Student-led Evaluation of the McMaster University Tobacco and Smoke-Free Campus Policy

Background: McMaster University is a Canadian post-secondary institution focused on promoting health on campus in accordance with the 2015 Okanagan Charter. McMaster University implemented a Tobacco and Smoke-Free campus policy in 2018 and became the first 100% smoke-free campus in Ontario. The aim of this study was to evaluate and describe the impact of this policy.Methods: A cross-sectional community survey was conducted, a pre-post litter audit was performed, utilization of reduction and cessation services was tracked, and compliance data was analyzed. Descriptive statistics, Wilcoxon’s ranks sign test, paired samples t-test, and thematic analysis was performed with significance level at 0.05.Results: Over 1602 individuals responded to the survey. Most were aware of the policy prior to completing the survey (~93%). Respondents self-reported experiencing significantly less second-hand smoke on campus after the policy was implemented (p < 0.0001). Out of smokers, about half (52.2%) did not use tobacco or smoking products on university-owned property. There was an overall decrease in amount of litter from pre to post-policy implementation and an increase in the delivery and use of reduction and cessation services. Compliance data showed an increasing trend of security-related responses over the first four months, which is consistent with the overall gradual implementation of the policy.Conclusion: The results indicated that future policy implementation should focus on increasing communication and education regarding the policy, awareness and availability of reduction and cessation services, and making compliance more effective. This work is a useful resource for other post-secondary institutions considering similar policies

Immediate effect of the COVID-19 pandemic on patient health, health-care use, and behaviours: results from an international survey of people with rheumatic diseases.

BackgroundThe impact and consequences of the COVID-19 pandemic on people with rheumatic disease are unclear. We developed the COVID-19 Global Rheumatology Alliance Patient Experience Survey to assess the effects of the COVID-19 pandemic on people with rheumatic disease worldwide.MethodsSurvey questions were developed by key stakeholder groups and disseminated worldwide through social media, websites, and patient support organisations. Questions included demographics, rheumatic disease diagnosis, COVID-19 diagnosis, adoption of protective behaviours to mitigate COVID-19 exposure, medication access and changes, health-care access and communication with rheumatologists, and changes in employment or schooling. Adults age 18 years and older with inflammatory or autoimmune rheumatic diseases were eligible for inclusion. We included participants with and without a COVID-19 diagnosis. We excluded participants reporting only non-inflammatory rheumatic diseases such as fibromyalgia or osteoarthritis.Findings12 117 responses to the survey were received between April 3 and May 8, 2020, and of these, 10 407 respondents had included appropriate age data. We included complete responses from 9300 adults with rheumatic disease (mean age 46·1 years; 8375 [90·1%] women, 893 [9·6%] men, and 32 [0·3%] participants who identified as non-binary). 6273 (67·5%) of respondents identified as White, 1565 (16·8%) as Latin American, 198 (2·1%) as Black, 190 (2·0%) as Asian, and 42 (0·5%) as Native American or Aboriginal or First Nation. The most common rheumatic disease diagnoses included rheumatoid arthritis (3636 [39·1%] of 9300), systemic lupus erythematosus (2882 [31·0%]), and Sjögren's syndrome (1290 [13·9%]). Most respondents (6921 [82·0%] of 8441) continued their antirheumatic medications as prescribed. Almost all (9266 [99·7%] of 9297) respondents adopted protective behaviours to limit SARS-CoV-2 exposure. A change in employment status occurred in 2524 (27·1%) of 9300) of respondents, with a 13·6% decrease in the number in full-time employment (from 4066 to 3514).InterpretationPeople with rheumatic disease maintained therapy and followed public health advice to mitigate the risks of COVID-19. Substantial employment status changes occurred, with potential implications for health-care access, medication affordability, mental health, and rheumatic disease activity.FundingAmerican College of Rheumatology