Smoking Restrictions Research Articles

Staff representations and tobacco-related practices in a psychiatric hospital with an indoor smoking ban

The present study describes representations about smoking and practices related to patient smoking among staff of a large public psychiatric hospital. A survey was performed using a specially designed questionnaire. The return rate was 72.4% (n = 155). A large proportion of staff recognized the importance of both smoking status and mental health for patient's well-being (46.9%), and believed that smoking cessation was possible for psychiatric patients (58.6%). However, the role of the psychiatric hospital was perceived as providing information (85.3%) and helping to diminish cigarette consumption (51%), rather than proposing smoking cessation (29.5%). Staff daily practice included reminding patients of smoking restrictions (43.9%), managing cigarettes (46.5%), and nicotine replacement therapy (24.3%). A principal component analysis of tobacco-related practices revealed two main factors (59.8% of variance): basic hospital actions (factor 1) and more specialized interventions (factor 2), which were significantly associated with higher worries about personally developing smoke-related illnesses (Spearman r = 0.38, P < 0.0001). Compared with non-smokers, smokers reported higher perceived vulnerability to develop an illness due to tobacco and a higher level of worry about this. The discussion highlights the need to redefine roles and expectancies of mental health staff, and improve training and collaboration with experts, in order to improve efficiency concerning tobacco issues.

The Pattern of Indoor Smoking Restriction Law Transitions, 1970–2009: Laws Are Sticky

We examined the pattern of the passage of smoking laws across venues (government and private workplaces, restaurants, bars) and by strength (no law to 100% smoke-free). We conducted transition analyses of local and state smoking restrictions passed between 1970 and 2009, with data from the Americans for Nonsmokers' Rights Ordinance Database. Each decade, more laws were enacted, from 18 passed in the 1970s to 3172 in the first decade of this century, when 91% of existing state laws were passed. Most laws passed took states and localities from no law to some level of smoking restriction, and most new local (77%; 5148/6648) and state (73%; 115/158) laws passed in the study period did not change strength. Because these laws are "sticky"-once a law has passed, strength of the law and venues covered do not change often-policymakers and advocates should focus on passing strong laws the first time, rather than settling for less comprehensive laws with the hope of improving them in the future.

Regulatory Approaches to Ending Cigarette-Caused Death and Disease in the United States

Cigarettes result in over 400,000 preventable American deaths each year. In 2011, fewer than twenty percent of adults smoked. Since the publication of the first U.S. Surgeon General's Report on Smoking and Health nearly fifty years ago, when smoking prevalence was around forty percent, policies such as smoke-free laws, large tax increases, and litigation have collectively contributed to cut smoking prevalence in half. Unfortunately, no one expects the mix of policies currently proposed, which includes further tax increases, spatial smoking restrictions, somewhat higher minimum age restrictions, adverse publicity, and quitting assistance, to reduce U.S. smoking prevalence below fifteen percent in the foreseeable future.The rule adopted by the U.S. Food and Drug Administration (FDA) to require hard-hitting graphic warnings on cigarette packages, as is currently done in dozens of other countries, has thus far been rejected by federal judges who have found that warnings designed to arouse negative emotions violate cigarette manufacturers’ First Amendment rights.

Association Between Work-Family Conflict and Smoking Quantity Among Daily Smokers

Recent work demonstrated a direct relation between work-family conflict and likelihood of smoking. This study furthered this area of research by (a) testing the association between work-family conflict and smoking quantity and (b) testing demographic, workplace, and home factors as moderators of this relation. Participants (N = 423) were daily smokers from a Midwestern community-based sample. Ordinal regression analysis tested work-to-home and home-to-work conflict as predictors (after controlling for demographic characteristics, home factors, and workplace factors) of smoking quantity. Additionally, we tested whether the demographic, home, and workplace factors moderated the effects of work-to-home conflict and home-to-work conflict on smoking quantity. Males (OR = 8.81, p = .005), older participants (OR = 1.09, p = .012), those with less educational attainment (OR = 1.87, p = .001), those who reported lower levels of workplace smoking restrictions (OR = 0.87, p = .019), and those who reported higher levels of work-to-home conflict (OR = 1.39, p = .026) smoked more cigarettes per day. There was no significant main effect of home-to-work conflict on smoking quantity (OR = 1.46, p = .099). A significant interaction (OR = 0.55, p = .043) revealed that home-to-work conflict was associated with smoking quantity for females but not for males. After controlling for demographic characteristics and potential confounders, work-to-home conflict had a negative impact on smoking quantity for all participants, and home-to-work conflict was associated with smoking quantity for women. Workplace wellness programs to reduce smoking among employees should take into account the direction of conflict and how the effect of the conflict on smoking behavior may vary based on other factors.

Smoking Restrictions Among Households of Childhood and Young Adult Cancer Survivors: Implications for Tobacco Control Efforts

This study assessed the prevalence of smoking restrictions among households of survivors of childhood and young adult cancer who smoke. It also examined the relationship between home smoking restrictions and motivation to quit smoking, as well as other smoking, psychosocial, and environmental factors. Participants included 374 smokers who were childhood or young adult cancer survivors (between the ages of 18 and 55 years) recruited from five cancer centers to participate in a randomized smoking cessation trial. Survivors completed baseline measures about the smoking restrictions in their households, their smoking behavior, and related psychological and environmental factors, which are the focus of the current manuscript. Almost 54% of survivors reported that smoking was prohibited in their households. Living with a nonsmoking partner, having a strict smoking policy at work, and not being nicotine dependent all increased the likelihood of having a total home smoking ban. Participants who were older, smoked more cigarettes per day over the prior week, and received prior chemotherapy were less likely to reside in households that adopted total bans. Findings suggest that socio-environmental factors and current smoking behaviors are associated with complete smoking restrictions in the homes of survivors. These factors should be considered when communicating with survivors about the importance of establishing strict smoking policies in their private residences.

Clean Indoor Air Policies and Smoking in Mexico

This paper empirically tests the association between recently adopted state‐level clean indoor air laws and the smoking behaviour ofMexican men and women. To deal with the problem of highly correlated policies across venues,Iconstruct an index of clean indoor air policies that measures the degree of strictness of smoking restrictions in different locations and the level of enforcement of the laws. Matching policies to individual‐level data from theNationalHealthSurvey 2006,Ifind that more comprehensive laws are not associated with the decision to smoke, but are negatively related to daily consumption of cigarettes by men. More specifically, a one unit increase in the index is associated with 3.9 fewer cigarettes smoked a day. The results that test for policy endogeneity show that states with higher intensity of smoking were not more or less likely to pass more comprehensive laws, which suggests that restrictive clean indoor air policies might have been effective at reducing the number of cigarettes smoked byMexican men who smoke.

Where to snuff the puff? Relative effectiveness of U.S. smoking control policies

This research examines the relative effectiveness of various smoking control initiatives in lowering U.S. smoking prevalence. The main contribution lies in considering alternate state-level restrictions on retailers as well as smokers. Greater restrictions on smokers lower smoking prevalence, while those directed at retailers are largely ineffective. Upon disaggregation, territorial restrictions banning smoking in restaurants are found to be effective, whereas those in workplaces and in bars do not appreciably lower smoking prevalence. We also find some gender differences in the effectiveness of smoking restrictions. These findings are generally robust to alternate model specifications.

“I only smoke when I have nothing to do”: a qualitative study on how smoking is part of everyday life in a Greenlandic village

BackgroundSmoking-related illnesses, such as chronic obstructive pulmonary disease, cardiovascular disease and lung cancer, are common in Greenland. Factors such as age, gender, cigarette use, restricted smoking at home and socio-economic determinants are well-known predictors for smoking and smoking cessation. In 2005, 66% of the adult population in were Greenland smokers, despite widespread smoking cessation campaigns. It is therefore imperative to identify the factors that influence the low levels of smoking cessation to be able to offer cessation interventions of high quality.AimTo develop knowledge about how smoking forms an incorporated part of a social and cultural context in the daily lives of unskilled residents of a small town in northern Greenland.DesignAn ethnographic field study was carried out in 2010, including participant observation, informal conversation with health professionals and semi-structured interviews with 4 smokers (2 women and 2 men). Data were analysed with a phenomenological hermeneutic approach.ResultsAll informants were daily smokers. During work hours, they smoked fewer cigarettes due to control policy as well as having something to do. At home, they smoke more during leisure time. Having time on one's hands can be a factor in smokers remaining as smokers. It appears that smokers seem to consider themselves to be stigmatised. This may be one reason for wanting to stop smoking. Smokers ask how to quit and also ask for help to give up smoking with regard to medical treatment for withdrawal symptoms. Serious illness and pregnancy both appear to be triggers to consider giving up smoking. Severe withdrawal symptoms and lack of knowledge about how to give up smoking are barriers to participants achieving their goal.ConclusionPrevention initiatives should be targeted at all smokers and a smoking cessation service should be developed, where smokers are supervised and receive medical treatment for withdrawal symptoms.

Muslim communities learning about second-hand smoke (MCLASS): study protocol for a pilot cluster randomised controlled trial.

BackgroundIn the UK, 40% of Bangladeshi and 29% of Pakistani men smoke cigarettes regularly compared to the national average of 24%. As a consequence, second-hand smoking is also widespread in their households which is a serious health hazard to non-smokers, especially children. Smoking restrictions in households can help reduce exposure to second-hand smoking. This is a pilot trial of ‘Smoke Free Homes’, an educational programme which has been adapted for use by Muslim faith leaders, in an attempt to find an innovative solution to encourage Pakistani- and Bangladeshi-origin communities to implement smoking restrictions in their homes. The primary objectives for this pilot trial are to establish the feasibility of conducting such an evaluation and provide information to inform the design of a future definitive study.Methods/DesignThis is a pilot cluster randomised controlled trial of ‘Smoke Free Homes’, with an embedded preliminary health economic evaluation and a qualitative analysis. The trial will be carried out in around 14 Islamic religious settings. Equal randomisation will be employed to allocate each cluster to a trial arm. The intervention group will be offered the Smoke Free Homes package (Smoke Free Homes: a resource for Muslim religious teachers), trained in its use, and will subsequently implement the package in their religious settings. The remaining clusters will not be offered the package until the completion of the study and will form the control group. At each cluster, we aim to recruit around 50 households with at least one adult resident who smokes tobacco and at least one child or a non-smoking adult. Households will complete a household survey and a non-smoking individual will provide a saliva sample which will be tested for cotinine. All participant outcomes will be measured before and after the intervention period in both arms of the trial. In addition, a purposive sample of participants and religious leaders/teachers will take part in interviews and focus groups.DiscussionThe results of this pilot study will inform the protocol for a definitive trial.Trial registrationCurrent Controlled Trials ISRCTN03035510

Adapting the Stage of Change model to investigate adolescent behavior related to reducing second hand smoke exposure

Aims: Second hand smoke (SHS) exposure is increasingly recognized as a major public health concern. Assessing adolescents’ motivational level to avoid SHS is vital to promote and reinforce reductions in SHS exposure. Methods: A brief measure based on the Stage of Change model was developed to characterize adolescents’ behavior related to reducing SHS exposure and used to identify potential determinants of SHS stage of change. The sample consisted of 1172 adolescents aged 13 to 15 years who participated in an internet-based cohort study of youth in British Columbia, Canada. Results: Sixty-six percent of the adolescents reported they had consistently made efforts to reduce exposure to SHS for more than 6 months, while 19% did not intend to reduce their exposure to SHS in the next 6 months. Adolescents’ SHS stage of change significantly differed by ethnicity, whether they had tried cigarettes, amount of tobacco smoked in their lifetime, parental and peer smoking statuses, past months’ exposure to SHS, frequent smoking in the home, and home smoking restrictions (all p exposure. Conclusion: This brief measure based on the Stage of Change model can be used in future studies to characterize adolescents’ behavior around SHS. Adolescents who smoke or have parents and/or friends who smoke appear to be a population that could benefit from stage-matched interventions designed to raise awareness of the risks associated with SHS for smokers and non-smokers, and ultimately reduce SHS exposure.

The Effects of Smoking Bans on Self-Assessed Health: Evidence from Germany

The 16 German federal states introduced smoking bans on different dates during 2007 and 2008. These bans restricted smoking in enclosed public places, particularly in restaurants and bars. This study examines the effects of smoking bans on self-assessed health. Using data from the Socio-Economic Panel (SOEP), difference-in-differences estimations provide evidence for health improvements for the population at large. Health benefits from the secondhand smoke-free environment are equivalent to an increase in household income of approximately 30%. Further subgroup analyses show that health improvements are largest among young non-smokers (below 30 years) whereas smokers report no or even adverse health effects in response to bans. Exploiting differences in the dates of introduction and enforcement, we find no evidence that the effects of bans depend on enforcement measures.

Development and testing of a smoke-free homes intervention with Muslim faith leaders in Leeds, UK

BackgroundSmoking rates in south Asian communities in the UK, particularly men of Pakistani and Bangladeshi origin, are higher than in the general population. As a result, second-hand smoking is widespread in households, which poses a serious health hazard to non-smokers, especially children. Reductions in smoking within the household can help to lower exposure to second-hand smoke. We adapted the smoke-free homes (SFH) educational programme to use Muslim faith leaders as educators and advocates in an attempt to encourage Pakistani and Bangladeshi communities to negotiate and implement smoking restrictions within their homes. We have developed a structured educational guide for Muslim faith leaders. Our primary aim was to assess whether mosques could be acceptable and feasible settings for quality health-promotion programmes. Additionally, we aimed to develop preliminary programme theory for the SFH intervention that could be adapted to other settings and ethnic groups. MethodsThe intervention package was developed from exploratory qualitative research and participatory workshops done with potential users. We tested the programme in five mosques in Leeds, UK. This test was followed by qualitative assessment, with interviews and focus group discussions (FGDs). We did ten semistructured interviews with Muslim religious teachers and chairmen of mosque committees. Four focus groups, each with between five and eight participants, were undertaken with adults attending the mosques or associated women's circles in which the intervention was implemented. We recorded interviews and FGDs and transcribed them verbatim. We analysed data thematically. Three transcripts were translated from Urdu to English and coded by three researchers (two who speak Urdu). A coding frame was then agreed and the remaining transcripts were coded by the two Urdu-speaking researchers. Codes were both a priori (based on themes we had emphasised in the question guides) and emergent. We identified participants in FGDs with the help of religious leaders. Therefore, there could be a correlation between agreeing to deliver the intervention (religious leader), participation in the FGDs (participants), and positive feedback. We attempted to address this limitation by selecting groups with participants who had attended SFH sessions only once with regular attendees to better understand both facilitators and barriers to the SFH intervention. These participants were also shown religious leaders' SFH guide and asked to discuss their experience and share their views of the material. FindingsThe findings indicate that religion and religious leaders—such as Imams, Qur'an teachers, and men and women's circle leaders—are both relevant and important drivers of health promotion measures. There are various barriers to and motivators of to health promotion in mosques, including both surface and deep-seated factors such as existing beliefs, assumptions, experiences, associations, and unique cultural and religious constraints that are essential for understanding and development of a programme theory of SFH. For example, Islamic discourse was believed to have priority over deviant behaviours and resulted in acceptance of smoking restrictions in the home. Family members can act as both allies or barriers to the change, which was sometimes overcome through other support networks (ie, mosque or religious leaders). InterpretationThe mosque is an acceptable and feasible setting for high-quality health promotion interventions. What is needed is to further investigate similar community-based approaches and develop innovative solutions to use existing beliefs and community linkages to encourage positive change. Additionally, the capacity of the communities to promote a smoke-free environment within homes should be developed. Investigation of processes involved is fundamental for development of theory-based, real-programmatic models for intervention and policies. FundingUniversity of Leeds and NHS Leeds.

Associations between self-reported in-home smoking behaviours and surface nicotine concentrations in multiunit subsidised housing

IntroductionSmoke-free policies are being increasingly promoted and adopted in subsidised multiunit housing to address disparities in residential secondhand smoke exposure. In order to inform the planning and evaluation of these...

Minnesota's Comprehensive Statewide Smokefree Law: Short-Term Effects on Young Adults

Young adults have the highest rate of smoking among any age group. The purpose of this study is to assess the short-term effects of Minnesota's comprehensive statewide smokefree law on young adult smoking perceptions and behavior. Telephone surveys were conducted before and up to 18 months after Minnesota's statewide smokefree law went into effect on October 1, 2007 (data analyzed 2010-2011). Participants included young adults from a population-based cohort in Minnesota (n=1458) and from five other upper Midwest states that serve as a comparison (n=248). Differences in perceptions and smoking behavior were examined between Minnesota participants who lived with and without a local smokefree law prior to Minnesota's statewide law, and participants who lived in the comparison states. The majority of youth in Minnesota were aware of the smoking restrictions in restaurants and bars following the law. After implementation of the law, Minnesota participants who previously lived without a local law (versus comparison) were more likely to perceive fewer adult and peer smokers and less likely to report leaving social events early because it was too smoky. No changes in smoking behaviors were observed before and after the law. Minnesota participants, however, who lived without a prior law (versus participants with a prior law) were more likely to attribute a quit attempt after the law to smoking restrictions in restaurant and bars. Results suggest that Minnesota's law has changed perceptions of the tobacco environment. Longer-term follow-up may be needed to observe changes in smoking behavior.

Experience of Smokers and Recent Quitters with Smokefree Regulations and Quitting

Bans on smoking in public areas have increased as knowledge of secondhand smoke dangers has grown. Restrictions on smoking in public areas may lead to less smoking and increased quitting. This study examines the experiences of smokers and recent quitters with local smokefree regulations to better understand the possible mechanisms by which smokefree regulations affect individual tobacco users' patterns of tobacco consumption and quitting. Fifteen in-depth interviews and thirteen focus groups were conducted with tobacco users and recent quitters formerly enrolled in cessation programs provided by ClearWay Minnesota(SM). Data were collected 3 months after smokefree legislation was adopted in the Minneapolis/St. Paul metropolitan area in 2006, and were stratified by tobacco use status and strength of regulation. Essential themes were extracted using NVivo 8 software in 2011. Study participants reported that smokefree legislation forced them to confront their addiction. They experienced apprehension, frustration, and panic anticipating smoking restrictions. This motivated some to attempt to quit, whereas others felt punished by and angry at government intrusion. Both current and former tobacco users felt smokefree regulations contributed to stigmatizing smokers. They also reported smokefree legislation reduced the temptation to smoke. The physical absence of cigarette smoke in bars and restaurants appeared to support quit attempts. The inconvenience of smoking outside was reported to have a similar effect. Essential mechanisms by which bans influenced patterns of tobacco use and quitting include confronting addiction, temptation, inconvenience, and social norms. These findings highlight the success of tobacco control advocates in denormalizing tobacco use, and suggest that some tobacco users may be internalizing negative messages about tobacco.

Simultaneous measurement of urinary total nicotine and cotinine as biomarkers of active and passive smoking among Japanese individuals

Measuring urinary cotinine is a popular and established method of biologically monitoring exposure to tobacco smoke. However, the lower detection limit of cotinine often impedes the evaluation of passive (second-hand) smoking and this, together with unconverted nicotine, does not reflect actual levels of exposure. Furthermore, a portion of the Japanese population might have decreased ability to metabolize nicotine. The present study was therefore carried out to validate the simultaneous analysis of total concentrations of free nicotine and cotinine and their glucuronides to determine actual levels of voluntary and involuntary exposure to cigarette smoke. Urine samples from 118 Japanese smokers and 117 non-smokers were analyzed using gas chromatography-mass spectrometry. Voluntary and involuntary smoking status was self-reported and workplace smoking restrictions were objectively evaluated. The integrated sum of all concentrations showed 2.2- and 2.4-fold higher total levels (free and glucuronide) of nicotine and cotinine relative to the free levels. Median (quartiles) of total nicotine and cotinine were 1635 (2222) and 3948 (3512) ng/mL in smokers, and 3.5 (5.3) and 2.8 (4.2)ng/mL in non-smokers. Concentrations of urinary nicotine were higher than those of cotinine in 21% of smokers and in 54% of non-smokers. Nicotine and cotinine levels were significantly associated with a smoking habit, as well as being significantly associated with the workplace and home environments of non-smokers. The present method can monitor voluntary and involuntary exposure to tobacco smoke. Measuring total urinary nicotine levels might be useful for analyzing exposure to cigarette smoke among non-smokers.

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

BackgroundNearly 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.MethodsWe 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.ResultsExcluding 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 unenclosed, area had PM2.5 levels that were 10 to 60 μg/m3 and 6 to 23 μg/m3 higher than outdoor levels, respectively, indicating contamination from smoking.ConclusionsAlthough fewer than roughly 10% of casino patrons are actively smoking on average, these individuals substantially increase PM2.5 exposure for all patrons in smoking and unenclosed nonsmoking areas. Nonsmoking areas may be too inconvenient, small, or undesirable to serve a substantial number of nonsmoking patrons. Imposing indoor smoking bans, or contained smoking areas with a maximum capacity of up to 10% of the total patronage, would offer protection from PM2.5 exposures for nonsmoking patrons and reduce employee exposures.

Smoking restrictions on campus: changes and challenges at three Canadian universities, 1970-2010

This article examines the restriction of smoking on university campuses in the Canadian context. Indoor smoking on campus is now completely prohibited by law, and universities are increasingly moving to restrict, or prohibit, outdoor smoking on their grounds. The research focuses on three case studies to identify changes in spatial restrictions on campus smoking over the last four decades (1970-2010), and to determine the challenges involved in establishing bans in outdoor areas of campus. The three universities were selected for their different approaches to the issue of outdoor smoking. Data collection involved semi-structured interviews with 36 key informants, conducted from September 2010 to January 2011, supplemented by documentary information. Interview data were analysed thematically. Protection against environmental tobacco smoke (ETS) on campus proceeded incrementally, via policy-making at the provincial, municipal and institutional levels. Historically, institutional bans on indoor smoking were particularly significant, but their health benefits could be limited by the presence of private property on campus. Universities continue to initiate smoking restrictions today, with respect to outdoor bans. However, respondents reported myriad challenges in developing, implementing and maintaining such bans. Five principal concerns were articulated: the need for ongoing policy communication; management of community relations as smokers are displaced from campus; enforcement to ensure that the policy has practical effect; safety concerns; and difficulties relating to campus layout. Because challenges are diverse and contextual, effective protection against outdoor ETS on campus is likely to require an ongoing commitment on the part of administrators.

OP55 Socioeconomic Inequalities in Childhood Exposure to Secondhand Smoke Before and after Smoke-Free Legislation in three UK Countries

BackgroundSecondhand smoke (SHS) exposure is higher among children from lower socioeconomic status (SES) families, contributing to the intergenerational reproduction of health inequalities. Legislation prohibiting smoking in enclosed public places was...

Analysis of the Roles of Smoking and Allergy in Nasal Polyposis

Recent studies on the etiopathogenesis of nasal polyps have shown that smoking and nonallergenic inhalants such as occupational dust exposure cause chronic inflammation of the nasal mucosa. These factors may be associated with nasal polyps. The aim of this study was to use laboratory tests to investigate the effects of smoking and allergens on the development of nasal polyps. The study included 60 consecutive patients with a diagnosis of nasal polyposis who were treated with functional endoscopic sinus surgery at our clinic and 25 smoker and 25 nonsmoker participants who constituted a control group. In the patient and control groups, the mean absorbance value for cotinine in smokers was found to be statistically significantly lower than that in nonsmokers. There was a significant difference between the groups with respect to blood cotinine positivity. No significant difference was found between the groups in terms of allergy parameters. In the regression model, smoking was found to be the only significant risk factor for the development of nasal polyps, independent of smoking duration, absorbance value, or cotinine positivity. Smoking restriction and avoiding exposure to cigarette smoke by patients with nasal polyps may be an important strategy in the prevention and recurrence of nasal polyposis. No direct relationship was determined between allergy and nasal polyposis.