Workplace Smoking Restrictions Research Articles

The influence of demographic and lifestyle factors on urinary levels of PAH metabolites-empirical analyses of Cycle 2 (2009-2011) CHMS data.

Polycyclic aromatic hydrocarbons (PAHs) are a group of compounds formed during the incomplete combustion of organic matter. Several are mutagenic carcinogens; the magnitude of exposure can be assessed by examining urinary levels of PAH metabolites. Data from biomonitoring studies that record urinary PAH metabolite levels, as well as demographic and lifestyle information, can be used to investigate relationships between PAH exposure and variables, such as smoking status, workplace smoking restrictions, age, sex, household income, home age, and occupation. This study analysed creatinine-adjusted urinary PAH metabolite concentrations and questionnaire data from ~1200 individuals aged 16 years and older surveyed in Cycle 2 of the Canadian Health Measures Survey (CHMS). Statistical analyses revealed that smoking status, age, and sex are associated with urinary concentrations of a pyrene metabolite (1-OHP), phenanthrene metabolites (ΣOH-Phen), fluorene metabolites (ΣOH-Flu) and naphthalene metabolites (ΣOH-Nap). More specifically, smoking status, age and sex can collectively account for 30, 24, 52, and 34% of the observed variations in 1-OHP, ΣOH-Phen, ΣOH-Flu and ΣOH-Nap metabolites, respectively (p < 0.001). Analyses of non-smokers revealed weak but significant effects of age, sex, home age, and occupation on urinary levels of selected PAH metabolites (i.e., <7% of observed variation, p < 0.05). The unexplained variation in PAH metabolite levels is most likely related to diet, which was not examined. Although the results revealed significant relationships between urinary PAH metabolite levels and several lifestyle and/or demographic variables, robust examinations of selected effects (e.g., sex, home age, occupation) will require datasets that are balanced with respect to the other highlighted variables. The results can be used to identify remedial measures to reduce exposure and concomitant risk, and/or design follow-up studies to test hypotheses regarding the causes of exposure differences empirically related to sex, age, home age, and occupation.

Population-level estimates of workplace exposure to secondhand smoke in Canada.

Secondhand smoke (SHS) is a known lung carcinogen that is also associated with cardiovascular disease and premature death. An important source of exposure to SHS is the workplace. In the past, efforts have been made to reduce workplace SHS exposure across Canada, with corresponding benefits to public health. This study estimated the number of workers exposed to SHS in Canada in 2006 and 2016 and their level of exposure. The proportion of workers exposed to SHS and the proportion of workers reporting specific workplace smoking restrictions by occupation and province, acquired from the 2007-2009 and 2010-2012 Canadian Tobacco Use Monitoring Surveys, were applied to 2006 and 2016 Canadian census data to estimate population-level exposure. Workers were assigned to exposure levels (possible, moderate, high) using workplace smoking restrictions. Only moderately and highly exposed workers were considered exposed. The number of exposed workers decreased by 20% from 520,000 in 2006 to 418,000 in 2016. Workers were equally split between moderate and high exposure groups. Trades, transport and equipment operators, and workers in primary industry had the highest rates of overall exposure. The proportion of workers exposed varied by province, with the lowest rates in Ontario (approximately 2% in both years), and the highest in Saskatchewan in 2006 (6%) and Newfoundland in 2016 (4%). Workplace SHS exposure persists. The findings can help prioritize high-risk groups for interventions and inform studies of the burden of occupational disease. Further characterization of exposure is needed to better inform enforcement and prevention.

Workplace smoking restrictions and support for smoking cessation in the USA: state, region, and overall trends from 2010-11 to 2014-15.

We discuss the most recent changes in smoking policies and support for smoking cessation offered to smokers at US workplaces. We used reports of employed adults (n = 112,008) regarding smoking restrictions and support for smoking cessation offered at their indoor workplaces from the 2010–11 and 2014–15 Tobacco Use Supplement-Current Population Survey. The percentage of adults who reported having workplace smoking restrictions was 94% in 2010–11 and 93% in 2014–15 (P = 0.001). There was a decrease in the Northeastern region (P < 0.001) and no significant changes in the other three US regions. The percentages decreased in Hawaii, New York, Oregon, Pennsylvania, and Tennessee and increased in Indiana, Nebraska, and Wyoming. The percentage of employees who reported having workplace support for smoking cessation increased from 24% to 29% (P < 0.001), which was uniform across all US regions but differed across the US states. The percentages decreased in Hawaii and increased in the majority of states. Analysis of smokers’ reports (versus all reports) resulted in lower percentages of workplaces with smoking restrictions and support for smoking cessation. It is essential to further enhance support for smoking cessation offered to smokers at US workplaces.

Tobacco Advertising, Anti-Tobacco Information Exposure, Environmental Smoking Restrictions, and Unassisted Smoking Cessation Among Chinese Male Smokers: A Population-Based Study.

The study examined the prevalence of unassisted smoking cessation among Chinese urban male smokers and factors important in the decision to quit. A cross-sectional survey employing multistage sampling involving 5,782 participants in six cities in China was conducted. Survey respondents reported their smoking cessation status and related individual and environmental variables. Among current smokers 1,112 or 35.0% (95% CI [31.0%, 40.8%]) had attempted to quit and of those who had made such an attempt 87.6% reported that they had done so without assistance. Of all former smokers (3,389), most (97.6%; 95% CI [96.7%, 98.5%]) quit without assistance. Logistic regression analysis showed those who engaged in physical exercise and who had more belief in their ability to quit were more than twice as likely to make a quit attempt and be successful than those in comparable reference groups. Exposure to tobacco advertising was negatively associated with both unassisted quit attempts and success. By contrast, exposure to anti-tobacco information was positively associated with unassisted quit attempts while household and workplace smoking restrictions were negatively associated with unassisted attempts to quit. Most attempts to quit smoking among Chinese males are unassisted. Unassisted attempts to quit smoking and success rates are highly influenced by the presence of environmental smoking restrictions, tobacco advertising, and exposure to anti-tobacco information. Smoking cessation programs and policies in China need to pay greater attention to the social and cultural norms, which perpetuate high levels of smoking.

Did Slowdown on Taxes and Program Impact California's Smoking Decline?

Author(s): Pierce, John P; Shi, Yuyan; Hendrickson, Erik; White, Martha; Noble, Madison; Kealey, Sheila; Strong, David | Abstract: Objective: In this paper, we examine whether a slowdown in implementing tobacco control policies in California after 2000 influenced trends in smoking behavior. Methods: We assessed the strength of state tobacco control policies using excise tax data (1990-2014), tobacco control expenditures per capita, and workplace and home smoking restrictions (from the Tobacco Use Supplement of the Current Population Survey, 1992-2015). Smoking prevalence was assessed with the National Health Interview Survey, 1985-2015. We compared trends between California and the rest of the US using split regression models with a knot at 2000. Results: Throughout the 1990s, compared to the rest of the US, California had higher cigarette excise taxes, higher expenditures on tobacco control, more smoke-free workplaces, and more smokers with smoke-free homes. Except for smoke-free homes, these differences disappeared after 2000. During the 1990s, smoking prevalence declined much faster in California than in the rest of the US, but the decline slowed significantly after 2000. Conclusions: Smoking prevalence is sensitive to continued implementation of tobacco control policies.

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.

Second-hand smoke exposure among workers of restaurants, bars, and nightclubs in Lagos State

Background: The Lagos State Regulation of Smoking Law was passed in February 2014 and stipulates the total restriction of tobacco smoking in listed public places. Workers in hospitality venues are at a high risk of exposure to second-hand smoke (SHS). Therefore, their awareness of the health risks, attitudes toward SHS and their reported levels of exposure may play a crucial role in developing an effective monitoring, implementation, and enforcement mechanism. Methods: We conducted a cross-sectional, descriptive study among workers in restaurants, bars, and nightclubs registered with the Lagos State Ministry of Tourism in the second quarter of the year 2014. We used a multistage sampling technique to select one respondent each from the 300 centers randomly selected to participate in the survey. Data were collected using a modified version of the World Health Organization Global tobacco surveillance system tools. Univariate and bivariate analysis were carried out. Exposure to SHS in the workplace and in other public places was treated as the outcome variable in the bivariate analysis. Results: Majority (75.3%) of the respondents were aged between 21 and 40 years with a mean age of 27.7 + 8.6 years. Many (66%) were waiters/waitresses and spent more than 8 h a day. Most (60.6%) of the venues were indoor only establishments, and 26.8% had no form of smoking restrictions. Majority of the respondents were exposed to SHS at work, and this was higher in bars and nightclubs. A bivariate analysis of results showed that workers were exposed to SHS at work irrespective of workplace smoking restrictions or respondents smoking status. Conclusion: Our study demonstrates that second-hand smoke exposure is very high (65% in smokers; 65.6% in nonsmokers) among workers in restaurants, bars, and nightclubs in Lagos State. We are therefore of the opinion that strict enforcement of law would ensure the protection of these workers.

The Impact of Tobacco Control Policies on Smoking Among Socioeconomic Groups in Nine European Countries, 1990-2007.

It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries during the past two decades. This paper aims to investigate the impact of price and non-price related population-wide tobacco control policies on smoking by socioeconomic group in nine European countries between 1990 and 2007. Individual-level education, occupation and smoking status were obtained from nationally representative surveys. Country-level price-related tobacco control policies were measured by the relative price of cheapest cigarettes and of cigarettes in the most popular price category. Country-level non-price policies were measured by a summary score covering four policy domains: smoking bans or restrictions in public places and workplaces, bans on advertising and promotion, health warning labels, and cessation services. The associations between policies and smoking were explored using logistic regressions, stratified by education and occupation, and adjusted for age, Gross Domestic Product, period and country fixed effects. The price of popular cigarettes and non-price policies were negatively associated with smoking among men. The price of the cheapest cigarettes was negatively associated with smoking among women. While these favorable effects were generally in the same direction for all socioeconomic groups, they were larger and statistically significant in lower socioeconomic groups only. Tobacco control policies as implemented in nine European countries, have probably helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors. Policies with larger effects on lower socioeconomic groups are needed to reverse this trend. Socioeconomic inequalities in smoking widened between the 1990s and the 2000s in Europe. During the same period, there were intensified tobacco control policies in many European countries. It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries. This study shows that tobacco control policies as implemented in the available European countries have helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors.

Chinese smokers' behavioral response toward cigarette price: individual and regional correlates.

BackgroundMany studies have explored smokers’ behavioral response to cigarette prices at the individual level, but none have factored in regional variation and determinants. This study addresses these research gaps in the Chinese context.MethodsA cross-sectional multistage sampling process was used to recruit participants in 21 cities in China. Individual-level information was collected using standardized questionnaires. City-level variables were retrieved from a nationall database. Multilevel logistic regression analysis was used to assess price sensitivity variation at both individual and city levels.ResultsAmong 5660 current smokers, 5.9 % used non-self-paying cigarettes, 32.8 % purchased cigarettes in cartons, and 5.2 % decreased their smoking expenditure due to price. Multilevel analysis showed that individual demographic and smoking expenditure characteristics and regional smoking restrictions in work places, cigarette production, and media news coverage are associated with price sensitivity.ConclusionsThis study adds substantially to the understanding of Chinese smokers’ behavioral responses to cigarette prices. Increasing smoker sensitivity to cigarette prices will require stronger tobacco control and public education campaigns.

The Economic Impact of Smoking and of Reducing Smoking Prevalence: Review of Evidence.

The Economic Impact of Smoking and of Reducing Smoking Prevalence: Review of Evidence.

Environmental Smoking Restrictions and Light Cigarette Adoption Among Chinese Urban Smokers.

Light cigarette adoption involves complex psychological and behavioral processes with many underlying factors. While numerous studies have shown that environmental restrictions on smoking are associated with higher probability of smoking cessation, it is also possible that some smokers may switch from regular to light cigarettes due to environmental pressures. The current study evaluates whether smoking restrictions in households, workplaces, and public places were respectively associated with light cigarette adoption. A cross-sectional multistage sampling process was used to recruit participants and collect data about demographics and smoking characteristics and environmental restriction variables. Multiple logistic models were employed to examine the association between environmental smoking restrictions and light cigarette adoption. Of 4735 respondents, 1592 (30.3 %) were current smokers, and 69.7 % (N = 1141) of the smokers were identified as light cigarette adopters. In a multivariate model, smoking restrictions in households, workplaces, and public places were significantly associated with higher light cigarette adoption. Under environmental smoking restrictions, which pose unique challenges to tobacco control efforts, light cigarette adoption may increase. The study findings are essential for health policy makers in designing and implementing targeted smoking cessation interventions and health education programs.

Let’s Clear the Air for Casino Patrons and Employees

The benefits of smoke-free workplaces and public spaces have been clearly demonstrated.1,2 In fact, a 2012 scientific statement by the American Heart Association provided a class IA recommendation for legislation mandating smoke-free public spaces.3 Many regions of the country have implemented smoking restrictions in bars, restaurants, and other worksites, but workers and patrons in many states and regions remain unprotected.4 Although it is not surprising that tobacco companies would lobby fiercely against such policies, they are sometimes joined by other business interests to prevent the creation of smoke-free spaces. Article see p 811 In July 2006, when the state of Colorado banned smoking in the workplace, casinos were exempted. Many other states that have implemented clean indoor air laws have done the same, bowing to industry pressure that smoking restrictions in casinos would be bad for business and reduce tax revenues. Industry pressure has kept other states, particularly in the South, from implementing any substantive workplace smoking restrictions at all.4 An article in …

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.

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.

The emerging phenomenon of electronic cigarettes

The need for novel and more effective approaches to tobacco control is unquestionable. The electronic cigarette is a battery-powered electronic nicotine delivery system that looks very similar to a conventional cigarette and is capable of emulating smoking, but without the combustion products accountable for smoking’s damaging effects. Smokers who decide to switch to electronic cigarettes instead of continuing to smoke would achieve large health gains. The electronic cigarette is an emerging phenomenon that is becoming increasingly popular with smokers worldwide. Users report buying them to help quit smoking, to reduce cigarette consumption, to relieve tobacco withdrawal symptoms due to workplace smoking restrictions and to continue to have a ‘smoking’ experience but with reduced health risks. The focus of the present article is the health effects of using electronic cigarettes, with consideration given to the acceptability, safety and effectiveness of this product to serve as a long-term substitute for smoking or as a tool for smoking cessation.

Psychiatric Hospitals and Workplace Smoking Bans: A Biological and Sociological Commentary

AbstractSmoking is widely known as an architect of well-documented, negative health outcomes. The advent of legislated actions to ban work- and public-place smoking has reduced the overall smoking prevalence in Canada and around the world. However, what is often overlooked are patients with psychiatric illness who are confined in psychiatric institutions and are not able to take advantage of designated smoking areas. The aim of this commentary is to raise awareness of potential inequitable conditions that are inherent in workplace smoking restrictions particularly for psychiatric patients. A biological and social equity perspective will frame the discourse of the issue.

Workplace Smoking Restrictions That Wont Go Up In Smoke

A rumble went through the Boeing Company in April 1984 when it announced a policy of progressive work-site smoking restrictions eventually culminating in a total ban on smoking in all Boeing facilities. With this announcement, the 83,000-employee aerospace giant became the largest U.S. employer to make a commitment to a smoke-free work place.Boeing is not alone in its decision to institute a no-smoking policy in its workplace. Many other employers are learning that smoke in the corporate environment has an impact far beyond the lungs of smoking employees. The motivation for policy development can come from four areas: legislation, litigation, cost containment, and workplace health and safety.

Second-hand smoke exposure and household smoking bans in Chinese families: a qualitative study

As workplace smoking restrictions spread, smoking in the home is becoming the predominant source of exposure to second-hand smoke (SHS) among children and other non-smokers in the household. This study explored issues around children's exposure to SHS. Focus group discussions (FGDs) and in-depth interviews (IDI) were conducted among 31 Chinese households in urban Shanghai, China. All FGDs/IDIs were audio recorded and analysed thematically. The findings suggest that there are gaps in knowledge of the health consequences of smoking and SHS among the participants. Although there was a lack of knowledge about the health risk of exposure to SHS, most were willing to protect their child from the SHS exposure. In 16/31 households, families had partial home-smoking restrictions; there were no complete restrictions in any of the smokers' homes. Many families do not openly discuss smoking or smoking restrictions at home. Barriers to adopting a smoke-free home included the social acceptability of smoking (22/31), hosting social gatherings at home, which would involve smoking (12/31), authoritative attitudes of the husband or father-in-law (10/31), and difficulties with visitors who smoke (7/31). Most (28/31) participants stated they would accept a counselling intervention to reduce SHS exposure to children and suggested various measures to implement it. The findings from this intervention have implications for designing intervention strategies to reduce SHS exposure at home among children in China.

Businesses' voluntary pro-health tobacco policies: a review and research agenda

Research on the role of businesses in tobacco control has focused primarily on retailers, advertising firms and the hospitality industry, all of which have tended to support tobacco industry interests...

Effects of household, workplace, and public place smoking restrictions on smoking cessation

The aim of this study was to evaluate the association between environmental smoking restrictions, distinguished by site, and smoking cessation by Chinese urban residents. Recruited through multi-stage quota-sampling, residents in six Chinese cities were surveyed. Data were both individual-level and city-level. Among 4735 respondents, 715 were identified as successful quitters and 405 as unsuccessful. Multilevel logistic regression analysis showed smoking cessation to be associated with city-level public place and workplace restrictions and individual-level workplace and household restrictions. Results offer justification for decision-makers to implement environmental tobacco control policies and related public health interventions aimed at markedly diminishing the high smoking prevalence in China.