Tobacco Smoking In Public Places Research Articles

Assessing exposure to secondhand smoke among Iranian patients with cardiac diseases; a cross-sectional study

IntroductionStudies have linked secondhand smoke (SHS) exposure to adverse health effects. The high prevalence of heart disease necessitates the need for studies in this field. Therefore, the aim of the present study was to assess the exposure to SHS in cardiac patients. MethodThis study is a cross-sectional descriptive study. A total of 430 patients who were referred to Imam Ali Hospital in Kermanshah, Iran, in 2020 were included in the study based on predetermined inclusion and exclusion criteria. The researchers collected and recorded demographic information, disease history, and exposure to secondhand smoke (SHS) through a digital questionnaire. Bivariate analysis was conducted using a chi-square test and an independent T-test, depending on the variable scale. ResultsThe results of the study showed that 237 patients were male (55.12 %) and 193 were female (44.8 %). The prevalence of exposure to secondhand smoke was 72.09 %. Notably, the highest rate of exposure to secondhand smoke was associated with 'exposure to tobacco smoke in public places' with a rate of 69.30 %. Additionally, it was observed that approximately 39.07 % of patients reported exposure to secondhand smoke in public places at least once a week. ConclusionThe present study has found that cardiac patients frequently experience secondhand smoking exposure, with public settings being the primary location of exposure. Implementing intervention strategies and enacting laws that prohibit smoking can effectively mitigate the negative impact of SHS exposure.

Socio-demographic Patterns, BehaviouralPatterns, and Predominant Causes of Smoking Tobacco among Construction Workers:

The socio-demographic patterns, behavioural patterns, and predominant causes of smoking tobacco among construction workers were explored using data from Savar, Dhaka, Bangladesh construction sites. A mixed questionnaire based on the basic socio-demographic and behavioural patterns such as sex, age, education, marital status, average monthly income, family size etc. and predominant causes of smoking such as addiction/habit, peer pressure, personal/family/occupational stress relief etc. was prepared and presented to the consenting study respondents (n=110) at Savar, Dhaka, Bangladesh. The patterns and causes were selected based on the previous literature review. Also, a Focus Group Discussion (FGD) was conducted with 11 consenting participants. The resultant data was then analysed using the OpenEpi v3.01 software (CDC, USA).Chi-square tests and logistic regression analysis (OR and 95% CI)were conducted using the software. Preliminary analysis revealed that the overall smoking prevalence in the study sample was 63.63% (n = 70).The two most significant causes of smoking in the study sample were an addiction to smoking (44.29%) and peer pressure (24.29%). Through a review of the findings of this study, it can be ascertained thatthere is a high prevalence of smoking among the construction workers of Savar, Dhaka, and behavioural patterns of smoking are associated with critical socio-demographic factors. Findings suggest the need for control on the easy availability oftobacco and intervention policies such as a ban on tobacco smoking in public places, especially construction sites, imposing of high tax and surcharge on tobacco products etc., aimed at reducing tobacco use among the construction workers of Savar, Dhaka.
 Keywords: Savar, tobacco, smoking, patterns, causes, construction workers.

Banning Tobacco Smoking in Public Places via Customized Tobacco Control Vaccine Framework: Experience From Tigray, Ethiopia.

Tobacco use remained the most preventable cause of premature morbidities and deaths. Despite notable decrement of tobacco use prevalence globally, the prospect of the low- and middle-income countries lies at crossroads due to government's complacence and increased influence of the tobacco industry. Tigray regional state in Ethiopia which received World Health Organization recognition in 2017 spearheaded the tobacco control endeavor using cost-effective and whole-government approach via customized tobacco control vaccine framework. The job required interrelated endeavors of law making, advocacy, and law enforcement, but all with an effective community engagement and ownership framework. It did not require re-inventing the wheel but synthesizing available evidence and exhibiting the potential to reverse the course; enlisting challenges alone do not bear fruit. Tigray's notable achievement and Ethiopia's promising results should be supported by rigorous law enforcement and accountability mechanisms. The evolving tobacco industry influence and illicit tobacco trade pose a serious concern.

Compliance with the smoke-free public places legislation in Nepal: A cross-sectional study from Biratnagar Metropolitan City.

BackgroundSmoke-free legislation banning tobacco smoking in public places was implemented across Nepal in 2014 with the ambition to reduce the impact of second-hand smoking. As part of a comprehensive policy package on tobacco control, the implementation of the legislation has seen a marked reduction in tobacco consumption. Yet there remains uncertainty about the level of compliance with smoke-free public places.ObjectivesThis study assesses the compliance with smoke-free laws in public places and the factors associated with active smoking in public places in Biratnagar Metropolitan City, Nepal.MethodsA cross-sectional study was conducted in the Biratnagar metropolitan city in Province 1 of Nepal from July to December 2019. A total of 725 public places within the metropolitan city were surveyed using a structured survey tool. Active smoking was the primary outcome of the study which was defined as smoking by any person during the data collection time at the designated public place.ResultsThe overall compliance with smoke-free legislation was 56.4%. The highest compliance (75.0%) was observed in Government office buildings. The lowest compliance was observed in eateries, entertainment, and shopping venues (26.3%). There was a statistically significant association between active smoking and the presence of ‘no smoking’ notices appended at the entrance and the odds of active smoking in eateries, entertainment, hospitality, shopping venues, transportations and transits was higher compared to education and health care institutions. None of the ‘no smoking’ notices displayed fully adhered to the contents as prescribed by the law.ConclusionAs more than half of the public places complied with the requirements of the legislation, there was satisfactory overall compliance with the smoke-free public places law in this study. The public venues (eateries, shopping venues and transportations) that are more frequently visited and have a high turnover of the public have lower compliance with the legislation. The content of the message in the ‘no smoking’ notices needs close attention to adhere to the legal requirements.

Tobacco Consumption and its Associated Factors among Nepalese Students

Background: Tobacco smoking is one of the major issues among the adolescent population worldwide. WHO has estimated that tobacco use causes six million deaths worldwide each year and predicts reaching eight million by 2030. Our study aims to assess the proportion of tobacco use and its associated factors among Nepalese students. Methods: A cross-sectional analytical study was conducted among 430 students in Syangja, Nepal. Samples were selected through the cluster sampling technique. Data were collected by a self-administered questionnaire. Chi-square (χ2) test was used to find out the associated factors of tobacco consumption. Results: The prevalence of tobacco usage was found to be 22.8% (males 37.2%, females 8%). Students were regularly exposed to tobacco smoking in public places (70.3%) and at home (62.2%). Peer pressure (62.3%) was the most influencing factor for tobacco consumption, followed by experimentation (18.2%) and tobacco advertisements (7.8%). Cigarette (75.5%) and Hookah (74.5%) were the most common type of tobacco consumed by the participants. Tobacco consumption was higher among private school students (24.5%) than government school students (19.6%). Conclusion: Gender, family type, occupation, and pocket money were associated with tobacco usage (p<0.05). Although the majority of students were aware of the negative health impacts of tobacco use, the usage of tobacco products is still prevalent among Nepalese adolescent students. School-based health education and intervention programs should be implemented to reduce the habit of tobacco consumption.

Protecting children from tobacco-related harm in private vehicles

Protecting children from tobacco-related harm in private vehicles

Exposure to Second-Hand Smoke in Public Places and Barriers to the Implementation of Smoke-Free Regulations in The Gambia: A Population-Based Survey.

Introduction: Second-hand smoke is associated with more than 1.2 million deaths per year among non-smokers. Smoking in public places is prohibited in The Gambia but there is no information on the level of exposure to second-hand smoke among adolescents and adults 15–64 years. The aim of this study was to assess the level and predictors of exposure to second-hand smoke in public places and compliance with smoke-free regulations in The Gambia. Methods: A population-based survey was conducted in an established Health and Demographic Surveillance System (HDSS). A total of 4547 participants (15–64 years) from households within the Farafenni HDSS were interviewed at their homes but only 3343 were included in our analysis. Factors associated with exposure to second-hand smoke in public places were assessed by three different multivariable regression models. Results: Exposure to tobacco smoke in public places was high (66.1%), and higher in men (79.9%) than women (58.7%). Besides being male, less education, lower household income, urban residence and not aware of smoke-free regulations were strongly associated with exposure to second-hand smoke. Conclusion: Despite existing smoke-free regulations, reported exposure to second-hand smoke remains high in public places in The Gambia. The Ministry of Health should continue to strengthen their advocacy and sensitization programs to ensure smoke-free regulations are fully implemented. Some population subgroups are at a higher risk of exposure and could be targeted by interventions; and settings where these subgroups are exposed should be targeted by enforcement efforts.

Association of tobacco control policies with cigarette smoking among school youth aged 13-15 years in the Philippines, 2000-2015.

INTRODUCTIONIn 2003, the Philippines implemented legislation that prohibited the sale of tobacco products to youth, placed text warning labels on tobacco products, and prohibited tobacco smoking in public places. This study assessed if this legislation was associated with reduced cigarette smoking among youth.METHODSData came from the 2000–2015 Philippines Global Youth Tobacco Survey (GYTS), a nationally representative, cross-sectional survey of students aged 13–15 years. GYTS data were used to determine associations between tobacco control legislation and current, past 30-day, current cigarette smoking (CCS). Logistic regression models were adjusted for age, sex, current other tobacco product use (COTPU), and price per cigarette stick (PPCS).RESULTSIn the unadjusted model, the 2003 legislation was not associated with CCS (OR=0.77; 95% CI: 0.54–1.10). After adjusting for covariates, it was negatively associated (AOR=0.65; 95% CI: 0.53–0.80). Being 15 years old (OR=1.31; 95% CI: 1.08–1.58), male (OR=2.54; 95% CI: 2.17–2.98), and COTPU (OR=4.12; 95% CI: 3.47–4.91) were positively associated with CCS in unadjusted models. In adjusted models, being 14 years old (AOR=1.29; 95% CI: 1.08–1.53), 15 years old (AOR=1.55; 95% CI: 1.31–1.84), male (AOR=2.49; 95% CI: 2.13–2.91), and COTPU (AOR=3.96; 95% CI: 3.32–4.73), were associated with CCS. PPCS was not associated with CCS in either the unadjusted (OR=1.32; 95% CI: 0.82–2.11) or adjusted (AOR=1.32; 95% CI: 0.79–2.18) models.CONCLUSIONSAfter adjusting for covariates, the 2003 tobacco control legislation was associated with lower current cigarette smoking, but price per cigarette stick was not.

Impact of declining exposure to secondhand tobacco smoke in public places to decreasing smoking-related cancer mortality in the US population

BackgroundThe major decrease in exposure to secondhand smoke (SHS) in public places in recent decades could have contributed to the decline in smoking-related cancer mortality observed in the US population. MethodsProspective study among 11,856 non-smoking adults aged ≥40 years who participated in NHANES 1988–1994 or 1999–2004 and were followed for mortality through 2006. We estimated the amount of change in cancer mortality over time attributed to the intermediate pathway of changes in SHS exposure in public places, after adjustment for risk factors and SHS exposure at home. ResultsThe adjusted smoking-related cancer mortality rate ratios (95% CI) for a two-fold increase in serum cotinine and a 1-hour increase in occupational SHS exposure time were 1.10 (1.03, 1.17) and 1.14 (1.06, 1.24) for all-cancer, and 1.13 (1.03, 1.24) and 1.14 (1.02, 1.26) for smoking-related cancer, respectively. The absolute reduction in mortality comparing 1999–2004 to 1988–1994 was 75.8 (−25.5, 177.0) and 77.0 (2.6, 151.4) deaths/100,000 person-years, for all-cancer and smoking-related cancer, respectively. Among these avoided all-cancer deaths, 45.8 (2.8, 89.5) and 18.1 (−1.2, 39.6)/100,000 person-year were attributable to changes in serum cotinine concentrations and occupational SHS exposure time, respectively. The corresponding numbers of smoking-related cancer avoided deaths were 36.4 (0.7, 72.8) and 9.9 (−3.8, 24.9)/100,000 person-year. ConclusionsDeclines in SHS exposure were associated with reductions in all-cancer and smoking-related cancer mortality, supporting that smoking bans in public places may have reduced cancer mortality among non-smoking adults.

Geographical Inequality in Tobacco Control in China: Multilevel Evidence From 98 058 Participants.

We investigated the spatial patterning and correlates of tobacco smoking, exposure to secondhand smoke, smoking in public places, workplace smoking prohibition, pro- and counter-tobacco advertisements in mainland China. Choropleth maps and multilevel models were used to assess geographical variation and correlates of the aforementioned outcome variables for 98 058 participants across 31 provinces of China in 2010. Current tobacco smoking prevalence was higher in the central provinces for men and in the north eastern provinces and Tibet for women. Secondhand smoke was higher for both genders in Qinghai and Hunan provinces. Workplace tobacco restrictions was higher in the north and east, whereas smoking in public places was more common in the west, central, and far northeast. Protobacco advertising was observed in public places more often by men (18.5%) than women (13.1%). Men (35.5%) were also more likely to sight counter-tobacco advertising in public places than women (30.1%). Awareness of workplace tobacco restrictions was more common in affluent urban areas. Lower awareness of workplace tobacco restrictions was in less affluent urban and rural areas. Sightings of tobacco smoking in public places was highest in restaurants (80.4% for men, 75.0% for women) and also commonly reported in less affluent urban and rural areas. Exposure to secondhand smoke was lower among women (but not men) where workplace tobacco restrictions was more common and higher regardless of gender in areas where smoking in public places was more commonly observed. Geographical and gender-sensitive targeting of tobacco prevention and control initiatives are warranted. This study demonstrates spatial patterning of China's 300 million smokers across the country that are different for men and women. Many of the factors that influence tobacco use, such as pro- and counter-advertising, also vary geographically. Workplace smoking restrictions are more commonly reported among individuals with higher educational attainment, but this not does appear to translate into reduced exposure to secondhand smoke. There is a need to intervene in other contexts, especially in restaurants and on public transport. Geographically targeted and gender-sensitive policy is required to advance effective tobacco control and prevention of noncommunicable diseases across all of China.

Secondhand tobacco smoke exposure among adolescents in an Ethiopian school

Tobacco use is responsible for 6 million deaths globally per year, of which 600,000 deaths are due to secondhand smoke (SHS) mainly among women and children. This study aims to determine the prevalence of SHS exposure among school-going adolescents and highlights the essential determinants in developing successful strategies to prevent adverse health effects in Ethiopia. The analysis is based on a school based cross sectional study where 1673 students with 98.2% of response rate from grade 9-12, aged 13-19 were included. Data was collected by a self-administered questionnaire that is adapted from the global youth tobacco survey questionnaire. Proportions and 95% confidence intervals were obtained as estimates of prevalence. Bivariate and multivariate analyses were made using logistic regression on SPSS version 20.0 software in order to predict factors associated with SHS exposure. About 17% of adolescents were exposed to tobacco smoke in their home, whereas more than half (60.8%) of adolescents were exposed to tobacco smoke in public places. In multivariate analysis, sex, parent smoking, peer smoking, and absence of discussion in the classroom about dangers of smoking were seen significantly associated with SHS exposure. The prevalence of SHS exposure among adolescents in Ethiopia is highest. Moreover, exposure to SHS in public places is much higher than at home.

Effects of environmental tobacco smoke on peak expiratory flow rates on healthy school children

Introduction: Tobacco smoke is one of the most important environmental pollutants (ETS). Passive exposure to tobacco smoke is involuntary and it presents a health risk for children. Objective: To establish if there are differences in Peak Expiratory Flow Rates (PEF) values of healthy school children who live in households with and without tobacco smoke. Methods: PEF measurements were taken for 830 school children, from elementary schools in Nis and Laplje Selo. Measurements were obtained with new peak flow meters Vitalograf-normal range (EN 13826), 3 to 5 times. The highest values were taken for analysis. P < 0.05 was considered significant. Results: We considered PEF values for 830 healthy school children, 599 (72.17%) from households with tobacco smoke (ETS), and 231 (27.83%) without ETS. Exposure to parenteral smoking was associated with reduced PEF rates: 312.01 L/min (95% CI=301.38-322.65 L/min), for boys and 284.64 L/min (95% CI=275.73-293.55 L/min), for girls. PEF rates for children from households without ETS are 313.79 L/min (95% CI=295.63-331.93 L/min) for boys, and 302.0 L/min (95% CI=287.02- 316.98 L/min) for girls. PEF rates were significantly lower for girls from households with ETS (p<0.05). Boys, with and without ETS, had no statistically significant differences between their height, weight and age, so their PEF rates could be compared by their absolute values. For girls, this was not the case, and after age, height and weight adjustments their PEF rates showed no statistical significance (p= 0,346). Conclusions: Parental and household smoking were associated with decreased lung function in school age children. Although it's possible to reduce exposure to tobacco smoke in public places, it's important to inform parents about long-term impact of tobacco smoke on the health of their children.

Geographical variation and correlates of tobacco smoking, second-hand smoke exposure, workplace tobacco prohibition, and pro-tobacco and counter-tobacco advertising in mainland China: a cross-sectional study of 98 058 participants

BackgroundWith more than 300 million people directly affected by tobacco smoking and an additional 740 million non-smokers affected by second-hand smoke, new insights are needed to inform more aggressive and effective tobacco prevention and control policy in China. MethodsChloropleth maps and multilevel logistic regression was used to assess geographical variation in data on tobacco smoking, exposure to second-hand smoke, the prominence of tobacco advertising and promotion, counter-advertising and regulatory responses for 98 058 participants spread across 161 Disease Surveillance Points (DSPs) and in all 31 provinces of China in 2010. The data and study was approved by the ethics committee of the China Center for Disease Control and Prevention. Findings98 058 people participated in the survey. Current tobacco smoking was markedly different between men (54% [95% CI 52·6–54·9%]) and women (3% [3·0–3·8%]). Workplace tobacco prohibition was highest among provinces in the north and east parts of China, whereas smoking in public places was more common in the west, central, and far northeast parts of China. Men (19% [17·7–19·4%]) were more likely to notice pro-tobacco advertising in public places than women (13% [12·4–13·8%]). Awareness of pro-tobacco advertising was highest in Tibet and in southern China. Men (36% [34·4%–36·6%]) were also slightly more likely to notice counter-tobacco advertising in public places than women (30% [29·1–31·1%]). After adjusting for confounders, substantial geographic variation in all of the outcome variables remained unexplained. Awareness of workplace tobacco prohibition was more common in the most affluent urban areas. Awareness of workplace tobacco prohibition was weakest in the least affluent urban and rural areas. Sightings of tobacco smoking in public places was especially high in restaurants (80% for men, 75% for women) and tended to be more commonly reported in the least affluent urban and rural areas. Exposure to passive smoking was lowest among women where workplace tobacco prohibition was more common and in areas where smoking in public places was sighted more often. InterpretationGeographical targeting is required to ensure that prevention and control of tobacco is optimised in China, particularly within the least affluent communities. FundingAustralian-China Science and Research Fund. XF is supported by a UIC International Links Scheme. TAB is supported by a National Heart Foundation of Australia Postdoctoral Fellowship (#100161).

Cardiovascular Events Following Smoke-Free Legislations: An Updated Systematic Review and Meta-Analysis.

Legislations banning smoking in indoor public places and workplaces are being implemented worldwide to protect the population from secondhand smoke exposure. Several studies have reported reductions in hospitalizations for acute coronary events following the enactment of smoke-free laws. We set out to conduct a systematic review and meta-analysis of epidemiologic studies examining how legislations that ban smoking in indoor public places impact the risk of acute coronary events. We searched MEDLINE, EMBASE, and relevant bibliographies including previous systematic reviews for studies that evaluated changes in acute coronary events, following implementation of smoke-free legislations. Studies were identified through December 2013. We pooled relative risk (RR) estimates for acute coronary events comparing post- vs. pre-legislation using inverse-variance weighted random-effects models. Thirty-one studies providing estimates for 47 locations were included. The legislations were implemented between 1991 and 2010. Following the enactment of smoke-free legislations, there was a 12 % reduction in hospitalizations for acute coronary events (pooled RR: 0.88, 95 % CI: 0.85-0.90). Reductions were 14 % in locations that implemented comprehensive legislations compared to an 8 % reduction in locations that only had partial restrictions. In locations with reductions in smoking prevalence post-legislation above the mean (2.1 % reduction) there was a 14 % reduction in events compared to 10 % in locations below the mean. The RRs for acute coronary events associated with enacting smoke-free legislation were 0.87 vs. 0.89 in locations with smoking prevalence pre-legislation above and below the mean (23.1 %), and 0.87 vs. 0.89 in studies from the Americas vs. other regions. The implementation of smoke-free legislations was related to reductions in acute coronary event hospitalizations in most populations evaluated. Benefits are greater in locations with comprehensive legislations and with greater reduction in smoking prevalence post-legislation. These cardiovascular benefits reinforce the urgent need to enact and enforce smoke-free legislations that protect all citizens around the world from exposure to tobacco smoke in public places.

Comprehensive smoke-free policies: a tool for improving preconception health?

Lower income women are at higher risk for preconception and prenatal smoking, are less likely to spontaneously quit smoking during pregnancy, and have higher prenatal relapse rates than women in higher income groups. Policies prohibiting tobacco smoking in public places are intended to reduce exposure to secondhand smoke; additionally, since these policies promote a smoke-free norm, there have been associations between smoke-free policies and reduced smoking prevalence. Given the public health burden of smoking, particularly among women who become pregnant, our objective was to assess the impact of smoke-free policies on the odds of preconception smoking among low-income women. We estimated the odds of preconception smoking among low-income women in Ohio between 2002 and 2009 using data from repeated cross-sectional samples of women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A logistic spline regression was applied fitting a knot at the point of enforcement of the Ohio Smoke-free Workplace Act to evaluate whether this policy was associated with changes in the odds of smoking. After adjusting for individual- and environmental-level factors, the Ohio Smoke-free Workplace Act was associated with a small, but statistically significant reduction in the odds of preconception smoking in WIC participants. Comprehensive smoke-free policies prohibiting smoking in public places and workplaces may also be associated with reductions in smoking among low-income women. This type of policy or environmental change strategy may promote a tobacco-free norm and improve preconception health among a population at risk for smoking.

Comparison of Tobacco-Containing and Tobacco-Free Waterpipe Products: Effects on Human Alveolar Cells

In recent years, a class of products marketed as "tobacco-free" alternatives for the "health conscious user" has become widely available for waterpipe (hookah, narghile, or shisha) smoking. Their adoption may be in part driven by regulations banning tobacco smoking in public places and by an increasing awareness of the hazards of waterpipe tobacco smoking. Although these products are presented in advertising as a "healthier" choice, very little is known about their health effects. In this study, we compared the effects of smoke generated with tobacco-free and conventional tobacco-derived products on human alveolar cells. Smoke was generated with a smoking machine that precisely mimicked the puffing behavior of 15 experienced waterpipe smokers when they used conventional waterpipe tobacco products of their choice and flavor-matched tobacco-free products. Human alveolar epithelial cells (A549) were treated with particulate matter sampled from the smoke, and the effects on cell cycle, proliferation, and doubling time were measured during the subsequent 72hr. We found that smoke from both types of waterpipe products markedly reduced cell proliferation, caused cell cycle arrest at G0/G1, and increased cell doubling time. There were no significant differences across product in any measure. Tobacco-free and tobacco-based waterpipe products exert substantial and similar deleterious effects on human lung cells. This study adds to the nascent evidence base indicating that except for exposure to nicotine and its derivatives, use of tobacco-free waterpipe products does not present a reduced health risk relative to the use of conventional tobacco-based products.

Factors Influencing the Persistence of Tobacco Smoking in Public Places in Tanzania: A Cross-Sectional Study in Urban, Rural and Semi-Rural Settings

Background: In 2003 the government of Tanzania enacted the Tobacco Products (Regulation) Act 2003, which, among other things, prohibited smoking in public places. However, smoking has persisted despite the existence of the Act. This study aims to establish the reasons behind the persistence of tobacco smoking in public places. ②Methods: This was a cross-sectional study where data were collected using pre-tested, self-administered questionnaires with both open and closed questions and documentary reviews. The study was conducted in urban, rural and semi-rural areas in three districts located in eastern, central and northern Tanzania. Quantitative data were analyzed using SPSS ver. 15. Qualitative data were analyzed manually using a thematic content approach. ③Results: The study involved 240 participants, of whom 67% were males. Overall smoking prevalence was 26.5% (36.3% for males and 6.4% for females, p 0.05). About 40% of the smokers were between 25-35 years old and 52.4% had primary school as their highest level of education. About 56% of participants said they were aware of the Tobacco Regulation Act, but the majority could neither define it nor state the penalties for its infringement. Only 59.5% were aware that tobacco smoking causes lung cancer. About 4 out of 10 cigarette smokers do not adhere to NO SMOKING warnings. ④ Conclusions: Cigarette smoking in public places in Tanzania has persisted mainly due to low awareness and passive implementation of the Tobacco Regulation Act, 2003. Other causes are aggressive advertising and promotion by the tobacco industry and insufficient awareness about the health effects associated with tobacco smoking. This study calls for an increase in cigarette taxation, sensitization about the dangers of both smoking and second-hand smoke and active enforcement of the act as immediate intervention strategies.

The Effect of Comprehensive Smoking Bans in European Workplaces.

Many European countries have recently implemented comprehensive smoking bans to reduce exposure to tobacco smoke in public places and all indoor workplaces. We use a difference-in-differences approach and comparable microdata for a number of European countries to evaluate the impact of national comprehensive smoking bans on workers' perceived health. Results show that the introduction of comprehensive smoking bans has a significant effect on the probability of both exposure to smoke and work-related respiratory problems. We also highlight unintended effects in terms of mental distress. The impact across countries is shown to vary with the degree of strictness of the bans.

Global Adult Tobacco Survey data as a tool to monitor the WHO Framework Convention on Tobacco Control (WHO FCTC) implementation: the Brazilian case.

The Global Adult Tobacco Survey (GATS) was conducted in Brazil to provide data on tobacco use in order to monitor the WHO FCTC implementation in the country. It was carried out in 2008 using an international standardized methodology. The instrument included questions about tobacco use prevalence, cessation, secondhand smoke, knowledge, attitudes, media and advertising. Weighted analysis was used to obtain estimates. A total of 39,425 interviews were conducted. The prevalence of current tobacco use was 17.5%, (22.0%, men; 13.3%, women). The majority of users were smokers (17.2%) and their percentage was higher in rural areas (20.4%) than in urban areas (16.6%). About 20% of individuals reported having been exposed to tobacco smoke in public places. Over 70% of respondents said they had noticed anti-smoking information in several media and around 65% of smokers said they had considered quitting because of warning labels. About 30% of respondents had noticed cigarette advertising at selling points and 96% recognized tobacco use as a risk factor for serious diseases. Data in this report can be used as baseline for evaluation of new tobacco control approaches in Brazil, vis-à-vis WHO FCTC demand reduction measures.

Reduction of secondhand tobacco smoke in public places following national smoke-free legislation in Uruguay

BackgroundSmoke-free legislation eliminating tobacco smoke in all indoor public places and workplaces is the international standard to protect all people from exposure to secondhand smoke. Uruguay was the first country...