Implementing a smoking ban in an acute psychiatric admissions unit

In contrast to general medical hospitals, psychiatric hospitals often allow patients to smoke cigarettes. In addition to obvious health concerns, smoking can also interfere with clinical assessments and therapeutic activities, Implementation of a smoking ban on an acute male admissions unit did not result in any increase in aggressive behaviors. In addition, staff attitudes following the ban improved, and most staff members believed the ban was both ethical and beneficial to patients. Our research indicates that banning smoking on an acute admissions unit is feasible and well tolerated by patients and staff, although it may require extra vigilance for smoking-related contraband.     

THE DEMAND FOR CASINO GAMING WITH SPECIAL REFERENCE TO A SMOKING BAN

This study adds to the limited literature on the demand for casino gaming. The major focus is on the effect of a statewide smoking ban. A system of slot machine demand equations, one each for the three Delaware racinos (racetrack casinos), was developed. The number of slot machines at a racino, at competing in-state racinos, and income were significant demand determinants. Competing out-of-state gaming venues had insignificant effects on gaming demand over the study period. The smoking ban had a significant negative impact on demand, which was not significantly different across the three racinos. The smoking ban reduced gaming demand 15.9%. ( JEL L83)     

Sociodemographic correlates of public perceptions regarding a smoking ban in bars and restaurants

As the health threat of environmental tobacco smoke is widely recognized, more state and local governments join the passage of ordinances that ban smoking in public establishments. This study investigated public perceptions regarding banning smoking in bars and restaurants among Indiana residents. A representative sample of 529 adult Indiana residents ages 18 or older was interviewed using random-digit dialing after two waves of pilot tests. Of the total respondents, 65% favored the smoking ban in bars and restaurants. Logistic regression analyses indicated that gender, education, and spouse's education were significant predictors for attitudes toward the smoking ban in bars and restaurants.     

A quit smoking group. Pilot study

1. While the rate of smoking is extremely high among persons with mental illness, there have been efforts to assist this population to quit. A 10-week smoking cessation program was provided for 10 highly nicotine dependent persons with persistent mental illness. 2. No significant differences were found in psychiatric symptoms or drug side effects prior to and after smoking cessation efforts. Four months later, for the 7 subjects who completed the program, 14% were abstinent, 43% maintained reduced tobacco intake, and 43% had resumed previous smoking patterns. 3. Specific barriers to quitting include a lack of nonsmoking coping skills, long-term identity as a smoker, ready access to tobacco products, nicotine addiction, and limited nonsmoking social support.     

Philadelphia says smoking ban has not led to treatment impact

Despite charges by Brooke Feldman and others (see “Advocate: Philadelphia smoking ban shuts some patients out of treatment,” https://onlinelibrary.wiley.com/doi/10.1002/adaw.32388 , ADAW, June 10), the number of people leaving addiction treatment in Philadelphia is up, not down, after the smoking ban, the Department of Behavioral Health and Intellectual disAbility services (DBHIDS) stated last week in a press release. The statement came out June 24, the day before a planned protest spearheaded by Feldman.     

Is nonsmoking dangerous to the health of restaurants? The effect of California's indoor smoking ban on restaurant revenues

The state of California passed the Smoke-Free Workplace Act on January 1, 1995. This legislation effectively banned indoor smoking in all public and private workplaces including restaurants. Many restaurant owners, especially owners of restaurants that served alcohol, opposed the ban for fear that their businesses would be affected adversely because of the loss of patrons who smoked. Using an interrupted times-series autoregressive integrative moving average study design, the authors assess the effect of California's indoor smoking ban on revenue rates for all restaurants, for non-alcohol-serving restaurants, and for alcohol-serving restaurants. Results showed that revenues for alcohol-serving restaurants dropped by about 4% immediately following the establishment of the indoor smoking ban. However, this reduction was temporary because revenues for alcohol-serving restaurants quickly returned to normal levels. Findings also revealed that the indoor smoking ban had little observable impact on the revenue rate for restaurants overall and for non-alcohol-serving restaurants.     

Employment and mental hospitalization: the case of Buffalo, New York, 1914-55

This paper explores the connection between employment trends and state mental hospital admissions first presented by Brenner in Mental Illness and the Economy. The analysis is based on employment data for the Buffalo SMSA and admissions to the SMSAs only major public psychiatric hospital for the years 1914 to 1955. We employ a series of specifications in time-series analyses. Our findings contrast with Brenner's; unlike his analysis, ours indicates that employment is positively related to admissions. Consistent with other previous research, hospital capacity is also found to be important in predicting admissions. We offer a number of interpretations for the results, in particular noting the need for the examination of the stressful effects of work itself, not merely its loss.     

The Receptlveness of Health Risk Appraisals in Health Instruction

Abstract

Objectives: Data on effective strategies to enforce policies banning outdoor smoking are sparse. This study tested the effects of an enforcement package implemented on a college campus. Participants: Thirty-nine observers recorded compliance of 709 outside smokers. Methods: Smoking within 25 feet of buildings was noncompliant. The intervention included moving receptacles, marking the ground, improving signage, and distributing reinforcements and reminder cards. Results: The proportion of smokers complying with the ban was 33% during the baseline observation period, increased to 74% during the intervention week, and was at 54% during the follow-up. Differences across conditions was statistically significant (χ² (2, N = 709) = 6.299, p <.001). Compliance proportions varied by location in all conditions. Conclusions: Enforcing an outdoor smoking ban using a multiple component package increased compliance with the nonsmoking policy on a college campus.     

The Use of Tobacco as Gambling Currency by Federal Offenders in Canada Before and After a Tobacco Ban

In 2008 tobacco was banned in federal correctional institutions in Canada. In this paper we compare the use of tobacco as currency for gambling in two studies that we conducted, one before and one after the tobacco ban. The data from two studies were compared. The questionnaires were administered to offenders in federal and provincial institutions in Ontario. Study 1 included 254 male offenders and study 2 included 395 male offenders. The focus in this paper is on one questionnaire about the type of wager made while incarcerated. It was found that the use of tobacco as a currency in gambling went from 28.6% of those offenders who gamble to 2.3% of those offenders who gamble. In addition, there was an overall decrease in the number of federal offenders who reported gambling while incarcerated. However, information gained from the questionnaire and from interviews with incarcerated offenders suggests that there has been a shift to money wagers and that gambling inside has become more serious since the tobacco ban. The results suggest that the ban on smoking has resulted in a change in the type of currency used for gambling inside correctional institutions in Ontario Canada.     

Characteristics of cocaine users in a private inpatient treatment setting.

Patient records were reviewed from an eighteen-month period of a private hospital adult addictive disease unit. Of 667 consecutive admissions, sixty-five (49 males, 16 females) were diagnosed with cocaine abuse or dependence; 38 percent were from rural areas. Although mean age of males and females was similar, males had a longer duration of use (8.2 years versus 5.8 years), however, females used an average of 14 grams per week versus 9.5 grams per week for males. African-American patients were over-represented among the cocaine using sample and also among the sample who chose smoking as their route of administration. A larger percentage of males had legal problems and admitted to "dealing," when compared to females. Those from rural areas were more likely to be married and less apt to have legal problems.     

College smoking policies and smoking cessation programs: results of a survey of college health center directors

College students' cigarette smoking rose dramatically during the 1990s. Little is known about what colleges do to address the problem. Health center directors at 393 4-year US colleges provided information (response rate: 65.1%) about college policies addressing smoking and the availability of smoking cessations programs. Of the health center directors surveyed, 85% considered students' smoking a problem; yet only 81% of colleges prohibit smoking in all public areas and only 27% ban smoking in all indoor areas, including students' rooms in dormitories and in private offices. More than 40% of the respondents reported that their schools did not offer smoking cessation programs and that the demand for existing program was low. Colleges need to do more to discourage student tobacco use. Recommended actions include campus-wide no-smoking policies that apply to student residences and identification of new ways of providing smoking prevention and cessation services.     

Banning alcohol in a major college stadium: impact on the incidence and patterns of injury and illness

To evaluate the effect of banning alcohol on the incidence of injuries and illness among spectators, we reviewed 4 years (1983 to 1986) of medical incident reports from a major collegiate football stadium. At no time had alcoholic beverages been sold inside the stadium, but before 1985, fans were allowed to bring alcohol into the stadium. In 1985, this practice was banned. During the study period, 340 medical incidents (M = 12.6/game) were reported. Several alterations of specific injury/illness patterns were noted after initiation of the ban: heat-related illness occurred more frequently before initiation of the ban, whereas extremity injuries and syncope (fainting from coronary insufficiency) occurred with greater frequency afterwards. The injury/illness rates per 10,000 fans were 2.95 in 1983, 2.45 in 1984, 1.92 in 1985, and 3.48 in 1986. There was no significant change in the overall incident rate after the ban. Evaluation of medical incidents revealed an alteration in specific injury/illness patterns but no change in overall incidence after institution of the ban. Future investigations are needed to elucidate more clearly the impact of banning alcohol on injury/illness rates and patterns at mass gatherings.     

Texas college students' opinions of no-smoking policies, secondhand smoke, and smoking in public places

Abstract. The authors examined college student opinions of no-smoking policies, secondhand smoke, and smoking in public places. A convenience sample of 1,188 (66.4% female; 26.9% White, 64.1% Black, and 9.0% Hispanic) students attending 5 Texas colleges volunteered to complete a 60-item anonymous survey on tobacco attitudes and behaviors. Results of our study showed that women, Black students, and nonsmoking students reported the most favorable attitudes toward no smoking. Male students, white students, and students who smoked in the past 30 days (current smokers) reported the least favorable attitudes. The lowest level of agreement by all subgroups was provided for prohibiting smoking everywhere on campus (inside and outside of buildings). Implications for tobacco control on college campuses are discussed.     

Understanding factors related to nonsmoking intention among college students

Abstract

Objective: While cigarette smoking in the United States has declined, the age range of smoking initiation has risen to include young adults. This study investigated the relationship of Theory of Planned Behavior constructs (TPB; attitudes, subjective norms, and perceived behavioral control [PBC]) to nonsmoking intention among college students. Participants: Participants were 619 students at a Southeastern US university (69.8% female, 70.8% ≤ age 21, and 73.5% white). Methods: Students were recruited by email in March 2013 to participate in an online TPB-based questionnaire. Results: Future-oriented attitudes and PBC predicted higher nonsmoking intention; subjective norms did not. Moderator analyses indicated injunctive norms were more influential for occasional smokers and PBC was less influential. Conclusions: Findings suggest TPB is useful in predicting nonsmoking intention, but differentially for nonsmokers and occasional smokers. Future work should consider the health-related utility of future-oriented attitudes toward nonhealth domains and the differing beliefs of occasional smokers.     

College Smoking Policies and Smoking Cessation Programs: Results of a Survey of College Health Center Directors

Abstract

College students' cigarette smoking rose dramatically during the 1990s. Little is known about what colleges do to address the problem. Health center directors at 393 4-year US colleges provided information (response rate: 65.1%) about college policies addressing smoking and the availability of smoking cessation programs. Of the health center directors surveyed, 85% considered students' smoking a problem; yet only 81% of colleges prohibit smoking in all public areas and only 27% ban smoking in all indoor areas, including students' rooms in dormitories and in private offices. More than 40% of the respondents reported that their schools did not offer smoking cessation programs and that the demand for existing program was low. Colleges need to do more to discourage student tobacco use. Recommended actions include campus-wide no-smoking policies that apply to student residences and identification of new ways of providing smoking prevention and cessation services.     

The air we breathe

Public attitudes toward smoking are complex, but the facts for businesses are clear. Second-hand smoke is a major health hazard, and the most unhealthy places for second-hand smoke are bars and restaurants. While there is little support for a total smoking ban, selected bans are more popular. Even if new federal rules don't force restaurants to ban smoking, businesses can gain a competitive edge by going smoke-free.     

SOUTH AFRICA'S PRESS RESTRICTIONS EFFECTS ON PRESS COVERAGE AND PUBLIC OPINION TOWARD SOUTH AFRICA

The 2 November 1985 ban on photographic and sound recordingsby the South African government provided an opportunity to investigatehypotheses concerning the effect of the ban on U.S. media coverageof South Africa and on public opinion toward South Africa. Wehypothesized that the ban would result in (1) a decrease incoverage of protest-related stories, (2) a tapering off of thevolume of coverage, and (3) a decline in the prominence of theSouth Africa story. We further hypothesized that (4) all ofthese effects would be stronger for broadcast than for printmedia, that (5) if the press ban reduced coverage of eventsin South Africa, there would be less attentiveness to the SouthAfrican problem among the general public in the United States,and that (6) sympathy for the black population would decreaseas a result of the press restrictions. We found that the press restrictions did not have the effectspredicted, either on press coverage or on United States publicopinion. Relative to levels of political violence in South Africa,coverage levels did decline. However, the decline did not occurabruptly in November, but appeared as a continuation of decreasesthat had already begun in September, prior to the press restrictions.     

‘Kids who Smoke Think that They Can Be Adults as Well’: Children's Smoking and Transitions to Adulthood

This article aims to explore the ways in which preadolescents associate smoking with transitions to adulthood, in the context of sociological theories of childhood, using data from the Liverpool Longitudinal Study of Smoking. The research found that at age 9 many of the cohort argued that smoking was more acceptable for adults because they had bigger bodies than children. Some children also suggested that smoking was appropriate for adults because adults were competent to make important decisions and to balance risks. By age 11, when several of the cohort had actually tried smoking, children's views about the risks smoking posed to their bodies had altered, and many children were aware of smoking‐related disease among adults. The cohort also suggested that some children might take up smoking to demonstrate that they are ‘grown up’ too. In the UK, legal restrictions on the age of tobacco purchase are reinforced by social norms that construct smoking as an activity that is only suitable for adults. The goal of legal restrictions that ban the sale of cigarettes to children is to protect their health. The unintended outcome, however, is that for many young people smoking is a way of demonstrating maturity and adult status.     

Multifamily therapy in the community mental health network: A pragmatic randomized and controlled study

Multifamily therapy (MFT) is a psychotherapeutic group intervention for patients with severe mental disorders (SMDs) and their families. The present study is a multicenter, randomized, and controlled trial that analyzes the benefit of MFT during outpatient treatment. The recruited patients were randomly assigned to the experimental group (n = 26), which received 24 MFT sessions in addition to their treatment as usual (TAU), or to the control group (n = 29), which received only TAU (individual and family sessions). Six months after the inclusion in the MFT, the experimental group showed a significant decrease in number of visits to the psychiatric emergency services, number of psychiatric admissions, and the days of admission. The need for hospital care 6 months after recruitment was also lower in the experimental group compared to the control group. These results suggest that the implementation of MFT during outpatient treatment facilitates community management of people diagnosed with mental health problems.     

COMPETITION AND THE CIGARETTE TV ADVERTISING BAN

The 1970 ban on television advertising for cigarettes constitutes a quasi-experiment allowing the effect of advertising on competition to be evaluated. Assuming the ban reduced the efficacy of industry advertising, an analysis of various proxies for competition before and after the ban enables one to deduce whether advertising promotes or limits competition among cigarette firms. The results indicate that in this case the restriction of advertising reduced competition.