Domestic Violence in the Workplace

Intimate partner violence (IPV) is a pervasive problem that follows victims from the home into the workplace. Many women who experience violence in their homes are also harassed at work and are abused in the workplace. For the current study, thirty women who reported a history of workplace violence were recruited from a homeless women’s shelter. Of the participants, thirteen experienced domestic violence in the workplace, and this paper focuses on the results obtained from those thirteen respondents. This paper also discusses the link between poverty and homelessness, intimate partner violence, and workplace violence

IMPLEMENTATION EFFECTIVENESS OF CAMPUS TOBACCO-FREE POLICIES

Tobacco use and secondhand smoke exposure are leading causes of preventable morbidity and mortality in the United States. Outdoor tobacco smoke exposure conveys many of the same risks as indoor secondhand smoke exposure. Tobacco-free campuses policies are an intervention to promote a positive social norm that encourages smoking cessation, as well as reduces exposure to outdoor tobacco smoke. This dissertation contains a review of the policy implementation literature; findings from a psychometric analysis of the newly developed Tobacco-free Compliance Assessment Tool (TF-CAT) to assess compliance with tobacco-free campus policies; and results of a campus intervention study to promote compliance. The TF-CAT protocol is designed to count cigarette butts, observe smokers, and use GIS mapping to display hot spots. A total of 413 observations in primary and secondary campus locations yielded compliance data on both the academic healthcare and main campuses. Results show support for the concurrent validity of the TF-CAT. Inter-rater reliability of the measure is strong, and the tool is feasible, though time- and resource-intensive. The intervention study tested the effects of an efficacy-based messaging campaign on the number of cigarette butts observed on campus. After distributing 6,000 message cards in high-traffic areas over three days, there were fewer cigarette butts per day per site post-intervention compared to pre-intervention (n = 312 observations; median = 4.7 vs. 1.9; U=2239, p=.004). It is crucial for tobacco control advocates to ensure implementation effectiveness of tobacco-free policies. Future research needs to refine methods to measure policy implementation effectiveness. In addition, interventions need to be developed and tested to promote policy implementation effectiveness

Tailoring a NICU-Based Tobacco Treatment Program for Mothers Who Are Dependent on Opioids

Objective—To collect formative information to design a tailored tobacco treatment intervention for women with newborns treated or evaluated for neonatal abstinence syndrome and to explore current tobacco use behaviors and facilitators and barriers to smoking cessation. Design—Qualitative descriptive study. Setting—An academic medical center in the southern United States. Participants—Mothers of newborns who were treated or evaluated for neonatal abstinence syndrome at birth within the preceding three months. Women were recruited who were older than 18 and reported opioid dependence and smoking during pregnancy. Methods—Participants took part in semi-structured individual interviews that lasted approximately one hour. Interviews were professionally transcribed and analyzed in MAXQDA using content analysis. Results—Five themes emerged from the data: Strategizing to Reduce Risk, Desire to Quit Smoking in the Future; Holding on to Smoking While Working Through Recovery, Feeling Judged by Nurses, and Feeling Supported And Empowered By Nurses. Participants reported planning to reduce risk to their newborns by avoiding secondhand and thirdhand smoke exposure. Participants wanted to stop smoking but reported many barriers, including multiple life stressors compounded by their newborns’ extended stays in the hospital. However, most participants described overall positive experiences and the support of health care providers. Conclusions—Holistic tobacco treatment programs that incorporate stress relief and social support and are led by trusted health care providers have the potential to be effective to reduce smoking in new mothers with histories of opioid dependence disorders and smoking and whose newborns are in the NICU

The Carrot and the Stick? Strategies to Improve Compliance with College Campus Tobacco Policies

Objective: Tobacco-free policies are being rapidly adopted nationwide, yet compliance with these policies remains a challenge. This study explored college campus key informants\u27 experiences with tobacco policies, and their perceived benefits, drawbacks, and outcomes. Participants: The sample for this study was 68 key informants representing 16 different California universities with varying tobacco policies (no smoking indoors and within 20 feet of entrances, designated smoking areas, 100% smoke-free, and 100% tobacco-free). Methods: Qualitative, descriptive study. Semistructured interviews were transcribed verbatim and analyzed using content analysis. Results: Strategies to improve compliance ranged from a social approach to a heavy focus on punitive enforcement. Key informants from campuses using a social approach alone reported barriers to improving compliance, including a perceived lack of efficacy of the approach. However, these campuses found it challenging to incorporate enforcement through campus police or security. Conclusions: College campus decision makers should explore using a combined approach (social approach as well as formal enforcement), with enforcement primarily the responsibility of nonpolice university channels (eg, Student Affairs, employee supervisors)

Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons

Introduction—Lesbian, gay, and bisexual (LGB) individuals smoke at rates 1.5–2 times higher than the general population, but less is known about LGB consumption of other tobacco products (OTPs) and gender differences. OTP use among young adult LGB bar patrons and the relationship among past quit attempts, intention to quit, and binge drinking with OTP use was examined. Methods—A cross-sectional survey of young adults (aged 18–26) in bars/nightclubs in seven U.S. cities between 2012 and 2014 (N=8,010; 1,101 LGB participants) was analyzed in 2016. Logistic regressions examined current use of five OTPs (cigarillos, electronic cigarettes, hookah, chewing tobacco, and snus) and sexual minority status, adjusting for demographics and comparing LB women and GB men with their heterosexual counterparts. Results—LGB bar/nightclub patrons used all OTPs more than their heterosexual counterparts. LB women were more likely than heterosexual women to use cigarillos, electronic cigarettes, hookah, chew, and snus. GB men were more likely than heterosexual men to smoke cigarillos, electronic cigarettes, hookah, and use chew and snus. Past-year quit attempt was associated with increased odds of electronic cigarette use in men and women, and increased odds of dual use (cigarettes and OTPs) among men. Intention to quit was negatively associated with dual use among women. Binge drinking was associated with increased use of all OTPs across genders. Conclusions—LGB bar-going young adults are at higher risk for OTP use than their heterosexual counterparts. Bar-based interventions are needed to address all forms of tobacco use in this high-risk group

Pharmacists\u27 Role in Harm Reduction: A Survey Assessment of Kentucky Community Pharmacists\u27 Willingness to Participate in Syringe/Needle Exchange

Background: Pharmacists\u27 role in harm reduction is expanding in many states, yet there are limited data on pharmacists\u27 willingness to participate in harm reduction activities. This study assessed community pharmacists\u27 willingness to participate in one harm reduction initiative: syringe/needle exchange. Methods: In 2015, all Kentucky pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community pharmacist respondents. Ordinal logistic regression estimated the impact of community pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both dependent variables were defined as Likert-type questions on a scale of 1 (not at all willing) to 6 (very willing). Results: Of 4699 practicing Kentucky pharmacists, 1282 pharmacists responded (response rate = 27.3%); the majority (n = 827) were community pharmacists. Community pharmacists were divided on willingness to provide clean needles/syringes, with 39.1% not willing (score 1 or 2 of 6) and 30% very willing (score 5 or 6 of 6). Few were willing to dispose of used needles/syringes, with only 18.7% willing. Community pharmacists who agreed that pharmacists could have significant public health impact by providing access to clean needles expressed 3.56 times more willingness to provide clean needles (95% CI 3.06-4.15), and 2.04 times more willingness to dispose of used needles (95% CI 1.77-2.35). Chain/supermarket pharmacists (n = 485, 58.6% of community pharmacies) were 39% less likely to express willingness to dispose of used needles (95% CI 0.43-0.87) when compared with independent community pharmacists (n = 342, 41.4% of community pharmacies). Independent pharmacists reported different barriers (workflow) than their chain/supermarket pharmacist colleagues (concerns of clientele). Conclusions: Kentucky community pharmacists were more willing to provide clean needles than to dispose of used needles. Strategies to mitigate barriers to participation in syringe/needle exchange are warranted

Effects of a Smoke-free Law in Parks and Beaches on Smoking Behaviour: Methods to Determine Effectiveness

As part of a comprehensive approach to tobacco control,smoke free laws have resulted in reductions of indoor air pollution, improvements in respiratory and cardiovascular health, reduction of smoking uptake by youth, and increasing tobacco use cessation in various jurisdictions. Although many studies have demonstrated the beneficial effects of smoke-free policies in indoor spaces (e.g., restaurants, bars, workplaces, hospital settings, etc.), little is known about the effectiveness of such policies in outdoor public spaces. On September 1st, 2010, Vancouver’s smoke-free by-law for the city’s parks, beaches, and facilities came into effect. The aims of this study are two-fold: a) to examine the effect of this smoke-free law on the frequency of smoking in selected parks and beaches, and b) to determine the change in location of smoking, within parks and beaches, following the enactment of the smoke-free law. The hypotheses guiding this study are: 1) There will be a lower frequency of observed smoking behaviour following the introduction of the law and 2) Smoking behaviour will be dispersed to the peripheries (i.e., margins) of the parks and beaches, following the enactment of the smoke-free law

Associations of First Trimester Co-Use of Tobacco and Cannabis with Prenatal Immune Response and Psychosocial Well-Being

PURPOSE: This study aims to describe the association of first trimester co-use of tobacco and cannabis with maternal immune response and psychosocial well-being, relative to tobacco use only. METHODS: A preliminary midpoint analysis included 138 pregnant women with biologically verified tobacco use, 38 of whom (28%) also tested positive for recent cannabis use. Maternal perceived stress (Perceived Stress Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and serum immune markers (IL-1β, IL-2, IL-6, IL-8, IL-10, TNFα, CRP, MMP8), were collected, although cytokine data were only available for 122 women. RESULTS: Participant average age was 29.1 years, approximately half had a high school education or less, and half were unemployed. Compared to tobacco only users, co-users were more likely to be non-White, younger and more economically disadvantaged. In the adjusted linear regression models, TNF-α levels were significantly lower among co-users relative to tobacco only users, after adjusting for age, race/ethnicity, body mass index and tobacco use group (tobacco cigarettes, electronic nicotine delivery devices [ENDS] or both). TNF-α was the only immune marker found to be significant in this analysis. Measured stress levels (M = 5.9, SD = 3.3; potential range 0-16) and depression scores (M = 7.8, SD = 5.8; potential range 0-30) were low across all participants and did not differ as a function of co-use. CONCLUSION: Preliminary results suggest women co-using during the first trimester exhibit decreased pro-inflammatory immune responsivity on one out of eight markers. Further research is needed to determine the impact of this immune modulation on fetal health outcomes and the unique contribution of cannabis

Effects of a Smoke-free Law in Parks and Beaches on Smoking Behaviour: Methods to Determine Effectiveness (2011)

As part of a comprehensive approach to tobacco control,smoke free laws have resulted in reductions of indoor air pollution, improvements in respiratory and cardiovascular health, reduction of smoking uptake by youth, and increasing tobacco use cessation in various jurisdictions. Although many studies have demonstrated the beneficial effects of smoke-free policies in indoor spaces (e.g., restaurants, bars, workplaces, hospital settings, etc.), little is known about the effectiveness of such policies in outdoor public spaces. On September 1st, 2010, Vancouver’s smoke-free by-law for the city’s parks, beaches, and facilities came into effect. The aims of this study are two-fold: a) to examine the effect of this smoke-free law on the frequency of smoking in selected parks and beaches, and b) to determine the change in location of smoking, within parks and beaches, following the enactment of the smoke-free law. The hypotheses guiding this study are: 1) There will be a lower frequency of observed smoking behaviour following the introduction of the law and 2) Smoking behaviour will be dispersed to the peripheries (i.e., margins) of the parks and beaches, following the enactment of the smoke-free law

Advertising Exposure and Use of E-Cigarettes Among Female Current and Former Tobacco Users of Childbearing Age

Objective: The study examined the relationship between exposure to e‐cigarette advertising and e‐cigarette use by pregnancy status, including use of flavored e‐cigarette products, among women of childbearing age. Design: A cross‐sectional, correlational design was used. Subjects: Female current or former tobacco users in Central and Eastern Kentucky, 18–45 years old (N = 194, 52% pregnant). Measures: Demographics, pregnancy status, cigarette and e‐cigarette use, and exposure to e‐cigarette advertising. Results: Younger age, white non‐Hispanic race, and greater exposure to e‐cigarette advertising were associated with a higher likelihood of ever using e‐cigarettes (p \u3c .05 for each variable). Pregnancy was not associated with ever use (p = .11). Younger age was associated with use of flavored e‐cigarettes (p = .0027). Among e‐cigarette users, those who used flavored products were more likely to have seen advertisements or information about e‐cigarettes on social media, compared to those who used unflavored e‐cigarettes only (p = .016). Conclusion: There is a link between advertising exposure and ever use of e‐cigarettes. Pregnancy status is not significantly associated with ever use. Use of flavored e‐cigarettes is associated with younger age. E‐cigarette users with greater exposure to advertising on social media were more likely to use flavored products