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). Issue 12 (11th December 2019)

• Record Type: Journal Article
• Authors: Sansone, Genevieve; Fong, Geoffrey T; Yan, Mi; Meng, Gang; Craig, Lorraine; Xu, Steve S; Quah, Anne C K; Wu, Changbao; Feng, Guoze; Jiang, Yuan
• Is Part Of: BMJ open. Volume 9:Issue 12(2019)
• Publication Date: 2019-12-11
• Subjects: public health -- smoking -- secondhand smoke -- tobacco control -- policy evaluation; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2019-031891
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To 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. Design: Data 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. Setting: Face-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). Participants: In 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 measures: Prevalence 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. Results: Although 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. Conclusions: Partial 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.