Self-reported secondhand smoke exposure following the adoption of a national smoke-free policy in Poland: analysis of serial, cross-sectional, representative surveys, 2009–2019

ObjectiveWe assessed changes in secondhand smoke (SHS) exposure in workplaces and public venues in Poland over a 9-year period following the adoption of a smoke-free policy in Poland in 2010.DesignSix waves of cross-sectional surveys were carried out between 2009 and 2019.ParticipantsA nationally representative sample of adult Polish residents (age 15 years and older) was surveyed.Survey respondents self-reported SHS exposure in the workplace and 12 different public venues. Data were analysed separately for samples consisting of (1) all respondents and (2) non-smokers only.SHS exposure was defined based on self-report, which may invoke error such as demand bias or recall bias and study protocol do not include participation of paediatric populations that are key limitations of this study.ResultsWithin a year of adopting the smoke-free policy in 2010, the proportion of non-smokers exposed to SHS in Polish workplaces decreased by more than half (from 19.2% in 2009 to 9.5% in 2011). Over 10 years, a substantial reduction in SHS exposure was observed in all public venues. The highest decrease in SHS exposure was observed in transport services (decreased from 45.7% to 11.7% among all respondents and from 44.2% to 11.7% among non-smokers) and in bars/pubs (SHS exposure decreased from 45.0% to 7.0% among all respondents and from 39.4% to 7.0% among non-smokers).ConclusionsThis study demonstrates the substantial success of a national smoke-free law. Nevertheless, smoke-free laws must continue to be refined in terms of their legal boundaries as well as implementation strategies to eliminate disparities in SHS exposure in certain types of venues.

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Voluntary Smoke-Free Home Rules and Exposure to Secondhand Smoke in Poland: A National Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207502 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7502

Author(s):

Mateusz Jankowski ◽

Jarosław Pinkas ◽

Wojciech S. Zgliczyński ◽

Dorota Kaleta ◽

Waldemar Wierzba ◽

...

Keyword(s):

Secondhand Smoke ◽

Home Rule ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Public Places ◽

Private And Public ◽

Shs Exposure ◽

Nationally Representative ◽

Private Homes ◽

Exposure To Secondhand Smoke

Smoke-free policies have been shown to significantly reduce secondhand smoke (SHS) exposure in private and public places. The objectives of this study were to: (1) to assess the prevalence and characteristics of voluntary smoke-free home rules in Poland; and (2) assess the association of smoke-free rules with self-reported SHS exposure in private homes. A cross-sectional survey was conducted in September 2019 with a nationally representative sample of 1011 individuals aged 15 and over. Nationally, 66.1% of individuals had a 100% smoke-free home rule (78.9% of non-smokers and 18.6% of smokers; p < 0.001), while a further 24.6% had adopted a partial home smoking rule. SHS exposure in the home during past month was reported by 6.1% of respondents (11.5% of smokers and 4.5% of non-smokers; p < 0.001). The lowest level of SHS exposure (1.8%) was observed among respondents who had implemented a full smoke-free home rule. Non-smokers had higher odds of having adopted a total smoke-free home rule compared with smokers (aOR: 19.17; 95% CI: 12.89–28.50). Moreover, non-smokers had lower odds (aOR: 0.35; 95% CI: 0.20–0.61; p < 0.001) of self-reporting SHS smoke exposure at home. Although two-thirds of the Polish population have adopted a full smoke-free home rule in their homes, smokers continue to lag in adoption rates relative to non-smokers.

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Relationship between childhood secondhand smoke exposure and the occurrence of hyperlipidaemia and coronary heart disease among Chinese non-smoking women: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-048590 ◽

2021 ◽

Vol 11 (7) ◽

pp. e048590

Author(s):

Kewei Wang ◽

Yuanqi Wang ◽

Ruxing Zhao ◽

Lei Gong ◽

Lingshu Wang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Coronary Heart Disease ◽

Heart Disease ◽

Secondhand Smoke ◽

Chinese Women ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Shs Exposure

ObjectiveThe objective of this study was to evaluate the influence of secondhand smoke (SHS) exposure during childhood on type 2 diabetes mellitus, hypertension, hyperlipidaemia and coronary heart disease among Chinese non-smoking women.MethodsIn this cross-sectional study, the SHS exposure data in childhood were obtained using a questionnaire survey. Self-reported childhood SHS exposure was defined as the presence of at least one parent who smoked during childhood.ResultsOf the 6522 eligible participants, 2120 Chinese women who had never smoked were assessed. The prevalence of SHS exposure in the entire population was 28.1% (596). SHS exposure during childhood was not significant for the standard risk factors of type 2 diabetes mellitus (p=0.628) and hypertension (p=0.691). However, SHS was positively associated with hyperlipidaemia (p=0.037) after adjusting for age, obesity, education status, physical activity, alcohol consumption, current SHS exposure status, diabetes mellitus and hypertension. In addition, childhood SHS increased the occurrence of coronary heart disease (p=0.045) among non-smokers after further adjusting for hyperlipidaemia.ConclusionSHS exposure during childhood is associated with prevalent hyperlipidaemia and coronary heart disease in adulthood among non-smoking Chinese women.

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Prevalence of depressive symptoms and syndromes in later life in ten European countries

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.036772 ◽

2007 ◽

Vol 191 (5) ◽

pp. 393-401 ◽

Cited By ~ 156

Author(s):

Erico Castro-Costa ◽

Michael Dewey ◽

Robert Stewart ◽

Sube Banerjee ◽

Felicia Huppert ◽

...

Keyword(s):

Later Life ◽

European Countries ◽

Self Report ◽

Depression Symptoms ◽

Factor Scores ◽

Late Life Depression ◽

Cross Sectional ◽

Cultural Research ◽

Gender Education ◽

Nationally Representative

BackgroundThe EURO–D, a 12-item self-report questionnaire for depression, was developed with the aim of facilitating cross-cultural research into late-life depression in Europe.AimsTo describe the national variation in depression symptoms and syndrome prevalence across ten European countries.MethodThe EURO–D was administered to cross-sectional nationally representative samples of non-institutionalised persons aged ≥50 years (n = 22 777). The effects of age, gender, education and cognitive functioning on individual symptoms and EURO–D factor scores were estimated. Country-specific depression prevalence rates and mean factor scores were re-estimated, adjusted for these compositional effects.ResultsThe prevalence of all symptoms was higher in the Latin ethno-lingual group of countries, especially symptoms related to motivation. Women scored higher on affective suffering; older people and those with impaired verbal fluency scored higher on motivation.ConclusionsThe prevalence of individual EURO–D symptoms and of probable depression (cut-off score ≥4) varied consistently between countries. Standardising for effects of age, gender, education and cognitive function suggested that these compositional factors did not account for the observed variation.

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Evaluation of Secondhand Smoke Using PM2.5 and Observations in a Random Stratified Sample in Hospitality Venues from 12 Cities

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16081381 ◽

2019 ◽

Vol 16 (8) ◽

pp. 1381 ◽

Cited By ~ 1

Author(s):

Bekir Kaplan ◽

Asli Carkoglu ◽

Gul Ergor ◽

Mutlu Hayran ◽

Xisca Sureda ◽

...

Keyword(s):

Action Plan ◽

Cross Sectional Study ◽

Cross Sectional ◽

Public Places ◽

Smoke Free Policy ◽

Stratified Sample ◽

Outdoor Area ◽

Shs Exposure ◽

Particulate Matter 2.5 ◽

Main Entrance

Background: Turkey passed a law banning smoking in all indoor public places in 2008. In response to the indoor smoking restriction, many smokers may have relocated to outdoor areas of venues. The aim of this study was to evaluate air pollution related to SHS exposure in indoor and outdoor areas of hospitality venues in 12 cities in Turkey. Method: In this cross-sectional study, we evaluated hospitality venues in 12 cities in Turkey. In each visited venue, we evaluated a pre-specified number of study locations such as the outdoor area of the main entrance, indoor areas, and patios or other outdoor dining areas, completely or partially covered with window walls. We measured particulate matter 2.5 (PM2.5) in those areas. Results: The fieldworkers visited 72 randomly selected hospitality venues and measured PM2.5 concentrations in 165 different locations (indoor, outdoor, and patios) of those venues. Overall, 2573 people were observed, 909 of them smoking. The median (IQR) PM2.5 concentrations were 95 (39–229) μg/m3 indoors, 25 (13–48) μg/m3 outdoors, and 31 μg/m3 (16–62) in the patios (p < 0.001). After adjustment, each additional smoker was associated with a 2% increase in PM2.5 concentrations in patio air (GMR (95% CI): 1.02 (1.00, 1.05), and a 4% increase in indoor air (GMR (95% CI): 1.04 (1.02, 1.05). Conclusions: There were unhealthy levels of smoking-caused PM2.5 concentrations, not only indoors, but also in the patios of hospitality venues. Legislative efforts to expand the smoke-free legislation to outdoor areas adjacent to indoor public places and an action plan to increase compliance with the smoke-free policy are urgently needed in Turkey.

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Setting-Specific and Symptom-Specific Association between Secondhand Smoke Exposure and Depressive Symptoms

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16071249 ◽

2019 ◽

Vol 16 (7) ◽

pp. 1249

Author(s):

Xiaohua Ye ◽

Jingya Huang ◽

Liang Xia ◽

Xiaojun Xu ◽

Xiao Gong ◽

...

Keyword(s):

Depressive Symptoms ◽

Dose Response ◽

Secondhand Smoke ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Response Relationship ◽

Dose Response Relationship ◽

Cross Sectional ◽

Shs Exposure ◽

The Impact

Few studies have focused on the potential relationship between secondhand smoke (SHS) exposure and depressive symptoms. This study aimed to explore the potential association between SHS exposure and depressive symptoms and differentiate this association in setting-specific exposure and symptom-specific outcomes. A cross-sectional study was conducted in Guangdong province of China from September to December 2010 using a multistage sampling method to randomly sample adults aged 18 years and older. SHS exposure was defined as inhalation by non-smokers of the smoke exhaled from smokers for at least 1 day a week in the past 30 days. Depressive symptoms were measured using the nine-item Patient Health Questionnaire. The zero-inflate negative binomial regression models were used to explore the associations between SHS exposure and depressive symptoms. A total of 2771 non-smokers were included in this study, with mean age of 49.6 ± 14.0 years and 70.3% of females. The prevalence of depressive symptoms was significantly higher in participants with SHS exposure than in those without exposure (incidence rate ratio (IRR) = 1.32, 95% confidence interval (CI) 1.16–1.51), and there were similar positive associations for SHS exposure in medical facilities (IRR = 1.37, 95% CI 1.17–1.61) and in schools (IRR = 1.46, 95% CI 1.20–1.77). Notably, there was a monotonically increasing dose-response relationship between frequency of SHS exposure and depressive symptoms. When differentiating this relationship by the dimensions of depressive symptoms, there were similar dose-response relationships for cognitive-affective and somatic symptoms. When differentiating this relationship by sex, only females showed a significant dose-response relationship. Our findings suggest dose-response relationships between SHS exposure and depressive symptoms in sex-specific and symptom-specific manners. Future longitudinal studies are needed to establish the biological mechanisms of the impact of SHS exposure.

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Nursing Research in Community-Based Approaches to Reduce Exposure to Secondhand Smoke

Annual Review of Nursing Research ◽

10.1891/0739-6686.27.365 ◽

2009 ◽

Vol 27 (1) ◽

pp. 365-391 ◽

Cited By ~ 4

Author(s):

Ellen J. Hahn ◽

Kristin B. Ashford ◽

Chizimuzo T. C. Okoli ◽

Mary Kay Rayens ◽

S. Lee Ridner ◽

...

Keyword(s):

Socioeconomic Status ◽

Indoor Air ◽

Secondhand Smoke ◽

The United States ◽

Population Based ◽

Emergency Department Visits ◽

Nursing Research ◽

Smoke Free Policy ◽

Shs Exposure ◽

Race Ethnicity

Secondhand smoke (SHS) is the third leading cause of preventable death in the United States and a major source of indoor air pollution, accounting for an estimated 53,000 deaths per year among nonsmokers. Secondhand smoke exposure varies by gender, race/ethnicity, and socioeconomic status. The most effective public health intervention to reduce SHS exposure is to implement and enforce smoke-free workplace policies that protect entire populations including all workers regardless of occupation, race/ethnicity, gender, age, and socioeconomic status. This chapter summarizes community and population-based nursing research to reduce SHS exposure. Most of the nursing research in this area has been policy outcome studies, documenting improvement in indoor air quality, worker’s health, public opinion, and reduction in Emergency Department visits for asthma, acute myocardial infarction among women, and adult smoking prevalence. These findings suggest a differential health effect by strength of law. Further, smoke-free laws do not harm business or employee turnover, nor are revenues from charitable gaming affected. Additionally, smoke-free laws may eventually have a positive effect on cessation among adults. There is emerging nursing science exploring the link between SHS exposure to nicotine and tobacco dependence, suggesting one reason that SHS reduction is a quit smoking strategy. Other nursing research studies address community readiness for smoke-free policy, and examine factors that build capacity for smoke-free policy. Emerging trends in the field include tobacco free health care and college campuses. A growing body of nursing research provides an excellent opportunity to conduct and participate in community and population-based research to reduce SHS exposure for both vulnerable populations and society at large.

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Secondhand Smoke Exposure 7 Years After an Indoor Smoke-Free Law

American Journal of Health Promotion ◽

10.1177/0890117116671390 ◽

2016 ◽

Vol 32 (1) ◽

pp. 131-134 ◽

Cited By ~ 3

Author(s):

Ann W. St. Claire ◽

Michael S. Amato ◽

Raymond G. Boyle ◽

Peter Rode ◽

Ann M. Kinney

Keyword(s):

Secondhand Smoke ◽

Health Benefit ◽

Community Settings ◽

Public Places ◽

Public Health Benefit ◽

The Past ◽

Smoke Free Policy ◽

Low Incomes ◽

Random Digit Dial ◽

Shs Exposure

Purpose: To examine locations of secondhand smoke (SHS) exposure among nonsmokers, 7 years after a statewide smoke-free policy. Design: Data collected via statewide, random digit dial telephone survey. Response rates were 64.7% for landline and 73.5% for cell phone. Setting: Minnesota, 2014. Participants: Representative sample of 7887 nonsmoking adults. Measures: Self-reported locations of SHS exposure and opinions on smoke-free restrictions. Analysis: Descriptive statistics and logistic regression. Results: A total of 35.5% of nonsmokers reported SHS exposure in the past 7 days. The greatest proportion of exposure occurred in community settings (31.7%) followed by cars (6.9%) and in the home (3.2%). Young adults were more likely to be exposed in a home or car than older adults. Nonsmokers living with a smoker were 39.6 (20.6-75.8) times more likely to be exposed to SHS in their home and 5.3 (4.1-6.8) times more likely to be exposed in a car, compared to those who did not live with a smoker. Conclusion: SHS exposure continues after comprehensive smoke-free policies restricted it from public places. Disparities in exposure rates exist for those who live with a smoker, are young, and have low incomes. Findings suggest the need for additional policies that will have the greatest public health benefit.

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Informing Proactive integrated virtual healthcare resource use in primary care

BMC Health Services Research ◽

10.1186/s12913-021-06783-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jolie N. Haun ◽

Bridget A. Cotner ◽

Christine Melillo ◽

Vanessa Panaite ◽

William Messina ◽

...

Keyword(s):

Primary Care ◽

Best Practices ◽

Cultural Change ◽

Information Exchange ◽

Healthcare Resource ◽

Medical Center ◽

Implementation Strategies ◽

Self Report ◽

Coordinated Care ◽

Cross Sectional

Abstract Background Proactive integrated virtual healthcare resource (VHR) use can improve efficiency, maximize resource capacity for delivering optimal coordinated care and improve patient outcomes. Proactive integrated VHR use is vital for delivering high quality care. Our objectives were to identify proactive integrated VHR use among primary care teams, best practices and targeted implementation strategies to promote proactive integrated VHR use. Methods This is a mixed-method descriptive study. We employed a community-based participatory approach to collect data and the Consolidated Framework for Implementation Research to analyze and contextualize findings. A cross-sectional sample of primary care team members (n = 65) from a Department of Veterans Affairs medical center participated in focus groups, follow-up interviews (n = 16), and respond to self-report surveys. Operational subject matter experts (n = 15) participated in informant interviews. Results Survey data described current use and factors that influenced singular VHR use and were convergent with qualitative findings. Focus group and interview data described no evidence of proactive integrated VHR use. Differences and similarities were identified between both utilization groups, such as facilitators and barriers, recommendations, patient education and preferred implementation strategies. All groups reported issues around VHR availability knowledge and access and functionality. Participants identified the need for best practices that are specific to care tasks and performance measures. Expert informant interviews identified a list of VHR tools that could be proactively integrated across the healthcare continuum. Conclusions Health systems are leveraging technologies to proactively integrate VHR to maximize information exchange, clinical decision support and patient engagement. VHR is critical during global pandemics, such as COVID-19, to maintain access to care coordination and delivery while abiding by public health recommendations. Though recent requirements for reducing contact create an intrinsic motivation, cultural change through education and best practices of proactive integrated use across the healthcare continuum is needed to create a culture of VHR super users.

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Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey

International Journal of Hypertension ◽

10.1155/2020/8082341 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Neo M. Tapela ◽

Lei Clifton ◽

Gontse Tshisimogo ◽

Moagi Gaborone ◽

Tebogo Madidimalo ◽

...

Keyword(s):

Population Based ◽

Self Report ◽

Sub Saharan Africa ◽

Health Concern ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Adherence Support ◽

Hypertension Awareness ◽

Nationally Representative ◽

And Control

Introduction. Hypertension is a leading risk factor for cardiovascular mortality and an emerging public health concern in sub-Saharan Africa. Few studies have examined performance on the management of hypertension in this region, where the context may be distinct from other developing regions. Objectives. We aimed to determine the prevalence and correlates of hypertension, awareness, treatment, and control among adults in Botswana, a middle-income African country undergoing rapid demographic transition and with high HIV burden. Methods. In this 2014 cross-sectional survey of adults aged 15–69 years, information on sociodemographic characteristics, lifestyle behavior, and medical history was collected through in-person interviews and physical measurements (body mass index and triplicate blood pressure (BP)). Hypertension was defined as self-report of use of antihypertensives in the previous two weeks and/or having elevated BP (≥140/90 mmHg). Multivariable logistic regression was employed to explore factors associated with hypertension, awareness (report of previous diagnosis), treatment (antihypertensives), and control (BP < 140/90). Results. Our analysis (N = 4,007) yielded an age-standardized hypertension prevalence of 30% (95% CI: 28%–32%, N = 1,393). Among hypertensives, 54% (50–58%) were unaware of their condition, 45% (40–50%) of those aware were untreated, and 63% (55–70%) of those on medications were suboptimally treated (BP ≥ 140/90 mmHg). A fifth of hypertensives who were diagnosed but not on medications had BP ≥ 180/110 mmHg. Diabetes was the strongest correlate of hypertension and awareness (aOR 4.00, 1.86–8.59; aOR 3.30, 1.44–7.55, respectively). Males were less likely to be aware (aOR 0.62, 0.41–0.94) or controlled (aOR 0.36, 0.16–0.83). Obese individuals were more likely to be treated (aOR 2.17, 1.12–4.22), yet less likely to be controlled (aOR 0.32, 0.15–0.66). Conclusions. We report the first nationally representative estimates of the hypertension care cascade performance in Botswana, which will support planning and future policy evaluations. Findings contribute to the relatively sparse evidence on this subject and may inform development of innovations that improve quality of hypertension management and adherence support in similar settings.

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The Effects of COVID-19 Infection Cues on Preventive Behaviors: Development of a Moderated Mediation Model (Preprint)

10.2196/preprints.28986 ◽

2021 ◽

Author(s):

Guangteng Meng ◽

Xiaoyan Yuan ◽

Qi Li ◽

Bibing Dai ◽

Xun Liu

Keyword(s):

Risk Perception ◽

Online Survey ◽

Negative Emotions ◽

Moderated Mediation ◽

Self Report ◽

Preventive Behaviors ◽

Cross Sectional ◽

Perceived Efficacy ◽

Moderated Mediation Model ◽

Nationally Representative

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has disrupted the lives of everyone worldwide. Prevention behaviors are especially critical to protect the people who have patients around; however, little work has been done to explore the influences of infection cues on preventive behaviors. OBJECTIVE The purpose of this study was to explore the influence of infection cues on preventive behaviors and the roles of risk perception, negative emotions, and perceived efficacy in this influence. METHODS A cross-sectional online survey with a nationally representative sample in China was conducted during the first wave of COVID-19 in China. Self-report measures of infection cues, preventive behaviors, risk perception, negative emotions, and perceived efficacy. The PROCESS macro (Model 85) was used to test our conceptual model. RESULTS A total of 26511 participants responded to the survey and 20205 valid responses (76.2%) were obtained for further analysis. Moderated mediation results show that infection cues positively predicted preventive behaviors and in turn affected preventive behaviors through risk perception and negative emotions. Moreover, perceived efficacy moderated the influence of infection cues not only on preventive behaviors but also on risk perception and negative emotions related to preventive behaviors. The higher the perceived efficacy, the stronger these influences were. CONCLUSIONS This study revealed that infection cues promoted preventive behaviors by increasing risk perception and negative emotions and that high perceived efficacy further enhanced these effects.

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