Tobacco smoking among government employees in six cities in China.
ABSTRACT: Employer-based tobacco control interventions have been highly successful in developed countries, and, recently, Chinese officials announced a focus on quitting among government employees. However, there are few data offering estimates of smoking prevalence among government workers from developing nations. In this study, we investigate smoking behaviours among government workers in six Chinese cities stratified by educational attainment and occupational grade.Individual-level study of Chinese government employees.Tobacco-Free Cities Initiative of China Tobacco Control Partnership.Employed adults aged 18-61 at government worksites in six cities were included (N=6176). Prevalence of current and former smoking across educational (postgraduate, graduate, high school, secondary school or less) and occupational (senior executives, mid-level managers, workers) groups were compared.Overall prevalence of male current smoking was 40.7% (95% CI 39.1% to 42.4%). Age-adjusted smoking prevalence was lowest among those with a postgraduate degree (26.2% (95% CI 21.0% to 31.4%)) compared with those with lower levels of education (college (39.8%; 37.7% to 41.8%); high school (51.0%; 95% CI 45.0% to 57.0%); secondary or less (45.1%; 95% CI 40.3% to 49.8%)). There was no evidence of an association between current smoking and occupational grade. Prevalence of smoking was low in women (1.5%).Smoking prevalence among male government employees at all levels of education was high and patterned by educational attainment. Government initiatives to address tobacco control among employees should consider targeted interventions for different educational levels.
Project description:Insomnia among workers reduces the quality of life, contributes toward the economic burden of healthcare costs and losses in work performance. The relationship between occupational stress and insomnia has been reported in previous studies, but there has been little attention to temperament in occupational safety and health research. The aim of this study was to clarify the relationships between temperament, occupational stress, and insomnia. The subjects were 133 Japanese daytime local government employees. Temperament was assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A). Occupational stress was assessed using the Generic Job Stress Questionnaire (GJSQ). Insomnia was assessed using the Athens Insomnia Scale (AIS). Stepwise multiple logistic regression analyses were conducted. In a stepwise multivariate logistic regression analysis, it was found that the higher subdivided stress group by "role conflict" (OR = 5.29, 95% CI, 1.61-17.32) and anxious temperament score (OR = 1.33; 95% CI, 1.19-1.49) was associated with the presence of insomnia using an adjusted model, whereas other factors were excluded from the model. The study limitations were the sample size and the fact that only Japanese local government employees were surveyed. This study demonstrated the relationships between workers' anxious temperament, role conflict, and insomnia. Recognizing one's own anxious temperament would lead to self-insight, and the recognition of anxious temperament and reduction of role conflict by their supervisors or coworkers would reduce the prevalence of insomnia among workers in the workplace.
Project description:Few studies have investigated differences in age- and gender-specific educational gradients in tobacco smoking among the whole range of adult age groups. We examined educational inequality in smoking among Japanese adults aged 25-94 years.Using a large nationally representative sample (167,925 men and 186,588 women) in 2010, prevalence of current smoking and heavy smoking among daily smokers and their inequalities attributable to educational attainment were analyzed according to sex and age groups.Among men aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 68.4% (95% confidence interval [CI], 66.0%-70.6%), and graduate school graduates had the lowest at 19.4% (95% CI, 17.2%-21.9%). High school graduates had the second highest current smoking prevalence (e.g., 55.9%; 95% CI, 54.9%-56.8% in men aged 25-34 years). Among men aged 75-94 years, the difference in current smoking across educational categories was small. A similar but steeper educational gradient in current smoking was observed among women. Among women aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 49.3% (95% CI, 46.3%-52.3%), and graduate school graduates had the lowest at 4.8% (95% CI, 2.9%-7.4%). Compared with older age groups, such as 65-94 years, younger age groups, such as 25-54 years, had higher estimates of inequality indicators for educational inequality in both current and heavy smoking in both sexes.Educational inequalities in current and heavy smoking were apparent and large in the young population compared with older generations. The current study provides basic data on educational inequalities in smoking among Japanese adults.
Project description:BACKGROUND:Higher smoking prevalence in less educated persons and manual workers is well known. This study examines the independent relationship of education and occupation with tobacco use. METHODS:We used anonymized data from a nationwide population survey (30,617 men and 33,934 women). Education was divided into junior high school, high school, or university attainment. Occupation was grouped into upper non-manual, lower non-manual, and manual. Poisson regression models stratified by age and gender were used to estimate adjusted prevalence ratio (PR) and 95% confidence interval (CI) for current smoking. RESULTS:After adjustment for covariates, education, and occupation, education was significantly related to current smoking in both genders; compared to university graduates, PRs of junior high school graduates aged 20-39, 40-64, and ?65 were 1.74 (95% CI, 1.53-1.98), 1.50 (95% CI, 1.36-1.65), and 1.28 (95% CI, 1.08-1.50) among men, and 3.54 (95% CI, 2.92-4.30), 2.72 (95% CI, 2.29-3.23), and 1.74 (95% CI, 1.14-2.66) among women, respectively. However, significantly higher smoking prevalence in manual than in upper non-manual was found only in men aged 20-64; compared to upper non-manual, the PRs of manual workers aged 20-39, 40-64, and ?65 were 1.11 (95% CI, 1.02-1.22), 1.18 (95% CI, 1.10-1.27), and 1.10 (95% CI, 0.89-1.37) among men, and 0.95 (95% CI, 0.75-1.20), 0.92 (95% CI, 0.75-1.12), and 0.46 (95% CI, 0.22-0.95) among women, respectively. CONCLUSIONS:Independent of occupation, educational disparities in smoking existed, regardless of age and gender. Occupation-smoking relationship varied with age and gender. Our study suggests that we should pay attention to social inequality in smoking as well as national smoking prevalence.
Project description:In the absence of comprehensive smoking bans in public places, bars and nightclubs have the highest concentrations of secondhand tobacco smoke, posing a serious health risk for workers in these venues.To assess exposure of bar and nightclub employees to secondhand smoke, including non-smoking and smoking employees.Between 2007 and 2009, the authors recruited approximately 10 venues per city and up to five employees per venue in 24 cities in the Americas, Eastern Europe, Asia and Africa. Air nicotine concentrations were measured for 7 days in 238 venues. To evaluate personal exposure to secondhand smoke, hair nicotine concentrations were also measured for 625 non-smoking and 311 smoking employees (N=936).Median (IQR) air nicotine concentrations were 3.5 (1.5-8.5) ?g/m(3) and 0.2 (0.1-0.7) ?g/m(3) in smoking and smoke-free venues, respectively. Median (IQR) hair nicotine concentrations were 6.0 (1.6-16.0) ng/mg and 1.7 (0.5-5.5) ng/mg in smoking and non-smoking employees, respectively. After adjustment for age, sex, education, living with a smoker, hair treatment and region, a twofold increase in air nicotine concentrations was associated with a 30% (95% CI 23% to 38%) increase in hair nicotine concentrations in non-smoking employees and with a 10% (2% to 19%) increase in smoking employees.Occupational exposure to secondhand smoke, assessed by air nicotine, resulted in elevated concentrations of hair nicotine among non-smoking and smoking bar and nightclub employees. The high levels of airborne nicotine found in bars and nightclubs and the contribution of this exposure to employee hair nicotine concentrations support the need for legislation measures that ensure complete protection from secondhand smoke in these venues.
Project description:<h4>Background</h4>Tobacco smoking affects the incidence of various illnesses such as lung cancer, respiratory diseases, and cardiovascular diseases. In an effort to prevent smoking-related cancers, we aimed to estimate the smoking prevalence, intensity, and number of workers exposed to smoking, which would be specific to the occupational and industrial circumstances in Korea.<h4>Methods</h4>We used the Korean Working Condition Survey (KWCS) and Korea's Census data. Smoking prevalence and intensity were estimated using the KWCS data. The number of smokers was estimated by multiplying smoking prevalence with the number of workers in the occupation or industry. Smoking prevalence, intensity, and number of smokers were estimated for major, sub-major, and minor groups of occupation and industry.<h4>Results</h4>Of the total labor force in 2010, 52.66% of men and 5.24% of women workers were estimated to be current smokers. Men workers smoked 15.42 cigarettes/day, and women workers 11.29 cigarettes/day. In terms of occupation, "craft and related trades workers" demonstrated the highest smoking prevalence (52.24%). "Managers" smoked the highest number of cigarettes (16.63 cigarettes/day) and "equipment, machine operating, and assembling workers" comprised the largest number of estimated smokers (1,368,726 workers). In terms of industry, "mining and quarrying" had the highest smoking prevalence (69.27%). Those in "construction" smoked the highest number of cigarettes (17.16 cigarettes/day) and those in "manufacturing" comprised the largest number of estimated smokers (1,629,893 workers).<h4>Conclusion</h4>Our results may help in setting priorities for smoking prevention-related activities. In addition, these results can be used for epidemiological studies controlling for the effect of smoking by occupation or industry.
Project description:AIMS/HYPOTHESIS:The workplace is a potentially important arena for prevention of type 2 diabetes and the first step is to identify occupations where the disease is common and/or risk is high. Therefore, our aim was to analyse incidence and prevalence of type 2 diabetes across all occupational groups in Sweden. METHODS:This nationwide study included all Swedish citizens born between 1937 and 1979 and gainfully employed between 2001 and 2013 (N?=?4,550,892), and followed for a diagnosis of diabetes from 2006 to 2015 (n?=?201,717) through national registers. Prevalence in 2013 (mean age 51 years; range 35-67) and age-standardised incidence (per 1000 person-years) were analysed across the 30 most common occupations among men and women. Information on BMI, physical fitness and smoking was obtained through the National Conscription (mean age 18) and Medical Birth Registers (mean age 29). RESULTS:Prevalence of type 2 diabetes was 5.2% in men and 3.2% in women; in men it was highest among motor vehicle drivers (8.8%) and in women it was highest among manufacturing workers (6.4%). Incidence varied dramatically across occupational groups. In men, it was highest among manufacturing workers (9.41) and professional drivers (9.32) and lowest among university teachers (3.44). In women, incidence was highest in manufacturing workers (7.20) and cleaners (6.18) and lowest in physiotherapists (2.20). We found major differences in the prevalence of being overweight and smoking and in the level of physical fitness across these occupational groups even at young ages. CONCLUSIONS/INTERPRETATION:Professional drivers, manufacturing workers and cleaners have a threefold increased risk of type 2 diabetes compared with university teachers and physiotherapists. These differences most likely reflect dramatic differences in the prevalence of lifestyle risk factors. If workplace interventions could reduce weight and increase physical activity among employees in these occupations, major health gains may be made.
Project description:Tobacco use is the most important preventable cause of premature death and major risk factor for non-communicable diseases. Due to strict tobacco legislation in the western hemisphere, many African nations like Nigeria have shifted from being a tobacco-producing nation to a tobacco-consuming one. The purpose of this study was to systematically review existing literature on tobacco use among Nigerian adolescents and young people and identify the prevalence, distribution and factors influencing of tobacco smoking. These data are necessary to formulate and adapt control measures aimed at tobacco cessation among young people, and preventing long-term smoking behaviors.Three databases (African Journals Online, PsychInfo, PubMed) were searched for peer-reviewed publications, published between January 2000 and March 2017. Additional searches were completed on Google Scholar, and other documents and reports of the Nigerian government and the Global Youth Tobacco Survey were consulted. Using the PRISMA guidelines to evaluate studies, we included studies that reported prevalence of tobacco use in adolescents or youths, aged 10 to 24, and excluded evaluations of tobacco-related medical conditions.A total of 30 studies with a total population of 26,709 were reviewed. Prevalence rates of tobacco smoking ranged from 0.2% to 32.5%. Among the gender-specific studies, the prevalence of smoking among females ranged between 2.2% to 10% while that of males ranged from 1% to 32.5%. Gender distribution among these studies was mixed (80.0%), males only (13.3%) and females only (6.7%). Smoking prevalence was higher among males than females. The most common risk factors for tobacco use included peer influence, family conditions, psychosocial factors and male gender. Additional risk factors included concomitant substance abuse, media advertisements and increasing age.Tobacco smoking poses a huge burden to Nigerian youths and various determinants were highlighted in this review. It is imperative that all stakeholders engage in concerted efforts to target both in-school and out-of-school youths in tobacco control strategies.
Project description:INTRODUCTION:Despite extensive knowledge about effective tobacco control interventions, the prevalence of tobacco use in many middle- and low-income countries continues to rise. In these countries, public appreciation of levels of protection provided by laws and regulations on tobacco use and exposure to tobacco smoke is limited. After ratification of the Framework Convention on Tobacco Control, Kenya enacted the Tobacco Control Act, 2007, banning smoking in public places except in designated smoking areas. OBJECTIVE:To assess adherence to the Tobacco Control Act, 2007 by determining the presence of a workplace policy on tobacco use in bars and restaurants. METHODS:A survey of 176 liquor licensed bars and restaurants in Nairobi County was carried out. Their managers were asked about the presence of a workplace policy governing smoking of tobacco, and observations made on provisions that determine adherence to the Tobacco Control Act, 2007. RESULTS:Smoking took place in almost all bars and restaurants (150 (85%)). Half the establishments (86 (49%)) had a workplace policy governing tobacco use among employees, although a difference between bars (11 (23%)) and restaurants (75 (58%)) was recorded (p<0.001). Establishments at which managers had lower levels of education were less likely to have a workplace policy (p<0.001) and less likely to have 'no smoking' signs and designated smoking areas (p<0.005). CONCLUSIONS AND RECOMMENDATIONS:Kenya's implementation of the Tobacco Control Act, 2007 does not provide sufficient protection of patrons and workers in bars and restaurants. It is important to sensitise hospitality workers to the dangers of tobacco smoke. Bar and restaurants managers should have a minimum post-secondary education level. The Tobacco Control Act, 2007 requires strengthening to ensure that bars and restaurants have a smoke-free environment.
Project description:Background:Tobacco use is a serious health concern in Albania. While the prevalence of tobacco smoking has traditionally been higher for men, the increasing prevalence of smoking for women is becoming a concern. The 2007 Tobacco Control policy mandated smoke-free indoor spaces, banned various forms of tobacco advertising, required written health warnings on packaging and levied excise taxes on cigarette sales. Since smoking behavior varies among different demographic groups, each group's response to a uniform policy will differ, blunting the effectiveness of these efforts as a result. This study examines various socioeconomic, demographic and behavioral factors affecting both the likelihood and frequency of smoking in Albanian households in order to provide insights on targeting various populations more effectively. Methods:The study utilizes data from Albanian 2008-09 and 2017-18 Demographic and Health Surveys consisting of adults aged 15-49?years. The outcome variable includes respondents' current tobacco smoking behaviour and its frequency. The exposure variables include respondents' sociodemographic and lifestyle characteristics. We use a two-level random intercept model with the two-stage residual inclusion estimation method to determine the association between outcome and exposure variables. By including a time variable, we capture the change in smoking behavior during the 2009-2018 period. We also extend the analysis by assessing the differential influence of gender on the likelihood of smoking, both by income quintiles and education. Results:The results suggest that the likelihood of smoking decreased by 23% in 2017-18 compared to 2008-09, after controlling for various socioeconomic and demographic factors. Tobacco smoking is also found to be linked to alcohol consumption, with binge drinkers 59% more likely to smoke tobacco compared to moderate drinkers. We also found significant inter-quintile and inter-educational differences in smoking practices within each gender category. While the likelihood of tobacco smoking decreases with increasing wealth and educational attainment among men, the opposite (for wealth) or more involved (for educational attainment) patterns are true among women. Conclusions:To further enhance the effectiveness of the current Tobacco Control policy, the Government of Albania should target various demographic groups (such as poor males, rich and educated females) in a differentiated fashion.
Project description:OBJECTIVE:To explore young adults' perceptions and experiences of smoking and their smoking trajectories in the context of their social and occupational histories and transitions, in a country with advanced tobacco control. DESIGN:Indepth qualitative interviews using day and life grids to explore participants' smoking behaviour and trajectories in relation to their educational, occupational and social histories and transitions. SETTING:Scotland. PARTICIPANTS:Fifteen ever-smokers aged 20-24?years old in 2016-2017. RESULTS:Participants had varied and complex educational/employment histories. Becoming and/or remaining a smoker was often related to social context and educational/occupational transitions. In several contexts smoking and becoming a smoker had perceived benefits. These included getting work breaks and dealing with stress and boredom, which were common in the low-paid, unskilled jobs undertaken by participants. In some social contexts smoking was used as a marker of time out and sociability. CONCLUSIONS:The findings indicate that while increased tobacco control, including smokefree policies, and social disapproval of smoking discourage smoking uptake and increase motivations to quit among young adults, in some social and occupational contexts smoking still has perceived benefits. This finding helps explain why smoking uptake continues into the mid-20s. It also highlights the importance of policies that reduce the perceived desirability of smoking and that create more positive working environments for young adults which address the types of working hours and conditions that may encourage smoking.