Evaluation of smoke-free policies in seven cities in China, 2007-2012

Abstract

Background China is the world’s largest consumer of tobacco, with hundreds of millions of people exposed daily to secondhand smoke (SHS). Comprehensive smoke-free policies are the only effective way to protect the population from the harms of SHS. China does not have a comprehensive national smoke-free law but some local-level regulations have been implemented. Objective To evaluate local level smoke-free regulations across seven cities in China by measuring the prevalence of smoking in public places (workplaces, restaurants, and bars), and support for smoke-free policies over time. Methods Data were from Waves 2 to 4 of the International Tobacco Control (ITC) China Survey (2007–2012), a face-to-face cohort survey of approximately 800 smokers in each of seven cities in mainland China. Multivariate logistic regression models estimated with GEE were used to test the changes in variables over time. Results As of 2012, over three-quarters of respondents were exposed to smoking in bars; more than two-thirds were exposed to smoking in restaurants and more than half were exposed to smoking in indoor workplaces. Small decreases in the prevalence of smoking were found overall from Wave 2 to Wave 4 for indoor workplaces, restaurants, and bars; although the decline was minimal for bars. Support for complete smoking bans increased over time for each venue, although it was lowest for bars. Conclusions Existing partial smoking bans across China have had minimal impact on reducing smoking in public places. A strongly enforced, comprehensive national smoke-free law is urgently needed in order to achieve greater public health gains.

Secondhand smoke exposure and support for smoke-free policies in cities and rural areas of China from 2009 to 2015: a population-based cohort study (the ITC China Survey)

“…While smoking decreased in those cities that had implemented partial smoke-free laws between survey waves, there was no difference in the decrease in these cities compared with cities where no laws were implemented, demonstrating the failure of partial smoking bans to achieve even a partial reduction in SHS. These results are also consistent with previous research in China showing high levels of SHS exposure in public places—especially in rural areas—as well as no difference in SHS exposure in Chinese cities that had smoke-free restrictions in place compared with those without local smoke-free laws 10 13 29–31…”

“…Although studies have shown the weak impact of existing partial smoke-free laws across China and the need for stronger comprehensive laws,8–11 very little is known about the impact of current smoke-free policies in rural areas—where almost half (44%) of the Chinese population lives 12. Rural smoking rates have risen in recent years such that by 2015, male smokers in rural areas had a higher smoking prevalence, smoked more cigarettes per day and spent more of their income on cigarettes than urban smokers 13 14.…”

Are hospitality workers aware and do they support the State-wide Regulation of Smoking Law in Lagos state Nigeria?

“…Particularly in hospitals and schools and to a lesser extent in hospitality venues like hotels and bars. These findings are similar to a study carried out in China, where the majority of the population supported the prohibition of smoking in schools and public vehicles (85%), in hospitals (73%) and in offices (58%) while only 17% supported prohibiting smoking in restaurants and 11% supported in bars 21 . Similar findings were observed in Poland where the respondents also favoured bans in workplaces, on public transportation and public buildings over bans in bars, pubs and cafes 22 .…”

Children’s Exposure to Secondhand Smoke during Ramadan in Jakarta, Indonesia

“…In those venues, PM 2.5 levels were significantly greater than in non-smoking venues. As has been observed in Indonesia [20,21] and internationally [22,23,24], we found that non-enforcement of smoke-free laws fails to provide needed protection from SHS exposure for nonsmokers, including children. The PM 2.5 levels observed in this study were lower than those found in a 2009 convenience sample of 17 restaurants in Jakarta (~110 µg/m 3 ) [21] and in many similar venues sampled globally [16,25,26].…”