Household Smoking Restrictions Research Articles

Tobacco-related risk perceptions, social influences and public smoke-free policies in relation to smoke-free home restrictions: findings from a baseline cross-sectional survey of Armenian and Georgian adults in a community randomised trial

ObjectivesGiven 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...

Household Smoking Restrictions, Time to First Cigarette and Tobacco Dependence.

Objective Environmental factors, such as household smoking restrictions (HSR), may impact a range of smoking-related outcomes. The current study examined the effects of various levels of HSR on smoking behaviors, including the number of cigarettes smoked per day and levels of nicotine dependence in a population of adult smokers. (1) Having specific HSR reduces the urges to smoke (path A); (2) having specific HSR reduces CPD (path B); (3) having specific HSR results in lower overall nicotine addiction (path C), and later, TTFC will be associated with (4) lower urges to smoke in the morning (path A'), (5) fewer CPD (path B'), and (6) lower levels of nicotine addiction (path C'). Method Regression models using self-reported data from the Pennsylvania Adult Smoking Study (N = 353) were used. TTFC was measured minutes between waking and the first cigarette of the day. Household smoking restrictions were measured as follows: (1) full ban on smoking in the home, (2) partial ban, or (3) no ban. Results Subjects with no household smoking restrictions had lower incomes and education than those with at least some household smoking restrictions; those with full bans smoked less and had an earlier TTFC than those with at least some household smoking restrictions. Smokers with a full ban had a later TTFC, mediated by fewer cigarettes per day and lower cravings. Among those with partial bans, there is no reduction in cigarettes per day and an increase in urges to smoke. Conclusions Partial household smoking restrictions are no better than no household smoking restrictions with regard to cigarettes per day and TTFC, and may cause an increase in urges to smoke in the morning.

Tobacco Advertising, Anti-Tobacco Information Exposure, Environmental Smoking Restrictions, and Unassisted Smoking Cessation Among Chinese Male Smokers: A Population-Based Study.

The study examined the prevalence of unassisted smoking cessation among Chinese urban male smokers and factors important in the decision to quit. A cross-sectional survey employing multistage sampling involving 5,782 participants in six cities in China was conducted. Survey respondents reported their smoking cessation status and related individual and environmental variables. Among current smokers 1,112 or 35.0% (95% CI [31.0%, 40.8%]) had attempted to quit and of those who had made such an attempt 87.6% reported that they had done so without assistance. Of all former smokers (3,389), most (97.6%; 95% CI [96.7%, 98.5%]) quit without assistance. Logistic regression analysis showed those who engaged in physical exercise and who had more belief in their ability to quit were more than twice as likely to make a quit attempt and be successful than those in comparable reference groups. Exposure to tobacco advertising was negatively associated with both unassisted quit attempts and success. By contrast, exposure to anti-tobacco information was positively associated with unassisted quit attempts while household and workplace smoking restrictions were negatively associated with unassisted attempts to quit. Most attempts to quit smoking among Chinese males are unassisted. Unassisted attempts to quit smoking and success rates are highly influenced by the presence of environmental smoking restrictions, tobacco advertising, and exposure to anti-tobacco information. Smoking cessation programs and policies in China need to pay greater attention to the social and cultural norms, which perpetuate high levels of smoking.

Intention to Quit among Smokers in Kazakhstan: Data from 2014 Global Adult Tobacco Survey

Kazakhstan is one of the countries with higher-than-average smoking prevalence and tobacco-related mortality. Intention to quit is a key step toward smoking cessation, yet has not been studied in Kazakhstan. This study explored prevalence and correlates of intention to quit among smokers in Kazakhstan. We drew data from the nationally representative survey, the Global Adult Tobacco Survey (GATS), conducted during 2014 in Kazakhstan. Our sample consisted of 649 smokers aged ≥15 years. We examined prevalence of intention to quit by demographics, knowledge of tobacco-related diseases, nicotine dependence, attempt to quit in the past 12 months, household smoking restrictions, and awareness of antismoking messages. Univariate and multivariate logistic regressions were used to test the significance of these correlates. Prevalence of intention to quit was around 75.9% among smokers. Older age (p < 0.001), knowledge of tobacco-related diseases (p < 0.01), moderate nicotine dependence (p < 0.001), attempt to quit within the past 12 months (p < 0.001), and having household smoking restrictions (p < 0.001) were all significant correlates. We suggest investing in efforts to promote cessation activities for smokers of all ages, to disseminate comprehensive information on tobacco-related diseases, and to uphold and strengthen policies on smoking bans.

Adult Attitudes and Practices Regarding Smoking Restrictions and Child Tobacco Smoke Exposure: 2000 to 2015.

Since 2000, tobacco control efforts have greatly increased state and local protections from childhood tobacco smoke exposure. The objective of this study is to examine changes in attitudes and practices regarding smoking bans in multiple public and private settings from 2000 to 2015, as well as to examine the changes in pediatrician and family practitioner screening and counseling for tobacco smoke exposure. Cross-sectional data from the annual Social Climate Survey of Tobacco Control were analyzed. The majority of adults, 69.3%, reported household smoking restrictions in 2000, and these restrictions increased to 79.5% through 2015 (P < .05). Car smoking prohibitions increased from 68.3% to 81.8% (P < .05). A growing majority of adults supports smoke-free policies in public settings, and tobacco counseling by child health care providers also increased. However, members of 1 in 5 households still permit smoking inside the home and family vehicle, and half of the US population is not protected by state or local laws prohibiting smoking inside of hospitality venues. Despite dramatic progress since 2000, these trend data reveal potential areas where child health care clinicians might focus effort at the family and community level to accelerate the protection of children from tobacco smoke exposure.

Coaching to create a smoke-free home in a brief secondhand smoke intervention.

Few community interventions exist to reduce secondhand exposure to tobacco smoke in the home. This study presents the coaching process of a larger intervention to promote smoke-free homes across an efficacy and 2 effectiveness trials. It furthers assesses the coaching call's reach and participants' satisfaction with the call across three intervention sites. The sources of the data were from baseline and 3-month follow-up surveys, coaching forms or online tracking system and interviews with coaches. Reach for the coaching call across trials was fairly high from 72% to 92%. Overall, the majority of participants were highly satisfied with the intervention (M = 3.76) and found it useful in creating a smoke-free home (M = 3.63). Common goals set were changing the environment to support a home smoking ban (e.g. putting up signs, removing ashtrays) (82%) or picking a date (60%). Challenges to a smoke-free home were consistent with other literature on barriers related to household smoking restrictions, including need for assistance in quitting, outside weather and smokers who do not want to quit. Additional research is needed to explore differential reach and reactions to the coaching call as it is disseminated and the impact of coaching call on the outcome of a smoke-free home.

The challenge of mothers learning about secondhand smoke (MLASS): a quasi-experimental, mixed methods feasibility study.

BackgroundExposure to secondhand smoke (SHS) in the antenatal and postnatal period is associated with a detrimental health impact to the foetus and newborn baby and is recognised as a preventable public health challenge. The aim of the mother’s learning about secondhand smoke (MLASS) study was to test the feasibility of delivering and evaluating the effectiveness of a smoke-free homes (SFH) health education intervention in the antenatal and postnatal period to reduce foetal and newborn exposure to SHS.MethodsPregnant women aged 17–40 years old who attended their first community-based antenatal appointment in Leeds, UK, were eligible to participate if they currently smoked, or if they were non-smokers but lived in a household where someone else smoked, or had regular visitors to the home who smoked. A SFH health education intervention was delivered at four time points by community midwives and health visitors. Outcome measures included self-reported level of household smoking restrictions and SHS exposure in pregnant women who did not smoke during pregnancy and in the newborn baby, measured by salivary and urine cotinine levels, respectively. We planned to conduct focus group discussions with participants and health professionals. A post hoc survey of pregnant women was conducted at the recruitment site.ResultsEight pregnant women were recruited over a 6-month recruitment period. Of the 65 eligible pregnant women approached, 57 (88 %) declined to participate in the study. The majority declined to participate due to lack of interest in the study. In the post hoc survey, the majority of pregnant women reported that they were already implementing household smoking restrictions to reduce SHS; only a small number had no household smoking restrictions.ConclusionsThe post hoc survey identified women who could benefit from a SFH intervention; therefore, future studies should consider what SFH means to pregnant women and may wish to target those not currently implementing household smoking restrictions. Future recruitment strategies in studies of an SFH intervention in the context of maternity service pressures needs careful consideration; this includes the capacity to undertake the research, the recruitment setting, the criteria for individuals requiring the intervention, and individuals’ willingness to engage with such research.Electronic supplementary materialThe online version of this article (doi:10.1186/s40814-016-0048-0) contains supplementary material, which is available to authorized users.

Who smokes in smoke-free public places in China? Findings from a 21 city survey.

Efforts toward controlling secondhand smoke in public places have been made throughout China. However, in contrast to the western world, significant challenges remain for effectively implementing smoke-free regulations. This study explores individual and regional factors which influence smoking in smoke-free public places. Participants included 16 866 urban residents, who were identified through multi-stage sampling conducted in 21 Chinese cities. The reported smoking prevalence in smoke-free public places was 41.2%. Of those who smoked in smoke-free public places, 45.9% had been advised to stop smoking. Participants stated that no-smoking warnings/signs with 'please' in the statement had a better likelihood of gaining compliance and preventing smoking in public spaces. Multilevel logistic regression analysis showed that ethnicity, education, occupation, type of smoking, age of smoking initiation, smoking situation, stress, household smoking restrictions and city population were all associated with smoking in smoke-free public places. Interestingly local smoke-free regulations were not associated with smoking in public places. The findings underscore that efforts to restrict smoking in public places in China should emphasize strong enforcement, while simultaneously raising public awareness of the perils of second hand smoke.

Household smoking restrictions among urban residents in China: individual and regional influences.

The present study examines individual and regional influences on household smoking restrictions (HSR) in China. Participants were 16,866 urban residents, who were identified through a multistage survey sampling process conducted in 21 Chinese cities. The data collection instrument was a self-administered questionnaire. The sample was characterized in terms of the prevalence of complete HSRs. Multilevel logistic regression models were used to examine individual and environmental influences on HSR. Almost 22% of respondents reported HSR. Both individual and regional-level restrictions on smoking in the workplace were associated with HSR. There was a negative association between individual household income and HSR, and positive associations between HSR awareness of secondhand smoking (SHS), and smoking in smoke-free public places, respectively. This study revealed individual and regional influences on HSR in China. Findings underscore that efforts to restrict smoking in Chinese households should emphasize environmental smoking restrictions, while simultaneously raising public awareness of the perils of SHS. This information should be considered in designing interventions to sustain and promote the adoption of HSR in Chinese and other populations.

Household Smoking Restrictions Relate To Time To First Cigarette Smoked In The Morning.

The time a smoker waits until the first cigarette of the morning is often used as a measure of dependence with the rationale that more dependent smokers will smoke sooner upon waking than will less dependent smokers after going several hours without a cigarette overnight. We sought to examine the relationship between time-to-first-cigarette (TTFC) and household smoking restrictions in two independent samples. Two samples of smokers, one treatment-seeking community sample (N = 433) and one non-treatment-seeking sample of smokers with serious mental illness (i.e., Schizophrenia, Schizoaffective Disorder, or Bipolar I Disorder) (N = 94), provided information on cigarette dependence with the Fagerström Test for Nicotine Dependence and on household smoking restrictions. Half (50%) of smokers with serious mental illness and 36.7% of smokers from the general population reported that there were no limitations to smoking in their home. Household smoking restrictions were significantly and positively related to TTFC in both samples. These data indicate that greater attention to TTFC may be warranted. The TTFC item is intended to measure dependence based on the premise that greater dependence should be associated with shorter TTFC. If TTFC is related to a household smoking ban, however, this item may not be assessing dependence as intended in some cases.

Correlates of former smoking in patients with cerebrovascular disease: a cross-sectional study

ObjectiveTo identify multilevel correlates of former smoking in patients with cerebrovascular disease.DesignSecondary data analysis of the Canadian Community Health Survey.MethodsWe used data from the 2007–2008 Canadian Community Health Survey (CCHS)....

Household Smoking Restrictions Related to Secondhand Smoke Exposure in Guangdong, China: A Population Representative Survey

China has a higher household secondhand smoke exposure rate than other countries. This study aims to estimate the prevalence rate of households implementing smoking bans in Guangdong and to identify factors correlated with household smoking bans. A cross-sectional, stratified random cluster sampling survey was conducted in Guangdong in 2010. A total of 2,114 adults aged 15 and older completed the face-to-face interviews with a response rate of 70%. The survey employed an adapted and validated questionnaire from the China Global Adult Tobacco Survey. Household smoking policy was divided into 3 groups: full ban, partial ban, and no ban. A multiple logistic regression model was employed to explore factors related to a full household smoking ban. The survey found 14.2% of respondents reported a full ban, 23.6% reported a partial ban, and 62.2% reported no ban of smoking at home. Current smoking status was the strongest predictor for less restrictive household smoking policies (odds ratio [OR] = 4.9, 95% CI = 2.634-8.999). Our study suggested that people with a high level of education were more likely to implement a full household smoking ban (OR = 4.4, 95% CI = 2.388-8.178). Additionally, urban residents were significantly more likely to report a full household smoking ban than rural residents (OR = 1.67, 95% CI = 1.202-2.322). Household smoking bans were not sufficiently established in Guangdong, China. Intensified efforts were called to promote home smoking bans, especially for those with a lower education level, with lower income, and living in rural areas.

Factors Influencing Exposure to Secondhand Smoke in Preschool Children Living With Smoking Mothers

The health effects on young children of exposure to secondhand smoke (SHS) are well described. Recent work suggests that over one quarter of school-aged children in Scotland are regularly exposed to SHS in the home. The study was designed to describe SHS exposure in preschool children whose mothers smoked and identify factors that influence exposure. Smoking mothers with at least one child aged 1-5 years were recruited to the Reducing Families' Exposure to Secondhand Smoke in the Home study. Concentrations of airborne particulate matter less than 2.5 μm in size (PM(2.5)) in the home were measured together with child's salivary cotinine. Demographics including age, accommodation type, socioeconomic status, and number of cigarettes smoked at home were recorded. Data were collected from 54 homes. In 89% of the homes, concentrations of PM(2.5) exceeded health-based guidance values at some point of the day. Household PM(2.5) concentrations were highest during the evening hours of 6 p.m. to midnight. Younger children had higher salivary cotinine concentrations than older children, and the geometric mean of salivary cotinine was 2.36 ng/ml. Household smoking restrictions and maternal confidence in enforcing smoking restrictions in their own home were strongly associated with child's SHS exposure. Preschool children's exposure to SHS in homes where the mother smokes is considerable. Interventions and policy development to increase parental awareness of the health effects of SHS and provide parents with the confidence to implement smoke-free households are required to reduce the SHS exposure of preschool age children.

The Association Between Household Smoking Restrictions and Smoking Abstinence: Does Age Matter?

AbstractAim: The purpose of this study is to explore how effective household smoking restrictions (HSRs) are in different age groups in predicting smoking abstinence. Methods: The study analysed the Canadian Community Health Survey (CCHS) cycle, 3.1. Smoking abstinence was defined as individuals who reported to not have smoked greater than 100 cigarettes (n = 1 024 578) and were selected for this analysis. Important covariates include sex, age, education and immigrant status. Logistic regression was used to assess the association between smoking household restrictions and smoking abstinence when taking covariates into consideration. Results: Individuals who implemented HSRs reported to be abstinent from smoking at 12% compared to those with no HSRs at 0.7%. When adjusted for covariates of interest, the odds ratio (OR) for smoking abstinence was 1.43 (95% confidence interval (CI): 1.04, 1.97; P &lt; .026). It was found that age was a strong predictor of smoking abstinence particularly in youths at 3.11 (95% CI: 1.65, 5.84; P &lt; .001) and young adults at 1.92 (95% CI: 1.44, 1.92; P &lt; .001). Conclusion: It is suggested that HSRs is an important anti-tobacco socialisation tool in youths and young adults. Individuals living in a home with HSRs may internalise behavioural norms against the initiation or continuation of smoking.

Effects of household, workplace, and public place smoking restrictions on smoking cessation

The aim of this study was to evaluate the association between environmental smoking restrictions, distinguished by site, and smoking cessation by Chinese urban residents. Recruited through multi-stage quota-sampling, residents in six Chinese cities were surveyed. Data were both individual-level and city-level. Among 4735 respondents, 715 were identified as successful quitters and 405 as unsuccessful. Multilevel logistic regression analysis showed smoking cessation to be associated with city-level public place and workplace restrictions and individual-level workplace and household restrictions. Results offer justification for decision-makers to implement environmental tobacco control policies and related public health interventions aimed at markedly diminishing the high smoking prevalence in China.

Socioeconomic Differences in Exposure to Tobacco Smoke Pollution (TSP) in Bangladeshi Households with Children: Findings from the International Tobacco Control (ITC) Bangladesh Survey

This study assessed the pattern of exposure to tobacco smoke pollution (TSP; also known as, secondhand smoke) in Bangladeshi households with children and examined the variations in household smoking restrictions and perception of risk for children’s exposure to TSP by socioeconomic status. We interviewed 1,947 respondents from Bangladeshi households with children from the first wave (2009) of the International Tobacco Control (ITC) Bangladesh Survey. 43.5% of the respondents had complete smoking restrictions at home and 39.7% were very or extremely concerned about TSP risk to children’s health. Participants with lower level of education were significantly less likely to be concerned about the risk of TSP exposure to children’s health and less likely to adopt complete smoking restrictions at home. Logistic regression revealed that the predictors of concern for TSP exposure risk were educational attainment of 1 to 8 years (OR = 1.94) or 9 years or more (OR = 4.07) and being a smoker (OR = 0.24). The predictors of having complete household smoking restrictions were: urban residence (OR = 1.64), attaining education of 9 years or more (OR = 1.94), being a smoker (OR = 0.40) and being concerned about TSP exposure risk to children (OR = 3.25). The findings show that a high proportion of adults with children at home smoke tobacco at home and their perceptions of risk about TSP exposure to children’s health were low. These behaviours were more prevalent among rural smokers who were illiterate. There is a need for targeted intervention, customized for low educated public, on TSP risk to children’s health and tobacco control policy with specific focus on smoke-free home.

Effect of Smoke-Free Home and Workplace Policies on Second-Hand Smoke Exposure Levels in Children: An Evidence Summary

Second-hand smoke (SHS) is a major avoidable cause of developmental and respiratory disease and premature death among children worldwide. SHS is a ‘Class A’ carcinogen, and there is no safe level of SHS exposure. Almost 700 million children worldwide are exposed daily to SHS at home. This article reviews and summarizes evidence based on available studies that report on ‘voluntary’ home smoking restrictions and their effects on SHS exposure levels in children aged 0–17 years. All potentially relevant publications within a 10-year period (January 2000–April 2010) were identified (n = 19 full-text articles) through comprehensive database searches. In general, voluntary household smoking restrictions reported a significant reduction in childhood SHS exposure ranging between 20–50% reductions, using both self-reported and biological measures. Mandated comprehensive workplace and enclosed public smoke-free policies also suggested an apparent benefit in some specific pediatric health encounters, namely, decreased preterm birth risks and reduced emergency hospital visits owing to asthma.

Relationships between Household Smoking Restrictions and Intention to Quit Smoking among Korean American Male Smokers in California

This cross-sectional study examined the relationships between household smoking restrictions and intentions to quit smoking among Korean American male smokers in California. We used data from the California Korean American Tobacco Use Survey (CKATUS), which was conducted in 2004 using computer-assisted telephone interviewing. Among the 2,545 respondents who participated in the CKATUS, the 387 male smokers who answered a question assessing their intention to quit smoking were included in the final analyses. In univariable analyses, smokers who reported having household smoking restrictions were more likely to intend to quit smoking as compared with those who did not (P<0.01). Other independent correlates of having an intention to quit smoking were being less than 50 yr of age, having spent more than 50% of one's life in the US, being assimilated, and having other smokers in the household. In a multiple logistic regression analysis, the significant correlates of having an intention to quit smoking were household smoking restrictions (complete or partial restriction vs. no restriction on smoking; odds ratio, 2.54; 95% confidence interval, 1.22-5.28) and absence of other smokers in the household. In conclusion, smoking restrictions in the household are associated with an intention to quit smoking among Korean American male smokers in California.

Erratum: Correction of References

To the Editor: We found an error in our published article: Myung SK, McDonnell DD, Kazinets G, Seo HG, Moskowitz JM. Relationships between household smoking restrictions and intention to quit smoking among Korean American male smokers in California. J Korean Med Sci 2010; 25: 245-50. The published references on pages 249-250 are identical with pages 238-239. It was a mistake that occurred during the editing process of references by the editorial staff. We have attached a corrected version of the references of the above article. Corrected

THE ASSOCIATION BETWEEN HOUSEHOLD SMOKING RESTRICTIONS AND SMOKING ABSTINENCE

Aim: The purpose of this study is to explore how effective household smoking restrictions (HSRs) are in different age groups in predicting smoking abstinence. Methods: The study analysed the Canadian Community Health Survey (CCHS) cycle, 3.1. Smoking abstinence was defined as individuals who reported to not have smoked greater than 100 cigarettes (n = 1 024 578) and were selected for this analysis. Important covariates include sex, age, education and immigrant status. Logistic regression was used to assess the association between smoking household restrictions and smoking abstinence when taking covariates into consideration. Results: Individuals who implemented HSRs reported to be abstinent from smoking at 12% compared to those with no HSRs at 0.7%. When adjusted for covariates of interest, the odds ratio (OR) for smoking abstinence was 1.43 (95% confidence interval (CI): 1.04, 1.97; P < .026). It was found that age was a strong predictor of smoking abstinence particularly in youths at 3.11 (95% CI: 1.65, 5.84; P < .001) and young adults at 1.92 (95% CI: 1.44, 1.92; P < .001). Conclusion: It is suggested that HSRs is an important anti-tobacco socialisation tool in youths and young adults. Individuals living in a home with HSRs may internalise behavioural norms against the initiation or continuation of smoking.