Duan Zongshuan, Wang Yu, Huang Jidong, Redmon Pamela B, Eriksen Michael P
School of Public Health, Georgia State University, Atlanta, Georgia, USA.
School of Public Health, Georgia State University, Atlanta, Georgia, USA
BMJ Open. 2020 Dec 29;10(12):e044570. doi: 10.1136/bmjopen-2020-044570.
To assess the levels of secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative.
City-wide representative, cross-sectional surveys (Tobacco Questions for Surveys, TQS) were conducted in each participating city before and after the implementation of TFC.
Five large Chinese cities (Chengdu, Chongqing, Wuhan, Xiamen and Xi'an) participated in the TFC initiative.
A total of 10 184 adults participated in the 2015 TQS survey, and 10 233 adults participated in the 2018 TQS survey, respectively.
The TFC initiative, which included targeted media campaigns, educational programmes, implementing city-wide smoke-free policies and providing cessation interventions, was implemented in these five cities between 2015 and 2018.
Self-reported past 30-day (P30D) SHS exposure in indoor workplaces, restaurants and homes.
The pre-TFC and post-TFC SHS exposure levels were compared among all residents and among certain population subgroups. Multivariate logistic regressions were used to estimate the adjusted associations between P30D SHS exposure and individual characteristics.
Across all five cities, the overall rate of self-reported P30D SHS exposure declined in indoor workplaces (from 49.6% (95% CI: 46.4% to 52.8%) to 41.2% (95% CI: 37.7% to 44.7%)), restaurants (from 72.4% (95% CI: 69.8% to 74.9%) to 61.7% (95% CI: 58.7% to 64.7%)) and homes (from 39.8% (95% CI: 36.9% to 42.7%) to 34.7% (95% CI: 31.5% to 37.8%)) from 2015 to 2018. These declines were statistically significant after controlling for individual characteristics. The P30D SHS exposure was associated with sex, age, education level, occupation and current smoking status. The associations varied by venues.
Our analysis showed that compared with the nationwide SHS exposure levels reported in concurrent national surveys, the declines in P30D SHS exposure in five Chinese cities that implemented the TFC initiative were larger in indoor workplaces and restaurants. Our findings suggest that the TFC initiative was effective in reducing SHS exposure in Chinese cities.
评估“无烟城市”（TFC）倡议实施前后的二手烟暴露水平。
在TFC实施前后，对每个参与城市进行全市范围的代表性横断面调查（烟草调查问题，TQS）。
中国五个大城市（成都、重庆、武汉、厦门和西安）参与了TFC倡议。
分别有10184名成年人参与了2015年的TQS调查，10233名成年人参与了2018年的TQS调查。
2015年至2018年期间，在这五个城市实施了TFC倡议，其中包括有针对性的媒体宣传活动、教育项目、实施全市范围的无烟政策以及提供戒烟干预措施。
自我报告的过去30天内在室内工作场所、餐馆和家中的二手烟暴露情况。
比较了TFC实施前和实施后所有居民以及特定人群亚组中的二手烟暴露水平。使用多变量逻辑回归来估计过去30天二手烟暴露与个体特征之间的调整关联。
在所有五个城市中，自我报告的过去30天内在室内工作场所的二手烟暴露总体率有所下降（从49.6%（95%CI：46.4%至52.8%）降至41.2%（95%CI：37.7%至44.7%）），餐馆中的暴露率从72.4%（95%CI：69.8%至74.9%）降至61.7%（95%CI：58.7%至64.7%），家中的暴露率从39.8%（95%CI：36.9%至42.7%）降至34.7%（95%CI：31.5%至37.8%）。在控制个体特征后，这些下降具有统计学意义。过去30天的二手烟暴露与性别、年龄、教育水平、职业和当前吸烟状况有关。这些关联因场所而异。
我们的分析表明，与同期全国调查中报告的全国二手烟暴露水平相比，实施TFC倡议的中国五个城市在过去30天内室内工作场所和餐馆的二手烟暴露下降幅度更大。我们的研究结果表明，TFC倡议在减少中国城市的二手烟暴露方面是有效的。
