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Int. J. Environ. Res. Public Health 2013, 10(6), 2370-2383; doi:10.3390/ijerph10062370

Public Place Smoke-Free Regulations, Secondhand Smoke Exposure and Related Beliefs, Awareness, Attitudes, and Practices among Chinese Urban Residents

1,* , 2,3
1 Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China 2 School of Public Health, Guangxi Medical University, Nanning 530021, China 3 Boston Medical Center, Boston University Medical Campus, Boston, MA 02118, USA 4 Injury Control Research Center and Department of Epidemiology (School of Public Health), West Virginia University, Morgantown, WV 26506, USA 5 International Union Against Tuberculosis and Lung Disease, Beijing 100005, China 6 Department of Environmental Health, University of Cincinnati, Cincinnati, OH 45221, USA 7 Sydney School of Public Health, University of Sydney, NSW 2006, Australia
* Author to whom correspondence should be addressed.
Received: 21 November 2012 / Revised: 28 May 2013 / Accepted: 29 May 2013 / Published: 7 June 2013
(This article belongs to the Special Issue Tobacco Control in Vulnerable Population Groups)
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Objective: To evaluate the association between smoke-free regulations in public places and secondhand smoke exposure and related beliefs, awareness, attitudes, and behavior among urban residents in China. Methods: We selected one city (Hangzhou) as the intervention city and another (Jiaxing) as the comparison. A structured self-administered questionnaire was used for data collection, and implemented at two time points across a 20-month interval. Both unadjusted and adjusted logistic methods were considered in analyses. Multiple regression procedures were performed in examining variation between final and baseline measures. Results: Smoke-free regulations in the intervention city were associated with a significant decline in personal secondhand smoke exposure in government buildings, buses or taxis, and restaurants, but there was no change in such exposure in healthcare facilities and schools. In terms of personal smoking beliefs, awareness, attitudes, and practices, the only significant change was in giving quitting advice to proximal family members. Conclusions: There was a statistically significant association between implementation of smoke-free regulations in a city and inhibition of secondhand tobacco smoking exposure in public places. However, any such impact was limited. Effective tobacco control in China will require a combination of strong public health education and enforcement of regulations.
Keywords: tobacco control; smoke-free regulations; secondhand smoke tobacco control; smoke-free regulations; secondhand smoke
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Yang, T.; Abdullah, A.S.; Li, L.; Rockett, I.R.H.; Lin, Y.; Ying, J.; Guo, W.; Wu, D.; Li, M. Public Place Smoke-Free Regulations, Secondhand Smoke Exposure and Related Beliefs, Awareness, Attitudes, and Practices among Chinese Urban Residents. Int. J. Environ. Res. Public Health 2013, 10, 2370-2383.

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