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This presentation discusses the progress made in implementing smoke-free air policies, the challenges faced, and available resources. It explores the evaluation of these policies and their impact on public support, compliance, exposure, health, and economy. The presentation also addresses emerging challenges such as waterpipe smoking and e-cigarettes.
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Smoke-Free Air Policies: Progress, Challenges, and Resources Mark J. Travers, PhD, MS Roswell Park CancerInstitute Buffalo, NY, USA mark.travers@roswellpark.org Pre-Conference Workshop 15th World Conference on Tobacco or Health Singapore March 19, 2012 1
Countries, States, and Provinces That Have Banned Smoking in Indoor Workplaces and Other Indoor Public Places. Source: Koh et al. New England Journal of Medicine, 2007.
Smokefree Latin America & the Caribbean 100% national smokefree Comprehensive national Sub-national smokefree Smoking designated areas or no restrictions Regulation pending
Conceptual Framework for the Evaluation of Smokefree Policies Proximal Variables Intermediate Distal Smokefree Policies Compliance with SHS exposure Health of Non-smokers smokefree policies Moderators Incidental Outcomes SHS awareness / attitudes, Economic impact, home occupation, SES, Tobacco control smoking, cessation behavior policies SHS: secondhand smoke SES: socio-economic status Source: IARC Handbook of Cancer Prevention, Volume 12. Methods for Evaluating Tobacco Control Policies.
http://www.iarc.fr/en/publications/pdfs-online/prev/handbook13/index.phphttp://www.iarc.fr/en/publications/pdfs-online/prev/handbook13/index.php
5 Main Evaluation Outcomes • 1) Public Support • 2) Compliance • 3) Exposure • 4) Health Impact • 5) Economic Impact
Measuring Exposure to Tobacco Smoke Pollution Cigarettes, cigars and pipes are major emitters of respirable suspended particles less than 2.5 microns (PM2.5) in diameter that are easily inhaled deep into the lungs TSI SidePak AM510 Personal Aerosol Monitor (weight: ~1 lb) This device is a real-time laser photometer with a built-in sampling pump that measures airborne particle mass-concentration
Training course at:www.tobaccofreeair.orghttp://vimeo.com/channels/84864
PM2.5Findings Around the World Source: Hyland et. Al. Tobacco Control 2008.
U.S.A. See next slide
Conceptual Framework for the Evaluation of Smokefree Policies Proximal Variables Intermediate Distal Smokefree Policies Compliance with SHS exposure Health of Non-smokers smokefree policies Moderators Incidental Outcomes SHS awareness / attitudes, Economic impact, home occupation, SES, Tobacco control smoking, cessation behavior policies SHS: secondhand smoke SES: socio-economic status Source: IARC Handbook of Cancer Prevention, Volume 12. Methods for Evaluating Tobacco Control Policies.
Challenges: New and emerging products Coal Head Tobacco Body Hose Bowl Water Mouthpiece
Waterpipe, hookah, narghile • Common phenomenon in Eastern Mediterranean and South Asian countries… • Emerging challenge in U.S. and other Western countries, often passes through loopholes in existing smokefree air laws Waterpipe café in “smokefree” New York State
“Hazardous” PM2.5 level according to USEPA Air Quality Index (17x higher than “Good” air quality) National Ambient Air Quality standard for CO (USEPA)
E-cigarettes Johnny Depp in “The Tourist”
Is poor smoke-free law compliance a developing country phenomenon? • Consider India, Netherlands, Germany • Consider comprehensiveness of policy and education (i.e. SHS awareness and attitudes)
What are some challenges you face in implementing smoke-free air policies?