Abstract
BackgroundA certain level of public support for smoke-free environments is a prerequisite for adoption and enforcement of policies and can be used as an indicator of readiness for legislative action. This study assessed support for comprehensive smoke-free policies in a range of settings such as hotels and colleges among government workers in China and identified factors associated with support for smoke-free policies. Understanding the extent to which government workers, a large segment of the working population in China, report a smoke-free workplace and support for smoke-free policies may be important indicators of readiness for strengthened policies given their role in formulating, implementing and enforcing regulations.MethodsData were from an evaluation of the Tobacco Free Cities initiative of Emory University’s Global Health Institute-China Tobacco Control Partnership. Self-administered surveys were completed by 6,646 workers in 160 government agencies in six Chinese cities. Multivariate logistic regression was used to identify factors associated with support for smoke-free worksites, bars, hotels, and colleges.ResultsOver half (54.6%) of participants were male. A large percentage of the male workers smoked (45.9%,) whereas very few women did (1.9%). Fewer than 50% of government workers reported smoke-free policies at work, with 19.0% reporting that smoking is allowed anywhere. Support for smoke-free policies was generally very high, with the lowest levels of support for smoke-free bars (79.0%) and hotels (82.3%), higher levels of support for restaurants (90.0%) and worksites (93.0%), and above 95% support for hospitals, schools, colleges, public transportation and religious settings. Knowledge of the harmfulness of secondhand smoke was positively associated with support for smoke-free policies. Stricter worksite smoking policies were associated with support for smoke-free workplaces and bars, but not hotels and colleges. Women and nonsmokers were more supportive of smoke-free policies in general.ConclusionGovernment workers play important roles in formulating, implementing and enforcing regulations; results suggest support for a more comprehensive approach to smoke-free environments in China among workers across a broad range of agencies.
Highlights
A certain level of public support for smoke-free environments is a prerequisite for adoption and enforcement of policies and can be used as an indicator of readiness for legislative action
Data collected in 2006 from six Chinese cities showed that support for bans was over 90% for schools and public transportation vehicles, but was lower for hospitals, worksites, and restaurants and bars among the general public
As suggested by prior studies, those who know the dangers of secondhand smoke (SHS) are more likely to support smoke-free policies [17,22,26,27]
Summary
A certain level of public support for smoke-free environments is a prerequisite for adoption and enforcement of policies and can be used as an indicator of readiness for legislative action. Understanding the extent to which government workers, a large segment of the working population in China, report a smoke-free workplace and support for smoke-free policies may be important indicators of readiness for strengthened policies given their role in formulating, implementing and enforcing regulations. With its high prevalence of smoking among men (52.9% in 2010) and modest regulations and enforcement of smoke-free environments, secondhand smoke (SHS) is a major public health problem in China [1,2,3,4]. Exposure to SHS causes more than 20,000 lung cancer deaths a year in China and more than 30,000 deaths from ischemic heart disease per year [5]. Progress is underway in creating smoke-free legislation at the city level, enforcement issues remain [13,14,15]
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