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Introduction: Due to decades of decentralisation of public health policies, local governments have been given increased tobacco control responsibilities across European countries. Previous studies suggest that implementing local tobacco control policies is not without challenges (e.g., lack of resources and enforcement capabilities). This study investigates the policy implementation of both smoke-free environments and smoking cessation support services by local public health professionals in the Netherlands. Method: We interviewed 24 officials of regional public health departments about the barriers and facilitators of implementing local tobacco control policies. Interviews were transcribed, analysed and classified using the Behaviour Change Wheel model (COM-B) comprising of the three components capability, opportunity, and motivation. Results: Personal motivation was an important condition for public health professionals to work on specific subtopics within tobacco control. Smoke-free environments were generally considered most motivating to work on, but also involve practical obstacles such as a lack of enforcement capabilities. Smoking cessation support services were reported to be less attractive to work on, as there are no clear guidelines on what public health professionals could and should do regarding smoking cessation support. Conclusion: Municipalities and local public health departments may contribute to tobacco control by creating smoke-free areas and offering services to help people stop smoking. The national government of the Netherlands could support local governments by providing clearer guidelines on creating smoke-free spaces and on how to improve local smoking cessation support services. [ABSTRACT FROM AUTHOR]

Objective: to synthesize evidence about the efficacy of electronic cigarettes versus Nicotine Replacement Therapy and placebo to quit smoking. Data sources: We searched for clinical trials with no publication date restriction until December 2019. The search included CENTRAL, MEDLINE, PsycINFO, Science Direct, Center for reviews and dissemination and HTA database and Trip database, clinical trials registries, gray literature and examined the references of relevant articles. Inclusion and exclusion criteria: Two review authors independently checked the titles and abstracts then the full text of initial hits. Main outcomes were sustained continuous abstinence rate, 7-day point prevalence abstinence rate, sustained reduction of 50% or greater in baseline cigarette consumption and adverse effects. Data extraction and synthesis: Two review authors independently extracted data and assessed risk of bias using the Cochrane RoB 2 tool. We conducted a random-effects model through the Mantel-Haenszel method. Results: We retrieved 12 trials involving 9863 participants. CO- validated 1-month continuous abstinence rate improved by 33% in the e-cigarettes group (range 6-66%, moderate evidence). We are uncertain if e-cigarettess influence continuous abstinence rate at 3-, 6- and 12 months as well as sustained reduction of 50% or greater in baseline cigarette consumption at different follow-up periods. One study of 884 participants displayed improved 12-month 7-day point abstinence by 46% (range 17%-82%). E-cigarettes may increase or do not affect the proportion of serious adverse effect at 6 and 12 months follow up. Conclusion: Very low certainty evidence supported e-cigarettess to help quit smoking in the short term. There is not enough evidence to determine if e-cigarettess are a safe and efficacious means of smoking cessation in the long term (12+ months). [ABSTRACT FROM AUTHOR]

Abstract Background Smoking has played a significant role in the historical culture of mental healthcare settings. Mental health professionals (MHPs) often hold dismissive attitudes regarding the importance of smoking cessation in the context of mental healthcare. In 2007, English mental health inpatient buildings were required by law to become smoke-free, and healthcare trusts have more recently begun to implement comprehensive policies (i.e. smoke-free grounds and buildings) and staff training in response to national guidance. It is therefore important to explore MHPs practice around smoking, smoking cessation, and smoke-free policy adherence. This study aimed to explore these issues by using the COM-B (capability, opportunity, motivation, behaviour) model to systematically identify barriers to, and facilitators for, MHPs addressing smoking with their patients. Methods Five focus groups with a total of 36 MHPs were conducted between March and August 2017. MHPs were recruited from one of the largest mental health trusts in Europe. Discussions were guided by a semi-structured guide. Responses were audio recorded, transcribed and coded using thematic analysis and the COM-B framework. Results Addressing smoking with patients was undermined by MHPs’ 1) psychological capability to recall training content, misunderstand the potential benefits of addressing patient smoking and harm reduction approaches; 2) physical opportunity in terms of time constraints, and easy accessibility of tobacco in the community; 3) social opportunity in terms of increased cultural value of tobacco following inpatient smoke-free policy implementation, and lack of support from colleagues to enforce the smoke-free policy; 4) automatic motivation, including intrinsic biases regarding patients abilities and motivations to quit, and 5) reflective motivation, including perceived job role and decision making processes related to addressing behaviours deemed more important than smoking. The main facilitating factors identified were MHPs’ having opportunity in the form of patients asking directly for support, and MHPs having access to resources such as stop smoking services and spirometers. Conclusion Multiple barriers were identified across all key domains of the COM-B framework that undermine MHPs’ practice regarding smoking cessation. Few facilitators were identified which may have implications for future smoke-free policy and clinical practice.

Résumé: Introduction.: Les méfaits du tabagisme sur la santé et l'environnement ne sont plus à démontrer. C'est pourquoi la lutte pour la réduction de ce fléau devient une priorité de santé publique et une exigence pour tous les États du monde. L'objectif de la présente étude était de faire l'état des lieux de la mise en œuvre, au Bénin, des articles 8, 12 et 13 de la Convention-cadre de l'Organisation mondiale de la santé (OMS) pour la lutte antitabac. Méthode.: Cette étude a combiné deux enquêtes transversales : l'enquête STEPS 2015 et celle sur l'application de la loi antitabac dans les hôtels, bars, restaurants et boîtes de nuit, réalisée en 2018. Un sondage aléatoire à trois degrés a été réalisé pour la première enquête et un échantillonnage stratifié pour la seconde. Au total, 5 126 sujets et 120 établissements ont été inclus respectivement pour la première et la seconde enquête. Une analyse statistique descriptive des données a été faite à l'aide du logiciel STATA version 12, suivie d'une analyse des forces, faiblesses, opportunités et menaces de la mise en œuvre de la Convention-cadre. Résultats.: Aux termes de l'étude , 49,70 % des enquêtés étaient de sexe masculin et 50,30 % de sexe féminin. La moyenne d'âge était de 37,33 ans ± 12,80 ans. Considérant la période des 30 derniers jours avant l'enquête, 19 % des enquêtés avaient déclaré être exposés à la fumée du tabac à la maison et 5,87 % avoir la même exposition dans des zones fermées sur leur lieu de travail. Un total de 94,50 % ont déclaré n'avoir pas remarqué des informations sur les dangers du tabagisme ou le sevrage du tabac dans les journaux ou magazines, contre 83,90 % à la télévision et 67,40 % à la radio. Dans tous les établissements où la consommation de tabac a été rapportée, le tabac fumé était le plus consommé (50 %-81 %), alors que seulement 14,17 % des établissements enquêtés disposaient d'un « espace fumeur ». Conclusion.: Le tabagisme est un phénomène qui est à l'origine de nombreuses maladies non transmissibles. La ratification de la Convention-cadre de l'OMS par le Bénin et sa mise en œuvre devraient aider à une réduction de la prévalence de ce fléau. Il faut cependant noter qu'il reste des efforts à fournir pour relever certains défis d'ordre structurel à court et moyen termes. Introduction.: There is no longer any doubt about the harmful effects of smoking on health and the environment. Countries the world over are required to make non-smoking a public health priority. The aim of this study was to examine how Articles 8, 12, and 13 of the WHO Framework Convention on Tobacco Control are implemented in Benin. Method.: Our study combined two cross-sectional surveys: the 2015 STEPS survey and the survey on the implementation of the anti-smoking law in hotels, bars/restaurants, and nightclubs conducted in 2018. The first survey used three-step random sampling and the second stratified random sampling. The first study included 5126 subjects and the second 120 establishments. A descriptive analysis of the data was performed with STATA 12 software, followed by a SWOT (strengths, weaknesses, opportunities, and threats) analysis of the implementation of the Framework Convention. Results.: 49.7% of the respondents were male and 50.3% female. Their average age was 37.33 ± 12.80 years. Exposure to tobacco smoke during the 30 days before the survey at home by 19% of respondents and in closed areas of their workplace by 5.87%. Among those surveyed, 94.5% said they had not noticed any information about the dangers of smoking or recommendations to stop smoking in newspapers or magazines, 83.9% on television and 67.4% on radio. In all establishments where tobacco consumption was reported, smoking tobacco was the type used most often (50%-81%), while the existence of smoking spaces was observed in only 14.17% of the surveyed establishments. Conclusion.: Smoking is the cause of many noncommunicable diseases. Benin's ratification and implementation of the WHO Framework Convention should help to reduce its prevalence. It should be noted, however, that more needs to be done to address some of the structural challenges in the short and medium terms. [ABSTRACT FROM AUTHOR]

Background: Smoking has played a significant role in the historical culture of mental healthcare settings. Mental health professionals (MHPs) often hold dismissive attitudes regarding the importance of smoking cessation in the context of mental healthcare. In 2007, English mental health inpatient buildings were required by law to become smoke-free, and healthcare trusts have more recently begun to implement comprehensive policies (i.e. smoke-free grounds and buildings) and staff training in response to national guidance. It is therefore important to explore MHPs practice around smoking, smoking cessation, and smoke-free policy adherence. This study aimed to explore these issues by using the COM-B (capability, opportunity, motivation, behaviour) model to systematically identify barriers to, and facilitators for, MHPs addressing smoking with their patients. Methods: Five focus groups with a total of 36 MHPs were conducted between March and August 2017. MHPs were recruited from one of the largest mental health trusts in Europe. Discussions were guided by a semi-structured guide. Responses were audio recorded, transcribed and coded using thematic analysis and the COM-B framework. Results: Addressing smoking with patients was undermined by MHPs' 1) psychological capability to recall training content, misunderstand the potential benefits of addressing patient smoking and harm reduction approaches; 2) physical opportunity in terms of time constraints, and easy accessibility of tobacco in the community; 3) social opportunity in terms of increased cultural value of tobacco following inpatient smoke-free policy implementation, and lack of support from colleagues to enforce the smoke-free policy; 4) automatic motivation, including intrinsic biases regarding patients abilities and motivations to quit, and 5) reflective motivation, including perceived job role and decision making processes related to addressing behaviours deemed more important than smoking. The main facilitating factors identified were MHPs' having opportunity in the form of patients asking directly for support, and MHPs having access to resources such as stop smoking services and spirometers. Conclusion: Multiple barriers were identified across all key domains of the COM-B framework that undermine MHPs' practice regarding smoking cessation. Few facilitators were identified which may have implications for future smoke-free policy and clinical practice. [ABSTRACT FROM AUTHOR]

Background: In Indonesia, 61 million adults smoked in 2018 and 59 million were exposed to secondhand smoke at offices or restaurants in 2011. The Presidential Decree 109/2012 encouraged local governments to implement smoke-free policy (SFP) with Jayapura city enacted a local bill (1/2015) in 2015., Objective: This study aims to evaluate the compliance and explore the challenges in implementing., Methods: We conducted a mixed-methods study. The quantitative method assessed the compliance to six criteria (as per the bill) including having signage, no smoking activity, no selling, no advertisement, no smoke, and no ashtray at SFP facilities. We surveyed 192 facilities including health facilities, educational facilities, places of worship, government offices, and indoor/outdoor public facilities. The qualitative method explored challenges in implementing through by interviewing 19 informants (government officers, students and community)., Results: The compliance rate to all six criteria was 17% overall, ranging from 0% at outdoor public facilities to 50% at health facilities. We found no spatial patterning as shown by similar compliance rates between SFP facilities within and outside of 1-kilometer around the provincial and city health offices. Implementation challenges included (a) limited budget for enforcement, (b) lack of support from local non-government organizations and universities, (c) lack of public awareness at facilities, and (c) lack of examples from local leaders., Conclusion: The overall compliance was low in Jayapura city due to many challenges. This provides lessons learnt for tobacco control policy in the areas that are least developed and farthest from the central government.