Dataset Information

The impact of local smoke-free policies on smoking behaviour among adults in Indonesia: a quasi-experimental national study.

ABSTRACT: AIMS:To investigate to what extent the adoption of local smoke-free policies (SFPs) in Indonesia in 2007-13 was associated with changes in adult smoking behaviour. DESIGN:A quasi-experimental study. SETTING:Indonesia, 2007 and 2013. PARTICIPANTS:A total of 1?052?611 > 25-year-old adults. Data were derived from the 2007 and 2013 Indonesian national health survey. MEASUREMENTS:For both years, provincial and district SFPs were identified from government documents in 497 districts in 33 provinces. Multi-level logistic regression analysis assessed the association of adoption of provincial and district SFPs between 2007 and 2013 with smoking continuation (among ever-smokers), current smoking and high smoking intensity (among current smokers). We controlled for survey year, SFP in 2007, socio-demographics and district characteristics. FINDINGS:Provincial SFP exposure was associated with lower odds of smoking continuation [strong SFP versus no SFP: odds ratio (OR) = 0.71, 95% confidence interval (CI) = 0.66-0.76] and smoking intensity (strong SFP: OR= 0.91, 95% CI = 0.86-0.97), but also with higher odds of current smoking (strong SFP versus no SFP: OR = 1.08; 95% CI = 1.04-1.12). District SFP exposure was associated with higher odds of smoking continuation (strong SFP versus no SFP: OR = 1.07, 95% CI = 1.01-1.14) and current smoking (strong SFP versus no SFP: OR = 1.09, 95% CI = 1.05-1.14), but with lower odds of smoking intensity (moderately strong SFP versus no SFP: OR = 0.95, 95% CI = 0.91-0.99). CONCLUSIONS:There may be an association between the adoption of local smoke-free policies in Indonesia and decreased adult smoking intensity. However, the evidence is inconsistent, which may reflect problems with policy implementation and enforcement.

SUBMITTER: Septiono W

PROVIDER: S-EPMC7687215 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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The impact of local smoke-free policies on smoking behaviour among adults in Indonesia: a quasi-experimental national study.

Septiono Wahyu W Kuipers Mirte A G MAG Ng Nawi N Kunst Anton E AE

Addiction (Abingdon, England) 20200527 12

<h4>Aims</h4>To investigate to what extent the adoption of local smoke-free policies (SFPs) in Indonesia in 2007-13 was associated with changes in adult smoking behaviour.<h4>Design</h4>A quasi-experimental study.<h4>Setting</h4>Indonesia, 2007 and 2013.<h4>Participants</h4>A total of 1 052 611 > 25-year-old adults. Data were derived from the 2007 and 2013 Indonesian national health survey.<h4>Measurements</h4>For both years, provincial and district SFPs were identified from government documents ...[more]

PMID: 32386096

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Project description:IntroductionSmoking remains a major health risk factor and China is the world's largest consumer of tobacco. Smoke-free policies in public places are a powerful weapon in tobacco control. Therefore, the aim of this study was to assess the association between smoke-free policies in public places and smoking cessation among smokers in China from 2012 to 2020.MethodsIn this study, we assessed the impact of smoke-free public places policies on smoking cessation situation among smokers aged 16 years and older. We do this by conducting a difference-in-differences analysis using data from the China Family Panel Study (CFPS) 2012-2020.FindingsBy 2020, about 60.2% of the cities were covered by partial smoke-free policies and about 38.5% by comprehensive smoke-free policies. Based on the results of the study, we found that the medium-term effect model (Model 2, 2012:2016; Model 3, 2012:2018) of the impact of partial smoke-free policies on smoking cessation was not statistically significant using 2012 as the study baseline; the short-term effect model (Model 1; 2012:2014; P< .01) and the long-term effect model (Model 4; 2012:2020; P< .05) were statistically significant; the effect of a comprehensive smoke-free policy on smoking cessation (Model 5; 2012:2020; P<.05) was statistically significant.ConclusionChina's existing comprehensive smoke-free policies have had a modest impact on smoking cessation among the smoking population, and a strong, comprehensive national smoke-free law is urgently needed to achieve greater public health outcomes.ImplicationsSmoke-free policies are an important intervention to influence smoking behavior. This study demonstrates that comprehensive smoke-free policies in public places in China can effectively influence smoking behavior and show long-term trends in smoke-free behavior, while also reflecting the need to promote comprehensive smoke-free policies. This study provides a basis for the implementation of comprehensive smokefree policies into law and also provides a basis for policy makers.

Project description:The increasing denormalization of smoking by tobacco control policies and a normative smoke-free climate may shift power towards adolescent non-smokers. It is unclear, however, how common stigmatization of smokers is among adolescents or how stigmatization relates to the denormalization of smoking in their school and social environment. This paper aims to measure (1) whether stigmatization among European adolescents varies according to smoking status and socioeconomic position (SES), and (2) whether stigmatization is greater in school environments in which smoking is denormalized (i.e. those with low smoking rates and strong school tobacco policies). Data on 12,991 adolescents were collected in 55 schools in seven European countries (SILNE R-survey, 2016/17). We applied Stuber's adapted scale of perceived stereotyping and discrimination towards smokers to smoking status and five variables indicating a power shift towards non-smokers: the school's tobacco control policy (STP) score, the percentage of adolescents in the school who smoke, parents' level of education, students' academic performance, and the percentage of their friends who smoke. Multilevel regressions were applied to the global score for perceived stigmatization. Discrimination against smokers and stereotyping of smokers were frequently reported. Smokers reported less 'perceived stigmatization of smoking' than non-smokers (Beta = -0.146, p < 0.001). High-SES students reported stereotyping and discrimination more frequently than lower-SES students. The perception of stigmatization was lower among students whose academic performance was poor (Beta = -0.070, p < 0.001) and among those who had friends who smoked (Beta = -0.141, p < 0.001). Stigmatization was lower in schools with greater exposure to smoking and was not associated with the school's STP score. Perceived stigmatization of smoking is common among European adolescents. Smokers themselves, however, perceive stigmatization less often than non-smokers. Strong school tobacco policies do not increase stigmatization, but a social environment that is permissive of smoking decreases perceived stigmatization.

Project description:ObjectiveIn view of the high-smoking rate among university students in Lebanon and the known adverse effects of second-hand smoking, the American University of Beirut (AUB) decided to implement a non-smoking policy on campus. This study sought to examine the students' compliance and attitudes following the ban.DesignCross-sectional study.SettingA private university in Lebanon.Participants545 randomly selected students were approached. A stratified cluster sample of classes offered in the spring semester of the 2008/2009 academic year was selected. Students completed a self-administered paper and pencil survey during class time.Primary and secondary outcome measuresThe main outcomes were compliance with and attitudes towards the ban. Other secondary outcomes were the perception of barriers to implementation of the ban and attitudes towards tobacco control in general.Results535 students participated in the study. Smokers were generally compliant with the ban (72.7%) and for some (20%) it led to a decrease in their smoking. Students' attitude towards the ban and the enforcement of a non-smoking policy in public places across Lebanon varied according to their smoking status whereby non-smokers possessed a more favourable attitude and strongly supported such policies compared with smokers; overall, the largest proportions of students were satisfied to a large extent with the ban and considered it justified (58.6% and 57.2%, respectively). While much smaller percentages reported that the ban would help in reducing smoking to a large extent (16.7%) or it would help smokers quit (7.4%). Perceived barriers to implementation of the non-smoking policy in AUB included the lack of compliance with and strict enforcement of the policy as well as the small number and crowdedness of the smoking areas.ConclusionsAn education campaign, smoking cessation services and strict enforcement of the policy might be necessary to boost its effect in further reducing students' cigarette use.

Dataset Information

The impact of local smoke-free policies on smoking behaviour among adults in Indonesia: a quasi-experimental national study.

Publications

The impact of local smoke-free policies on smoking behaviour among adults in Indonesia: a quasi-experimental national study.

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