Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, Laoshan District, Shandong Province, China.
Qingdao Municipal Center for Disease Control and Prevention, Qingdao, Shibei District, Shandong Province, China.
PLoS One. 2023 Aug 3;18(8):e0289658. doi: 10.1371/journal.pone.0289658. eCollection 2023.
Smoke-free government(SFG), as a key tobacco control measure, has been added in Healthy China 2030 blueprint and Qingdao started the establishment of the demonstrative SFG in 2020.This study examined the effects of SFG policy on smoking and smoke-free(SF) environment after establishing the demonstrative SFG. This cross-sectional survey selected participants by simple random sampling from party and government agencies in Qingdao (N = 3625) and the participants filled in questionnaires online from November 31 to December 15, 2020. We utilized AMOS to set up models to analyze the direct and indirect effects of SFG policy. The findings showed that knowledge of SFG policy was positively associated with SF environment(β = 0.29, P<0.001) and negatively associated with smoking(β = -0.14,P<0.001). Knowledge of SFG policy had indirect effects on SF environment through four channels: independent mediation of discouraging smoking and attitude towards SFG policy, as well as chain mediation of these two factors, and perception of tobacco hazards and discouraging smoking, with indirect effects accounting for 33.5% of the total effect. Knowledge of SFG policy had indirect effects on smoking reduction via SF environment and two chain mediation: SF environment and attitude towards SFG policy, perception of tobacco hazards and intention to quit smoking, with indirect effects accounting for 50.2% of the total effect. The results provided the evidence that SFG policy not only had positive effects on creating SF environment but also on reducing smoking. The efficient policy infiltration to individuals played a vital role in the establishment of SFG. Attitude towards SFG policy, discouraging smoking and SF environment were the potential mediators for SFG policy. Findings in this study added more evidence related to effect mechanism of SFG policy and had a positive influence on promoting the implementation SFG policies for China and other countries.
无烟政府（SFG）作为一项关键的控烟措施，已被纳入《健康中国 2030 规划纲要》，青岛市于 2020 年开始建立示范 SFG。本研究考察了建立示范 SFG 后 SFG 政策对吸烟和无烟（SF）环境的影响。本横断面调查采用简单随机抽样法从青岛市党政机关中抽取参与者（N=3625），并于 2020 年 11 月 31 日至 12 月 15 日在线填写问卷。我们利用 AMOS 建立模型来分析 SFG 政策的直接和间接效应。研究结果表明，SFG 政策知识与 SF 环境呈正相关（β=0.29，P<0.001），与吸烟呈负相关（β=-0.14，P<0.001）。SFG 政策知识通过四个渠道对 SF 环境产生间接影响：劝阻吸烟和 SFG 政策态度的独立中介作用，以及这两个因素的连锁中介作用，以及对烟草危害和劝阻吸烟的感知，间接效应占总效应的 33.5%。SFG 政策通过 SF 环境和两个连锁中介对减少吸烟产生间接影响：SF 环境和 SFG 政策态度，对烟草危害的感知和戒烟意愿，间接效应占总效应的 50.2%。研究结果提供了证据表明，SFG 政策不仅对创造 SF 环境有积极影响，而且对减少吸烟也有积极影响。政策对个人的有效渗透在建立 SFG 方面发挥了重要作用。SFG 政策态度、劝阻吸烟和 SF 环境是 SFG 政策的潜在中介因素。本研究的结果增加了与 SFG 政策效果机制相关的更多证据，对促进中国和其他国家实施 SFG 政策具有积极影响。
