Support For Smoke-free Policies Research Articles

South African College Students’ Attitudes Regarding Smoke-Free Policies in Public, on Campus, and in Private Spaces

Background: Despite the increase in smoke-free policies globally, there has been limited research regarding reactions to them among young adults. Thus, the objectives of the current study are to examine smoking behaviors and attitudes toward smoke-free policies among South African college students. Design and Methods: In Summer 2010, University of Cape Town students were recruited for surveys and focus groups through fliers and classroom announcements. Survey assessments included sociodemographics, smoking behaviors, and attitudes toward smoke-free policies. The online survey was completed by 103 college students, and 4 focus groups among 27 college smokers were conducted. Results: Of 103 survey participants, 41.7% (n=43) were current (past 30-day) smokers. Correlates of current smoking included being male (OR=0.32, p=.020), having more friends that smoke (OR=1.32, p=.031), more frequently consuming alcohol (OR=1.07, p=.060), and having used marijuana in the past 30 days (OR=3.75, p=.029). Participants reported high levels of approval of smoke-free policies in public (93.2%) and on campus (60.2%) and frequently implemented smoke-free policies in their homes (67.0%) and cars (73.8%). Correlates of receptivity to public policies included not living with smokers (p=.020) and being nonsmokers (p=.003). Receptivity to a smoke-free campus was associated with fewer friends who smoke (p=.022), having nonsmoking parents (p=.014), and being nonsmokers (p<.001). Correlates of having a smoke-free home included not using alcohol in the past 30 days (p=.053), having nonsmoking parents (p=.024), and not living with smokers (p<.001). Having a smoke-free car was associated with not recently using alcohol (p=.002), living on campus (p=.037), and being nonsmokers (p=.009). Focus group data indicated that, despite support for smoke-free policies, enforcement of public and campus policies is limited. Conclusions: Future tobacco control efforts might focus cessation among young adults and enforcement of existing public and campus policies in South Africa.

Support for smoke-free policy, and awareness of tobacco health effects and use of smoking cessation therapy in a developing country

BackgroundPreventing an epidemic increase in smoking prevalence is a major challenge for developing countries. Ghana, has maintained a low smoking prevalence despite the presence of cigarette manufacturing for many decades. Some of this success may have been contributed by cultural factors and attitudes. We have studied public awareness of health risks, attitudes to smoke-free policy, tobacco advertising/promotion and other factors in a Ghanaian population sample.MethodsWe used two-stage cluster randomized sampling to study household members aged 14 and over in a representative household sample in the Ashanti Region of Ghana.Results6258 people, 88% of those eligible, took part in the study. Knowledge of health risks of smoking and passive smoking was high; radio was the main source of such information. Most people work and/or spend time in places where smoking is permitted. There was very strong support (97%) for comprehensive smoke-free legislation, particularly among Christians and Muslims. Despite the advertising ban, a third of respondents (35%), particularly in urban areas, had noticed advertising of tobacco or tobacco products, on the radio (72%) and television (28%). Among smokers, 76% had attempted to quit in the last 6 months, with the main sources of advice being friends and spouses. Use of nicotine replacement therapy was very rare. Low levels of health awareness were seen in females compared with males (Adjusted Odds Ratio (AOR); 0.51, 95% CI 0.39-0.69, p < 0.001). High levels of health awareness was seen among Traditionalists compared with Christians AOR; 2.16 95% CI 0.79-5.94, p < 0.05) and the relatively well educated (AOR; 1.70 95% CI 1.12-2.58, p < 0.05) and those living in rural areas (AOR 1.46 95% CI 1.14-1.87, p = 0.004).ConclusionAwareness of health risks and support for smoke-free policy are high in Ghana. Exposure to tobacco advertising or promotion is limited and most smokers have tried to quit. Whether these findings are cause or effect of current low smoking prevalence is uncertain.

Adolescents' Support for Smoke-Free Public Settings: The Roles of Social Norms and Beliefs About Exposure to Secondhand Smoke

To assess support for smoke-free policies in public settings among adolescent smokers and nonsmokers in a pro-smoking culture. A total of 1,924 Greek secondary school students (mean age = 14 years, standard deviation = 1.00, 50% female) from nine schools in the urban area of Thessaloniki, Greece, participated in the study. The main outcome measures were supportiveness of smoke-free policies in public settings. Smoker adolescents were less supportive of smoke-free policies, compared with nonsmokers. Regression analysis showed that policy support was predicted by smoking status and motivation to smoke, social norms, and beliefs about the effects of smoking and exposure to secondhand smoke. A significant interaction between smoking status and social norms was also observed, as smoker adolescents who often encountered others smoking in public places reported less support for smoke-free public settings. Three important processes underlying adolescents' support for smoke-free policies not mentioned in previous research were identified. First, social norms of the immediate social environment play a pivotal role in shaping policy support of young people. Second, the effects of smoking status on policy support are significantly moderated by exposure to public smoking. Finally, beliefs about the effects of exposure to secondhand smoke significantly predict young people's support for smoke-free public settings.

An Examination of Smoking Behavior and Opinions About Smoke-free Environments in a Large Sample of Sexual and Gender Minority Community Members

The purpose of this study is to more completely quantify smoking rate and support for smoke-free policies in private and public environments from a large sample of self-identified sexual and gender minority (SGM) populations. A targeted sampling strategy recruited participants from 4 Missouri Pride Festivals and online surveys targeted to SGM populations during the summer of 2008. A 24-item survey gathered information on gender and sexual orientation, smoking status, and questions assessing behaviors and preferences related to smoke-free policies. The project recruited participants through Pride Festivals (n = 2,676) and Web-based surveys (n = 231) representing numerous sexual and gender orientations and the racial composite of the state of Missouri. Differences were found between the Pride Festivals sample and the Web-based sample, including smoking rates, with current smoking for the Web-based sample (22%) significantly less than the Pride Festivals sample (37%; p < .0001). The SGM group (n = 2,162) was 1.49 times more likely to be current smokers compared with the study's heterosexual group (n = 436; p = .005). Statistically fewer SGM racial minorities (33%) are current smokers compared with SGM Whites (37%; p = .04). Support and preferences for public and private smoke-free environments were generally low in the SGM population. The strategic targeting method achieved a large and diverse sample. The findings of high rates of smoking coupled with generally low levels of support for smoke-free public policies in the SGM community highlight the need for additional research to inform programmatic attempts to reduce tobacco use and increase support for smoke-free environments.

College student reactions to smoking bans in public, on campus and at home.

We examined college student reactions to a statewide public smoke-free policy, campus policies and private restrictions through an online survey among 2260 students at a 2-year college and a university and 12 focus groups among smokers. Among survey participants, 34.6% smoked in the past month (35.0% daily, 65.0% non-daily). Correlates of receptivity to public policies included attending the university, not living with smokers and non-smoker status (versus daily and non-daily smoking). Correlates of receptivity to outdoor campus policies included being a university student, unmarried, without children, from homes where parents banned indoor smoking and a non-smoker. Correlates of having home restrictions included not living with smokers, no children, parents banning indoor smoking and non-smoker status. Correlates of having car restrictions included attending the university, not living with smokers, having children, parents banning indoor smoking and non-smoker status. Qualitative findings indicated support for smoke-free policies in public (albeit greater support for those in restaurants versus bars) and on campus. Participants reported concern about smokers' and bar/restaurant owners' rights, while acknowledging several benefits. Overall, 2-year college students and smokers (non-daily and daily) were less supportive of smoke-free policies.

Trends in Adult Attitudes Toward Secondhand Smoke in Indiana, 2002–2007

As more research has been distributed through the media about the negative health impact of exposure to secondhand smoke (SHS), the public's support for smoke-free policies has increased. The purpose of this study was to evaluate trends in knowledge and attitudes about SHS exposure among Indiana adults by smoking status. Study data were from four cross-sectional studies previously conducted by the Indiana Tobacco Prevention and Cessation Agency using the Adult Tobacco Survey protocol between the years 2002 and 2007. Eighteen questions were identified as addressing SHS, 16 of which were available for more than 1 year and were evaluated for time trends. Significant overall trends toward increased awareness of SHS's health effects and support for smoking bans were noted in 10 of the 16 questions analyzed. No significant overall change, positive or negative, occurred in the remaining six questions. When responses were analyzed by smoking status, never smokers and former smokers consistently exhibited higher rates of anti-SHS sentiments and knowledge of SHS than did current smokers. In general, the trends are encouraging to public health efforts to raise awareness about SHS, but there remains much room for improvement, particularly among current smokers.

Multiunit housing residents' experiences and attitudes toward smoke-free policies

Secondhand smoke (SHS) causes significant disease and death. A person's home represents a prominent source of SHS, and the potential for exposure is elevated among those who live in close proximity to smokers in multiunit housing (MUH). This study assessed the prevalence and predictors of SHS exposure and smoke-free policy support among MUH residents. Data were obtained from 5,936 MUH residents who participated in the New York State Adult Tobacco Survey between May 2007 and May 2009. Bivariate analyses were used to assess the prevalence of smoke-free home policies, SHS incursions, and support for smoke-free policies. Logistic regression was used to identify predictors of these measures while adjusting for gender, age, ethnicity, education, region, children in household, and housing type. A total of 73.1% of respondents reported a personal smoke-free home policy in their home. Among these individuals, 46.2% indicated that SHS has ever entered their home in the past year, while 9.2% reported daily incursions. Overall, a majority of respondents (55.6%) support a policy that bans smoking in all areas of their building, including residential units; support was significantly higher among ethnic minorities and individuals who reside with children. Nearly half of New York MUH residents with a smoke-free home policy have experienced a SHS incursion in their home. Since a majority of MUH residents support smoke-free policies and nearly three quarters already prohibit smoking in their home, opportunities exist for initiatives to promote smoke-free building policies.

Support for Smoke-Free Policies: A Nationwide Analysis of Immigrants, US-Born, and Other Demographic Groups, 1995–2002

We examined whether support for tobacco control policies varies by demographic group, including nativity status (i.e., immigrant versus US born). We analyzed 1995 to 2002 data from the Current Population Survey Tobacco Use Supplement (n=543,951). The outcome was a summary attitudinal measure assessing support of smoking bans in 4 of 6 venues. US-born respondents, smokers, male respondents, Native Americans, Whites, and those who were unmarried, of lower socioeconomic status, and whose workplaces and homes were not smoke free were less likely to support smoking bans. Immigrants exhibited stronger support for banning smoking in every venue, with a generation-specific gradient in which support eroded with increasing assimilation to the United States. Levels of support were more than twice as high among immigrants as among US-born respondents (odds ratio [OR]=2.16; 95% confidence interval [CI]=2.08, 2.23). Naturalized citizens displayed higher support than US-born citizens, which may be relevant for mobilization of the electorate. Differences in population composition and contexts (e.g., smoke-free workplaces) only partially accounted for immigrants' stronger level of support. Immigrants and their children may be valuable tobacco control allies given their supportive attitudes toward smoke-free policies.

Perceived justice and popular support for public health laws: A case study around comprehensive smoke-free legislation in Mexico City

The World Health Organization's Framework Convention on Tobacco Control promotes comprehensive smoke-free laws. The effective implementation of these laws requires citizen participation and support. Risk communication research suggests that citizens' perceptions of the fairness of smoke-free laws would help explain their support for the law. This study aimed to assess the factors that correlate with citizens' perceptions of the distributive, procedural and interpersonal justice of smoke-free laws, as well as how these perceptions are related to support for and intention to help enforce these laws. Study data came from a cross-sectional, population-based survey of 800 Mexico City inhabitants before a comprehensive smoke-free policy was implemented there in 2008. Structural equation modeling was used to estimate the bivariate and multivariate adjusted paths relating study variables. In the final multivariate model, the three justice concepts mediated the influence of smoking status, perceived dangers of secondhand smoke exposure, strength of home smoking ban, and perceived rights of smokers on the two distal constructs of support for smoke-free policy and intention to help enforce it. Statistically significant paths were estimated from distributive and procedural justice to support for the law and intention help enforce it. The path from interpersonal justice to support for the law was not significant, but the path to intention to help enforce the law was. Finally, the path from support for the law to the intention to enforce it was statistically significant. These results suggest that three distinct dimensions of perceived justice help explain citizen support for smoke-free policies. These dimensions of perceived justice may explain the conditions under which smoke-free policies are effectively implemented and could help shape the focus for communication strategies that aim to ensure effective implementation of this and other public health policies.

Support for smoke-free policy among restaurant owners and managers in Ulaanbaatar, Mongolia

Objectives:Exposure to second-hand smoke (SHS) is widespread in restaurants in Ulaanbaatar, the capital city of Mongolia. While a smoke-free policy is the most effective way of protecting restaurant workers and...

After the smoke has cleared: evaluation of the impact of a new national smoke-free law in New Zealand

Background:The New Zealand 2003 Smoke-free Environments Amendment Act (SEAA) extended existing restrictions on smoking in office and retail workplaces by introducing smoking bans in bars, casinos, members’ clubs, restaurants and...

Support for and reported compliance with smoke-free restaurants and bars by smokers in four countries: findings from the International Tobacco Control (ITC) Four Country Survey

Objective: To explore determinants of support for and reported compliance with smoke-free policies in restaurants and bars across the four countries of the International Tobacco Control (ITC) Four Country Survey....