Tobacco smoke pollution in the non-smoking sections of selected popular restaurants in Pretoria, South Africa

Exposure to second-hand tobacco smoke (SHS) has been associated with several adverse health effects including increased risk of lung cancer, heart disease and also asthma in children. Hence, the WHO's Framework Convention on Tobacco Control (FCTC) obligates parties to the Convention, to implement measures to protect all people from the exposure to SHS. Even prior to signing the WHO FCTC in 2005, the South African government in 2001 implemented a regulation to restrict smoking in public places, including restaurants.3 However, the current regulation in South Africa allows for a designated ‘smoking area’. It is pertinent to note that the enabling legislation provided for a ban in smoking in public places, but also gave the Minister of Health powers to permit smoking in a prescribed portion of a public place. The Minister at that time exercised these powers.The American Cancer Society (ACS) grant number A0U146http://tobaccocontrol.bmj.comhb2017Community Dentistr

Intention to Switch to Smokeless Tobacco Use among South African Smokers: Results from the 2007 South African Social Attitudes Survey

Background: Some smokeless tobacco products (SLT) have been shown to be associated with only a fraction of the risks of cigarettes. This study assessed South African smokers’ interest in switching to a hypothetical reduced harm SLT product. Methods: The 2007 South African Social Attitudes Survey was analysed for 678 exclusive cigarette smokers. Respondents were asked about their perceptions about relative harm of snuff compared to cigarettes, and their interest in switching to snuff if informed it was 99% less harmful than cigarettes. Results: About 49.7% of exclusive cigarette smokers believed that snuff was equally as harmful as cigarettes; 12.9% thought snuff was more harmful; 5.7% thought snuff was less harmful; while 31.8% did not know if there was a difference in harm between snuff and cigarettes. Approximately 24.2% of exclusive cigarette smokers indicated interest in switching to snuff, with significantly greater interest observed among those exposed to 100% smoke-free work environment. Interest in switching was highest (34.7%) among smokers who believed a priori that using snuff was more harmful than cigarettes, and lowest (14.5%) among those who did not know if there was a difference in harm. In a multi-variable adjusted logistic regression model, this latter group remained less likely to be interested in harm reduction switching (adjusted odds ratio = 0.42; 95% CI: 0.19–0.91). Conclusion: About a quarter of smokers indicated interest in harm reduction switching to snuff. SLT products have a potential role in reducing the harm from smoking in South Africa, but only if they are not used to circumvent smoke-free laws that have been associated with reduced smoking

Oral health and subjective psychological well-being among South African adults : findings from a national household survey

OBJECTIVE : To determine the association between oral health and socioeconomic status with subjective psychological well-being. METHODS : An interviewer-administered questionnaire was conducted during 2011 on a nationally representative sample of South African adults >16 years (n=2,971) who reported on socio-demographic data, past dental visit patterns, number of remaining teeth and oral and general health status. Subjective well-being was computed as the sum of scores obtained from participants' estimates of level of happiness (scale 0-6) and rating of level of satisfaction with life (scale 0-4). Analyses included t-tests and multivariable-adjusted Poisson regression. RESULTS : The average score on a scale of 0-10 for subjective well-being was 6.31 (95%CI=6.17-6.44), which decreased with age, but increased with level of education and frequency of dental visits. Even after controlling for socioeconomic status, those who rated their oral health as good were more likely to report a higher subjective well-being (Prevalence Rate ratio (PRR) =1.14; 95% CI=1.03-1.27). Those who reported visiting a dentist at least every 6 months reported higher subjective well-being (PRR=1.10; 1.04-1.16. CONCLUSIONS : Good oral health is independently associated with greater subjective well-being. This highlights the need to prioritise oral health promotion as an integral part of promoting general health and improving the quality of life of South Africans.http://www.sada.co.zaam201

All rights reserved Ó 2008 The Authors

Brushing twice daily with fluoridated toothpaste is a universally recommended self-care practice to promote oral health. It remains the most effective practice for the prevention of periodontal disease (1) and dental caries (2). Considering the growing evidence of the association between poor oral health and systemic health (3), an understanding of the determinants of regular tooth-brushing behaviour is important to general public health. Abstract -Objective: To determine the association between adolescents' sense of coherence (SOC) and their tooth-brushing behaviour. Methods: This 18-month longitudinal study involved a representative sample of 8th-graders (n = 1025) from 11 randomly selected public high schools in the Limpopo Province, South Africa. Data collected by means of a self-administered questionnaire included respondents' socio-demographic profiles, vulnerability to depression, smoking status, dental treatment attendance pattern, frequency of and motivation for tooth-brushing. Based on the responses to the question on readiness to change brushing behaviour and in line with the integrated change model, respondents were also categorized as being in the pre-contemplation, contemplation or preparation ⁄ action stages. Respondents' SOC was measured using a six-item adapted Antonovsky SOC scale. Data analysis included chi-squared analysis, t-tests and step-wise multiple logistic regression. Results: At baseline, 72.6% (n = 744) of the respondents reported that they were not consistently brushing twice daily. Of those who did not brush twice daily and were followed up on (n = 578), those living with their mother at baseline not only presented with a greater increase in their SOC over time (follow-up minus baseline), but they were also more likely to be brushing twice daily at the time of the follow-up (15.4% versus 10.6%; P = 0.04). Adding baseline intention state to a multivariate model attenuated the influence of baseline SOC to a statistically insignificant level. However, increasing withinsubject SOC changes (b = 0.16; P < 0.01), living with the mother (b = 0.11; P < 0.05), smoking (b = )0.14; P < 0.05), being depression vulnerable (b = )0.23; P < 0.01) and in the preparation ⁄ action stage (b = 0.13; P < 0.05) remained associated with the transition to twice-daily toothbrushing. Conclusions: In planning oral health promotion interventions, it should be considered that children's psychological predisposition and family environment might significantly influence their tooth-brushing behaviour

Exposure to secondhand smoke and voluntary adoption of smoke-free home and car rules among non-smoking South African adults

Background: Secondhand smoke (SHS) exposure is a well-established health hazard. To determine the effectiveness of existing smoke-free policies and adoption of smoke-free rules in South Africa, we assessed exposure to SHS from several sources among non-smoking adults during 2010. Methods: Data were analyzed for 3,094 adults aged ≥16 years who participated in the 2010 South African Social Attitudes Survey. Descriptive statistics and multivariate analyses were used to assess presence of smoke-free rules among all South Africans, and prevalence and correlates of SHS exposure at work, at home, and at hospitality venues among non-smokers. Results: Overall, 70.6% of all South African adults had 100% smoke-free rules in their private cars, 62.5% in their homes, while 63.9% worked in places with 100% smoke-free policies. Overall, 55.9% of all non-smokers reported exposure to SHS from at least one source (i.e., in the home, workplace or at a hospitality venue). By specific source of exposure, 18.4% reported being exposed to SHS at work, 25.2% at home, 33.4% in a restaurant, and 32.7% at a bar. Presence of work bans on indoor smoking conferred lower likelihood of SHS exposure at work among non-smokers (adjusted odds ratio [aOR] = 0.23; 95% CI: 0.09-0.60). Similarly, smoke-free home rules decreased the odds of being exposed to SHS at home among non-smokers (aOR =0.16; 95% CI: 0.09-0.30). Conclusion: Over half of South African adults reported SHS exposure in the home or at public places such as the workplace and at hospitality venues. This underscores the need for comprehensive smoke-free laws that prohibit smoking in all public indoor areas without exemptions

Factors associated with retreatment tuberculosis in Tshwane, South Africa : the role of tobacco smoking

There is evidence from international studies that tobacco smoking increases the risk of tuberculosis recurrence through its effects on the immunological and barrier functions of the airways. In this cross-sectional study, the association between current tobacco smoking and retreatment tuberculosis was studied in a population of 1 926 South African tuberculosis patients with high human immunodeficiency virus (HIV) co-infection rates. Retreatment tuberculosis was more common in male and among HIV-positive participants currently on antiretroviral treatment, or with unknown antiretroviral treatment status. However, we did not find an association between smoking and retreatment tuberculosis. A longitudinal study is needed to confirm these findings.http://www.sajei.co.za/index.php/SAJEIhb201

A global assessment of knowledge of dental students about nicotine replacement therapy : findings from 43 countries

OBJECTIVES : Knowledge of nicotine replacement therapy (NRT) is a competency that is expected from receiving training in the treatment for tobacco dependence. This study therefore assessed the knowledge of dental students in 43 countries about NRT. METHODS : The 2005–2011 dental Global Health Professions Student Survey data were analysed for 13,040 third-year dental students from 43 countries. Knowledge about NRT was self-reported and country-specific prevalence estimates were calculated. To assess for correlates of knowledge about NRT amongst dental students, a multivariate logistic regression model was fitted (P < 0.05), with pooled data from all 43 countries. The model assessed for geographical location, gross national income, tobacco cessation training in school, sex, current tobacco use and survey year. RESULTS : Amongst all dental students, the proportion that knew about NRT ranged from 37.0% (Mongolia) to 97.6% (Slovakia). The odds of knowing about NRT were lower amongst dental students in the Eastern Mediterranean region (aOR = 0.52; 95%CI: 0.34–0.79) compared to those in the European region. Dental students in upper-middle-income (aOR = 2.46; 95% CI: 1.57–3.85) and high-income countries (aOR=4.55; 95% CI: 2.28–9.09) both had higher odds of knowing about NRT com-pared to dental students in low-income countries. Also, current use of any tobacco product and receipt of tobacco cessation training in school were both associated with higher likelihood of knowing about NRT. No significant gender differences in knowl-edge of NRT were observed. CONCLUSIONS : A large proportion of dental students in several countries knew about NRT. However, disparities in knowledge existed across regions. Enhanced efforts are needed to formally train dental students on tobacco cessation techniques.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-05792015-08-31hb201

Influence of rural non-smoking adolescents' sense of coherence and exposure to household smoking on their commitment to a smoke-free lifestyle

This 18-month longitudinal study examined the influence of adolescents’ sense of coherence (SOC) and exposure to household smoking on their commitment to a smoke-free lifestyle. This study investigated a representative sample of 8th graders from 21 randomly selected high schools in the rural Limpopo Province of South Africa (n = 2,119). Of the total sample of 2,119 participants, 294 (14%) reported smoking at baseline and were therefore excluded from further analysis. Of those who did not smoke at baseline, 98.1% (n = 1,767) reported no intention of smoking in the upcoming 12 months. Of those who completed follow-up and had no intention of smoking at baseline (n = 1,316), 89.1% still did not smoke and remained committed to being smoke-free. Having a lower SOC, reporting alcohol binge-drinking at baseline, and having a household member who regularly smokes indoors (OR = 0.46: 0.26–0.82), as compared to not having any smoker in the household, were associated with lower odds of honoring a commitment to a smoke-free lifestyle. Furthermore, those who identified themselves as black Africans, as opposed to belonging to other race groups, were more likely to maintain a smoke-free lifestyle. Our findings suggest that interventions to prevent adolescent smoking should prioritize stress-coping skills and promote smoke-free homes.The Cancer Association of South Africa (CANSA)http://www.mdpi.com/journal/ijerphhb2016Community Dentistr

‘Roll-your-own’ cigarette smoking in South Africa between 2007 and 2010

BACKGROUND: The prevalence of smoking and consumption of cigarettes have decreased in South Africa over the last 20 years. This decrease is a result of comprehensive tobacco control legislation, particularly large cigarette tax increases. However, little attention has been given to the potential use of ‘roll-your-own’ cigarettes as cheaper alternatives, especially among the socio-economically disadvantaged population. This study therefore sought to determine socio-demographic correlates of ‘roll-your-own’ cigarette use among South African adults (2007–2010). METHODS: This secondary data analysis used a merged dataset from two nationally representative samples of 2 907 and 3 112 South African adults (aged ≥16 years) who participated in the 2007 and 2010 annual South African Social Attitude Surveys respectively. The surveys used a face-to-face interviewer-administered questionnaire. The overall response rates were 83.1% for 2007 and 88.9% for 2010. Data elicited included socio-demographic data, current smoking status, type of tobacco products used, past quit attempts and self-efficacy in quitting. Data analysis included chi-square statistics and multi-variable adjusted logistic regression analysis. RESULTS: Of the 1 296 current smokers in this study, 24.1% (n = 306) reported using roll-your-own cigarettes. Some of whom also smoked factory-made cigarettes. Roll-your-own cigarette smoking was most common among black Africans and was more common among male smokers than among female smokers (27% vs 15.8%; p < 0.01). Compared to smokers who exclusively used factory-made cigarettes, roll-your-own cigarette smokers were less confident that they could quit, more likely to be less educated, and more likely to reside in rural areas. The odds of use of roll-your-own cigarette were significantly higher in 2010 than in 2007 (OR = 1.24; 95% CI: 1.07-1.44). CONCLUSIONS: Despite an aggregate decline in smoking prevalence, roll-your-own cigarette smoking has increased and is particularly common among smokers in the lower socio-economic group. The findings also suggest the need for a more intensive treatment intervention to increase self-efficacy to quit among roll-your-own cigarette smokers.This work was carried out with the support of a grant from the American Cancer Society (Grant A0U146).http://www.biomedcentral.com/1471-2458/13/597am201