Towards smokefree public places 2002

Health reports, 2004

This article examines exposure to second-hand smoke (SHS) in 2003 in various settings by age and sex, and compares exposure indicators by province and health region. The data are from the 2000/01 and 2003 Canadian Community Health Survey, conducted by Statistics Canada. Rates of exposure to SHS among non-smokers are calculated by sex, age and location for the household population aged 12 or older. Rates of exposure at work are examined for employed non-smokers aged 15 or older. Smoking prevalence is expressed as a percentage of the household population aged 12 or older. In 2003, 33% of non-smokers reported that they were regularly exposed to SHS. The risk of exposure was greatest in public spaces, but regardless of setting, rates of exposure were higher for men than women. Exposure rates varied by age and peaked in young adulthood. However, at home and at work, the younger the non-smokers, the more likely they were to be exposed to SHS. Disparities in SHS exposure by province/territ...

Tobacco Control, 2012

The social gradient in smoking contributes substantially to the health gap between the rich and poor. Passive smoking by children is associated with increased risk of more severe asthma, respiratory diseases and infections, middle ear disease and Sudden Infant Death Syndrome. This study examined trends in the social gradient of children's exposure to second-hand smoke (SHS) in Australian households between 2001 and 2010.

Environmental …

"Background: On 1st July 2007, smokefree legislation was implemented in England, making virtually all enclosed public places and workplaces smokefree. Objectives: To analyse trends in and predictors of secondhand smoke exposure among non-smoking adults, whether exposure changed after the introduction of smokefree legislation and whether these changes varied by socio-economic and household smoking status. Methods: Analysis of salivary cotinine data from the Health Survey for England, collected in seven of 11 annual surveys undertaken between 1998 and 2008. We conducted multivariate regression analyses to examine secondhand smoke exposure as measured by the proportion of non-smokers with undetectable cotinine and by geometric mean cotinine. Results: Secondhand smoke exposure was higher among those exposed at home and in lower socio-economic groups. Exposure declined markedly from 1998 to 2008 (the proportion with undetectable cotinine was 2.9 times higher and geometric mean cotinine declined by 80%). There was a significant fall in exposure after legislation was introduced – the odds of having undetectable cotinine were 1.5 times higher (95% CI: 1.3, 1.8) and geometric mean cotinine fell by 27% (95% CI: 17%, 36%) after adjustment for the pre-legislative trend and potential confounders. Significant reductions were not however seen in those living in lower social class households or homes where smoking occurs inside on most days. Conclusions: England’s smokefree legislation impacted on secondhand smoke exposure above and beyond the underlying long-term decline demonstrating the positive effect of the legislation. Nevertheless, some population subgroups appear not to have benefitted significantly from the legislation, suggesting that these groups should receive more support to reduce their exposure."

PLOS ONE, 2022

Background More deprived populations typically experience higher cancer incidence rates and smoking prevalence compared to less deprived populations. We calculated the proportion of cancer cases attributable to smoking by socioeconomic deprivation in England and estimated the impact smoking has on the deprivation gap for cancer incidence. Methods Data for cancer incidence (2013-2017), smoking prevalence (2003-2007) and population estimates (2013-2017) were split by sex, age-group and deprivation quintile. Relative risk estimates from meta-analyses were used to estimate the population attributable fraction (PAF) for 15 cancer types associated with smoking. The deprivation gap was calculated using age-specific incidence rates by deprivation quintile. Results Smoking-related cancer PAFs in England are 2.2 times larger in the most deprived quintile compared to the least deprived quintile (from 9.7% to 21.1%). If everyone had the same smoking prevalence as the least deprived quintile, 20% of the deprivation gap in cancer incidence could have been prevented. If nobody smoked, 61% of the deprivation gap could have been prevented. Conclusions The majority of the deprivation gap in cancer incidence could have been prevented in England between 2013-2017 if nobody had smoked. Policy makers should ensure that tobacco control policies reduce overall smoking prevalence by tackling smoking inequalities.

Annals of the New York Academy of Sciences, 2012

Smoking prevalence is higher among disadvantaged groups, and disadvantaged smokers may face higher exposure to tobacco's harms. Uptake may also be higher among those with low socioeconomic status (SES), and quit attempts are less likely to be successful. Studies have suggested that this may be the result of reduced social support for quitting, low motivation to quit, stronger addiction to tobacco, increased likelihood of not completing courses of pharmacotherapy or behavioral support sessions, psychological differences such as lack of self-efficacy, and tobacco industry marketing. Evidence of interventions that work among lower socioeconomic groups is sparse. Raising the price of tobacco products appears to be the tobacco control intervention with the most potential to reduce health inequalities from tobacco. Targeted cessation programs and mass media interventions can also contribute to reducing inequalities. To tackle the high prevalence of smoking among disadvantaged groups, a combination of tobacco control measures is required, and these should be delivered in conjunction with wider attempts to address inequalities in health.

Journal of Epidemiology & Community Health, 2007

American Journal of Preventive Medicine, 2009

Although implementation of secondhand smoke policies is increasing, little research has examined the unintended consequences of these policies for disadvantaged women.

Environmental health : a global access science source, 2012

Exposure to second hand smoke (SHS) is an important preventable cause of morbidity and mortality in children. We hypothesised that there has been a growth in social inequality in children's exposure to SHS at home over time. The purpose of this study was to investigate temporal change in smoking in homes including children, focusing on the socioeconomic differences. Data is from a repeated cross-sectional survey, 'Health Profiles of the Capital Region of Denmark' conducted in 2007 and 2010, in 29 municipalities. The response rate was 52.3%, in both surveys. Our study included persons aged 25 to 64, living with children ≤15 years of age; N=9,289 in 2007 and 12,696 in 2010. Analyses were weighted for size of municipality and for non-response, which was higher among men and among persons who were younger, had a lower income, were living alone, were unemployed, and/or were of an ethnicity other than Danish. Regression analyses were used to investigate smoking in homes includ...

International Journal of Drug Policy, 2009

Background: The relationship between smoking and poverty is a public health issue in many countries, and several studies have shown a link between living in deprived neighbourhoods and smoking. In France the prevalence of smoking has decreased since the year 2000s. We examined whether reduced smoking rates differed by socio-economic status, anticipating reductions to be smaller amongst lower socio-economic groups. We also investigated whether poor housing conditions and/or living in a deprived neighbourhood were significantly associated with smoking. Methods: Data were collected by telephone surveys conducted between 2000 and 2007 with representative samples of the French population aged 18-75. The data from the last of these surveys (2007, N = 6007) were also used to carry out a cluster analysis on various indicators relating to housing conditions and neighbourhood. Results: Between 2000 and 2007 the social differential in smoking rates increased sharply in France. Specific types of neighbourhood and poor housing conditions (described as cramped housing in a noisy and stressful environment or deprived neighbourhood), which were closely correlated with socio-economic status, were found to be significantly correlated with smoking, even after adjusting for potential key confounders and especially for individual markers of social disadvantage. Conclusion: Interventions which do not specifically target smoking but which contribute to improving poor smokers' living conditions, are necessary to promote smoking cessation.