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1.
PLoS One ; 17(5): e0267319, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35511766

RESUMO

BACKGROUND: Serum cotinine has become the most widely used biomarker of secondhand smoke exposure (SHS) over time in all ages. The aim of this study was to review the serum cotinine cut-points used to classify children under 5 years as exposed to SHS. METHODS: A systematic review performed in the Pubmed (MEDLINE) and EMBASE databases up to April 2021 was conducted using as key words "serum cotinine", "tobacco smoke pollution" (MeSH), "secondhand smoke", "environmental tobacco smoke" and "tobacco smoke exposure". Papers which assessed SHS exposure among children younger than 5 years old were included. The PRISMA 2020 guidelines were followed. Analysis was pre-registered in PROSPERO (registration number: CRD42021251263). RESULTS: 247 articles were identified and 51 fulfilled inclusion criteria. The selected studies were published between 1985-2020. Most of them included adolescents and adults. Only three assessed postnatal exposure exclusively among children under 5 years. None of the selected studies proposed age-specific cut-points for children < 5 years old. Cut-point values to assess SHS exposure ranged from 0.015 to 100 ng/ml. The most commonly used cut-point was 0.05 ng/ml, derived from the assay limit of detection used by the National Health and Nutrition Examination Survey (NHANES). CONCLUSIONS: No studies have calculated serum cotinine age-specific cut-points to ascertained SHS exposure among children under 5 years old. Children's age-specific cut-points are warranted for health research and public health purposes aimed at accurately estimating the prevalence of SHS exposure and attributable burden of disease to such exposure, and at reinforcing 100% smoke-free policies worldwide, both in homes, private vehicles and public places.


Assuntos
Política Antifumo , Poluição por Fumaça de Tabaco , Adolescente , Adulto , Criança , Pré-Escolar , Cotinina , Exposição Ambiental/análise , Humanos , Inquéritos Nutricionais , Prevalência
2.
Artigo em Inglês | MEDLINE | ID: mdl-35409538

RESUMO

Secondhand smoke (SHS) exposure causes chronic illness and occurs at a higher prevalence in low-income communities than the general public. In 2018, the U.S. Department of Housing and Urban Development (HUD) instituted a smoke-free housing rule for Public Housing Authorities (PHAs) to address persistent health inequities. However, the success of smoke-free housing requires evidence to inform effective implementation approaches. A mixed-methods, cross-sectional survey was conducted in a national sample of PHAs. Questions focused on housing officials' use of specific implementation strategies. Adjusted odds ratios were used to assess associations between implementation approaches and variations among PHAs (i.e., region, size, or recency of policy adoption). Qualitative analyses were conducted to assess the perceived effectiveness of implementation strategies. Resident engagement, staff training, and smoking cessation support were the most frequently used implementation strategies. Engagement with local stakeholders was cited less frequently. Enforcement actions were limited with no violations referred to housing court. Support for policy adherence was identified as a sixth implementation strategy. While most PHAs used at least some evidence-informed implementation strategies, a lack of a systematic approach may limit overall effectiveness. Further research is required to resolve implementation barriers experienced disproportionately by a subset of PHAs, and to inform a best practice implementation framework that meets the needs of a heterogeneous population.


Assuntos
Política Antifumo , Abandono do Hábito de Fumar , Poluição por Fumaça de Tabaco , Estudos Transversais , Habitação , Humanos , Habitação Popular , Poluição por Fumaça de Tabaco/análise
3.
Artigo em Inglês | MEDLINE | ID: mdl-35409615

RESUMO

In this paper, we examine efforts by health organizations seeking comprehensive smokefree ordinances over Louisiana casinos and bars between 2010 and 2020 to determine best practices for increasing coverage. Bars and casinos remain less protected from secondhand smoke compared to other workplaces in the United States. Casino behavior is compared to the Policy Dystopia Model (PDM), a tobacco industry strategy framework. We performed a historical case study using snowball searches for news on the Access World News Database and the internet. We performed web searches using the names of key actors, organizations, and locations and interviewed nine participants. Starting in 2010, the Louisiana Campaign for Tobacco-Free Living ran ordinance campaigns supplemented by an ongoing statewide smokefree media initiative. Utilizing consistent strategies, including promoting performers as cultural emblems deserving protection, health organizations coalesced in New Orleans during 2014 and Baton Rouge in 2016 and 2017 to pursue ordinances. The coalitions secured ordinances in Louisiana's population and tourism centers despite business resistance. Organizations obtained 30 smokefree laws across Louisiana by 2021. Casinos used PDM strategies to resist ordinances, indicating the framework may predict strategies by non-tobacco entities resisting tobacco control. Louisiana shows that ongoing local campaigns, social justice themes and cultural messaging with coalitions in cities can secure smokefree laws covering casinos and bars and that local ordinance campaigns are a viable method for advancing smokefree protections over those venues in states where the state legislatures are resistant to action.


Assuntos
Política Antifumo , Indústria do Tabaco , Produtos do Tabaco , Poluição por Fumaça de Tabaco , Humanos , Louisiana , Restaurantes , Tabaco , Poluição por Fumaça de Tabaco/prevenção & controle , Estados Unidos
4.
Inquiry ; 59: 469580221092814, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35403482

RESUMO

BACKGROUND: Individuals from low-income groups report disproportionate rates of cigarette use, secondhand smoke (SHS) exposure with increased morbidity and mortality. Smoking bans in public housing have been enacted in attempt to reduce tobacco use and SHS exposure among lower income individuals. This study investigated the support needs of tobacco users living in two public housing complexes in Detroit, Michigan (USA), including their perspectives on smoking, resources and barriers for smoking cessation, and the impact of policy changes. METHODS: This is a mixed-methods study, using a qualitative focus groups approach and a short survey, public housing residents interview data was analyzed to explore themes related to smoking-related issues. Specifically, six themes were assessed across four focus groups: (1) Quitting Smoking, (2) Current Smoking Cessation Resources, (3) Legal Mandates, (4) Education and Perceptions of Smoking, (5) Community Needs and Barriers, and (6) Medical Experiences. RESULTS: There were 59 participants; the majority (39/42, 93%) of smokers reported at least one quit attempt. During the focus groups, several participants indicated a desire to quit smoking but reported barriers to smoking cessation, such as lack of access to medications, social triggers to continue smoking, and socioeconomic stressors. A number of suggestions were provided to improve smoking cessation resources, including support groups, graphic images of smoking-related diseased tissue, and better communication with health care providers. CONCLUSIONS: These findings demonstrate smoking bans in two public housing complexes can be effective yet are dependent upon a complex set of issues, including numerous barriers to care.


Assuntos
Política Antifumo , Abandono do Hábito de Fumar , Grupos Focais , Humanos , Habitação Popular , Fumar/epidemiologia , Abandono do Hábito de Fumar/métodos
5.
Front Public Health ; 10: 853862, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35400041

RESUMO

Background: Risk factor controls, including smoking cessation and prevention, impact health costs. This study aimed to describe the Kaltim Prima Coal (KPC), one of Indonesia's largest coal mining operations, comprehensive tobacco control policy program in 2015 and its impact on smoking behavior among the employees. Method: A survey among 404 employees was conducted to assess the impact of the smoke-free KPC programs. In addition to the descriptive analysis, logistic regression was used to measure the association of intention to the smoking behavior change and the association between intention and the determinants using the Theory of Planned Behavior in 102 smokers. Results: A series of tobacco control programs: advocacy, health education, brief interventions for smoking cessation, peer counselor training, media campaigns, and policy regulations were implemented. About 95.5% of the respondents attended the KPC Smoke-Free 2015 programs, and 97.8% reported they already knew that KPC is a total smoke-free area. Nearly 50% of the respondents expressed that the staff complied with the rules and no longer smoked in KPC. Majority of smokers (76.6%) reduced their consumption, and 5.6% of them quit smoking. Among smokers, we found that attitude toward smoking cessation, subjective norm, and perceived control for quitting were related to the intention to stop smoking. Conclusions: The KPC smoke-free policy has been comprehensively implemented. Regulations on smoking and tobacco controls should be maintained, and monitoring should be consistently done. Media campaigns on the regulations and the availability of trained peer educators for smoking cessation help need to be applied continuously.


Assuntos
Política Antifumo , Abandono do Hábito de Fumar , Humanos , Indonésia , Prevenção do Hábito de Fumar , Tabaco
6.
Prev Med ; 157: 107006, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35240141

RESUMO

Little is known about exposure to secondhand cannabis smoke (SHCS) among residents of detached single-family homes and multiunit housing (MUH). Using data from the 2019 International Cannabis Policy Study, the prevalence of (a) self-reported exposure to SHCS at home (n = 33,024) and (b) self-reported SHCS incursions into MUH (defined as SHCS from another unit/the outdoors, n = 15,634) was estimated in (1) Canada; (2) US states where non-medical cannabis use was legal, and (3) US states where it remained illegal. Factors associated with exposures and incursions were assessed using weighted logistic regression. Overall, 16.9% of residents in Canada, 20.6% in US legal states, and 15.5% in US illegal states reported exposure to SHCS in their homes at least once in the previous month. One quarter (25.7%) of Canadian MUH residents, 26.6% from US legal states, and 20.1% from US illegal states reported at least monthly incursions. Sociodemographic factors associated with incursions suggested MUH residents reporting incursions lived in qualitatively different MUH than those not reporting incursions. Irrespective of the legality of non-medical cannabis use, smoke-free policies in MUH should protect residents from involuntary exposure to all types of secondhand smoke.


Assuntos
Cannabis , Política Antifumo , Poluição por Fumaça de Tabaco , Canadá/epidemiologia , Habitação , Humanos , Prevalência , Autorrelato , Estados Unidos/epidemiologia
7.
PLoS One ; 17(3): e0264895, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35263360

RESUMO

BACKGROUND: Smoke-free legislation banning tobacco smoking in public places was implemented across Nepal in 2014 with the ambition to reduce the impact of second-hand smoking. As part of a comprehensive policy package on tobacco control, the implementation of the legislation has seen a marked reduction in tobacco consumption. Yet there remains uncertainty about the level of compliance with smoke-free public places. OBJECTIVES: This study assesses the compliance with smoke-free laws in public places and the factors associated with active smoking in public places in Biratnagar Metropolitan City, Nepal. METHODS: A cross-sectional study was conducted in the Biratnagar metropolitan city in Province 1 of Nepal from July to December 2019. A total of 725 public places within the metropolitan city were surveyed using a structured survey tool. Active smoking was the primary outcome of the study which was defined as smoking by any person during the data collection time at the designated public place. RESULTS: The overall compliance with smoke-free legislation was 56.4%. The highest compliance (75.0%) was observed in Government office buildings. The lowest compliance was observed in eateries, entertainment, and shopping venues (26.3%). There was a statistically significant association between active smoking and the presence of 'no smoking' notices appended at the entrance and the odds of active smoking in eateries, entertainment, hospitality, shopping venues, transportations and transits was higher compared to education and health care institutions. None of the 'no smoking' notices displayed fully adhered to the contents as prescribed by the law. CONCLUSION: As more than half of the public places complied with the requirements of the legislation, there was satisfactory overall compliance with the smoke-free public places law in this study. The public venues (eateries, shopping venues and transportations) that are more frequently visited and have a high turnover of the public have lower compliance with the legislation. The content of the message in the 'no smoking' notices needs close attention to adhere to the legal requirements.


Assuntos
Política Antifumo , Produtos do Tabaco , Poluição por Fumaça de Tabaco , Estudos Transversais , Humanos , Nepal , Restaurantes , Inquéritos e Questionários , Poluição por Fumaça de Tabaco/prevenção & controle
8.
Artigo em Inglês | MEDLINE | ID: mdl-35329199

RESUMO

This study assessed changes in smoking behavior and secondhand smoke (SHS) exposure after implementation of the U.S. Department of Housing and Urban Development (HUD) rule prohibiting the use of cigarettes, cigars, pipes, and waterpipes in all federally subsidized public housing, including within residential units (apartments). Using quantitative data from a repeated cross-sectional mail survey of New York State residents of five public housing authorities (N = 761 at Wave 1, N = 649 at Wave 2), we found evidence of policy compliance (99% decrease in odds of self-reported smoking in units, OR = 0.01, p < 0.01, CI: 0.00-0.16), reduced SHS incursions (77% decrease in odds of smelling smoke within developments, OR = 0.23, p < 0.01, CI: 0.13-0.44), and lower reported smoking rates in July 2018 (9.5%, down from 16.8%), 10 months after implementation of the rule. Despite evident success, one-fifth of residents reported smelling smoke inside their apartment at least a few times per week. This study provides insights into how the policy was implemented in selected New York public housing authorities, offers evidence of policy-intended effects, and highlights challenges to consistent and impactful policy implementation.


Assuntos
Política Antifumo , Poluição por Fumaça de Tabaco , Estudos Transversais , Habitação , Humanos , New York/epidemiologia , Habitação Popular , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/análise
9.
Tob Control ; 31(2): 164-168, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35241583

RESUMO

BACKGROUND: The paper focuses on the geographical region of Oceania. We highlight the tobacco control leadership demonstrated in this region and describe the challenges and opportunities to achieving country-specific smoke-free goals. RESULTS: Significant achievements include smoke-free nation goals, world-leading initiatives such as plain packaging, and a bold plan by New Zealand to reduce the retail availability of smoked tobacco products and remove virtually all the nicotine from cigarettes and rolling tobacco. There are significant challenges and opportunities before reaching smoke-free status including implementation pathways requiring strong governance and leadership and compliance monitoring and enforcement. CONCLUSIONS: We conclude that achieving a smoke-free Oceania is possible through already existing bold country and regional smoke-free goals, excellent tobacco control leadership, experience and resources, and an understanding of how to work collectively. However, a commitment to focus tobacco control efforts regionally is required to achieve a smoke-free Oceania together.


Assuntos
Política Antifumo , Indústria do Tabaco , Produtos do Tabaco , Poluição por Fumaça de Tabaco , Humanos , Nicotina , Tabaco
10.
Tob Control ; 31(2): 250-256, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35241597

RESUMO

Adoption of smoke-free measures has been one of the central elements of tobacco control activity over the past 30 years. The past decade has seen an increasing number of countries and proportion of the global population covered by smoke-free policies to some extent. Despite reductions in global smoking prevalence, population growth means that the number of non-smokers exposed to the harms caused by secondhand smoke remains high. Smoke-free policy measures have been shown to be useful in protecting non-smokers from secondhand smoke, and can additionally increase cessation and reduce smoking initiation. Policies tend to be aimed primarily at enclosed public or workplace settings with very few countries attempting to control exposure in private or semiprivate spaces such as homes and cars, and, as a result, children may be benefiting less from smoke-free measures than adults. Compliance with legislation also varies by country and there is a need for education and empowerment together with guidance and changing social norms to help deliver the full benefits that smoke-free spaces can bring. Restrictions and policies on use of electronic cigarettes (e-cigarettes) in smoke-free settings require more research to determine the benefits and implications of bystanders' exposure to secondhand e-cigarette aerosol, dual use and smoking cessation.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Política Antifumo , Produtos do Tabaco , Poluição por Fumaça de Tabaco , Adulto , Criança , Humanos , não Fumantes , Poluição por Fumaça de Tabaco/análise , Poluição por Fumaça de Tabaco/prevenção & controle
11.
Eur J Health Law ; 29(2): 261-274, 2022 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-35303720

RESUMO

The Framework Convention for Tobacco Control (FCTC) is undoubtedly the most efficient international instrument for tobacco control. Article 8 FCTC shapes many smoke-free policies worldwide and in doing so it is usually associated with smoke-free regulation in enclosed public spaces. Our paper highlights that the FCTC contains a sound foundation for smoke-free policies that stretch beyond enclosed public places, such as open public spaces and (quasi-)private spaces. We demonstrate, in particular, that such wide smoke-free regulation, which is gaining momentum around the globe, is versatile and compatible with human rights standards. As such, these expanded smoke-free policies contribute to a wider culture of smoking denormalisation that scales up FCTC's aspiration for tobacco control and subsequently to a smoke-free global society.


Assuntos
Política Antifumo , Indústria do Tabaco , Produtos do Tabaco , Humanos , Cooperação Internacional , Prevenção do Hábito de Fumar , Tabaco , Organização Mundial da Saúde
12.
BMC Public Health ; 22(1): 537, 2022 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-35303831

RESUMO

BACKGROUND: Increasing the proportion of adults living in smoke-free homes is a US Healthy People 2020 objective. Complete home smoking bans are associated with higher odds of smoking cessation attempts and cessation duration. Sexual minority adults have disproportionality higher rates of smoking. This study investigates correlates of having a complete home smoking ban among sexual minority adults in California. METHODS: Secondary data analyses of the California Behavioral Risk Factor Surveillance System (CA BRFSS), 2014-2016. The CA BRFSS telephone survey of adults was conducted in English and Spanish and used random digit dial for landline and cell numbers. Weighted descriptives were stratified by sexual orientation and biological sex. Weighted bivariate and multivariable logistic regression analyses included only sexual minorities (i.e., lesbian, gay, bisexual) and were analyzed as a group and separately by biological sex to account for intragroup variances. The final weighted total of sexual minority adults (N = 359,236) included sexual minority adult females (N = 163,490) and sexual minority adult males (N = 195,746). RESULTS: Sexual minority adults in California had a lower prevalence of complete home smoking bans (Female 76.2%; Male 75.7%), higher prevalence of current cigarette smoking (Female 23.3%; Male 17.4%) and of e-cigarette use (Female 5.8%; Male 6.4%) than their straight counterparts. Sexual minorities that smoke everyday (Female Adjusted Odds Ratio (AOR) 0.26, 95% Confidence Interval (CI) 0.11-0.63; Male AOR 0.24, 95% CI 0.01-0.56) or some days (Female AOR 0.28, 95% CI 0.09-0.90) had lower adjusted odds of having a complete home smoking ban compared to those who never smoked. CONCLUSIONS: Smoking everyday was the only consistent predictor of not having a complete home smoking ban among sexual minority adults. Focused efforts to increase prevalence of complete home smoking bans should address smoking status to improve health equity among sexual minority adults.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Equidade em Saúde , Homossexualidade Feminina , Minorias Sexuais e de Gênero , Política Antifumo , Adulto , Feminino , Humanos , Masculino
13.
Artigo em Inglês | MEDLINE | ID: mdl-35270744

RESUMO

The tobacco industry's efforts to undermine clean indoor air policies in the hospitality industry, public spaces and workspaces is well documented, but less is known about their efforts to respond to the implementation of smoke-free policies in multi-unit housing (MUH). From 1988 to 2018, public and private multi-unit housing properties voluntarily implemented smoke-free polices in their buildings. We searched the UCSF's Truth Tobacco Industry Documents Library to examine whether the tobacco industry responded to the implementation of these smoke-free policies in MUH using the same strategies they deployed to respond to smoke-free policies in other industries. We found that the tobacco industry used two primary strategies to respond to smoke-free policies in multi-unit housing: (1) distortion, which included funding studies that downplayed the link between SHS and asthma among low-income, inner-city MUH residents; and (2) deflection, which included engaging in corporate responsibility for youth living in low-income MUH. Despite these efforts, local jurisdictions continued to voluntarily implement smoke-free policies in MUH, pointing to a potential counter strategy to the tobacco industry influence.


Assuntos
Política Antifumo , Indústria do Tabaco , Poluição por Fumaça de Tabaco , Adolescente , Habitação , Humanos , Pobreza , Poluição por Fumaça de Tabaco/prevenção & controle
14.
BMJ Open ; 12(3): e056891, 2022 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-35304398

RESUMO

OBJECTIVES: Promoting smoke-free policies is a key intervention for reducing secondhand smoke (SHS) exposure. During the COVID-19 pandemic in Japan, many indoor smoking spaces in workplaces were closed. This study aimed to reveal the association between a workplace smoke-free policy and SHS exposure among non-smoking employees, distinguishing between SHS exposure from cigarettes and exposure to secondhand heated tobacco product (HTP) aerosol, which have recently become popular in Japan. DESIGN AND SETTING: We used data from the Japan COVID-19 and Society Internet Survey conducted in August-September 2020. PARTICIPANTS: Among the 25 482 eligible respondents, 8196 non-smoking employees were analysed. PRIMARY OUTCOME MEASURE: Multivariable logistic regression models were used to examine the impact of smoke-free policies in the workplace. RESULTS: Compared with complete smoking bans, the ORs and 95% CIs for workplace SHS exposure at least once a week from cigarettes were 2.06 (95% CI: 1.60 to 2.65) for partial bans with no longer available smoking spaces, 1.92 (95% CI: 1.63 to 2.25) for partial smoking bans with still available smoking spaces and 5.33 (95% CI: 4.10 to 6.93) for no smoking bans. The corresponding ORs and 95% CIs for exposure to secondhand HTP aerosol were 4.15 (95% CI: 3.22 to 5.34), 2.24 (95% CI: 1.86 to 2.71) and 3.88 (95% CI: 2.86 to 5.26), respectively. CONCLUSIONS: The effect of partial bans was limited, and temporary closure of smoking spaces might contribute to increased exposure to secondhand HTP aerosol. Complete smoking bans in the workplace were reaffirmed to be the best way to reduce SHS exposure from cigarettes and exposure to secondhand HTP aerosol.


Assuntos
COVID-19 , Política Antifumo , Produtos do Tabaco , Poluição por Fumaça de Tabaco , Aerossóis , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Japão/epidemiologia , Pandemias/prevenção & controle , Poluição por Fumaça de Tabaco/prevenção & controle , Local de Trabalho
15.
BMJ Open ; 12(2): e055396, 2022 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-35131832

RESUMO

OBJECTIVES: Given high prevalence of smoking and secondhand smoke exposure in Armenia and Georgia and quicker implementation of tobacco legislation in Georgia versus Armenia, we examined correlates of having no/partial versus complete smoke-free home (SFH) restrictions across countries, particularly smoking characteristics, risk perceptions, social influences and public smoking restrictions. DESIGN: Cross-sectional survey study design. SETTING: 28 communities in Armenia and Georgia surveyed in 2018. PARTICIPANTS: 1456 adults ages 18-64 in Armenia (n=705) and Georgia (n=751). MEASUREMENTS: We used binary logistic regression to examine aforementioned correlates of no/partial versus complete SFH among non-smokers and smokers in Armenia and Georgia, respectively. RESULTS: Participants were an average age of 43.35, 60.5% women and 27.3% smokers. In Armenia, among non-smokers, having no/partial SFHs correlated with being men (OR=2.63, p=0.001) and having more friend smokers (OR=1.23, p=0.002); among smokers, having no/partial SFHs correlated with being unmarried (OR=10.00, p=0.001), lower quitting importance (OR=0.82, p=0.010) and less favourable smoking attitudes among friends/family/public (OR=0.48, p=0.034). In Georgia, among non-smokers, having no/partial SFHs correlated with older age (OR=1.04, p=0.002), being men (OR=5.56, p<0.001), lower SHS risk perception (OR=0.43, p<0.001), more friend smokers (OR=1.49, p=0.002) and fewer workplace (indoor) restrictions (OR=0.51, p=0.026); among smokers, having no/partial SFHs correlated with being men (OR=50.00, p<0.001), without children (OR=5.88, p<0.001), daily smoking (OR=4.30, p=0.050), lower quitting confidence (OR=0.81, p=0.004), more friend smokers (OR=1.62, p=0.038) and fewer community restrictions (OR=0.68, p=0.026). CONCLUSIONS: Private settings continue to lack smoking restrictions in Armenia and Georgia. Findings highlight the importance of social influences and comprehensive tobacco legislation, particularly smoke-free policies, in changing household smoking restrictions and behaviours. TRIAL REGISTRATION NUMBER: NCT03447912.


Assuntos
Política Antifumo , Poluição por Fumaça de Tabaco , Adolescente , Adulto , Armênia/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção Social , Tabaco , Poluição por Fumaça de Tabaco/análise , Adulto Jovem
16.
BMJ Open ; 12(2): e058909, 2022 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-35193923

RESUMO

OBJECTIVES: To examine the effect of smoke-free prison policy implementation in November 2018 on purchasing patterns in the prison canteen (shop). DESIGN: Interrupted time series. SETTING: All 12 closed, publicly run prisons in Scotland, UK. PARTICIPANTS: People in custody (PiC) between August 2018 and end of March 2019 (n=11 944). INTERVENTIONS: Implementation of smoke-free prisons policy. OUTCOME MEASURES: Total spent on all products, nicotine-related products, and food and beverage products per week. METHODS: Canteen data were provided for the period July 2018-September 2019 by the Scottish Prison Service. In a series of generalised linear mixed effects models, the amount spent before and after implementation of smoke-free prison policy was compared for all purchases in the time period, and for PiC identified as 'smokers' and 'non-smokers' from their pre-implementation tobacco purchasing patterns. RESULTS: The amount spent on nicotine-related products significantly decreased from pre-implementation to post implementation (incident rate ratio (IRR) 0.40; 99% CI 0.33 to 0.51, p<0.001). However, total canteen spend did not change over the study period (IRR 0.92; 99% CI 0.84 to 1.00). Post implementation about 25% of previous 'smokers' total canteen spend was on nicotine-related products. The amount spent by previous 'smokers' on food and beverages increased from £8.67 (99% CI 8.23 to 9.13) pre-implementation to £10.24 in the post implementation period (99% CI 9.58 to 10.90). CONCLUSION: Although the amount of money previous 'smokers' in prison spent on nicotine-related products decreased after smoke-free policy, nicotine products still account for a large proportion of canteen spend among PiC in smoke-free prisons in Scotland. Results indicate that many PiC may continue to use nicotine in smoke-free prisons where e-cigarettes are permitted.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Prisioneiros , Política Antifumo , Produtos do Tabaco , Humanos , Nicotina , Prisões , Escócia , Tabaco , Reino Unido
17.
East Mediterr Health J ; 28(1): 50-57, 2022 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-35165878

RESUMO

BACKGROUND: In 2002, the Government of Pakistan implemented a national law governing the use of tobacco products. The law included smoke-free policies banning smoking in all public places, and required no-smoking signage to be displayed at all such venues. Compliance with smoke-free policies is imperative, as it protects the health of nonsmokers. Almost two decades later, efforts to assess compliance with smoke-free policies in Karachi have been lacking, with only one study conducted in 2016. AIMS: To investigate smoke-free compliance across public places in Karachi, the most populous city in Pakistan. METHODS: A cross-sectional observational study was conducted in the east and south districts of Karachi between October and December 2019. Data pertaining to evidence of smoking (observed smoking, cigarette butt litter, and display of ashtrays/ similar instruments), the presence of designated smoking areas/rooms (DSAs/DSRs), and the display and location of no-smoking signage were collected via direct observations. Results are reported using descriptive statistics. RESULTS: Observations were conducted at 1704 indoor and outdoor public venues. Among the sample, 972 (57%) were compliant with the composite indicator assessing evidence of smoking. DSAs were observed at 104 (6%) places and DSRs at 16 (1%) places. No-smoking signage was displayed at the main entrance of 104 (6%) places and inside 174 (10%) places. CONCLUSION: Compliance with smoke-free policies is lacking in Karachi. Enhanced efforts by enforcement agencies and venue managers are needed to establish 100% smoke-free public places across Karachi.


Assuntos
Política Antifumo , Produtos do Tabaco , Poluição por Fumaça de Tabaco , Estudos Transversais , Humanos , Paquistão
18.
J Public Health Policy ; 43(1): 40-53, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35145216

RESUMO

Comprehensive smoke-free policy is a strategy to prevent cardiovascular disease (CVD) at a population-level; however, evaluating their long-term outcomes is difficult. This study used an agent-based model to estimate long-term impacts of a comprehensive smoke-free policy, as it was implemented in two communities, Arlington and Mesquite, Texas. The model predicted the percentage of myocardial infarction (MI), stroke, and diabetes in the population 10 and 20 years following policy adoption. In Arlington, the percentage of the population with these conditions each decreased by approximately 0.5% over 20 years; in Mesquite, the percentage of the population with diabetes, myocardial infarction (MI), and stroke decreased by 1.1%, 0.6%, and 0.3%, respectively, after 20 years. The results were statistically significant (p < 0.001). As an evaluation strategy, agent-based modeling can help researchers and practitioners estimate the potential long-term effects of policies and garner intervention support for implementation.


Assuntos
Política Antifumo , Política de Saúde , Humanos , Saúde Pública , Análise de Sistemas , Estados Unidos/epidemiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-35206595

RESUMO

Roughly 70-80% of adults experiencing homelessness smoke cigarettes. Smoke-free living/workplace policies are an empirically-supported tobacco control intervention. However, homeless shelters may be reluctant to implement smoke-free policies due to fears of it discouraging current/potential shelter guests from taking refuge there. The current study was meant to characterize guest support for on-property smoke-free policies within a homeless shelter with an extant indoor tobacco use ban amongst never smokers, former smokers, and current smokers to provide data on this point. Participants comprised a convenience sample of adult guests of a homeless shelter in Texas (N = 394, 28.2% women; 10.2% former; and 75.9% current smokers). Participant sociodemographics, smoking status, behavioral health diagnoses, and support for two versions of an on-property outdoor courtyard smoke-free policy (one partial, one complete) were assessed. Data were collected in two waves in a repeated cross-sectional design. Overall, 64.0% of participants supported a partial, and 32.0% a full smoking ban. Logistic regressions, controlling for wave of data collection, age, sex, and any additional significant predictors from a semi-adjusted model, examined associations between participant characteristics and policy support. Older participants (OR = 1.024, CI0.95 = 1.005-1.044), non-veterans (OR = 2.523, CI0.95 = 1.156-5.506), former smokers (OR = 2.730, CI0.95 = 1.191-6.258), and those without severe mental illness (OR = 1.731, CI0.95 = 1.061-2.824) had significantly greater odds of supporting a partial smoking ban. Relative to current smokers, never smokers (OR = 3.902, CI0.95 = 2.133-7.137) and former smokers (OR = 8.257, CI0.95 = 3.951-17.258) had significantly greater odds of supporting a complete smoking ban. The implementation of smoke-free living/workplace policies in homeless shelters may enjoy more support from guests-specifically, non-smokers-than anticipated by shelter administrators. Aside from reducing ambient smoke exposure for never and former smokers, these policies can help to reduce ubiquitous smoking cues for those who may want to quit, are undergoing a quit attempt, or are trying to maintain abstinence. Interventionists might partner with shelter guests, particularly smokers, to inform the roll-out of such policies for maximal acceptance and adoption.


Assuntos
Pessoas em Situação de Rua , Política Antifumo , Poluição por Fumaça de Tabaco , Adulto , Estudos Transversais , Feminino , Habitação , Humanos , Masculino , Fumantes , Poluição por Fumaça de Tabaco/prevenção & controle
20.
Am J Health Promot ; 36(4): 673-677, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35081759

RESUMO

PURPOSE: Determine associations of strength of local smoke-free laws and urban/rural location with cigarette and smokeless tobacco use among high school students in grades 10 and 12. DESIGN: Secondary data analysis from the 2004-2018 biennial Kentucky Incentives for Prevention Survey. SETTING: Public high schools in Kentucky. SAMPLE: N = 353502 10th/12th graders. MEASURES: County-level smoke-free law status from the Kentucky Center for Smoke-free Policy; Rural Urban Continuum Codes; self-reported last 30-day alcohol, marijuana, cigarette, and smokeless tobacco use. ANALYSIS: Generalized estimating equations modeling assessed the association of law status and urban/rural location with tobacco use across cohorts, controlling for demographics and other substance use. RESULTS: Students in counties with a comprehensive smoke-free law were 23% less likely to smoke cigarettes and 16% less likely to use smokeless, compared to those in counties without a law. Students in counties with moderate/weak laws did not differ in likelihood of use for either product, compared to those in counties without a law. Students in urban counties were 14% less likely to smoke, but there was no difference in likelihood of smokeless use by urban/rural location. CONCLUSION: Comprehensive smoke-free laws are associated with a lower likelihood of youth cigarette and smokeless use. Rural youth may be at increased risk of cigarette smoking relative to youth in urban areas.


Assuntos
Política Antifumo , Produtos do Tabaco , Adolescente , Humanos , Kentucky/epidemiologia , População Rural , Tabaco , Uso de Tabaco/epidemiologia
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