Reshuffling and Relocating: The Gendered and Income-Related Differential Effects of Restricting Smoking Locations

This study investigates secondhand smoke (SHS) exposure and management in the context of smoking location restrictions, for nonsmokers, former, and current smokers. A purposive sample of 47 low income and non-low-income men and women of varied smoking statuses was recruited to participate in a telephone interview or a focus group. Amidst general approval of increased restrictions there were gendered patterns of SHS exposure and management, and effects of SHS policies that reflect power, control, and social roles that need to be considered as policies are developed, implemented and monitored. The experience of smoking restrictions and the management of SHS is influenced by the social context (relationship with a partner, family member, or stranger), the space of exposure (public or private, worksite), the social location of individuals involved (gender, income), and differential tolerance to SHS. This confluence of factors creates differing unintended and unexpected consequences to the social and physical situations of male and female smokers, nonsmokers, and former smokers. These factors deserve further study, in the interests of informing the development of future interventions and policies restricting SHS

Smoke-Free Men: Competing and Connecting to Quit

Purpose: The purpose of this study was to explore gender-related factors that motivate and support men’s smoking reduction and cessation to inform effective men-centered interventions. Approach or Design: Focus group design using a semi-structured interview guide. Setting: Three communities in British Columbia, Canada. Participants: A total of 56 men who currently smoked and were interested in reducing or quitting or had quit. Intervention: N/A. Methods: Data collected in 6 focus group discussions were transcribed and analyzed in accord with principles of thematic qualitative methods. Results: We report the results across 4 interconnected themes: (1) the fight to quit takes several rounds, (2) the motivation of supportive competition, (3) challenges and benefits of connecting with smoke-free peers, and (4) playing up the physical and financial gains. Conclusions: Masculine-based perspectives positioned quitting alongside fighting for self-control, competing, connecting, physical prowess, and having extra cash as motivating components of programs to engage men in efforts to be smoke-free. It may be worthwhile to consider the inclusion of gain-framed and benefit-focused messaging in programs that support men’s tobacco cessation

A qualitative study on Chinese Canadian male immigrants’ perspectives on stopping smoking: Implications for tobacco control in China

China has the largest number of smokers in the world; more than half of adult men smoke. Chinese immigrants smoke at lower rates than the mainstream population and other immigrant groups do. This qualitative study was to explore the influence of denormalization in Canada on male Chinese immigrant smoking after migration. Semistructured interviews were conducted with 22 male Chinese Canadian immigrants who were currently smoking or had quit smoking in the past 5 years. The study identified that, while becoming a prospective/father prompted the Chinese smokers to quit or reduce their smoking due to concern of the impacts of their smoking on the health of their young children, changes in smoking were also associated with the smoking environment. Four facilitators were identified which were related to the denomormalized smoking environment in Canada: (a) the stigma related to being a smoker in Canada, (b) conformity with Canadian smoking bans in public places, (c) the reduced social function of smoking in Canadian culture, and (d) the impact of graphic health messages on cigarette packs. Denormalization of tobacco in Canada in combination with collectivist values among Chinese smokers appeared to contribute to participants’ reducing and quitting smoking. Although findings of the study cannot be claimed as generalizable to the wider population of Chinese Canadian immigrants due to the small number of the participants, this study provides lessons for the development of tobacco control measures in China to reverse the current prosmoking social environment

Program assessment framework for a rural palliative supportive service

Although there are a number of quality frameworks available for evaluating palliative services, it is necessary to adapt these frameworks to models of care designed for the rural context. The purpose of this paper was to describe the development of a program assessment framework for evaluating a rural palliative supportive service as part of a community-based research project designed to enhance the quality of care for patients and families living with life-limiting chronic illness. A review of key documents from electronic databases and grey literature resulted in the identification of general principles for high-quality palliative care in rural contexts. These principles were then adapted to provide an assessment framework for the evaluation of the rural palliative supportive service. This framework was evaluated and refined using a community-based advisory committee guiding the development of the service. The resulting program assessment framework includes 48 criteria organized under seven themes: embedded within community; palliative care is timely, comprehensive, and continuous; access to palliative care education and experts; effective teamwork and communication; family partnerships; policies and services that support rural capacity and values; and systematic approach for measuring and improving outcomes of care. It is important to identify essential elements for assessing the quality of services designed to improve rural palliative care, taking into account the strengths of rural communities and addressing common challenges. The program assessment framework has potential to increase the likelihood of desired outcomes in palliative care provisions in rural settings and requires further validation

Equity, Evidence & Ethics: Assessing the Implications of Outdoor Smoke-free Policies for Vulnerable Populations

Smoke-free policies in outdoor settings are becoming increasingly common. Economic and social conditions tend to influence tobacco use patterns as well as exposure to secondhand smoke. Thus, active and passive smoking are both health equity and social justice concerns. Smoking on the Margins is a multi-component,mixed-methods project that applies an ethical framework to outdoor smoke-free policies in order to identify both concerns and opportunities to promote health and health equity. Justification for smoke-free policies Smoke-free spaces are primarily justified on the basis of three goals: 1) Reducing exposure to secondhand smoke; 2) Encouraging people to quit smoking; and 3) Preventing youth smoking initiation. Smoke-free policies in parks and beaches may have a small positive population health impact. Such policies reduce secondhand smoke exposure by eliminating a combination of circumstances that create sufficient concentration of tobacco smoke to pose serious health risk; such bans may also facilitate smoking cessation or reduction for some people. There is little evidence to date,however, that smoke-free policies in parks and on beaches have an impact on the prevention of smoking initiation among youth. As well, the documented positive benefits may be offset by other, unintended and/or inequitable burdens, such as when the stigmatization of smoking makes it harder for some smokers to quit or contributes to greater health inequalities

Prostate cancer support groups: Canada-based specialists\u27 perspectives

To understand prostate cancer (PCa) specialists’ views about prostate cancer support groups (PCSGs), a volunteer sample of Canada-based PCa specialists ( n = 150), including urologists ( n = 100), radiation oncologists ( n = 40), and medical oncologists ( n = 10) were surveyed. The 56-item questionnaire used in this study included six sets of attitudinal items to measure prostate cancer specialists’ beliefs about positive and negative influences of PCSGs, reasons for attending PCSGs, the attributes of effective PCSGs, and the value of face-to-face and web-based PCSGs. In addition, an open-ended question was included to invite additional input from participants. Results showed that PCSGs were positively valued, particularly for information sharing, education and psychosocial support. Inclusivity, privacy, and accessibility were identified as potential barriers, and recommendations were made for better marketing PCSGs to increase engagement. Findings suggest prostate cancer specialists highly valued the role and potential benefits of face-to-face PCSGs. Information provision and an educational role were perceived as key benefits. Some concerns were expressed about the ability of web-based PCSGs to effectively engage and educate men who experience prostate cancer

Smoking on the Margins? Assessing the Effects of a Smoke-free Law in Parks and on Beaches

This study uses a health equity lens to examine the development, adoption and implementation of an outdoor smoke-free bylaw in Vancouver, BC, Canada. The study aims to: Understand the health and health equity effects of a new outdoor smoke-free policy in parks and on beaches; Assess the differential impacts of the policy for diverse groups of women and men, in particular those with a high prevalence and susceptibility to smoking and those who are exposed to secondhand smoke (SHS); Develop recommendations to enhance the effectiveness of future smoke-free policies to reduce any unintended contributions to health inequities arising from their implementation

Equitable Consequences? Issues of Evidence, Equity and Ethics Arising from Outdoor Smoke-free Policies

From introduction: Kass argues that an ethical approach in public health is one that places the fewest burdens on individuals’ health without significantly reducing the potential benefits of intervening. Yet many population health regulations are highly intrusive, compromising individual liberty and imposing penalties for non-compliance. Moreover, the benefits of these regulations and the burdens they impose may not be shared equally. When developing interventions, the state has, therefore, an obligation to consider the benefits and burdens, particularly on those vulnerable to health inequities and other disparities

Perceptions of genetic discrimination among people at risk for Huntington’s disease: a cross sectional survey

Objective To assess the nature and prevalence of genetic discrimination experienced by people at risk for Huntington’s disease who had undergone genetic testing or remained untested

Smoking on the Margins? Assessing the Effects of a Smoke-free Law in Parks and on Beaches

This study uses a health equity lens to examine the development, adoption and implementation of an outdoor smoke-free bylaw in Vancouver, BC, Canada. The study aims to: Understand the health and health equity effects of a new outdoor smoke-free policy in parks and on beaches; Assess the differential impacts of the policy for diverse groups of women and men, in particular those with a high prevalence and susceptibility to smoking and those who are exposed to secondhand smoke (SHS); Develop recommendations to enhance the effectiveness of future smoke-free policies to reduce any unintended contributions to health inequities arising from their implementation