Thesis (M. Nurs.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 170-178).

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Community Medicine / Master / Master of Public Health

published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Public Health / Master / Master of Public Health

Introduction: Smoking has been considered as one of the leading preventable cause of lung disease, cardiovascular disease and cancer. China, has 20% of the population in the world, but consumes 30% of the world’s cigarette and has suffered 1 million deaths per year from tobacco use. The workplace is an important field for smoking control, but there are relatively few reports on the current situation of workplace smoking control with the exception of reports from North American countries. Objectives: This project aims to investigate the effectiveness of workplace smoking control policy on smokers’ behavior in Asian population, mainly the comparison of smoke free policy, smoke restriction ban with no smoking ban, and to identify the potential factors that associated with the compliance of smoking policy. Methods：Articles that are relevant to workplace smoking policy were searched and identified through PubMed and CNKI by using a combination of keywords. Articles that studied the effects of workplace smoking control policy on smoking behavior and the factors that associated the compliance of smoke control policy were included. All studies were conducted in the Asian countries and the outcome measures were current smoking prevalence, daily cigarette consumption, and willingness to quit smoking. Results: Of the 541 studies identified, 11 articles were identified to be relevant and included in this systematic review. Smoking-free policy was showed to be the most effective strategy to enhance the changes in smokers’ behavior. Eight of nine studies that compared smoke free with no smoke ban gave consistent conclusion that smoking free policy could reduce the prevalence of smoking dramatically. It was associated with higher willingness to quit smoking among smokers and could reduce the smokers’ daily cigarettes consumption by 3 to 4 cigarettes per day. There was limited evidence that smoke restriction policy could reduce the prevalence of smokers. Even though smoke restriction policy could reduce daily cigarettes consumption and increased the smokers’ willingness to quit smoking, but the effect was much lower than those in the workplace with smoke free policy. In addition, occupation, such as salesmen and marketing employee, the reason of implementing the smoke control policy(e.g. ‘workplace safety’, ‘maintain good air quality’, ‘reduce ETS in non-smokers’), and lack of knowledge of hazard in cigarettes were the factors contributed to the low compliance of smoke control policy. Conclusion: Overall, workplace smoke-free policy is the most effective way in changing smoking behavior. Workplace smoke-free should be implemented as a public health priority and accompanied with health education and smoking cessation service to assure the compliance. / published_or_final_version / Medicine / Master / Master of Public Health

Background: Over the past ten years or so, there is a huge increase in the popularity of electronic cigarettes around the world. Some people regard e-cigarettes as a tobacco substitute and use them to help smoking abstinence and relieve nicotine withdrawal symptom. On the other hand, there are those who believe that e-cigarettes should not be promoted since safety and efficacy of these battery-operated devices are still under investigation. Hence, this project aims to evaluate the effect of using electronic cigarettes to quit smoking among the conventional smokers. Methods: This project used key words to search on PubMed, MEDLINE, The Cochrane Library, 中国知网(CNKI), EMBASE, and BBCNEWS. Eventually, a total of 111 items in PubMed, 6 in The Cochrane Library and 23 were obtained in CNKI. After the screening process, finally 11relevant papers were reviewed in this project. There were two randomized controlled trials on evaluating the effect of reducing smoking with e-cigarettes. Five surveys(Survey 1-5) analyzed users’ satisfaction and their original expectations on trying electronic cigarettes. Two proof-of-concept trials also assessed the effect of using e-cigarettes on reducing and quitting smoking. In addition, a qualitative study and a case series study provided evidence on interpreting whethere-cigarettes could help smoking abstinence. Results: Brown et al. 10conducted a RCT and showed that in an intention to treat analysis, combined ≥50% smoking reduction and complete smoking abstinence was shown in 33% (99/300) at 12 weeks and 19% (57/300) at 52 weeks. Another RCT conducted by Bullen et al. showed the continuous abstinence at 1 month was23.2%in nicotine e-cigarettes group and15.9%in nicotine patches group and 16.4%in placebo e-cigarettes group; at 3 month, the rateswere13.1%, 9.2% and 6.8%; at 6 months, the rates were 7.3%, 5.8% and 4.1%.In survey 1 (Etter), satisfaction of helping smokers quit was79%; in survey 2 (Kralikova et al.), satisfaction of helping quit was over 60%; in survey 3 (Dawkins et al. 14), participants reported their situation of smoking cessation: 38% for >1 year, 19% for 6-11 months, 43% for < 6months;in survey 4 (Etter and Bullen), 92% current smokers and 96%former smokers reported ECs were effective to reduce their smoking consumption; in survey 5 (B. Siegel et al. ), 66.8% smokers reported it helped quitting smoking. In two proof-of-concept trials, sustained quitting more than 50% including quitter accounted for 55% and 64.3%.Thequalitative study and the case series study indicated that ECs were modestly effective to reduce smoking consumption with less toxic effects. Conclusion: There is some preliminary evidence from11studiesthatelectronic cigarettes could be effective for reducing conventional smoking consumption within a short period. Because there is a lack of adequate and long-term randomized controlled trials to assess the safety and efficacy of e-cigarettes, particularly in comparison to nicotine replacement therapy, government regulations should be established to control e-cigarettes and to the claim that e-cigarettes can be used as a standard as nicotine smoking cessation aid. / published_or_final_version / Public Health / Master / Master of Public Health

Background: Data on the typical daily exposure of non-smokers to second-hand smoke (SHS) are limited. The aim of this study was to estimate the SHS exposure encountered by adults and children in Scotland and to examine the proportion of total exposure received within different microenvironments. Methods: Primary research was carried out to gather information on SHS concentrations within cars in both simulated and real-life settings. Observational work was also carried out to determine the prevalence of exposure to SHS in cars. Further work was carried out to gather information on occupational SHS exposure. Data from all of these components were combined with data from previously published sources to produce estimates of how much SHS-derived PM2.5 exposure is typically received by adults and children within different micro-environments. Results: The contribution to total SHS exposure from each micro-environment was calculated. This was carried out for a child living in: a non-smoking home; a home where only the father smokes; a home where only the mother smokes; and a home where both parents smoke. In addition to this the equivalent dose of SHS inhaled (expressed as a mass) were also calculated for each of the micro-environments. This method was also used to determine the SHS contribution of different micro-environments for adult non-smokers. Exposure calculations were carried out assuming that exposure in the home was reduced to the levels found in non-smoking homes and the contribution from the remaining micro-environments unchanged. Observations identified that 2.4% of cars carrying children exposed children to SHS and exposure intensities during smoking car journeys can be particularly high with peak exposures ranging from 55 to 886 μgm-3. Conclusion: This is the first study to estimate the SHS exposure contributions from different microenvironments encountered by children and adults in Scotland. This study indicates that encouraging behavioural change in terms of smoking in home and car micro-environments has the greatest potential to reduce non-smokers’ daily exposure to tobacco derived fine particulate matter.

This study evaluated the perceived impact of cigarette advertisement on smoking habit among students in selected Nigerian universities. It also investigated the influences of age and significant others on the students’ smoking habit as well as the relationship between cigarette advertisement and rate of smoking. Data were collected using structured questionnaires. The sample consisted of 566 smokers (503 males and 63 females) selected from among students of six universities in southwest Nigeria. Data obtained were subjected to both descriptive and inferential analyses using the Statistical Package for the Social Sciences (SPSS). Simple regression analysis, analysis of variance (ANOVA) and t- test were used to examine five hypotheses formulated for the study. The study showed a significant impact relationship between cigarette advertisement and motives for smoking ( =0.279; t =. 6.179; p< 0.001) and also between smokers’ perception of the health hazards associated with cigarette smoking and rate of smoking (t (514) = 4.469, p< 0.001). Smokers’ age and influence of significant others had substantial impact on their motive for smoking ( = 0.348; t = 5.99; p< 0.001; F(4,463) = 2.642; p<0.05). There was however, no significant relationship between cigarette advertisement and rate of smoking ( = 0.026; t= 0.581; p>0.562). The study concluded that cigarette advertisement had significant impact on cigarette smoking habit among students in Nigerian universities. The findings are discussed in the light of its implications for designing smoking intervention programmes targeted at youths.

This study evaluated the perceptions of Nigerian university students concerning the influence of cigarette advertisement on their smoking habit. It also assessed the influences of smokers’ age and significant others on their smoking habits. Data were collected using structured questionnaires and focus group discussion (FGD) technique from 566 smokers (503 males and 63 females) selected from among students of six universities in south- western Nigeria. Information obtained from the FGD was analysed qualitatively and presented in this study. Specifically, responses from the FGD was analysed based on the following: History of student’s smoking habit, perceived smoking benefits, health hazards of smoking, advertisement and smoking, roles of families, friends and peers in preventing or promoting smoking habit and attitudes of smokers towards anti-smoking regulations in the country. The study concluded that cigarette advertisement had substantial influence on smoking habit among students in the Nigerian universities. Implications of the findings for designing smoking intervention programmes targeted at the youth are discussed.