Total Smoking Ban Research Articles

Impact of a total smoking ban in a high secure hospital

Aims and methodTo assess the impact of a total smoking ban in a high secure psychiatric hospital. Staff and patients were surveyed before and after implementation. Data were collected on untoward incidents, seclusions, nicotine replacement therapy and changes in psychotropic medication.ResultsOf the 298 patients in the hospital for the evaluation period, 72.8% were smokers before the ban. There were no significant differences in rates of seclusion before and after the ban and only one significant comparison (P =0.01) showed an increase in untoward incidents for smokers. There were no significant increases in the use of psychotropic medication after the ban.Clinical implicationsWith adequate preparation, it is possible to implement a total smoking ban in a high secure psychiatric setting without serious negative consequences.

The impact of Finnish tobacco legislation on restaurant workers’ exposure to tobacco smoke at work

To evaluate the impact of Finnish tobacco legislation concerning restaurants, questionnaire surveys were carried out four times between 1999 and 2007. Their purpose was to assess the effects of the legislation on employees' exposure to tobacco smoke in bars and restaurants in Finland before the total prohibition of smoking. National questionnaire surveys on reported exposure to tobacco smoke among restaurant workers were conducted in 1999, 2001, 2003, and in the spring of 2007 just before the total smoking ban. The data show that smoking is more common among restaurant workers than in the Finnish population in general. Reported exposure to tobacco smoke in bars and restaurants declined slowly after the launch of the renewed Tobacco Act. Between 1999 and 2007, it decreased from 73% to 43% among waiters who were exposed for over four hours per work shift and from 93% to 67% among bartenders. At the same time, non-exposed waiters increased from 15% to 39% and bartenders from 5% to 10%. The number of daily smoked cigarettes, however, remained the same among restaurant workers during the seven-year follow-up. We conclude that the reform of the Finnish tobacco legislation in 2000, which did not totally prohibit smoking in restaurants, decreased the exposure to environmental tobacco smoke but was not sufficiently effective in protecting restaurant workers from occupational exposure to tobacco smoke.

Total smoking bans in psychiatric inpatient services: a survey of perceived benefits, barriers and support among staff

BackgroundThe introduction of total smoking bans represents an important step in addressing the smoking and physical health of people with mental illness. Despite evidence indicating the importance of staff support in the successful implementation of smoking bans, limited research has examined levels of staff support prior to the implementation of a ban in psychiatric settings, or factors that are associated with such support. This study aimed to examine the views of psychiatric inpatient hospital staff regarding the perceived benefits of and barriers to implementation of a successful total smoking ban in mental health services. Secondly, to examine the level of support among clinical and non-clinical staff for a total smoking ban. Thirdly, to examine the association between the benefits and barriers perceived by clinicians and their support for a total smoking ban in their unit.MethodsCross-sectional survey of both clinical and non-clinical staff in a large inpatient psychiatric hospital immediately prior to the implementation of a total smoking ban.ResultsOf the 300 staff, 183 (61%) responded. Seventy-three (41%) of total respondents were clinical staff, and 110 (92%) were non-clinical staff. More than two-thirds of staff agreed that a smoking ban would improve their work environment and conditions, help staff to stop smoking and improve patients' physical health. The most prevalent clinician perceived barriers to a successful total smoking ban related to fear of patient aggression (89%) and patient non-compliance (72%). Two thirds (67%) of all staff indicated support for a total smoking ban in mental health facilities generally, and a majority (54%) of clinical staff expressed support for a ban within their unit. Clinical staff who believed a smoking ban would help patients to stop smoking were more likely to support a smoking ban in their unit.ConclusionsThere is a clear need to more effectively communicate to staff the evidence that consistently applied smoking bans do not increase patient aggression. There is also a need to communicate the benefits of smoking bans in aiding the delivery of smoking cessation care, and the benefits of both smoking bans and such care in aiding patients to stop smoking.

Effects of socialization in the household on youth susceptibility to smoking: a secondary analysis of the 2004/05 Canadian Youth Smoking Survey

To determine associations between younger youths' susceptibility to smoking and four household variables related to tobacco socialization: parental and sibling smoking, restrictions on smoking in the home and exposure to smoking in vehicles. A secondary analysis of the 2004/05 Canadian Youth Smoking Survey used logistic regression to investigate the relationships between youth susceptibility to smoking, gender, and four household variables related to tobacco socialization. Susceptibility to smoking was operationalized by three levels of smoking experience and intention: non-susceptible non-smoker, susceptible non-smoker and experimenter/smoker. The national survey included 29 243 grade 5 to 9 students from randomly sampled public and private schools in ten provinces. For non-smokers, the odds of being susceptible to smoking increased with having a sibling who smokes, a lack of a total household smoking ban and riding in a vehicle with a smoker in the previous week, when adjusting for all other variables in the model. These variables also increased the odds of being an experimenter/smoker versus a susceptible non-smoker. Parent smoking status was not significant in these models. Denormalization messages, through enforced home and vehicle smoking bans, appear to support youth in maintaining a resolve to not smoke, regardless of parental smoking status.

The Impact of Implementing Smoking Bans Among Incarcerated Substance Users: A Qualitative Study

This article reports a study evaluating the effects of implementing smoking bans among drug-using prisoners in Taiwan. Seventy-seven new entrants were recruited in May 2008. Six focus groups were conducted in a prison-based treatment center, the only prison with a total smoking ban in Taiwan. All the subjects were male and their average age was 37 years. Three general reactions to the ban were identified across all focus groups: (a) unfair/hypocritical policy; (b) being forced to stop smoking; and (c) finding ways to smoke anyway. Future studies should compare the effects of total versus partial smoking bans among drug abusers in prison to better explore policy options.

PW01-212 - Correlates of home smoking restrictions among Lithuanian adult smokers

ObjectiveThe aim of study was to estimate the relationships among smoking/quitting behavior, having a smoke-free home and a number of social variables, including perceived family pressure to quit, the presence of adult non-smokers and children in the household, and belief in the harmfulness of secondhand smoke.MethodsThe study analyses data from Lithuanian adult population health behavior surveys, performed in period of 1994- 2008. For every survey the national random sample of 3000 inhabitants aged 20-64 was taken from the National Population Register. The study material was collected through mailed questionnaires covering smoking habits, sociodemographic characteristics.Results65% of current smokers reported living in a home with a total smoking ban, 35% reported having no restrictions on smoking in the home. Report of a recent quit attempt and intention to quit were associated with family preference that the smoker not smoke. Smoke-free homes appear to prolong time to relapse following cessation. Male smokers were more likely than females to report smoke-free homes, and such reports decreased with age. Smokers were nearly 5 times more likely to report smoke-free homes if they lived with a non-smoking adult and child compared to when there was no child or adult nonsmoker in the household, and over 4 times more likely to report a smoke-free home if they believed in the harmfulness of secondhand smoke.ConclusionsSocial influences, especially at the family level, motivate smokers to modify smokers’ behavior in ways that would help them quit and stay quit.

Support for and Reported Compliance Among Smokers With Smoke-Free Policies in Air-Conditioned Hospitality Venues in Malaysia and Thailand: Findings From the International Tobacco Control Southeast Asia Survey

This study examined support for and reported compliance with smoke-free policy in air-conditioned restaurants and other similar places among adult smokers in Malaysia and Thailand. Baseline data (early 2005) from the International Tobacco Control Southeast Asia Survey (ITC-SEA), conducted face-to-face in Malaysia and Thailand (n = 4005), were used. Among those attending venues, reported total smoking bans in indoor air-conditioned places such as restaurants, coffee shops, and karaoke lounges were 40% and 57% in Malaysia and Thailand, respectively. Support for a total ban in air-conditioned venues was high and similar for both countries (82% Malaysian and 90% Thai smokers who believed there was a total ban), but self-reported compliance with bans in such venues was significantly higher in Thailand than in Malaysia (95% vs 51%, P < .001). As expected, reporting a ban in air-conditioned venues was associated with a greater support for a ban in such venues in both countries.

Factors associated with attitudes toward tobacco control policy in public places among adults in three counties of China

vestigate the attitudes of urban and rural community members toward total banning on smoking in public places and to explore the factors associated with these attitudes, in three counties/cities in China. A cross-sectional study was conducted in three counties/cities in 2004, including Xin' an county of Henan province, Anyi county of Jiangxi province, and Mianzhu city of Sichuan province. A total of 5642 residents at age of 18-69 years old were interviewed face-to-face with a uniform questionnaire by locally-trained interviewers, through a random three-stage stratified sampling in each county. Factors were assumed to be associated with attitudes, using chi-square test in univariate analysis and non-conditional logistic regression model in multivariate analysis. The prevalence of current smoking among respondents was 44.3%. 80.7% (1379/1709) of the current smokers reported smoking often or sometimes in public places. Only 9.6% (479/4983) of the respondents reported that their indoor workplaces had totally banned on smoking. 43.5% of the respondents supported a total smoking ban strategy in pubic venues. The results of multivariate logistic regression model showed that eight factors were significantly associated with support for the total smoking ban in public places included region, residency, age, gender, education, smoking status, awareness about passive smoking hazards, and hearing of any message on tobacco control through media differences of rates regarding the factors as: residents in urban to rural areas (OR = 1.29), elderly to youngsters (30-49 vs. 18-29, OR = 1.46; 50-69 vs. 18-29, OR = 1.71), female to male (OR = 1.27), high-educated to less-educated ones, quitters to current smokers (OR = 1.90), nonsmokers to current smokers (OR = 2.01). Those who know messages on health hazards of passive smoking (OR = 2.26), or heard of message on tobacco control through media (OR = 1.43). Results from our study revealed that a thorough smoke-free policy in public places should be developed and implemented in these three counties/cities.

Investigating Smoker's Profile: The Role of Psychosocial Characteristics and the Effectiveness of Tobacco Policy Tools

AbstractThis article investigates smoker's profile by addressing the determinants of cigarette demand and providing a circumstantial exposition of the psychosocial characteristics that differentiate smoking patterns. At the same time, the impact of tobacco control policies on smoking rates and their effectiveness on decreasing cigarette consumption are also analyzed. Consumers are distinguished in four smoking groups in concurrence to smoking status, and dichotomous indicators are constructed to describe tobacco control policies, psychosocial, demographic, and socioeconomic characteristics. The empirical analysis estimates an ordered probit model with sample selectivity. The results indicate the absence of selectivity bias for cigarette consumption; hence, the subsample of smokers comprises a random independent sample and smoking participation and cigarette consumption form distinct stages of smoking behavior. Most of the psychosocial factors are found to be statistically significant in the econometric analysis, implying the main determinants of smoking behavior. In addition, total smoking bans in workplaces and educational institutions comprise efficient policy tools for decreasing cigarette demand, while partial smoking restrictions are accrued to be ineffective in reducing smoking participation.

Staff attitudes to smoking and the smoking ban

Aims and MethodOur aim was to explore attitudes of in-patient mental health staff to smoking and the smoking ban. A questionnaire was distributed to staff (n=450) working at National Health Service psychiatric units in three different locations.ResultsWe obtained 308 responses, at a response rate of 68.4%. Staff were generally less permissive towards smoking in mental health units when compared with previous studies. However, most (78.9%) feared that service users' states would deteriorate if they were not allowed to smoke.Clinical ImplicationsWe found small but noticeable change in staff attitudes following initial reforms in smoking policy. However, there is a need for further significant change in staff attitudes to facilitate implementation of a total smoking ban from July 2008.

Government slow to act on public preference for total pub smoking ban

Government slow to act on public preference for total pub smoking ban

Smoking Restrictions and Treatment for Smoking: Policies and Procedures in Psychiatric Inpatient Units in Australia

Tobacco smoking is the leading preventable cause of death and disease in Australia. Even though smoking prevalence in the general population has been reduced (20% smoke), prevalence rates remain high among psychiatric inpatients (70%-90%). This study aimed to identify smoking policies and procedures in public psychiatric inpatient units in New South Wales, Australia; the provision of "smoking care" in such units (for example, quit-smoking advice or nicotine replacement therapy); and policies and procedures associated with the assessment of smoking status and provision of smoking care. A cross-sectional survey was mailed to all public psychiatric inpatient units in New South Wales for completion by nurse unit managers. Of the 131 units, 123 units completed and returned surveys (94%). Over one-third (36%) of respondents reported instances in which inpatients began smoking during their admission. A similar proportion (39%) reported that staff provided cigarettes to patients who smoked when patients' supply was expended. Fifty percent of respondents reported that all patients were assessed for smoking status; however, 70% reported that nicotine dependence was not assessed. Units on which staff adhered to smoking restrictions were three times as likely to assess patients' smoking status as units where staff never adhered to restrictions (odds ratio=3.05, p=.01). Inadequate establishment of nonsmoking environments and of smoking restriction enforcement as well as inconsistencies in the provision of smoking care were evident. The findings suggest that failure of psychiatric services to provide smoking care is systemic and not related to particular types of services (for example acute versus nonacute or regional versus metropolitan).

Time to stub it out

After a year’s grace period, psychiatric nurses now have to impose and police a total smoking ban

Secondhand Smoke Exposure in Hospitality Venues in Europe

BackgroundAlthough in the last few years some European countries have implemented smoking bans in hospitality venues, the levels of secondhand smoke (SHS) in this occupational sector could still be extremely high in most countries.ObjectiveThe aim of this study was to assess exposure to SHS in hospitality venues in 10 European cities.MethodsWe included 167 hospitality venues (58 discotheques and pubs, 82 restaurants and cafeterias, and 27 fast-food restaurants) in this cross-sectional study. We carried out fieldwork in 10 European cities: Vienna (Austria), Paris (France), Athens (Greece), Florence and Belluno (Italy), Galway (Ireland), Barcelona (Spain), Warsaw and Lublin (Poland), and Bratislava (Slovak Republic). We measured vapor-phase nicotine as an SHS marker.ResultsWe analyzed 504 samples and found nicotine in most samples (97.4%). We found the highest median concentrations in discos/pubs [32.99 μg/m3; interquartile range (IQR), 8.06–66.84 μg/m3] and lower median concentrations in restaurants/cafeterias (2.09 μg/m3; IQR, 0.49–6.73 μg/m3) and fast-food restaurants (0.31 μg/m3; IQR, 0.11–1.30 μg/m3) (p < 0.05). We found differences of exposure between countries that may be related to their smoking regulations. Where we sampled smoking and nonsmoking areas, nicotine concentrations were significantly lower in nonsmoking areas.ConclusionsHospitality venues from European cities without smoking regulations have very high levels of SHS exposure. Monitoring of SHS on a regular basis as well as a total smoking ban in hospitality sector would be needed.

Akzeptanz eines totalen Rauchverbots an Schulen: Einstellungen der Schülerinnen und Schüler

The purpose of this study was to measure students' attitudes towards a total smoking ban in schools and towards impositions in cases of violation. Cross-sectional survey of 1 738 students of 12 public schools in Schleswig-Holstein (grades 7-13, age 11-20 years). Data were collected by means of written questionnaires administered during class time. The following variables were assessed: attitude towards smoking ban, attitude towards impositions, age, sex, citizenship, perceived school climate, current smoking, lifetime smoking; for smokers, and additionally, the "Heaviness of Smoking Index". 76.5% of all students agreed with a total smoking ban, 66.4% agreed with the punishment of violations. Higher acceptance rates were found among girls, young students (11-15 years of age), for never-smokers, and for students who feel comfortable at school. Acceptance of the smoking ban is closely related to current smoking status: 93% of the non-smoking students, but only 14% of the daily smoking students agreed with the regulations. Refusal of the ban increased with increasing physical dependence. The intensification of the smoking ban in public schools meets approval by the majority of students. Smoking students should be more strongly involved in the implementation process, e.g., by supplemental cessation programmes.

Indoor air quality in prisons before and after implementation of a smoking ban law

Objective:To ascertain whether a new indoor smoking ban law in North Carolina correctional facilities was successfully implemented and whether the indoor air quality has improved as a result.Method:Before the law...

Acceptability and impact of a partial smoking ban followed by a total smoking ban in a psychiatric hospital

Objective To assess the impact of a partial smoking ban followed by a total smoking ban in a psychiatric hospital in Switzerland. Methods In 2003, smoking was allowed everywhere in psychiatric units. In 2004, smoking was prohibited everywhere except in smoking rooms. In 2006, smoking rooms were removed and smoking was totally prohibited indoors. Patients and staff were surveyed in 2003 ( n = 106), 2004 ( n = 108), 2005 ( n = 119) and 2006 ( n = 134). Results Exposure to environmental tobacco smoke (ETS) decreased after the partial ban and further decreased after the total ban. Among patients, after the total ban, more smokers attempted to quit smoking (18%) relative to before the total ban (2%, odds ratio = 10.1, p = 0.01). More smokers said that hospital staff gave them nicotine replacement products after the total ban (52%), compared with before (13%, odds ratio = 7.6, p < 0.001). Many participants (55%) commented that the total ban was too strict, and most (64%) preferred the partial ban. Conclusions The partial ban decreased exposure to ETS and the total ban further improved the situation and increased the proportion of smokers who attempted to quit smoking and received nicotine medications. The total ban was loosely enforced and was overall acceptable, but most participants preferred a partial ban.

Implementation of the Total Smoking Ban in Taxis in Oita and Beppu City, in Japan

Implementation of the Total Smoking Ban in Taxis in Oita and Beppu City, in Japan

Environmental tobacco smoke in hospitality venues in Greece.

BackgroundExposure to environmental tobacco smoke is a major threat to public health. Greece, having the highest smoking prevalence in the European Union is seriously affected by passive smoking. The purpose of this study was to measure environmental tobacco smoke (ETS) exposure in the non smoking areas of hospitality venues and offices in Greece and to compare the levels of exposure to levels in the US, UK and Ireland before and after the implementation of a smoking ban.MethodsExperimental measurements of particulate matter 2.5 μm (PM2.5), performed during a cross sectional study of 49 hospitality venues and offices in Athens and Crete, Greece during February – March 2006.ResultsLevels of ETS ranged from 19 μg/m3 to 612 μg/m3, differing according to the place of measurement. The average exposure in hospitality venues was 268 μg/m3 with ETS levels found to be highest in restaurants with a mean value of 298 μg/m3 followed by bars and cafes with 271 μg/m3. ETS levels were 76% lower in venues in which smoking was not observed compared to all other venues (p < 0.001). ETS levels in Greek designated non-smoking areas are similar to those found in the smoking sections of UK hospitality venues while levels in Ireland with a total smoking ban are 89% lower and smoke-free communities in the US are 91 – 96% lower than levels in Greece.ConclusionDesignated non-smoking areas of hospitality venues in Greece are significantly more polluted with ETS than outdoor air and similar venues in Europe and the United States. The implementation of a total indoor smoking ban in hospitality venues has been shown to have a positive effect on workers and patrons' health. The necessity of such legislation in Greece is thus warranted.

The Relative Effect of Household and Workplace Smoking Restriction on Health Status Among Chinese Americans Living in New York City

Households and workplaces are the predominant location for exposure to secondhand smoke. The purpose of this study is to examine the association between health status and smoking restrictions at home and work and to compare the relative effect of household and workplace smoking restrictions on health status. This study uses data from a cross sectional representative probability sample of 2,537 Chinese American adults aged 18-74 living in New York City. The analysis was limited to 1,472 respondents who work indoors for wages. Forty-three percent of respondents reported a total smoking ban at home and the workplace, 20% at work only, 22% home only, and 15% reported no smoking restriction at home or work. Nonsmokers [corrected] who live under a total household smoking ban only or both a total household and total workplace ban were respectively 1.90 and 2.61 times more likely to report better health status compared with those who reported no smoking ban at work or home. Before the NYC Clean Indoor Air Act second-hand smoke (SHS) exposure among this immigrant Chinese population at home and work was high. This study finds that household smoking restrictions are more strongly associated with better health status than workplace smoking restrictions. However, better health status was most strongly associated with both a ban at work and home. Public health efforts should include a focus on promoting total household smoking bans to reduce the well-documented health risks of SHS exposure.