Tobacco-related risk perceptions, social influences and public smoke-free policies in relation to smoke-free home restrictions: findings from a baseline cross-sectional survey of Armenian and Georgian adults in a community randomised trial

Abstract

ObjectivesGiven high prevalence of smoking and secondhand smoke exposure in Armenia and Georgia and quicker implementation of tobacco legislation in Georgia versus Armenia, we examined correlates of having no/partial versus complete smoke-free home (SFH) restrictions across countries, particularly smoking characteristics, risk perceptions, social influences and public smoking restrictions.DesignCross-sectional survey study design.Setting28 communities in Armenia and Georgia surveyed in 2018.Participants1456 adults ages 18–64 in Armenia (n=705) and Georgia (n=751).MeasurementsWe used binary logistic regression to examine aforementioned correlates of no/partial versus complete SFH among non-smokers and smokers in Armenia and Georgia, respectively.ResultsParticipants were an average age of 43.35, 60.5% women and 27.3% smokers. In Armenia, among non-smokers, having no/partial SFHs correlated with being men (OR=2.63, p=0.001) and having more friend smokers (OR=1.23, p=0.002); among smokers, having no/partial SFHs correlated with being unmarried (OR=10.00, p=0.001), lower quitting importance (OR=0.82, p=0.010) and less favourable smoking attitudes among friends/family/public (OR=0.48, p=0.034). In Georgia, among non-smokers, having no/partial SFHs correlated with older age (OR=1.04, p=0.002), being men (OR=5.56, p<0.001), lower SHS risk perception (OR=0.43, p<0.001), more friend smokers (OR=1.49, p=0.002) and fewer workplace (indoor) restrictions (OR=0.51, p=0.026); among smokers, having no/partial SFHs correlated with being men (OR=50.00, p<0.001), without children (OR=5.88, p<0.001), daily smoking (OR=4.30, p=0.050), lower quitting confidence (OR=0.81, p=0.004), more friend smokers (OR=1.62, p=0.038) and fewer community restrictions (OR=0.68, p=0.026).ConclusionsPrivate settings continue to lack smoking restrictions in Armenia and Georgia. Findings highlight the importance of social influences and comprehensive tobacco legislation, particularly smoke-free policies, in changing household smoking restrictions and behaviours.Trial registration numberNCT03447912.

Smoke-free home restrictions in Armenia and Georgia: motives, barriers and secondhand smoke reduction behaviors

“… 15 , 16 Moreover, SHSe rates in Armenia and Georgia are concerning—with estimates of past-month SHSe of 74.2% (79.5% in Armenia, 68.9% in Georgia) and daily SHSe of 24.4%—and SHSe rates are high even where smoking is prohibited. 17 , 18 Although Armenia and Georgia ratified the FCTC in 2004 and 2006, respectively, progress in advancing tobacco control, including smoke-free policy, has lagged. However, both countries have made substantial advances in implementing public smoke-free policies, effective in Georgia since 2018 and in Armenia since 2022.…”

“…Despite this progress, 2018 data indicated that smoking is allowed in >75% of homes in Armenia and ∼50% of homes in Georgia. 18 With the recent implementation of national smoke-free policies, understanding theoretical factors (e.g. outcome expectancies, perceived barriers) related to implementing SFHs is crucial for deterring potential displacement of smoking behaviors to private settings and capitalizing on a critical period for promoting SFHs.…”

Examining local smoke-free coalitions in Armenia and Georgia: context and outcomes of a matched-pairs community-randomised controlled trial

“…Smoking rates among men are among the top ten highest globally (56.1% and 49.5%, respectively); rates among women are lower (2.6% and 8.5%) 34 35. Moreover, 74.2% of people (79.5% in Armenia, 68.9% in Georgia) experience past-month SHSe, with 24.4% experiencing daily SHSe 36. SHSe rates are high even where smoking is prohibited 36 37.…”

“… 34 35 Moreover, 74.2% of people (79.5% in Armenia, 68.9% in Georgia) experience past-month SHSe, with 24.4% experiencing daily SHSe. 36 SHSe rates are high even where smoking is prohibited. 36 37 Armenia and Georgia ratified the FCTC in 2004 and 2006, respectively; yet, tobacco control progress has lagged until recently.…”

“… 36 SHSe rates are high even where smoking is prohibited. 36 37 Armenia and Georgia ratified the FCTC in 2004 and 2006, respectively; yet, tobacco control progress has lagged until recently. 38 39 Notably, the use of community mobilisation efforts, such as coalitions, to promote public health initiatives has been limited, given the sociopolitical histories in these former Soviet Union countries.…”