Dataset Information

Feasibility and practicability studies of an evaluation index system for implementation of smoke-free laws and regulations of cities in China.

ABSTRACT:

Introduction

The aim of the study is to adjust and improve the feasibility and practicability of an evaluation index system, developed for the implementation of smoke-free laws and regulations, by applying it to analyze and compare the contents and implementation of smoke-free laws and regulations in eight legislative cities in China.

Methods

In regard to indicators of the established evaluation index system, data on tobacco control/smoke-free laws and regulations and their implementation in some legislative cities in China were collected, sorted, and compared, to examine and adjust the feasibility and practicality of the indicators.

Results

The evaluation index system for implementation of smoke-free laws and regulations of cities in China has been adjusted to include 5 first-level indicators, including: 1) Simple, clear and executable legislation; 2) Careful planning and sufficient resources for law enforcement; 3) Participation of civil society; 4) Communication; and 5) Monitoring and evaluation of the implementation and impact of laws. There were 27 second-level indicators, including management department, scope of smoke-free places, requirements for non-smoking places etc. There were 27 third-level indicators, including construction of law enforcement, coordination network, work of coordination agencies, staffing situation etc.

Conclusions

The preliminary adjusted evaluation index system for the implementation of smoke-free laws and regulations of cities in China provides a reference and standardization for evaluating effectiveness of implementation of Chinese tobacco control laws and regulations.

SUBMITTER: Song L

PROVIDER: S-EPMC8809369 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Feasibility and practicability studies of an evaluation index system for implementation of smoke-free laws and regulations of cities in China.

Song Lili L Luo Xiaowei X Yang Jie J

Tobacco induced diseases 20220202

<h4>Introduction</h4>The aim of the study is to adjust and improve the feasibility and practicability of an evaluation index system, developed for the implementation of smoke-free laws and regulations, by applying it to analyze and compare the contents and implementation of smoke-free laws and regulations in eight legislative cities in China.<h4>Methods</h4>In regard to indicators of the established evaluation index system, data on tobacco control/smoke-free laws and regulations and their implem ...[more]

PMID: 35300050

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Project description:BackgroundThe 2019 Ethiopia's comprehensive tobacco control proclamation mandates 100% smoke-free public places and workplaces. Despite the proclamation, compliance remains uncertain, particularly at hospitality venues (HVs). The aim of this study was to evaluate the extent of compliance with smoke-free laws in HVs and to also understand the factors associated with non-compliance.MethodsThis cross-sectional observational study was conducted in 10 cities in Ethiopia-Addis Ababa, Adama, Assosa, Bahir Dar, Dire Dawa, Gambella, Harar, Hawassa, Jigjiga, and Semera-Logia -between December 5th and 28th, 2022. Data were collected electronically using smartphones, utilizing a pre-tested, standardized checklist and covert observation. The subjects were selected through multi-stage cluster sampling. A total of 1,370 HVs (hotels, restaurants, bars, bars and restaurants, café and restaurants, butcher houses and restaurants, groceries, and nightclubs/ lounges) were observed. Specific and composite compliance indicators were computed for indoor and outdoor spaces. Poisson regression analyses identified factors associated with indoor active smoking and non-compliance. Statistical significance was set at P<0.05. Data were analyzed using SPSS version 26.ResultsAmong the 1,370 HVs included in this study, 1,368 had indoor spaces, 327 had both indoor and outdoor spaces, and two had only outdoor spaces. Active smoking was observed in 32.2% (95% CI:30-35) of indoor HVs, with the highest rates in nightclubs/lounges (68.6%) and bars (65.7%). Semera-Logia reported the highest prevalence of active smoking (70.4%). Adherence with 'no smoking' signage was low (35.2%), while ashtrays, lighters, and designated smoking areas (DSAs) were rarely present. Outdoor active smoking was observed in 46.5% (95% CI:41-52) of HVs. Only 12.8% of indoor spaces were fully adherent to the smoke-free law requirements. Venues in Semera-Logia were over twice as likely to have active smoking (adjusted prevalence ratio [aPR]: 2.71; 95% CI: 2.00-3.66) compared to Addis Ababa. Bars and nightclubs/lounges had significantly higher prevalence of active smoking than cafés/restaurants. 'No smoking' signs were associated with reduced prevalence of indoor active smoking (aPR: 0.77; 95% CI: 0.67-0.89), while smoking within a 10-meter range (aPR: 2.67; 95% CI: 2.13-3.32), the presence of lighters (aPR: 1.69; 95% CI: 1.41-2.02), and the sale of tobacco products (aPR: 1.58; 95% CI: 1.34-1.86) were all associated with higher prevalence of indoor active smoking.ConclusionCompliance with 'no active smoking' and adherence to smoke-free laws in HVs remain low, particularly in bars, nightclubs/lounges, and Semera-Logia, with high rates of active smoking both indoors and outdoors. Enhanced enforcement and targeted are needed to educate the public and HV owners about the risks of SHS and the importance of tobacco control laws.

Project description:ObjectivesTo assess the levels of secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative.DesignCity-wide representative, cross-sectional surveys (Tobacco Questions for Surveys, TQS) were conducted in each participating city before and after the implementation of TFC.SettingFive large Chinese cities (Chengdu, Chongqing, Wuhan, Xiamen and Xi'an) participated in the TFC initiative.ParticipantsA total of 10 184 adults participated in the 2015 TQS survey, and 10 233 adults participated in the 2018 TQS survey, respectively.InterventionsThe TFC initiative, which included targeted media campaigns, educational programmes, implementing city-wide smoke-free policies and providing cessation interventions, was implemented in these five cities between 2015 and 2018.Main outcomeSelf-reported past 30-day (P30D) SHS exposure in indoor workplaces, restaurants and homes.Data analysisThe pre-TFC and post-TFC SHS exposure levels were compared among all residents and among certain population subgroups. Multivariate logistic regressions were used to estimate the adjusted associations between P30D SHS exposure and individual characteristics.ResultsAcross all five cities, the overall rate of self-reported P30D SHS exposure declined in indoor workplaces (from 49.6% (95% CI: 46.4% to 52.8%) to 41.2% (95% CI: 37.7% to 44.7%)), restaurants (from 72.4% (95% CI: 69.8% to 74.9%) to 61.7% (95% CI: 58.7% to 64.7%)) and homes (from 39.8% (95% CI: 36.9% to 42.7%) to 34.7% (95% CI: 31.5% to 37.8%)) from 2015 to 2018. These declines were statistically significant after controlling for individual characteristics. The P30D SHS exposure was associated with sex, age, education level, occupation and current smoking status. The associations varied by venues.ConclusionsOur analysis showed that compared with the nationwide SHS exposure levels reported in concurrent national surveys, the declines in P30D SHS exposure in five Chinese cities that implemented the TFC initiative were larger in indoor workplaces and restaurants. Our findings suggest that the TFC initiative was effective in reducing SHS exposure in Chinese cities.

Project description:IntroductionLittle is known about the relationship between smoke-free laws and persistent disparities in secondhand smoke (SHS) exposure among nonsmoking adults in the United States.Aims and methodsWe constructed time-varying smoke-free law measures representing whether or not at least 50% of each US county's population was covered by smoke-free laws in workplaces and hospitality venues (restaurants/bars). We merged these data with restricted data on cotinine-derived SHS exposure among nonsmokers from the National Health and Nutrition Examination Survey, 1999-2014 (N = 25 444). Using logistic regression, we estimated associations between smoke-free law coverage and SHS exposure among all nonsmokers, and within age strata (25-39, 40-59, 60+). We explored differential associations by gender, race/ethnicity, education, and poverty-income ratio (PIR) by testing the significance of interactions terms for the full sample and within age strata.ResultsIn adjusted models, hospitality coverage was associated with lower odds of SHS exposure in the full sample (odds ratio [OR] = 0.62; 95% confidence interval [CI] = 0.51-0.76), and within each age group, with ORs ranging from 0.58 (ages 25-39) to 0.67 (ages 60+). Workplace coverage was associated with lower SHS exposure only among younger adults (OR = 0.81; 95% CI = 0.65-0.99). Within the full sample and among adults ages 40-59, hospitality laws were associated with narrowing SHS exposure differentials between males and females. Among adults ages 40-59, workplace laws were associated with narrowing exposure differentials between males and females, but worsening exposure disparities by PIR.ConclusionsSmoke-free laws may reduce SHS exposure among adult nonsmokers, but may be insufficient to improve disparities in SHS exposure.ImplicationsIn a repeated cross-sectional sample of adult nonsmokers, smoke-free laws in hospitality venues were consistently associated with lower odds of SHS exposure and appeared to narrow exposure differentials between males and females. Associations between workplace smoke-free laws and SHS exposure were variable by age. Among adults ages 40-59, workplace laws were associated with narrowing exposure differentials between males and females while exacerbating exposure differentials by PIR. Differential patterns of association highlight the need to examine the impacts of tobacco control policies on downstream health equity.

Dataset Information

Feasibility and practicability studies of an evaluation index system for implementation of smoke-free laws and regulations of cities in China.

Introduction

Methods

Results

Conclusions

Publications

Feasibility and practicability studies of an evaluation index system for implementation of smoke-free laws and regulations of cities in China.

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