda J. P.; Jansen, Maria W. J.; van Oers, Hans J. A. M.

2018-01-01

The effectiveness of outdoor smoking bans on smoking behavior among adolescents remains inconclusive. This study evaluates the long-term impact of outdoor school ground smoking bans among adolescents at secondary schools on the use of conventional cigarettes, e-cigarettes (with/without nicotine) and water pipes. Outdoor smoking bans at 19 Dutch secondary schools were evaluated using a quasi-experimental design. Data on 7733 adolescents were obtained at baseline, and at 6 and 18-month follow-up. The impact of outdoor smoking bans on ‘ever use of conventional cigarettes’, ‘smoking onset’, ‘ever use of e-cigarette with nicotine’, ‘e-cigarette without nicotine’, and ‘water pipe’ was measured. Multilevel logistic regression analysis was used. At schools with a ban, implementation fidelity was checked. At schools where a ban was implemented, at 18-month follow-up more adolescents had started smoking compared to the control condition. No effect of implementation of the ban was found for smoking prevalence, e-cigarettes with/without nicotine, and water pipe use. Implementation fidelity was sufficient. No long-term effects were found of an outdoor smoking ban, except for smoking onset. The ban might cause a reversal effect when schools encounter difficulties with its enforcement or when adolescents still see others smoking. Additional research is required with a longer follow-up than 18 months. PMID:29370137

Impact of an Outdoor Smoking Ban at Secondary Schools on Cigarettes, E-Cigarettes and Water Pipe Use among Adolescents: An 18-Month Follow-Up.

PubMed

Rozema, Andrea D; Hiemstra, Marieke; Mathijssen, Jolanda J P; Jansen, Maria W J; van Oers, Hans J A M

2018-01-25

Abstract : The effectiveness of outdoor smoking bans on smoking behavior among adolescents remains inconclusive. This study evaluates the long-term impact of outdoor school ground smoking bans among adolescents at secondary schools on the use of conventional cigarettes, e-cigarettes (with/without nicotine) and water pipes. Outdoor smoking bans at 19 Dutch secondary schools were evaluated using a quasi-experimental design. Data on 7733 adolescents were obtained at baseline, and at 6 and 18-month follow-up. The impact of outdoor smoking bans on 'ever use of conventional cigarettes', 'smoking onset', 'ever use of e-cigarette with nicotine', 'e-cigarette without nicotine', and 'water pipe' was measured. Multilevel logistic regression analysis was used. At schools with a ban, implementation fidelity was checked. At schools where a ban was implemented, at 18-month follow-up more adolescents had started smoking compared to the control condition. No effect of implementation of the ban was found for smoking prevalence, e-cigarettes with/without nicotine, and water pipe use. Implementation fidelity was sufficient. No long-term effects were found of an outdoor smoking ban, except for smoking onset. The ban might cause a reversal effect when schools encounter difficulties with its enforcement or when adolescents still see others smoking. Additional research is required with a longer follow-up than 18 months.

Bar and restaurant workers' attitudes towards Norway's comprehensive smoking ban: a growth curve analysis.

PubMed

Braverman, Marc T; Aarø, Leif Edvard; Bontempo, Daniel E; Hetland, Jørn

2010-06-01

Norway passed legislation banning smoking in restaurants, bars and other public spaces in 2004. This study tracks changes in hospitality workers' attitudes towards Norway's ban over three time points, using growth modelling analysis to examine predictors of attitude change. Participants were a national sample of 1525 bar and restaurant workers. Surveys were conducted, by phone or internet, one month before the ban's implementation and at 4 and 12 months thereafter. Exploratory principal components analysis of nine survey items revealed one primary attitude component. A latent growth model was fitted to the data to examine trajectories of attitude change and individual differences in rate of change. Respondents supported the ban before implementation and increased support at 4 months (p=0.021) and again at 12 months (p=0.001). Concern for one's job followed a quadratic trend, increasing at 4 months and decreasing at 12 months (p<0.001). All demographic categories were associated with attitude increase; rate of increase was greater for females than males. Two within-person variables--change in smoking status and change in job concern--strongly predicted (p<0.001) respondents' deviations from their predicted group trajectories, explaining over 70% of residual between-person slope variance. Norway's hospitality workers increased their support of the ban over its first year. The strong influence of the within-person variables leads to two primary policy recommendations. First, support should be provided to assist cessation efforts and prevent relapse. Second, informational campaigns should inform hospitality workers about evidence that smoking bans are not economic threats to the industry.

The cigarette advertising broadcast ban and magazine coverage of smoking and health.

PubMed

Warner, K E; Goldenhar, L M

1989-01-01

At the time of the cigarette broadcast advertising ban, which took effect in 1971, cigarette manufacturers rapidly shifted advertising expenditures from the broadcast media to the print media. In the last year of broadcast advertising and the first year of the ban, cigarette ad expenditures in a sample of major national magazines increased by 49 and then 131 percent in constant dollars. From an 11-year period preceding the ban to an 11-year period following it, these magazines decreased their coverage of smoking and health by 65 percent, an amount that is statistically significantly greater than decreases found in magazines that did not carry cigarette ads and in two major newspapers. This finding adds to evidence that media dependent on cigarette advertising have restricted their coverage of smoking and health. This may have significant implications for public health, as well as raising obvious concerns about the integrity of the profession of journalism.

Exposure to fine and ultrafine particles from secondhand smoke in public places before and after the smoking ban, Italy 2005.

PubMed

Valente, Pasquale; Forastiere, Francesco; Bacosi, Antonella; Cattani, Giorgio; Di Carlo, Simonetta; Ferri, Monica; Figà-Talamanca, Irene; Marconi, Achille; Paoletti, Luigi; Perucci, Carlo; Zuccaro, Piergiorgio

2007-10-01

A smoking ban in all indoor public places was enforced in Italy on 10 January 2005. We compared indoor air quality before and after the smoking ban by monitoring the indoor concentrations of fine (<2.5 microm diameter, PM2.5) and ultrafine particulate matter (<0.1 microm diameter, UFP). PM2.5 and ultrafine particles were measured in 40 public places (14 bars, six fast food restaurants, eight restaurants, six game rooms, six pubs) in Rome, before and after the introduction of the law banning smoking (after 3 and 12 months). Measurements were taken using real time particle monitors (DustTRAK Mod. 8520 TSI; Ultra-fine Particles Counter-TRAK Model 8525 TSI). The PM2.5 data were scaled using a correction equation derived from a comparison with the reference method (gravimetric measurement). The study was completed by measuring urinary cotinine, and pre-law and post-law enforcement among non-smoking employees at these establishments In the post-law period, PM2.5 decreased significantly from a mean concentration of 119.3 microg/m3 to 38.2 microg/m3 after 3 months (p<0.005), and then to 43.3 microg/m3 a year later (p<0.01). The UFP concentrations also decreased significantly from 76,956 particles/cm3 to 38,079 particles/cm3 (p<0.0001) and then to 51,692 particles/cm3 (p<0.01). Similarly, the concentration of urinary cotinine among non-smoking workers decreased from 17.8 ng/ml to 5.5 ng/ml (p<0.0001) and then to 3.7 ng/ml (p<0.0001). The application of the smoking ban led to a considerable reduction in the exposure to indoor fine and ultrafine particles in hospitality venues, confirmed by a contemporaneous reduction of urinary cotinine.

A Qualitative Study Among Mexican Americans to Understand Factors Influencing the Adoption and Enforcement of Home Smoking Bans.

PubMed

Savas, Lara S; Mullen, Patricia Dolan; Hovell, Melbourne F; Escoffrey, Cam; Fernandez, Maria E; Jones, Jennifer A; Cavazos, Jazmine; Gutierrez Monroy, Jo Ann A; Kegler, Michelle C

2017-11-07

One-third of Mexican-American children, in addition to nonsmoker adults, are exposed to secondhand smoke at home, yet few interventions target Mexican-American households. An effective, brief English language program, tested with United Way 2-1-1 callers in Atlanta, increased home smoking bans (confirmed by air monitors). Two randomized controlled trials in North Carolina and Texas replicated those results. We explored factors determining adoption and enforcement of smoking bans in Mexican-American households to inform program linguistic and cultural adaptation to broaden program reach and relevance. Bilingual interviewers recruited convenience samples of Mexican-American smokers and nonsmokers living with at least one smoker in Houston and San Diego households and asked open-ended questions regarding conditions for implementing home and vehicle smoking bans and conditions for varying acceptance of bans. Investigators independently reviewed English transcripts and completed a descriptive analysis using ATLAS.ti. Participants (n = 43) were predominantly female (n = 31), current smokers (n = 26), interviewed in Spanish (n = 26), had annual household incomes less than $30000 (n = 24), and allowed smoking inside the home (n = 24). Themes related to difficulty creating and enforcing bans included courtesy, respect for guests and heads of household who smoke, and gender imbalances in decision making. Participants viewed protecting children's health as a reason for the ban but not protecting adult nonsmokers' health. A dual-language, culturally adapted intervention targeting multigenerational Mexican-American households should address household differences regarding language and consider influences of cultural values on family dynamics and interactions with guests that may weaken bans. Qualitative interviews suggested cultural and family considerations to address in adapting a brief evidence-based smoke-free homes intervention for Mexican Americans, including traditional

The impact of the Cyprus comprehensive smoking ban on air quality and economic business of hospitality venues.

PubMed

Christophi, Costas A; Paisi, Martha; Pampaka, Despina; Kehagias, Martha; Vardavas, Constantine; Connolly, Gregory N

2013-01-27

Several countries, including Cyprus, have passed smoke-free legislations in recent years. The goal of this study was to assess the indoor levels of particulate matter in hospitality venues in Cyprus before and after the implementation of the law on 1/1/2010, evaluate the role of enforcement, and examine the legislation's effect on revenue and employment. Several hospitality venues (n = 35) were sampled between April 2007 and January 2008, and 21 of those were re-sampled after the introduction of the smoking ban, between March and May 2010. Data on enforcement was provided by the Cyprus Police whereas data on revenue and employment within the hospitality industry of Cyprus were obtained from the Cyprus Statistical Service; comparisons were made between the corresponding figures before and after the implementation of the law. The median level of PM2.5 associated with secondhand smoking was 161 μg/m3 pre-ban and dropped to 3 μg/m3 post-ban (98% decrease, p < 0.0001). Furthermore, in the year following the ban, the hotel turnover rate increased by 4.1% and the restaurant revenue by 6.4%; employment increased that same year by 7.2% and 1.0%, respectively. Smoke free legislations, when enforced, are highly effective in improving the air quality and reducing the levels of indoor PM2.5. Strict enforcement plays a key role in the successful implementation of smoking bans. Even in nations with high smoking prevalence comprehensive smoking laws can be effectively implemented and have no negative effect on accommodation, food, and beverage services.

The impact of the Cyprus comprehensive smoking ban on air quality and economic business of hospitality venues

PubMed Central

2013-01-01

Background Several countries, including Cyprus, have passed smoke-free legislations in recent years. The goal of this study was to assess the indoor levels of particulate matter in hospitality venues in Cyprus before and after the implementation of the law on 1/1/2010, evaluate the role of enforcement, and examine the legislation’s effect on revenue and employment. Methods Several hospitality venues (n = 35) were sampled between April 2007 and January 2008, and 21 of those were re-sampled after the introduction of the smoking ban, between March and May 2010. Data on enforcement was provided by the Cyprus Police whereas data on revenue and employment within the hospitality industry of Cyprus were obtained from the Cyprus Statistical Service; comparisons were made between the corresponding figures before and after the implementation of the law. Results The median level of PM2.5 associated with secondhand smoking was 161 μg/m3 pre-ban and dropped to 3 μg/m3 post-ban (98% decrease, p < 0.0001). Furthermore, in the year following the ban, the hotel turnover rate increased by 4.1% and the restaurant revenue by 6.4%; employment increased that same year by 7.2% and 1.0%, respectively. Conclusion Smoke free legislations, when enforced, are highly effective in improving the air quality and reducing the levels of indoor PM2.5. Strict enforcement plays a key role in the successful implementation of smoking bans. Even in nations with high smoking prevalence comprehensive smoking laws can be effectively implemented and have no negative effect on accommodation, food, and beverage services. PMID:23351838

Significant reduction of AECOPD hospitalisations after implementation of a public smoking ban in Graubünden, Switzerland.

PubMed

Dusemund, Frank; Baty, Florent; Brutsche, Martin H

2015-07-01

Only a few studies have examined the effect of public smoking bans on respiratory conditions. These showed reduced admission rates for different respiratory diseases. The objective of the present study was to evaluate the effect of the public smoking ban implemented in Graubünden, Switzerland, on the incidence of acute hospital admissions for acute exacerbated chronic obstructive pulmonary disease (AECOPD). We searched a database, including all nationwide hospitalisations in Switzerland, for AECOPD and analysed incidence rates before and after introduction of the smoking ban using Poisson regression and incidence rate ratios (IRRs). After introduction of the smoking ban, we observed a significant 22.4% decrease in the incidence of AECOPD hospitalisations in Graubünden (IRR=0.78 (0.68 to 0.88), p<0.001). In the same period, the incidence of AECOPD hospitalisations only slightly decreased by 7.0% in the rest of Switzerland (IRR=0.93 (0.91 to 0.95), p<0.001). The observed reduction in AECOPD hospitalisation incidence was significantly greater in GR than in the rest of CH (p=0.008). Our study supports the limited body of evidence demonstrating that a reduction of secondhand smoke by legislated bans on smoking is associated with reduced rates of admission to hospital for respiratory conditions, hereby shown for AECOPD, in addition to the meanwhile well-documented impact on cardiovascular disease. 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.

Tobacco Use by Male Prisoners Under an Indoor Smoking Ban

PubMed Central

Ferketich, Amy K.; Murray, David M.; Bellair, Paul E.; Wewers, Mary Ellen

2011-01-01

Introduction: Most correctional facilities have implemented tobacco restrictions in an effort to reduce costs and improve prisoner health, but little has been done to evaluate the impact of these policy changes. Patterns of tobacco use among prisoners were explored to determine the impact of incarceration in a facility with an indoor smoking ban on tobacco use behaviors. Methods: Recently incarcerated male inmates (n = 200) were surveyed about their tobacco use prior to and during incarceration. Results: Tobacco use was prevalent prior to arrest (77.5%) and increased during incarceration (81.0%). Though the number of cigarette smokers increased during imprisonment, per-capita cigarette consumption declined by 7.1 cigarettes/day (p < .001). Despite widespread tobacco use, most participants recognized that smoking is a cause of lung cancer (96.0%) and heart disease (75.4%) and that it can be addicting (97.5%). Most tobacco users (70.0%) reported a desire to quit, with 63.0% saying they intended to try quitting in the next year. Conclusions: Indoor smoking bans do not promote cessation in prisons but may reduce the amount of tobacco consumed. Though smoking is commonplace in prisons, most prisoners recognize the risks involved and wish to quit. This creates an ideal setting for intervention. Evidence-based cessation assistance should be made freely available to all incarcerated smokers. PMID:21447838

Compliance with the workplace-smoking ban in the Netherlands.

PubMed

Verdonk-Kleinjan, Wendy M I; Rijswijk, Pieter C P; de Vries, Hein; Knibbe, Ronald A

2013-02-01

In 2004 the Dutch government instituted a workplace-smoking ban. This study focuses on differences in compliance over time and between occupational sectors, and describes the background variables. Telephone interviews were conducted with company employees across industry, public and service sectors in 2004 (n=705), 2006 (n=2201) and 2008 (n=2034). The questions concerned smoking policy, aspects of awareness and motivation to implement this ban. Compliance rates increased between 2006 (83%) and 2008 (96%) after an initial stagnation in the rate of compliance between 2004 and 2006. The increase in compliance was accompanied by a less negative attitude and an increase in confidence in one's ability to comply (self-efficacy). Differences in compliance between sectors with the highest compliance (public sector) and the lowest compliance (industry) decreased from about 20% to nearly 4%. Simultaneously, in the industry there was a stronger increase for risk perception of enforcement, social influence and self-efficacy. The initial stagnation in increase of compliance might be due to the lack of a (new) coherent package of policy measures to discourage smoking. Over the entire period there was a stronger increase in compliance in the industry sector, probably due to the intensification of enforcement activities and additional policy like legislation, which might increase awareness and social support. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

A Nationwide Assessment of the Association of Smoking Bans and Cigarette Taxes With Hospitalizations for Acute Myocardial Infarction, Heart Failure, and Pneumonia

PubMed Central

Ho, Vivian; Ross, Joseph S.; Steiner, Claudia A.; Mandawat, Aditya; Short, Marah; Ku-Goto, Meei-Hsiang; Krumholz, Harlan M.

2016-01-01

Multiple studies claim that public place smoking bans are associated with reductions in smoking-related hospitalization rates. No national study using complete hospitalization counts by area that accounts for contemporaneous controls including state cigarette taxes has been conducted. We examine the association between county-level smoking-related hospitalization rates and comprehensive smoking bans in 28 states from 2001 to 2008. Differences-in-differences analysis measures changes in hospitalization rates before versus after introducing bans in bars, restaurants, and workplaces, controlling for cigarette taxes, adjusting for local health and provider characteristics. Smoking bans were not associated with acute myocardial infarction or heart failure hospitalizations, but lowered pneumonia hospitalization rates for persons ages 60 to 74 years. Higher cigarette taxes were associated with lower heart failure hospitalizations for all ages and fewer pneumonia hospitalizations for adults aged 60 to 74. Previous studies may have overestimated the relation between smoking bans and hospitalizations and underestimated the effects of cigarette taxes. PMID:27624634

A Nationwide Assessment of the Association of Smoking Bans and Cigarette Taxes With Hospitalizations for Acute Myocardial Infarction, Heart Failure, and Pneumonia.

PubMed

Ho, Vivian; Ross, Joseph S; Steiner, Claudia A; Mandawat, Aditya; Short, Marah; Ku-Goto, Meei-Hsiang; Krumholz, Harlan M

2017-12-01

Multiple studies claim that public place smoking bans are associated with reductions in smoking-related hospitalization rates. No national study using complete hospitalization counts by area that accounts for contemporaneous controls including state cigarette taxes has been conducted. We examine the association between county-level smoking-related hospitalization rates and comprehensive smoking bans in 28 states from 2001 to 2008. Differences-in-differences analysis measures changes in hospitalization rates before versus after introducing bans in bars, restaurants, and workplaces, controlling for cigarette taxes, adjusting for local health and provider characteristics. Smoking bans were not associated with acute myocardial infarction or heart failure hospitalizations, but lowered pneumonia hospitalization rates for persons ages 60 to 74 years. Higher cigarette taxes were associated with lower heart failure hospitalizations for all ages and fewer pneumonia hospitalizations for adults aged 60 to 74. Previous studies may have overestimated the relation between smoking bans and hospitalizations and underestimated the effects of cigarette taxes.

Cross shift changes in lung function among bar and restaurant workers before and after implementation of a smoking ban

PubMed Central

Skogstad, M; Kjærheim, K; Fladseth, G; Gjølstad, M; Daae, H L; Olsen, R; Molander, P; Ellingsen, D G

2006-01-01

Objective To study possible cross shift effects of environmental tobacco smoke (ETS) on pulmonary function among bar and restaurant employees before and after the implementation of a smoking ban in Norway. Methods The study included 93 subjects employed in 13 different establishments in Oslo. They were examined at the beginning and end of a workshift both while ETS exposure was present and when smoking was banned. The mean exposure level of nicotine and total dust before the ban was 28 μg/m3 (range 3–65) and 275 μg/m3 (range 81–506), respectively. Following the smoking ban, the mean level of nicotine and total dust was 0.6 μg/m3 and 77 μg/m3, respectively. Assessment of lung function included dynamic lung volumes and flows. Results The cross shift reduction in forced vital capacity (FVC) among 69 subjects participating in both examinations changed from 81 ml (SD 136) during exposure to ETS to 52 ml (SD 156) (p = 0.24) following the smoking ban. The reduction in forced expired volume in one second (FEV1) during a workshift, was borderline significantly reduced when comparing the situation before and after the intervention, by 89 ml (SD = 132) compared to 46 ml (SD = 152) (p = 0.09), respectively. The reduction in forced mid‐expiratory flow rate (FEF25–75%) changed significantly from 199 ml/s (SD = 372) to 64 ml/s (SD = 307) (p = 0.01). Among 26 non‐smokers and 11 asthmatics, the reduction in FEV1 and FEF25–75% was significantly larger during ETS exposure compared to after the smoking ban. There was an association between the dust concentration and decrease in FEF25–75% before the ban among non‐smokers (p = 0.048). Conclusions This first study of cross shift changes before and after the implementation of a smoking ban in restaurants and bars shows a larger cross shift decrease in lung function before compared with after the implementation of the ban. PMID:16551754

Is Nonsmoking Dangerous to the Health of Restaurants? The Effect of California's Indoor Smoking Ban on Restaurant Revenues

ERIC Educational Resources Information Center

Stolzenberg, Lisa; D'Alessio, Stewart J.

2007-01-01

The state of California passed the Smoke-Free Workplace Act on January 1, 1995. This legislation effectively banned indoor smoking in all public and private workplaces including restaurants. Many restaurant owners, especially owners of restaurants that served alcohol, opposed the ban for fear that their businesses would be affected adversely…

Change in indoor particle levels after a smoking ban in Minnesota bars and restaurants.

PubMed

Bohac, David L; Hewett, Martha J; Kapphahn, Kristopher I; Grimsrud, David T; Apte, Michael G; Gundel, Lara A

2010-12-01

Smoking bans in bars and restaurants have been shown to improve worker health and reduce hospital admissions for acute myocardial infarction. Several studies have also reported improved indoor air quality, although these studies generally used single visits before and after a ban for a convenience sample of venues. The primary objective of this study was to provide detailed time-of-day and day-of-week secondhand smoke-exposure data for representative bars and restaurants in Minnesota. This study improved on previous approaches by using a statistically representative sample of three venue types (drinking places, limited-service restaurants, and full-service restaurants), conducting repeat visits to the same venue prior to the ban, and matching the day of week and time of day for the before- and after-ban monitoring. The repeat visits included laser photometer fine particulate (PM₂.₅) concentration measurements, lit cigarette counts, and customer counts for 19 drinking places, eight limited-service restaurants, and 35 full-service restaurants in the Minneapolis/St. Paul metropolitan area. The more rigorous design of this study provides improved confidence in the findings and reduces the likelihood of systematic bias. The median reduction in PM₂.₅ was greater than 95% for all three venue types. Examination of data from repeated visits shows that making only one pre-ban visit to each venue would greatly increase the range of computed percentage reductions and lower the statistical power of pre-post tests. Variations in PM₂.₅ concentrations were found based on time of day and day of week when monitoring occurred. These comprehensive measurements confirm that smoking bans provide significant reductions in SHS constituents, protecting customers and workers from PM₂.₅ in bars and restaurants. Copyright © 2010 American Journal of Preventive Medicine. All rights reserved.

Effects of the Irish smoking ban on respiratory health of bar workers and air quality in Dublin pubs.

PubMed

Goodman, Patrick; Agnew, Michelle; McCaffrey, Marie; Paul, Gillian; Clancy, Luke

2007-04-15

Environmental tobacco smoke (ETS) causes disease in nonsmokers. Workplace bans on smoking are interventions to reduce exposure to ETS to try to prevent harmful health effects. On March 29, 2004, the Irish government introduced the first national comprehensive legislation banning smoking in all workplaces, including bars and restaurants. This study examines the impact of this legislation on air quality in pubs and on respiratory health effects in bar workers in Dublin. Exposure study. Concentrations of particulate matter 2.5 microm or smaller (PM(2.5)) and particulate matter 10 microm or smaller (PM(10)) in 42 pubs were measured and compared before and after the ban. Benzene concentrations were also measured in 26 of the pubs. Health effects study. Eighty-one barmen volunteered to have full pulmonary function studies, exhaled breath carbon monoxide, and salivary cotinine levels performed before the ban and repeated 1 year after the ban. They also completed questionnaires on exposure to ETS and respiratory symptoms on both occasions. Exposure study. There was an 83% reduction in PM(2.5) and an 80.2% reduction in benzene concentration in the bars. Health effects study. There was a 79% reduction in exhaled breath carbon monoxide and an 81% reduction in salivary cotinine. There were statistically significant improvements in measured pulmonary function tests and significant reductions in self-reported symptoms and exposure levels in nonsmoking barmen volunteers after the ban. A total workplace smoking ban results in a significant reduction in air pollution in pubs and an improvement in respiratory health in barmen.

Nicotine replacement prescribing trends in a large psychiatric hospital, before and after implementation of a hospital-wide smoking ban.

PubMed

Scharf, Deborah; Fabian, Tanya; Fichter-DeSando, Cecilia; Douaihy, Antoine

2011-06-01

We examined prescribing patterns for nicotine replacement therapies (NRTs) in a large psychiatric hospital, before and after the implementation of a smoking ban. We extracted 5 years of NRT utilization data from hospital pharmacy records. The ban went into effect on January 1, 2007. Data reflect NRT prescriptions from 2 years before and 3 years after the ban, and N = 30,908 total inpatient hospital admissions. The monthly rate of total NRT prescriptions increased after the ban from M = 254.25 (SD = 126.60) doses per month to M = 4,467.52 (SD = 1,785.87) doses per month (>1,700% increase, p < .0001). After the smoking ban, clinicians prescribed higher doses of transdermal (but not oral) NRT (Tukey, p < .0001). Comparisons of NRT prescribing across hospital units tentatively suggested that patients being treated on the substance use disorders unit were prescribed more doses of NRT, as well as higher doses of NRT compared with patients on other units. Analysis of trends over time showed no apparent downward trend for NRT usage during the 3 years following the smoking ban, suggesting that clinicians continued to treat nicotine dependence after smoking was restricted. Clinicians are more likely to identify and treat symptoms of nicotine withdrawal when smoking is restricted. Hospitals should consider monitoring prescriptions for NRT as part of their ongoing quality assurance practices so that patients receive aggressive treatment of nicotine withdrawal symptoms--an essential component of high-quality patient care.

Implementation of a campus-wide Irish hospital smoking ban in 2009: prevalence and attitudinal trends among staff and patients in lead up.

PubMed

Fitzpatrick, Patricia; Gilroy, Irene; Doherty, Kirsten; Corradino, Deborah; Daly, Leslie; Clarke, Anna; Kelleher, Cecily C

2009-09-01

We report the evidence base that supported the decision to implement the first campus-wide hospital smoking ban in the Republic of Ireland with effect from 1 January 2009. Three separate data sources are utilized; surveillance data collected from patients and staff in 8 surveys between 1997 and 2006, a 1-week observational study to assess smoker behaviour in designated smoking shelters and an attitudinal interview with 28 smoker patients and 30 staff on the implications of the 2004 indoors workplace smoking ban, conducted in 2005. The main outcome measures were trends in prevalence of smoking over time according to age, sex and occupational groups and attitudes to the 2004 ban and a projected outright campus ban. Smoking rates among patients remained steady, 24.2% in 1997/98 and 22.7% in 2006. Staff smoking rates declined from 27.4% to 17.8%, with a strong occupational gradient. Observational evidence suggested a majority of those using smoking shelters in 2005 were women and health-care workers rather than patients. Attitudes of patients and staff were positive towards the 2004 ban, but with some ambivalence on the effectiveness of current arrangements. Staff particularly were concerned with patient safety issues associated with smoking outdoors. The 2004 ban was supported by 87.6% of patients and 81.3% of staff in 2006 and a majority of 58.6% of patients and 52.4% of staff agreed with an outright campus ban being implemented. These findings were persuasive in instigating a process in 2007/08 to go totally smoke-free by 2009, the stages for which are discussed.

Five-year lung function observations and associations with a smoking ban among healthy miners at high altitude (4000 m).

PubMed

Vinnikov, Denis; Blanc, Paul D; Brimkulov, Nurlan; Redding-Jones, Rupert

2013-12-01

To assess the annual lung function decline associated with the reduction of secondhand smoke exposure in a high-altitude industrial workforce. We performed pulmonary function tests annually among 109 high-altitude gold-mine workers over 5 years of follow-up. The first 3 years included greater likelihood of exposure to secondhand smoke exposure before the initiation of extensive smoking restrictions that came into force in the last 2 years of observation. In repeated measures modeling, taking into account the time elapsed in relation to the smoking ban, there was a 115 ± 9 (standard error) mL per annum decline in lung function before the ban, but a 178 ± 20 (standard error) mL per annum increase afterward (P < 0.001, both slopes). Institution of a workplace smoking ban at high altitude may be beneficial in terms of lung function decline.

Social-cognitive beliefs, alcohol, and tobacco use: a prospective community study of change following a ban on smoking in public places.

PubMed

Orbell, Sheina; Lidierth, Patrick; Henderson, Caroline J; Geeraert, Nicolas; Uller, Claudia; Uskul, Ayse K; Kyriakaki, Maria

2009-11-01

To examine social-cognitive change associated with behavior change after the introduction of a smoke-free public places policy. Adults (N = 583) who use public houses licensed to sell alcohol (pubs) completed questionnaires assessing alcohol and tobacco consumption and social-cognitive beliefs 2 months prior to the introduction of the smoking ban in England on July 1, 2007. Longitudinal follow-up (N = 272) was 3 months after the introduction of the ban. Social-cognitive beliefs, daily cigarette consumption, and weekly alcohol consumption. Smokers consumed considerably more alcohol than did nonsmokers at both time points. However, a significant interaction of Smoking Status x Time showed that while smokers had consumed fewer units of alcohol after the ban, nonsmokers showed an increase over the same period. There was a significant reduction in number of cigarettes consumed after the ban. Subjective norms concerning not smoking, and perceived severity of smoking-related illness increased across time. Negative outcomes associated with not smoking were reduced among former smokers and increased across time among smokers. Regression analyses showed that changes in subjective norm and negative outcome expectancies accounted for significant variance in change in smoking across time. Results suggest that the smoking ban may have positive health benefits that are supported by social-cognitive change. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Impact of 2 Successive Smoking Bans on Hospital Admissions for Cardiovascular Diseases in Spain.

PubMed

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

2018-04-16

To evaluate the impact of 2 smoking bans enacted in 2006 (partial ban) and 2011 (comprehensive ban) on hospitalizations for cardiovascular disease in the Spanish adult population. The study was performed in 14 provinces in Spain. Hospital admission records were collected for acute myocardial infarction (AMI), ischemic heart disease (IHD), and cerebrovascular disease (CVD) in patients aged ≥ 18 years from 2003 through 2012. We estimated immediate and 1-year effects with segmented-linear models. The coefficients for each province were combined using random-effects multivariate meta-analysis models. Overall, changes in admission rates immediately following the implementation of the partial ban and 1 year later were -1.8% and +1.2% for AMI, +0.1 and +0.4% for IHD, and +1.0% and +2.8% for CVD (P>.05). After the comprehensive ban, immediate changes were -2.3% for AMI, -2.6% for IHD, and -0.8% for CVD (P>.05), only to return to precomprehensive ban values 1 year later. For patients aged ≥ 65 years of age, immediate changes associated with the comprehensive ban were -5.0%, -3.9%, and -2.3% for AMI, IHD, and CVD, respectively (P<.05). Again, the 1-year changes were not statistically significant. In Spain, smoking bans failed to significantly reduce hospitalizations for AMI, IHD, or CVD among patients ≥ 18 years of age. In the population aged ≥ 65 years, hospital admissions due to these diseases showed significant decreases immediately after the implementation of the comprehensive ban, but these reductions disappeared at the 1-year evaluation. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Prevalence and predictors of home and automobile smoking bans and child environmental tobacco smoke exposure: a cross-sectional study of U.S.- and Mexico-born Hispanic women with young children.

PubMed

Gonzales, Melissa; Malcoe, Lorraine Halinka; Kegler, Michelle C; Espinoza, Judith

2006-10-27

Detrimental effects of environmental tobacco smoke (ETS) exposure on child health are well documented. Because young children's primary exposure to ETS occurs in homes and automobiles, voluntary smoking restrictions can substantially reduce exposure. We assessed the prevalence of home and automobile smoking bans among U.S.- and Mexico-born Hispanics in the southwestern United States, and examined the influence of mother's country of birth and smoking practices on voluntary smoking bans and on child ETS exposure. U.S.- and Mexico-born Hispanic mothers of children aged 2 through 12 years were systematically sampled from health clinics in Albuquerque, New Mexico. In-person interviews were conducted with 269 mothers (75.4% response rate) to obtain information on main study outcomes (complete versus no/partial home and automobile smoking bans; child room and automobile ETS exposure) and risk factors (mother's country of birth, maternal and household smoking behaviors). Data were analyzed with chi square tests and logistic regression models. Three-fourths (74-77%) of U.S.-born and 90-95% of Mexico-born mothers reported complete automobile and home smoking bans. In multivariate analyses, mother's U.S nativity, mother's current smoking, and presence of other adult smokers in the home were associated with significantly increased odds of not having a complete home or automobile smoking ban. Mother's smoking was associated with child ETS exposure both indoors (odds ratio [OR] = 3.31) and in automobiles (OR = 2.97). Children of U.S.-born mothers had increased odds of exposure to ETS indoors (OR = 3.24; 95% confidence interval [CI]: 1.37-7.69), but not in automobiles. Having complete smoking bans was associated with substantially reduced odds of child ETS exposure both indoors (OR = 0.10; 95% CI: 0.04-0.27) and in automobiles (OR = 0.14; 95% CI: 0.05-0.36). This study of Hispanic mothers in the southwestern U.S. indicates that there are substantial differences between U.S.- and

Prevalence and predictors of home and automobile smoking bans and child environmental tobacco smoke exposure: a cross-sectional study of U.S.- and Mexico-born Hispanic women with young children

PubMed Central

Gonzales, Melissa; Malcoe, Lorraine Halinka; Kegler, Michelle C; Espinoza, Judith

2006-01-01

Background Detrimental effects of environmental tobacco smoke (ETS) exposure on child health are well documented. Because young children's primary exposure to ETS occurs in homes and automobiles, voluntary smoking restrictions can substantially reduce exposure. We assessed the prevalence of home and automobile smoking bans among U.S.- and Mexico-born Hispanics in the southwestern United States, and examined the influence of mother's country of birth and smoking practices on voluntary smoking bans and on child ETS exposure. Methods U.S.- and Mexico-born Hispanic mothers of children aged 2 through 12 years were systematically sampled from health clinics in Albuquerque, New Mexico. In-person interviews were conducted with 269 mothers (75.4% response rate) to obtain information on main study outcomes (complete versus no/partial home and automobile smoking bans; child room and automobile ETS exposure) and risk factors (mother's country of birth, maternal and household smoking behaviors). Data were analyzed with chi square tests and logistic regression models. Results Three-fourths (74–77%) of U.S.-born and 90–95% of Mexico-born mothers reported complete automobile and home smoking bans. In multivariate analyses, mother's U.S nativity, mother's current smoking, and presence of other adult smokers in the home were associated with significantly increased odds of not having a complete home or automobile smoking ban. Mother's smoking was associated with child ETS exposure both indoors (odds ratio [OR] = 3.31) and in automobiles (OR = 2.97). Children of U.S.-born mothers had increased odds of exposure to ETS indoors (OR = 3.24; 95% confidence interval [CI]: 1.37–7.69), but not in automobiles. Having complete smoking bans was associated with substantially reduced odds of child ETS exposure both indoors (OR = 0.10; 95% CI: 0.04–0.27) and in automobiles (OR = 0.14; 95% CI: 0.05–0.36). Conclusion This study of Hispanic mothers in the southwestern U.S. indicates that

The effect of workplace smoking bans on heart rate variability and pulse wave velocity of non-smoking hospitality workers.

PubMed

Rajkumar, Sarah; Schmidt-Trucksäss, Arno; Wellenius, Gregory A; Bauer, Georg F; Huynh, Cong Khanh; Moeller, Alexander; Röösli, Martin

2014-08-01

To investigate the effect of a change in second-hand smoke (SHS) exposure on heart rate variability (HRV) and pulse wave velocity (PWV), this study utilized a quasi-experimental setting when a smoking ban was introduced. HRV, a quantitative marker of autonomic activity of the nervous system, and PWV, a marker of arterial stiffness, were measured in 55 non-smoking hospitality workers before and 3-12 months after a smoking ban and compared to a control group that did not experience an exposure change. SHS exposure was determined with a nicotine-specific badge and expressed as inhaled cigarette equivalents per day (CE/d). PWV and HRV parameters significantly changed in a dose-dependent manner in the intervention group as compared to the control group. A one CE/d decrease was associated with a 2.3% (95% CI 0.2-4.4; p = 0.031) higher root mean square of successive differences (RMSSD), a 5.7% (95% CI 0.9-10.2; p = 0.02) higher high-frequency component and a 0.72% (95% CI 0.40-1.05; p < 0.001) lower PWV. PWV and HRV significantly improved after introducing smoke-free workplaces indicating a decreased cardiovascular risk.

Banning shisha smoking in public places in Iran: an advocacy coalition framework perspective on policy process and change.

PubMed

Khayatzadeh-Mahani, Akram; Breton, Eric; Ruckert, Arne; Labonté, Ronald

2017-07-01

Shisha smoking is a widespread custom in Iran with a rapidly growing prevalence especially among the youth. In this article, we analyze the policy process of enforcing a federal/state ban on shisha smoking in all public places in Kerman Province, Iran. Guided by the Advocacy Coalition Framework (ACF), we investigate how a shisha smoking ban reached the political agenda in 2011, how it was framed by different policy actors, and why no significant breakthrough took place despite its inclusion on the agenda. We conducted a qualitative study using a case study approach. Two main sources of data were employed: face-to-face in-depth interviews and document analysis of key policy texts. We interviewed 24 policy actors from diverse sectors. A qualitative thematic framework, incorporating both inductive and deductive analyses, was employed to analyze our data. We found that the health sector was the main actor pushing the issue of shisha smoking onto the political agenda by framing it as a public health risk. The health sector and its allies advocated enforcement of a federal law to ban shisha smoking in all public places including teahouses and traditional restaurants whereas another group of actors opposed the ban. The pro-ban group was unable to neutralize the strategies of the anti-ban group and to steer the debate towards the health harms of shisha smoking. Our analysis uncovers three main reasons behind the policy stasis: lack of policy learning due to lack of agreement over evidence and related analytical conflicts between the two groups linked to differences in core and policy beliefs; the inability of the pro-ban group to exploit opportunities in the external policy subsystem through generating stronger public support for enforcement of the shisha smoking ban; and the nature of the institutional setting, in particular the autocratic governance of CHFS which contributed to a lack of policy learning within the policy subsystem. Our research demonstrated the utility

Low birthweight and preterm birth rates 1 year before and after the Irish workplace smoking ban.

PubMed

Kabir, Z; Clarke, V; Conroy, R; McNamee, E; Daly, S; Clancy, L

2009-12-01

It is well-established that maternal smoking has adverse birth outcomes (low birthweight, LBW, and preterm births). The comprehensive Irish workplace smoking ban was successfully introduced in March 2004. We examined LBW and preterm birth rates 1 year before and after the workplace smoking ban in Dublin. A cross-sectional observational study analysing routinely collected data using the Euroking K2 maternity system. Coombe University Maternal Hospital. Only singleton live births were included for analyses (7593 and 7648, in 2003 and 2005, respectively). Detailed gestational and clinical characteristics were collected and analysed using multivariable logistic regression analyses and subgroup analyses. Maternal smoking rates, mean birthweights, and adjusted odds ratios (ORs) of LBW and preterm births in 2005 versus 2003. There was a 25% decreased risk of preterm births (OR, 0.75; 95% CI, 0.59-0.96), a 43% increased risk of LBW (OR, 1.43; 95% CI, 1.10-1.85), and a 12% fall in maternal smoking rates (from 23.4 to 20.6%) in 2005 relative to 2003. Such patterns were significantly maintained when specific subgroups were also analysed. Mean birthweights decreased in 2005, but were not significant (P=0.99). There was a marginal increase in smoking cessation before pregnancy in 2005 (P=0.047). Significant declines in preterm births and in maternal smoking rates after the smoking ban are welcome signs. However, the increased LBW birth risks might reflect a secular trend, as observed in many industrialised nations, and merits further investigations.

Focusing management in implementing a smoking ban in a university hospital in Sweden.

PubMed

Ullén, H; Höijer, Y; Ainetdin, T; Tillgren, P

2002-04-01

To explore the impact of various steps when introducing a smoking ban at the Karolinska Hospital (1000 beds; 6000 employees) in Stockholm, Sweden, a multiple evaluation strategy was performed over 5 years. All heads of clinical departments (N = 41) and a random sample of employees (n = 517) and a convenience sample of hospital labour managers (n = 17) were separately addressed through questionnaire surveys at different time intervals after the introduction of the ban in 1992. An observational and interview study completed the follow-up. The implementation process was supplemented by a comprehensive information strategy over 5 years. The two most important steps during implementation were management support and focus on environmental tobacco. The ban was well known at introduction. Heads of clinical departments reported a third of staff to be satisfied with the restrictions. In contrast, the staff survey revealed 62% to be positive. A shift in favour of a radical tobacco-free hospital was perceived during follow-up. Co-operation between hospital board, heads of clinical departments and local labour managers proved successful. The consecutive evaluations served as tools in labour management and contributed to staff compliance. A total ban, including the selling of tobacco and smoking in the hospital grounds is still to be achieved.

Enforcing an Outdoor Smoking Ban on a College Campus: Effects of a Multicomponent Approach

ERIC Educational Resources Information Center

Harris, Kari Jo; Stearns, Julee N.; Kovach, Rachel G.; Harrar, Solomon W.

2009-01-01

Objectives: Data on effective strategies to enforce policies banning outdoor smoking are sparse. This study tested the effects of an enforcement package implemented on a college campus. Participants: Thirty-nine observers recorded compliance of 709 outside smokers. Methods: Smoking within 25 feet of buildings was noncompliant. The intervention…

Effect of a smoking ban and school-based prevention and control policies on adolescent smoking in Spain: a multilevel analysis.

PubMed

Galán, Iñaki; Díez-Gañán, Lucía; Gandarillas, Ana; Mata, Nelva; Cantero, Jose Luis; Durbán, María

2012-12-01

We evaluated the impact of a smoking ban in schools and of school-based smoking prevention and control policies on adolescent smoking. Annual surveys carried out between 2001 and 2005 that were representative of students in the 4th year of secondary education in the Madrid region, with 203 schools and 9127 students participating. The student questionnaire gathered information about personal and family variables. The contextual factors were: the periods before (years 2001-2002) and after the law; and through a survey of school management boards: compliance with the law, policy reflected in the school regulations, existence of complaints against smoking, and undertaking of educational activities regarding smoking. Multilevel logistic regression models were constructed with two dependent variables: current smoking and the proportion giving up smoking. Smoking declined in 2003, the first year after the law came into force (Odds ratio: 0.80; CI 95%: 0.66-0.96), and this decline was maintained in 2005. By contrast, smoking increased in those schools that did not undertake educational programmes regarding smoking (Odds ratio: 1.34; CI 95%: 1.13-1.59), and in those that received complaints about smoking (Odds ratio: 1.12; CI 95%: 0.96-1.29). This association is partly due to the effect of the increase in giving up smoking. The inclusion of contextual variables into the model with the individual factors reduces the variability of smoking between schools by 32.6%. In summary, the coming into force of a law banning smoking in schools, and the implementing of educational policies for the prevention and control of smoking are related to a lower risk of adolescent smoking.

Effects of a national smoking ban on hospital admissions for cardiovascular diseases: a time-series analysis in Taiwan.

PubMed

Yang, Yue-Nin; Huang, Yu-Tung; Yang, Chun-Yuh

2017-01-01

On January 11, 2009, a comprehensive smoking ban was implemented in Taiwan. The aim of this study was to evaluate the effect of this ban on hospital admissions for ischemic heart disease (IHD). Trends in the country-level monthly hospital admission rates for IHD were determined and frequency compared to other conditions such as control conditions cholecystitis, bowel obstruction, and appendicitis from January 1997 (1 year before the first phase of smoke-free laws was implemented) to December 2012 (3 years after the second phase of the ban). Poisson regression with a monthly time-series model was used to determine alterations in the trend of admission rates for IHD with comparison to rates of other disorders after the ban. Hospital admissions for IHD decreased by 0.8% (incidence rate ratio [RR]: 0.992; 95% confidence interval [CI] = 0.991-0.994) and 1.1% (incidence RR: 0.989; 95% CI = 0.988-0.991) following the first (September 19, 1997 to January 10, 2009) and second (January 11, 2009 to December 31, 2012) phases of the ban, respectively, compared with those prior to the pre-ban period, the corresponding values for the control conditions were 0.6% (95% CI = 0.5%-0.7%) and 0.7% (95% CI = 0.6%-0.9%). The admission rates significantly fell for both men and women and for all examined age categories after both first and second phases of the ban. The present findings provide evidence of a significant reduction in hospital admissions for IHD in Taiwan following smoking bans.

Correlates of smoking, quit attempts and attitudes towards total smoking bans at university: findings from eleven faculties in Egypt.

PubMed

El Ansari, Walid; Labeeb, Shokria; Kotb, Safaa; Yousafzai, Mohammad T; El-Houfey, Amira; Stock, Christiane

2012-01-01

Smoking among university students represents a formidable and global public health challenge. We assessed the associations between socio-demographic, health and wellbeing variables as independent variables, with daily smoking, attempts to quit smoking, and agreement with smoking ban as dependent variables. A sample of 3258 undergraduate students from eleven faculties at Assiut University, Assiut, Egypt, completed a general health questionnaire. Overall daily or occasional smoking in last three months prior to the survey was about 9% (8% occasional and 1% daily smokers), and smoking was generally more prevalent among males (male=17%, female=0.6%, P < 0.001). After adjustment for confounders, not having normal BMI and having a mother who completed at least bachelor's degree education was positively associated with daily smoking, and conversely, no history of illicit drug use was a protective factor. About 76% of smokers had attempted to quit smoking within the last 12 months prior to the survey. Although a large proportion of students agreed/ strongly agreed with the banning of smoking at university altogether (87%), such agreement was less likely among smokers. There is need for implementation of non-smoking policies on university premises, as well as regular up-to-date information on, and the periodic/yearly monitoring of tobacco use by university students employing standardised data collection instruments and reference periods. In addition, it would be valuable to develop campus-based educational/ awareness campaigns designed to counteract tobacco advertisement directed towards young people in Middle East countries. Otherwise, the danger could be that the current relatively low smoking prevalence among university students may escalate in the future.

[Tobacco smoking and psychiatric intensive care unit: Impact of the strict smoking ban on the risk of violence].

PubMed

Boumaza, S; Lebain, P; Brazo, P

2015-06-01

Tobacco smoking is the main cause of death among mentally ill persons. Since February 2007, smoking has been strictly forbidden in French covered and closed psychiatric wards. The fear of an increased violence risk induced by tobacco withdrawal is one of the most frequent arguments invoked against this tobacco ban. According to the literature, it seems that the implementation of this ban does not imply such a risk. All these studies compared inpatients' violence risk before and after the tobacco ban in a same psychiatric ward. We aimed to analyse the strict tobacco withdrawal consequences on the violence risk in a retrospective study including patients hospitalised in a psychiatric intensive care unit of the university hospital of Caen during the same period. We compared clinical and demographic data and the violence risk between the smoker group (strict tobacco withdrawal with proposed tobacco substitution) and the non-smoker group (control group). In order to evaluate the violence risk, we used three indicators: a standardised scale (the Bröset Violence Checklist) and two assessments specific to the psychiatric intensive care setting ("the preventing risk protocol" and the "seclusion time"). The clinical and demographic data were compared using the Khi2 test, Fisher test and Mann-Whitney test, and the three violence risk indicators were compared with the Mann-Whitney test. Firstly, comparisons were conducted in the total population, and secondly (in order to eliminate a bias of tobacco substitution) in the subgroup directly hospitalised in the psychiatric intensive care setting. Finally, we analysed in the smoker group the statistical correlation between tobacco smoking intensity and violence risk intensity using a regression test. A population of 72 patients (50 male) was included; 45 were smokers (62.5%) and 27 non-smokers. No statistically significant differences were found in clinical and demographic data between smoker and non-smoker groups in the whole

The effect of workplace smoking bans on heart rate variability and pulse wave velocity of non-smoking hospitality workers

PubMed Central

Rajkumar, Sarah; Schmidt-Trucksäss, Arno; Wellenius, Gregory A.; Bauer, Georg F.; Huynh, Cong Khanh; Moeller, Alexander; Röösli, Martin

2014-01-01

Objectives To investigate the effect of a change in second hand smoke (SHS) exposure on heart rate variability (HRV) and pulse wave velocity (PWV), this study utilized a quasi-experimental setting when a smoking ban was introduced. Methods HRV, a quantitative marker of autonomic activity of the nervous system, and PWV, a marker of arterial stiffness, were measured in 55 non-smoking hospitality workers before and 3 to 12 months after a smoking ban and compared to a control group that did not experience an exposure change. SHS exposure was determined with a nicotine specific badge and expressed as inhaled cigarette equivalents per day (CE/d). Results PWV and HRV parameters significantly changed in a dose dependent manner in the intervention group compared to the control group. A one CE/d decrease was associated with a 2.3% (95% CI: 0.2, 4.4; p=0.031) higher root mean square of successive differences (RMSSD), a 5.7 % (95% CI: 0.9, 10.2; p=0.02) higher high frequency component and a 0.72% (95 % CI: 0.40–1.05; p<0.001) lower PWV. Conclusions PWV and HRV significantly improved after introducing smoke-free workplaces indicating a decreased cardiovascular risk. PMID:24504155

Secondhand tobacco smoke in bars and restaurants in Santiago, Chile: evaluation of partial smoking ban legislation in public places

PubMed Central

Iglesias, Veronica; Droppelmann, Andrea; Acuña, Marisol; Peruga, Armando; Breysse, Patrick N; Navas-Acien, Ana

2010-01-01

Objective To compare air nicotine concentrations according to the smoking policy selected by bars/restaurants in Santiago, Chile before and after the enactment of partial smoking ban legislation in 2007 (establishments could be smoke free, have segregated (mixed) smoking and non-smoking areas, or allow smoking in all areas). Methods The study measured air nicotine concentrations over 7 days to characterise secondhand smoke exposure in 30 bars/restaurants in 2008. Owner/manager interviews and physical inspections were conducted. Results Median IQR air nicotine concentrations measured in all venues were 4.38 (0.61–13.62) μg/m3. Air nicotine concentrations were higher in bars (median 7.22, IQR 2.48–15.64 μg/m3) compared to restaurants (1.12, 0.15–9.22 μg/m3). By smoking status, nicotine concentrations were higher in smoking venues (13.46, 5.31–16.87 μg/m3), followed by smoking areas in mixed venues (9.22, 5.09–14.90 μg/m3) and non-smoking areas in mixed venues (0.99, 0.19–1.27 μg/m3). Air nicotine concentrations were markedly lower in smoke-free venues (0.12, 0.11–0.46 μg/m3). After adjustment for differences in volume and ventilation, air nicotine concentrations were 3.2, 35.5 and 56.2 times higher in non-smoking areas in mixed venues, smoking areas in mixed venues and smoking venues, respectively, compared to smoke-free venues. Conclusions Exposure to secondhand smoke remains high in bars and restaurants in Santiago, Chile. These findings demonstrate that the partial smoking ban legislation enacted in Chile in 2007 provides no protection to employees working in those venues. Enacting a comprehensive smoke-free legislation which protects all people from exposure to secondhand smoke in all public places and workplaces is urgently needed. PMID:20798021

Air Quality, Biomarker Levels, and Health Effects on Staff in Korean Restaurants and Pubs Before and After a Smoking Ban.

PubMed

Kim, Jeonghoon; Kwon, Ho-Jang; Lee, Kiyoung; Lee, Do-Hoon; Paek, Yujin; Kim, Sung-Soo; Hong, Soyoung; Lim, Wanryung; Heo, Jae-Hyeok; Kim, Kyoosang

2015-11-01

The Korean government implemented a smoking ban at square floor area of ≥150 m(2), rather than <150 m(2), restaurants and pubs from July 2013. This study examined the effects of the smoking regulations in restaurants and pubs in terms of the air quality, biomarker levels and health effects on staff. Particulate matter smaller than 2.5 µm (PM2.5) was measured in 146 facilities before and 1 month after the ban. The urinary cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1- butanol (NNAL) levels were measured in 101 staff members at 77 facilities before and 1 month after the ban. We also measured self-reported respiratory and sensory symptoms on both phases. Of the 146 facilities, 121 facilities were included in the PM2.5 analysis. In ≥150 m(2) pubs, the indoor PM2.5 concentration was significantly reduced after the ban (p < .05). While the urinary cotinine concentrations of the staff in all facilities were not changed after the ban, the total NNAL concentrations of the staff in ≥150 m(2) pubs were significantly reduced after the ban (p < .05). The health effects on staff show that only sensory symptoms significantly improved in ≥150 m(2) facilities after the ban (p < .05). The smoking ban significantly reduced the levels of PM2.5 and total NNAL concentrations in ≥150 m(2) pubs and improved sensory health among staff in ≥150 m(2) facilities. The results of this study can be useful in supporting an expansion of the smoking ban in all indoor places, including <150 m(2) restaurants and pubs. © 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.

Incidence of acute myocardial infarction after implementation of a public smoking ban in Graubünden, Switzerland: two year follow-up.

PubMed

Bonetti, Piero O; Trachsel, Lukas D; Kuhn, Max U; Schulzki, Thomas; Erne, Paul; Radovanovic, Dragana; Reinhart, Walter H

2011-05-27

In the first year after implementation of a public smoking ban a significant decrease in the incidence of acute myocardial infarction (AMI) was observed in Graubünden. In the present study we analyzed the incidence of AMI in the second year of the ban. In addition, we investigated the contribution of smoking ban-unrelated factors to the reduced incidence of AMI incidence observed after enactment of the ban. Data of all AMI patients who underwent coronary angiography at the Kantonsspital Graubünden, the only tertiary care hospital with a cardiac catheterization laboratory in Graubünden, between March 1st, 2009 and February 28th, 2010 were collected prospectively. Data were compared with those of the three preceding 12-month periods. We also estimated AMI incidence during the corresponding time period in Lucerne, a region with no smoke-free legislation, using data of the AMIS Plus registry. The influence of outdoor air pollution was analyzed with the help of official measurements of PM(10)- and NO(2)-concentrations in Graubünden. The prescription of lipid-lowering drugs was estimated by using sales figures in Graubünden and Lucerne. In Graubünden, the number of patients with AMI in the second year after adoption of the smoking ban was similar to that in the first year of the ban (188 vs. 183; P = ns) and significantly lower than in each of the two years preceding the ban (229 and 242, respectively; P <0.05 vs. each of the 12-month periods after the ban). Overall, the number of AMI patients in the two post-ban years was 21% lower than in the two pre-ban years. The reduction in the number of patients with AMI was most pronounced in non-smokers and individuals with known coronary artery disease. During the corresponding time period, no similar decrease in the incidence of AMI was observed in Lucerne. No association was found between the magnitude of outdoor air pollution and the incidence of AMI. During the observation period, the use of lipid-lowering drugs

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

PubMed

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-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.

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

PubMed Central

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

2015-01-01

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. PMID:26053296

[Impact of smoking ban at indoor public places on indoor air quality].

PubMed

Bilir, Nazmi; Özcebe, Hilal

2012-01-01

This study aims at evaluation of the effect of smoke-free policy at hospitality workplaces on indoor air quality. Study includes 151 hospitality venues (restaurants, cafes, bars and tea-houses) at eight provinces of Turkey. PM2.5 measurements were done at each of the venues three months prior to, and 4-5 months after the implementation of smoking ban at the same venues. Measurements were done using SidePak 2.5 by two engineers. During the 30 minutes of measurement, the device takes multiple samples, measures PM2.5 particles, and calculates the average value and standard deviation of the measurements. Using the measurement results two kinds of evaluation were done: in each province, increase/decrease after implementation for each of the venues included in the study was evaluated, and average PM2.5 values were calculated for provinces using the PM2.5 values of the venues in the province. The average PM2.5 values before the implementation were higher than the post implementation values in general. Nevertheless, in some provinces higher values were found during the second measurements, particularly at the restaurants. Therefore, there is need to enforce the smoking ban at the hospitality workplaces.

Airborne exposure and biological monitoring of bar and restaurant workers before and after the introduction of a smoking ban.

PubMed

Ellingsen, Dag G; Fladseth, Geir; Daae, Hanne L; Gjølstad, Merete; Kjaerheim, Kristina; Skogstad, Marit; Olsen, Raymond; Thorud, Syvert; Molander, Paal

2006-03-01

The aims were to assess the impact of a total smoking ban on the level of airborne contaminants and the urinary cotinine levels in the employees in bars and restaurants. In a follow up design, 13 bars and restaurants were visited before and after the implementation of a smoking ban. Ninety-three employees in the establishments were initially included into the study. The arithmetic mean concentration of nicotine and total dust declined from 28.3 microg m(-3) (range, 0.4-88.0) and 262 microg m(-3) (range, 52-662), respectively, to 0.6 microg m(-3) (range, not detected-3.7) and 77 microg m(-3) (range, not detected-261) after the smoking ban. The Pearson correlation coefficient between airborne nicotine and total dust was 0.86 (p < 0.001; n = 48). The post-shift geometric mean urinary cotinine concentration declined from 9.5 microg g(-1) creatinine (cr) (95% CI 6.5-13.7) to 1.4 microg g(-1) cr (95% CI 0.8-2.5) after the ban (p < 0.001) in 25 non-snuffing non-smokers. A reduction from 1444 microg g(-1) cr (95% CI 957-2180) to 688 microg g(-1) cr (95% CI 324-1458) was found (p < 0.05) in 29 non-snuffing smokers. The urinary cotinine levels increased from 11.7 microg g(-1) cr (95% CI 7.0-19.6) post-shift to 21.9 microg g(-1) cr (95% CI 13.3-36.3) (p < 0.01) in the next morning in 24 non-snuffing non-smokers before the smoking ban. A substantial reduction of airborne nicotine and total dust was observed after the introduction of a smoking ban in bars and restaurants. The urinary cotinine levels were reduced in non-smokers. The decline found in smokers may suggest a reduction in the amount of smoking after intervention. In non-smokers cotinine concentrations were higher based on urine sampled the morning after a shift than based on urine sampled immediately post-shift.

Impact of the Irish smoking ban on sales in bars using a large business-level data set from 1999 to 2007.

PubMed

Cornelsen, Laura; Normand, Charles

2014-09-01

Ireland introduced comprehensive smoke-free workplace legislation in 2004. This study evaluates the economic impact of the workplace smoking ban on the value of sales in bars. Data on the value of bar sales were derived from a large, nationally representative, annual business-level survey from 1999 to 2007. The economic impact of the smoking ban was evaluated according to geographical region and bar size. Analysis was based on an econometric model which controlled for background changes in population income and wealth and for investments made by the bars during this period. The overall impact of the Irish smoking ban on bar sales appears to be very small. The ban was associated with an increase in sales among medium to large bars in the Border-Midland-West (more rural) region of Ireland, and a small reduction in sales among large bars in the more urban, South-East region. We failed to find any evidence of a change in bar sales in the remaining categories studied. The results indicate that although some bars saw positive effects and some negative, the overall impact of the smoking ban on the value of sales in bars was negligible. These findings provide further supporting evidence that comprehensive smoke-free workplace legislation does not harm hospitality businesses while having positive health effects. 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.

76 FR 79678 - City of Banning, CA; Notice of Petition for Declaratory Order

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-22

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. NJ12-3-000] City of Banning, CA; Notice of Petition for Declaratory Order Take notice that on December 9, 2011, pursuant to Rules...) Tariff of the City of Banning, California (Banning), Banning filed a Petition for Declaratory Order...

Evaluation of implementation, compliance and acceptance of partial smoking bans among hospitality workers before and after the Swiss Tobacco Control Act.

PubMed

Rajkumar, Sarah; Hoffmann, Susanne; Röösli, Martin; Bauer, Georg F

2015-03-01

The World Health Organization recommends uniform comprehensive smoking bans in public places. In Switzerland, regulations differ between various areas and are mostly incomplete for hospitality venues. As ambiguous regulations offer more leeway for implementation, we evaluated the Swiss regulations with respect to their effects on implementation, acceptance and compliance among hospitality workers. In our longitudinal study, a standardized, self-administered questionnaire was mailed to a sample of 185 hospitality workers before and 4-6 month after the smoking ban came into effect. The matched longitudinal sample comprised 71 participants (repeated response rate 38.4%). We developed a seven-item acceptance scale. Logistic regressions were performed to explore the factors associated with acceptance. Acceptance of smoking bans was influenced by smoking status and perceived annoyance with second-hand smoke in private. Although not statistically significant (P = 0.09), we found some indications that post-ban acceptance increased in an area with strict regulations, whereas it decreased in two areas with less stringent regulations. Tobacco bans in Swiss hospitality venues are still in a period of consolidation. The incomplete nature of the law may also have had a negative impact on the development of greater acceptance. © 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.

Impact of the smoking ban on the volume of bar sales in Ireland: evidence from time series analysis.

PubMed

Cornelsen, Laura; Normand, Charles

2012-05-01

This paper is the first to estimate the economic impact of a comprehensive smoking ban in all enclosed public places of work, on bars in Ireland. The demand in bars, represented by a monthly index of sales volume, is explained by relative prices in bars, prices of alcohol sold in off-licences and the aggregate retail sales (ARS) as a proxy for general economic activity and incomes. The smoking ban is included into the model as a step dummy and the modelling is done using ARIMAX strategy. The results show a reduction in the volume of sales in bars by -4.6% (p<0.01) following the ban. Copyright © 2011 John Wiley & Sons, Ltd.

Exploring Impacts of Taxes and Hospitality Bans on Cigarette Prices and Smoking Prevalence Using a Large Dataset of Cigarette Prices at Stores 2001-2011, USA.

PubMed

Ballester, Lance S; Auchincloss, Amy H; Robinson, Lucy F; Mayne, Stephanie L

2017-03-20

In the USA, little is known about local variation in retail cigarette prices; price variation explained by taxes, bans, and area-level socio-demographics, and whether taxes and hospitality bans have synergistic effects on smoking prevalence. Cigarette prices 2001-2011 from chain supermarkets and drug stores ( n = 2973) were linked to state taxes ( n = 41), state and county bar/restaurant smoking bans, and census block group socio-demographics. Hierarchical models explored effects of taxes and bans on retail cigarette prices as well as county smoking prevalence (daily, non-daily). There was wide variation in store-level cigarette prices in part due to differences in state excise taxes. Excise taxes were only partially passed onto consumers (after adjustment, $1 tax associated with $0.90 increase in price, p < 0.0001) and the pass-through was slightly higher in areas that had bans but did not differ by area-level socio-demographics. Bans were associated with a slight increase in cigarette price (after adjustment, $0.09 per-pack, p < 0.0001). Taxes and bans were associated with reduction in smoking prevalence and taxes had a stronger association when combined with bans, suggesting a synergistic effect. Given wide variation in store-level prices, and uneven state/county implementation of taxes and bans, more federal policies should be considered.

Changes in hospitalizations for chronic respiratory diseases after two successive smoking bans in Spain

PubMed Central

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

2017-01-01

Background Existing evidence on the effects of smoke-free policies on respiratory diseases is scarce and inconclusive. Spain enacted two consecutive smoke-free regulations: a partial ban in 2006 and a comprehensive ban in 2011. We estimated their impact on hospital admissions via emergency departments for chronic obstructive pulmonary disease (COPD) and asthma. Methods Data for COPD (ICD-9 490–492, 494–496) came from 2003–2012 hospital admission records from the fourteen largest provinces of Spain and from five provinces for asthma (ICD-9 493). We estimated changes in hospital admission rates within provinces using Poisson additive models adjusted for long-term linear trends and seasonality, day of the week, temperature, influenza, acute respiratory infections, and pollen counts (asthma models). We estimated immediate and gradual effects through segmented-linear models. The coefficients within each province were combined through random-effects multivariate meta-analytic models. Results The partial ban was associated with a strong significant pooled immediate decline in COPD-related admission rates (14.7%, 95%CI: 5.0, 23.4), sustained over time with a one-year decrease of 13.6% (95%CI: 2.9, 23.1). The association was consistent across age and sex groups but stronger in less economically developed Spanish provinces. Asthma-related admission rates decreased by 7.4% (95%CI: 0.2, 14.2) immediately after the comprehensive ban was implemented, although the one-year decrease was sustained only among men (9.9%, 95%CI: 3.9, 15.6). Conclusions The partial ban was associated with an immediate and sustained strong decline in COPD-related admissions, especially in less economically developed provinces. The comprehensive ban was related to an immediate decrease in asthma, sustained for the medium-term only among men. PMID:28542337

Thirdhand smoke and exposure in California hotels: non-smoking rooms fail to protect non-smoking hotel guests from tobacco smoke exposure.

PubMed

Matt, Georg E; Quintana, Penelope J E; Fortmann, Addie L; Zakarian, Joy M; Galaviz, Vanessa E; Chatfield, Dale A; Hoh, Eunha; Hovell, Melbourne F; Winston, Carl

2014-05-01

This study examined tobacco smoke pollution (also known as thirdhand smoke, THS) in hotels with and without complete smoking bans and investigated whether non-smoking guests staying overnight in these hotels were exposed to tobacco smoke pollutants. A stratified random sample of hotels with (n=10) and without (n=30) complete smoking bans was examined. Surfaces and air were analysed for tobacco smoke pollutants (ie, nicotine and 3-ethynylpyridine, 3EP). Non-smoking confederates who stayed overnight in guestrooms provided urine and finger wipe samples to determine exposure to nicotine and the tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone as measured by their metabolites cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), respectively. Compared with hotels with complete smoking bans, surface nicotine and air 3EP were elevated in non-smoking and smoking rooms of hotels that allowed smoking. Air nicotine levels in smoking rooms were significantly higher than those in non-smoking rooms of hotels with and without complete smoking bans. Hallway surfaces outside of smoking rooms also showed higher levels of nicotine than those outside of non-smoking rooms. Non-smoking confederates staying in hotels without complete smoking bans showed higher levels of finger nicotine and urine cotinine than those staying in hotels with complete smoking bans. Confederates showed significant elevations in urinary NNAL after staying in the 10 most polluted rooms. Partial smoking bans in hotels do not protect non-smoking guests from exposure to tobacco smoke and tobacco-specific carcinogens. Non-smokers are advised to stay in hotels with complete smoking bans. Existing policies exempting hotels from complete smoking bans are ineffective.

Results of a Prospective Study of Acute Coronary Syndrome Hospitalization After Enactment of a Smoking Ban in Public Places in Hyogo Prefecture　- Comparison With Gifu, a Prefecture Without a Public Smoking Ban.

PubMed

Sato, Yukihito; Minatoguchi, Shinya; Nishigaki, Kazuhiko; Hirata, Ken-Ichi; Masuyama, Tohru; Furukawa, Yutaka; Uematsu, Masaaki; Yoshikawa, Junichi; Otsuji, Satoru; Iida, Mami; Fujiwara, Hisayoshi

2016-11-25

Hyogo Prefecture is the 2nd prefecture in Japan, after Kanagawa, to enact a ban with penal code on smoking in public places, although the restriction is partial.Methods and Results:This study included consecutive patients with acute coronary syndrome (ACS) who were admitted to 33 major hospitals in the Hyogo District during the 12 months before implementation of the legislation and during the 24 months thereafter. Consecutive patients with ACS from Gifu Prefecture who were admitted to 20 major hospitals were enrolled as geographical controls. The number of ACS admissions did not change from the years 2012-2015 in both Hyogo District (1,774 in the pre-year, 1,784 in the 1st year, and 1,720 in the 2nd year) and Gifu Prefecture (1,226 in the pre-year, 1,174 in the 1st year, and 1,206 in the 2nd year). However, a clear reduction was observed in the subanalysis for Kobe City (895 in the preceding year, 830 (-7.3%) in the 1st year, and 792 (-11.5%) in the 2nd year), where adherence to the smoking ban was higher than in other Hyogo districts. The primary endpoint did not show a significant change. However, the subanalysis showed a significant decrease in ACS admissions in Kobe City. These results suggest that ACS reduction may depend on the degree of adherence to a smoking ban. (Circ J 2016; 80: 2528-2532).

Workplace-related smoking in New South Wales: extent of bans, public attitudes and relationships with relapse.

PubMed

Walsh, Raoul A; Paul, Christine L; Paras, Lorraine; Stacey, Fiona; Tzelepis, Flora

2011-08-01

Little research has examined issues surrounding employee smoking outside smoke-free workplaces. The study's aims were to: 1) document the proportion of NSW indoor employees covered by total workplace smoking bans; 2) examine community perceptions of employee smoking during working hours; 3) identify the characteristics of having a supportive attitude toward tobacco control in the workplace; and 4) describe relationships between smoking relapse and workplace-related smoking. Two cross-sectional, computer-assisted telephone interview surveys of randomly selected adults were conducted. Consent rates were 49.1% in 2004 and 45.8% in 2006, with sample sizes of 1,158 and 2,393 respectively. Total workplace bans were reported by 92.9% of indoor employees. Community attitudes to smoking in working hours were highly negative: 77.7% agreed smoking breaks waste too much time and 85.1% opposed smoking near workplace doorways. Being female, born in Australia and a non-smoker were associated with more negative attitudes. A higher proportion of smokers (78.3%) perceived smoking was more common outside their place of work or study than at five other locations: rail/bus stop (60.2%), friends' houses (59.3%), own street (35.2%), parks (34.3%), and outside school (22.6%). Of smokers making a quit attempt in the past year, 42.1% relapsed at home, 22.1% at licensed premises and 18.7% at work. Findings emphasise the low support for smoking during or near work. Smoking outside workplaces is highly visible. Data on relapse suggest a modest relationship with workplace-related smoking.

Air Contamination Due to Smoking in German Restaurants, Bars, and Other Venues—Before and After the Implementation of a Partial Smoking Ban

PubMed Central

Gleich, Florian; Pötschke-Langer, Martina

2011-01-01

Introduction: The present study examined the reduction in exposure to tobacco smoke in German hospitality venues following the implementation of a partial smoking ban by measuring the indoor air concentration of PM2.5 in 2005 and 2009, that is, before and after the legislation was implemented. Methods: The concentration of respirable suspended particles (PM2.5) in the indoor air of German hospitality venues was measured using a laser photometer (AM510). The prelegislation sample from 2005 included 80 venues of which 58 could be revisited in 2009. After replenishment, the postlegislation sample consisted of 79 venues. Results: Compared with the prelegislation measurement, the concentration of PM2.5 in hospitality venues was reduced significantly after introduction of the smoke-free legislation. The median mass concentration of PM2.5 was reduced by 87.1% in coffee bars, by 88.7% in restaurants, by 66.3% in bars, and by 90.8% in discotheques. Notably, legal exemptions to the smoking ban are an issue: At the postlegislation measurement in 2009, the mass concentrations of PM2.5 were substantially higher in venues allowing smoking in the whole venue or in a designated smoking room than in completely smoke-free venues. Conclusions: The German smoke-free legislation significantly reduced the levels of respirable suspended particles in the indoor air of hospitality venues, benefiting the health of employees and patrons alike. But legal exemptions attenuated the effectiveness of the policy. PMID:21622497

Air contamination due to smoking in German restaurants, bars, and other venues--before and after the implementation of a partial smoking ban.

PubMed

Gleich, Florian; Mons, Ute; Pötschke-Langer, Martina

2011-11-01

The present study examined the reduction in exposure to tobacco smoke in German hospitality venues following the implementation of a partial smoking ban by measuring the indoor air concentration of PM(2.5) in 2005 and 2009, that is, before and after the legislation was implemented. The concentration of respirable suspended particles (PM(2.5)) in the indoor air of German hospitality venues was measured using a laser photometer (AM510). The prelegislation sample from 2005 included 80 venues of which 58 could be revisited in 2009. After replenishment, the postlegislation sample consisted of 79 venues. Compared with the prelegislation measurement, the concentration of PM(2.5) in hospitality venues was reduced significantly after introduction of the smoke-free legislation. The median mass concentration of PM(2.5) was reduced by 87.1% in coffee bars, by 88.7% in restaurants, by 66.3% in bars, and by 90.8% in discotheques. Notably, legal exemptions to the smoking ban are an issue: At the postlegislation measurement in 2009, the mass concentrations of PM(2.5) were substantially higher in venues allowing smoking in the whole venue or in a designated smoking room than in completely smoke-free venues. The German smoke-free legislation significantly reduced the levels of respirable suspended particles in the indoor air of hospitality venues, benefiting the health of employees and patrons alike. But legal exemptions attenuated the effectiveness of the policy.

Exploring Impacts of Taxes and Hospitality Bans on Cigarette Prices and Smoking Prevalence Using a Large Dataset of Cigarette Prices at Stores 2001–2011, USA

PubMed Central

Ballester, Lance S.; Auchincloss, Amy H.; Robinson, Lucy F.; Mayne, Stephanie L.

2017-01-01

In the USA, little is known about local variation in retail cigarette prices; price variation explained by taxes, bans, and area-level socio-demographics, and whether taxes and hospitality bans have synergistic effects on smoking prevalence. Cigarette prices 2001–2011 from chain supermarkets and drug stores (n = 2973) were linked to state taxes (n = 41), state and county bar/restaurant smoking bans, and census block group socio-demographics. Hierarchical models explored effects of taxes and bans on retail cigarette prices as well as county smoking prevalence (daily, non-daily). There was wide variation in store-level cigarette prices in part due to differences in state excise taxes. Excise taxes were only partially passed onto consumers (after adjustment, $1 tax associated with $0.90 increase in price, p < 0.0001) and the pass-through was slightly higher in areas that had bans but did not differ by area-level socio-demographics. Bans were associated with a slight increase in cigarette price (after adjustment, $0.09 per-pack, p < 0.0001). Taxes and bans were associated with reduction in smoking prevalence and taxes had a stronger association when combined with bans, suggesting a synergistic effect. Given wide variation in store-level prices, and uneven state/county implementation of taxes and bans, more federal policies should be considered. PMID:28335533

Secondhand smoke exposure and risk following the Irish smoking ban: an assessment of salivary cotinine concentrations in hotel workers and air nicotine levels in bars.

PubMed

Mulcahy, M; Evans, D S; Hammond, S K; Repace, J L; Byrne, M

2005-12-01

To investigate whether the Irish smoking ban has had an impact on secondhand smoke (SHS) exposures for hospitality workers. Before and after the smoking ban a cohort of workers (n = 35) from a sample of city hotels (n = 15) were tested for saliva cotinine concentrations and completed questionnaires. Additionally, a random sample (n = 20) of city centre bars stratified by size (range 400-5000 square feet), were tested for air nicotine concentrations using passive samplers before and after the ban. Salivary cotinine concentrations (ng/ml), duration of self reported exposures to secondhand smoke, air nicotine (microg/cubic metre). Cotinine concentrations reduced by 69%, from 1.6 ng/ml to 0.5 ng/ml median (SD 1.29; p < 0.005). Overall 74% of subjects experienced decreases (range 16-99%), with 60% showing a halving of exposure levels at follow up. Self reported exposure to SHS at work showed a significant reduction from a median 30 hours a week to zero (p < 0.001). There was an 83% reduction in air nicotine concentrations from median 35.5 microg/m3 to 5.95 microg/m3 (p < 0.001). At baseline, three bars (16%) were below the 6.8 microg/m3 air nicotine significant risk level for lung cancer alone; at follow up this increased to 10 (53%). Passive smoking and associated risks were significantly reduced but not totally eliminated. Exposure to SHS is still possible for those working where smoking is still allowed and those working where smoke may migrate from outdoor areas. Further research is required to assess the true extent and magnitude of these exposures.

[Hospitality workers' exposure to environmental tobacco smoke before and after implementation of smoking ban in public places: a review of epidemiological studies].

PubMed

Polańska, Kinga; Hanke, Wojciech; Konieczko, Katarzyna

2011-01-01

Environmental tobacco smoke (ETS) exposure induces serious negative health consequences, of which the increased risk of cardiovascular diseases, cancer, respiratory symptoms and poor pregnancy outcomes appear to be most important. Taking into account those health consequences of ETS exposure most countries have introduced legislation to ban or restrict smoking in public places. In this paper the effectiveness of the introduced legislation was analyzed with regard to the protection of hospitality workers from ETS exposure in the workplace. The analysis of 12 papers published after 2000 covered the year of publication, type of legislation, study population, hospitality venue (pub, bar, restaurant, disco) and type of markers or self-reported perception of exposure to ETS. The analysis indicates that the legislation to ban smoking in hospitality venues protects workers from ETS exposure when the venues are 100% tobacco smoke free. The reduction of the cotinine level in biological samples after the implementation of smoke free law was 57-89%, comparing to the biomarker level in the samples taken before the new law was introduced. About 90% of reduction in nicotine and PM levels was also noted. In addition, the positive self perception reported by workers proved the effectiveness of new legislation protecting them from ETS exposure.

Assessing knowledge and attitudes of owners or managers of hospitality venues regarding a policy banning indoor smoking.

PubMed

Alaaeddine, G; Al Kuhaimi, T; Al Assaad, R; Dany, M; Diab, R; Hanna, E; Hirmas, N; Ismail, H; Mahmassani, D; Sleiman Tellawi, R; Nakkash, R

2013-05-01

In response to accumulating evidence on the detrimental health effects of second-hand smoke, governments throughout the world have adopted laws prohibiting indoor smoking in public places. Lebanon has recently enacted a law prohibiting indoor smoking in all of its forms, rendered effective as of 3 September 2012. This study examined the knowledge and attitudes of owners/managers of restaurants, cafes, pubs and nightclubs in Beirut towards the ban, three months before it came into effect. Self-administered cross-sectional survey. Data were derived from a self-administered cross-sectional survey conducted in June 2012. In total, 262 hospitality venues (restaurants, cafes, pubs and nightclubs) were sampled at random to participate. The response rate was 74% (194/262). Overall, 84% of owners/managers reported that they were aware of the ban, yet the average knowledge score was only 3.43/10. A general positive attitude was noted towards customer satisfaction (44.8%), law enforcement (61.1%) and employee protection from second-hand smoke (74%), while 55% of owners/managers were concerned that their revenues would decrease. However, 83.3% expressed their willingness to implement the law. This quantitative study is the first to examine the knowledge and attitudes of owners/managers of hospitality venues regarding the indoor smoking ban in Lebanon. Civil society and government bodies should use the findings to develop a campaign to address the knowledge and attitudes of owners/managers of hospitality venues to ensure successful enforcement. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Secondhand smoke exposure and risk following the Irish smoking ban: an assessment of salivary cotinine concentrations in hotel workers and air nicotine levels in bars

PubMed Central

Mulcahy, M; Evans, D; Hammond, S; Repace, J; Byrne, M

2005-01-01

Objective: To investigate whether the Irish smoking ban has had an impact on secondhand smoke (SHS) exposures for hospitality workers. Design, setting, and participants: Before and after the smoking ban a cohort of workers (n = 35) from a sample of city hotels (n = 15) were tested for saliva cotinine concentrations and completed questionnaires. Additionally, a random sample (n = 20) of city centre bars stratified by size (range 400–5000 square feet), were tested for air nicotine concentrations using passive samplers before and after the ban. Main outcome measures: Salivary cotinine concentrations (ng/ml), duration of self reported exposures to secondhand smoke, air nicotine (µg/cubic metre). Results: Cotinine concentrations reduced by 69%, from 1.6 ng/ml to 0.5 ng/ml median (SD 1.29; p < 0.005). Overall 74% of subjects experienced decreases (range 16–99%), with 60% showing a halving of exposure levels at follow up. Self reported exposure to SHS at work showed a significant reduction from a median 30 hours a week to zero (p < 0.001). There was an 83% reduction in air nicotine concentrations from median 35.5 µg/m3 to 5.95 µg/m3 (p < 0.001). At baseline, three bars (16%) were below the 6.8 µg/m3 air nicotine significant risk level for lung cancer alone; at follow up this increased to 10 (53%). Conclusions: Passive smoking and associated risks were significantly reduced but not totally eliminated. Exposure to SHS is still possible for those working where smoking is still allowed and those working where smoke may migrate from outdoor areas. Further research is required to assess the true extent and magnitude of these exposures. PMID:16319361

Impact on smoking of England's 2012 partial tobacco point of sale display ban: a repeated cross-sectional national study.

PubMed

Kuipers, Mirte A G; Beard, Emma; Hitchman, Sara C; Brown, Jamie; Stronks, Karien; Kunst, Anton E; McNeill, Ann; West, Robert

2017-03-01

A partial tobacco point of sale (PoS) display ban was introduced in large shops (>280 m 2 floor area) in England on 6 April 2012. The aim of this study was to assess the medium-term effects of the partial tobacco PoS display ban on smoking in England. Data were used from 129 957 respondents participating in monthly, cross-sectional household surveys of representative samples of the English adult population aged 18+ years from January 2009 to February 2015. Interrupted-time series regression models assessed step changes in the level of current smoking and cigarette consumption in smokers and changes in the trends postban compared with preban. Models were adjusted for sociodemographic variables and e-cigarette use, seasonality and autocorrelation. Potential confounding by cigarette price was accounted for by time, as price was almost perfectly correlated with time. Following the display ban, there was no immediate step level change in smoking (-3.69% change, 95% CI -7.94 to 0.75, p=0.102) or in cigarette consumption (β -0.183, 95% CI -0.602 to 0.236). There was a significantly steeper decline in smoking post display ban (-0.46% change, 95% CI -0.72 to -0.20, p=0.001). This effect was demonstrated by respondents in manual occupations (-0.62% change, 95% CI -0.72 to -0.20, p=0.001), but not for those in non-manual occupations (-0.42, 95% CI -0.90 to 0.06, p=0.084). Cigarette consumption declined preban period (β -0.486, 95% CI -0.633 to -0.339, p<0.001), but no significant change in cigarette consumption trend was observed (β 0.019, 95% CI -0.006 to 0.042, p=0.131). The partial tobacco PoS display ban introduced in England in April 2012 did not lead to an immediate decline in smoking, but was followed by a decline in the trend of smoking prevalence that could not be accounted for by seasonal factors, e-cigarette use or price changes. 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 the Danish smoking ban on hospital admissions for acute myocardial infarction.

PubMed

Christensen, Tabita Maria; Møller, Lisbeth; Jørgensen, Torben; Pisinger, Charlotta

2014-01-01

Exposure to secondhand smoke is associated with an increased risk of acute myocardial infarction (AMI). The positive impact of a smoking ban on AMI hospitalization rates has been demonstrated both inside and outside Europe. A national smoking ban (SB) was implemented in Denmark on 15 August 2007. To evaluate the impact of the Danish SB on hospital admissions for AMI. Poisson regression models were used to analyse changes over time in AMI-admissions in Denmark. We investigated a seven year period: five years before and two years after implementation of the SB. We accounted for the variation in the population size and for seasonal trends. Potential confounders included were: gender, age and the incidence of type 2 diabetes (T2D). A significant reduction in the number of AMI-admissions was found in the last three years of the study period after adjusting for the potential confounders. The significant reductions were found one year before the SB (relative rate (RR) = 0.86, 95% confidence interval (CI) 0.79-0.94), one year after the SB (RR = 0.77, 95% CI 0.71-0.85) and two years after the SB (RR = 0.77, 95% CI 0.70-0.84). A significant reduction in the number of AMI-admissions was found already one year before the SB after adjustment for the incidence of T2D. The results differ from most results found in similar studies throughout the world and may be explained by the incremental enactment of SBs in Denmark and the implementation of a nation-wide ban on industrially produced trans-fatty acids in food in 2004.

Cohort study investigating the effects of first stage of the English tobacco point-of-sale display ban on awareness, susceptibility and smoking uptake among adolescents

PubMed Central

Bogdanovica, Ilze; McNeill, Ann; Britton, John

2017-01-01

Objective A prospective evaluation of the effect of 2012 point-of-sale (PoS) display ban in supermarkets in England on perceived exposure to PoS displays, and on changes in susceptibility and smoking uptake among young people. Design Cohort study. Settings Seven schools in Nottinghamshire, England. Participants 1035 11–16-year-old school children. Primary and secondary outcome measures Changes in reported exposure to PoS displays before and after prohibition, and the association between exposure to and awareness of PoS displays and change in susceptibility to smoking and smoking status between 2011 and 2012 (before the ban) and 2012 and 2013 (after the ban). Results The proportion of children noticing tobacco PoS displays in supermarkets most or every time they visited a shop changed little between 2011 and 2012 (59.6% (95% CI 56.6% to 62.6%) and 58.8% (95% CI 55.8% to 61.8%), respectively); but decreased by about 13 percentage points to 45.7% (95% CI 42.7% to 48.7%) in 2013, after the ban. However, after adjusting for confounders, implementation of the first stage of the PoS ban in 2012 did not result in significant changes in the relation between susceptibility to smoking and smoking status and exposure to and awareness of PoS displays. Conclusions Prohibition of PoS in large supermarkets resulted in a decline in the proportion of young people noticing PoS displays in large shops, but little or no change in smoking uptake or susceptibility. It remains to be seen whether extension of the PoS ban to all shops in 2015 has a more marked effect. PMID:28115330

Hospital discharge rates before and after implementation of a city-wide smoking ban in a Texas city, 2004-2008.

PubMed

Head, Phil; Jackson, Bradford E; Bae, Sejong; Cherry, Debra

2012-01-01

The objective of this study was to examine hospital discharge data on 5 tobacco-related diagnoses before and after implementation of a smoking ban in a small Texas city. We compared hospital discharge rates for 2 years before and 2 years after implementation of the ban in the intervention city with discharge rates during the same time in a similar city with no ban. The discharge rates for blacks and whites combined declined significantly after the ban in the intervention city for acute myocardial infarction (MI) (rate ratio [RR], 0.74; 95% confidence interval [CI], 0.65-0.85) and for stroke or cerebrovascular accident (RR, 0.71; 95% CI, 0.62-0.82); discharge rates in the intervention city also declined significantly for chronic obstructive pulmonary disease (RR, 0.64; 95% CI, 0.54-0.75) and asthma (RR, 0.69; 95% CI, 0.52-0.91) for whites only. Discharge rates for 4 of 5 diagnoses in the control city did not change. Although postban reduction in acute MI is well documented, this is one of the first studies to show a racial disparity in health benefits and a decline in tobacco-related diagnoses other than acute MI after implementation of a city-wide smoking ban.

A study of the atmosphere in London underground trains before and after the ban on smoking.

PubMed

Proctor, C

1987-01-01

Measurements of the ambient atmosphere in London Underground train compartments were made before and after a ban on smoking. Levels of nicotine and carbon monoxide and estimates of airborne particulates are given. This paper describes the analytical techniques used in measuring constituents of tobacco smoke in the ambient air of public environments. Levels observed were all found to be far lower than recommended OSHA limits for safe exposure.

Cohort study investigating the effects of first stage of the English tobacco point-of-sale display ban on awareness, susceptibility and smoking uptake among adolescents.

PubMed

Bogdanovica, Ilze; McNeill, Ann; Britton, John

2017-01-23

A prospective evaluation of the effect of 2012 point-of-sale (PoS) display ban in supermarkets in England on perceived exposure to PoS displays, and on changes in susceptibility and smoking uptake among young people. Cohort study. Seven schools in Nottinghamshire, England. 1035 11-16-year-old school children. Changes in reported exposure to PoS displays before and after prohibition, and the association between exposure to and awareness of PoS displays and change in susceptibility to smoking and smoking status between 2011 and 2012 (before the ban) and 2012 and 2013 (after the ban). The proportion of children noticing tobacco PoS displays in supermarkets most or every time they visited a shop changed little between 2011 and 2012 (59.6% (95% CI 56.6% to 62.6%) and 58.8% (95% CI 55.8% to 61.8%), respectively); but decreased by about 13 percentage points to 45.7% (95% CI 42.7% to 48.7%) in 2013, after the ban. However, after adjusting for confounders, implementation of the first stage of the PoS ban in 2012 did not result in significant changes in the relation between susceptibility to smoking and smoking status and exposure to and awareness of PoS displays. Prohibition of PoS in large supermarkets resulted in a decline in the proportion of young people noticing PoS displays in large shops, but little or no change in smoking uptake or susceptibility. It remains to be seen whether extension of the PoS ban to all shops in 2015 has a more marked effect. 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/.

Small proportions of actively-smoking patrons and high PM2.5 levels in southern California tribal casinos: support for smoking bans or designated smoking areas.

PubMed

Klepeis, Neil E; Omoto, Jason; Ong, Seow Ling; Omoto, Harmeena Sahota; Dhaliwal, Narinder

2012-09-22

Nearly all California casinos currently allow smoking, which leads to potentially high patron exposure to secondhand tobacco smoke pollutants. Some argue that smoking restrictions or bans would result in a business drop, assuming > 50% of patrons smoke. Evidence in Nevada and responses from the 2008 California tobacco survey refute this assertion. The present study investigates the proportion of active smokers in southern California tribal casinos, as well as occupancy and PM(2.5) levels in smoking and nonsmoking sections. We measured active-smoker and total-patron counts during Friday or Saturday night visits (two per casino) to smoking and nonsmoking gaming areas inside 11 southern California casinos. We counted slot machines and table games in each section, deriving theoretical maximum capacities and occupancy rates. We also measured PM(2.5) concentrations (or used published levels) in both nonsmoking and smoking areas. Excluding one casino visit with extremely high occupancy, we counted 24,970 patrons during 21 casino visits of whom 1,737 were actively smoking, for an overall active- smoker proportion of 7.0% and a small range of ~5% across casino visits (minimum of 5% and maximum of 10%). The differences in mean inter-casino active-smoker proportions were not statistically significant. Derived occupancy rates were 24% to 215% in the main (low-stakes) smoking-allowed slot or table areas. No relationship was found between observed active-smoker proportions and occupancy rate. The derived maximum capacities of nonsmoking areas were 1% to 29% of the overall casino capacity (most under 10%) and their observed occupancies were 0.1 to over 3 times that of the main smoking-allowed casino areas. Seven of twelve visits to nonsmoking areas with no separation had occupancy rates greater than main smoking areas. Unenclosed nonsmoking areas don't substantially protect occupants from PM2.5 exposure. Nonsmoking areas encapsulated inside smoking areas or in a separate, but

Small proportions of actively-smoking patrons and high PM2.5 levels in southern California tribal casinos: support for smoking bans or designated smoking areas

PubMed Central

2012-01-01

Background Nearly all California casinos currently allow smoking, which leads to potentially high patron exposure to secondhand tobacco smoke pollutants. Some argue that smoking restrictions or bans would result in a business drop, assuming > 50% of patrons smoke. Evidence in Nevada and responses from the 2008 California tobacco survey refute this assertion. The present study investigates the proportion of active smokers in southern California tribal casinos, as well as occupancy and PM2.5 levels in smoking and nonsmoking sections. Methods We measured active-smoker and total-patron counts during Friday or Saturday night visits (two per casino) to smoking and nonsmoking gaming areas inside 11 southern California casinos. We counted slot machines and table games in each section, deriving theoretical maximum capacities and occupancy rates. We also measured PM2.5 concentrations (or used published levels) in both nonsmoking and smoking areas. Results Excluding one casino visit with extremely high occupancy, we counted 24,970 patrons during 21 casino visits of whom 1,737 were actively smoking, for an overall active- smoker proportion of 7.0% and a small range of ~5% across casino visits (minimum of 5% and maximum of 10%). The differences in mean inter-casino active-smoker proportions were not statistically significant. Derived occupancy rates were 24% to 215% in the main (low-stakes) smoking-allowed slot or table areas. No relationship was found between observed active-smoker proportions and occupancy rate. The derived maximum capacities of nonsmoking areas were 1% to 29% of the overall casino capacity (most under 10%) and their observed occupancies were 0.1 to over 3 times that of the main smoking-allowed casino areas. Seven of twelve visits to nonsmoking areas with no separation had occupancy rates greater than main smoking areas. Unenclosed nonsmoking areas don’t substantially protect occupants from PM2.5 exposure. Nonsmoking areas encapsulated inside smoking areas

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

PubMed

Sureda, Xisca; Ballbè, Montse; Martínez, Cristina; Fu, Marcela; Carabasa, Esther; Saltó, Esteve; Martínez-Sánchez, Jose M; Fernández, Esteve

2014-01-01

On January 2, 2011, the Spanish government passed a new smoking law that banned smoking in hospital campuses. The objective of this study was to evaluate the implementation of smoke-free campuses in the hospitals of Catalonia based on both airborne particulate matter and observational data. This cross-sectional study included the hospitals registered in the Catalan Network of Smoke-free Hospitals. We measured the concentration of particulate matter < 2.5 µm in μg/m(3) at different locations, both indoors and outdoors before (2009) and after (2011) the implementation of the tobacco law. During 2011, we also assessed smoke-free zone signage and indications of smoking in the outdoor areas of hospital campuses. The overall median particulate matter < 2.5 µm concentration fell from 12.22 μg/m(3) (7.80-19.76 μg/m(3)) in 2009 to 7.80 μg/m(3) (4.68-11.96 μg/m(3)) in 2011. The smoke-free zone signage within the campus was moderately implemented after the legislation in most hospitals, and 55% of hospitals exhibited no indications of tobacco consumption around the grounds. 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/m(3)). Our data showed the feasibility of implementing a smoke-free campus ban and its positive effects.

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

PubMed Central

Sureda, Xisca; Ballbè, Montse; Martínez, Cristina; Fu, Marcela; Carabasa, Esther; Saltó, Esteve; Martínez-Sánchez, Jose M.; Fernández, Esteve

2014-01-01

Introduction On January 2, 2011, the Spanish government passed a new smoking law that banned smoking in hospital campuses. The objective of this study was to evaluate the implementation of smoke-free campuses in the hospitals of Catalonia based on both airborne particulate matter and observational data. Methods This cross-sectional study included the hospitals registered in the Catalan Network of Smoke-free Hospitals. We measured the concentration of particulate matter < 2.5 µm in μg/m3 at different locations, both indoors and outdoors before (2009) and after (2011) the implementation of the tobacco law. During 2011, we also assessed smoke-free zone signage and indications of smoking in the outdoor areas of hospital campuses. Results The overall median particulate matter < 2.5 µm concentration fell from 12.22 μg/m3 (7.80–19.76 μg/m3) in 2009 to 7.80 μg/m3 (4.68–11.96 μg/m3) in 2011. The smoke-free zone signage within the campus was moderately implemented after the legislation in most hospitals, and 55% of hospitals exhibited no indications of tobacco consumption around the grounds. 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. PMID:26844041

The big ban on bituminous coal sales revisited: Serious epidemics and pronounced trends feign excess mortality previously attributed to heavy black-smoke exposure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wittmaack, K.

The effect of banning bituminous coal sales on the black-smoke concentration and the mortality rates in Dublin, Ireland, has been analyzed recently. Based on the application of standard epidemiological procedures, the authors concluded that, as a result of the ban, the total nontrauma death rate was reduced strongly (-8.0% unadjusted, -5.7% adjusted). The purpose of this study was to reanalyze the original data with the aim of clarifying the three most important aspects of the study, (a) the effect of epidemics, (b) the trends in mortality rates due to advances in public health care, and (c) the correlation between mortalitymore » rates and black-smoke concentrations. Particular attention has been devoted to a detailed evaluation of the time dependence of mortality rates, stratified by season. Death rates were found to be strongly enhanced during three severe pre-ban winter-spring epidemics. The cardiovascular mortality rates exhibited a continuous decrease over the whole study period, in general accordance with trends in the rest of Ireland. These two effects can fully account for the previously identified apparent correlation between reduced mortality and the very pronounced ban-related lowering of the black-smoke concentration. The third important finding was that in nonepidemic pre-ban seasons even large changes in the concentration of black smoke had no detectable effect on mortality rates. The reanalysis suggests that epidemiological studies exploring the effect of ambient particulate matter on mortality require improved tools allowing proper adjustment for epidemics and trends.« less

Decrease in mortality rate and hospital admissions for acute myocardial infarction after the enactment of the smoking ban law in São Paulo city, Brazil.

PubMed

Abe, Tania M O; Scholz, Jaqueline; de Masi, Eduardo; Nobre, Moacyr R C; Filho, Roberto Kalil

2017-11-01

Smoking restriction laws have spread worldwide during the last decade. Previous studies have shown a decline in the community rates of myocardial infarction after enactment of these laws. However, data are scarce about the Latin American population. In the first phase of this study, we reported the successful implementation of the law in São Paulo city, with a decrease in carbon monoxide rates in hospitality venues. To evaluate whether the 2009 implementation of a comprehensive smoking ban law in São Paulo city was associated with a reduction in rates of mortality and hospital admissions for myocardial infarction. We performed a time-series study of monthly rates of mortality and hospital admissions for acute myocardial infarction from January 2005 to December 2010. The data were derived from DATASUS, the primary public health information system available in Brazil and from Mortality Information System (SIM). Adjustments and analyses were performed using the Autoregressive Integrated Moving Average with exogenous variables (ARIMAX) method modelled by environmental variables and atmospheric pollutants to evaluate the effect of smoking ban law in mortality and hospital admission rate. We also used Interrupted Time Series Analysis (ITSA) to make a comparison between the period pre and post smoking ban law. We observed a reduction in mortality rate (-11.9% in the first 17 months after the law) and in hospital admission rate (-5.4% in the first 3 months after the law) for myocardial infarction after the implementation of the smoking ban law. Hospital admissions and mortality rate for myocardial infarction were reduced in the first months after the comprehensive smoking ban law was implemented. 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/.

Respirable particles and carcinogens in the air of delaware hospitality venues before and after a smoking ban.

PubMed

Repace, James

2004-09-01

How do the concentrations of indoor air pollutants known to increase risk of respiratory disease, cancer, heart disease, and stroke change after a smoke-free workplace law? Real-time measurements were made of respirable particle (RSP) air pollution and particulate polycyclic aromatic hydrocarbons (PPAH), in a casino, six bars, and a pool hall before and after a smoking ban. Secondhand smoke contributed 90% to 95% of the RSP air pollution during smoking, and 85% to 95% of the carcinogenic PPAH, greatly exceeding levels of these contaminants encountered on major truck highways and polluted city streets. This air-quality survey demonstrates conclusively that the health of hospitality workers and patrons is endangered by tobacco smoke pollution. Smoke-free workplace laws eliminate that hazard and provide health protection impossible to achieve through ventilation or air cleaning.

Implementation of smoke-free homes in Poland.

PubMed

Kaleta, Dorota; Fronczak, Adam; Usidame, Bukola; Dziankowska-Zaborszczyk, Elżbieta; Makowiec-Dąbrowska, Teresa; Wojtysiak, Piotr

2016-01-01

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. Data from cross-sectional, household study - Global Adult Tobacco Survey (GATS 2009-2010) were analyzed. The logistic regression model was applied for appropriate calculations. 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. 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. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Perceptions of Smoking Prevalence by Youth in Countries With and Without a Tobacco Advertising Ban

PubMed Central

BURTON, DEE; GRAHAM, JOHN W.; JOHNSON, C. ANDERSON; UUTELA, ANTTI; VARTIAINEN, ERKKI; PALMER, RAYMOND F.

2010-01-01

This study examined a proposed mechanism by which exposure to cigarette advertising may mediate the subsequent smoking of youth. We hypothesized that children’s exposure to cigarette advertising leads them to overestimate the prevalence of smoking, and that these distorted perceptions, in turn, lead to increased intentions to smoke. Children in Finland, where there has been a total tobacco advertising ban since 1978, were compared with children in the United States at a time when tobacco advertising was ubiquitous. Samples of 477 8- to 14-year-old Helsinki students and 453 8- to 14-year-old Los Angeles students whose lifetime cigarette use consisted of no more than a puff of a cigarette were administered questionnaires in their classrooms. The primary hypothesis was confirmed. Los Angeles youth were significantly more likely than Helsinki youth to overestimate the prevalence of adult smoking, in spite of the fact that actual adult smoking prevalence in Helsinki was almost twice that of Los Angeles adults. A similar, significant pattern for perceived peer smoking was obtained, with Los Angeles youth being more likely than Helsinki youth to overestimate prevalence, in spite of the actual greater prevalence of youth smoking in Helsinki. PMID:20812125

Perceptions of smoking prevalence by youth in countries with and without a tobacco advertising ban.

PubMed

Burton, Dee; Graham, John W; Johnson, C Anderson; Uutela, Antti; Vartiainen, Erkki; Palmer, Raymond F

2010-09-01

This study examined a proposed mechanism by which exposure to cigarette advertising may mediate the subsequent smoking of youth. We hypothesized that children's exposure to cigarette advertising leads them to overestimate the prevalence of smoking, and that these distorted perceptions, in turn, lead to increased intentions to smoke. Children in Finland, where there has been a total tobacco advertising ban since 1978, were compared with children in the United States at a time when tobacco advertising was ubiquitous. Samples of 477 8- to 14-year-old Helsinki students and 453 8- to 14-year-old Los Angeles students whose lifetime cigarette use consisted of no more than a puff of a cigarette were administered questionnaires in their classrooms. The primary hypothesis was confirmed. Los Angeles youth were significantly more likely than Helsinki youth to overestimate the prevalence of adult smoking, in spite of the fact that actual adult smoking prevalence in Helsinki was almost twice that of Los Angeles adults. A similar, significant pattern for perceived peer smoking was obtained, with Los Angeles youth being more likely than Helsinki youth to overestimate prevalence, in spite of the actual greater prevalence of youth smoking in Helsinki.

Second-hand smoke exposure in different types of venues: before and after the implementation of smoke-free legislation in Guangzhou, China

PubMed Central

Ye, Xiaohua; Yao, Zhenjiang; Gao, Yanhui; Xu, Ya; Xu, Ying; Zhu, Zhengwei; Chen, Sidong; Yang, Yi

2014-01-01

Objectives Smoke-free legislation was implemented in Guangzhou on 1 September 2010. However, the smoke-free policy did not cover all indoor areas and smoking rooms can be set in some public places. This study aimed to assess changes in self-reported second-hand smoke (SHS) exposure in different types of venues and in homes, in order to evaluate the effectiveness of smoke-free legislation. Methods/design A repeated cross-sectional survey of representative participants was conducted in Guangzhou before and after the smoke-free legislation. Logistic regression models were used to examine the effectiveness of smoke-free legislation. Main outcome measures Self-reported exposure to SHS,antitobacco advertisements and tobacco advertisements. Participants A total of 4900 participants before the ban and 5135 participants after the ban were selected using a multistage stratified design. Results In full smoking ban places, overall self-reported SHS exposure has declined significantly from 58.8% to 50.3% (p<0.05) with greater drops in cultural venues, government offices and commercial venues. The smoke-free policy did not alter SHS exposure in smokers’ homes (39.6% in 2009 vs 40.0% in 2011; p=0.454). Although a slight decrease in SHS exposure was observed in smoking rooms in hotels, workplaces, restaurants, cafes/bars/nightclubs and amusement parks, SHS continued to be high in those areas. The implementation of smoke-free legislation was accompanied by an increase in antitobacco advertisements. Conclusions SHS exposure declines more significantly in full smoking ban places than in partial smoking ban places. The smoke-free policy in public places does not lead to more SHS exposure in homes. Therefore, it is recommended that Guangzhou should implement a 100% smoke-free policy in all public places and workplaces in the future. PMID:24534259

[Smoke-free environment--nurse attitudes towards smoke-free regulations].

PubMed

Kaleta, Dorota; Polańska, Kinga; Dziankowska-Zaborszczyk, Elzbieta; Bak-Romaniszyn, Leokadia; Czarnecka, Karolina; Drygas, Wojciech

2009-01-01

The aim of the study was to analyze the nurse attitudes towards smoke-free regulations in public places. The study population consisted of 299 nurses. Among the study population questionnaire was conducted including socio-demographic characteristic, smoking and ETS profile, knowledge about health effects of smoking and abilities for conduction of antismoking counseling. Detail information was collected about nurse opinion on smoke-free public places such as offices, other workplaces, health and educational buildings, restaurants and bars. About 18% of study participants declared current tobacco smoking and 25% were former smokers. Almost all participating in the study women (85%-98%) are in favor of smoking ban in offices, health and educational buildings. 75% supported smoking ban in workplaces but 15% of them were somewhat opposed. Most of the nurses were in favor of smoke-free restaurants (64%) but they were less likely to support smoke-free bars, pubs and clubs (45%). Unfortunately 63% of interview women do not accept smoking ban in private cars. The percentage of women who support total ban of smoking in the presence of pregnant women was 93% and in the presence of children 79%. It is important to conduct educational and informational activities to increase public awareness on health consequences of active and passive smoking and the ways of elimination of such exposures.

A Casino goes smoke free: a longitudinal study of secondhand and thirdhand smoke pollution and exposure.

PubMed

Matt, Georg E; Quintana, Penelope J E; Hoh, Eunha; Zakarian, Joy M; Chowdhury, Zohir; Hovell, Melbourne F; Jacob, Peyton; Watanabe, Kayo; Theweny, Teaba S; Flores, Victoria; Nguyen, Anh; Dhaliwal, Narinder; Hayward, Gary

2018-02-08

Secondhand smoke (SHS) in US casinos is common, but little is known about the residue of tobacco smoke pollutants left behind in dust and on surfaces, commonly referred to as thirdhand smoke (THS). We examined SHS and THS pollution and exposure before and during a casino smoking ban and after smoking resumed. A casino was visited nine times over a 15-month period to collect dust, surface and air samples in eight locations. Finger wipe and urine samples were collected from non-smoking confederates before and after a 4-hour casino visit. Samples were analysed for markers of SHS and THS pollution and exposure. Exceptionally high levels of THS were found in dust and on surfaces. Although the smoking ban led to immediate improvements in air quality, surface nicotine levels were unchanged and remained very high for the first month of the smoking ban. Surface nicotine decreased by 90% after 1 month (P<0.01), but nicotine and tobacco-specific nitrosamines in dust decreased more slowly, declining by 90% only after 3 months (P<0.01). Exposure was significantly reduced after the ban, but the benefits of the ban were reversed after smoking resumed. Long-term smoking in a casino creates deep THS reservoirs that persist for months after a smoking ban. A complete smoking ban immediately improves air quality and significantly reduces exposure to SHS and THS. However, THS reservoirs contribute to continued low-level exposure to toxicants. To accelerate the effect of smoking bans, remediation efforts should address specific THS reservoirs, which may require intensive cleaning as well as replacement of carpets, furniture and building materials. © 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.

The population impact of smoke-free workplace and hospitality industry legislation on smoking behaviour. Findings from a national population survey.

PubMed

Nagelhout, Gera E; Willemsen, Marc C; de Vries, Hein

2011-04-01

To study the impact of implementing smoke-free workplace and hospitality industry legislation on smoking behaviour. A cross-sectional population survey from 2001 to 2008 (n ≈ 18,000 per year) was used to assess trends and seasonal patterns in smoking and quitting, and to examine whether changes could be observed after the workplace smoking ban in the Netherlands in 2004 and the hospitality industry ban in 2008. Outcome measures were smoking prevalence, quit attempts and successful quit attempts. Interactions with educational level (socio-economic status) and bar visiting (exposure to the hospitality industry ban) were tested. The workplace ban was followed by a decrease in smoking prevalence (OR = 0.91, P < 0.001), but the hospitality industry ban was not (OR = 0.96, P = 0.127). Both bans, especially the workplace ban, were followed by an increase in quit attempts and successful quit attempts: workplace ban, OR = 1.31, P < 0.001; OR = 1.49, P < 0.001; hospitality industry ban, OR = 1.13, P = 0.013; OR = 1.44, P < 0.001. The workplace ban had a larger effect on successful quitting among higher-educated (OR = 0.35, P < 0.001) than on lower-educated respondents (OR = 0.74, P = 0.052). The hospitality industry ban had a larger effect on quit attempts among frequent bar visitors (OR = 1.48, P = 0.003) than on non-bar visitors (OR = 0.71, P = 0.014). A workplace smoking ban in the Netherlands was followed by more changes in smoking and quitting than a hospitality industry ban. The hospitality industry ban only appeared to have an impact on quit attempts, and not on smoking prevalence. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Assessing the effects of the Spanish partial smoking ban on cardiovascular and respiratory diseases: methodological issues.

PubMed

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

2015-12-01

Recent research has assessed the impact of tobacco laws on cardiovascular and respiratory morbidity. In this study, we also examined whether the association between the implementation of the 2005 Spanish smoking ban and hospital admissions for cardiovascular and respiratory diseases varies according to the adjustment for potential confounders. Ecological time series analysis. Residents of Madrid and Barcelona cities (Spain). Data on daily emergency room admissions for acute myocardial infarction, cerebrovascular disease, chronic obstructive pulmonary disease (COPD), and asthma derived from the 2003-2006 Spanish hospital admissions registry. Changes in admission rates between 2006 and the 2003-2005 period were estimated using additive Poisson models allowing for overdispersion adjusted for secular trend in admission, seasonality, day of the week, temperature, number of flu and acute respiratory infection cases, pollution levels, tobacco consumption prevalence and, for asthma cases, pollen count. In Madrid, fully adjusted models failed to detect significant changes in hospital admission rates for any disease during the study period. In Barcelona, however, hospital admissions decreased by 10.2% (95% CI 3.8% to 16.1%) for cerebrovascular diseases and by 16.0% (95% CI 7.0% to 24.1%) for COPD. Substantial changes in effect estimates were observed on adjustment for linear or quadratic trend. Effect estimates for asthma-related admissions varied substantially when adjusting for pollen count in Madrid, and for seasonality and tobacco consumption in Barcelona. Our results confirm that the potential impact of a smoking ban must be adjusted for the underlying secular trend. In asthma-related admissions, pollen count, seasonality and tobacco consumption must be specified in the model. The substantial variability in effects detected between the two cities of Madrid and Barcelona lends strong support for a nationwide study to assess the overall effect of a smoking ban in Spain

Adolescent Smoking and Exposure to Tobacco Marketing Under a Tobacco Advertising Ban: Findings From 2 Norwegian National Samples

PubMed Central

Braverman, Marc T.; Aarø, Leif Edvard

2004-01-01

Objectives. We examined the extent to which adolescents in Norway have been exposed to tobacco marketing despite an existing ban, and whether exposure is related to their current smoking or expectations they will smoke in the future. Methods. Questionnaires were administered to nationally representative systematic samples of Norwegian youths aged 13 to 15 years in 1990 (n = 4282) and 1995 (n = 4065). Results. About half in each cohort reported exposure to marketing. Youths reporting exposure were significantly more likely to be current smokers and to expect to be smokers at 20 years of age, after control for important social influence predictors. Conclusions. Adolescents’ current smoking and future smoking expectations are linked to marketing exposure even in limited settings, suggesting the need for comprehensive controls to eliminate the function of marketing in promoting adolescent smoking. PMID:15226148

The Effect of Household Smoking Bans on Household Smoking

PubMed Central

Bleakley, Amy; Mallya, Giridhar; Romer, Daniel

2014-01-01

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. PMID:24524533

Implementing the ban on smoking in Israeli pubs: measuring airborne nicotine and enforcement by local authorities.

PubMed

Satran, Carmit; Drach-Zahavy, Anat; Hammond, S Katharine; Baron-Epel, Orna

2014-06-01

In 2007 an amendment to the law restricting smoking in pubs and bars (P&Bs) was enacted in Israel. However, a year after the ban only slight decreases in airborne smoke in P&Bs in one city have been reported. We aimed to assess levels of airborne nicotine in Israeli P&Bs and to measure ifself-reported enforcement of the law by local officials was associated with levels of airborne nicotine in P&Bs. Airborne nicotine levels were measured in 72 P&Bs in 29 towns in Israel; this consisted of 90% of eligible towns. In addition, 73 local authority officials were interviewed in 25 of these towns. The officials were asked to assess the local authority's level of enforcement of the law banning smoking in P&Bs. The association of levels of airborne nicotine with the levels of enforcement of the law was calculated. Data were collected during 2009-2010 and analyzed in 2010-2011. Levels of airborne nicotine were comparatively high in P&Bs. No association was detected between levels of nicotine and the P&Bs' characteristics. In the larger towns, levels of airborne nicotine were higher. In 16% of towns the local authority officials reported high levels of law enforcement. Generally, levels of reported enforcement by local authorities were low and did not predict levels of airborne nicotine in the P&Bs. Self-reported local authorities' law enforcement was not associated with levels of airborne nicotine in P&Bs in these towns. There is a need to develop ways to increase law enforcement by the local authorities or other agencies.

The tobacco endgame in Hong Kong: public support for a total ban on tobacco sales.

PubMed

Wang, Man Ping; Wang, Xin; Lam, Tai Hing; Viswanath, Kasisomayajula; Chan, Sophia S

2015-03-01

Tobacco endgame policies are increasingly advocated to end tobacco use. This study investigated public support for a total ban on tobacco sales, use and possession in Hong Kong. A telephone survey was conducted among 1537 randomly selected residents in 2012 to assess their support for a total ban on tobacco sales, usage and possession. Information on sociodemographic characteristics, smoking, and second hand smoke exposure were collected. Logistic regression was used to investigate factors associated with support for a total ban. Most of the never smokers (75.3%), ex-smokers (63.9%), and nearly half of current smokers (48.9%) backed some form of a total ban on tobacco. A total ban on tobacco sales was the most popular option among the three groups, with over half (64.8%) of all respondents supporting a ban within 10 years. Current smoking and higher educational attainment were associated with less support for a total ban on tobacco sales. Among current smokers, having quit intentions and attempts to quit were associated with support for a total ban. A total ban on tobacco sales was supported by most respondents. Ex-smokers and current smokers also voiced substantial support, although less than never smokers. A total ban on tobacco sales before 2022 should be the goal as it is supported by most of the respondents. Interim tobacco control measures, such as tax increases, expansion of smoking cessation services and plain packaging should be implemented to help current smokers quit and reduce smoking initiation before implementation of the ban. 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.

Out of Sight and Out of Mind? Evaluating the Impact of Point-of-Sale Tobacco Display Bans on Smoking-Related Beliefs and Behaviors in a Sample of Australian Adolescents and Young Adults.

PubMed

Dunlop, Sally; Kite, James; Grunseit, Anne C; Rissel, Chris; Perez, Donna A; Dessaix, Anita; Cotter, Trish; Bauman, Adrian; Young, Jane; Currow, David

2015-07-01

The Australian states of New South Wales (NSW) and Queensland implemented bans on tobacco pack displays at point-of-sale (PoS) in July 2010 and November 2011, respectively. This study evaluated the medium-term impact of the bans on youth. Data were drawn from the Tobacco Promotion Impact Study, a repeated cross-sectional survey of youth (12-24 years) in NSW and Queensland conducted yearly 2010-2012 (n = 6,014). Regression analyses examined differences in youth's recall of PoS tobacco displays, smoking-related beliefs, and smoking behaviors in relation to the timing of the PoS display bans. Recall of PoS tobacco displays was significantly less likely for youth interviewed after the bans versus before (OR = 0.45, 95% CI = 0.39, 0.52, p < .01). They were also less likely to report tobacco brand awareness (OR = 0.76, 95% CI = 0.62, 0.92, p < .01), to over-estimate peer smoking (OR = 0.84, 95% CI = 0.74, 0.96, p < .01), or be current smokers (OR = 0.73, 95% CI = 0.55, 0.96, p < .05). Stratified analyses showed that these differences were primarily apparent in the group of youth most likely to be affected by tobacco PoS displays: those who visit tobacco retailers most frequently. After the bans, smokers were less likely to report that they think about smoking as a result of seeing PoS tobacco displays (OR = 0.60, 95% CI = 0.37, 0.97, p < .039). Our findings suggest an immediate impact of display bans on youth's exposure to tobacco pack displays, and likely impacts on smoking-related outcomes. These results suggest that removing tobacco displays from retail environments can positively contribute to the denormalization of smoking among youth. © 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.

[The 2015 China Adult Tobacco Survey: exposure to second-hand smoke among adults aged 15 and above and their support to policy on banning smoking in public places].

PubMed

Nan, Y; Xi, Z; Yang, Y; Wang, L L; Tu, M W; Wang, J J; Jiang, Y

2016-06-01

To understand the situation on exposure to second-hand smoke among Chinese adults aged 15 and above and their support to policy on banning smoking in public places in 2015. A cross-sectional survey was conducted based on the protocol on Global Adult Tobacco Survey. Stratified multi-stage cluster sampling was used to select 16 800 households in China. Data were collected through household survey, using the electronic devices. One eligible respondent was selected by random sampling in each household. Standardized questionnaire was used from Global Tobacco Surveillance System. Data were weighted and analyzed by SAS 9.3 and SUDAAN 10.0.1 complex survey data analysis program. 93.1% (60 128×10(3)/64 575×10(3)), 76.3% (455 473×10(3)/596 782×10(3)), 57.1% (621 793×10(3)/1 089 582×10(3)), 54.3% (218 792×10(3)/402 732×10(3)), 38.1% (61 208×10(3)/160 574×10(3)), 26.9% (119 783×10(3)/444 679×10(3)), 23.8%(17 598×10(3)/73 993×10(3)), 17.2% (41 099×10(3)/239 022×10(3)) and 16.4% (102 153×10(3)/623 015×10(3)) of the respondents reported that smoking did exsit in the following places as: inside of bars or night clubs, in the restaurants, households homes, working places, government buildings, health care facilities, universities, primary and high schools (both indoor and outdoor areas), and on public transportation, respectively. Compared with those data in 2010, the proportions of exposure to indoor areas of restaurants, government buildings, health care facilities, primary and high schools (both indoor and outdoor areas), public transportation, and homes all significantly decreased after standardization of data. RESULTS also showed that most respondents were supportive to the policy on banning smoking in public and working places. However, the proportions of exposure to indoor areas of restaurants were still high but almost 70% of the respondents thought smoking should not be allowed in indoor areas of restaurants. From 2010 to 2015, proportions of exposure to

Reduction in myocardial infarction admissions in Liverpool after the smoking ban: potential socioeconomic implications for policymaking

PubMed Central

Liu, Andrew; Guzman Castillo, Maria; Capewell, Simon; Lucy, John; O'Flaherty, Martin

2013-01-01

Objectives To analyse the trends and trend changes in myocardial infraction (MI) and coronary heart disease (CHD) admissions, to investigate the effects of the 2007 smoke-free legislation on these trends, and to consider the policy implications of any findings. Design setting Liverpool (city), UK. Participants Hospital episode statistics data on all 56 995 admissions for CHD in Liverpool between 2004 and 2012 (International Classification of Diseases codes I20–I25 coded as an admission diagnosis within the defined dates). Primary and secondary outcome measures Trend gradient and change points (by trend regressions analysis) in age-standardised MI admissions in Liverpool between 2004 and 2012; by sex and by socioeconomic status. Secondary analysis on CHD admissions. Results A significant and sustained reduction was seen in MI admissions in Liverpool beginning within 1 year of the smoking ban. Comparing 2005/2006 and 2010/2011, the age-adjusted rates for MI admissions fell by 42% (39–45%) (41.6% in men and by 42.6% in women). Trend analysis shows that this is significantly greater than the background trend of decreasing admissions. These reductions appeared consistent across all socioeconomic groups. Interestingly, admission rates for total CHD (including mild to severe angina) increased by 10% (8–12%). Conclusions A dramatic reduction in MI admissions in Liverpool has been observed coinciding with the smoking ban in 2007. Furthermore, the benefits were apparent across the socioeconomic spectrum. Health inequalities were not affected and may even have been reduced. The rapid effects observed with this top-down, environmental policy may further increase its value to policymakers. PMID:24282240

Second-hand smoke in Italy.

PubMed

Gallus, S

2015-12-01

Second-hand smoke (SHS) has been classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO) [IARC, 2004]. Of the 5.7 million deaths attributable each year to tobacco smoking, more than 600,000 (i.e., around 1% of all deaths worldwide) refer to subjects who never smoked and that prematurely die due to their lifetime exposure to SHS [WHO, 2012]. Italy has been one of the pioneering countries - and the first large country worldwide - to enact a comprehensive smoke-free legislation in 2005. The law, introduced in order to reduce SHS exposure, banned smoking in indoor public places, including restaurants and bars, and in all workplaces [Gallus et al., 2006]. This legislation has had an undisputed success from a public health perspective: it was widely supported and strongly observed, restaurant and bar owners did not experience any dreaded decline in their business, and tobacco smoking (and its detrimental health effects) substantially decreased [Gallus et al., 2006; Gorini et al., 2007]. More importantly, the regulation has been effective in dramatically reducing SHS exposure [Gorini et al., 2007; Martinez-Sanchez et al., 2012]. Most high- income countries followed Italy in the adoption of similar comprehensive smoking ban legislations over the last decade [IARC, 2009]. These regulations and the information campaigns conducted for their enforcement had also the effect to increase the social unacceptability of SHS and consequently the adoption of voluntary home smoking bans [Ferketich et al., 2014; Martinez-Sanchez et al., 2014]. This notwithstanding, in 2010 specific Italian subpopulations were still frequently exposed to SHS, both in public and private places. In particular, 54% of the young (i.e., age 15-24 years) were still exposed to SHS in any settings, 27% in private houses, and 33% in private cars [Martinez-Sanchez et al., 2012]. The relatively high SHS exposure in private cars is of

Students' attitude and smoking behaviour following the implementation of a university smoke-free policy: a cross-sectional study.

PubMed

Chaaya, Monique; Alameddine, Maysam; Nakkash, Rima; Afifi, Rima A; Khalil, Joanna; Nahhas, Georges

2013-01-01

In view of the high-smoking rate among university students in Lebanon and the known adverse effects of second-hand smoking, the American University of Beirut (AUB) decided to implement a non-smoking policy on campus. This study sought to examine the students' compliance and attitudes following the ban. Cross-sectional study. A private university in Lebanon. 545 randomly selected students were approached. A stratified cluster sample of classes offered in the spring semester of the 2008/2009 academic year was selected. Students completed a self-administered paper and pencil survey during class time. The main outcomes were compliance with and attitudes towards the ban. Other secondary outcomes were the perception of barriers to implementation of the ban and attitudes towards tobacco control in general. 535 students participated in the study. Smokers were generally compliant with the ban (72.7%) and for some (20%) it led to a decrease in their smoking. Students' attitude towards the ban and the enforcement of a non-smoking policy in public places across Lebanon varied according to their smoking status whereby non-smokers possessed a more favourable attitude and strongly supported such policies compared with smokers; overall, the largest proportions of students were satisfied to a large extent with the ban and considered it justified (58.6% and 57.2%, respectively). While much smaller percentages reported that the ban would help in reducing smoking to a large extent (16.7%) or it would help smokers quit (7.4%). Perceived barriers to implementation of the non-smoking policy in AUB included the lack of compliance with and strict enforcement of the policy as well as the small number and crowdedness of the smoking areas. An education campaign, smoking cessation services and strict enforcement of the policy might be necessary to boost its effect in further reducing students' cigarette use.

Smoking ban policies in Italy and the potential impact of the so-called Sirchia Law: state of the art after eight years.

PubMed

Gualano, Maria Rosaria; Bert, Fabrizio; Scaioli, Giacomo; Passi, Stefano; La Torre, Giuseppe; Siliquini, Roberta

2014-01-01

The aim of the present work is to describe the state of the art of tobacco habits in Italy, eight years after the law was introduced. Time series analyses, based on estimates of smoking prevalence/consumption derived from the openly available data of national surveys performed during the 2001-2013 period, were performed. Data have been expressed in percentage of smokers and daily cigarettes consumption. Time changes are expressed as expected annual percentage change (EAPC). Over time, the percentage of Italian smokers shows a constant and statistically significant decrease (from 28.9% in 2001 to 20.6% in 2013, EAPC = -2.6%, and P < 0.001). Regarding data stratified by gender, we found a stronger reduction among men (EAPC = -2.9%, P < 0.001) than in women (EAPC = -2.5%, P < 0.001). Similarly, the consumption of tobacco smoking, measured as the number of daily cigarettes smoked, registered a downward trend (P < 0.001). No join point (time point when a significant trend change is detected) resulted from the trend analysis. Data show a constant decrease of tobacco consumption in Italy, with no join point related to the introduction of the banning law. These findings require to reflect on the priorities of the smoking banning policies that may be focused on other intervention activities such as to increase the price of cigarettes.

Smoking Behaviors and Attitudes Among Clients and Staff at New York Addiction Treatment Programs Following a Smoking Ban: Findings After 5 Years.

PubMed

Pagano, Anna; Guydish, Joseph; Le, Thao; Tajima, Barbara; Passalacqua, Emma; Soto-Nevarez, Arturo; Brown, Lawrence S; Delucchi, Kevin L

2016-05-01

Addiction treatment clients are more likely to die of tobacco-related diseases than of alcohol or illicit drug-related causes. We aimed to assess smoking behavior, and smoking-related attitudes and services, in New York addiction treatment programs before a statewide smoking ban in treatment facilities was implemented (2008), 1 year (2009) and 5 years after implementation (2013). We conducted surveys at each time point with clients (N = 329, 341, and 353, respectively) and staff (N = 202, 203, and 166, respectively) from five residential and two methadone maintenance programs in New York State. At each data collection wave, questionnaires measured smoking behavior as well as smoking-related knowledge, attitudes, and experiences with tobacco cessation services as part of addiction treatment. Staff smoking prevalence decreased from 35.2% in 2008 to 21.8% in 2013 (P = .005) while client smoking prevalence over the same period was unchanged (68.1% vs. 66.0%, P = .564). Among clients who smoked, mean cigarettes per day decreased from 13.7 (SD = 8.38) to 10.2 (SD = 4.44; P < .001). There were significant time-by-treatment-type interactions for client tobacco-related attitudes and cessation services received; and for staff self-efficacy and cessation services provided. In residential programs, scores for most items decreased (became less positive) in 2009 followed by a partial rebound in 2013. Methadone program scores tended to rise (become more positive) throughout the study period. Staff and clients may respond differentially to tobacco-free policies depending on type of treatment program, and this finding may help to inform the implementation of tobacco-free policies in other statewide addiction treatment systems. © 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.

Students’ attitude and smoking behaviour following the implementation of a university smoke-free policy: a cross-sectional study

PubMed Central

Chaaya, Monique; Alameddine, Maysam; Nakkash, Rima; Afifi, Rima A; Khalil, Joanna; Nahhas, Georges

2013-01-01

Objective In view of the high-smoking rate among university students in Lebanon and the known adverse effects of second-hand smoking, the American University of Beirut (AUB) decided to implement a non-smoking policy on campus. This study sought to examine the students’ compliance and attitudes following the ban. Design Cross-sectional study. Setting A private university in Lebanon. Participants 545 randomly selected students were approached. A stratified cluster sample of classes offered in the spring semester of the 2008/2009 academic year was selected. Students completed a self-administered paper and pencil survey during class time. Primary and secondary outcome measures The main outcomes were compliance with and attitudes towards the ban. Other secondary outcomes were the perception of barriers to implementation of the ban and attitudes towards tobacco control in general. Results 535 students participated in the study. Smokers were generally compliant with the ban (72.7%) and for some (20%) it led to a decrease in their smoking. Students' attitude towards the ban and the enforcement of a non-smoking policy in public places across Lebanon varied according to their smoking status whereby non-smokers possessed a more favourable attitude and strongly supported such policies compared with smokers; overall, the largest proportions of students were satisfied to a large extent with the ban and considered it justified (58.6% and 57.2%, respectively). While much smaller percentages reported that the ban would help in reducing smoking to a large extent (16.7%) or it would help smokers quit (7.4%). Perceived barriers to implementation of the non-smoking policy in AUB included the lack of compliance with and strict enforcement of the policy as well as the small number and crowdedness of the smoking areas. Conclusions An education campaign, smoking cessation services and strict enforcement of the policy might be necessary to boost its effect in further reducing students

Smoke-Free Legislation in Spain and Prematurity.

PubMed

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 (<37 gestational weeks), small for gestational age (SGA; <10th weight percentile according to Spanish reference tables), and low birth weight (<2500 g). We estimated immediate and gradual rate changes after smoking bans by using overdispersed Poisson models with different linear trends for 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.

Personal space smoking restrictions among African Americans.

PubMed

King, Gary; Mallett, Robyn; Kozlowski, Lynn; Bendel, Robert B; Nahata, Sunny

2005-01-01

This paper investigates the association between implementing a personal space smoking restriction for the home or automobile, and various sociodemographic, social, behavioral, and attitudinal variables. Approximately 1000 African-American adults (aged >18 years) residing in non-institutionalized settings were randomly selected using a cross-sectional stratified cluster sample of ten U.S. congressional districts represented by African Americans. A 62.0% and 70.4% ban was found, respectively, on smoking in homes and cars. Multivariate analysis revealed that region, marital status, number of friends who smoked, beliefs about environmental tobacco smoke (ETS), and smoking status predicted home smoking bans, while age, number of children in household, number of friends who smoked, and beliefs about ETS and smoking status predicted car smoking bans. Results suggest that a substantial segment of African Americans have accepted and translated public policy concerns about ETS into practice and reveal other variables that could be targeted in future interventions to increase implementation of personal space smoking restrictions.

How does electronic cigarette access affect adolescent smoking?

PubMed

Friedman, Abigail S

2015-12-01

Understanding electronic cigarettes' effect on tobacco smoking is a central economic and policy issue. This paper examines the causal impact of e-cigarette access on conventional cigarette use by adolescents. Regression analyses consider how state bans on e-cigarette sales to minors influence smoking rates among 12 to 17 year olds. Such bans yield a statistically significant 0.9 percentage point increase in recent smoking in this age group, relative to states without such bans. Results are robust to multiple specifications as well as several falsification and placebo checks. This effect is both consistent with e-cigarette access reducing smoking among minors, and large: banning electronic cigarette sales to minors counteracts 70 percent of the downward pre-trend in teen cigarette smoking for a given two-year period. Copyright © 2015 Elsevier B.V. All rights reserved.

Smoking ban in public areas is associated with a reduced incidence of hospital admissions due to ST-elevation myocardial infarctions in non-smokers. Results from the Bremen STEMI Registry.

PubMed

Schmucker, J; Wienbergen, H; Seide, S; Fiehn, E; Fach, A; Würmann-Busch, B; Gohlke, H; Günther, K; Ahrens, W; Hambrecht, R

2014-09-01

Laws banning tobacco smoking from public areas have been passed in several countries, including the region of Bremen, Germany at the end of 2007. The present study analyses the incidence of hospital admissions due to ST-elevation myocardial infarctions (STEMIs) before and after such a smoking ban was implemented, focusing on differences between smokers and non-smokers. In this respect, data of the Bremen STEMI Registry (BSR) give a complete epidemiological overview of a region in northwest Germany with approximately 800,000 inhabitants since all STEMIs are admitted to one central heart centre. Between January 2006 and December 2010, data from the BSR was analysed focusing on date of admission, age, gender, and prior nicotine consumption. A total of 3545 patients with STEMI were admitted in the Bremen Heart Centre during this time period. Comparing 2006-2007 vs. 2008-2010, hence before and after the smoking ban, a 16% decrease of the number of STEMIs was observed: from a mean of 65 STEMI/month in 2006-2007 to 55/month in 2008-2010 (p < 0.01). The group of smokers showed a constant number of STEMIs: 25/month in 2006-2007 to 26/month in 2008-2010 (+4%, p = 0.8). However, in non-smokers, a significant reduction of STEMIs over time was found: 39/month in 2006-2007 to 29/month in 2008-2010 (-26%, p < 0.01). The decline of STEMIs in non-smokers was consistently observed in all age groups and both sexes. Adjusting for potentially confounding factors like hypertension, obesity, and diabetes mellitus did not explain the observed decline. In the BSR, a significant decline of hospital admissions due to STEMIs in non-smokers was observed after the smoking ban in public areas came into force. No reduction of STEMI-related admissions was found in smokers. These results may be explained by the protection of non-smokers from passive smoking and the absence of such an effect in smokers by the dominant effect of active smoking. © The Author(s) 2013 Reprints and

Involuntary Smoking in Adolescents, Their Awareness of Its Harmfulness, and Attitudes towards Smoking in the Presence of Non-Smokers

PubMed Central

Kaleta, Dorota; Polanska, Kinga; Wojtysiak, Piotr; Szatko, Franciszek

2017-01-01

The aim of the study was to examine involuntary smoking among young people, their awareness of its harmfulness and the factors associated with attitudes towards smoking in the presence of non-smokers. A cross-sectional study was conducted among 3552 students from a socially disadvantaged rural area in central Poland. Almost 40% of the participants were exposed to involuntary smoking at home and 60% outside of home on a daily or almost daily basis. More than 80% of the students felt that smoking should be banned around children at home, 59% thought it should be banned in vehicles, and 41% in the presence of non-smokers. The majority of the students were aware of the health consequences of active smoking, and 69% understood the threats of passive smoking. Females, never-smokers and current non-smokers, as well as those without smoking parents were more likely to claim that smoking should be banned at home and in vehicles (p < 0.05). Those aware of the fact that smoking was harmful to health, who discussed those issues with their parents and teachers, and who saw school tobacco control policies, were more likely to maintain that passive smoking should be banned (p < 0.05). The study results highlight the need for programs and policies to eliminate involuntary smoking among young people. PMID:28934143

Involuntary Smoking in Adolescents, Their Awareness of Its Harmfulness, and Attitudes towards Smoking in the Presence of Non-Smokers.

PubMed

Kaleta, Dorota; Polanska, Kinga; Wojtysiak, Piotr; Szatko, Franciszek

2017-09-21

The aim of the study was to examine involuntary smoking among young people, their awareness of its harmfulness and the factors associated with attitudes towards smoking in the presence of non-smokers. A cross-sectional study was conducted among 3552 students from a socially disadvantaged rural area in central Poland. Almost 40% of the participants were exposed to involuntary smoking at home and 60% outside of home on a daily or almost daily basis. More than 80% of the students felt that smoking should be banned around children at home, 59% thought it should be banned in vehicles, and 41% in the presence of non-smokers. The majority of the students were aware of the health consequences of active smoking, and 69% understood the threats of passive smoking. Females, never-smokers and current non-smokers, as well as those without smoking parents were more likely to claim that smoking should be banned at home and in vehicles ( p < 0.05). Those aware of the fact that smoking was harmful to health, who discussed those issues with their parents and teachers, and who saw school tobacco control policies, were more likely to maintain that passive smoking should be banned ( p < 0.05). The study results highlight the need for programs and policies to eliminate involuntary smoking among young people.

Clove cigar sales following the US flavoured cigarette ban.

PubMed

Delnevo, Cristine D; Hrywna, Mary

2015-12-01

Following the passage of the Family Smoking Prevention and Tobacco Control Act in 2009, flavoured cigarettes, including clove cigarettes, were banned based on the rationale that such cigarettes appealed to youth. However, the ban on characterising flavours was not extended to cigars. This study reviewed industry documents from Kretek International, the parent company behind Djarum clove cigars, to document the changes in their marketing and production strategies following the flavour ban on cigarettes. To assess sales trends following the ban, data for clove cigar sales in the USA from 2009 to 2012 were analysed using Nielsen's Convenience Track retail scanner database. Additionally, data on tobacco imports to the USA from Indonesia were obtained from the USDA Foreign Agricultural Service's Global Agricultural Trade System for the years 2008-2012. In anticipation of Food and Drug Administration's (FDA) flavour ban on cigarettes and recognising the regulatory advantages of cigars, Kretek International began developing Djarum clove cigars in 2007. Immediately following the flavour ban, sales of this product increased by more than 1400% between 2009 and 2012. During this same period, tobacco imports to the USA from Indonesia, a leader in clove tobacco production, shifted from cigarettes to almost exclusively cigars. Kretek International, like other tobacco manufacturers, manipulated its products following the Family Smoking Prevention and Tobacco Control Act as a way to capitalise on regulatory loopholes and replace its now banned clove cigarettes. As a result, consumption of the company's Djarum clove cigars increased exponentially in recent years. 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 ban on smoking in public places (Decree No. 2006-1386 of 15th November 2006): Impact over 12 months on smoking status of hospital nurses].

PubMed

Maurel-Donnarel, E; Baumstarck-Barrau, K; Barlesi, F; Lehucher-Michel, M-P

2010-03-01

In France, the decree No. 2006-1386 banned smoking in public places such as hospitals. The aim of our study was to describe the impact of the legislation on the smoking status of hospital nurses. A descriptive study was undertaken in a university hospital of Marseilles, under the responsibility of the occupational medicine service. Between April and June 2008, a questionnaire was distributed to the nurses who had been working for more than one year. The following data were collected: demographic information, smoking status, behaviour and attitudes regarding smoking addiction, knowledge regarding existing preventive measures. Sixty-four percent of 715 eligible subjects responded; thirty percents reported themselves as current smokers, 25 % as ex-smokers and 45 % as non-smokers. Among the smokers, 68 % said that they had decreased their tobacco consumption during their working hours and 28 % their overall daily consumption. Among ex-smokers, 20 % declared that they were in the process of quitting. The nurses had decreased their tobacco consumption at work and these positive results should be confirmed over a long-term perspective. The preventive role of the occupational physician could be reinforced. Copyright 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Education and indoor smoking among parents who smoke: the mediating role of perceived social norms of smoking.

PubMed

Saito, Junko; Shibanuma, Akira; Yasuoka, Junko; Kondo, Naoki; Takagi, Daisuke; Jimba, Masamine

2018-02-02

Parents with less formal education are more likely to smoke indoors, causing socioeconomic disparity in children's exposure to second-hand smoke. However, little is known about the roles of social factors in the socioeconomic gradients of indoor smoking. We tested the potential mediating role of perceived smoking norms on the associations between education and indoor smoking among parents who smoke. In this cross-sectional study, 822 smoking fathers and 823 smoking mothers, who lived with young children and were members of a Japanese online survey panel, participated. Structural equation modelling tested the mediating effects of perceived descriptive and subjective norms on the association between education and indoor smoking. Perceived pro-smoking norms, which were more prevalent among less-educated parents, mediated the association between education and indoor smoking. Household smoking status and worksite smoking ban also mediated this association via perceived norms, but only for fathers. Perceived descriptive norms explained 28.5% of the association for fathers and 37.6% for mothers; the corresponding percentages for perceived subjective norms were 9.8% and 26.6%, respectively. Perceived smoking norms, household smoking status, and a worksite smoking ban could be vital targets of a strategy aimed at reducing the socioeconomic disparity in parental home smoking behaviours.

Developing a smoke free household initiative: an Indonesian case study.

PubMed

Nichter, Mimi; Nichter, Mark; Padmawati, Retna Siwi; Ng, Nawi

2010-01-01

Little research has focused on women's exposure to secondhand smoke (SHS) in LMICs, local perceptions of SHS risk to women and children, and women's attempts to limit exposure to tobacco smoke in their households. This paper describes a community based survey in Indonesia that investigated these issues as one step in a movement to initiate community wide household smoking bans. The survey found high levels of exposure to SHS, high levels of awareness among both women and men that SHS placed women and children at risk for illness, a very low percentage of households having indoor smoking rules, great interest on the part of women to participate in a communitywide ban, and a promising level of male smoker agreement to comply with such a ban. Women expressed a low sense of self efficacy in individually getting their husbands to quit smoking in their homes, but a strong sense of collective efficacy that husbands might agree to a well-publicized and agreed-upon community household smoking ban. Men and women expressed concern about the social risk of asking guests not to smoke in their homes without a communitywide ban and visible displays communicating their participation in this movement. The smoke free initiative described requires the participation of doctors in community education programs, and is attempting to introduce household smoking bans as a way of turning tobacco control into a family health and not just a smokers' health issue.

Where there's smoking, there's fire: the effects of smoking policies on the incidence of fires in the USA.

PubMed

Markowitz, Sara

2014-11-01

Fires and burns are among the leading causes of unintentional death in the USA. Most of these deaths occur in residences, and cigarettes are a primary cause. In this paper, I explore the relationship between smoking, cigarette policies, and fires. As smoking rates decline, there are fewer opportunities for fires; however, the magnitude of any reduction is in question. Using a state-level panel, I find that increases in cigarette prices are associated with fewer residential fires and deaths. However, laws regulating indoor smoking are associated with more fires; in particular, restaurant and bar smoking bans are associated with an increase in fires at eating and drinking establishments. This increase is important given the growing popularity of smoking bans in the USA and around the world. As workplaces, schools, and businesses ban smoking and remove ashtrays, smokers who continue to smoke are left without safe options for disposal of cigarettes, leading to more opportunities for fires to start. Copyright © 2013 John Wiley & Sons, Ltd.

Location restrictions on smoking: assessing their differential impacts and consequences in the workplace.

PubMed

Bell, Kirsten; McCullough, Lucy; Devries, Karen; Jategaonkar, Natasha; Greaves, Lorraine; Richardson, Lindsay

2009-01-01

To analyze existing evidence on the impact of two types of location restrictions on smoking: workplace bans and bans in hospitality settings, and to assess the extent to which they differentially affect subpopulations. A review of international studies on location restrictions on smoking published between 1990-2007. Although workplace smoking bans reduce exposure to second-hand smoke (SHS) at work, their effects on overall cigarette consumption and smoking prevalence may be uneven across the population. Bans in hospitality settings reduce SHS exposure among workers, but have potentially uneven effects based on the interactions between gender, socio-economic status (SES) and ethnicity. The unintended consequences of smoking bans are also more likely to be experienced by low SES groups. Although location restrictions on smoking reduce SHS exposure and may serve to positively impact smoking behaviours, there is preliminary evidence that they may have a reduced impact on subpopulations such as low-income groups, although further research is needed.

Prevalence and predictors of smoking in “smoke-free” bars. Findings from the International Tobacco Control (ITC) Europe Surveys

PubMed Central

Nagelhout, Gera E.; Mons, Ute; Allwright, Shane; Guignard, Romain; Beck, Francois; Fong, Geoffrey T.; de Vries, Hein; Willemsen, Marc C.

2015-01-01

National level smoke-free legislation is implemented to protect the public from exposure to second-hand tobacco smoke (SHS). The first aim of this study was to investigate how successful the smoke-free hospitality industry legislation in Ireland (March 2004), France (January 2008), the Netherlands (July 2008), and Germany (between August 2007 and July 2008) was in reducing smoking in bars. The second aim was to assess individual smokers’ predictors of smoking in bars post-ban. The third aim was to examine country differences in predictors and the fourth aim to examine differences between educational levels (as an indicator of socioeconomic status). This study used nationally representative samples of 3,147 adult smokers from the International Tobacco Control (ITC) Europe Surveys who were surveyed pre- and post-ban. The results reveal that while the partial smoke-free legislation in the Netherlands and Germany was effective in reducing smoking in bars (from 88% to 34% and from 87% to 44% respectively), the effectiveness was much lower than the comprehensive legislation in Ireland and France which almost completely eliminated smoking in bars (from 97% to 3% and from 84% to 3% respectively). Smokers who were more supportive of the ban, were more aware of the harm of SHS, and who had negative opinions of smoking were less likely to smoke in bars post-ban. Support for the ban was a stronger predictor in Germany. SHS harm awareness was a stronger predictor among less educated smokers in the Netherlands and Germany. The results indicate the need for strong comprehensive smoke-free legislation without exceptions. This should be accompanied by educational campaigns in which the public health rationale for the legislation is clearly explained. PMID:21497973

Impact of the Spanish Smoking Law on Exposure to Second-Hand Smoke and Respiratory Health in Hospitality Workers: A Cohort Study

PubMed Central

Fernández, Esteve; Fu, Marcela; Pascual, José A.; López, María J.; Pérez-Ríos, Mónica; Schiaffino, Anna; Martínez-Sánchez, Jose M.; Ariza, Carles; Saltó, Esteve; Nebot, Manel

2009-01-01

Background A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban. Methods and Finding We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, p<0.01). Cotinine concentration decreased by 27.6% (p = 0.068) among workers in venues with designated smoking areas, and by 10.7% (p = 0.475) among workers in venues where smoking was allowed. In Portugal and Andorra, no differences between cotinine concentration were found before (1.2 ng/ml) and after the ban (1.2 ng/ml). In Spain, reported respiratory symptom declined significantly (by 71.9%; p<0.05) among workers in venues that became smoke-free. After adjustment for potential confounders, salivary cotinine and respiratory symptoms decreased significantly among workers in Spanish hospitality venues where smoking was totally banned. Conclusions Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its

Impact of the Spanish smoking law on exposure to second-hand smoke and respiratory health in hospitality workers: a cohort study.

PubMed

Fernández, Esteve; Fu, Marcela; Pascual, José A; López, María J; Pérez-Ríos, Mónica; Schiaffino, Anna; Martínez-Sánchez, Jose M; Ariza, Carles; Saltó, Esteve; Nebot, Manel

2009-01-01

A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban. We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, p<0.01). Cotinine concentration decreased by 27.6% (p = 0.068) among workers in venues with designated smoking areas, and by 10.7% (p = 0.475) among workers in venues where smoking was allowed. In Portugal and Andorra, no differences between cotinine concentration were found before (1.2 ng/ml) and after the ban (1.2 ng/ml). In Spain, reported respiratory symptom declined significantly (by 71.9%; p<0.05) among workers in venues that became smoke-free. After adjustment for potential confounders, salivary cotinine and respiratory symptoms decreased significantly among workers in Spanish hospitality venues where smoking was totally banned. Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its consequences for respiratory health.

Clearing the airways: advocacy and regulation for smoke-free airlines

PubMed Central

Holm, A; Davis, R

2004-01-01

Objective: To examine the advocacy and regulatory history surrounding bans on smoking in commercial airliners. Methods: Review of historical documents, popular press articles, and other sources to trace the timeline of events leading up to the US ban on smoking in airliners and subsequent efforts by airlines and other nations. Results: In early years, efforts by flight attendants and health advocates to make commercial airliners smoke-free were not productive. Advocacy efforts between 1969 and 1984 resulted in maintenance of the status quo, with modest exceptions (creation of smoking and non-smoking sections of aircraft, and a ban on cigar and pipe smoking). Several breakthrough events in the mid 1980s, however, led to an abrupt turnaround in regulatory efforts. The first watershed event was the publication in 1986 of the National Academy of Science's report on the airliner cabin environment, which recommended banning smoking on all commercial flights. Subsequently, following concerted lobbying efforts by health advocates, Congress passed legislation banning smoking on US domestic flights of less than two hours, which became effective in 1988. The law was made permanent and extended to flights of less than six hours in 1990. This landmark legislation propelled the adoption of similar rules internationally, both by airlines and their industry's governing bodies. Though the tobacco industry succeeded in stalling efforts to create smoke-free airways, it was ultimately unable to muster sufficient grassroots support or scientific evidence to convince the general public or policymakers that smoking should continue to be allowed on airlines. Conclusions: The movement to ban smoking in aircraft represents a case study in effective advocacy for smoke-free workplaces. Health advocates, with crucial assistance from flight attendants, used an incremental advocacy process to push for smoking and non-smoking sections on US commercial flights, then for smoking bans on short

Clearing the airways: advocacy and regulation for smoke-free airlines.

PubMed

Holm, A L; Davis, R M

2004-03-01

To examine the advocacy and regulatory history surrounding bans on smoking in commercial airliners. Review of historical documents, popular press articles, and other sources to trace the timeline of events leading up to the US ban on smoking in airliners and subsequent efforts by airlines and other nations. In early years, efforts by flight attendants and health advocates to make commercial airliners smoke-free were not productive. Advocacy efforts between 1969 and 1984 resulted in maintenance of the status quo, with modest exceptions (creation of smoking and non-smoking sections of aircraft, and a ban on cigar and pipe smoking). Several breakthrough events in the mid 1980s, however, led to an abrupt turnaround in regulatory efforts. The first watershed event was the publication in 1986 of the National Academy of Science's report on the airliner cabin environment, which recommended banning smoking on all commercial flights. Subsequently, following concerted lobbying efforts by health advocates, Congress passed legislation banning smoking on US domestic flights of less than two hours, which became effective in 1988. The law was made permanent and extended to flights of less than six hours in 1990. This landmark legislation propelled the adoption of similar rules internationally, both by airlines and their industry's governing bodies. Though the tobacco industry succeeded in stalling efforts to create smoke-free airways, it was ultimately unable to muster sufficient grassroots support or scientific evidence to convince the general public or policymakers that smoking should continue to be allowed on airlines. The movement to ban smoking in aircraft represents a case study in effective advocacy for smoke-free workplaces. Health advocates, with crucial assistance from flight attendants, used an incremental advocacy process to push for smoking and non-smoking sections on US commercial flights, then for smoking bans on short domestic flights, and finally for completely

The Control of Environmental Tobacco Smoke: A Policy Review

PubMed Central

McNabola, Aonghus; Gill, Laurence William

2009-01-01

According to World Health Organisation figures, 30% of all cancer deaths, 20% of all coronary heart diseases and strokes and 80% of all chronic obstructive pulmonary disease are caused by cigarette smoking. Environmental Tobacco Smoke (ETS) exposure has also been shown to be associated with disease and premature death in non-smokers. In response to this environmental health issue, several countries have brought about a smoking ban policy in public places and in the workplace. Countries such as the U.S., France, Italy, Ireland, Malta, the Netherlands, Sweden, Scotland, Spain, and England have all introduced policies aimed at reducing the population exposure to ETS. Several investigations have monitored the effectiveness of these smoking ban policies in terms of ETS concentrations, human health and smoking prevalence, while others have also investigated a number of alternatives to smoking ban policy measures. This paper reviews the state of the art in research, carried out in the field of ETS, smoking bans and Tobacco Control to date and highlights the need for future research in the area. PMID:19440413

Creating Healthful Environments in Schools through a Total Ban on Tobacco Use.

ERIC Educational Resources Information Center

Barta, Kathleen; Totten, Samuel

1995-01-01

Health and medical researchers have conclusively proven that smoking and secondhand smoke constitute a major health danger. Students get mixed messages when school staff smoke or use other tobacco products on campus. This article advocates a total ban on tobacco use in school settings, offers policymaking guidelines, summarizes state legislation,…

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

PubMed

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.