Influence Of Environmental Restrictions On Smoking Behavior

Background:Tobacco is one of the serious public health problems. Each year, the tobacco-smoking epidemic kills approximately6million people globally. Unchecked, this death toll will exceed8million annually by2030. More than80%of these deaths will occur in less-developed countries, with the epidemic striking hardest in the rapidly growing economies. China leads the world in tobacco consumption and approximately one million Chinese die each year from tobacco-related causes. The number of deaths is projected to reach two million annually by2025and three million by2050.Approximately100million Chinese will die from smoking-related causes over the next50years if the current high prevalence of smoking persists.To control the global spread of tobacco use, the World Health Organization (WHO) launch to establish the Framework Convention on Tobacco Control (hereinafter referred to as the "Convention") in1996. This framework was fully endorsed by member states on May21,2003. The FCTC is the first legally binding multilateral treaty in the field of medicine and public health. The Chinese National People’s Congress ratified the FCTC on August27,2005. On January9,2006, the "Convention" came into effect in China. Article8of the "Convention" requires Parties to take effective measures to guard against public exposure to tobacco smoke. In July2007, the Second Conference of the Parties to the Convention adopted the "Guidelines on Protection from Exposure to Tobacco Smoke"(hereinafter referred to as "Guidelines"). The Guidelines specific measures and approaches for reducing population-wide tobacco smoke exposure. National and local ordinances and regulations to reduce such exposure have been implemented in many more-developed countries.Objectives:The aim of this study is to evaluate whether cigarette smoking and cessation in Chinese urban settings were associated with smoking bans in households, workplaces, and open air public spaces.Methods:This evidence-based study was developed on social norm theory and the theory of social unacceptability.4735urban residents over15years old were identified and sampled through multi-stage quota sampling conducted in6Chinese cities. Data about sociodemographics, smoking status, and regional tobacco control measures were collected by the survey. Multilevel logistic model was employed to analyze the association between smoking behavior and environmental smoking restrictions.Results and policy application:The model rendered that smoking is negatively related to workplace and household smoking bans. Smoking cessation is positively associated with city-level public space and workplace restriction of smoking and individual-level workplace and household restrictions. The association of smoking behavior and environmental smoking bans supports smoking-free regulation policy. The results offer justification for policy makers to implement environmental tobacco control and relevant public health interventions aimed at reducing smoking prevalence in China. We suggest that the government should introduce comprehensive smoking-free law in the nation as soon as possible.