Voluntary Smoke-Free Home Rules and Exposure to Secondhand Smoke in Poland: A National Cross-Sectional Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Measures
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Kim, A.; Ko, H.J.; Kwon, J.H.; Lee, J.M. Exposure to Secondhand Smoke and Risk of Cancer in Never Smokers: A Meta-Analysis of Epidemiologic Studies. Int. J. Environ. Res. Public Health 2018, 15, 1981. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- World Health Organization (WHO). Tobacco. Available online: https://www.who.int/news-room/fact-sheets/detail/tobacco (accessed on 26 July 2020).
- Sureda, X.; Fernández, E.; López, M.J.; Nebot, M. Secondhand tobacco smoke exposure in open and semi-open settings: A systematic review. Environ. Health Perspect. 2013, 121, 766–773. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mlinarić, M.; Hoffmann, L.; Kunst, A.E.; Schreuders, M.; Willemsen, M.C.; Moor, I.; Richter, M. Explaining mechanisms that influence smoke-free implementation at the local level: A realist review of smoking bans. Nicotine Tob. Res. 2019, 21, 1609–1620. [Google Scholar] [CrossRef] [PubMed]
- U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2014. Available online: https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm (accessed on 26 July 2020).
- European Commissioner for Health and Consumer Policy. Tobacco in the EU: Exposure to Secondhand Smoke Reduced, But Still Too High, Says Commission Report. Available online: https://ec.europa.eu/commission/presscorner/detail/en/IP_13_147 (accessed on 23 July 2020).
- International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Tobacco Smoke and Involuntary Smoking; IARC: Lyon, France, 2004; Volume 83, Available online: https://monographs.iarc.fr/wp-content/uploads/2018/06/mono83.pdf (accessed on 23 July 2020).
- Framework Convention on Tobacco Control; World Health Organization (WHO): Geneva, Switzerland, 2003; Available online: http://www.who.int/fctc/about/en/ (accessed on 23 July 2020).
- Kabir, Z.; Manning, P.J.; Holohan, J.; Keogan, S.; Goodman, P.G.; Clancy, L. Second-hand smoke exposure in cars and respiratory health effects in children. Eur. Respir. J. 2009, 34, 629–633. [Google Scholar] [CrossRef] [Green Version]
- Xi, B.; Liang, Y.; Liu, Y.; Yan, Y.; Zhao, M.; Ma, C.; Bovet, P. Tobacco use and second-hand smoke exposure in young adolescents aged 12-15 years: Data from 68 low-income and middle-income countries. Lancet Glob. Health 2016, 4, e795–e805. [Google Scholar] [CrossRef] [Green Version]
- Fichtenberg, C.M.; Glantz, S.A. Effect of smoke-free workplaces on smoking behaviour: Systematic review. BMJ 2002, 325, 188. [Google Scholar] [CrossRef] [Green Version]
- Hyland, A.; Higbee, C.; Travers, M.J.; Van Deusen, A.; Bansal-Travers, M.; King, B.; Cummings, K.M. Smoke-free homes and smoking cessation and relapse in a longitudinal population of adults. Nicotine Tob. Res. 2009, 11, 614–618. [Google Scholar] [CrossRef] [Green Version]
- Hopkins, D.P.; Razi, S.; Leeks, K.D.; Kalra, G.P.; Chattopadhyay, S.K.; Soler, R.E.; Task Force on Community Preventive Services. Smokefree policies to reduce tobacco use. A systematic review. Am. J. Prev. Med. 2010, 38, S275–S289. [Google Scholar] [CrossRef]
- Mills, A.L.; Messer, K.; Gilpin, E.A.; Pierce, J.P. The effect of smoke-free homes on adult smoking behavior: A review. Nicotine Tob. Res. 2009, 11, 1131–1141. [Google Scholar] [CrossRef] [PubMed]
- Albers, A.B.; Biener, L.; Siegel, M.; Cheng, D.M.; Rigotti, N. Household smoking bans and adolescent antismoking attitudes and smoking initiation: Findings from a longitudinal study of a Massachusetts youth cohort. Am. J. Public Health. 2008, 98, 1886–1893. [Google Scholar] [CrossRef] [PubMed]
- Owusu, D.; Quinn, M.; Wang, K.; Williams, F.; Mamudu, H.M. Smokefree home rules and cigarette smoking intensity among smokers in different stages of smoking cessation from 20 low-and-middle income countries. Prev. Med. 2020, 132, 106000. [Google Scholar] [CrossRef]
- Shojima, K.; Tabuchi, T. Voluntary home and car smoke-free rules in Japan: A cross-sectional study in 2015. BMJ Open 2019, 9, e024615. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kruger, J.; Jama, A.; Homa, D.H.; Babb, S.D.; King, B.A. Smoke-free home and vehicle rules by tobacco use status among US adults. Prev. Med. 2015, 78, 9–13. [Google Scholar] [CrossRef] [Green Version]
- Nazar, G.P.; Lee, J.T.; Arora, M.; Millett, C. Socioeconomic inequalities in secondhand smoke exposure at home and at work in 15 low- and middle-income countries. Nicotine Tob. Res. 2016, 18, 1230–1239. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kaleta, D.; Fronczak, A.; Usidame, B.; Dziankowska-Zaborszczyk, E.; Makowiec-Dąbrowska, T.; Wojtysiak, P. Implementation of smoke-free homes in Poland. Int. J. Occup. Med. Environ. Health 2016, 29, 137–148. [Google Scholar] [CrossRef]
- WHO Regional Office for Europe. Global Adult Tobacco Survey Poland 2009–2010. Available online: https://www.who.int/tobacco/surveillance/en_tfi_gats_poland_report_2010.pdf (accessed on 25 July 2020).
- Pinkas, J.; Szymański, J.; Poznański, D.; Wierzba, W. Smoke-free policy in Poland on the example of the implementation into national law of the European Parliament and Council Directive 2014/40 /EU of 3 April 2014 on the approximation of laws, regulations and administrative provisions of the Member States concerning the production, presentation and sale of tobacco and related products, and repealing Directive 2001/37/WE. Ann. Agric. Environ. Med. 2016, 23, 395–398. [Google Scholar] [PubMed]
- Pinkas, J.; Kaleta, D.; Zgliczyński, W.S.; Lusawa, A.; Wrześniewska-Wal, I.; Wierzba, W.; Gujski, M.; Jankowski, M. The prevalence of tobacco and e-cigarette use in Poland: A 2019 nationwide cross-sectional survey. Int. J. Environ. Res. Public Health 2019, 16, 4820. [Google Scholar] [CrossRef] [Green Version]
- Cheng, K.W.; Glantz, S.A.; Lightwood, J.M. Association between smokefree laws and voluntary smokefree-home rules. Am. J. Prev. Med. 2011, 41, 566–572. [Google Scholar] [CrossRef] [Green Version]
- Monson, E.; Arsenault, N. Effects of enactment of legislative (public) smoking bans on voluntary home smoking restrictions: A review. Nicotine Tob. Res. 2017, 19, 141–148. [Google Scholar] [CrossRef] [Green Version]
- Kissinger, L.; Lorenzana, R.; Mittl, B.; Lasrado, M.; Iwenofu, S.; Olivo, V.; Helba, C.; Capoeman, P.; Williams, A.H. Development of a computer-assisted personal interview software system for collection of tribal fish consumption data. Risk Anal. 2010, 30, 1833–1841. [Google Scholar] [CrossRef]
- Central Statistical Office. National Official Register of the Territorial Division of the Country. Available online: http://eteryt.stat.gov.pl/eTeryt/english.aspx (accessed on 15 October 2019).
- Kantar Public for Chief Sanitary Inspectorate. A Report from a Nationwide Survey on Attitudes Towards Smoking. Available online: https://gis.gov.pl/wp-content/uploads/2018/04/Postawy-Polak%C3%B3w-dopalenia-tytoniu-Raport-2017.pdf (accessed on 22 July 2020).
- Fu, M.; Castellano, Y.; Tigova, O.; Kyriakos, C.N.; Fong, G.T.; Mons, U.; Zatoński, W.A.; Agar, T.K.; Quah, A.C.K.; Trofor, A.C.; et al. Prevalence and correlates of different smoking bans in homes and cars among smokers in six countries of the EUREST-PLUS ITC Europe Surveys. Tob. Induc. Dis. 2018, 16, A8. [Google Scholar]
- Gallus, S.; Lugo, A.; Gorini, G.; Colombo, P.; Pacifici, R.; Fernandez, E. Voluntary home smoking ban: Prevalence, trend and determinants in Italy. Eur. J. Public Health 2016, 26, 841–844. [Google Scholar] [CrossRef] [Green Version]
- Mons, U.; Nagelhout, G.E.; Allwright, S.; Guignard, R.; van den Putte, B.; Willemsen, M.C.; Fong, G.T.; Brenner, H.; Pötschke-Langer, M.; Breitling, L.P. Impact of national smoke-free legislation on home smoking bans: Findings from the International Tobacco Control Policy Evaluation Project Europe Surveys. Tob. Control 2013, 22, e2–e9. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Centre for Public Opinion Research. Report from the Survey: Tobacco Use in Poland (no. 104/2019). Available online: https://cbos.pl/SPISKOM.POL/2019/K_104_19.PDF (accessed on 25 July 2020).
- Centre for Public Opinion Research. Report from the survey: Health and Pro-Health Behavior of Poles (no. 138/2016). Available online: https://www.cbos.pl/SPISKOM.POL/2016/K_138_16.PDF (accessed on 25 July 2020).
- Mattes, W.; Yang, X.; Orr, M.S.; Richter, P.; Mendrick, D.L. Biomarkers of tobacco smoke exposure. Adv. Clin. Chem. 2014, 67, 1–45. [Google Scholar]
Variable | Total N = 1011 | Smokers n = 226 | Non-Smokers n = 785 | p | |||
---|---|---|---|---|---|---|---|
Weighted | Weighted | Weighted | |||||
n | % (95% CI) | n | % (95% CI) | n | % (95% CI) | ||
Gender | |||||||
Men | 484 | 47.9 (44.8–51.0) | 125 | 55.3 (48.8–61.7) | 359 | 45.7 (42.3–49.2) | 0.01 |
Women | 527 | 52.1 (49.1–55.2) | 101 | 44.7 (38.4–51.2) | 426 | 54.3 (50.8–57.7) | |
Age (years) | |||||||
15–19 | 63 | 6.2 (4.9–7.9) | 1 | 0.4 (0.01–2.5) | 62 | 7.9 (6.2–10.0) | <0.001 |
20–29 | 168 | 16.6 (14.5–19.0) | 28 | 12.4 (8.7–17.3) | 140 | 17.8 (15.3–20.7) | |
30–39 | 195 | 19.3 (17.0–21.8) | 54 | 23.9 (18.8–29.9) | 142 | 18.1 (15.6–20.9) | |
40–49 | 153 | 15.1 (13.1–17.5) | 43 | 19.0 (14.4–24.6) | 110 | 14.0 (11.8–16.6) | |
50–59 | 167 | 16.5 (14.4–18.9) | 46 | 20.4 (15.6–26.1) | 121 | 15.4 (13.1–18.1) | |
60+ | 264 | 26.1 (23.5–28.9) | 54 | 23.9 (18.8–29.9) | 210 | 26.8 (23.8–30.0) | |
Marital status | |||||||
Ever married | 744 | 73.6 (70.8–76.2) | 182 | 80.2 (74.5–84.8) | 562 | 71.7 (68.4–74.7) | 0.01 |
Never married | 267 | 26.4 (23.8–29.2) | 45 | 19.8 (15.2–25.5) | 222 | 28.3 (25.3–31.6) | |
Occupational status | |||||||
Active | 627 | 62.0 (59.0–65.0) | 144 | 63.7 (57.3–68.7) | 483 | 61.5 (58.1–64.9) | 0.6 |
Passive | 384 | 38.0 (35.0–41.0) | 82 | 36.3 (30.3–42.7) | 302 | 38.5 (35.1–41.9) | |
Education level | |||||||
Less than secondary | 453 | 44.8 (41.8–47.9) | 125 | 55.3 (48.8–61.7) | 328 | 41.8 (38.4–45.3) | <0.001 |
Secondary or above | 558 | 55.2 (52.1–58.2) | 101 | 44.7 (38.4–51.2) | 457 | 58.2 (54.7–61.6) | |
Income class | |||||||
High | 232 | 23.0 (20.5–25.6) | 41 | 18.1 (13.7–23.7) | 192 | 24.5 (21.6–27.6) | 0.1 |
Medium | 497 | 49.2 (46.1–52.2) | 116 | 51.3 (44.8–57.8) | 380 | 48.4 (44.9–51.9) | |
Low | 282 | 27.9 (25.2–30.7) | 69 | 30.5 (24.9–36.8) | 213 | 27.1 (24.1–30.4) | |
Number of household members | |||||||
1 | 231 | 22.9 (20.4–25.5) | 51 | 22.5 (17.5–28.3) | 180 | 23.0 (20.2–26.0) | 0.9 |
2 or more | 780 | 77.1 (74.5–79.6) | 176 | 77.5 (71.7–82.5) | 604 | 77.0 (74.0–79.9) | |
Children in home | |||||||
Yes | 232 | 23.0 (20.5–25.6) | 65 | 28.8 (23.3–35.0) | 167 | 21.3 (18.6–24.3) | 0.02 |
No | 779 | 77.0 (74.4–79.5) | 161 | 71.2 (65.0–76.8) | 618 | 78.7 (75.7–81.5) | |
Place of residence | |||||||
Rural | 394 | 39.0 (36.0–42.0) | 76 | 33.5 (27.7–39.9) | 318 | 40.5 (37.1–44.0) | 0.06 |
Urban | 617 | 61.0 (58.0–64.0) | 151 | 66.5 (60.2–72.3) | 467 | 59.5 (56.0–62.9) |
Type of Smoke-Free Rules | Smoke-Free Home Rules | p | Exposure to SHS at Home (Answered Yes) | p | ||
---|---|---|---|---|---|---|
Smokers (n = 226) | Non-Smokers (n = 785) | Smokers (n = 226) | Non-Smokers (n = 785) | |||
% (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | |||
Full rule | 18.6 (14.1–24.2) | 79.8 (76.8–82.4) | <0.001 | 2.4 (0.4–12.3) | 1.8 (1.0–3.1) | <0.001 |
Partial rule | 46.5 (40.1–53.0) | 18.5 (15.9–21.3) | 8.6 (4.6–15.5) | 11.7 (7.5–18.0) | ||
No rules | 35.0 (29.0–41.4) | 1.8 (1.1–3.0) | 20.3 (12.9–30.4) | 57.1 (32.6–78.6) |
Variable | Yes | Simple Regression | Multiple Regression | ||
---|---|---|---|---|---|
Model 1 | Model 2 | Model 3 | |||
n (%) | OR (95% CI) | aOR (95% CI) | |||
Smoking status | |||||
Smoker | 42 (18.6) | Reference | Reference | Reference | Reference |
Non-smoker | 626 (79.8) | 17.20 (11.79–25.07) ** | 18.81 (12.74–27.78) ** | 18.70 (12.62–27.72) ** | 19.17 (12.89–28.50) ** |
Gender | |||||
Women | 355 (67.4) | Reference | Reference | Reference | Reference |
Men | 313 (64.7) | 0.89 (0.69–1.16) | 1.11 (0.81–1.51) | 1.11 (0.81–1.52) | 1.14 (0.83–1.57) |
Age (years) | |||||
15–19 | 44 (69.8) | Reference | Reference | Reference | Reference |
20–29 | 115 (68.5) | 0.91 (0.49–1.71) | 1.49 (0.77–2.90) | 1.46 (0.73–2.93) | 1.43 (0.71–2.88) |
30–39 | 120 (61.2) | 0.67 (0.36–1.24) | 1.46 (0.76–2.81) | 1.43 (0.72–2.83) | 1.27 (0.62–2.57) |
40–49 | 103 (67.3) | 0.88 (0.47–1.67) | 2.26 (1.12–4.56) * | 2.21 (1.07–4.57) * | 2.08 (0.99–4.32) |
50–59 | 109 (64.9) | 0.79 (0.42–1.47) | 1.88 (0.95–3.72) | 1.85 (0.92–3.72) | 1.91 (0.94–3.88) |
60+ | 177 (67.1) | 0.87 (0.48–1.58) | 1.62 (0.86–3.04) | 1.60 (0.85–3.03) | 1.63 (0.84–3.16) |
Education level | |||||
Less than secondary | 282 (62.3) | Reference | Reference | Reference | |
Secondary or above | 386 (69.2) | 1.37 (1.05–1.78) * | 1.04 (0.74–1.45) | 1.04 (0.74–1.46) | |
Number of household members | |||||
1 | 155 (67.1) | Reference | Reference | ||
2 or more | 514 (65.9) | 0.95 (0.70–1.30) | 0.91 (0.61–1.37) | ||
Children in home | |||||
No | 518 (66.5) | Reference | Reference | ||
Yes | 150 (64.7) | 0.93 (0.69–1.27) | 1.36 (0.87–2.12) |
Variable | Yes | Simple Regression | Multiple Regression | ||
---|---|---|---|---|---|
Model 1 | Model 2 | Model 3 | |||
n (%) | OR (95% CI) | aOR (95% CI) | |||
Smoking status | |||||
Smoker | 26 (11.5) | Reference | Reference | Reference | Reference |
Non-smoker | 36 (4.6) | 0.37 (0.22–0.63) ** | 0.35 (0.20–0.60) ** | 0.36 (0.21–0.63) ** | 0.35 (0.20–0.61) ** |
Gender | |||||
Women | 31 (5.9) | Reference | Reference | Reference | Reference |
Men | 30 (6.2) | 1.07 (0.64–1.79) | 0.97 (0.58–1.64) | 0.94 (0.56–1.59) | 0.90 (0.53–1.53) |
Age (years) | |||||
15–29 | 16 (6.9) | Reference | Reference | Reference | Reference |
30–49 | 20 (5.8) | 0.82 (0.43–1.56) | 0.70 (0.36–1.36) | 0.65 (0.34–1.27) | 0.64 (0.32–1.30) |
50+ | 25 (5.8) | 0.82 (0.42–1.60) | 0.67 (0.33–1.33) | 0.68 (0.34–1.37) | 0.76 (0.37–1.56) |
Education level | |||||
Less than secondary | 35 (7.7) | Reference | Reference | Reference | |
Secondary or above | 27 (4.8) | 0.62 (0.37–1.04) | 0.66 (0.39–1.14) | 0.66 (0.39–1.13) | |
Number of household members | |||||
1 | 12 (5.2) | Reference | Reference | ||
2 or more | 50 (6.4) | 1.26 (0.66–2.42) | 1.33 (0.67–2.67) | ||
Children in home | |||||
No | 50 (6.4) | Reference | Reference | ||
Yes | 12 (5.2) | 0.80 (0.42–1.53) | 0.64 (0.30–1.35) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Jankowski, M.; Pinkas, J.; Zgliczyński, W.S.; Kaleta, D.; Wierzba, W.; Gujski, M.; Rees, V.W. Voluntary Smoke-Free Home Rules and Exposure to Secondhand Smoke in Poland: A National Cross-Sectional Survey. Int. J. Environ. Res. Public Health 2020, 17, 7502. https://doi.org/10.3390/ijerph17207502
Jankowski M, Pinkas J, Zgliczyński WS, Kaleta D, Wierzba W, Gujski M, Rees VW. Voluntary Smoke-Free Home Rules and Exposure to Secondhand Smoke in Poland: A National Cross-Sectional Survey. International Journal of Environmental Research and Public Health. 2020; 17(20):7502. https://doi.org/10.3390/ijerph17207502
Chicago/Turabian StyleJankowski, Mateusz, Jarosław Pinkas, Wojciech S. Zgliczyński, Dorota Kaleta, Waldemar Wierzba, Mariusz Gujski, and Vaughan W. Rees. 2020. "Voluntary Smoke-Free Home Rules and Exposure to Secondhand Smoke in Poland: A National Cross-Sectional Survey" International Journal of Environmental Research and Public Health 17, no. 20: 7502. https://doi.org/10.3390/ijerph17207502