The Role of Cities in Reducing Smoking in China

Redmon, Pamela; Koplan, Jeffrey P.; Eriksen, Michael P.; Li, Shuyang; Wang, Ke-an

doi:10.3390/ijerph111010062

Cited by 21 publications

(10 citation statements)

References 8 publications

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“…In China, cities may play an important role in changing the social norms of tobacco use from a bottom-up approach through efforts such as public education and media campaigns. By educating citizens, as well as taking the charge on implementing and enforcing smoke-free policies at the local level, cities have the opportunity and responsibility to increase acceptance and support for smoke-free laws, thus enhancing the likelihood of their success 37…”

Section: Discussionmentioning

confidence: 99%

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)

Sansone

Fong²,

Yan

et al. 2019

BMJ Open

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ObjectivesTo examine trends in smoking prevalence in key venues (workplaces, restaurants, bars) and in public support for comprehensive smoke-free laws, with comparisons between cities and rural areas in China.DesignData are from Waves 3–5 (2009–2015) of the International Tobacco Control (ITC) China Survey, a cohort survey of smokers and non-smokers. Logistic regression analyses employing generalised estimating equations assessed changes in smoking prevalence and support for smoke-free laws over time; specific tests assessed whether partial smoking bans implemented in three cities between Waves 3 and 4 had greater impact.SettingFace-to-face surveys were conducted in seven cities (Beijing, Changsha, Guangzhou, Kunming, Shanghai, Shenyang and Yinchuan) and five rural areas (Changzhi, Huzhou, Tongren, Yichun and Xining).ParticipantsIn each survey location at each wave, a representative sample of approximately 800 smokers and 200 non-smokers (aged 18+) were selected using a multistage cluster sampling design.Main outcome measuresPrevalence of smoking (whether respondents noticed smoking inside restaurants, bars and workplaces); smoking rules inside these venues; and support for complete smoking bans in these venues.ResultsAlthough smoking prevalence decreased and support increased over time, neither trend was greater in cities that implemented partial smoke-free laws. Smoking was higher in rural than urban workplaces (62% vs 44%, p<0.01), but was equally high in all restaurants and bars. There were generally no differences in secondhand smoke (SHS) exposure between smokers and non-smokers except in rural workplaces (74% vs 58%, p<0.05). Support for comprehensive bans was equally high across locations.ConclusionsPartial laws have had no effect on reducing SHS in China. There is an urgent need for comprehensive smoke-free laws to protect the public from exposure to deadly tobacco smoke in both urban and rural areas. The high support among Chinese smokers for such a law demonstrates that public support is not a barrier for action.

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Section: Discussionmentioning

confidence: 99%

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)

Sansone

Fong²,

Yan

et al. 2019

BMJ Open

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“…Previous research has shown that cities play a critical role in changing social norms of tobacco use and may be the driving force for this change in developing countries. 38 Hence, tobacco bans in cities hosting mega-events are important strategies to initiate and sustain tobacco-free social norm changes. However, it is important to recognize that there are limitations to this approach.…”

Section: Discussionmentioning

confidence: 99%

Cigarette Smoking and Secondhand Smoke Exposure Before and After a Tobacco-Free Olympic Policy Period: Qingdao, China

Zhao

Stewart

et al. 2018

Nicotine &Amp; Tobacco Research

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Introduction We explored the impact of a temporary tobacco-free public policy for the 2008 Summer Olympics on the smoking prevalence and secondhand smoke exposure among the population of a co-hosting city, Qingdao, China. Methods The Qingdao Diabetes Survey was analyzed for 2006 (n = 4599) and 2009 (n = 4680), which are survey years before and after the tobacco-free Olympics public policy period (July 2007 to January 2009). We analyzed the differences in self-reported smoking prevalence and exposure to secondhand smoke at home and/or workplace, and compared odds of smoking by survey year and of exposure to secondhand smoke among nonsmokers. Results From 2006 to 2009, the male smoking prevalence declined from 51.4% (95% confidence interval [CI] = 49.0% to 53.9%) to 42.6% (95% CI = 40.2% to 45.1%), and the proportion of lighter smokers decreased more. Among nonsmokers, the secondhand smoke exposure rate declined from 62.2% (95% CI = 60.5% to 63.9%) to 56.8% (95% CI = 55.1% to 58.6%). Regression analyses show 34% lower odds of men smoking after Olympics (OR = 0.66, 95% CI = 0.57% to 0.77%). Rural residents and individuals who are not retired were more likely to smoke. Female nonsmokers report 17% less exposure to secondhand smoke after Olympics (OR = 0.83, 95% CI = 0.70% to 0.98%). Urban nonsmokers were more likely to be exposed than their rural counterparts. Conclusions Smoking prevalence among men and secondhand smoke exposure among women significantly decreased in Qingdao, China, after the tobacco-free Olympics public policy period. As only the proportion of lighter smokers decreased, this may help explain why urban nonsmokers reported increased exposure. Unintended increased secondhand smoke exposure and cessation support need to be addressed in large-scale policy campaigns. Implications Hosting the Olympic Games can help to initiate large-scale tobacco-free public policies for hosting cities. Although previous studies have demonstrated reduction in nonsmoker exposure to secondhand smoke, the impact on the hosting city’s smoking prevalence or exposure rates is unclear. After the Olympic Games in Qingdao, China, smoking prevalence among men significantly decreased, mostly due to light smokers. Secondhand smoke exposure at home and/or workplace significantly decreased among female nonsmokers. Urban nonsmokers had an unintended consequence of increased secondhand smoke exposure after the tobacco-free Olympic policy period. Concurrent promotion of cessation support for heavier smokers may be needed.

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“…The aim of the partnership, which was established in 2008, is to reduce the health, social, environmental and economic burdens of tobacco through several initiatives implemented in 17 Chinese cities 25. The 17 grantee cities were allowed to decide where to focus their efforts based on each city's unique context.…”

Section: Methodsmentioning

confidence: 99%

Tobacco smoking among government employees in six cities in China

et al. 2014

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Objective 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. Design Individual-level study of Chinese government employees. Data sources Tobacco-Free Cities Initiative of China Tobacco Control Partnership. Analysis 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. Results 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%). Conclusions 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.

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The Role of Cities in Reducing Smoking in China

Cited by 21 publications

References 8 publications

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)

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)

Cigarette Smoking and Secondhand Smoke Exposure Before and After a Tobacco-Free Olympic Policy Period: Qingdao, China

Tobacco smoking among government employees in six cities in China

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