Impact Of Smoke-free Policies Research Articles

The impact of smoke-free policies on smoking at outdoor sports clubs: a qualitative study

ObjectivesSmoking may still occur at sports clubs with an outdoor smoke-free policy (SFP). This study aims to map the occurrence of smoking at various sports clubs in the Netherlands and to understand why smoking occurs at some clubs but not at others. Study designThis was a qualitative design in the form of semistructured interviews. MethodsSemistructured interviews (n = 34) were held online with smoking and non-smoking members of 17 Dutch outdoor sports clubs (in field hockey, korfball, football, and tennis) with an outdoor SFP. Data were analyzed using content analysis. ResultsWe identified four situations where smoking still occurred: (1) directly at the entrance, (2) at some distance from the entrance, (3) in particular places on the premises, and (4) in various places or on occasions when alcohol is consumed. Smoking directly at the entrance was most often perceived as a bothersome situation that was difficult to avoid. The occurrence of these situations differed per sports club depending on the scope of the SFP (the comprehensiveness of the SFP and the presence or absence of a smoking area) and factors influencing policy compliance (physical characteristics of the sports club's premises, the presence or absence of children, and several enforcement difficulties). ConclusionIn some sports clubs, smoking remained common on the premises despite an outdoor SFP. Exposure to second-hand smoke might be reduced by formulating a comprehensive SFP, improving policy compliance also in situations where children are absent, and organizing the enforcement of the policy.

Impact of smoke-free policies in hospitality venues and the home environment on smoking behaviour and exposure to second-hand smoke: results of two systematic reviews

Abstract Background Smoke-free policies (SFPs) have proven to be effective in protecting people from exposure to second-hand smoke (SHS) and lowering smoking rates. Our aims were to assess the impact of SFPs in hospitality venues (e.g. bars) on smoking behaviour of young people and to assess the impact of SFPs in the home environment on smoking behaviour and exposure to SHS. Methods Two reviews were conducted. The first was conducted in June 2020. We searched PubMed, Embase, and Scopus for studies that assessed the association between any form of SFPs in hospitality venues and a measure of smoking behaviour among young people (aged 10-24 years). The second review will be conducted in June 2022. Searches will be conducted in PubMed, Embase, Web of Science, PsycINFO and CENTRAL. We will search for studies that assess the association between any form of SFPs in the home environment (e.g. multi-unit housing) and a measure of smoking behaviour (e.g. initiation) or SHS exposure. Results Nine studies (publication years 2005-2016) were included in the first review, of which the majority used a quasi-experimental design. Four studies evaluated SFPs in hospitality venues specifically. Two studies reported that strict, but not weaker, SFPs decrease progression to established smoking. Two other studies provided mixed results. Five studies also included other workplaces, of which three studies found significant decreases in current smoking, smoking frequency, and/or smoking quantity. The results of the second review will be presented in detail during the workshop, however an exploration suggests that SFPs in the home environment may prevent smoking and SHS exposure. Conclusions Most studies of the first review found that SFPs in hospitality venues are associated with a decrease in smoking behaviour among young people. Their results indicate the need for strict smoke-free legislation without exemptions. The conclusions of the second review will be presented during the workshop.

Impact of a smoke-free policy on smoking prevalence on hospital grounds: A before-after study.

INTRODUCTIONStudies on the impact of smoke-free policies (SFPs) on hospitals grounds on on-site smoking are scarce. On 1 October 2019, an SFP was implemented on the grounds of the Amsterdam UMC hospital in the Netherlands, including measures for sustained enforcement. This study assessed the impact of this SFP on smoking prevalence on hospital grounds up to 18 months after implementation.METHODSObservations were systematically conducted 7 weeks before and after the SFP was implemented, and at 5 and 18 months afterwards. A total of 32 sites were included in the study, divided over two hospital locations. On each site, the number of smokers was systematically observed and categorized into staff, patient, student, or visitor. Smoking prevalence on hospital grounds was calculated by the number of observed smokers as a proportion of all people observed. Bubble maps were created to visualize changes in the geographical distribution of smokers.RESULTSSmoking prevalence on hospital grounds decreased significantly from 17.4% before to 3.3% after implementation of the SFP. Following implementation, the largest decrease was observed in smoking among staff (-96.7%) and patients (-92.3%). The decrease in smoking prevalence was sustained 18 months after implementation (5.0%). The number of smokers decreased on nearly all sites.CONCLUSIONSThe substantial and sustained decrease in smoking prevalence found in this study highlights the potential of SFPs on hospital grounds to protect people from exposure to (secondhand) smoking. Continued enforcement of these SFPs seems essential to ensure ongoing compliance.

Commentary on Titus et al.: Understanding how smoke-free policies can contribute to smoke-free generations.

Commentary on Titus et al.: Understanding how smoke-free policies can contribute to smoke-free generations.

Changes in adolescent smoking with implementation of local smoke-free policies in Indonesia: Quasi-experimental repeat cross-sectional analysis of national surveys of 2007 and 2013

BackgroundBanning smoking from public places may prevent adolescent smoking, but there is little evidence on impact of smoke-free policies (SFPs) from low and middle-income countries. This study assessed to what extent the adoption of local SPFs in Indonesia between 2007 and 2013 associated with adolescent smoking. MethodsData on 239,170 adolescents (12–17 years old) were derived from the 2007 and 2013 national health surveys in 497 districts and 33 provinces. This study compared 2013 survey respondents living in districts/provinces that adopted SFPs between 2007 and 2013, with 2007 respondents and 2013 respondents in districts/provinces that did not adopt policies. Multilevel logistic regression analysis assessed whether SFP was associated with daily and non-daily smoking. We controlled for survey year, SFP in 2007, socio-demographics, and district characteristics. ResultsStrong district SFPs was significantly associated with lower odds of daily smoking (OR:0.81, 95 %CI:0.69-0.97), but non-significantly with non-daily smoking (OR:0.89, 95 %CI:0.76-1.05). Strong provincial SFPs was not associated with daily smoking (OR:1.02, 95 %CI:0.84–1.25), but was associated with higher odds of non-daily smoking (OR:1.22, 95 %CI:0.99-1.51). Moderately strong SFPs did not consistently show associations in the same direction. For example, moderately strong provincial SFP was associated with higher odds of daily smoking (OR:1.27, 95 %CI:1.11-1.46) and lower odds of non-daily smoking (OR:0.82, 95 %CI:0.72-0.93). ConclusionWe did not detect a consistent short-term effect of district and province-level smoke-free policies on adolescent smoking in Indonesia. Weak implementation and poor compliance may compromise effectiveness, which would call for improvement of SFP implementation in Indonesia.

The Adoption, Implementation, and Impact of Smoke-Free Policies among Gaelic Athletic Association Clubs in Ireland: A Qualitative Study.

The Gaelic Athletic Association (GAA) is a major stakeholder in promoting smoke-free policies in Ireland. Several GAA clubs have adopted smoke-free policies, and there is a growing interest among other GAA clubs to also become smoke-free. As such, the purpose of this study is to explore the process of how GAA clubs adopt, implement, and enforce smoke-free policies in order to discover best practices that other clubs could replicate. Representatives from 15 smoke-free clubs were interviewed regarding how their club became smoke-free. Interview data were analyzed, in which four major themes emerged: (1) process (planning a smoke-free policy, communicating the policy to the community, providing smoking cessation resources), (2) barriers (opinions and behaviors of club members who smoke, bars connected to club houses, policy exceptions, visitors and umpires who were unaware of the policy), (3) enforcement (community-based style of enforcement, non-confrontational approach, non-enforcement), and (4) impact (observation of policy compliance and decrease in cigarette litter). The study’s findings indicate a general ease of becoming smoke-free with minimal barriers. As such, the GAA should urge each club to become smoke-free and to use the effective methods used by current smoke-free clubs for communicating and enforcing smoke-free policies.

The impact of the Danish smoking ban from 2007 on smoking-related morbidity. A register-based natural experiment

Introduction The number of countries introducing national tobacco control policies has increased. In terms of both countries and population covered, smoking bans in public settings that protect nonsmokers from second hand tobacco smoke, create supportive environments that encourage smoking cessation, and prevent smoking initiation, represents the one tobacco control policy with the greatest progress since 2007. Extensive research has documented the impact of smoke-free policies on preventing adverse health outcomes, especially cardiovascular diseases, reducing exposure to second hand tobacco smoke and decreasing smoking-related mortality. In 2007, Denmark introduced a national smoking ban, prohibiting all indoor smoking in workplaces and public places. However, little is known about the impact of this smoking ban over time on smoking-related morbidity in the Danish population. This study investigates the effect of the Danish smoking ban on hospital admissions for acute myocardial infarction (AMI), chronic obstructive pulmonary disorder (COPD) and cancer in oral cavity and pharynx. We hypothesized that admission rates decreased after the introduction of the Danish smoking ban in 2007 compared to pre-legislation. Methods This study was designed as a natural experiment in which the whole Danish population form the study population (> 30 years). Interrupted time series analysis was performed to quantify changes in-hospital admission rates for AMI, COPD and cancer in oral cavity and pharynx, pre- and post the introduction of the national smoking ban. Monthly age-standardised admission rates per 100,000 inhabitants were estimated for each diagnosis and two subperiods defined: pre-legislation (January 2000 to August 2007) and post-legislation (September 2007 to December 2015). As an immediate change in admission rates after the introduction of the smoking ban was not expected, increases or decreases in the slope of the trend after the introduction of the ban were compared with pre-legislative trends. Diagnostic information was obtained from the Danish National Patient Register and information on demographics was obtained from the Danish Civil Registration System. The exposure was defined as the introduction of the smoking ban in August 2007 and the outcome as hospital admissions during the study period 2000–2015 due to a primary diagnosis of AMI (I21), COPD (J44) and cancer in oral cavity and pharynx (C06-C06.9, C14). Results We found no significant changes in trends for hospital admissions for any of the included smoking-related diseases after the introduction of the smoking ban compared to post-legislation trends. To exemplify, a steady decrease in-hospital admissions for AMI was observed during the study period suggesting that the decrease in AMI admissions at the time the smoking ban was introduced represented a continuation of a pre-existing trend. Conclusion The findings may be explained by the fact that the smoking ban included several exceptions resulting in a less comprehensive ban compared to other countries.

Media Coverage of Smoke-Free Policies After Their Innovation

Smoke-free policies are critical to global tobacco control, and prior research on media coverage of smoke-free policies primarily focused on the period when they were first innovated; however, the scientific basis for smoke-free policies has broadened, and how media coverage has changed, if at all, is unknown. The authors characterized the actors, arguments, and favorability of media coverage of smoke-free policies from 2006 to 2009, by content-analyzing 452 news stories in the 4 primary newspapers in South Carolina. Most media coverage was favorable (45%) or mixed (43%) toward smoke-free policies, and negative coverage decreased over time (B = −1.001, SE = 0.326; p = .008). The most prevalent argument concerned the harms of secondhand smoke (44%). A higher percentage of articles mentioned economic arguments against (26%) than for (17%) smoke-free policies (χ2 = 10.89, p < .01, for the difference between 26% and 17%), and these percentages did not change over time. Advocates and media should improve communications to more effectively represent scientific evidence regarding the null or positive impact of smoke-free policies on businesses.

Smoke-free policies in U.S. Prisons and jails: A review of the literature.

Despite progress in limiting exposure to secondhand smoke (SHS) in the United States, little is known about the impact of smoke-free polices in prisons and jails. SHS exposure in this setting may be great, as smoking prevalence among inmates is more than three times higher than among non-incarcerated adults. To inform the implementation of smoke-free policies, this article reviews the literature on the extent, nature, and impact of smoke-free policies in U.S. prisons and jails. We systematically searched PubMed, Embase, EconLit, and Social Services Abstracts databases. We examined studies published prior to January 2014 that described policies prohibiting smoking tobacco in adult U.S. correctional facilities. Twenty-seven studies met inclusion criteria. Smoke-free policies in prisons were rare in the 1980s but, by 2007, 87% prohibited smoking indoors. Policies reduced SHS exposure and a small body of evidence suggests they are associated with health benefits. We did not identify any studies documenting economic outcomes. Non-compliance with policies was documented in a small number of prisons and jails, with 20%-76% of inmates reporting smoking in violation of a policy. Despite barriers, policies were implemented successfully when access to contraband tobacco was limited and penalties were enforced. Smoke-free policies have become increasingly common in prisons and jails, but evidence suggests they are not consistently implemented. Future studies should examine the health and economic outcomes of smoke-free policies in prisons and jails. By implementing smoke-free policies, prisons and jails have an opportunity to improve the health of staff and inmates.

Economic Impact of a Noncomprehensive Smoke-Free Air Law

Many stakeholders were interested in the potential economic impact of Pennsylvania's 2008 Clean Indoor Air Act (CIAA). This study focused on the examination of economic change subsequent to CIAA and, because CIAA allows certain venue exemptions among eating and drinking establishments, if the allowance of exemptions influenced that impact. Policy analysis. Prais-Winsten regressions were employed to assess effects of CIAA and law exemptions on county-level quarterly taxable sales in restaurants and drinking establishments. Regressions controlled for general economic activity, trends in eating/drinking establishment sales, seasonality, and county characteristics. Across models, CIAA had no significant negative effects on taxable sales in full-/limited-service restaurants or drinking establishments and some positive effects. CIAA exemptions for drinking establishments do not offer a clear economic benefit. Restaurant and drinking establishment taxable sales were strongly related to overall economic conditions and seasonality. After controlling for confounding factors, and consistent with the weight of the evidence from literature on the economic impact of smoke-free policies, our study concludes that the Pennsylvania CIAA had no negative effects on per capita restaurant and drinking establishment taxable sales. High rates of drinking establishment exemptions were not economically beneficial. This study can inform efforts to make smoke-free laws more comprehensive.

Smoking spaces and practices in pubs, bars and clubs: Young adults and the English smokefree legislation

Young adulthood is an important but overlooked period in the development of smoking behaviour. We know little about the impact of smokefree policies on this group. In a secondary analysis of longitudinal, qualitative interview data we explore smoking practices in young adulthood, the role of smoking in the spaces of the night-time economy, and the impact of smokefree legislation. Participants carefully managed their smoking in different spaces in relation to the self they wished to present. This was shaped by the transitional nature of young adulthood. Smoking played a role in constructing time-out periods from the demands of everyday life in a similar way to alcohol use. The restrictions imposed by the smokefree legislation quickly became normal for most; however, the experience of smoking was influenced by the nature and quality of smoking spaces. The re-spatialisation of smoking necessitated by the smokefree legislation may reaffirm processes of social denormalisation and stigmatisation of smoking, whilst simultaneously allowing young adult smokers to produce, in some contexts, a positive, fun, sociable smoker identity.

Impact of smoke-free hospital grounds policies: Patient experiences and perceptions

Implementation of a smoke-free hospital grounds policy changes the health care context for patients. This article examines patient's perspectives, providing insight into the shifting culture of smoking in hospitals and the impact of smoke-free policy during hospitalization. This qualitative study used semi-structured interviews (N=82) to explore patient perspectives of tobacco use, policy compliance, and abstinence support in Canadian hospitals with smoke-free grounds policies. Results indicated general support for smoke-free policies, but also highlighted that the intended goals were not realized; patients reported the policy is routinely violated, second-hand smoke exposure remained common at hospital entrances and assessment and treatment of tobacco dependency was inadequate. Patients provided rationales for policy violation, which included significant concern for personal safety. Health authorities must lend careful consideration to the effects of policy on hospitalization. Study results highlight patient views on tobacco dependence, hospitalization, and treatment expectations, which when adequately addressed could support abstinence, promote healthy recovery and hospital policy compliance.

Mass Calibration and Relative Humidity Compensation Requirements for Optical Portable Particulate Matter Monitors: The IMPASHS (Impact of Smoke-free Policies in Eu Member States) Wp2 Preliminary Results

PP-30-010 Background/Aims: Better knowledge of particulate matter concentrations needs portable, reliable, user friendly, low cost, real time mass analyzers of particulate matter (PM2.5) and PM10. Optical particle counters (OPC) measuring mass have manufacturer calibration specific gravity “K” factor referred to polystyrene latex particles, which are completely different than those of the real world; therefore, they require specific calibrations. Measurements are also subject to relative humidity (RH) heavy interference. The aim of this study is to evaluate, within the Impact of Smoke-free Policies in Eu Member States WP2 Project, the performance of 4 different OPC's in environmental tobacco smoke and background urban pollution and to find the new “K” factors using 1 Model BAM-1020 with certificate number EPQM-0798-122 for comparison. Methods: All instruments have been operating in parallel measuring PM2.5 generated by cigarettes (ETS) indoor and by urban pollution outdoor, and the data were replicated 3 times. Results: “K” factors were widely different between manufacturer's model, instrument serial numbers, ETS, and urban pollution, ranging from 0.5 to 2.27. Correlation with BAM-1020 was ranging from 0.7500 to 0.9800 and Student t test from 0.3000 to 0.9500. RH interference resulted mathematically compensable up to 75% RH, but above becomes uncontrollable and sample drying becomes compulsory. Conclusion: OPCs are very reliable and accurate, but need specific calibration and special care in handling and elaboration of the measurements.