Background: Environmental tobacco smoke (ETS) exposure is associated with an increased risk of many diseases. Many countries have ratified a national smoking ban in public places, but studies on factors related to smoking issues in public places post-ban are lacking. Aim: To identify facilitators and barriers that influenced smokers’ compliance with smoking bans in public places. Methods: Using PubMed, MEDLINE, and the Web of Science database, we conducted a systematic search of English articles published before June 2015 on factors of smokers’ compliance with the smoking bans in public places. Results: A total of 390 references were identified, among which seventeen articles (twelve quantitative studies, two qualitative studies, three mixed-method studies) were included in this review. These studies focused on four types of public places including recreational venues (n = 7), hospital (n = 5), school (n = 4), and workplace (n = 1). Factors at the individual-, interpersonal-, and organizational-level were identified: at the individual level, nicotine dependence, insufficiency of tobacco-related knowledge, and the negative attitudes towards smoking bans were the most commonly identified barriers; at the interpersonal level, the smoking behaviors of people around, close relatives, and friends’ approval were the main barriers; and at the organizational level, the main barriers were inefficient implementation of the bans and the inconvenience of the designative smoking areas. Conclusions: This synthesis of the literature provided evidence of the identified barriers and facilitators of smokers’ compliance with the smoking bans. It will be beneficial for the policy-maker to consider interventions on multiple levels of factors to overcome the barriers and enhance smokers’ compliance with the smoking bans in public places. Full article

Objective: The present study was designed to assess the quality of Chinese-language Internet-based information on HIV/AIDS. Methods: We entered the following search terms, in Chinese, into Baidu and Sogou: “HIV/AIDS”, “symptoms”, and “treatment”, and evaluated the first 50 hits of each query using the Minervation validation instrument (LIDA tool) and DISCERN instrument. Results: Of the 900 hits identified, 85 websites were included in this study. The overall score of the LIDA tool was 63.7%; the mean score of accessibility, usability, and reliability was 82.2%, 71.5%, and 27.3%, respectively. Of the top 15 sites according to the LIDA score, the mean DISCERN score was calculated at 43.1 (95% confidence intervals (CI) = 37.7–49.5). Noncommercial websites showed higher DISCERN scores than commercial websites; whereas commercial websites were more likely to be found in the first 20 links obtained from each search engine than the noncommercial websites. Conclusions: In general, the HIV/AIDS related Chinese-language websites have poor reliability, although their accessibility and usability are fair. In addition, the treatment information presented on Chinese-language websites is far from sufficient. There is an imperative need for professionals and specialized institutes to improve the comprehensiveness of web-based information related to HIV/AIDS. Full article

Background: This study is one part of a five-year tobacco-control project in China, which aimed to gain insight into the smoking behavior, knowledge, and attitudes among medical teachers in China. Methods: In May 2010, a cross-sectional survey was conducted among medical teachers of Xiangya Medical School, Central South University, China. Results: A total number of 682 medical teachers completed the surveys. Latent class analysis indicated the sample of smoking patterns was best represented by three latent subgroups of smoking consumption severity levels. Most respondents were informed of smoking related knowledge, but lack of knowledge on smoking cessation. Most of them held a supportive attitude towards their responsibilities among tobacco control, as well as the social significance of smoking. However, both smoking related knowledge and attitude were not correlated with severity of smoking consumption among medical teachers. Conclusion: The smoking prevalence among medical teachers in China remains high. Programs on smoking cessation training are required. Future study should also develop targeted interventions for subgroups of smokers based on smoking consumption. Persistent and effective anti-tobacco efforts are needed to achieve the goals of creating smoke-free campuses and hospitals. Full article

Objectives: To assess counseling to caregivers and classroom health education interventions to reduce environmental tobacco smoke exposure of children aged 5–6 years in China. Methods: In a randomized controlled trial in two preschools in Changsha, China, 65 children aged 5–6 years old and their smoker caregivers (65) were randomly assigned to intervention (n = 33) and control (no intervention) groups (n = 32). In the intervention group, caregivers received self-help materials and smoking cessation counseling from a trained counselor, while their children were given classroom-based participatory health education. Children’s urinary cotinine level and the point prevalence of caregiver quitting were measured at baseline and after 6 months. Results: At the 6-month follow-up, children’s urinary cotinine was significantly lower (Z = –3.136; p = 0.002) and caregivers’ 7-day quit rate was significantly higher (34.4% versus 0%) (p < 0.001; adjusted OR = 1.13; 95% CI: 1.02–1.26) in the intervention than control group. Conclusions: Helping caregivers quitting smoke combined with classroom-based health education was effective in reducing children’s environmental tobacco smoke exposure. Larger-scale trials are warranted. Full article

Objective: To assess the impact of different smoking behaviors of caregivers on environmental tobacco smoke (ETS) exposure in children aged 5–6 years in Changsha, China. Methods: We conducted a cross-sectional, random digit-dial telephone survey of caregivers (n = 543) between August and October 2013. Caregivers’ smoking behaviors were collected by a questionnaire. Exposure assessment was based upon determination of urinary cotinine levels in children employing gas chromatography–triple quadrupole mass spectrometry (GC-MS/MS). Results: In children not living with a smoker, children living with one smoker, and children living with more than one smoker at home, median urinary cotinine concentrations (ng/mL) were 0.72, 2.97, and 4.46, respectively. For children living with one smoker, median urinary cotinine levels of children exposed to ETS were associated with caregiver smoking behaviors, i.e., if a caregiver consumed more cigarettes (>20 compared with ≤10; 7.73 versus 2.29 ng/mL, respectively). Conclusions: The magnitude of ETS exposure in children is correlated with the smoking behaviors of the caregiver. Counseling for smoking cessation and educational interventions are needed urgently for smoking caregivers to increase their awareness about ETS exposure and to encourage smoking cessation at home or to take precautions to protect children’s health. Full article